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Patrick G, Mattia A, Melchor J, Leonard M, Quirindongo E, Sangha N, Long B, Grant N, Cruz V, Narayanan A“S, Chang M, Fleischer C. Systematic review of existing literature regarding the prevalence of pediatric atopic dermatitis in Honduras. JAAD Int 2024; 15:44-50. [PMID: 38371663 PMCID: PMC10869933 DOI: 10.1016/j.jdin.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2023] [Indexed: 02/20/2024] Open
Abstract
Background Atopic dermatitis (AD) is an inflammatory skin condition, often multifactorial in origin, and most commonly manifests during childhood. Although there remains a deficit in literature, current data suggest Honduras may have the highest prevalence and severity of AD among all Latin American countries. Objective To assess the current prevalence of pediatric AD in Honduras and evaluate existing gaps in available literature to monitor disease burden. Methods A comprehensive literature search was performed in March 2023. Articles were removed if they were published before 2007, were of the incorrect study design, or were focused on countries outside of Honduras. The articles were independently reviewed by 2 authors. Results The initial literature search yielded 174 studies, of which 7 met inclusion criteria. AD prevalence rates in children in Honduras ranged from 0.7% to 40.0%. Limitations Limitations include elements of study design, analytic methods, study populations, and limited articles. Conclusion There appears to be a disproportionately higher prevalence and disease burden of pediatric AD in Honduras. Future research should acquire accurate data to further understand the prevalence, incidence, and severity of AD in Honduras.
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Affiliation(s)
| | | | - Julian Melchor
- Florida State University College of Medicine, Tallahassee, Florida
| | | | | | - Nicole Sangha
- Florida State University College of Medicine, Tallahassee, Florida
| | - Brittany Long
- Florida State University College of Medicine, Tallahassee, Florida
| | | | - Victoria Cruz
- National Autonomous University of Honduras Medical College, Tegucigalpa, Honduras
| | | | - Meihmy Chang
- Universidad Católica de Honduras, San Pedro Sula, Honduras
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De Bortoli Cassiani SH, Moreno Dias B, Meléndez Romero BE, Rivera J. [The role of nursing professionals in the development and care of adolescent health in HondurasPapel dos profissionais de enfermagem no desenvolvimento e na atenção à saúde de adolescentes em Honduras]. Rev Panam Salud Publica 2024; 48:e25. [PMID: 38562958 PMCID: PMC10984222 DOI: 10.26633/rpsp.2024.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/11/2024] [Indexed: 04/04/2024] Open
Abstract
Objective Identify and analyze the role of nursing professionals in the development and care of adolescent health in Honduras, by analyzing the curricular content of the training provided to nursing students with respect to adolescent health, and by studying policies on adolescent health. Methods Mixed methods study, with a sequential explanatory approach, carried out from May to July 2023 through surveys of nursing schools, analysis of policy documents, a survey with nursing professionals, and a focus group. Quantitative data were analyzed using descriptive statistics and qualitative data, applying the theoretical framework of Walt and Gilson. Results During the research, 18 documents were analyzed and seven nursing schools, 141 nurses, and 10 key actors in leadership positions participated. The results point to the need to update and disseminate the regulatory framework, ensure the necessary resources and structure to implement sustainable intersectoral programs, and train professionals. Schools are an important space for the implementation of actions; in this context, the adoption of school nursing programs could be beneficial. Nurses were identified as key figures in program implementation and should be taken into consideration when developing policies aimed at adolescents. Conclusions Nurses participate in various stages of the policy implementation process and can make important contributions to school health at the first level of care. To this end, it is necessary to increase the capacities of nurses and nursing educators in relation to current and relevant issues in adolescent care.
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Affiliation(s)
- Silvia Helena De Bortoli Cassiani
- Organización Panamericana de la SaludWashington, D.C.Estados Unidos de AméricaOrganización Panamericana de la Salud, Washington, D.C., Estados Unidos de América.
| | - Bruna Moreno Dias
- Organización Panamericana de la SaludWashington, D.C.Estados Unidos de AméricaOrganización Panamericana de la Salud, Washington, D.C., Estados Unidos de América.
| | | | - Jairo Rivera
- Universidad Andina Simón BolívarQuitoEcuadorUniversidad Andina Simón Bolívar, Quito, Ecuador.
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Huber-Krum S, Miedema SS, Shortt JW, Villaveces A, Kress H. Path Analysis of Adverse Childhood Experiences, Early Marriage, Early Pregnancy, and Exposure to Intimate Partner Violence Among Young Women in Honduras. J Fam Violence 2024; 39:705-722. [PMID: 38655238 PMCID: PMC11034739 DOI: 10.1007/s10896-023-00520-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/24/2023] [Indexed: 04/26/2024]
Abstract
Purpose The pathways by which adverse childhood experiences (ACEs) are associated with early marriage and early pregnancy are poorly understood. Early marriage and early pregnancy may be risk factors for adulthood intimate partner violence (IPV). The aim of this study was to assess the relationships among ACEs, early marriage, early pregnancy, and IPV among women in Honduras. Method We used weighted data from 1,436 women aged 18-24 years from the nationally representative 2017 Honduras Violence Against Children and Youth Survey. We used path analysis to estimate relationships and accounted for sample design, non-response, and within-country clustering. Results We found that ACEs had differential relationships with outcomes of interest. For example, witnessing violence in the community was directly associated with increased probability of early pregnancy (10 percentage points (PP); 95% CI: 0.04, 0.15) and IPV (6 PP; 95% CI: 0.01, 0.10), while emotional violence was not directly or indirectly associated with any outcome. Early marriage and early pregnancy had no direct or indirect effect on IPV, but the total effect of early marriage on IPV was significant. Conclusions Understanding the relationship between ACEs, early marriage, early pregnancy, and IPV may help inform prevention efforts. For example, programs aiming to reduce early pregnancy may consider addressing sexual violence experienced in childhood.
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Affiliation(s)
- Sarah Huber-Krum
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA
| | - Stephanie Spaid Miedema
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA
| | - Joann Wu Shortt
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA
| | - Andrés Villaveces
- Field Epidemiology and Prevention Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA
| | - Howard Kress
- Field Epidemiology and Prevention Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA
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Banegas R, Rojas L, Castillo M, Lagos L, Barber K, Ethridge B, O’Connor S. Mapping Human Resources to Guide Ophthalmology Capacity-Building Projects in Honduras: Sub-national Analyses of Physician Distribution and Surgical Practices. Ann Glob Health 2024; 90:20. [PMID: 38495416 PMCID: PMC10941696 DOI: 10.5334/aogh.4384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/17/2024] [Indexed: 03/19/2024] Open
Abstract
Objective To map ophthalmologist locations and surgical practices as they vary sub-nationally within Honduras to maximize the impact of efforts to develop cataract surgical capacity. Methods An anonymous survey was sent to all Honduran ophthalmologists with questions on surgical volume, department-level location, type of facility in which they work, surgical methods, and age. Surgical volume, population, and poverty data sourced through the Oxford Poverty Human Development Initiative were mapped at the department level, and cataract surgical rates (CSR; surgeries per million population per year) were calculated and mapped. Results Sixty-one of the 102 Honduran ophthalmologists contacted responded. Of those, 85% perform cataract surgery, and 49% work at least part time in a non-profit or governmental facility. Honduras has fewer surgical ophthalmologists per million than the global average, and though national CSR appears to be increasing, it varies significantly between departments. The correlation between CSR and poverty is complex, and outliers provide valuable insights. Conclusion Mapping ophthalmological surgical practices as they relate to population and poverty at a sub-national level provides important insights into geographic trends in the need for and access to eye care. Such insights can be used to guide efficient and effective development of cataract surgical capacity.
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Affiliation(s)
- Rocio Banegas
- Advanced Center for Eyecare Global, 1721 Westwind Drive, Suite B, Bakersfield, CA 93301, US
| | | | - Mariela Castillo
- Advanced Center for Eyecare Global, US
- Hospital San Felipe, Tegucigalpa, HN
- Centro de Salud Integral ZOE, Tegucigalpa, HN
| | - Luis Lagos
- Advanced Center for Eyecare Global, US
- Hospital San Felipe, Tegucigalpa, HN
| | | | - Britton Ethridge
- Advanced Center for Eyecare Global, Alabama College of Osteopathic Medicine, 445 Health Sciences Blvd, Dothan, AL 36303, US
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García-Aguilar JA, Alger J. Frequency of strongyloidiasis and associated factors: Analysis of 13 years of laboratory results in a tertiary referral hospital in Honduras, 2010-2022. Biomedica 2023; 43:492-505. [PMID: 38109136 PMCID: PMC10776084 DOI: 10.7705/biomedica.7086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION The frequency of detected strongyloidiasis is affected by the selected laboratory method in the studied population. Considering that Honduras has few community-based studies, the analysis of the laboratory record data can provide information helping to understand this parasitosis. OBJECTIVE To estimate the frequency and to identify the factors associated with strongyloidiasis, analyzing the laboratory records of the Servicio de Parasitología at Hospital Escuela in Tegucigalpa (Honduras) between 2010 and 2022. MATERIALS AND METHODS We carried out a descriptive, cross-sectional, analytical study. The laboratory diagnosis consisted of stool samples' examination by direct smear and modified Baermann technique. We estimated frequencies and percentages. The statistical association was calculated with prevalence ratios and a 95% confidence interval. Software R, version 4.2.0, and epiR package, version 2.0.46, were used to perform the analysis. RESULTS The frequency of strongyloidiasis was 0.29% (112/38,085). It was higher with the modified Baermann technique (0.87%; 40/4,575) among male patients (0.44%; 70/15,758). Regarding the age, strongyloidiasis was higher in the 20-40 years old group (0.41%; 28/6,886) with direct smear and 41-61 years old (1.14%; 14/1,232) group with the modified Baermann technique. Among the factors associated with strongyloidiasis were age between 20 and 61 years old (PR=2.26, CI 95%=1.53-3.31), male patients (PR=2.34, CI 95%=1.60‑3.44), mucus (PR=1.86, CI 95%=1.22-2.83) and Charcot-Leyden crystals in stool (PR=8.47, CI 95%=5.14-13.96); watery stool (PR=2.39, CI 95%=1.55-3.68), and other helminthiases (PR=6.73, CI 95%=3.98-11.38). Associated factors to cases detected with the modified Baermann technique were outpatient consultation (PR=4.21, CI 95%=1.91-9.28) and formed stools (PR=3.99, CI 95%=1.94-8.19). CONCLUSIONS The modified Baermann technique increased the detection of strongyloidiasis almost four times. Most cases were distributed among male adults. The cases diagnosed exclusively with the modified Baermann technique have differences from those with observed larvae in the direct smear. It is necessary to develop community-based population studies.
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Affiliation(s)
- Jorge Alberto García-Aguilar
- Servicio de Parasitología, Departamento de Laboratorio Clínico, Hospital Escuela, Tegucigalpa, Honduras; Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras; Asociación Hondureña de Parasitología, Tegucigalpa, Honduras.
| | - Jackeline Alger
- Servicio de Parasitología, Departamento de Laboratorio Clínico, Hospital Escuela, Tegucigalpa, Honduras; Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras; Asociación Hondureña de Parasitología, Tegucigalpa, Honduras.
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Dickason RM, Hertelendy AJ, Hart A, Ciottone GR. Disasters in the Northern Triangle: A Descriptive Analysis Using the EM-DAT Database 1902-2022. Prehosp Disaster Med 2023; 38:668-676. [PMID: 37753629 DOI: 10.1017/s1049023x23006374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
INTRODUCTION Since 1902, disasters in the Northern Triangle of Central America, which consists of the countries Guatemala, Honduras, and El Salvador, have caused over one-hundred-thousand deaths, affected millions of people, and caused tens of billions of dollars in damages. Understanding the nature and frequency of these events will allow stakeholders to decrease both the acute damages and the long-term deleterious consequences of disasters. STUDY OBJECTIVE This study provides a descriptive analysis of all disasters recorded in the Emergency Events Database (EM-DAT) affecting Guatemala, Honduras, and El Salvador from 1902-2022. METHODS Data were collected and analyzed from the EM-DAT, which categorizes disasters by frequency, severity, financial cost, distribution by country, burden of death, number of people affected, financial cost by country, and type of disasters most prevalent in each country. Results are presented as absolute numbers and as a percentage of the overall disaster burden. These trends are then graphed over the time period of the database. RESULTS The EM-DAT recorded 359 disasters in the Northern Triangle from 1902 through 2022. Meteorologic events (floods and storms) were the most common types of disaster (44%), followed by transport accidents (13%). Meteorologic events and earthquakes were the most severe, as measured by deaths (62%), people affected (60%), and financial cost (86%). Guatemala had the greatest number of disasters (45%), deaths (68%), and affected people (52%). The financial costs of the disasters were evenly distributed between the three countries. CONCLUSION Meteorologic disasters are the most common and most severe type of disaster in the Northern Triangle. Earthquakes and transport accidents are also common. As climate change causes more severe storms in the region, disasters are likely to increase in severity as well. Governments and aid organizations should develop disaster preparedness and mitigation strategies to lessen the catastrophic effects of future disasters. Missing data limit the conclusions of this study to general trends.
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Affiliation(s)
- R Myles Dickason
- BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MassachusettsUSA
| | - Attila J Hertelendy
- BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MassachusettsUSA
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FloridaUSA
| | - Alexander Hart
- BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MassachusettsUSA
- Department of Emergency Medicine, Hartford Hospital, Hartford, ConnecticutUSA
- University of Connecticut School of Medicine, Farmington, ConnecticutUSA
| | - Gregory R Ciottone
- BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MassachusettsUSA
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Lucchi E, Schuberth M. Negotiating humanitarian space with criminal armed groups in urban Latin America. Disasters 2023; 47:700-724. [PMID: 36379913 DOI: 10.1111/disa.12569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Humanitarian and development agencies intervening in Latin American cities increasingly face the challenge posed by criminal armed groups (CAGs). Yet, there is a need for evidence-based comparative studies on how international agencies deal with them. Drawing on data collected in Colombia, El Salvador, Haiti, Honduras, and Mexico, this paper presents a novel typology of humanitarian organisations' access strategies that distinguishes between different levels of interaction with CAGs. The paper shows how humanitarian agencies assess a variety of risks and balance the potential consequences of their engagement with CAGs with the need to maintain constructive and trustful relationships with the state and the community with which they work. It finds that indirect dialogue or negotiation with CAGs via community leaders who act as intermediaries might provide a low-risk alternative to direct negotiation with CAG leaders, provided that 'do no harm' and humanitarian protection considerations vis-à-vis communities and intermediaries play a central role.
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Affiliation(s)
| | - Moritz Schuberth
- Visiting Fellow, London School of Economics and Political Science, United Kingdom
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8
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Paz S, Escobar D, Fontecha G. Update on the susceptibility to chloroquine of Plasmodium falciparum in Honduras. Travel Med Infect Dis 2023; 54:102600. [PMID: 37315826 DOI: 10.1016/j.tmaid.2023.102600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/01/2023] [Indexed: 06/16/2023]
Affiliation(s)
- Sandra Paz
- National Malaria Laboratory, National Department of Surveillance, Ministry of Health of Honduras, Centro de Salud Alonso Suazo, Bulevard Suyapa. 11101, Tegucigalpa, Honduras.
| | - Denis Escobar
- Instituto de Investigaciones en Microbiología, Universidad Nacional Autónoma de Honduras, Ciudad Universitaria, Bulevard Suyapa, Edificio J1, segundo piso. 11101, Tegucigalpa, Honduras.
| | - Gustavo Fontecha
- Instituto de Investigaciones en Microbiología, Universidad Nacional Autónoma de Honduras, Ciudad Universitaria, Bulevard Suyapa, Edificio J1, segundo piso. 11101, Tegucigalpa, Honduras.
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Larkin K, Toloza AC, Gabrie JA, Rodríguez CA, Rueda MM, Matamoros G, Palacio O, Jamani S, Fontecha G, Sanchez AL. First Detection of Acinetobacter baumannii in Pediculus humanus capitis from Latin America. Trop Med Infect Dis 2023; 8:345. [PMID: 37505641 PMCID: PMC10386172 DOI: 10.3390/tropicalmed8070345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/17/2023] [Accepted: 06/26/2023] [Indexed: 07/29/2023] Open
Abstract
Several studies have documented the presence of Acinetobacter baumannii, a known multi-drug-resistant pathogen, in the human head louse, Pediculus humanus capitis. Since no reports from countries in Latin America have been published, the aim of the present study was to determine whether A. baumannii was present in head lice specimens collected in this geographic region. Head lice specimens from Argentina, Colombia, and Honduras were analyzed. PCR assays were performed to confirm the specimens' species and to investigate whether the DNA of A. baumannii was present. The products of the latter were sequenced to confirm bacterial identity. Altogether, 122 pools of head lice were analyzed, of which two (1.64%) were positive for A. baumannii's DNA. The positive head lice had been collected at the poorest study site in Honduras. The remaining specimens were negative. This study is the first to report the presence of A. baumannii in human head lice from Latin America. Further investigations are required to elucidate whether these ectoparasites can serve as natural reservoirs or even effectively transmit A. baumannii to humans.
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Affiliation(s)
- Kelsey Larkin
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
| | - Ariel Ceferino Toloza
- Centro de Investigaciones de Plagas e Insecticidas (CONICET-UNIDEF), Villa Martelli, Buenos Aires 1603, Argentina
| | - Jose Antonio Gabrie
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
| | - Carol A Rodríguez
- Department of Parasitology, Universidad Nacional Autónoma de Honduras, Boulevard Suyapa, Tegucigalpa 11101, Honduras
| | - Maria Mercedes Rueda
- Department of Parasitology, Universidad Nacional Autónoma de Honduras, Boulevard Suyapa, Tegucigalpa 11101, Honduras
| | - Gabriela Matamoros
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Boulevard Suyapa, Tegucigalpa 11101, Honduras
| | - Oscar Palacio
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
| | - Shabana Jamani
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
| | - Gustavo Fontecha
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Boulevard Suyapa, Tegucigalpa 11101, Honduras
| | - Ana L Sanchez
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON L2S 3A1, Canada
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Karyadi E, Reddy JC, Dearden KA, Purwanti T, Mardewi, Asri E, Roquero LB, Juguan JA, Sapitula‐Evidente A, Anand B, Warvadekar K, Bhardwaj A, Alam MK, Das S, Nair GK, Srivastava A, Raut MK. Antenatal care is associated with adherence to iron supplementation among pregnant women in selected low-middle-income-countries of Asia, Africa, and Latin America & the Caribbean regions: Insights from Demographic and Health Surveys. Matern Child Nutr 2023; 19:e13477. [PMID: 36705031 PMCID: PMC10019046 DOI: 10.1111/mcn.13477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/02/2022] [Accepted: 01/05/2023] [Indexed: 01/28/2023]
Abstract
Anaemia is a global public health problem affecting 800 million women and children globally. Anaemia is associated with perinatal mortality, child morbidity and mortality, mental development, immune competence, susceptibility to lead poisoning and performance at work. The objective of this article is to identify whether antenatal care-seeking was associated with the uptake of iron supplementation among pregnant women, adjusting for a range of covariates. This article used data from the cross-sectional recent Demographic and Health Surveys (DHS) of 12 countries in Asia, Africa and Latin America & the Caribbean regions. The individual-level data from 273,144 women of reproductive age (15-49 years) were analysed from multi-country DHS. Multiple Logistic regression analyses were conducted using Predictive Analytics Software for Windows (PASW), Release 18.0. Receiving at least four antenatal care visits was significantly associated with the consumption of 90 or more iron-containing supplements in 12 low and middle income countries across three regions after adjusting for different household and respondent characteristics, while mass media exposure was found to be a significant predictor in India and Indonesia. Antenatal care seems to be the most important predictor of adherence to iron intake in the selected countries across Africa, Asia, Latin America and Caribbean regions.
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Affiliation(s)
- Elvina Karyadi
- Former Country Director, Nutrition InternationalIndonesia Country OfficeJakartaIndonesia
| | - J. C. Reddy
- Senior Program Officer, Research and Evaluation, Nutrition InternationalAsia Regional OfficeNew DelhiIndia
| | - Kirk A. Dearden
- Senior Technical Advisor for Nutrition and WASHIMA World Health/Corus InternationalWashingtonDistrict ColumbiaUSA
| | - Tutut Purwanti
- Former Maternal and Child Nutrition Advisor, Nutrition InternationalIndonesia Country OfficeJakartaIndonesia
| | - Mardewi
- Former Program Coordinator ‐ Maternal and Child Health, Nutrition InternationalIndonesia Country OfficeJakartaIndonesia
| | - Eriana Asri
- Former Adolescent Nutrition Advisor, Nutrition InternationalIndonesia Country OfficeJakartaIndonesia
| | - Loreto B. Roquero
- Former Country DirectorNutrition International, Philippines Country OfficeManilaPhilippines
| | - Jocelyn A. Juguan
- Country Program Coordinator, Nutrition InternationalPhilippines Country OfficeManilaPhilippines
| | | | - Binu Anand
- Technical Assistance to Nutrition, Nutrition InternationalAsia Regional OfficeNew DelhiIndia
| | - Kirti Warvadekar
- Regional Program Officer, Research and Evaluation, Asia, Nutrition InternationalAsia Regional OfficeNew DelhiIndia
| | - Anjali Bhardwaj
- Regional Technical Advisor, Adolescent and Women's Health and Nutrition, Nutrition InternationalAsia Regional OfficeNew DelhiIndia
| | - Md. K. Alam
- Project DirectorSave the ChildrenDhakaBangladesh
| | - Susmita Das
- Deputy Regional Director, Nutrition InternationalAsia Regional OfficeNew DelhiIndiaIndia
| | - Gopa K. Nair
- Chief Executive OfficerLeo and Mia FoundationLondonUK
| | | | - Manoj K. Raut
- Asia Regional Technical Advisor, Research and Evaluation, Global Technical ServicesNutrition InternationalNew DelhiIndia
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Matamoros G, Escobar D, Pinto A, Serrano D, Ksandrová E, Grimaldi N, Juárez-Fontecha G, Moncada M, Valdivia HO, Fontecha G. PET-PCR reveals low parasitaemia and submicroscopic malarial infections in Honduran Moskitia. Malar J 2023; 22:110. [PMID: 36978056 PMCID: PMC10053754 DOI: 10.1186/s12936-023-04538-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Malaria remains a main parasitic disease of humans. Although the largest number of cases is reported in the African region, there are still endemic foci in the Americas. Central America reported 36,000 malaria cases in 2020, which represents 5.5% of cases in the Americas and 0.015% of cases globally. Most malaria infections in Central America are reported in La Moskitia, shared by Honduras and Nicaragua. In the Honduran Moskitia, less than 800 cases were registered in 2020, considering it an area of low endemicity. In low endemicity settings, the number of submicroscopic and asymptomatic infections tends to increase, leaving many cases undetected and untreated. These reservoirs challenge national malaria elimination programmes. This study aimed to assess the diagnostic performance of Light Microscopy (LM), a nested PCR test and a photoinduced electron transfer polymerase chain reaction (PET-PCR) in a population of febrile patients from La Moskitia. METHODS A total of 309 febrile participants were recruited using a passive surveillance approach at the Puerto Lempira hospital. Blood samples were analysed by LM, nested PCR, and PET-PCR. Diagnostic performance including sensitivity, specificity, negative and positive predictive values, kappa index, accuracy, and ROC analysis was evaluated. The parasitaemia of the positive samples was quantified by both LM and PET-PCR. RESULTS The overall prevalence of malaria was 19.1% by LM, 27.8% by nPCR, and 31.1% by PET-PCR. The sensitivity of LM was 67.4% compared to nPCR, and the sensitivity of LM and nPCR was 59.6% and 80.8%, respectively, compared to PET-PCR. LM showed a kappa index of 0.67, with a moderate level of agreement. Forty positive cases by PET-PCR were not detected by LM. CONCLUSIONS This study demonstrated that LM is unable to detect parasitaemia at low levels and that there is a high degree of submicroscopic infections in the Honduran Moskitia.
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Affiliation(s)
- Gabriela Matamoros
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Denis Escobar
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Alejandra Pinto
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Delmy Serrano
- Hospital de Puerto Lempira, Secretaría de Salud de Honduras, Gracias a Dios, Honduras
| | - Eliška Ksandrová
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Nicole Grimaldi
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Gabriel Juárez-Fontecha
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Marcela Moncada
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Hugo O Valdivia
- Department of Parasitology, U.S. Naval Medical Research Unit 6 (NAMRU-6), 07006, Lima, Peru
| | - Gustavo Fontecha
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras.
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Fontecha G. The Honduran diaspora and infectious diseases: An urgent need for action. Travel Med Infect Dis 2023; 53:102567. [PMID: 36958705 DOI: 10.1016/j.tmaid.2023.102567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/25/2023]
Abstract
Recently, there has been a significant increase in irregular migration from Central America's northern triangle (Honduras, Guatemala and El Salvador). Hondurans who migrate to North America face numerous risks to their lives and health. Infectious diseases are one of the most serious threats to migrants both during the migration process and once they arrive in the host country. The major infectious diseases affecting both migrants and the health services in non-endemic countries that care for these migrants are discussed.
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Affiliation(s)
- Gustavo Fontecha
- Instituto de Investigaciones en Microbiología, Universidad Nacional Autónoma de Honduras, Ciudad Universitaria, Bulevard Suyapa, Edificio J1, Segundo Piso, 11101, Tegucigalpa, Honduras.
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13
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Escobar D, Pérez F, Ortiz B, Fontecha G. PCR-RFLP assays for the identification of Anopheles (Diptera: Culicidae) species circulating in Honduras. Malar J 2023; 22:57. [PMID: 36805673 PMCID: PMC9938605 DOI: 10.1186/s12936-023-04494-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/13/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Vector populations are a key target for malaria control and elimination. In Honduras, there are at least 12 reported anopheline species, however, the definitive number of species remains uncertain. Due to the inherent limitations of morphological identification of Anopheles species, molecular approaches have been developed to provide accurate identification and robust surveillance of local malaria vectors. The aim of this study was to design and assess three PCR-RFLP assays to identify anopheline species known to presently occur in Honduras. METHODS Mosquitoes captured between 2018 and 2022 in seven malaria-endemic and non-endemic departments in Honduras were analysed. The ITS2 ribosomal region and three restriction enzyme-based assays were evaluated in silico and experimentally. RESULTS A total of 132 sequences from 12 anopheline species were analysed. The ITS2 marker showed length polymorphisms that generated products between 388 and 592 bp and no relevant intraspecies polymorphisms were found. Furthermore, the three PCR-RFLP assays were able to differentiate 11 species with sufficient precision and resolution. CONCLUSION The ITS2 region was shown to be a useful molecular marker for identifying local Anopheles species. In addition, the PCR-RFLP assays evaluated here proved to be capable of discriminating most of the anopheline species present in Honduras. These methods provide alternatives to improve entomological surveillance of Anopheles in Honduras and other Mesoamerican countries.
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Affiliation(s)
- Denis Escobar
- grid.10601.360000 0001 2297 2829Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Fernando Pérez
- grid.10601.360000 0001 2297 2829Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Bryan Ortiz
- grid.10601.360000 0001 2297 2829Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Gustavo Fontecha
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras.
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Hasemann Lara JE. Health Sector Reform in Honduras: Privatization as Institutional Bad Faith. Med Anthropol 2023; 42:62-75. [PMID: 36174649 DOI: 10.1080/01459740.2022.2125388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
I address the privatization of public health care services in Honduras by focusing on one family's experiences using both private and public health services. I juxtapose their increasing use of private health care services, over public services, against sustained and consistent episodes of health sector reform culminating in protests against decrees that sought to further restructure the Ministry of Health during early 2019. By complementing the concept of "privatization by attrition" with "institutional bad faith," I argue that the increased use of private health care may be understood as privatization by coercion.
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15
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Espinoza-Turcios E, Gonzales-Romero RM, Sosa-Mendoza C, Sierra-Santos M, Castro-Ramos HN, Zambrano LI, Armada J, Mejía CR. Factors associated with hopelessness, depression and anxiety in the Honduran-Central America population during the COVID-19 pandemic. Front Psychiatry 2023; 14:1116881. [PMID: 36937724 PMCID: PMC10014751 DOI: 10.3389/fpsyt.2023.1116881] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/07/2023] [Indexed: 03/05/2023] Open
Abstract
IntroductionThe mental health of the population has been affected by COVID-19, reporting in many populations higher levels of depressive, anxious and stress symptoms, however, in Honduras there are no studies showing the impact of COVID-19 on the mental health of the population.AimTo determine the factors associated with hopelessness, depression and anxiety in times of COVID-19 in the Honduran population.MethodsCross-sectional analytical study. Three scales were used, Beck for hopelessness, Hamilton for depression and anxiety, through interviews with the population attending different levels of health care throughout the country. Descriptive and analytical statistics were obtained. For hopelessness, the Beck Hopelessness Scale was used; for depression and anxiety, the Hamilton Scale was used.ResultsOf the 8,125 participants, the population in general showed results of hopelessness 14.9%, depression 12.9% and anxiety 1.2%, there was less hopelessness among women (p = 0.004), university students (p < 0.001), but greater among those who had a family member deceased by COVID-19 (p < 0.001), among those who had diabetes mellitus (DM) (p < 0.001), history of mental illness (p < 0.001) or had consumed drugs in the last 6 months (p < 0.001). There was more depression among those with arterial hypertension (p = 0.002), obesity (p = 0.019), DM (p = 0.004), history of mental illness (p < 0.001) or had consumed drugs in the last 6 months (p < 0.001). There was more anxiety among those infected with COVID-19 (p = 0.023), according to having a family member deceased by COVID-19 (p = 0.045) and in those with a history of mental illness (p < 0.001).DiscussionThe Honduran population presented important differences in the socio-pathological, according to the loss of family members or having previous illnesses, this according to the presentation of problems in the mental sphere.ConclusionWe found factors associated with hopelessness, we found factors associated with hopelessness, depression and anxiety in times of COVID-19 in the Honduran population.
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Affiliation(s)
- Eleonora Espinoza-Turcios
- Scientific Research Unit (UIC), Faculty of Medical Sciences (FCM), Institute for Research in Medical Sciences and Right to Health (ICIMEDES), National Autonomous University of Honduras (UNAH), Tegucigalpa, Honduras
- *Correspondence: Eleonora Espinoza-Turcios,
| | - René Mauricio Gonzales-Romero
- Scientific Research Unit (UIC), Faculty of Medical Sciences (FCM), Institute for Research in Medical Sciences and Right to Health (ICIMEDES), National Autonomous University of Honduras (UNAH), Tegucigalpa, Honduras
| | - Carlos Sosa-Mendoza
- Honduran Institute for the Prevention of Alcoholism, Drug Addiction and Drug Dependency (IHADFA), Tegucigalpa, Honduras
| | - Manuel Sierra-Santos
- Scientific Research Unit (UIC), Faculty of Medical Sciences (FCM), Institute for Research in Medical Sciences and Right to Health (ICIMEDES), National Autonomous University of Honduras (UNAH), Tegucigalpa, Honduras
| | - Henry Noel Castro-Ramos
- Scientific Research Unit (UIC), Faculty of Medical Sciences (FCM), Institute for Research in Medical Sciences and Right to Health (ICIMEDES), National Autonomous University of Honduras (UNAH), Tegucigalpa, Honduras
| | - Lysien Ivania Zambrano
- Scientific Research Unit (UIC), Faculty of Medical Sciences (FCM), Institute for Research in Medical Sciences and Right to Health (ICIMEDES), National Autonomous University of Honduras (UNAH), Tegucigalpa, Honduras
| | - José Armada
- Faculty of Business Sciences, Universidad Continental, Huancayo, Peru
| | - Christian R. Mejía
- Translational Medicine Research Centre, Universidad Norbert Wiener, Lima, Peru
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16
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Faktor KL, Payán DD, Ramirez AJ, May FP. Impact and Sustainability of Foreign Medical Aid: A Qualitative Study with Honduran Healthcare Providers. Ann Glob Health 2023; 89:17. [PMID: 36876301 DOI: 10.5334/aogh.3995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/02/2023] [Indexed: 03/06/2023] Open
Abstract
Background There is growing concern about the sustainability and long-term impact of short-term medical missions (STMMs)-an increasingly common form of foreign medical aid-given that brief engagements do little to address the underlying poverty and fragmented healthcare system that plagues many low- and middle-income countries (LMICs). In the absence of formal evaluations, unintended but serious consequences for patients and local communities may arise, including a lack of continuity of patient care, poor alignment with community needs, and cultural and language barriers. Objective We conducted semi-structured interviews with Honduran healthcare providers (n = 88) in 2015 to explore local providers' perceptions of the impact and sustainability of foreign medical aid on patient needs, community health, and the country's healthcare system. Methods Respondents represented a random sample of Honduran healthcare providers (physicians, dentists, nurses) who worked for either a government-run rural clinic or non-governmental organization (NGO) in Honduras. Findings Honduran healthcare providers largely framed foreign medical teams as being assets that help to advance community health through the provision of medical personnel and supplies. Nonetheless, most respondents identified strategies to improve implementation of STMMs and reduce negative impacts. Many respondents emphasized a need for culturally- and linguistically-tailored medical care and health education interventions. Participants also recommended strengthening local partnerships to mitigate the risk of dependence, including on-going training and support of community health workers to promote sustainable change. Conclusions Guidelines informed by local Honduran expertise are needed to increase accountability for more robust training of foreign physicians in the provision of context-appropriate care. These findings provide valuable local perspectives from Honduran healthcare providers to improve the development and implementation of STMMs, informing strategies that can complement and strengthen healthcare systems in LMICs.
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Letona P, Felker-Kantor E, Wheeler J. Sexual and reproductive health of migrant women and girls from the Northern Triangle of Central America. Rev Panam Salud Publica 2023; 47:e59. [PMID: 36909804 PMCID: PMC10003450 DOI: 10.26633/rpsp.2023.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 02/10/2023] [Indexed: 03/08/2023] Open
Abstract
Objective To understand the sexual and reproductive health (SRH) experiences of migrant women and girls of reproductive age (15-49 years) from the Northern Triangle of Central America (El Salvador, Guatemala and Honduras) during their journey to the United States. Methods A descriptive, qualitative research design included 39 in-depth interviews with migrant women and unaccompanied migrant girls from El Salvador, Guatemala and Honduras from January to June 2022. Participants were recruited using purposive sampling. Interviews were transcribed, coded and analyzed using thematic analysis. Results Migrant women and girls lack information and resources to manage their SRH during migration. The SRH of those traveling with smugglers is compromised due to their limited access to menstrual pads, water and sanitation services; the risks of transactional sex and sexual violence; the high risk of sexually transmitted infections; the inability to report sexual violence; the lack of access to SRH and prenatal services; and limited knowledge about their sexual and reproductive rights. Conclusions There is a significant need for improved interventions during the predeparture phase of migration to inform migrant women and girls about the SRH risks they may encounter and to provide information and resources to support their SRH throughout their journey. Special attention should be directed towards trying to reach girls and women who will travel with smugglers.
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Affiliation(s)
- Paola Letona
- Population Services International Guatemala Guatemala City Guatemala Population Services International Guatemala, Guatemala City, Guatemala
| | - Erica Felker-Kantor
- Population Services International Washington, DC USA Population Services International, Washington, DC, USA
| | - Jennifer Wheeler
- Population Services International Washington, DC USA Population Services International, Washington, DC, USA
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18
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Guity-Zapata NA, Stone WM, Nygaard C. Community response to COVID-19: The case of rental housing cooperatives in Melbourne, Australia and Choluteca, Honduras. Habitat Int 2023; 131:102737. [PMID: 36591006 PMCID: PMC9790866 DOI: 10.1016/j.habitatint.2022.102737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
COVID-19 and its restrictions have had widely documented negative impacts for private and social rental sectors, internationally. Limited evidence exists about how the pandemic effects were experienced in alternative forms of renting such as housing cooperatives. Rental cooperatives, recognised for their principles of democratic control, education and training and concern for community, may offer different outcomes for members than more individually-oriented rental forms. This paper seeks to explore whether and how COVID-19 was responded to within cooperative rental housing models, and if the pandemic posed a challenge to cooperative principles. Using a social practices approach, the analysis first identifies cooperative members' formal and informal responses to COVID-19, and second explores the meaning of such activities in the pandemic context in Australia and Honduras cooperatives. The continuity of usual housing cooperative practices and pandemic measures were analysed via in-depth interviews with 15 residents. Findings indicate that cooperative responses acted to reduce negative impacts of the pandemic or to find effective solutions. Rental housing cooperative residents' lived experiences during the COVID-19 pandemic, invite us to reflect on the role of housing cooperatives in the housing sector, the importance of collaborative housing models and the relevance of housing-based community resilience.
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Affiliation(s)
| | - Wendy M Stone
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Australia
| | - Christian Nygaard
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Australia
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Johnson E, Rodriguez C, Puyana JC, Bonilla-Escobar FJ. Traumatic Brain Injury in Honduras: The Use of a Paper-based Surveillance System to Characterize Injuries Patterns. Int J Med Stud 2022; 10:381-386. [PMID: 37378001 PMCID: PMC10299781 DOI: 10.5195/ijms.2022.1384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Traumatic brain injuries (TBI) are a leading cause of death and disability worldwide. Violence is the leading cause of mortality in Honduras. However, the incidence and impact of TBI in this low-middle income country (LMIC) is unknown. The aim of this study is to describe the epidemiology of TBI in Honduras, as captured by an injury surveillance tool in the country's major referral center. METHODS A cross sectional review of all TBI-related emergency department visits at the main referral hospital in Honduras from January to December 2013 was conducted. The calculation of descriptive statistics from Injury Surveillance System (InSS) data was performed. RESULTS Of 17,971 total injuries seen in 2013, 20% were traumatic brain injuries (n=3,588). The main mechanisms of injury were falls (41.11%), road traffic accidents (23.91%), blunt trauma (20.82%), penetrating knife injuries (5.85%), and firearm injuries (2.26%). Most TBI were classified as mild; 99.69% (Glasgow Coma Scale=15). Emergency room mortality was low (1.11%). The modified Kampala Trauma Score median was 8 (interquartile range 7-8). CONCLUSION Mild TBI accounts for a significant percentage of all injuries presenting to a high-volume referral center in Honduras in 2013. Despite the high incidence of violence in this country, most TBI were accidental, secondary to road traffic accidents and falls. Further research is required with more recent data as well as with prospective data collection methods.
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Affiliation(s)
- Erica Johnson
- MD, University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Juan C. Puyana
- MD, FRCSC, FACS, FACCP. School of Medicine, Department of Surgery, Professor of Surgery, Critical Care Medicine, and Clinical Translational Science, Director for Global Health-Surgery, University of Pittsburgh, Pittsburgh, PA, United States. Editorial Board Member, IJMS
| | - Francisco J. Bonilla-Escobar
- MD, MSc, PhD(c). Researcher, Department of Ophthalmology; Institute for Clinical Research Education (ICRE), University of Pittsburgh, Pittsburgh, PA, United States. CEO, Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO/Science to Serve the Community Foundation, SCISCO Foundation, Cali, Colombia. Grupo de investigación en Visión y Salud Ocular, VISOC, Universidad del Valle, Cali, Colombia. Editor in Chief, IJMS
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20
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Pineda E, Singh J, Pineda MV, Umanzor JG, Baires F, Benitez LG, Burgos C, Sekhon AK, Crisp N, Lewis AS, Radwanski J, Bermudez M, Barjun KS, Diaz O, Palou E, Escalante RE, Hernandez CI, Stevens ML, Eberhard D, Sierra M, Alvarado T, Videa O, Sierra-Hoffman M, Valerio-Pascua F. Impact of fluvoxamine on outpatient treatment of COVID-19 in Honduras in a prospective observational real-world study. Front Pharmacol 2022; 13:1054644. [PMID: 36532727 PMCID: PMC9748291 DOI: 10.3389/fphar.2022.1054644] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/02/2022] [Indexed: 09/06/2023] Open
Abstract
Background: The COVID-19 pandemic has impacted millions of lives globally. While COVID-19 did not discriminate against developed or developing nations, it has been a significant challenge for third world countries like Honduras to have widespread availability of advanced therapies. The concept of early treatment was almost unheard of when early outpatient treatments utilizing repurposed drugs in Latin American countries began showing promising results. One such drug is fluvoxamine, which has shown tremendous potential in two major studies. As a direct result, fluvoxamine was added to the standard of care in a major medical center outpatient COVID-19 clinic. Methods: This is a prospective observational study performed at the Hospital Centro Médico Sampedrano (CEMESA) in San Pedro Sula, Cortes, Honduras in the COVID-19 outpatient clinic. All patients were at least 15 years of age who had presented with mild or moderate signs and symptoms of COVID-19, and who also had a documented positive SARS-CoV-2 antigen or Reverse Transcription Polymerase Chain Reaction (RT-PCR) were included in the study. These patients then were all prescribed fluvoxamine. The cohort of patients who decided to take fluvoxamine were compared for primary endpoints of mortality and hospitalization risk to the cohort who did not take fluvoxamine. Patients were then monitored for 30 days with the first follow up at 7 days and the second follow up at 10-14 days of symptom onset. Categorical variables were compared by Pearson Chi-square test. The Relative risk was calculated using regression models. Continuous variables were compared by t-test and Wilcoxon rank-sum tests. Results: Out of total 657 COVID-19 cases, 594 patients took fluvoxamine and 63 did not take fluvoxamine. A total of five patients (0.76 percent) died, with only one death occurring in the fluvoxamine group. Patients who received fluvoxamine had a significantly lower relative risk of mortality (RR 0.06, p 0.011, 95% CI 0.007-0.516). There was a lower relative risk of hospitalization in the patients who in the fluvoxamine group. (-10 vs. 30 hospitalizations, RR 0.49, p = 0.035, 95% CI 0.26-0.95). There was 73 percent reduction in relative risk of requiring oxygen in the fluvoxamine group (RR 0.27, p < 0.001, 95% CI 0.14-0.54 Mean lymphocytes count on the first follow-up visit was significantly higher in the fluvoxamine group (1.72 vs. 1.38, Δ 0.33, p 0.007, CI 0.09-0.58). Conclusion: The results of our study suggest that fluvoxamine lowers the relative risk of death, hospitalization, and oxygen requirement in COVID 19 patients.
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Affiliation(s)
- Estela Pineda
- Department of Internal Medicine Hospital CEMESA, San Pedro Sula, Honduras
| | - Jarmanjeet Singh
- Department of Cardiovascular Medicine, University of California, Riverside, Riverside, CA, United States
| | - Miguel Vargas Pineda
- Department of Internal Medicine Hospital Mario Catarino Rivas, San Pedro Sula, Honduras
| | - Jose Garay Umanzor
- Department of Obstetrics and Gynecology Hospital Mario Catarino Rivas, San Pedro Sula, Honduras
| | - Fernando Baires
- Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Luis G. Benitez
- Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Cesar Burgos
- Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | | | - Nicole Crisp
- Wound Care Department El Campo Memorial Hospital, El Campo, TX, United States
| | - Anita S. Lewis
- Pharmacy Department El Campo Memorial Hospital, El Campo, TX, United States
| | - Jana Radwanski
- Pharmacy Department Citizens Hospital, Victoria, TX, United States
| | - Marco Bermudez
- Department of Medicine SBH Health System, Bronx, NY, United States
| | - Karen Sanchez Barjun
- Department of Internal Medicine Hospital Mario Catarino Rivas, San Pedro Sula, Honduras
| | - Oscar Diaz
- Department of Critical Care Hospital Regional del Norte Instituto Hondureño de Seguridad Social, San Pedro Sula, Honduras
| | - Elsa Palou
- Internal Medicine Department, Facultad de Ciencas Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Rossany E. Escalante
- Department of Medicine, Facultad de Ciencas Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | | | - Mark L. Stevens
- Research Department, Texas A&M College of Medicine, Detar Family Medicine Residency Program, Victoria, TX, United States
| | - Deke Eberhard
- Research Department, Texas A&M College of Medicine, Detar Family Medicine Residency Program, Victoria, TX, United States
| | - Manuel Sierra
- Universidad Tecnológica Centroamericana, Tegucigalpa, Honduras
| | - Tito Alvarado
- Infectiology Department, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Omar Videa
- Clínica de Atención Medica Integral CAMI, Tegucigalpa, Honduras
| | - Miguel Sierra-Hoffman
- Research and Infectious Disease Department, Texas A&M College of Medicine, Detar Family Medicine Residency Program, Victoria, TX, United States
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Zambrano LI, Fuentes-Barahona IC, Portillo-Pineda R, Aguilar-Ponce M, Murillo-Padilla JC, Suazo-Menocal M, Antunez-Salgado C, Medina-Bassilet E, Muñoz-Lara F, Bonilla-Aldana DK, Montenegro-Idrogo JJ, Rodríguez-Morales AJ. Assessment of Post-Dengue Rheumatic Symptoms Using the WOMAC and DAS-28 Questionnaires in a Honduran Population after a Four-Month Follow-Up. Trop Med Infect Dis 2022; 7. [PMID: 36548649 DOI: 10.3390/tropicalmed7120394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/08/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction: Alphaviruses may cause arthritis, but there is a lack of studies assessing it in flaviviruses such as dengue. Through the 28 Joint Disease Activity Score (DAS-28), incorporating swollen joint counts, and through the Arthritis Index from Western Ontario and McMaster Universities (WOMAC), we assessed pain, stiffness, and dimensions of arthritic function in post-DENV patients. Methods: Prospective study of a cohort of participants who were diagnosed with dengue in centres in Honduras from December 2019 to February 2020, with a follow-up period of 4 months to evaluate post-dengue rheumatological disease through the WOMAC and DAS-28 questionnaires. Results: After a four-month follow-up phase with 281 participants, the final cohort comprised 58.8% women and 41.20% men. After the follow-up, 63.02% persisted with the clinical findings. According to WOMAC, joint involvement was higher in women with (58.76%) (p < 0.0001) these symptoms or functional limitations when performing daily activities were limited to pain when walking (34.81% vs. 5.51%), climbing or descending stairs (36.46% vs. 8.66%), and at night at bedtime (28.73% vs. 7.08%). With the DAS-28, we found at least one alteration with inflammation or pain in 14.91% of the participants, primarily women (p < 0.01). Discussion: Joint involvement was high during the dengue epidemic in 2019. We observed a significant proportion of women with inflammation and joint pain, showing that dengue may lead to the development of chronic rheumatological findings, although lower than in CHIKV, still affecting everyday life and, consequently, their quality of life. Additional long-term evaluation studies after dengue are required.
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García-Santos S, Sánchez-Murillo R, Peña-Paz T, Chirinos-Escobar MJ, Hernández-Ortiz JO, Mejía-Escobar EJ, Ortega L. Water stable isotopes reveal a complex rainfall to groundwater connectivity in central Honduras. Sci Total Environ 2022; 844:156941. [PMID: 35753477 DOI: 10.1016/j.scitotenv.2022.156941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 06/09/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
The inter-mountainous region of central Honduras has been experiencing abrupt urban drinking water shortages during the last decade. Land use fragmentation and rainfall deficits have rapidly reduced surface water quality and quantity in this region. Here we present a 3-yr (2018-2020) tracer study within the headwaters of the Choluteca River basin (2949 km2). We sampled rainfall (weekly N = 156; daily N = 270), drilled wells (N = 166; up to ~300 m depth), boreholes (N = 70; ~4-12 m depth), and springs (N = 128) to assess the spatiotemporal connectivity between rainfall and mean groundwater recharge elevations (MREs). Clear W-shaped incursions characterized rainfall isotopic seasonality from the dry to the wet season. Air mass back trajectory analysis revealed three primary moisture sources: 73 % (east, Caribbean Sea), 17 % (southwest, Pacific Ocean), and 10 % (north; Gulf of Mexico). Groundwater sources exhibited a strong meteoric origin with evidence of secondary evaporation evolution, characterized by low d-excess values. MREs for the drilled wells ranged from 821 to 2018 m asl with a mean value of 1570 ± 150 m asl. Seasonal isotopic variability during dry-wet transitions and the influence of rapid infiltration limited the performance of the MRE method in springs and boreholes. MREs coincided primarily with coniferous forests, pasture, and crop areas, within regions of moderate to high transmissivity. These results are intended to guide the mapping and delineation of critical recharge areas in central Honduras to enhance municipal water regulations, effective environmental protection, and long-term conservation practices.
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Affiliation(s)
- S García-Santos
- Instituto Hondureño de Ciencias de la Tierra, IHCIT, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - R Sánchez-Murillo
- Department of Earth and Environmental Sciences, University of Texas at Arlington, 500 Yates Street, Arlington, TX 76019, USA.
| | - T Peña-Paz
- Centro Experimental y de Innovación del Recurso Hídrico (CEIRH), Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - M J Chirinos-Escobar
- Instituto Hondureño de Ciencias de la Tierra, IHCIT, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - J O Hernández-Ortiz
- Centro Experimental y de Innovación del Recurso Hídrico (CEIRH), Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - E J Mejía-Escobar
- Instituto Hondureño de Ciencias de la Tierra, IHCIT, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - L Ortega
- International Atomic Energy Agency, Isotope Hydrology Section, Vienna International Center, Vienna, Austria
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Johnson JV, Exton DA, Dick JTA, Oakley J, Jompa J, Pincheira-Donoso D. The relative influence of sea surface temperature anomalies on the benthic composition of an Indo-Pacific and Caribbean coral reef over the last decade. Ecol Evol 2022; 12:ECE39263. [PMID: 36091340 PMCID: PMC9448965 DOI: 10.1002/ece3.9263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 08/08/2022] [Accepted: 08/14/2022] [Indexed: 11/06/2022] Open
Abstract
Rising ocean temperatures are the primary driver of coral reef declines throughout the tropics. Such declines include reductions in coral cover that facilitate the monopolization of the benthos by other taxa such as macroalgae, resulting in reduced habitat complexity and biodiversity. Long-term monitoring projects present rare opportunities to assess how sea surface temperature anomalies (SSTAs) influence changes in the benthic composition of coral reefs across distinct locations. Here, using extensively monitored coral reef sites from Honduras (in the Caribbean Sea), and from the Wakatobi National Park located in the center of the coral triangle of Indonesia, we assess the impact of global warming on coral reef benthic compositions over the period 2012-2019. Bayesian generalized linear mixed effect models revealed increases in the sponge, and hard coral coverage through time, while rubble coverage decreased at the Indonesia location. Conversely, the effect of SSTAs did not predict any changes in benthic coverage. At the Honduras location, algae and soft coral coverage increased through time, while hard coral and rock coverage were decreasing. The effects of SSTA at the Honduras location included increased rock coverage, but reduced sponge coverage, indicating disparate responses between both systems under SSTAs. However, redundancy analyses showed intralocation site variability explained the majority of variance in benthic composition over the course of the study period. Our findings show that SSTAs have differentially influenced the benthic composition between the Honduras and the Indonesian coral reefs surveyed in this study. However, the large intralocation variance that explains the benthic composition at both locations indicates that localized processes have a predominant role in explaining benthic composition over the last decade. The sustained monitoring effort is critical for understanding how these reefs will change in their composition as global temperatures continue to rise through the Anthropocene.
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Affiliation(s)
- Jack V Johnson
- Macrobiodiversity Lab, School of Biological Sciences Queen's University Belfast Belfast UK.,Operation Wallacea Spilsby UK
| | | | - Jaimie T A Dick
- Institute for Global Food Security, School of Biological Sciences Queen's University Belfast Belfast UK
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Menjívar C, Agadjanian V, Oh B. The Contradictions of Liminal Legality: Economic Attainment and Civic Engagement of Central American Immigrants on Temporary Protected Status. Soc Probl 2022; 69:678-698. [PMID: 37649781 PMCID: PMC10468158 DOI: 10.1093/socpro/spaa052] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
This study examines how Temporary Protected Status (TPS) may shape immigrants' integration trajectories. Building on core themes identified in the immigrant incorporation scholarship, it investigates whether associations of educational attainment with labor market outcomes and with civic participation, which are well established in the general population, hold for immigrants who live in the "liminal legality" of TPS. Conducted in 2016 in five U.S. metropolitan areas, the study is based on a unique survey of Salvadoran and Honduran TPS holders, the majority of immigrants on this status. The analyses find that TPS holders with higher levels of educational attainment do not derive commensurate significant occupational or earnings premiums from their education. In contrast, the analysis of the relationship between educational attainment and civic engagement detects a positive association: more educated TPS holders are more likely to be members of community organizations and to participate in voluntary community service, compared to their less educated counterparts. These findings illustrate the contradictions inherent to TPS as it may hinder certain aspects of immigrant integration but not others. This examination contributes to our understanding of the implications of immigrants' legal statuses and of immigration law and policy for key aspects of immigrant integration trajectories.
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Dye-Braumuller KC, Rodríguez Aquino MS, Self SCW, Kanyangarara M, Nolan MS. Spotted Fever Group Rickettsioses in Central America: The Research and Public Health Disparity among Socioeconomic Lines. Insects 2022; 13:674. [PMID: 35893029 DOI: 10.3390/insects13080674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 01/27/2023]
Abstract
Simple Summary Tick-borne diseases are an important public health issue globally. Spotted fever group rickettsioses (SFGR), a group of related tick-borne pathogens, can cause significant disease, but is widely underreported and likely misdiagnosed. In Central America, there is little known about SFGR, and there seems to be a socioeconomic-related difference between the most-developed and least-developed countries in the region. The least-developed countries (El Salvador, Guatemala, Honduras, and Nicaragua) disproportionately underreport research or studies regarding SFGR disease compared to the most-developed countries (Belize, Panama, and Costa Rica). We compared human development and poverty indicators among Central American countries for this review of SFGR Rickettsia-related articles. The least-developed countries are at a higher risk or are more vulnerable to SFGR disease than the most-developed countries in this region. Abstract Tick-borne diseases including rickettsial diseases are increasing in incidence worldwide. Many rickettsial pathogens can cause disease which is commonly underdiagnosed and underreported; Rickettsia pathogens in the spotted fever group (SFGR) are thus classified as neglected bacterial pathogens. The Central American region shoulders a large proportion of the global neglected disease burden; however, little is known regarding SFGR disease here. Although development varies, four of the seven countries in this region have both the highest poverty rates and SFGR disease burdens (El Salvador, Honduras, Guatemala, and Nicaragua), compared to Belize, Panama, and Costa Rica. Utilizing the Human Development Index (HDI), we compared published articles related to SFGR Rickettsia prevalence in the lowest-HDI-scoring countries to the highest-HDI-scoring countries. Our analysis identified a distinct dichotomy in publication, and by proxy, potentially awareness and knowledge of SFGR tick-borne disease in Central America, where the least-developed countries are at the highest risk for, yet the most vulnerable to, SFGR disease.
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Fontecha G, Escobar D, Ortiz B, Pinto A. A PCR-RFLP Technique to Assess the Geographic Origin of Plasmodium falciparum Strains in Central America. Trop Med Infect Dis 2022; 7:tropicalmed7080149. [PMID: 35893657 PMCID: PMC9394469 DOI: 10.3390/tropicalmed7080149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 11/20/2022] Open
Abstract
The elimination of malaria requires strengthening diagnosis and offering adequate and timely treatment. Imported cases of falciparum malaria represent a major challenge for pre-elimination areas, such as Central America, where chloroquine and primaquine continue to be used as first-line treatment. The pfs47 gene has been previously described as a precise molecular marker to track the geographic origin of the parasite. The aim of this study was to design a simple and low-cost technique using the polymorphic region of pfs47 to assess the geographic origin of P. falciparum strains. A PCR-RFLP technique was developed and evaluated using the MseI enzyme that proved capable of discriminating, with reasonable precision, the geographical origin of the parasites. This method could be used by national surveillance laboratories and malaria elimination programs in countries such as Honduras and Nicaragua in cases of malaria where an origin outside the Central American isthmus is suspected.
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Reichman DR. Putting climate-induced migration in context: the case of Honduran migration to the USA. Reg Environ Change 2022; 22:91. [PMID: 35814810 PMCID: PMC9251033 DOI: 10.1007/s10113-022-01946-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 06/05/2022] [Indexed: 06/15/2023]
Abstract
Over the past decade, unauthorized migration from Honduras to the USA has become a topic of pressing international concern and a major factor in the political and humanitarian crisis at the southern border of the USA that has been unfolding since 2014. Untangling the causes of recent Honduran migration requires attending to economic change, political instability, the impact of violence and crime, rapidly changing gender roles, among many other forces that shape migration patterns. Recently, scholars and policy-makers have analyzed the impact of drought in the so-called Dry Corridor of Central America as a major source of migration, particularly among coffee producers who have been hard hit by unprecedented heat and lack of rain in parts of Honduras. Drawing on ethnographic studies of Honduran coffee farmers, this paper will discuss how and if climatic factors can be isolated from other factors to explain recent Honduran migration behavior, in order to move towards a holistic explanation of climate-driven migration.
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Affiliation(s)
- Daniel R. Reichman
- Department of Anthropology, University of Rochester, Rochester, NY 14627 USA
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Abstract
Intimate partner violence (IPV) is a widespread issue that affects millions of individuals each year. Prior research suggests that IPV approval is associated with an increased likelihood of IPV perpetration. However, scant research has examined predictors of IPV approval, and even less has examined the predictors of IPV approval in Latin America. Social cognitive theory describes the acquisition of ideas, values, attitudes, and behaviors through social observation, including through media. This study uses social cognitive theory to examine the effects of media use on men's approval of IPV in Honduras, while controlling for demographic variables and IPV risk factors. We hypothesized that greater engagement with media (via television, radio, and newspapers or magazines) would be associated with decreases in the approval of IPV. Using ordinal logistic regression, we analyzed data from the Men's Survey Module of the 2011-2012 Honduras Demographic and Health Survey. The final sample included 4,760 currently partnered men. Results suggest that listening to the radio one or more times per week was associated with greater IPV approval, while newspaper/magazine and television use were not significantly associated with IPV approval. Education, marital status, increased age at first cohabitation, and having a female partner or someone else making decisions about earnings were all protective against IPV approval. Further investigation into the content of Honduran radio and other media is called for in order to inform interventions to reduce acceptance of IPV.
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Escobar D, Archaga O, Reyes A, Palma A, Larson RT, Vásquez GM, Fontecha G. A Follow-Up to the Geographical Distribution of Anopheles Species in Malaria-Endemic and Non-Endemic Areas of Honduras. Insects 2022; 13:insects13060548. [PMID: 35735885 PMCID: PMC9225189 DOI: 10.3390/insects13060548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 12/10/2022]
Abstract
Simple Summary Malaria is a tropical disease caused by parasites of the genus Plasmodium. The parasite is transmitted to humans through the bite of the female mosquito Anopheles. Honduras is close to the goal of eliminating malaria, but the region called La Moskitia continues to concentrate almost all of the country’s malaria cases. One of the key factors in achieving malaria elimination is a thorough understanding of the mosquito vectors that transmit the disease. There are few studies related to malaria vectors in Honduras. This study aims to contribute to knowing which are the species of vector mosquitoes, mainly in the Department of Gracias a Dios and in other departments in which cases of malaria occur, in addition to describing molecularly for the first time the anophelines of the Bay Islands. The most abundant species found here were Anopheles albimanus, but seven other species were also identified, some of which may contribute to parasite transmission. Abstract Anopheles species are the vectors of malaria, one of the diseases with the greatest impact on the health of the inhabitants of the tropics. Due to their epidemiological relevance and biological complexity, monitoring of anopheline populations in current and former malaria-endemic areas is critical for malaria risk assessment. Recent efforts have described the anopheline species present in the main malaria foci in Honduras. This study updates and expands knowledge about Anopheles species composition, geographical distribution, and genetic diversity in the continental territory of Honduras as in the Bay Islands. Outdoor insect collections were carried out at 25 sites in eight municipalities in five departments of Honduras between 2018 and 2021. Specimens were identified using taxonomic keys. Partial COI gene sequences were used for molecular species identification and phylogenetic analyses. In addition, detection of Plasmodium DNA was carried out in 255 female mosquitoes. Overall, 288 Anopheles mosquitoes were collected from 8 municipalities. Eight species were morphologically identified. Anopheles albimanus was the most abundant and widely distributed species (79.5%). A subset of 175 partial COI gene sequences from 8 species was obtained. Taxonomic identifications were confirmed via sequence analysis. Anopheles albimanus and An. apicimacula showed the highest haplotype diversity and nucleotide variation, respectively. Phylogenetic clustering was found for An. argyritarsis and An. neomaculipalpus when compared with mosquitoes from other Neotropical countries. Plasmodium DNA was not detected in any of the mosquitoes tested. This report builds upon recent records of the distribution and diversity of Anopheles species in malaria-endemic and non-endemic areas of Honduras. New COI sequences are reported for three anopheline species. This is also the first report of COI sequences of An. albimanus collected on the island of Roatán with apparent gene flow relative to mainland populations.
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Affiliation(s)
- Denis Escobar
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (D.E.); (O.A.)
| | - Osman Archaga
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (D.E.); (O.A.)
| | - Allan Reyes
- Unidad de Entomología, Región Sanitaria de Gracias a Dios, Secretaría de Salud de Honduras, Puerto Lempira, Gracias a Dios 33101, Honduras;
| | - Adalid Palma
- Vysnova Partners, Inc., Landover, MD 20785, USA;
| | - Ryan T. Larson
- Department of Entomology, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Bellavista 07006, Peru; (R.T.L.); (G.M.V.)
| | - Gissella M. Vásquez
- Department of Entomology, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Bellavista 07006, Peru; (R.T.L.); (G.M.V.)
| | - Gustavo Fontecha
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (D.E.); (O.A.)
- Correspondence: ; Tel.: +504-33935443
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Ortiz B, Laínez-Arteaga I, Galindo-Morales C, Acevedo-Almendárez L, Aguilar K, Valladares D, López M, Fontecha G. First Molecular Identification of Three Clinical Isolates of Fungi Causing Mucormycosis in Honduras. Infect Dis Rep 2022; 14:258-65. [PMID: 35447883 DOI: 10.3390/idr14020031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 03/31/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023] Open
Abstract
Mucormycoses are rare but serious opportunistic fungal infections caused by filamentous organisms of the order Mucorales. Here we report the first molecular identification of Rhizopus oryzae (heterotypic synonym Rhizopus arrhizus), R. delemar, and Apophysomyces ossiformis as the etiological agents of three cases of severe mucormycosis in Honduras. Conventional microbiological cultures were carried out, and DNA was extracted from both clinical samples and axenic cultures. The ITS ribosomal region was amplified and sequenced. Molecular tools are suitable strategies for diagnosing and identifying Mucorales in tissues and cultures, especially in middle-income countries lacking routine diagnostic strategies.
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31
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Hasemann Lara JE. Care in Ruination: Accessing Children's Critiques of Health Through Playwriting. Med Anthropol 2022; 41:546-559. [PMID: 35324361 DOI: 10.1080/01459740.2022.2053966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Using two plays written by girls and boys, I discuss how children from low-income urban neighborhoods in Honduras reflected on the slow process of privatization of the Honduran national health system. The children peppered their narratives with motifs suggestive of ongoing processes of material and social deterioration under capitalism, while paying attention to the different social mechanisms through which care could be mobilized. The plays speak to the value of incorporating children's perspectives on topics of health-disease processes that circle political, economic, and social tensions, and the importance of incorporating new ways of producing knowledge through artistic mediums.
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Pacheco-Montoya D, Murphy-Graham E, Valencia López EE, Cohen AK. Gender Norms, Control Over Girls' Sexuality, and Child Marriage: A Honduran Case Study. J Adolesc Health 2022; 70:S22-S27. [PMID: 35184826 DOI: 10.1016/j.jadohealth.2021.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/10/2021] [Accepted: 11/09/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE This study explores links among marianismo, girls' mobility and sexuality, and child marriage among adolescent girls in rural areas of Honduras. METHODS We analyze quantitative and qualitative data collected in 2008-2016 for a longitudinal cohort study of rural Honduran adolescent girls. These data include interviews (n = 10 married before age 18) and surveys (n = 563; 155 married early). We also use qualitative data from focus groups in 2016 that included students, parents, teachers, and community members (n = 120). RESULTS We find that girls who scored higher on a scale of traditional gender norms were more likely to marry early. Furthermore, our qualitative findings indicate that girls experienced control over their mobility and their sexuality because of rigid gender norms prevalent in their communities. The control girls experience clashes with undergoing psychosocial changes that are associated with increased desire for autonomy and intimacy as well as increased awareness of their sexuality. In some cases, girls believed that marriage was better than staying in their restrictive households, and/or they viewed marriage as the only way to have a romantic relationship. DISCUSSION Rigid gender norms that promote excessive regulation of girls' behavior and sexuality influence girls' decision-making processes to enter child marriage. Educational initiatives that challenge sexist gender norms and explain and normalize attraction and intimacy during adolescence should be a central component of child marriage prevention programming for adolescents, parents, and community members.
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Affiliation(s)
- Diana Pacheco-Montoya
- Graduate School of Education, University of California, Berkeley, Berkeley, California.
| | - Erin Murphy-Graham
- Graduate School of Education, University of California, Berkeley, Berkeley, California
| | | | - Alison K Cohen
- Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California
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Agudelo Higuita NI, Varela Bustillo D, Denning DW. Burden of serious fungal infections in Honduras. Mycoses 2022; 65:429-439. [PMID: 35165955 DOI: 10.1111/myc.13432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/09/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The burden of serious fungal infections in Honduras is unknown. The diagnosis of fungal diseases relies on almost exclusively on microscopy and culture limiting an accurate estimate of the burden of disease. OBJECTIVES The primary objective of the study was to estimate the burden of serious fungal infections in Honduras using previously described methods. METHODS National and international demographic data on population, HIV, tuberculosis, asthma, COPD and cancer were obtained. A thorough literature search was done for all epidemiological studies and case series of serious fungal diseases. Using these risk populations and whatever incidence and prevalence could be found that was most pertinent to Honduras, a burden estimate was derived. RESULTS The estimated number of serious fungal infection was estimated to be between 178,772 and 179,624 with nearly 2300 cases of these representing opportunistic infections in people living with HIV. The incidence of histoplasmosis and cryptococcosis in people living with HIV is high and estimated to be 4.3 and 4.6 cases per 100,000 population respectively. Approximately 12,247-13,099 cases of aspergillosis and 164,227 of other serious fungal infections were estimated to occur each year. CONCLUSION An accurate estimate of the burden of serious fungal infections in Honduras is unknown but based on our results, likely significant. Serious fungal infections represent an important public health problem in Honduras affecting approximately 1.8% of the population. There is a clear need for better access to diagnostic tools and antifungals to conduct research to better understand the impact of fungal diseases in Honduras.
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Affiliation(s)
- Nelson Iván Agudelo Higuita
- Department of Medicine, Section of Infectious Diseases, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Diana Varela Bustillo
- Department of Medicine, Infectious Diseases Service, Hospital Escuela, Tegucigalpa, Honduras
| | - David W Denning
- Manchester Fungal Infection Group, Core Technology Facility, The University of Manchester and the Manchester Academic Health Science Centre, Manchester, UK
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Huber-Krum S, Miedema SS, Shortt JW, Villaveces A, Kress H. Associations between adverse childhood experiences and contraceptive use among young adults in Honduras. Child Abuse Negl 2022; 123:105381. [PMID: 34753054 PMCID: PMC9511159 DOI: 10.1016/j.chiabu.2021.105381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 10/05/2021] [Accepted: 10/28/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Research on adverse childhood experiences (ACEs) and use of modern contraception is limited in Honduras. The government has made substantial gains in promoting modern contraception. Young adults experience high rates of violence. The aim of this study was to assess the relationship between ACEs and contraceptive behaviors among young women and men. METHODS We used data from 810 women and 753 men aged 18-24 years from the 2017 Honduras Violence against Children Survey, a cross-sectional, nationally representative household survey of childhood adversity. We assessed associations between ACEs and three contraceptive use outcomes: use versus nonuse of modern contraceptives; use of methods requiring medium/high or low programmatic support among current contraceptive users; and frequent versus infrequent condom use. FINDINGS Exposure to physical or emotional abuse and witnessing violence in the home was not significantly associated with the three contraceptive use outcomes for men or women. Sexual abuse and parental separation reduced odds of contraceptive use among women (Odds Ratio (OR) < 0.60) but not among men. In contrast, orphan status increased odds of modern contraception use among men (OR 1.93) and frequent condom use among women (OR 2.22). CONCLUSION The inconsistent direction and magnitude of associations between ACEs and modern contraceptive use among young men and women suggests divergent relationships between ACEs and sexual and reproductive health behaviors. Results may highlight the strength of norms around contraceptive use and/or widespread access to community-based family planning programs and comprehensive sexuality education, irrespective of exposure to ACEs in Honduras.
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Affiliation(s)
- Sarah Huber-Krum
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Stephanie Spaid Miedema
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Joann Wu Shortt
- Research and Evaluation Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Andrés Villaveces
- Field Epidemiology and Prevention Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Howard Kress
- Field Epidemiology and Prevention Branch, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Fontecha G, Pinto A, Archaga O, Betancourth S, Escober L, Henríquez J, Valdivia HO, Montoya A, Mejía RE. Assessment of Plasmodium falciparum anti-malarial drug resistance markers in pfcrt and pfmdr1 genes in isolates from Honduras and Nicaragua, 2018-2021. Malar J 2021; 20:465. [PMID: 34906144 PMCID: PMC8670165 DOI: 10.1186/s12936-021-03977-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/10/2021] [Indexed: 12/04/2022] Open
Abstract
Background Central America and the island of Hispaniola have set out to eliminate malaria by 2030. However, since 2014 a notable upturn in the number of cases has been reported in the Mosquitia region shared by Nicaragua and Honduras. In addition, the proportion of Plasmodium falciparum malaria cases has increased significantly relative to vivax malaria. Chloroquine continues to be the first-line drug to treat uncomplicated malaria in the region. The objective of this study was to evaluate the emergence of chloroquine resistant strains of P. falciparum using a genetic approach. Plasmodium vivax populations are not analysed in this study. Methods 205 blood samples from patients infected with P. falciparum between 2018 and 2021 were analysed. The pfcrt gene fragment encompassing codons 72–76 was analysed. Likewise, three fragments of the pfmdr1 gene were analysed in 51 samples by nested PCR and sequencing. Results All samples revealed the CVMNK wild phenotype for the pfcrt gene and the N86, Y184F, S1034C, N1042D, D1246 phenotype for the pfmdr1 gene. Conclusions The increase in falciparum malaria cases in Nicaragua and Honduras cannot be attributed to the emergence of chloroquine-resistant mutants. Other possibilities should be investigated further. This is the first study to report the genotype of pfmdr1 for five loci of interest in Central America. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03977-8.
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Affiliation(s)
- Gustavo Fontecha
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras.
| | - Alejandra Pinto
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Osman Archaga
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Sergio Betancourth
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Lenin Escober
- National Malaria Laboratory, National Department of Surveillance, Ministry of Health of Honduras, Tegucigalpa, Honduras
| | - Jessica Henríquez
- National Malaria Laboratory, National Department of Surveillance, Ministry of Health of Honduras, Tegucigalpa, Honduras
| | - Hugo O Valdivia
- Department of Parasitology, U.S. Naval Medical Research Unit No, 6 (NAMRU-6), Lima, Peru
| | - Alberto Montoya
- National Center for Diagnosis and Reference, Health Ministry, Managua, Nicaragua
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Wheeler J, Hutchinson P, Leyton A. Intimate Partner Violence in Honduras: Ecological Correlates of Self-Reported Victimization and Fear of a Male Partner. J Interpers Violence 2021; 36:11483-11508. [PMID: 31928308 DOI: 10.1177/0886260519898441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The experience of intimate partner violence (IPV) is influenced by individual, relationship, community, and societal-level factors, including the prevalence and acceptance of societal violence in which the victim lives. These factors transcend a woman's present circumstances and personal history and the gender and power relationships within her household. This is particularly relevant in Honduras, where a high level of IPV occurs within a traditionally patriarchal society and growing societal violence and crime. This study examines the factors-informed by a social ecological theoretical perspective-associated with the experience of IPV. We use data from the Honduras Demographic and Health Survey (ENDESA) 2011-2012 to estimate multilevel, multivariate models predicting the likelihood that a woman experiences emotional, physical, and/or sexual IPV and/or fear of her partner. Our models contain higher level contextual effects that capture regional variations in social violence and aggregated norms capturing acceptance of IPV. We find that a woman's likelihood of experiencing violence is related to individual, relationship, and household-level characteristics, including marital status, age at first cohabitation, employment status, violence within the parental home, women's accepting attitudes toward IPV, autonomy in decision-making, partner's use of alcohol, the nature of the relationship with her partner (i.e., living together or not), and educational and age differences with her partner. Notably, women living in more violent areas-measured by violence statistics and aggregate community-level norms regarding spouse beating-were more likely to experience IPV. These findings contribute to our understanding of the risk of IPV and to the evidence that can be used to identify the most vulnerable women and opportunities for intervention to prevent further victimization. By using an analytical methodology that reflects the complexity of factors that place women at risk for IPV, we can isolate, address, and advocate for changing circumstances that make Honduran women vulnerable to IPV.
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Kamath AM, Thom MG, Johanns CK, Panhorst Harris K, Schwarzbauer K, Ochoa JC, Zuniga-Brenes P, Rios-Zertuche D, Mokdad AH, Hernandez B. Tackling equitable coverage and quality of care for neonates in hospitals: a pre-post assessment on asphyxia interventions in Mesoamerica. BMC Pediatr 2021; 21:534. [PMID: 34852795 PMCID: PMC8638427 DOI: 10.1186/s12887-021-02999-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intrapartum-related hypoxic events, or birth asphyxia, causes one-fourth of neonatal deaths globally and in Mesoamerica. Multidimensional care for asphyxia must be implemented to ensure timely and effective care of newborns. Salud Mesoamérica Initiative (SMI) is a performance-based program seeking to improve maternal and child health for low-income areas of Central America. Our objective was to assess the impact of SMI on neonatal asphyxia care in health centers and hospitals in the region. METHODS A pre-post design. Two hundred forty-eight cases of asphyxia were randomly selected from medical records at baseline (2011-2013) and at second-phase follow-up (2017-2018) in Mexico (state of Chiapas), Honduras, Nicaragua, and Guatemala as part of the SMI Initiative evaluation. A facility survey was conducted to assess quality of health care and the management of asphyxia. The primary outcome was coverage of multidimensional care for the management of asphyxia, consisting of a skilled provider presence at birth, immediate assessment, initial stabilization, and appropriate resuscitation measures of the newborn. Data were analyzed using multivariable logistic regression. RESULTS Management of asphyxia improved significantly after SMI. Proper care of asphyxia in intervention areas was better (OR = 2.4; 95% CI = 1.3-4.6) compared to baseline. Additionally, multidimensional care was significantly higher in Honduras (OR = 4.0; 95% CI = 1.4-12.0) than in Mexico. Of the four multidimensional care components, resuscitation showed the greatest progress by follow-up (65.7%) compared to baseline (38.7%). CONCLUSION SMI improved the care for neonatal asphyxia management across all levels of health care in all countries. Our findings show that proper training and adequate supplies can improve health outcomes in low-income communities. SMI provides a model for improving health care in other settings.
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Affiliation(s)
- Aruna M Kamath
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA. .,Department of Anesthesiology, University of Washington, Seattle, WA, USA.
| | - Maximilian G Thom
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA
| | - Casey K Johanns
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA
| | - Katie Panhorst Harris
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA
| | | | - José C Ochoa
- Inter-American Development Bank, Washington, DC, USA
| | | | | | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA
| | - Bernardo Hernandez
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA
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Pinto A, Archaga O, Mejía Á, Escober L, Henríquez J, Montoya A, Valdivia HO, Fontecha G. Evidence of a Recent Bottleneck in Plasmodium falciparum Populations on the Honduran-Nicaraguan Border. Pathogens 2021; 10:pathogens10111432. [PMID: 34832588 PMCID: PMC8617645 DOI: 10.3390/pathogens10111432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/25/2021] [Accepted: 11/01/2021] [Indexed: 12/04/2022] Open
Abstract
The countries of Central America and the island of Hispaniola have set the goal of eliminating malaria in less than a decade. Although efforts to reduce the malaria burden in the region have been successful, there has been an alarming increase in cases in the Nicaraguan Moskitia since 2014. The continuous decrease in cases between 2000 and 2014, followed by a rapid expansion from 2015 to the present, has generated a potential bottleneck effect in the populations of Plasmodium spp. Consequently, this study aimed to evaluate the genetic diversity of P. falciparum and the decrease in allelic richness in this population. The polymorphic regions of the pfmsp-1 and pfmsp-2 genes of patients with falciparum malaria from Honduras and Nicaragua were analyzed using nested PCR and sequencing. Most of the samples were classified into the K1 allelic subfamily of the pfmsp-1 gene and into the 3D7 subfamily of the pfmsp-2 gene. Despite the low genetic diversity found, more than half of the samples presented a polyclonal K1/RO33 haplotype. No sequence polymorphisms were found within each allelic subfamily. This study describes a notable decrease in the genetic diversity of P. falciparum in the Moskitia region after a bottleneck phenomenon. These results will be useful for future epidemiological investigations and the monitoring of malaria transmission in Central America.
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Affiliation(s)
- Alejandra Pinto
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa 11101, Honduras; (A.P.); (O.A.); (Á.M.)
| | - Osman Archaga
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa 11101, Honduras; (A.P.); (O.A.); (Á.M.)
| | - Ángel Mejía
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa 11101, Honduras; (A.P.); (O.A.); (Á.M.)
| | - Lenin Escober
- National Malaria Laboratory, National Department of Surveillance, Ministry of Health of Honduras, Tegucigalpa 11101, Honduras; (L.E.); (J.H.)
| | - Jessica Henríquez
- National Malaria Laboratory, National Department of Surveillance, Ministry of Health of Honduras, Tegucigalpa 11101, Honduras; (L.E.); (J.H.)
| | - Alberto Montoya
- National Center for Diagnosis and Reference, Health Ministry, Managua 11001, Nicaragua;
| | - Hugo O. Valdivia
- Department of Parasitology, U.S. Naval Medical Research Unit No, 6 (NAMRU-6), Lima 07006, Peru;
| | - Gustavo Fontecha
- Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa 11101, Honduras; (A.P.); (O.A.); (Á.M.)
- Correspondence: ; Tel.: +504-33935443
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Long K, Salter C, Good C, Caughey C, Fischer K, Meyer M. Exploring behavioural factors affecting nutritional supplement use among children in Honduras. Public Health Nutr 2021;:1-9. [PMID: 34706788 DOI: 10.1017/S1368980021004468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study explored social and behavioural factors associated with a home fortification of complementary foods program among families of undernourished children in 14 rural communities in Honduras. DESIGN We collected and analysed survey data from a convenience sample of 196 households participating in a nutritional program using home fortification of complementary foods in 2017. The program supplied families with a soy-based atole powder fortified with micronutrients. A research team completed a face-to-face survey exploring social and behavioural factors associated with nutritional supplement use. Anthropometric measurements for participating children were abstracted from health clinic records of previous quarterly appointments. SETTING The study took place in San Jose del Negrito, Honduras. PARTICIPANTS Participants were parents or guardians of children enrolled in the nutrition program. RESULTS Nearly half of participant families shared the nutritional supplement with other family members besides the index child, while 10 % reported using the supplement as a meal replacement for the child. Low education level of mothers was associated with improper use of the supplement (P = 0·005). Poorer families were more likely to share the supplement (P = 0·013). CONCLUSIONS These results highlight the challenges of programs using home fortification of complementary foods in the context of food scarcity. Findings highlight the importance of increasing rural children's overall caloric intake, perhaps by increasing access to locally available protein sources. Results also suggest transitioning nutritional programs to family-based interventions to increase overall intended compliance to nutrition programming.
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Kumar S, Christakis NA, Pérez-Escamilla R. Household food insecurity and health in a high-migration area in rural Honduras. SSM Popul Health 2021; 15:100885. [PMID: 34409149 PMCID: PMC8361312 DOI: 10.1016/j.ssmph.2021.100885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/26/2021] [Accepted: 07/30/2021] [Indexed: 12/01/2022] Open
Abstract
Household food insecurity (HFI) is a significant problem in the developing world. Relationships between HFI and nutrition, physical growth, and development have been elucidated; less is known about the non-nutritional impacts among individuals living in rural areas in low-income countries. The aim of this study was to determine if HFI is a risk factor for suboptimal mental health and overall health in rural Honduras. In a population of 24,696 adults with 176 isolated villages in western Honduras, we collected data on household food insecurity and physical and mental health outcome measures. Using logistic regression with and without adjusting for village and household level unobservables invariant across individual respondents, we show that females (OR: 1.11, p <0.01)), indigenous people (OR: 2:00, p < 0.01), and those planning to migrate (OR: 1.24, p <0.01) have higher odds of experiencing food insecurity. The risks of food insecurity and poor health were mitigated among respondents living where they were born and having multi-generations of relatives living in the same village-a measure of the opportunity and availability of social networks. Living in a food insecure compared to a food secure household was associated with 77 percent higher odds of being depressed, 35 percent higher odds of low overall mental health, and 20 percent higher odds for low overall health.
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Affiliation(s)
- Sanjeev Kumar
- Department of Health Policy and Management, Yale School of Public Health, Yale University, New Haven, CT, USA
| | | | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, 06510, USA
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Lopez-Ridaura S, Sanders A, Barba-Escoto L, Wiegel J, Mayorga-Cortes M, Gonzalez-Esquivel C, Lopez-Ramirez MA, Escoto-Masis RM, Morales-Galindo E, García-Barcena TS. Immediate impact of COVID-19 pandemic on farming systems in Central America and Mexico. Agric Syst 2021; 192:103178. [PMID: 36569352 PMCID: PMC9759656 DOI: 10.1016/j.agsy.2021.103178] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 05/04/2021] [Accepted: 05/12/2021] [Indexed: 06/14/2023]
Abstract
CONTEXT The COVID-19 pandemic has affected all sectors and human activities around the World. OBJECTIVE In this article we present a first attempt to understand the immediate impact of COVID-19 and the sanitary measures taken by governments on farming systems in Central America and Mexico (CAM). METHODS Through a review of information generated in these initial months of the COVID-19 pandemic (webinars, blogs, electronic publications, media) and 44 interviews with key informants across the region, we have identified the main impacts felt by different types of farming systems in the region. RESULTS AND CONCLUSIONS From corporate agricultural production systems, to small and medium scale entrepreneurs and smallholder subsistence farm households, all types of farming systems were impacted, more or less severely, by the different measures implemented by governments such as reduced mobility, closure of public and private venues and restrictions in borders. Larger corporate farming systems with vertical market integration and high level of control or coordination within the supply chain, and smallholder or subsistence farming systems with important focus on production for self-consumption and little external input use, were both relatively less impacted and showed greater adaptive capacity than the medium and small entrepreneurial farming systems dependent on agriculture as their primary income and with less control over the upstream and downstream parts of their supply chain. All types of farming systems implemented a series of mechanisms to cope with the COVID-19 pandemic including the development of alternative value chains, food and agricultural products delivery systems and the exponential use of digital means to communicate and maintain the viability of the different agricultural systems. Collective action and organization of farmers also proved to be an important coping mechanism that allowed some farmers to acquire inputs and deliver outputs in the context of restricted mobility, price volatility, and general uncertainty. Some features of the CAM region played an important role in mediating the impact of COVID-19 and associated sanitary measures. We identify as particularly relevant the nature of agricultural exports, the current structure of the agricultural sector, the diversified livelihood strategies of rural households, and the importance of mobility for rural livelihoods. SIGNIFICANCE The results presented focus only in the immediate effect of COVID-19 pandemic and the mechanisms implemented by farmers in the first months. Whether these impacts and response mechanisms will result in a transformation of the farming systems towards greater resilience and sustainability is still an open question.
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Affiliation(s)
- Santiago Lopez-Ridaura
- Sustainable Intensification Program (SIP) International Maize and Wheat Improvement Center (CIMMYT), Mexico
| | | | - Luis Barba-Escoto
- Sustainable Intensification Program (SIP) International Maize and Wheat Improvement Center (CIMMYT), Mexico
| | - Jennifer Wiegel
- Alliance of Bioversity International and the Center for International Tropical Agriculture (CIAT), Nicaragua
| | | | - Carlos Gonzalez-Esquivel
- Instituto de Investigaciones en Ecosistemas y Sustentabilidad (IIES), Universidad Nacional Autónoma de México (UNAM), Mexico
| | | | - Rene M Escoto-Masis
- Servicio de Información Mesoamericano sobre Agricultura Sostenible (SIMAS), Nicaragua
| | | | - Tomas S García-Barcena
- Centro Regional de Investigación del Altiplano Occidental, Instituto de Ciencia y Tecnología Agrícolas (ICTA), Guatemala
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Cardona Cordero NR, Ramos JP, Tavarez ZQ, McIntosh S, Avendaño E, DiMare C, Ossip DJ, De Ver Dye T. Relationship between perceived social support and postpartum care attendance in three Latin American countries: a cross-sectional analytic study. Glob Health Res Policy 2021; 6:16. [PMID: 33958000 PMCID: PMC8103641 DOI: 10.1186/s41256-021-00196-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 03/24/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Postpartum Care is a strategy to improve survival of women and newborns, especially in low- and middle-income countries. Early post-partum care can promote healthy behaviors and the identification of risk factors associated with poorer pregnancy-related outcomes. The objective of this study was to assess the association of perceived social support with attendance to post-partum care in women from three Latin-American and Caribbean countries: Costa Rica, Dominican Republic and Honduras. METHODS Women aged 18+ who completed a pregnancy in the past 5 years were interviewed in local healthcare and community settings in each country. Perceived social support (PSS) was the primary explanatory variable and the primary outcome was self-reported attendance to post-partum care. Odds Ratios (OR) with 95% confidence intervals derived from logistic regression documented the association between variables. Adjusted Odds Ratios (AOR) were calculated, controlling for social and pregnancy-related confounders. Hosmer- Lemeshow's Goodness-of-Fit statistic was computed to assess model fit. RESULTS Our cohort of 1199 women across the three Latin-American and Caribbean countries showed relatively high attendance to post-partum care (82.6%, n = 990). However, 51.7% (n = 581) of women reported lower levels of total PSS. Women were more likely to attend postpartum care if they had mean and higher levels of PSS Family subscale (OR: 1.9, 95%CI: 1.4, 2.7), Friends subscale (OR 1.3, 95%CI: 0.9,1.8), Significant Other subscale (OR 1.8, 95%CI: 1.3, 2.4) and the Total PSS (OR 1.8, 95%CI: 1.3, 2.5). All associations were statistically significant at p < 0.05, with exception of the Friends subscale. Women with higher levels of total PSS were more likely to attend to post-partum care (AOR:1.40, 0.97, 1.92) even after controlling for confounders (education, country, and food insecurity). CONCLUSIONS Women with higher perceived social support levels were more likely to attend to post-partum care. From all countries, women from Dominican Republic had lower perceived social support levels and this may influence attendance at post-partum care for this subgroup. Societal and geographic factors can act as determinants when evaluating perceived social support during pregnancy.
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Affiliation(s)
- Nancy R. Cardona Cordero
- University of Rochester, School of Medicine and Dentistry, Obstetrics and Gynecology Department Research Division, 601 Elmwood Avenue, Rochester, NY 14642 USA
| | - José Perez Ramos
- University of Rochester, School of Medicine and Dentistry, Obstetrics and Gynecology Department Research Division, 601 Elmwood Avenue, Rochester, NY 14642 USA
| | - Zahira Quiñones Tavarez
- Pontificia Universidad Católica Madre y Maestra, Santiago De Los Caballeros, 51000 República Dominicana
| | - Scott McIntosh
- University of Rochester, School of Medicine and Dentistry, Obstetrics and Gynecology Department Research Division, 601 Elmwood Avenue, Rochester, NY 14642 USA
| | - Esteban Avendaño
- Universidad de Ciencias Médicas, 400 metros oeste del M.A.G., Carr. Vieja a Escazú, San José, 10108 Costa Rica
| | - Carmen DiMare
- Universidad de Ciencias Médicas, 400 metros oeste del M.A.G., Carr. Vieja a Escazú, San José, 10108 Costa Rica
| | - Deborah J. Ossip
- University of Rochester, School of Medicine and Dentistry, Obstetrics and Gynecology Department Research Division, 601 Elmwood Avenue, Rochester, NY 14642 USA
| | - Timothy De Ver Dye
- University of Rochester, School of Medicine and Dentistry, Obstetrics and Gynecology Department Research Division, 601 Elmwood Avenue, Rochester, NY 14642 USA
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Flynn TG, Dunaway CM, LaRochelle E, Lyons K, Kennedy LS, Romano ME, Li Z, Spaller MR, Cervinski MA, Bejarano S, Tsongalis GJ, Huyck KL. Reducing dermal exposure to agrochemical carcinogens using a fluorescent dye-based intervention among subsistence farmers in rural Honduras. Int J Hyg Environ Health 2021; 234:113734. [PMID: 33799075 PMCID: PMC10805516 DOI: 10.1016/j.ijheh.2021.113734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 03/03/2021] [Accepted: 03/03/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Occupational exposure to agrochemicals, some of which are known or suspected carcinogens, is a major health hazard for subsistence agricultural workers and their families. These impacts are more prevalent in low-and-middle income countries (LMIC) due to weak regulations, lack of awareness of the risks of contamination, predominant use of handheld backpack style spraying equipment, general lack of personal protective equipment (PPE), and low literacy about proper agrochemical application techniques. Reducing exposure to agrochemicals was identified as a paramount concern by rural Hondurans working with a community-engaged research initiative. Fluorescent tracer dyes have been described as a means of visualizing and quantifying dermal exposure to agricultural chemicals, and exposure models adapted for LMIC have been developed previously. Tracer dyes have also been used in educational simulations to promote pesticide safety. However, studies evaluating the effectiveness of these educational dye interventions in reducing future exposure have been lacking. AIM To evaluate whether observing one's own chemical contamination after applying agrochemicals changed the amount of occupational dermal exposure during a subsequent chemical application. METHODS We employed a multi-modal community intervention in a rural village in Honduras that incorporated chemical safety education and use of a fluorescent tracer dye during pesticide application on two consecutive occasions, and compared dermal exposure between the intervention group (previous dye experience and safety education, n = 6) and the control group (safety education only, n = 7). RESULTS Mean total visual score (TVS) of the tracer dye, which accounts for both extent and intensity of whole-body contamination, was lower among those who had previously experienced the dye intervention (mean TVS = 41.3) than among participants who were dye-naïve (mean TVS = 78.4), with a difference between means of -37.10 (95% CI [-66.26, -7.95], p = 0.02). Stratifying by body part, contamination was significantly lower for the anterior left lower extremity and bilateral feet for the dye-experienced group vs. dye-naïve, with most other segments showing a trend toward decreased contamination as well. CONCLUSION Participants who had previously experienced the dye intervention were significantly less contaminated than the dye-naïve control group during a subsequent spraying event. The findings of this small pilot study suggest that a multi-modal, community-based approach that utilizes fluorescence-augmented contamination for individualized learning (FACIL) may be effective in reducing dermal exposure to carcinogenic agrochemicals among subsistence farmers in Honduras and other LMIC.
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Affiliation(s)
- Thomas G Flynn
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA; Geisel School of Medicine at Dartmouth, 1 Rope Ferry Road, Hanover, NH, 03755, USA.
| | - Charlene M Dunaway
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA; Geisel School of Medicine at Dartmouth, 1 Rope Ferry Road, Hanover, NH, 03755, USA.
| | - Ethan LaRochelle
- Thayer School of Engineering at Dartmouth, 14 Engineering Drive, Hanover, NH, 03755, USA.
| | - Kathleen Lyons
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA.
| | - Linda S Kennedy
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA.
| | - Megan E Romano
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA; Geisel School of Medicine at Dartmouth, 1 Rope Ferry Road, Hanover, NH, 03755, USA.
| | - Zhongze Li
- Geisel School of Medicine at Dartmouth, 1 Rope Ferry Road, Hanover, NH, 03755, USA.
| | - Mark R Spaller
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA; Geisel School of Medicine at Dartmouth, 1 Rope Ferry Road, Hanover, NH, 03755, USA; Department of Chemistry, Burke Laboratory, Dartmouth College, Hanover, NH, 03755, USA.
| | - Mark A Cervinski
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA.
| | - Suyapa Bejarano
- La Liga Contra el Cáncer, Barrio Suyapa, 8 Calle, 10-11 Avenida, San Pedro Sula, Cortés, C.A, Honduras.
| | - Gregory J Tsongalis
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA.
| | - Karen L Huyck
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA; Section of Occupational and Environmental Medicine, Department of Medicine, Geisel School of Medicine at Dartmouth, 1 Medical Center Drive, Lebanon, NH, 03766, USA.
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Betancourth S, Archaga O, Moncada W, Rodríguez V, Fontecha G. First Molecular Characterization of Cryptosporidium spp. in Patients Living with HIV in Honduras. Pathogens 2021; 10:pathogens10030336. [PMID: 33805766 PMCID: PMC8000384 DOI: 10.3390/pathogens10030336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/16/2021] [Accepted: 03/02/2021] [Indexed: 11/17/2022] Open
Abstract
Cryptosporidiosis is one of the most important causes of gastroenteritis in the world, especially in low- and middle-income countries. It is caused by the Apicomplexan parasite Cryptosporidium spp., and mainly affects children and immunocompromised people, in whom it can pose a serious threat to their health, or even be life threatening. In Honduras, there are no data on parasite species or on molecular diversity or Cryptosporidium subtypes. Therefore, a cross-sectional study was conducted between September 2019 and March 2020 for the molecular identification of Cryptosporidium spp. in 102 patients living with HIV who attended a national hospital in Tegucigalpa. Stool samples were analyzed by direct microscopy, acid-fast stained smears, and a rapid lateral flow immunochromatographic test. All samples that tested positive were molecularly analyzed to identify the species and subtype of the parasite using three different markers: gp60, cowp, and 18Sr. PCR products were also sequenced. Four out of 102 samples (3.92%) were positive for Cryptosporidiumparvum, and all were assigned to subtype IIa. These findings suggest a possible zoonotic transmission in this population.
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Affiliation(s)
- Sergio Betancourth
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (S.B.); (O.A.)
| | - Osman Archaga
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (S.B.); (O.A.)
| | - Wendy Moncada
- Servicio de Atención Integral para Pacientes que Viven con VIH/SIDA-Instituto Nacional Cardiopulmonar, Tegucigalpa 11101, Honduras; (W.M.); (V.R.)
| | - Vilma Rodríguez
- Servicio de Atención Integral para Pacientes que Viven con VIH/SIDA-Instituto Nacional Cardiopulmonar, Tegucigalpa 11101, Honduras; (W.M.); (V.R.)
| | - Gustavo Fontecha
- Microbiology Research Institute, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras; (S.B.); (O.A.)
- Correspondence: ; Tel.: +504-33935443
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Sandoval C, Araujo G, Sosa W, Avalos S, Silveira F, Corbett C, Zúniga C, Laurenti M. In situ cellular immune response in non-ulcerated skin lesions due to Leishmania (L.) infantum chagasi infection. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20200149. [PMID: 33708246 PMCID: PMC7909480 DOI: 10.1590/1678-9199-jvatitd-2020-0149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/25/2021] [Indexed: 11/29/2022] Open
Abstract
Background Skin lesions of patients affected by non-ulcerated cutaneous leishmaniasis
(NUCL) caused by L. (L.) infantum chagasi are characterized
by lymphohistiocytic inflammatory infiltrate associated with epithelioid
granuloma and scarce parasitism. However, the in situ
cellular immune response of these patients is unclear. Therefore, the aim of
the present study was to characterize the cellular immune response in the
skin lesions of patients affected by NUCL. Methods Twenty biopsies were processed by immunohistochemistry using primary
antibodies to T lymphocytes (CD4, CD8), NK cells, B lymphocytes,
macrophages, nitric oxide synthase and interferon-gamma. Results Immunohistochemistry revealed higher expression of all cellular types and
molecules (IFN-γ, iNOS) in the dermis of diseased skin compared to the skin
of healthy individuals (p < 0.05). Morphometric analysis performed in the
skin lesions sections showed the predominance of CD8+ T
lymphocytes in the mononuclear infiltrate, followed by macrophages, mostly
iNOS+, a response that could be mediated by IFN-γ. Conclusion Our study improves knowledge of the cellular immune response in
non-ulcerated or atypical cutaneous leishmaniasis caused by L. (L.)
infantum chagasi in Central America and pointed to the pivotal
participation of CD8+ T lymphocytes in the host defense
mechanisms against the parasite in patients with NUCL.
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Affiliation(s)
- Carmen Sandoval
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil
| | - Gabriela Araujo
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil
| | - Wilfredo Sosa
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil.,Microbiology Research Institute, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Sara Avalos
- Master Program in Infectious and Zoonotic diseases, School of Microbiology, National Autonomous University of Honduras, Tegucigalpa, Honduras
| | - Fernando Silveira
- Department of Parasitology, Evandro Chagas Institute, Secretariat of Health Surveillance, Ministry of Health, Belém, PA, Brazil.,Institute of Tropical Medicine, Federal University of Pará, Belém, PA, Brazil
| | - Carlos Corbett
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil
| | - Concepción Zúniga
- Department of Health Surveillance, School Hospital, Tegucigalpa, Honduras
| | - Marcia Laurenti
- Laboratory of Infectious Diseases Pathology, Department of Pathology, Medical School (FMUSP), University of São Paulo (USP), São Paulo, SP, Brazil
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Buckley MMM, Aguilar LB, Lainez RC, Valenzuela HJA, Ponce F, Melo DG. Neonatal screening program for five conditions in Honduras. J Community Genet 2021; 12:389-395. [PMID: 33462772 DOI: 10.1007/s12687-021-00506-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/11/2021] [Indexed: 11/29/2022] Open
Abstract
We present the initial results of a neonatal screening program in part of the public health system in Honduras, that is, the Honduran Social Security Institute. The program design includes steps from neonatal bloodspot in the first newborn days to evaluation and treatment when necessary. In 2018 and 2019, 19,911 newborns were tested for hypothyroidism, cystic fibrosis, galactosemia, phenylketonuria, and adrenal hyperplasia. Abnormalities were identified in 18 newborns, corresponding to a prevalence of 9:10,000. Considering all births in Honduras, the estimated coverage of screening ranged between 4.4 and 5.7%. These results reinforce the need to expand and consolidate neonatal screening.
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Affiliation(s)
| | - Lindsay Borjas Aguilar
- Immunology Laboratory, Department of Clinical Laboratory, Hospital Escuela, Tegucigalpa, Honduras
| | - Rosibel Colindres Lainez
- Clinical Analysis Laboratory, Instituto Hondureño de Seguridad Social (IHSS), Tegucigalpa, Honduras
| | | | - Fernando Ponce
- Statistics Department, Instituto Hondureño de Seguridad Social (IHSS), Tegucigalpa, Honduras
| | - Débora Gusmão Melo
- Postgraduate Nursing Program, Federal University of São Carlos (UFSCar), São Paulo, Brazil. .,Department of Medicine, Federal University of São Carlos (UFSCar), São Paulo, Brazil. .,Departamento de Medicina, Campus da UFSCar, Rod. Washington Luís (SP-310), Km 235, São Carlos, SP, CEP 13565-905, Brasil.
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47
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Fontecha G, Sánchez AL. What Will Happen to Biomedical Research in Low-and-Middle Income Countries in the PostCOVID-19 World? Curr Trop Med Rep 2021;:1-5. [PMID: 33425655 DOI: 10.1007/s40475-020-00223-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2020] [Indexed: 11/09/2022]
Abstract
Scientific research is essential for a nation’s development and is vital for generating solutions to population’s health. Individual country’s capacities to prevent and respond to public health issues, including health crises, is built with long-term investment in highly qualified professionals, infrastructure, and uninterrupted operating funding. Most Latin American countries, especially those at the bottom of the human development list, have limited capacity even though they are hot spots for tropical and other emerging infectious diseases. This weakness deepens these countries’ dependence on nations with higher development and corresponding scientific capacity. The current COVID-19 pandemic has wreaked havoc on the health of the world’s population and the global economy. Countries that lagged behind prior to the pandemic now face a myriad of additional challenges. On a more optimistic note, the pandemic could serve as a wake-up call for governments and funding agencies to strengthen scientific capacity around the world, so that we are better prepared to address the public health issues caused by current and prevalent diseases and by future diseases of pandemic potential.
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48
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Ortiz-Quezada J, Rodriguez EE, Hesse H, Molina L, Duran C, Lorenzana I, England JD. Chikungunya encephalitis, a case series from an endemic country. J Neurol Sci 2021; 420:117279. [PMID: 33373792 DOI: 10.1016/j.jns.2020.117279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 12/17/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND The Chikungunya Virus (CHIKV) was introduced into Honduras in 2015. Since then the WHO has reported more than 14,000 suspected cases in the country. OBJECTIVE To describe the clinical, laboratory, neuroimaging, and pathological features of CHIKV encephalitis. PATIENTS AND METHODS We evaluated all consecutive cases of CHIKV infection meeting encephalitis criteria at Hospital Escuela Universitario at Tegucigalpa, Honduras, during 2015. Who case definition was used: patient with neurological manifestations meeting clinical criteria (fever >38.5 °C, joint pain); resident/visitor in the last 15 days to an endemic area; laboratory confirmation with IgM/ELISA. Other etiologies were excluded by ancillary studies. RESULTS Out of 95 cases with suspected CHIKV infection, 7 (7%) cases with CHIKV encephalitis were identified; mean age was 56 years and four were men. The mean latency from onset of symptoms to diagnosis was 5 five days. Clinical manifestations were: fever/arthralgia, headache/alteration of consciousness and status epilepticus. The EEG demonstrated slow background activity and generalized epileptiform discharges in three patients. Brain MRI showed bilateral white matter hyperintensities and one with focal encephalitis; CSF analysis demonstrated lymphocytic pleocytosis and hyperproteinorrachia. Two patients died. Postmortem brain examination of one patient revealed lymphocytic infiltrates with focal necrosis in hippocampus, frontal lobes and medulla oblongata. CONCLUSIONS Neurological complications of CHIKV are infrequent, but may be severe. In this case series, the neurological manifestation was encephalitis. Predominant symptoms and signs were fever, behavioral abnormalities, headache and seizures. Because of the potential morbidity and mortality of CHIKV encephalitis, these patients should be admitted to hospital urgently.
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Root ED, Zarychta A, Tapia BB, Grillos T, Andersson K, Menken J. Organizations matter in local governance: evidence from health sector decentralization in Honduras. Health Policy Plan 2020; 35:1168-1179. [PMID: 33026429 DOI: 10.1093/heapol/czaa084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2020] [Indexed: 11/12/2022] Open
Abstract
Health systems strengthening is at the forefront of the global health agenda. Many health systems in low-resource settings face profound challenges, and robust causal evidence on the effects of health systems reforms is lacking. Decentralization has been one of the most prominent reforms, and after more than 50 years of implementation and hundreds of studies, we still know little about whether these policies improve, harm or are inconsequential for the performance of health systems in less-developed countries. A persistent problem in existing studies is the inability to isolate the effect of decentralization on health outcomes, struggling with heterogeneous meanings of decentralization and missing counterfactuals. We address these shortcomings with a quasi-experimental, longitudinal research design that takes advantage of a unique staggered reform process in Honduras. Using three waves of household survey data over 10 years for a matched sample of 65 municipalities in Honduras, we estimated difference-in-difference models comparing changes in outcomes over time between local health systems that were decentralized using one of three types of organizations [municipal governments, associations of mayors or non-governmental organization (NGOs)] and those that remained centrally administered. We find evidence of overall improvements between 2005 and 2016 in several service delivery-related outcomes, and additional improvements in decentralized municipalities governed by NGOs. NGO-led municipalities saw a 15% decrease in home delivery relative to centralized municipalities in 2016, a 12.5% increase in MCH facility delivery and a 7% increase in the use of a skilled birth attendant. There were no detectable positive treatment effects for vaccination, and a slight decline in the weight-for-length z-scores in NGO municipalities, but we find no systematic evidence of decentralization negatively impacting any maternal and child health outcomes. These findings highlight the importance of considering implementation context, namely organization type, when assessing the effects of decentralization reform.
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Affiliation(s)
- Elisabeth Dowling Root
- Department of Geography & Division of Epidemiology, The Ohio State University, 151 N. Oval Mall, Columbus, OH 43210, USA
| | - Alan Zarychta
- School of Social Service Administration, University of Chicago, 969 E. 60th Street, Chicago, IL 60637, USA
| | - Bertha Bermudez Tapia
- Department of Sociology, University of Colorado Boulder, 327 UCB, Ketchum 195, Boulder, CO 80309, USA.,Institute of Behavioral Science, University of Colorado Boulder, 1440 15th St, 483 UCB, Boulder, CO 80309, USA
| | - Tara Grillos
- Department of Political Science, Purdue University, 100 N University St, West Lafayette, IN 47907, USA
| | - Krister Andersson
- Institute of Behavioral Science, University of Colorado Boulder, 1440 15th St, 483 UCB, Boulder, CO 80309, USA.,Department of Political Science & Center for the Governance of Natural Resources, University of Colorado Boulder, 333 UCB, Boulder, CO 80309, USA
| | - Jane Menken
- Department of Sociology, University of Colorado Boulder, 327 UCB, Ketchum 195, Boulder, CO 80309, USA.,Institute of Behavioral Science, University of Colorado Boulder, 1440 15th St, 483 UCB, Boulder, CO 80309, USA
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50
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Zuniga-Moya JC, Romero-Reyes LE, Saavedra EB, Montoya S, Varela D, Borjas M, Cerna A, Bejarano S, Martinez P, Lujan K, Erazo K, Lainez I, Pineda L, Yanes D, O'Halloran JA, Spec A. Prevalence of Cryptococcal Antigen and Outcomes in People With Human Immunodeficiency Virus in Honduras: A Cohort Study. Open Forum Infect Dis 2020; 8:ofaa557. [PMID: 33447630 PMCID: PMC7794649 DOI: 10.1093/ofid/ofaa557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/06/2020] [Indexed: 11/12/2022] Open
Abstract
Background Cryptococcal meningitis is a major cause of death among people with human immunodeficiency virus (PWH). Cryptococcal antigen (CrAg) testing of asymptomatic patients is an important public health measure to reduce mortality in high-incidence areas. However, limited data exist on CrAg prevalence in Central America. Methods We conducted a prospective cohort study at the 2 largest human immunodeficiency virus (HIV) clinics and hospitals in Honduras. Cryptococcal antigen in serum and cerebrospinal fluid was performed in individuals with HIV who had CD4 ≤100 cells/mm3 between 2017 and 2018. After CrAg testing, individuals were observed for 12 months to assess mortality using adjusted Cox proportional hazard models. Results A total of 220 PWH were tested for CrAg, 12.7% (n = 28) of which tested positive. Cryptococcal antigen prevalence was higher among hospitalized individuals in 40% (n = 10 of 25) of the cases. The proportion (35.8%) of individuals taking antiretroviral therapy was significantly (P < .01) lower among those who tested positive for CrAg. Overall mortality among the cohort was 11.4% (n = 25 of 220) by 12 months. Cryptococcal antigen-positive cases were at a significantly higher risk of death (adjusted hazard ratio, 2.69; 95% confidence interval, 1.07-6.84) compared with CrAg-negative participants. Conclusions Cryptococcal antigen prevalence in Honduras was high among PWH. Moreover, individuals who tested positive for CrAg testing were at a higher risk of death. Systemic CrAg of PWH with a CD4 ≤100 cells/mm3 should be routinely performed in Central America.
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Affiliation(s)
- Julio C Zuniga-Moya
- Universidad Catolica de Honduras Campus San Pedro Sula Pablo, San Pedro Sula, Honduras
| | | | | | | | - Diana Varela
- Hospital Escuela Universitario, Tegucigalpa, Honduras
| | | | - Alicia Cerna
- Hospital Escuela Universitario, Tegucigalpa, Honduras
| | - Suyapa Bejarano
- Universidad Catolica de Honduras Campus San Pedro Sula Pablo, San Pedro Sula, Honduras
| | - Paola Martinez
- Universidad Catolica de Honduras Campus San Pedro Sula Pablo, San Pedro Sula, Honduras
| | - Karen Lujan
- Clinica de Servicios de Atencion Integral, Tegucigalpa, Honduras
| | - Karen Erazo
- Clinica de Servicios de Atencion Integral, Tegucigalpa, Honduras
| | - Isis Lainez
- Hospital Dr. Mario Catarino Rivas, San Pedro Sula, Honduras
| | | | - David Yanes
- Universidad Catolica de Honduras Campus San Pedro Sula Pablo, San Pedro Sula, Honduras
| | - Jane A O'Halloran
- Department of Medicine, Division of Infection, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Andrej Spec
- Department of Medicine, Division of Infection, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
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