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At least 19 recordsLinked to original sources
PubMed2006

Developing a neurology training program in Honduras: a joint project of neurologists in Honduras and the World Federation of Neurology.

One of the major barriers to the provision of quality care for patients with neurological disorders in developing countries is a low ratio of neurologists per inhabitants, the World Health Organization recommends one neurologist per 100,000. In 1998 Honduras had one neurologist per 325,000 inhabitants and all the neurologists were trained outside the country. The Education Committee of the World Federation of Neurology (WFN), in collaboration with the Postgraduate Direction of the National Autonomous University of Honduras, the Honduran Neurological Association, and the Honduran Secretary of Health helped establish the country's first Neurology Training Program in 1998. This program was established using a problem- and epidemiological-oriented methodology with oversight by an external WFN review board. By 2006 the program has resulted in a 31% increase in the national neurologist ratio per inhabitant, significantly improved the quality of patient care and promoted research in the neurosciences. The Honduras Neurology Training Program has provided a valuable model for other developing countries with similar needs for neurological care. Based on this Honduras experience, members of the Education Committee of the WFN have established guidelines for neurology training programs in developing countries.

Curriculum↗
PubMed2004

Surveillance for enteric parasites among U.S. military personnel and civilian staff on Joint Task Force Base-Bravo in Soto Cano, Honduras and the local population in Comayagua and La Paz, Honduras.

A study was conducted in Honduras to address whether military personnel assigned to Joint Task Force-Bravo in Soto Cano, Honduras, routinely acquire parasite infections, and the results were compared with those collected from civilian base workers and the general local population in the nearby towns of Comayagua and La Paz. Results from this study report 21 species of enteric parasites among Hondurans living in Comayagua and La Paz, 13 species among local Hondurans working as base civilian personnel, and 3 species among U.S. military servicemen and women. The most prevalent organism found was Blastocystis hominis, infecting 95 people (35.8% of 265 samples). Prevalence rates in this study are similar to documented reports on parasite transmission in Central American countries and other areas of Honduras. Although preventive protocols for U.S. military "force protection" appear to be effective in controlling transmission, continuous surveillance for enteric parasites is warranted because of the high parasite loads in the populations with which military personnel come into contact.

Honduras↗
PubMed1995

Geographical clustering of human T-cell lymphotropic virus type 1 infection in Honduras.

Geographical clustering of human T-cell lymphotropic virus type 1 (HTLV-1) infection has been identified in the nonmestizo communities in several cities along the Atlantic coast of Honduras. Of the 2,651 serum samples tested, 122 samples were repeatedly reactive for HTLV-1 antibodies in two different enzyme immunoassays and 3 were indeterminate. These sera did not react in the HTLV-2-specific antibody tests. The presence of HTLV-1 antibodies was confirmed by HTLV-1 immunoblots or Western blots (immunoblots), and the infection was verified by the detection of HTLV-1-specific genetic sequences in the cellular DNA by PCR. Genomic DNA from the peripheral blood mononuclear cells was first tested with generic primers and probes that identified both HTLV-1 and HTLV-2. Next, all DNA samples that showed HTLV reactivity were tested by PCR with specific primers and probes that distinguished HTLV-1 sequences from those of HTLV-2. Our results indicate that only HTLV-1 infection was present in the blood of both mestizo and nonmestizo residents of 15 cities in the Republic of Honduras. The overall prevalence of HTLV-1 infection in the nonmestizo population was 8.1% (95% confidence limit, 6.6 to 9.7%). The mestizo population residing in the same geographical vicinities showed a HTLV-1 antibodies in 0.5% of serum samples tested (95% confidence limit, 0.6 to 1.7%), indicating a significantly greater prevalence of HTLV-1 infection in the nonmestizo population than in the mestizo ethnic groups living in Honduras (P = 0.0001). Since no HTLV-2 antibody reactivity or HTLV-2-specific genetic sequences were detected by PCR with different primers and probes, it was concluded that HTLV-2 infection was not present in the Honduran population groups we tested. Our study also suggested an endemic nature for this virus because there was no difference in the prevalence rate of HTLV-1 antibodies in the nonmestizo community living in the coastal towns of Honduras between 1989 and 1993. This is the first report of HTLV-1 cluster identification in Honduras, Central America.

Adolescent↗
PubMed2004

The herpetofauna of the cloud forests of Honduras.

The cloud forest amphibians and reptiles constitute the most important herpetofaunal segment in Honduras, due to the prevalence of endemic and Nuclear Middle American-restricted species. This segment, however, is subject to severe environmental threats due to the actions of humans. Of the 334 species of amphibians and reptiles currently known from Honduras, 122 are known to be distributed in cloud forest habitats. Cloud forest habitats are found throughout the mountainous interior of Honduras. They are subject to a Highland Wet climate, which features annual precipitation of >1500 mm and a mean annual temperature of <18 degrees C. Cloud forest vegetation falls into two Holdridge formations, the Lower Montane Wet Forest and Lower Montane Moist Forest. The Lower Montane Wet Forest formation generally occurs at elevations in excess of 1500 m, although it may occur as low as 1300+ m at some localities. The Lower Montane Moist Forest formation generally occurs at 1700+ m elevation. Of the 122 cloud forest species, 18 are salamanders, 38 are anurans, 27 are lizards, and 39 are snakes. Ninety-eight of these 122 species are distributed in the Lower Montane Wet Forest formation and 45 in the Lower Montane Moist Forest formation. Twenty species are distributed in both formations. The cloud forest species are distributed among restricted, widespread, and peripheral distributional categories. The restricted species range as a group in elevation from 1340 to 2700 m, the species that are widespread in at least one of the two cloud forest formations range as a group from sea level to 2744 m, and the peripheral species range as a group from sea level to 1980 m. The 122 cloud forest species exemplify ten broad distributional patterns ranging from species whose northern and southern range termini are in the United States (or Canada) and South America, respectively, to those species that are endemic to Honduras. The largest segment of the herpetofauna falls into the endemic category, with the next largest segment being restricted in distribution to Nuclear Middle America, but not endemic to Honduras. Cloud forest species are distributed among eight ecophysiographic areas, with the largest number being found in the Northwestern Highlands, followed by the North-Central Highlands and the Southwestern Highlands. The greatest significance of the Honduran herpetofauna lies in its 125 species that are either Honduran endemics or otherwise Nuclear Middle American-restricted species, of which 83 are distributed in the country's cloud forests. This segment of the herpetofauna is seriously endangered as a consequence of exponentially increasing habitat destruction resulting from deforestation, even given the existence of several biotic reserves established in cloud forest. Other, less clearly evident environmental factors also appear to be implicated. As a consequence, slightly over half of these 83 species (50.6%) have populations that are in decline or that have disappeared from Honduran cloud forests. These species possess biological, conservational, and economic significance, all of which appear in danger of being lost.

Journal Article↗
PubMed2001

Honduras: Caribbean Coast.

The coast of Honduras, Central America, represents the southern end of the Mesoamerican Barrier Reef System, although its marine resources are less extensive and studied than nearby Belize and Mexico. However, the coastal zone contains mainland reef formations, mangroves, wetlands, seagrass beds and extensive fringing reefs around its offshore islands, and has a key role in the economy of the country. Like most tropical areas, this complex of benthic habitats experiences limited annual variation in climatic and oceanographic conditions but seasonal and occasional conditions, particularly coral bleaching and hurricanes, are important influences. The effects of stochastic factors on the country's coral reefs were clearly demonstrated during 1998 when Honduras experienced a major hurricane and bleaching event. Any natural or anthropogenic impacts on reef health will inevitably affect other countries in Latin America, and vice versa, since the marine resources are linked via currents and the functioning of the system transcends political boundaries. Much further work on, for example, movement of larvae and transfer of pollutants is required to delineate the full extent of these links. Anthropogenic impacts, largely driven by the increasing population and proportion of people living in coastal areas, are numerous and include key factors such as agricultural run-off, over-fishing, urban and industrial pollution (particularly sewage) and infrastructure development. Many of these threats act synergistically and, for example, poor watershed management via shifting cultivation, increases sedimentation and pesticide run-off onto coral reefs, which increases stress to corals already affected by decreasing water quality and coral bleaching. Threats from agriculture and fishing are particularly significant because of the size of both industries. The desire to generate urgently required revenue within Honduras has also led to increased tourism which provides an overarching stress to marine resources since most tourists spend time in the coastal zone. Hence the last decade has seen a dramatic increase in coastal development, a greater requirement for sewage treatment and more demand for freshwater, particularly in the Bay Islands. Although coastal zone management is relatively recent in Honduras, it is gaining momentum from both large-scale initiatives, such as the Ministry of Tourism's 'Bay Islands Environmental Management Project', and national and international NGO projects. For example, a series of marine protected areas and legislative regulations have been established, but management capacity, enforcement and monitoring are limited by funding, expertise and training. Existing and future initiatives, supported by increased political will and environmental awareness of stakeholders, are vital for the long-term economic development of the country.

Animals↗
PubMed2002

Country response to HIV/AIDS: national health accounts on HIV/AIDS in Brazil, Guatemala, Honduras, Mexico and Uruguay.

National expenditures on HIV/AIDS were estimated as summary indicators to assess the country's response to HIV/AIDS. The methodology is based on a matrix system describing the level and flow of health expenditures on HIV/AIDS: an adaptation of the National Health Accounts methods. The expenditures were classified by source (public, private, international), by the use of funds (prevention, care), by object, and by type of provider institution. The results are reported in US dollars using the official exchange rate for the year of estimation. For international comparisons monetary units were adjusted by the purchasing power parity (US dollars PPP). National HIV/AIDS total expenditures were: Guatemala US dollars PPP29.5 million, Uruguay US dollars PPP 32.5 million, Mexico US dollars PPP 257 million, and Brazil US dollars PPP 587.4 million during 1998, and Honduras US dollars PPP 33.9 million for 1999. The total HIV/AIDS expenditures per capita for 1998 were: Brazil US dollars 2.69, Mexico US dollars 1.25, Guatemala US dollars 1.08, Uruguay US dollars 6.63, and Honduras US dollars 3.6 for 1999. The 1998 distribution of the total HIV/AIDS expenditures in prevention and care were, respectively, Brazil 10 and 80%, Guatemala 15 and 70%, Mexico 29 and 66%, Uruguay 36 and 51%, and Honduras 28 and 65% for 1999. The share of total expenditures on antiretroviral drugs ranged from 52% in Guatemala to 75% in Brazil, even when the estimated coverage of antiretroviral therapy was close to 10% in Guatemala and universal in Brazil. The estimated flow from international sources per capita in 1998 was Uruguay US dollars 0.03, Brazil US dollars 0.24, Guatemala US dollars 0.11, Mexico US dollars 0.01, and Honduras US dollars 1.04 in 1999. The data allow international comparisons and provide critical information to improve equity and efficiency in the allocation of scarce resources. The National HIV/AIDS Accounts also constitute a powerful tool to describe the country's response to HIV/AIDS.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Financing health care at the local level: the community drug funds of Honduras.

In response to UNICEF's Bamako Initiative, hundreds of privately run Community Drug Funds were established in Honduras during the 1990s, generally under the auspices of a non-government organization and usually with the financial assistance of international agencies. Honduras' Community Drug Funds (CDF) are rotating drug funds intended to: (1) serve as a means of increasing access to care in isolated rural populations, (2) promote the more rational use of medicines and (3) promote community participation in the financing and oversight of primary health care activities. This study is the first to analyse empirically the impact and efficiency of these institutions, relying upon primary data obtained from a survey of 51 of the 450 active CDFs in Honduras. Archival data from Ministry of Health and other sources were also analysed. The structure, operations, and impact of CDFs are detailed, with special attention given to access and quality of care issues. The study found that CDFs are rapidly becoming under-capitalized because of basic management problems, principally in pricing and in medicine purchasing practices. These shortcomings, and more generally, increasing financial pressures on NGO sponsors, are negatively affecting quality and access to care. Given the rate of erosion in CDF assets, unless they are recapitalized, the current average estimated lifespan of a CDF is 5.5 years. If these funds are to be sustainable, changes in their financing, training and supervision will be required. In addressing these issues, Honduran health policy-makers must decide how best to balance the competing goals of holding down costs, while maintaining adequate quality and improving access to care.

Community Participation↗
PubMed1997

Leishmania chagasi: genotypically similar parasites from Honduras cause both visceral and cutaneous leishmaniasis in humans.

In the Mediterranean region Leishmania infantum causes both visceral and cutaneous leishmaniasis. These two pathologies tend to be caused by distinct parasite zymodemes. We have studied 33 isolates of Leishmania, 2 from sandflies, 5 from visceral cases, and 26 from cutaneous cases in Honduras, to determine if there is a correlation between pathology and parasite type in the New World similar to that in the Mediterranean region. Nine of the 26 cutaneous cases were caused by L. mexicana parasites, which have not been previously reported from Honduras; the remaining 17 cutaneous cases were due to L. chagasi. Only minor differences were found between the Honduran L. chagasi parasites by random amplified polymorphic DNA, differential display, pulsed-field gel electrophoresis, and schizodemes. This suggests that in Honduras the parasite type may not be the only factor determining the clinical outcome of L. chagasi infections.

Adolescent↗
PubMed2006

Gastric cancer and the high combination prevalence of host cytokine genotypes and Helicobacter pylori in Honduras.

BACKGROUND & AIMS: Inflammatory cytokine polymorphisms are associated with gastric adenocarcinoma in Helicobacter pylori-infected patients in Europe and Asia. We investigated the cytokine profile in the Latino population, specifically Honduras, a high-incidence region, and the use of the combination prevalence of H pylori and genotypes in identifying high-risk populations. METHODS: A population-based case-control study identified 170 incident gastric cancer cases and 162 healthy village controls. Interleukin (IL)-Ibeta-511, IL-1RN, IL-10-1082, and tumor necrosis factor-alpha-308 genotypes were determined. We define the combination prevalence index (CPI) as the product of H pylori and IL-1beta-511T+ genotype prevalence in healthy subjects. Medline identified gastric cancer studies to facilitate country-specific CPI calculations. RESULTS: In healthy, population-based Honduran controls, IL-1beta-511T+ prevalence was 81% (95% confidence interval, 75%-87%; CT, 57%; TT, 25%), which was among the highest reported. IL-10-1082A+ prevalence was 93% (95% confidence interval, 88%-97%), mirroring Asian populations. Seventeen percent were homozygous for both proinflammatory cytokines (TT/AA), with increased risk among cases (odds ratio, 2.6; 95% confidence intervals, 1.0-6.8). Tumor necrosis factor-alpha polymorphisms were nearly absent. Endemic H pylori infection (85%) was confirmed. Importantly, the CPI association with country incidence is highly significant (P = .0057), based on 16 global populations and Honduras. Sensitivity analysis confirms a robust CPI. CONCLUSIONS: The CPI, based on IL-1beta genotypes, has a strong association with country-specific gastric cancer incidence. The CPI correlation supports the chronic inflammation carcinogenesis model, and may explain the geographic variation. We report a novel cytokine profile in Honduras that mirrors Asian populations and explains the high incidence rates. This may have dyspepsia management and screening implications for the growing US Latino population.

Adult↗
PubMed2005

Challenges for traditional birth attendants in northern rural Honduras.

OBJECTIVE: to explore the relationship between community-based parteras, the staff at the Centro Materno Infantil (Mother-Child Centre), and other public health facilities within the district of Morazán in northern rural Honduras during the transition to new models of maternity care. DESIGN: focus-group discussions with two groups composed of a convenience sample of community parteras. After verbatim translation of the interviews, the transcripts were analysed for content. SETTING: the Centro de Salud of Morazán, Yoro Honduras. PARTICIPANTS: 28 community-based parteras and one partero (male community midwife). FINDINGS: five themes emerged from the focus group data: the shared view that attending birth is connected to a religious calling; the desire for additional training; the desire for support from, and connection to, existing public-health services and infrastructure; the role of parteras in providing services to women who otherwise would not receive care; and the lack of new parteras to carry on this work in the future. KEY CONCLUSIONS: traditional birth attendants are still relied upon to serve more than half of the childbearing women in Honduras. The findings from the focus groups provide a foundation upon which to strengthen the relationship between community-based parteras and the government-funded systems of health care during this time of transition to new models of maternity care.

Adult↗
PubMed1998

Seroprevalence of Taenia solium cysticercosis in pigs in a rural community of Honduras.

Several retrospective studies have shown that human Taenia solium cysticercosis is endemic in Honduras, but very few reports of porcine cysticercosis in rural communities have been published. To determine the local prevalence of this disease in pigs, a serological survey has been undertaken in a rural community, Salamá, in the Department of Olancho in central Honduras. Eighty-five families raising pigs in the community were randomly selected and sera were obtained from pigs older than one month of age. The sera were examined by the enzyme-linked immunoelectrotransfer blot assay (EITB). Of 192 porcine sera, 27.1% (52) were positive by the EITB. Seropositivity did not correlate with age and sex by statistical analysis. With respect to the number and the frequency of recognition of the seven diagnostic glycoprotein bands in the EITB, 67.3% of the positive serum specimens recognized only one band and 80.8% of them recognized GP42-39. Since recognition of GP42-39 has been reported as a characteristic of late infection, these results suggest that most of the seropositive pigs were in the late stage of infection (more than 5-8 weeks postinfection). It seems that pigs in this community may be infected with this parasite soon after the birth and be in a hyperendemic steady state. In view of a high prevalence of antibodies to T. solium in pigs or characteristics of the antigen detected by the EITB, the infection pressure of T. solium appears to be very high in this community. This is probably the case in most of the communities in Honduras.

Animals↗
PubMed2000

Injury control in Honduras: a survey of injury mortality.

STUDY OBJECTIVE: We sought to evaluate the methods and accuracy of mortality data collection and summarize the injury mortality rate in one sector of the State of Olancho, Honduras, with the intent to establish a baseline of injury mortality that will identify potential areas of intervention and serve as a comparison after subsequent interventions. METHODS: Mortality data were collected from a rural, regional, health center database containing age, sex, and cause of death for one geographic sector in the State of Olancho, Honduras. Causes of death were classified as medical or intentional versus nonintentional injury. RESULTS: Accurate mortality data were difficult to obtain for several reasons: (1) deaths are often recorded by untrained health care workers, (2) causes of death are not coded in a standard manner, and (3) infant mortality is underreported. We found 132 recorded noninfant deaths. A disproportionate number of these resulted from injury, especially from intentional injury, particularly among male subjects aged 12 to 49 years. Eighty-two percent of male subjects aged 12 to 49 years who died did so from injuries, and 52% died from intentional injuries. Overall, 48% of all male deaths were injury related. The estimated male mortality rate (age 12 to 49 years) from injuries was 4.5 times that of the United States. CONCLUSION: Injury, particularly intentional injury, is an important cause of mortality in rural Honduras, particularly among male subjects aged 12 to 49 years. This suggests a fertile opportunity for intervention. More reliable data collection will be necessary to accurately target which specific causes of injury death are most amenable to interventions and to monitor the effect of injury control programs.

Adolescent↗
PubMed2002

Ministry of Health user fees, equity and decentralization: lessons from Honduras.

Decentralization is commonly championed as a means for achieving equity. To date, however, there has been little discussion of the mechanisms underlying this relationship, and several of the few empirical investigations that have addressed the topic have found the converse; that decentralization has exacerbated inequalities. This article examines the performance and equity in financing of the Honduras Ministry of Health's (MOH) decentralized user fee system. The MOH of Honduras established a national user fee policy in 1989. It provided a framework of rules and regulations and decentralized administration of the system to the regional offices. A survey conducted under the auspices of this study provided detailed information about the structures and operations of MOH user fee systems. The survey revealed that the systems vary markedly by region, creating horizontal inequities, and that they have numerous other shortcomings. The average price of a consultation is low, US dollars 0.16, and revenues have consistently equalled just 2% of MOH expenditures. The systems' administrative costs are equal to 67% of their revenues. Eliminating the user fee systems in all but the national and regional hospitals would actually save money and/or enable the MOH to provide more care. Average consultation prices are highest in health posts, intermediate in centres and lowest in the national hospitals, thereby encouraging the inappropriate use of the MOH's pyramidal referral system and fostering MOH inefficiency. Fee levels and exemption practices are horizontally and vertically inequitable. The likelihood of paying for an ambulatory visit is highest at a health post, 89%, and lowest at a hospital, 49%. Individuals from the poorest one-fifth of households are the most likely to have to pay for care. Honduras' experience demonstrates that a decentralized user fee system is not necessarily equitable, and that, more generally, the gains that can be realized from decentralizing user fee systems are not automatic. They must be anticipated, planned for and cultivated by a well-designed and well-implemented initiative that is not a single, one-time event, but rather a dynamic, on-going enterprise.

Ambulatory Care Facilities↗
PubMed1990

Mortality trends among refugees in Honduras, 1984-1987.

Mortality data collected from 1984 to 1987 through a routine standardized health information system in the five main refugee populations of Honduras were reviewed. The direct standardized mean annual death rate for all refugees was 5.5 per 1000 population (Honduras population as reference; Honduras mortality rate: 10.1 per 1000). Mortality decreased or remained stable among Salvadoran refugees from 1984 to 1987, but increased among Nicaraguan refugees after 1985. The highest neonatal (56.1 per 1000 livebirths), infant (126.1 per 1000 livebirths) and under-five-year-olds (35.7 per 1000 child less than five years of age) mortality rates were observed in the two Nicaraguan camps. These two camps had the highest rate of newly arriving refugees. Deaths in infants and under-five-year-olds accounted for 42 and 54.1% of all deaths respectively. Of all deaths under five years of age, respiratory infections, diarrhoeal diseases and measles accounted for 21.4%, 22.1% and 4.7%, respectively. Mortality rates, particularly among under-five-year-olds and infants increased when the rate of newly arriving refugees was higher. The importance of adapted health surveillance in refugee settlements is discussed.

Adolescent↗