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At least 19 recordsLinked to original sources
PubMed2005

Chronic kidney disease in Costa Rica.

Costa Rica is one of the Central American countries, located between Nicaragua to the north and Panama to the south. Like other Latin American countries, Costa Rica deals with social and economic problems associated with poverty, except for one significant difference-Costa Rica has not had an army since 1948, and so the people and government can spend more money on education and health. For this reason, Costa Rica is very different from other Latin American countries. We do not need weapons, and we have had a democratic tradition for 100 years. Despite our economic and social limitations, Costa Ricans have universal access to a health system that covers 98% of the inhabitants. Renal replacement therapy (RRT) is accessible to all who need it. In the last 5 years, Costa Rica has doubled the number of patients on hemodialysis, and has the highest number of kidney transplants per million population (pmp) in Latin America, with 20.63 transplants pmp in 2000, 27.25 transplants pmp in 2001, and 24.81 transplants pmp in 2002. However, the prevalence of all forms of RRT in Costa Rica is currently 193 pmp. This suggests that end-stage renal disease is underdiagnosed in Costa Rica as it is in many other Latin American countries. Greater research efforts are needed to determine the true extent of renal disease in Costa Rica and to optimize the use of health-sector resources to provide a better and more robust program of RRT for patients with end-stage renal disease.

Chronic Disease↗
PubMed2006

Epidemiology and control of hypertension and diabetes in Costa Rica.

Costa Rica is one of the countries that make up Central America, neighboring Nicaragua and Panama. Costa Rica shares with its neighbors the social and economic problems characteristic of developing countries; however, one difference is that Costa Rica can derive a great part of its budget and expense to health and education, as it had abolished the army in 1948. It is for this reason that Costa Rica shares diseases characteristic of their region like the Dengue, yet at the same time have a true explosion in the fields of hypertension (HTA), diabetes (DM), and cardiovascular disease. The health system of Costa Rica has nearly universal coverage, reaching 98% of the population with primary and secondary diverse levels of attention that give appropriate and satisfactory treatment to all hypertensive and diabetic patients. The HTA and the DM are true public health problems; however, before 2004, there weren't appropriate data on their prevalence and management. Small studies showed an increase in the prevalence of HTA from 9 to 24%, though no data on the prevalence of DM were available. In 2004, the Multinational Survey of Diabetes and Hypertension and Other Factors of Risk carried out in San José, Costa Rica, determined a prevalence of HTA of 25% and of DM of 8%. Likewise, the methodology of the survey allowed an evaluation of the quality of the attention of the HTA (Tracer of Arterial Hypertension) and, consequently, appropriate control of hypertensive patients in Costa Rica; through it, it was determined that greater effort was required for earlier detection and resource optimization to better handle hypertensive and diabetic patients and thus reduce cardiovascular morbidity-mortality and chronic renal disease.

Cardiovascular Diseases↗
PubMed2003

Outdoor and indoor dose assessment using environmental thermoluminescence dosimeters (TLDs) in Costa Rica.

Costa Rica lies at the intersection of the Cocos and Caribbean plates in Central America. It has mountain ranges with many active volcanoes along its territory. Its soils are predominantly of volcanic origin. Natural radiation measurements utilising environmental CaF2:Dy thermoluminescence dosimeters were used for the first time in Costa Rica by the Dosimetry Section of the Atomic, Nuclear and Molecular Sciences Research Center of the University of Costa Rica. Seven hundred outdoor measurements were obtained in a 3.5-year period at eight different sites throughout the country. One hundred and seventy-four indoor readings were also collected at four sites for a 2-year period. Population-weighted averages give 82 nGy h(-1) for outdoors and 130 nGy h(-1) for indoors. The values lie on the upper range of worldwide reported values due to reported soil characteristics rich in uranium and potassium. A preliminary population-weighted value of 0.74 mSv/year for the effective dose is calculated for natural terrestrial gamma radiation in Costa Rica.

Algorithms↗
PubMed1991

Socioeconomic development, health interventions and mortality decline in Costa Rica.

Costa Rica, whose life expectancy was 74 years by 1985, has reached a health level comparable to a developed country. The health achievements of this country are product of political and socioeconomic circumstances as well as of right public health policies. Until about 1970 the features of Costa Rica mortality, although somewhat better than the Latin American average, evolved in a similar way to the rest of the region. In particular, the decades of 1940s and 1950s saw dramatic improvements in life expectancy, thanks mainly to the import of low-cost, high-effectiveness health technologies. In the 1970s, however, Costa Rica departed from a regional pattern of stagnation and managed to close the gap with developed countries in terms of mortality levels. A dramatic decline in the infant mortality rate from 60 to 19 per 1,000 took place in this decade. The main determinants of this breakthrough were health interventions, notably a primary health care program, even though favorable socioeconomic conditions and a reduced fertility also played a role. Ecological data and other evidence suggest that up to three fourths of the mortality decline was accounted for contemporary improvements in public health services, with about 40 percent attributable to primary health care interventions. Furthermore, by targeting interventions on the less privileged population, these interventions had the merit of reducing geographic and socioeconomic differentials in child mortality.

Cause of Death↗
PubMed1977

Extension of health service coverage in Costa Rica.

Costa Rica's National Health Plan for 1971-1980 has given top priority to extension of health coverage--focusing especially on marginal rural and periurban areas. By June 1977 implementation of this plan had provided coverage for over 80 per cent of Costa Rica's scattered rural population. Community participation was being encouraged, together with an integrated approach to the problems of these marginal regions.

Community Health Services↗
PubMed1990

International politics and primary health care in Costa Rica.

Costa Rica's internationally-renowned rural health program exemplifies the principles put forth by the 1978 Alma Ata Declaration on Primary Health Care with one exception: the government has not succeeded in achieving active community participation in health. This paper uses a historical and political-economic perspective to explain why the Costa Rican government failed in its efforts to enhance community participation after Alma Ata. International agencies have been closely involved in the design and implementation of rural health services in Costa Rica since the early 1900s, yet community participation did not figure in these programs until the mid-1970s. The demise of community participation in the early 1980s is attributed to a combination of factors including partisan conflicts, social class conflicts, interest group politics and, particularly, to the shifting priorities of international health and development agencies.

Community Health Services↗
PubMed1991

Export-led growth as a determinant of social development in Costa Rica.

Costa Rica has put considerable effort into the development of education, health care, housing and social security. In order to be sustainable, this process requires that the output of such sectors as agriculture and manufacturing expands over time. The article examines the growth of the Costa Rican economy in a long run perspective, with an emphasis on foreign trade policy. The fate of the Costa Rican economy has been highly dependent on the exports of primary products, mainly coffee and bananas, for more than a century. This, however, has created a very vulnerable economy. As a result, during the 1960s, a new development strategy emerged: production of manufactures for the Central American Common Market (CACM). At the end of the 1970s, the prices of traditional export fell and the CACM more or less collapsed. The Central American economies were thrown into an acute crisis, aggravated by faculty domestic economic policies, which also jeopardized social development. This necessitated a stabilization effort on the one hand, and the development of a new trade strategy--promotion of non-traditional exports--on the other. It would appear that both efforts have been successful, although not without difficulties.

Commerce↗
PubMedDate not supplied

[Local health systems, strategy for the consolidation of the national health system in Costa Rica].

Costa Rica has a notable record in the field of health care and in the implementation and development of local health systems. The Ministry of Health embarked on its course of local health system development in mid-1986 with the creation of commissions on the subjects of health teams, information, control, management, community participation, and health education. At the same time, administrative decentralization got under way with the shifting of human resources and supplies, finances, accounting, and maintenance functions to the health centers. The Comprehensive Health Program, which defines the Ministry of Health's basic scope of action in the local health system, was established in 1989. A total of 86 local health systems have been established to date, and considerable progress has been made both in defining a political and structural framework for health services integration and in enlisting the community's participation in analyzing the health problems that affect it, as well as in local decision-making for the resolution of such problems.

Costa Rica↗
PubMed1988

Some preliminary considerations on the sobada: a traditional treatment for gastrointestinal illness in Costa Rica.

Although Costa Rica has one of the most effective national health systems in Latin America, popular medicine still persists. The sobada is a traditional healing technique which involves rubbing. Used principally to treat pega, a folk-diagnosed gastrointestinal condition which mainly affects children and old people, it was used by 70% of a random sample of families from the poorer barrios of San José. In recent years Costa Rica's health system has been under great strain because of increased costs and numbers of users. The prevalence and possible resurgence of the sobada may be an adaptation of poor people to national health services which have grown suddenly very large and impersonal and to the recent introduction of oral rehydration in hospital settings.

Costa Rica↗
PubMed1996

Cancer in banana plantation workers in Costa Rica.

BACKGROUND: Costa Rica has population and disease registries with potential value for epidemiological research. Pesticides have been intensively used on banana plantations, for example dibromochloropropane (DBCP). This study was planned to examine the quality of the cancer and civil registries and the feasibility of record linkages, and to explore cancer patterns among a highly exposed group. METHODS: A retrospective cohort study was carried out. Workers on the payrolls of banana companies, as reported to the Social Security System at any time between 1972 and 1979, were followed up in the cancer registry between 1981 and 1992: 29 565 men and 4892 women for 407 468 person-years. The observed cases of cancer were compared to the expected values, derived from the national incidence rates. RESULTS: We identified 368 cancer cases, 292 among men (standardized incidence ratio [SIR] = 76, 95% confidence interval [CI] 67-84) and 76 among women (SIR = 116, 95% CI: 90-142). Among men increased SIR were observed for melanoma (SIR = 197, 95% CI: 94-362) and penile cancer (SIR = 149, 95% CI: 55-324); among women for cervix cancer (SIR = 182, 95% CI: 122-241) and leukaemia (SIR = 274, 95% CI: 86-639). Risk estimates for lung cancer were evaluated among male workers with the longest time of employment. CONCLUSIONS: Follow-up was difficult due to deficient identification variables in the cancer registry and to easier identification of the living compared to the decreased in the civil registry at the end of the observation period. The various systematic errors in this study are likely to produce an underestimation of the relative risk estimates. This study contributes to improvements of the registries and increases the potential for cancer epidemiology in Costa Rica and other developing countries.

Adult↗
PubMed2001

Short report: Asthma admissions and weather conditions in Costa Rica.

In Costa Rica there is little information about asthma admissions. In this report the monthly asthma admissions and weather data for a seven year period were reviewed. The hospital asthma admissions showed notable seasonal variation associated with variations in the rainfall and the relative humidity.

Adolescent↗
PubMed2004

[On a "prolific" relationship. The role of "health" in the propagation of contraceptive sterilization in Costa Rica].

In Costa Rica, female sterilization for contraceptive purposes is a practice common to women from diverse socio-economic sectors. This is the case despite the existence until 1999 of legal restrictions on its use. This article explores the role played by the idea of health as the rationale by which sterilization for contraceptive purposes has become available., inutially as the reason for allowing its availability (and demand) in a legal context that only permited its use for therapeutic purposes, and later, as the motive that legitimates its contraceptive use.

Contraception↗
PubMed1988

[Reproductive biology of the Central American rattlesnake Crotalus durissus durissus (Serpentes: Viperidae) in Costa Rica].

In Costa Rica, rattlesnakes mate during the early dry season (December and January) and births occur in the early rainy season (May-July). Gestation is therefore about 6 months. The mean number of offspring is 22.9 and is significantly correlated with the size of the female. Newborn rattlesnakes are 27.5-43.0 cm in length and weight 11.4-46.3 g. They are relatively docile. Adult males are longer and heavier than females. Females seem to have their first litter when their size exceeds 120 cm.

Animals↗
PubMed1996

[Seasonality of parasites and intestinal bacteria in vegetables that are consumed raw in Costa Rica].

In Costa Rica, a total of 640 samples from eight different vegetables used for raw consumption, were analyzed for the presence of intestinal parasites and fecal coliforms. Eighty samples of each vegetable were analyzed, forty during the dry season and forty in the rainy. A greater, but unsignificant (p > 0.05) level of fecal coliforms was found during the dry season. Levels of Escherichia coli, were higher (p < 0.05) during the dry season in lettuce (Latuca sativa) and cilantro (Coleandrum sativum) leaves. Cysts of Endolimax nana, Entamoeba coli, Entamoeba histolytica, Giardia intestinalis and Cryptosporidium sp. were found in all vegetables. The greater percentage of positive samples was found during the dry season, although these relation was only corroborated (p < 0.05) in radish (Raphanus sativus) and cilantro leaves. Only lettuce and cilantro levels showed a positive linear correlation (p < 0.05) between occurrences of intestinal parasites and fecal coliforms.

Animals↗
PubMed1999

[Presence of Clostridium perfringens in meat-based preparations in public food services in central San Jose, Costa Rica].

In Costa Rica there are a large number of public food services distributed along the country, where a considerable number of people eat daily. Clostridium perfringens is a bacteria associated with foodborne illness related, especially, to meat products kept for long time at temperatures under 70 degrees C. The aim of this study was to evaluate the public food services that use water baths for keeping food hot in order to establish the presence of C. perfringens in cooked bovine meat dishes and to evaluate the enterotoxigenic capacity of the strains isolated. 81 samples of cooked bovine meat plates coming from 27 public food services, located in the Central County of San José were analyzed. The methodology described by Labbe & Harmon for the isolation of C. perfringens was used in 10 g of sample. Also, the enterotoxigenic capacity of the strains was evaluated using the passive-reverse-latex-agglutination assay from Oxoid. From the 27 public food services analyzed, eight (30%) were positive in the three samplings done, nine (33%) were positive in one or two occasions, and ten (37%) were negative all times. This implies that in 17 (63%) of the establishments studied, the bacteria was isolated at least once. From the 81 preparations studied, 37 (46%) were positive for the bacteria. The temperatures at which food was kept varied from 56 to 82 degrees C, with an average of 68.7 degrees C. From the 37 strains identified as C. perfringens, 12 (32%) were positive for enterotoxin. In conclusion, the presence of C. perfringens in bovine meat dishes, maintained in water baths, represents an important risk for public health, and the temperature at which the preparation is kept is critical for the multiplication of the bacteria.

Animals↗
PubMed1996

Demersal crustacean assemblages along the Pacific coast of Costa Rica: a quantitative and multivariate assessment based on the Victor Hensen Costa Rica expedition (1993/1994).

During the first cruise leg with the RV Victor Hensen to the Pacific coast of Costa Rica in December 1993 (end of the rainy season) the crustacean fauna found in the demersal collections revealed an unexpected species richness and biomass. The Crustacea collections were analyzed qualitatively and quantitatively during the fourth leg (February 1994, dry season) in the three study areas Golfo Dulce (GD), Bahía Coronado in the Sierpe-Térraba-estuary (ST) and Golfo de Nicoya (GN). Qualitative data were available for comparison from the first leg in december 1993. A total of 24 beamtrawl and ten ottertrawl sample collections were done on an area of 860.000 m2 yielding a total of 119 species with a biomass of 37.8 kg (10275 specimens). Despite the smaller area covered by the beamtrawl, it collected a higher number of species and more biomass than the ottertrawl due to the smaller mesh size (0.8 cm). Judging from the shape of the species -per-area-curves, the crustacean fauna appeared as representatively sampled for the study area. As compared with the GN (biomass 0.36 g +/- 0.26, SR = 97) and the ST (0.41 g +/- 0.27, SR = 59) and according to the results of the log-series-plots constructed from the abundance data, the GD seems to be a depauperated area with significantly lower biomass (0.05 g +/- 0.07) and species richness (45 sp.). No crustaceans were found in the center of the deep basin of the GD put parts of the interior gulf with adjacent mangrove areas seem to be important as nursery area for some commercially important penaeid shrimp species. The ST-estuary revealed the highest mean species number per station in the whole study area, but the GN had the highest total number of species. Biomass seems to be regularly distributed and not depth-depending within the GN, while species abundance varies clearly, confirming previous results. In contrast, abundance and biomass correlated well in the ST. Based on the results of the multivariate analysis, seven station groups of particular species assemblages can be distinguished in the study areas. Despite a high variability between stations in abundance and biomass, the following four areas of characteristic species assemblages can be identified which are also confirmed by an independent study on demersal fishes: (1) the interior part of the GN, characterized by juvenile shrimps (Sicyonia disdorsalis, Trachypenaeus fuscina), several patchily distributed anomurans, brachyurans and other predator species like portunids (especially Portunus asper) and pre-adult stomatopods (Squilla spp.); (2) the exterior part of the GN with high amounts of caridean (Pantomus affins, Plesionika spp.) and penaeid shrimps (Sicyonia picta, Solenocera mutator), the highly abundant Iliacantha hancocki and some specimens of the stomatopod Hemisquilla stylifera and the deep water portunid Portunus iridescens; (3) a transition zone between 60 and 120 m water depth with a heterogeneous faunal composition, located in the ST and east of Isla Tortugas in the GN, and (4) the oxygen-depleted shelf edge area, dominated by the galatheid Pleuroncodes monodon. Mass occurrence of this species takes place off the GD and to a lesser extent off the ST-estuary, associated with high numbers of Solenocera spp. There seems to be a general trend of species groupings along abiotic gradients (depth, temperature, oxygen saturation) interrupted by small-scale variations in habitat type, current regime, food availability and other factors not identified in this study. Neither total abundance and biomass nor biotic summary parameters like diversity, dominance or species richness correlated well with the abiotic factors measured during this survey.

Animals↗