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- Zelaya Blandon, Elmer
(författare)
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Adolescent pregnancies in Nicaragua. The importance of education
- 1999
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Early adolescent pregnancy implies increased social and medical risks. There is lack of understanding of the mechanisms behind early sexual debut and pregnancy. This contributes to the difficulties to meet the educational and health care needs of adolescents. In Nicaragua, few reproductive health interventions target adolescents and even fewer studies focus on sexual and reproductive health in this age group. Therefore, the aim of this thesis is to analyze the background of adolescent pregnancy in Nicaragua, for future interventions.Focus group discussions and in-depth interviews were carried out with young and adult women and men from different social backgrounds in the city of León. Results were used in the planning of a cross-sectional household study carried out in 1993, covering a population of 43,765 in 50 randomly selected clusters in rural and urban León. Reproductive histories were obtained from all women aged 15 to 49 years (n= 10,867), corresponding to 176281 person years of reproductive life. Random sub-samples of men (n=388) and women (n=413) were interviewed in privacy about their age at sexual debut, contraceptive use and reproductive history. The background to early adolescent pregnancy was further analyzed in a matched case-referent study of girls who got their first pregnancy before 17 years of age (146 cases, 242 randomly selected age-matched referents).Economic deprivation and disturbed family relations with an unsatisfied craving for parental affection influence adolescent sexual behavior. Girls' romanticism, belief in virginity until marriage and the contrasting male machismo culture contribute to a lack of empowerment of adolescents.At 15 years of age, 25% of boys and girls had had their sexual debut, and at 18 years this was the case for 85% of boys and 53% of girls. Among girls, the latency period from sexual debut to the end of first pregnancy was only 22 months, indicating very limited access to contraceptive counseling and services. At 17 years of age, one fourth had become pregnant. Contraceptive use was 54% among sexually active adolescents, aged 15-19 years, pills being the most common method. Among adults, female sterilization was the most common method, followed by Intra Uterine Device (IUD) and pilL Condom use was low as well as the use of traditional methods. Low educational attainment was a strong determinant for lack of contraception.Age at sexual debut and age at first pregnancy had been increasing, and fertility rate had declined in Nicaragua from the 1970s to the 1990s. The increase in women’s education was found to be the strongest explanatory factor behind this transition in fertility. Girls who had successfully completed at least 5 years of schooling had lower risk for early pregnancy. This protective effect of education was found for groups with high as well as low socioeconomic status.The background of adolescent pregnancy consists of a complex interaction of socioeconomic, familial and cultural factors. Lack of political will to challenge current values, religious influence in sexual and educational issues, romanticism and lack of empowerment, especially among adolescent women, are also influencing elements. Contraceptive use is still low among sexually active teenagers in Nicaragua, and pregnancy follows soon after first intercourse. There is a strong need for family life education at schools and health services geared to adolescents. Non-use of contraception is associated with poverty and lack of education. The association between education and fertility decline, and the protective effect of education in preventing early pregnancies, even among poor families, indicates that education is a powerful tool in breaking the vicious cycles of poverty and early pregnancy.
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- Elming, SA, et al.
(författare)
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Results of magnetotelluric and gravimetric measurements in western Nicaragua, central America
- 1997
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Ingår i: GEOPHYSICAL JOURNAL INTERNATIONAL. - : BLACKWELL SCIENCE LTD. - 0956-540X. ; 128:3, s. 647-658
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Magnetotelluric and gravity data have been collected within a ca. 170 km long traverse running from the Pacific coast of Nicaragua in the west to the Nicaraguan Highland in the east. This part of Nicaragua is characterized by sedimentary rocks of the Paci
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- Cáceres, Mercedes
(författare)
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Ecological aspects of antimicrobial susceptibility of anaerobic bacteria in Nicaragua
- 1999
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Anaerobic bacteria are the predominant constituents of the normal flora on the skin and the mucous membranes of the human body. They may also act as potent pathogens in a variety of endogenous infections. Antimicrobial resistance is an increasing problem with anaerobic and aerobic bacteria. Different mechanisms for such resistance are known. However, [beta]-lactamase production is the most common mechanism of resistance. Emergence of resistant organisms in the normal flora during the administration of antimicrobial agents has a tremendous impact on the selection of antimicrobial agents for empirical therapy and is an important factor in the dissemination of resistant organisms to other patients. Anaerobic infections are common and frequently associated with severe morbidity and mortality, so empirical therapy has to be instituted as early as possible because of delays in obtaining the results of culture and susceptibility studies. The appropriate therapy should be based on local susceptibility patterns, as the prevalence of microorganisms causing infections and the antimicrobial susceptibility patterns may vary within geographic regions and even within hospitals. The aims of this thesis are to determine the antimicrobial susceptibility patterns and [beta]-lactamase production of anaerobic bacteria from the oral and gastrointestinal microflora of (i) hospitalized antimicrobial treated adults from Nicaragua and Sweden; (ii) antimicrobial treated and healthy Nicaraguan children under 2 years of age; (iii) aerobic and anaerobic bacteria isolated from Nicaraguan patients with mixed infections; and (iv) to estimate the class-specific antibody response against Bacteroides fragilis antigens in Nicaraguan and Swedish patients with intraabdominal infections; and (v) to determine the prevalence of enterotoxigenic B. fragilis in children with and without diarrhea in order to provide the physicians with data generated in Nicaragua to facilitate the selection of antimicrobial therapy. Bacteroides, Clostridium and Fusobacterium species resistant to at least one of the following antimicrobials: ampicillin, benzylpenicillin, piperacillin, cephalotin, cefoxitin and clindamycin, were isolated from the oral and gastrointestinal microflora of all antimicrobial treated adults included in this study. The percentage of resistant strains isolated from the Nicaraguan patients was higher than that found in the Swedish patients. Bacteroides strains resistant to ampicillin or cefoxitin were also isolated from the gastrointestinal normal flora of the children. The percentage of resistance increased with the age of the children (I month to 2 years of age). The resistant strains were mainly isolated from antimicrobial treated children. No resistance to cefoxitin was observed in the strains isolated from the healthy children until they were 18 months of age. The antimicrobial susceptibility pattern of anaerobic and aerobic bacteria isolated from 219 Nicaraguan patients with different infectious diseases was determined against the most common antimicrobial agents used in Nicaragua. The B. fragilis group were the most commonly isolated anaerobes and the most resistant to ampicillin, cefoxitin, and clindamycin. Only five B. fragilis group strains were resistant to metronidazole. Fusobacterium strains resistant to ampicillin and cefoxitin were also isolated. However, no resistance to imipenem and chloramphenicol was found in these anaerobes. Clostridium, Peptostreptococcus, Propionibacterium and non-spore forming Gram-positive rods were sensitive to all the antimicrobial agents tested. Mixed infections were found in 66% of the patients, mainly from intraabdominal infections. Together with B. fragilis group strains, Escherichia coli strains were the most common bacterial association. Ampicillin, benzylpenicillin, cefoxitin and chloramphenicol were the antimicrobial agents less active against the E. coli, P. aeruginosa and Klebsiella strains. Gentamicin, one of the most important antimicrobial agents used, showed good activity. No more than 18% of the aerobic strains were resistant. Methicillin resistant Staphylococcus aureus was also common. No vancomycin resistance was found. Enterotoxigenic B. fragilis strains were isolated only from children with diarrhea (8.4%) and mainly when they were less than 2 years of age. All strains were resistant to ampicillin and one strain was also resistant to clindamycin. The strongest [beta]-lactamase producers among the anaerobic bacteria isolated from normal flora and from infected sites were Bacteroides species followed by Fusobacterium species. Almost all the Gram-negative aerobic strains and S. aureus strains were [beta]-lactamase producers. A [beta]-lactamase from B. distasonis strains S:10:7 isolated from the saliva of a Nicaraguan patient was purified and characterized. The enzyme had a broad substrate profile, capable of hydrolyzing benzylpenicillin, ampicillin, piperacillin and cephalotin. No capacity to hydrolyze the [beta]-lactamase stable compounds cefoxitin and imipenem was observed. However, the B. distasonis strain S: 10:7 was resistant to cefoxitin. The enzyme was inhibited by clavulanic acid, sulbactam and tazobactam. The isoelectric point was 4.6 and the molecular weight 160,000 Daltons. Elevated IgG titers were mainly seen against the B. fragilis capsular polysaccharide (CPS) antigens in both groups of patients with intraabdominal infections, compared with the titers observed against lipopolysaccharide (LPS) antigens. However, when the titers in Swedish and Nicaraguan IgG patients were compared, the Swedish titers were higher than the Nicaraguan titers. Patients with intraabdominal abscess and perforated appendicitis had the highest antibody responses against the B. fragilis CPS. In conclusion, the results of the present investigation show a high level of resistance and B-lactamase production in Gram-negative anaerobic bacteria. This may be a reflection of the extensive antibiotic use in Nicaragua. In spite of these patterns, we can positively state that therapeutic alternatives are still available for the treatment of anaerobic bacterial infections because of the good results achieved by metronidazole, imipenem and chloramphenicol; less active, but still useful, were cefoxitin and clindamycin.
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- Erikson, R, et al.
(författare)
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Optimal conditions for primary production in a polymictic tropical lake (Lake Xolotlan, Nicaragua)
- 1998
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Ingår i: HYDROBIOLOGIA. - : KLUWER ACADEMIC PUBL. - 0018-8158. ; 382, s. 1-16
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- From 1987 to 1993 we assessed the variation of phytoplankton biomass, underwater irradiance and primary production in Lake Xolotlan (L. Managua, Nicaragua). Chlorophyll-a averaged 65 mg m(-3) and maximum and minimum concentrations were 120 and 30 mg m(-3)
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- Elming, Sten-åke, et al.
(författare)
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Results of magnetotelluric and gravimetric measurements in western Nicaragua, central America
- 1997
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Ingår i: Geophysical Journal International. - 0956-540X .- 1365-246X. ; 128:3, s. 647-658
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Tidskriftsartikel (refereegranskat)abstract
- Studies a ca. 170 km long traverse running from the Pacific coast of Nicaragua in the west to the Nicaraguan Highland in the east. This part of Nicaragua is characterized by sedimentary rocks of the Pacific Coastal Plain, separated from the Tertiary volcanic rocks of the Highland by the NW-SE-trending Nicaraguan Depression. The purpose of this study is to provide electric conductivity and density constraints on geological crustal structures along the transect. This may then serve as a base for the understanding of the tectonic evolution of this part of Central America. Questions to be answered are: (1) is the Pacific coastal province an accreted terrane? (2) What is the character of the depression? Is this a hidden contact between an accreted terrane and the continental Chortis block? (3) If so, is there a different physical signature for the crust of the Pacific province compared to that of the Highlands?
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