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- Anticona, Cynthia, et al.
(författare)
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Lead exposure among children from native communities of the Peruvian Amazon basin
- 2012
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Ingår i: Revista panamericana de salud pùblica. - 1020-4989 .- 1680-5348. ; 31:4, s. 296-302
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To assess potential risk factors associated with elevated blood lead levels (BLLs) among children in two communities from the Corrientes River basin in the Peruvian Amazon. Methods. Children aged 0-17 years were screened for BLLs, hemoglobin levels, and anthropometric measures. Dwelling, family, and child data were collected through a parental questionnaire. Statistical analysis included descriptive and bivariate analysis. Multiple linear and logistic regressions using generalized estimating equations were also conducted to determine associated risk factors. A map of each community was drawn to examine the spatial distribution of BLLs.Results. Of 208 children (88 from 23 households of the Peruanito community and 120 from 28 households of Santa Isabel), 27.4% had BLLs >= 10 mu g/dL. The geometric mean (+/- standard deviation) BLL was 8.7 +/- 4.0 mu g/dL (range 3.0-26.8 mu g/dL). In the total population, linear regression analysis indicated that age was positively associated with BLLs (P < 0.05). Logistic regression analysis showed that boys had 2.12 times greater odds of having BLLs >= 10 mu g/dL than girls (P < 0.05). Among the children 0-3 years, those whose mothers had BLLs >= 10 mu g/dL had 45.0% higher odds of presenting BLLs >= 10 mu g/dL than children whose mothers had BLLs < 10 mu g/dL (P < 0.05).Conclusions. Older age, male gender, and mothers' BLL >= 10 mu g/dL were the main risk factors for elevated BLLs. The higher risk in boys 7-17 years suggests that exposure could be related to specific activities in this group, such as fishing and hunting. Continuous monitoring of BLLs in the Corrientes River population is recommended.
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| 2. |
- Devries, Karen, et al.
(författare)
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Violence against children in Latin America and the Caribbean: What do available data reveal about prevalence and perpetrators?
- 2019
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Ingår i: Revista panamericana de salud publica = Pan American journal of public health. - 1680-5348. ; 43
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Tidskriftsartikel (refereegranskat)abstract
- To describe the prevalence of recent physical, sexual, and emotional violence against children 0 - 19 years of age in Latin America and the Caribbean (LAC) by age, sex, and perpetrator.A systematic review and analysis of published literature and large international datasets was conducted. Eligible sources from first record to December 2015 contained age-, sex-, and perpetrator-specific data from LAC. Random effects meta-regressions were performed, adjusting for relevant quality covariates and differences in violence definitions.Seventy-two surveys (2 publications and 70 datasets) met inclusion criteria, representing 1 449 estimates from 34 countries. Prevalence of physical and emotional violence by caregivers ranged from 30% - 60%, and decreased with increasing age. Prevalence of physical violence by students (17% - 61%) declined with age, while emotional violence remained constant (60% - 92%). Prevalence of physical intimate partner violence (IPV) ranged from 13% - 18% for girls aged 15 - 19 years. Few or no eligible past-year estimates were available for any violence against children less than 9 years and boys 16 - 19 years of age; sexual violence against boys (any age) and girls (under 15 years); IPV except for girls aged 15 - 19 years; and violence by authority figures (e.g., teachers) or via gangs/organized crime.Past-year physical and emotional violence by caregivers and students is widespread in LAC across all ages in childhood, as is IPV against girls aged 15 - 19 years. Data collection must be expanded in LAC to monitor progress towards the sustainable development goals, develop effective prevention and response strategies, and shed light on violence relating to organized crime/gangs.
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| 4. |
- Goicolea, Isabel, 1971-, et al.
(författare)
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Risk factors for pregnancy among adolescent girls in Ecuador's Amazon basin : a case-control study
- 2009
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Ingår i: Revista panamericana de salud pùblica. - : Organización Panamericana de la Salud. - 1020-4989 .- 1680-5348. ; 26:3, s. 221-228
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To examine risk factors for pregnancy among adolescent girls in the Amazonbasin of Ecuador.Methods. A matched case-control study with cases and controls identified within a community-based demographic and health survey was conducted in Orellana, Ecuador, from Mayto November 2006. A questionnaire focused on socioeconomic status, family structure, education,reproductive health, and childhood-adolescent trauma was applied. Conditional logisticregression was used to adjust for potential confounders.Results. Respondents included 140 cases and 262 controls. Factors associated with increasedrisk of adolescent pregnancies through multivariate analysis were: sexual abuse duringchildhood-adolescence (odds ratio (OR) 3.06, 95% confidence interval (CI) 1.08–8.68);early sexual debut (OR 8.51, 95% CI 1.12–64.90); experiencing periods without mother andfather (OR 10.67, 95% CI 2.67–42.63); and living in a very poor household (OR 15.23, 95%CI 1.43–162.45). Another two factors were statistically associated in the bivariate analysis:being married or in a consensual union (OR 44.34, 95% CI 17.85–142.16) and not being enrolledin school at the time of the interview (OR 6.31, 95% CI 3.70–11.27). For a subsampleof sexually initiated adolescents, “non-use of contraception during first sexual intercourse”was also found to be a risk factor (OR 4.30, 95% CI 1.33–13.90).Conclusion. The study found that early sexual debut, non-use of contraception during firstsexual intercourse, living in a very poor household, having suffered from sexual abuse duringchildhood-adolescence, and family disruption (living extended periods of life without both parents)were associated with adolescent pregnancy in Orellana.
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| 6. |
- Moran, Andrew E, et al.
(författare)
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Building the health-economic case for scaling up the WHO-HEARTS hypertension control package in low- and middle-income countries.
- 2022
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Ingår i: Revista panamericana de salud pùblica. - 1020-4989 .- 1680-5348. ; 46, s. e140-
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Tidskriftsartikel (refereegranskat)abstract
- Generally, hypertension control programs are cost-effective, including in low- and middle-income countries, but country governments and civil society are not likely to support hypertension control programs unless value is demonstrated in terms of public health benefits, budget impact, and value-for-investment for the individual country context. The World Health Organization (WHO) and the Pan American Health Organization (PAHO) established a standard, simplified Global HEARTS approach to hypertension control, including preferred antihypertensive medicines and blood pressure measurement devices. The objective of this study is to report on health economic studies of HEARTS hypertension control package cost (especially medication costs), cost-effectiveness, and budget impact and describe mathematical models designed to translate hypertension control program data into the optimal approach to hypertension care service delivery and financing, especially in low- and middle-income countries. Early results suggest that HEARTS hypertension control interventions are either cost-saving or cost-effective, that the HEARTS package is affordable at between US$ 18-44 per person treated per year, and that antihypertensive medicines could be priced low enough to reach a global standard of an average
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| 7. |
- Quizhpe, Edy, et al.
(författare)
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[Prevalence of anaemia in schoolchildren in the Amazon area of Ecuador].
- 2003
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Ingår i: Revista panamericana de salud pùblica. - 1020-4989 .- 1680-5348. ; 13:6, s. 355-61
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine the prevalence of anemia in rural school-age children in the Amazon region of Ecuador. METHODS: We carried out a cross-sectional study during May to October 2000 in two cantons of the province of Orellana, in northeastern Ecuador, involving 626 children from 17 schools. Demographic and anthropometric data (weight and height) were collected, values for hemoglobin and for zinc erythrocyte protoporphyrin were determined, and feces samples were analyzed to check for infestation by parasites. RESULTS: The general prevalence of anemia was 16.6% among the schoolchildren; of the affected children, 75.5% of them had iron-deficiency anemia. The prevalence of moderate chronic undernutrition was 28.8% and that of serious chronic undernutrition was 9.3%. There was also a prevalence of moderate acute undernutrition of 8.4% and of severe acute undernutrition of 3.4%. Parasitic infections were very frequent (82.0%). The most common parasites were Entamoeba coli (30.3%) and Ascaris lumbricoides (25.0%). There were no relationships between the prevalence of either anemia or of iron-deficiency anemia and any of the indicators of nutrition or of parasitic infection. CONCLUSIONS: Anemia is not a serious public health problem in the population studied. Nevertheless, the high prevalence of chronic undernutrition among the children points to the need to improve their diets. The lack of association between the prevalence of undernutrition and anemia could be due to low iron bioavailability or absorption rather than insufficient intake. Studies are needed to evaluate the customary diet of this population.
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| 9. |
- Wesseling, C., et al.
(författare)
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Chronic kidney disease of non-traditional origin in Mesoamerica: a disease primarily driven by occupational heat stress
- 2020
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Ingår i: Revista Panamericana De Salud Publica-Pan American Journal of Public Health. - : Pan American Health Organization. - 1020-4989. ; 44
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Tidskriftsartikel (refereegranskat)abstract
- The death toll of the epidemic of chronic kidney disease of nontraditional origin (CKDnt) in Mesoamerica runs into the tens of thousands, affecting mostly young men. There is no consensus on the etiology. Anecdotal evidence from the 1990s pointed to work in sugarcane; pesticides and heat stress were suspected. Subsequent population-based surveys supported an occupational origin with overall high male-female ratios in high-risk lowlands, but small sex differences within occupational categories, and low prevalence in non-workers. CKDnt was reported in sugarcane and other high-intensity agriculture, and in non-agricultural occupations with heavy manual labor in hot environments, but not among subsistence farmers. Recent studies with stronger designs have shown cross-shift changes in kidney function and hydration biomarkers and cross-harvest kidney function declines related to heat and workload. The implementation of a water-rest-shade intervention midharvest in El Salvador appeared to halt declining kidney function among cane cutters. In Nicaragua a water-rest-shade program appeared sufficient to prevent kidney damage among cane workers with low-moderate workload but not among cutters with heaviest workload. Studies on pesticides and infectious risk factors have been largely negative. Non-occupational risk factors do not explain the observed epidemiologic patterns. In conclusion, work is the main driver of the CKDnt epidemic in Mesoamerica, with occupational heat stress being the single uniting factor shown to lead to kidney dysfunction in affected populations. Sugarcane cutters with extreme heat stress could be viewed as a sentinel occupational population. Occupational heat stress prevention is critical, even more so in view of climate change.
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