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PubMed2007

Aging and health status of elderly in Latin America and the Caribbean: preliminary findings.

Aging in Latin America and the Caribbean will not proceed along known paths already followed by more developed countries. In particular, the health profile of the future elderly population is less predictable due to factors associated with their demographic past that may haunt them for a long time and make them more vulnerable, even if economic and institutional conditions turn out to be better than what they are likely to be. This paper answers a set of questions regarding the nature and determinants of health status among the elderly in Latin America and the Caribbean using SABE (Survey on Health and Well-Being of Elders), a cross-sectional representative sample of over 10,000 elderly aged 60 and above in private homes in seven major cities in Latin America and the Caribbean. We examine health outcomes such as self-reported health, functional limitations-Activities of Daily Living (ADL's) and Instrumental Activities of Daily Living (IADL's), obesity (ratio of weight in kilograms to the square of height in centimeters), and self-reported chronic conditions (including diabetes). The findings include: (a) Countries differ in self-reported health but exhibit much less differences in terms of functional limitations. The number of chronic conditions increase with age and is higher among females than among males; (b) On average SABE countries display levels of self-reported diabetes (and obesity) that are as high if not higher than those found in the US; (c) There is evidence, albeit weaker than expected, suggesting deteriorated health and functional status in the region; (d) There is important evidence pointing toward rather strong inequalities (by education and income) in selected health outcomes. Preliminary findings from SABE confirm that Latin America and the Caribbean display peculiarities in the health profile of elderly, particularly with regard to diabetes and obesity. It is important that new policy initiatives begin to seriously target the region's elderly, especially with an emphasis on the prevention and treatment of diabetes and obesity.

Activities of Daily Living↗
PubMed2007

Response to host volatiles by native and introduced populations of Dendroctonus valens (Coleoptera: Curculionidae, Scolytinae) in North America and China.

Bark beetles (Coleoptera: Curculionidae, Scolytinae) have specialized feeding habits, and commonly colonize only one or a few closely related host genera in their geographical ranges. The red turpentine beetle, Dendroctonus valens LeConte, has a broad geographic distribution in North America and exploits volatile cues from a wide variety of pines in selecting hosts. Semiochemicals have been investigated for D. valens in North America and in its introduced range in China, yielding apparent regional differences in response to various host volatiles. Testing volatiles as attractants for D. valens in its native and introduced ranges provides an opportunity to determine whether geographic separation promotes local adaptation to host compounds and to explore potential behavioral divergence in native and introduced regions. Furthermore, understanding the chemical ecology of host selection facilitates development of semiochemicals for monitoring and controlling bark beetles, especially during the process of expansion into new geographic ranges. We investigated the responses of D. valens to various monoterpenes across a wide range of sites across North America and one site in China, and used the resulting information to develop an optimal lure for monitoring populations of D. valens throughout its Holarctic range. Semiochemicals were selected based on previous work with D. valens: (R)-(+)-alpha-pinene, (S)-(-)-alpha-pinene, (S)-(-)-beta-pinene, (S)-(+)-3-carene, a commercially available lure [1:1:1 ratio of (R)-(+)-alpha-pinene:(S)-(-)-beta-pinene:(S)-(+)-3-carene], and a blank control. At the release rates used, (+)-3-carene was the most attractive monoterpene tested throughout the native range in North America and introduced range in China, confirming results from Chinese studies. In addition to reporting a more effective lure for D. valens, we present a straightforward statistical procedure for analysis of insect trap count data yielding cells with zero counts, an outcome that is common but makes the estimation of the variance with a Generalized Linear Model unreliable because of the variability/mean count dependency.

Animals↗
PubMed1995

International collaborative research: role of FAO and other international organizations on animal health programs in Latin America and the Caribbean.

The present situation, needs and potential for the veterinary research and diagnostic laboratories in Latin America and the Caribbean are presented based upon the evaluation of their scientific personnel. The following conclusions were arrived at. (a) The economic crisis in countries of Latin America and the Caribbean has seriously affected veterinary services in general and the diagnostic and research laboratories in particular. (b) Policies need to be reviewed regarding the hiring of new and young scientific personnel in order to replace those retiring, and to define the number and type of working posts needed for the proper operation of the laboratories. (c) Policies need to be reviewed to define the salaries for the scientific personnel of the diagnostic and research laboratories; the only way to retain qualified personnel is through competitive salaries. (d) At present there is more stability among the scientific personnel, especially in those laboratories considered as reference laboratories for the Network; this gives more reliability and guarantees the continuity of their programs and services. (e) Policies need to be reviewed in relation to the publication of scientific information. Latin America journals that have appeared regularly and are well indexed in the international bibliographic services need to be identified and promoted as cited journals for the dissemination of scientific information generated in Latin America and the Caribbean. Diagnostic and research institutions' presentations at national or international congresses should subsequently be published in scientific journals. (f) Evaluation methodology as stated in this review can be used to help identify reliable laboratories with top-quality personnel.

Animal Welfare↗
PubMed2005

TP53 mutations as biomarkers for cancer epidemiology in Latin America: current knowledge and perspectives.

Due to particular social and economical development, and to the impact of globalization of lifestyles, Latin America shows a superposition of cancers that are frequent in low resource countries (gastric, oesophageal squamous cell and cervical cancers) and high resource countries (cancers of breast, colon and rectum, lung and prostate). Latin America thus offers opportunities for investigating the impact on changing lifestyle patterns on the occurrence of cancer. At the molecular level, mutations in the tumor suppressor gene TP53 are common in many cancers and their distribution can be informative of the nature of the mutagenic mechanisms, thus giving clues to cancer etiology and molecular pathogenesis. However most of the data available are derived from studies in industrialized countries. In this review, we discuss current trends on cancer occurrence in Latin American countries, and we review the literature available on TP53 mutations and polymorphisms in patients from Latin America. Overall, a total of 285 mutations have been described in 1213 patients in 20 publications, representing 1.5% of the total number of mutations reported world-wide. Except for hematological cancers, TP53 mutation frequencies are similar to those reported in other regions of the world. The only tumor site presenting significant differences in mutation pattern as compared to other parts of the world is colon and rectum. However, this difference is based on a single study with 35 patients. Recently, a characteristic TP53 mutation at codon 337 (R337H) has been identified in the germline of children with adrenocortical carcinoma in Southern Brazil. Further and better focused analyses of TP53 mutation patterns in the context of epidemiological studies, should help to improve our understanding of cancer etiology in order to develop appropriate health policies and public health programs in Latin America.

Adult↗
PubMed2005

Cenozoic biogeography and evolution in direct-developing frogs of Central America (Leptodactylidae: Eleutherodactylus) as inferred from a phylogenetic analysis of nuclear and mitochondrial genes.

We report the first phylogenetic analysis of DNA sequence data for the Central American component of the genus Eleutherodactylus (Anura: Leptodactylidae: Eleutherodactylinae), one of the most ubiquitous, diverse, and abundant components of the Neotropical amphibian fauna. We obtained DNA sequence data from 55 specimens representing 45 species. Sampling was focused on Central America, but also included Bolivia, Brazil, Jamaica, and the USA. We sequenced 1460 contiguous base pairs (bp) of the mitochondrial genome containing ND2 and five neighboring tRNA genes, plus 1300 bp of the c-myc nuclear gene. The resulting phylogenetic inferences were broadly concordant between data sets and among analytical methods. The subgenus Craugastor is monophyletic and its initial radiation was potentially rapid and adaptive. Within Craugastor, the earliest splits separate three northern Central American species groups, milesi, augusti, and alfredi, from a clade comprising the rest of Craugastor. Within the latter clade, the rhodopis group as formerly recognized comprises three deeply divergent clades that do not form a monophyletic group; we therefore restrict the content of the rhodopis group to one of two northern clades, and use new names for the other northern (mexicanus group) and one southern clade (bransfordii group). The new rhodopis and bransfordii groups together form the sister taxon to a clade comprising the biporcatus, fitzingeri, mexicanus, and rugulosus groups. We used a Bayesian MCMC approach together with geological and biogeographic assumptions to estimate divergence times from the combined DNA sequence data. Our results corroborated three independent dispersal events for the origins of Central American Eleutherodactylus: (1) an ancestor of Craugastor entered northern Central America from South American in the early Paleocene, (2) an ancestor of the subgenus Syrrhophus entered northern Central America from the Caribbean at the end of the Eocene, and (3) a wave of independent dispersal events from South America coincided with formation of the Isthmus of Panama during the Pliocene. We elevate the subgenus Craugastor to the genus rank.

Animals↗
PubMed2003

Organ transplants in Latin America.

Latin America has carried out kidney transplantation for 45 years. Twenty-four countries perform kidney transplantations, 14 perform heart transplantations, 12 perform liver transplantations, 9 perform pancreas transplantations, and, 2 perform small bowel transplantations. Seventeen countries have nephrology societies, 10 have transplantation societies, and 10 have national transplant organizations. The potential donor rate, 40 to 100 per million population per year (pmp/y), is similar to that observed in developed countries, but the rate of potential notified donors is 5 to 25 pmp/y, and the rate of effective donors is lower, 2 to 12 pmp/y. Approximately 77,000 transplantations were performed in the region until 2001, 70,000 kidney transplantations, 4000 liver transplantations, and 2500 heart transplantations. The annual number of kidney transplantations in Latin America increased from less than 3000 in 1991 to almost 7000 in 2001. Latin America, with only 8.5% of the world population, performed 12.7% of the kidney transplantations. Future strategies to improve the transplantation situation in Latin America include the following: obtain financial coverage for all the population, establish a National Transplant Organization and registries with transplantation results, and improve cadaveric and living donation to 10 pmp/y each.

Animals↗
PubMed2000

Review of regional measles surveillance data in the Americas, 1996-99.

BACKGROUND: In 1994, ministers of health of countries of North and South America established the goal of measles eradication from the western hemisphere by 2000. To accomplish this goal, the Pan American Health Organization (PAHO) developed an enhanced measles vaccination strategy. METHODS: PAHO's measles eradication vaccination strategy has evolved into three principal components; a catch-up measles vaccination campaign, maintenance of high vaccination coverage (keep-up), and periodic follow-up measles vaccination campaigns. To monitor progress towards measles eradication, measles surveillance has been strengthened, including the laboratory investigation of suspected measles cases. FINDINGS: Both the catch-up and follow-up mass campaigns achieved high vaccination coverages in the respective targeted age groups. In 1996, only 2109 confirmed measles cases were reported in the Americas. In 1997, there was a resurgence of measles in the Americas, mostly as a result of a large measles outbreak with over 42000 cases, which occurred mainly among unvaccinated young adults in Sao Paulo State, Brazil. By 1998, there was a reduction in the number of reported confirmed measles cases, with a total of 14474 cases. Reduction of cases continued to the end of 1999, with a total of only 2828 confirmed cases. INTERPRETATION: PAHO's measles eradication strategy has been effective in interrupting transmission and maintaining the absence of measles virus circulation in most parts of the Americas. The PAHO experience provides strong evidence that with full implementation of an appropriate vaccination strategy, measles transmission can be effectively interrupted.

Adolescent↗
PubMed2001

Cervical cancer in Latin America.

Cervical cancer is a common cause of morbidity and mortality in developing countries. In Latin America, the incidence rates in several cities are among the highest worldwide, probably due to a high frequency of risk factors and/or a low screening coverage for cervical cancer. Epidemiologic studies conducted in Latin America (and some in the Caribbean), that have investigated the main risk factors for the disease, as well as screening coverage by Papanicolaou (Pap) smear, were reviewed. The prevalence of human papillomavirus (HPV) infection among women with negative Pap smears does not seem to explain the risk observed in Latin American countries. Results of some studies have suggested that reproductive factors and male sexual behavior might be responsible, at least partially, for the high occurrence of cervical cancer in Latin America. Concerning cytology screening, many women have a smear taken regularly (some every year). However, a significant proportion of women, probably those with a high risk of cancer of the cervix, have never had a Pap test. To reduce cervical cancer in these countries, screening programs in Latin America should have a wider coverage, especially reaching those women at higher risk. Semin Oncol 28:188-197.

Developing Countries↗
PubMed2005

Invasion success of vertebrates in Europe and North America.

Species become invasive if they (i) are introduced to a new range, (ii) establish themselves, and (iii) spread. To address the global problems caused by invasive species, several studies investigated steps ii and iii of this invasion process. However, only one previous study looked at step i and examined the proportion of species that have been introduced beyond their native range. We extend this research by investigating all three steps for all freshwater fish, mammals, and birds native to Europe or North America. A higher proportion of European species entered North America than vice versa. However, the introduction rate from Europe to North America peaked in the late 19th century, whereas it is still rising in the other direction. There is no clear difference in invasion success between the two directions, so neither the imperialism dogma (that Eurasian species are exceptionally successful invaders) is supported, nor is the contradictory hypothesis that North America offers more biotic resistance to invaders than Europe because of its less disturbed and richer biota. Our results do not support the tens rule either: that approximately 10% of all introduced species establish themselves and that approximately 10% of established species spread. We find a success of approximately 50% at each step. In comparison, only approximately 5% of native vertebrates were introduced in either direction. These figures show that, once a vertebrate is introduced, it has a high potential to become invasive. Thus, it is crucial to minimize the number of species introductions to effectively control invasive vertebrates.

Animals↗
PubMed2005

An Asian origin for a 10,000-year-old domesticated plant in the Americas.

New genetic and archaeological approaches have substantially improved our understanding of the transition to agriculture, a major turning point in human history that began 10,000-5,000 years ago with the independent domestication of plants and animals in eight world regions. In the Americas, however, understanding the initial domestication of New World species has long been complicated by the early presence of an African enigma, the bottle gourd (Lagenaria siceraria). Indigenous to Africa, it reached East Asia by 9,000-8,000 before present (B.P.) and had a broad New World distribution by 8,000 B.P. Here we integrate genetic and archaeological approaches to address a set of long-standing core questions regarding the introduction of the bottle gourd into the Americas. Did it reach the New World directly from Africa or through Asia? Was it transported by humans or ocean currents? Was it wild or domesticated upon arrival? Fruit rind thickness values and accelerator mass spectrometer radiocarbon dating of archaeological specimens indicate that the bottle gourd was present in the Americas as a domesticated plant by 10,000 B.P., placing it among the earliest domesticates in the New World. Ancient DNA sequence analysis of archaeological bottle gourd specimens and comparison with modern Asian and African landraces identify Asia as the source of its introduction. We suggest that the bottle gourd and the dog, two "utility" species, were domesticated long before any food crops or livestock species, and that both were brought to the Americas by Paleoindian populations as they colonized the New World.

Africa↗
PubMed2004

Determination of the source areas contributing to regionally high warm season PM2.5 in eastern North America.

An ensemble-trajectory analysis technique known as Quantitative Transport Bias Analysis was applied to determine which geographic areas systematically contributed to above- and below-average fine particle mass (PM2.5) over eastern North America. Six-hour average measurements from 12 rural or suburban locations in eastern North America collected using a tapered element oscillating microbalance were individually associated with corresponding 3-day back-trajectories for the warm seasons (May-September) of 2000 and 2001. Much of the populated areas of northeastern North America were implicated in the build-up of PM2.5 to above-average concentrations. The finer structure of the Quantitative Transport Bias Analysis pattern indicated that transport from the Ohio River Valley, particularly the eastern portion of this area, was most often associated with the highest PM2.5 concentrations. In addition, air masses originating over a relatively large area from southeast Ohio to the western part of Virginia and the western Kentucky to central Tennessee area tended to result in relatively high PM2.5 concentrations over northeastern North America. These observation-based findings were consistent with the spatial distribution of the main sulfur dioxide emissions sources and the major oxides of nitrogen point sources.

Air Movements↗
PubMed2001

Haemophilus influenzae resistance in Latin America: systematic review of surveillance data.

Haemophilus influenzae is a relevant cause of morbidity and mortality among children under 5 years of age in the developing world. In Latin America, H. influenzae type b (Hib) conjugate vaccine and surveillance of H. influenzae antimicrobial susceptibility have been implemented in recent years. We have undertaken a systematic review and a pooled analysis on H. influenzae antimicrobial resistance, including reports of 15 Latin America countries over a 10-year period (1990-2000). We have found that 450 (21.4%) of 2,100 invasive isolates were beta-lactamase producers compared to 145 (14.5%) of 998 isolates of noninvasive isolates (p < 0.05). Ampicillin resistance was detected among 783 (21.9%) of 3,577 invasive isolates compared to 111 (17.2%) of 646 noninvasive strains (p < 0.05). In contrast, 568 (41.9%) of 1,355 noninvasive strains were trimethoprim-sulfamethoxazole (TMP-SMX) resistance against 241 (26.9%) of 897 invasive ones (p < 0.05). Therefore, TMP-SMX resistance was more common in nonsterile fluids than in sterile fluids. Over time, rates of beta-lactamase-producing strains were stable in Brazil and Mexico, whereas rates of TMP-SMX resistance were increasing in Brazil. It is predictable that following the Hib immunization, Latin America countries will be faced with increased nontypeable H. influenzae infection. Although standing by the nontypeable H. influenzae vaccine, in this novel epidemiological scenario of post-Hib vaccination in Latin America settings there is a need to improve H. influenzae resistance monitoring to guide clinicians to choose efficacious antimicrobial therapy.

Data Interpretation, Statistical↗
PubMed1990

Diet, physical activity, and colorectal cancer among Chinese in North America and China.

In a population-based case-control study of colorectal cancer among Chinese men and women in western North America and the People's Republic of China, a common protocol was used to assess past life-style characteristics of 905 cases diagnosed during 1981-1986 and 2,488 controls. Risks for cancers of both the colon and rectum increased with increased food energy from fat, protein, carbohydrate, and all energy sources combined, for both sexes and on both continents. Yet, in multivariate analysis, colorectal cancer risk was significantly associated only with saturated fat; no relationships were seen with other dietary sources of energy. Colon cancer risk was elevated among men employed in sedentary occupations. On both continents and in both sexes, risks for cancers of both the colon and rectum increased with increasing time spent sitting. Further, the association between colorectal cancer risk and saturated fat was stronger among the sedentary than among the active. Risk among sedentary Chinese Americans of either sex increased more than fourfold from the lowest to the highest category of saturated fat intake. Among migrants to North America, risk increased with increasing years lived in North America. These observations suggest (a) that colorectal cancer risk increases with duration of exposure to a sedentary life-style and a diet rich in saturated fat; (b) that higher incidence among Chinese-American men relative to women is due to longer duration of these habits among men, who have lived longer in North America; and (c) that higher risk among Chinese Americans of both sexes relative to risk among the general population in China is due to differences in such habits. Attributable risk calculations suggest that, if these associations are causal, saturated fat intakes exceeding 10 g/day, particularly in combination with physical inactivity, could account for 60% of colorectal cancer incidence among Chinese-American men and 40% among Chinese-American women.

Adult↗
PubMed2006

Chronic hepatitis B: current epidemiology in the Americas and implications for management.

Hepatitis B virus (HBV) remains a serious health threat in many parts of the world. Although its prevalence is lower in the Americas than in Asia, Africa and the Middle East, it is responsible for significant morbidity and mortality in North, Central and South America. There is a nonuniform pattern of distribution throughout this region, with HBV prevalence related to geographical, social and cultural factors that predispose certain individuals to infection. This report details the incidence, modes of viral transmission of hepatitis B in the Americas and clinical course of disease in different regions of the Americas. Additionally, the implications for management focusing on issues predominant in high-risk populations are presented.

Americas↗
PubMed1991

Mammalian extinctions in the late Pleistocene of northern Eurasia and North America.

The 'mass extinctions' at the end of the Pleistocene were unique, both in the Pleistocene and earlier in the geological record, in that the species lost were nearly all large terrestrial mammals. Although a global phenomenon, late Pleistocene extinctions were most severe in North America, South America and Australia, and moderate in northern Eurasia (Europe plus Soviet Asia). In Africa, where nearly all of the late Pleistocene 'megafauna' survives to the present day, losses were slight. Ruling out epidemic disease or cosmic catastrophe, the contending hypotheses to explain late Pleistocene extinctions are: (a) failure to adapt to climatic/environmental change; and (b) extermination by human hunters ('prehistoric overkill'). This review focuses on extinctions in northern Eurasia (mainly Europe) in comparison with North America. In addition to reviewing the faunal evidence, the highly relevant environmental and archaeological backgrounds are summarized. The latest survival dates of extinct species are estimated from stratigraphic occurrences of fossil remains, radiocarbon dates, or association with archaeological industries. The Middle and Upper Pleistocene (ca. 700,000-10,000 BP) in northern Eurasia and North America was a time of constantly changing climate, ranging from phases of extensive glaciation in cold stages, to temperate periods (interglacials). In the Lateglacial (ca. 15,000-10,000 BP), during which most extinctions occurred, there was a major reorganization of vegetation, mainly involving the replacement of open vegetation by forests. These changes were more profound than earlier in the Last Cold Stage, but similar in nature to vegetational changes that took place at previous cold stage/interglacial transitions. The archaeological record shows that humans have been present in Europe since the early Middle Pleistocene. The arrival in Europe ca. 35,000 BP of 'anatomically modern humans', with their technologically more advanced upper palaeolithic industries, was a 'quantum leap' in human history. Extinctions occurred throughout the European Pleistocene, but until the late Pleistocene most losses were replaced by the evolution or immigration of new species, and most of those lost without replacement were small mammals. In marked contrast, extinctions without replacement in the late Pleistocene were almost entirely confined to the largest mammals (greater than 1000 kg) and some medium-large species (100-1000 kg).(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed2005

Quantitative risk assessment of rabies entering Great Britain from North America via cats and dogs.

Great Britain has been rabies-free since 1922, which is often considered to be in part due to the strict laws requiring that imported cats and dogs be vaccinated and quarantined for 6 months immediately on entry into the country. Except for two isolated incidents, this quarantine policy has contributed to ensuring that Great Britain has remained free of rabies. In 2000, amendments to the UK quarantine laws were made and the Pet Travel Scheme (PETS) was launched for companion animals traveling from European Union countries and rabies-free islands. Since its introduction, it has been proposed that other countries including North America should be included within the UK scheme. A quantitative risk assessment was developed to assist in the policy decision to amend the long-standing quarantine laws for dogs and cats from North America. It was determined that the risk of rabies entry is very low and is dependent on the level of compliance (i.e., legally conforming to all of the required regulations) with PETS and the number of pets imported. Assuming 100% compliance with PETS and the current level of importation of cats and dogs from North America, the annual probability of importing rabies is lower for animals traveling via PETS (7.22 x 10(-6), 95th percentile) than quarantine (1.01 x 10(-5), 95th percentile). These results, and other scientific evidence, directly informed the decision to expand the PETS scheme to North America as of December 2002.

Animals↗
PubMed2002

Ca3 fingerprinting of Candida albicans bloodstream isolates from the United States, Canada, South America, and Europe reveals a European clade.

It was previously demonstrated by a cluster analysis that 26 unrelated U.S. isolates of Candida albicans separated into three distinct groups (groups I, II, and III) while South African isolates separated into four distinct groups (groups I, II, III, and SA). To verify the absence or underrepresentation of SA isolates in North America, and to identify which groups are represented in Europe and South America, collections of bloodstream isolates from each geographical locale were analyzed by cluster analyses based on genetic fingerprinting with the Ca3 probe. The results verify that North America is almost devoid of SA isolates (2%). However, the results reveal a new clade, designated group E, relatively specific to Europe. While 26% of a European collection of 46 isolates was composed of group E isolates, only 2% of the 164 North American isolates, 5% of 22 South American isolates, and 1% of 361 South African isolates were composed of group E isolates. The North American collection proved to be the least-diverse collection in regard to group representation. In a comparison of collections from the Northeast, Midwest, and Southwest regions of the United States, Canada, and South America, it was demonstrated that both the U.S. Southwest and the South American collections were devoid of group II isolates. Together these results identify for the first time a European-specific clade and demonstrate clear distinctions in the representations of the five demonstrated clades (groups I, II, III, SA, and E) in different geographical locales.

Blood↗
PubMed2001

Ecological study of effect of breast feeding on infant mortality in Latin America.

OBJECTIVE: To estimate the effect of exclusive breast feeding and partial breast feeding on infant mortality from diarrhoeal disease and acute respiratory infections in Latin America. DESIGN: Attributable fraction analysis of national data on infant mortality and breast feeding. SETTING: Latin America and the Caribbean. MAIN OUTCOME MEASURES: Mortality from diarrhoeal disease and acute respiratory infections and nationally representative breastfeeding rates. RESULTS: 55% of infant deaths from diarrhoeal disease and acute respiratory infections in Latin America are preventable by exclusive breast feeding among infants aged 0-3 months and partial breast feeding throughout the remainder of infancy. Among infants aged 0-3 months, 66% of deaths from these causes are preventable by exclusive breast feeding; among infants aged 4-11 months, 32% of such deaths are preventable by partial breast feeding. 13.9% of infant deaths from all causes are preventable by these breastfeeding patterns. The annual number of preventable deaths is about 52 000 for the region. CONCLUSIONS: Exclusive breast feeding of infants aged 0-3 months and partial breast feeding throughout the remainder of infancy could substantially reduce infant mortality in Latin America. Interventions to promote breast feeding should target younger infants.

Acute Disease↗