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At least 19 recordsLinked to original sources
PubMed1996

[Management policy and utilization of botanical resources in the Dominican Republic].

The Dominican Republic has an extension of 48 442 km2. It occupies the eastern portion of the island of Hispaniola and is the second in size within the Greater Antilles. The floral resources of the Island have been extensively exploited without an adequate management policy. This has led to the destruction of about 90% of the forested lands of the country. The Dominican Republic has about 5600 species of vascular plants, of which 36% are endemic, many of which are in danger of extinction, due to overexploitation and/or destruction of the habitats. In order to protect the biodiversity of the Dominican Republic, 22 nature preserves were created, representing about 13.3% of the national territory. The primary institutions charged with the management and protection of the flora are the General Directorate of Forests, National Directorate of Parks, the National Botanical Garden, and the Department of Wild Life under the State Secretary of Agriculture (SEA). Numerous laws, resolutions and decrees have been promulgated, governing forest resources. As to the wildlife, emphasis is given to the protection of the fauna. At present, there is a technical body, which is structuring a Forest Code. Export of products of the wild flora is regulated by the Wildlife Department under the State Secretary of Agriculture (SEA). This Department also administers regulations for CITES. The Department of Plant Sanitation of the SEA and the Dominican Centre of Export Promotion (CEDOPEX) are also involved in the control of the export of biological materials.

Animals↗
PubMed1984

Economic development: the middle class and international migration in the Dominican Republic.

"The Dominican Republic is classified as one of a group of Latin American and Caribbean countries whose international migratory flows appear to be primarily composed of the urban middle class, rather than the rural poor. It is argued that Dominican middle class international migration has emerged as a partial solution to a political economic crisis that was dramatized by the April Revolution of 1965 and deepened through the 1970s with the failure of industrialization strategies to generate significant changes in the class structure."

Americas↗
PubMed1994

Counselling on contraceptive use strengthened in Dominican Republic.

In the Dominican Republic a study was conducted to identify the main factors associated with the occurrence of induced abortion. The study involved interviews with 350 women admitted in two hospitals with abortion complications, review of their clinical records, and in-depth interviews with 30 of these patients. The results indicated that the majority of these women had a low socioeconomic status and a low level of education. Many were born in rural areas but had migrated to Santo Domingo, the capital, in search of employment. Their average age was about 26 years. Adolescents represented 16% of the total study sample. Most of these women were in some sort of union, but only 13% were formally married. Contrary to popular belief that it is only unmarried adolescents who resort to induced abortions, the study showed that the majority were in permanent or semi-permanent unions. In fact, most of them had been in the union for three or more years. The use of contraception was low and unsystematic, with high discontinuation rates. Although 75% of the total study population declared to have used at least one contraceptive method during their lifetime, only 42% had tried a second method. This project has had a significant policy impact. In 1993, a revised Health Code was presented to the Dominican Congress for discussion and approval. The Senator who introduced this legislation, using results from the study, proposed to modify the law with respect to therapeutic abortions to include a clause that would make abortion legal under certain conditions and make corresponding services available as part of maternal and child health care programs. Also, with a view to lowering the incidence of abortion, PROFAMILIA, an agency affiliated to the international Planned Parenthood Federation, has adopted improved measures, reinforcing counselling and communication efforts to improve understanding of the correct way of using modern methods.

Abortion, Induced↗
PubMed2003

Preventing mother-to-child HIV transmission in a developing country: the Dominican Republic experience.

Transmission of HIV in the Dominican Republic occurs primarily through heterosexual contact. As part of a continuing strategy to prevent and contain the spread of HIV infection, the Ministry of Health of the Dominican Republic established an integrated package of interventions to reduce HIV mother-to-child transmission that was initiated on May 15, 2000. The program was designed to be implemented in 3 phases. The 1st phase included 4 mother and child hospitals; the 2nd phase included 8 mother and child health institutions in Santo Domingo, the capital of the Dominican Republic, and 7 additional mother and child hospitals. The 3rd phase will include the remaining 12 mother and child health care institutions of the Dominican Republic. Evaluation of the 1st year of this program, involving 8 hospitals and >40000 pregnant women, identified specific benefits and limitations. Low numbers of voluntary counseling sessions (6528/42666 = 28%) and inadequate number of HIV rapid tests (23067/42666 = 54%) were the 2 main obstacles encountered. From the 23067 pregnant women tested, 581 (2.5%) were HIV positive. Advantageous aspects included the successful administration of antiretroviral treatment to 89% (164/185) of the mothers and 98% (183/186) of the children. Cesarean section was performed in 67% (124/185) of the HIV-positive pregnant women, and infant formula was dispensed to 47% (87/186) of all cases. These findings demonstrate the feasibility of implementing a large-scale program to prevent mother-to-child transmission in a developing country.

Bottle Feeding↗
PubMed2005

Dengue in the Dominican Republic: epidemiology for 2004.

The Dominican Republic (DR) has experienced tremendous increase in the number of cases of dengue virus (DENV) reported in the past few years. There are four serotypes of DENV (1-4), and each can cause classic dengue fever (DF), dengue hemorrhagic fever (DHF), or dengue shock syndrome (DSS). DENV-1-4 are currently circulating in the DR; however, the Department of Epidemiology of the Dominican Republic (DIEGPI) has been able to isolate only DENV-2 and DENV-4. In the DR, the development of DENV infection occurred primarily in the second semester of the year. Since the DR instituted a vigilant approach to dengue infections, there have been three major outbreaks detected: one in 1998, one in 2000, and one in 2002. DF is the clinical presentation most currently seen at clinics, accounting for about 75% of cases, while patients with DHF account for about 19% of cases seen. Currently, there are seven provinces in which the total number of dengue cases per 100,000 inhabitants is higher than 32. With a vigilant approach, the DR should continue to see success in controlling the DENV outbreak.

DNA, Viral↗
PubMed1984

Monocyte suppression of antigen-specific lymphocyte responses in diffuse cutaneous leishmaniasis patients from the Dominican Republic.

Patients from the Dominican Republic with diffuse cutaneous leishmaniasis showed in vivo and in vitro anergy to leishmanial antigen. Relatives of these DCL patients living in the same endemic area frequently showed skin test and lymphocyte reactivity to leishmanial antigens. This further supports the concept of specific anergy in patients with diffuse cutaneous leishmaniasis. Adherent suppressor cells modulate the antigen-specific lymphocyte proliferative response. Suppressor cells could also be isolated by Percoll gradient centrifugation. Co-culturing of lymphocytes and monocytes from HLA-identical leishmanin responders and nonresponders also identified the suppressor cell as a monocyte. In one patient, this suppression disappeared when clinical cure had been accomplished.

Adolescent↗
PubMedDate not supplied

Midwifery curriculum for auxiliary maternity nurses: a case study in the Dominican Republic.

Although most deliveries in the Dominican Republic occur within hospitals, maternal mortality in that nation remains high. In nonteaching hospitals, almost all of the vaginal births are attended by maternity auxiliary nurses. This article reports on a series of educational conferences for maternity auxiliary nurses in 1 hospital that were developed in response to the maternal mortality rate there. These conferences, taught by a team of midwives from the continental United States and Puerto Rico, used a midwifery curriculum with a participatory action methodology. The educational initiative has developed into a nongovernmental organization named Proyecto ADAMES to build capacity among auxiliary nurses. A qualitative evaluation of the effectiveness of Proyecto ADAMES in improving the knowledge, skills, and attitudes of the auxiliary nurses revealed positive behavioral changes despite weak documentation of their newly acquired knowledge and skills. Findings suggest that midwifery education for auxiliary maternity nurses in the Dominican Republic may contribute to maternal mortality reduction.

Attitude of Health Personnel↗
PubMed1982

International migration in the Dominican Republic: implications for development planning.

"The Dominican Republic represents a microcosm of all the major migration patterns: substantial emigration and immigration, sizeable return migration, and persistent internal rural-urban migration. The impacts of these various types of migration are related and have a significant influence on the development process. This study analyzes the causes of these migrations as well as the costs and benefits in terms of the individual migrants and the country as a whole. Finally, it investigates the implications of migration for development planning in the Dominican Republic." The authors conclude "that the migration issue is not an area distinct from the various development focuses, but rather cuts across and is related to many of the program areas in which the government is involved."

Americas↗
PubMed1991

AIDS heterosexual predominance in the Dominican Republic.

AIDS surveillance data from the Dominican Republic are described for 1983-89. A positive serologic test for HIV was required, and standard clinical criteria were used for defining AIDS. There were 1,202 AIDS cases (820 men, 372 women, 10 of unknown gender) reported to the Ministry of Health, for a cumulative case rate of 17 per 100,000 persons. Rapid growth of the epidemic is noted, with 43% of the total cases reported in 1989. Heterosexual exposure accounts for 53% (593) of all cases, with a male-to-female ratio of 2.2:1, resembling a World Health Organization Pattern I/II country. Prevalence is highest in and surrounding the urbanized tourist areas of Santo Domingo and Puerto Plata and in districts with a high concentration of sugar plantation barracks, where laborers from Haiti and the Dominican Republic work and live. The distribution of AIDS cases is described by transmission exposure category, age, sex, year of diagnosis, and district. The National AIDS Surveillance Program can be improved by validation of exposure transmission categories through selected case investigation and by better reporting through training of health care providers. Surveillance data will assist in targeting future public health efforts to regions and persons at highest risk.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Misoprostol and declining abortion-related morbidity in Santo Domingo, Dominican Republic: a temporal association.

OBJECTIVE: To validate anecdotal reports that abortion-related complications decreased in the Dominican Republic after the introduction of misoprostol into the country. DESIGN: Retrospective records reviews and cross-sectional surveys, interviews and focus groups. SETTING: Family planning clinics, pharmacies, door-to-door canvassing and a tertiary care maternity hospital in Santo Domingo, Dominican Republic. POPULATION: Women of reproductive age in Santo Domingo, Dominican Republic. METHODS: Qualitative and quantitative methods were used. Individual interviews and focus groups of reproductive health professionals, non-governmental organisation leaders and women's group leaders (n= 50) were conducted to discover the role of misoprostol in the Dominican Republic. Local women (n= 157) were surveyed to determine their knowledge of misoprostol as an abortifacient and mystery client visits were made to 80 pharmacies in order to purchase misoprostol without a prescription. Sales data were obtained that documented when misoprostol was introduced to the Dominican Republic pharmacies. Hospital admissions for abortions from the prior eight years were reviewed and hospital emergency room consultation ledgers of 31,190 visits for the period 1994-2001 were reviewed for abortion complications. MAIN OUTCOME MEASURES: Frequencies of maternal morbidities and knowledge of misoprostol. RESULTS: Mystery clients purchased misoprostol without a prescription in nearly 64% of pharmacies; staff provided little additional information or counselling. Reliable sales data documented the introduction of misoprostol in 1986. Abortion complications decreased from 11.7% of abortions in 1986 to 1.7% in 2001. The majority of professionals interviewed felt that knowledge of these findings should be made public. CONCLUSIONS: The data were of too poor quality to validate the verbal reports reliably, but misoprostol appears to have been widely used over a period when abortion-related morbidity fell. It remains plausible that the use of misoprostol contributed to the reduction.

Abortifacient Agents, Nonsteroidal↗
PubMed2001

Update: Outbreak of poliomyelitis--Dominican Republic and Haiti, 2000-2001.

From July 12, 2000, through September 18, 2001, a total of 21 cases of poliomyelitis (including two fatal cases) were reported from the Caribbean island of Hispaniola, divided between Haiti and the Dominican Republic. In the Dominican Republic, 13 of 168 reported cases of acute flaccid paralysis (AFP) were confirmed as polio by isolation of poliovirus type 1 from either patients or their healthy contacts. The median age of the patients was 3 years (range: 9 months-14 years). None was vaccinated adequately. The most recent confirmed case-patient in the Dominican Republic had paralysis onset on January 25, 2001. In Haiti, eight of 40 AFP cases were confirmed virologically; seven of the confirmed cases occurred during January-July 2001. The median age of the patients was 7 years (range: 2-12 years). One patient had received at least 3 doses of oral poliovirus vaccine (OPV). The most recent confirmed case occurred in Haiti and the patient had paralysis onset on July 12, 2001. Eighteen AFP cases from the Dominican Republic and three from Haiti are pending final classification.

Adolescent↗
PubMed2005

Comparison of prevalence of chronic atrophic gastritis in Japan, China, Tanzania, and the Dominican Republic.

PURPOSE: To compare the prevalence of chronic atrophic gastritis (CAG) in Japan, China, Tanzania, and the Dominican Republic and to assess the usefulness of Helicobacter pylori infection and serum gastrin level as markers of CAG. METHODS: The subjects were volunteers from local communities in Japan (n=859), China (n=1741), Tanzania (n=573), and the Dominican Republic (n=1215). Each individual underwent a health checkup and blood sampling for measurement of serum pepsinogen I and II, pepsinogen I /II ratio, serum gastrin, and H. pylori antibodies, and responded to a questionnaire on upper digestive tract diseases. RESULTS: The prevalences of H. pylori infection (23.5-96.1%), CAG (5.6-60.4%), and serum gastrin (62.0-136.5 pg/ml) varied by age, sex, and country. Serum gastrin level for men differed in each country according to age. In Tanzanian men, the median gastrin level (101.0 pg/ml) was the highest in the 40 to 49 years age group (p < 0.01) while there was no significant difference among different age groups in Tanzanian women. Serum gastrin level in subjects > or = 70 years was higher than in other age groups in both sexes in the Dominican Republic (males, 92.5, females, 136.5 pg/ml). The prevalence of H. pylori infection increased (p < 0.01) with advancing age in Japan (only for women) and the Dominican Republic but was high in all age groups of both sexes in China and Tanzania. The prevalence of CAG increased (p < 0.01) with age in both sexes in Japan, China (women only), and the Dominican Republic, but not in Tanzania. The odds ratio of CAG in H. pylori infected subjects was 5.3 times that in H. pylori-negative subjects. The odds ratio of CAG increased by 0.6%/1 pg/ml increase in serum gastrin. CONCLUSIONS: Our results indicated that H. pylori infection, serum gastrin, and advancing age are good markers of CAG and that the prevalence of CAG is the highest in Japan.

Adult↗
PubMed1998

Migration, ethnicity and environment: HIV risk factors for women on the sugar cane plantations of the Dominican Republic.

OBJECTIVE: To determine risk factors for HIV infection among women living in the sugar cane plantation communities (bateyes) of a large private sugar cane company in the Dominican Republic. DESIGN: Cross-sectional study of sexually active female volunteers living in the bateyes. METHODS: Of 98 bateyes, 23 were randomly selected and visited by a mobile medical unit, to interview, examine and test volunteers for seroreactivity to HIV and syphilis. RESULTS: The 490 subjects ranged in age from 16 to 72 years (median, 37 years); 53% were born in Haiti, 36% in Dominican Republic bateyes, and 12% elsewhere in the Dominican Republic; 58% had no formal education; and 87% had no income. HIV seropositivity was found in 28 women (5.7%), including 8.8% of those aged < 35 years. By logistic regression analysis, HIV infection was independently associated with age < 35 years [odds ratio (OR), 4.5; P < 0.01), being single with children (OR, 4.3; P < 0.01), more than one lifetime sex partners (OR, 3.4; P = 0.06), engaging in sex during menses (OR, 3.2; P = 0.02), and self-description as a prostitute (OR, 4.4; P = 0.05)1. For Haitian women, those coming to the Dominican Republic alone were more likely to have HIV infection than those coming with a male partner. Less than 4% of women reported condom use at last intercourse. CONCLUSIONS: Women in the bateyes have a much higher rate of HIV infection than that estimated for women in the general population of Dominican Republic and a rate comparable to that of female sex workers in the Dominican Republic. AIDS prevention in the bateyes should address condom education and distribution as well as employment opportunities and education for women.

Adolescent↗
PubMed1999

Political analysis of health reform in the Dominican Republic.

This article examines the major political challenges associated with the adoption of health reform proposals, through the experience of one country, the Dominican Republic. The article briefly presents the problems of the health sector in the Dominican Republic, and the health reform efforts that were initiated in 1995. The PolicyMaker method of applied political analysis is described, and the results of its application in the Dominican Republic are presented, including analysis of the policy content of the health reform, and assessment of five key groups of players (public sector, private sector, unions, political parties, and other non-governmental organizations). The PolicyMaker exercise was conducted in collaboration with the national Office of Technical Coordination (OCT) for health reform, and produced a set of 11 political strategies to promote the health reform effort in the Dominican Republic. These strategies were partially implemented by the OCT, but were insufficient to overcome political obstacles to the reform by late 1997. The conclusion presents six factors that affect the pace and political feasibility of health reform proposals, with examples from the case of the Dominican Republic.

Developing Countries↗
PubMed2004

Nucleotide sequence and phylogenetic analyses of dengue type 2 virus isolated in the Dominican Republic.

Dengue virus infection has been recognized as an important public health problem in the Dominican Republic in the last decade. Complete genomic sequences of three strains of dengue type 2 (DEN-2) virus, DR23/01 and DR31/01 isolated from dengue fever (DF) patients, and DR59/01 isolated from a dengue hemorrhagic fever (DHF) patient, all with primary infection, in the Dominican Republic in 2001, have been established. This achievement constitutes the first genomic characterization of DEN-2 strains from the Dominican Republic. No amino acid differences were observed between the strains isolated from DHF and DF patients. They exhibited extensive homology with the strain from La Martinique, French West Indies. Although phylogenetic analysis was suggestive of their Southeast Asiatic origin, Dominican Republic strains and other Caribbean strains from La Martinique and Jamaica showed 26 amino acid changes that differed from both the Southeast Asia and native American genotypes.

Base Sequence↗
PubMed2004

Genetic background of people in the Dominican Republic with or without obese type 2 diabetes revealed by mitochondrial DNA polymorphism.

People in the Dominican Republic are considered to be genetically heterogeneous owing to the post-Colombian admixture of Native American, African, and European populations. To characterize their genetic background, nucleotide sequences of the D-loop region of human mitochondrial DNA (mtDNA) were examined in 33 healthy women and 50 gender-matched patients with obese type 2 diabetes (OD) from the Dominican Republic. Phylogenetic analysis of 198 mtDNA lineages including Native Americans, Africans, and Europeans enabled us to assess relative genetic contributions of the three ancestral fractions to the two groups in the Dominican Republic. In the OD group, the majority (64.0%) of the mtDNA lineages were from African ancestry, whereas the Native American fraction was predominant (51.5%) in the healthy group, with both showing smallest amounts (14.0% and 9.1%, respectively) of European contribution. This difference in maternal genetic background between the two groups was similarly demonstrated by phylogenetic analysis at the population level based on net nucleotide diversities between populations. These findings may imply ethnic-specific predisposition to OD, a possible association of an unidentified factor from African ancestry with OD in the Dominican Republic population.

Adult↗
PubMed1998

Drug-resistant tuberculosis in the Dominican Republic: results of a nationwide survey.

SETTING: The Dominican Republic. OBJECTIVE: To assess the extent of drug-resistant tuberculosis (TB) following the guidelines of the World Health Organization (WHO)/International Union Against Tuberculosis and Lung Disease (IUATLD) new global surveillance project on drug resistance in TB. METHODS: Using a multi-step proportional weighted approach, a sample of 688 sequential cases of smear positive pulmonary TB diagnosed between April 1994 and April 1995 was studied in six of the country's eight health regions. Pre-treatment sputum samples were cultured on Loewenstein-Jensen medium and drug susceptibility tests were performed using the economic variant of the proportion method. RESULTS: Of 420 cases with drug susceptibility results, resistance to one or more drugs was observed in 43.8%; resistance was found in 52.1% of 117 TB cases with a history of previous antituberculosis treatment and in 40.6% of 303 new TB cases. In five of the six health regions surveyed, > or = 41% of strains were resistant to one or more drugs. Multidrug resistance (MDR) to isoniazid and rifampicin with or without resistance to other drugs was found in 43 (10.2%) of 420 cases, including 6.6% of new TB cases. In five of the six health regions > or = 8% of strains were classified as MDR. Independent predictors of MDR-TB included being in the age group 25 to 44 years (odds ratio [OR] = 4.2, 95% confidence interval [Cl] 1.5, 11.6; P = 0.005), being aged 45 years and over (OR = 4.5, 95% CI 1.4, 14.4; P = 0.009), and having a prior history of TB (OR = 3.7, 95% CI 1.9, 7.4; P = 0.0001). CONCLUSION: The proportion of Mycobacterium tuberculosis strains resistant to one or more anti-TB drugs in the Dominican Republic is among the highest observed world-wide. The severity of the problem urgently requires the full implementation of TB control strategies endorsed by the WHO and the IUATID, which include political commitment to a National TB Program, case detection utilizing sputum-smear microscopy, directly observed treatment, regular drug supply, and standardised recording and reporting systems. Also, the sale of TB drugs in the private market should be controlled.

Adult↗