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Stakeholders’ perspectives on access-to-medicines policy and research priorities in Latin America and the Caribbean: face-to-face and web-based interviews

Azeredo, Thiago Botelho; Luiza, Vera Lucia; Oliveira, Maria Auxiliadora; Emmerick, Isabel Cristina Martins; Bigdeli, Maryam
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN_US
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Background: This study aims to rank policy concerns and policy-related research issues in order to identify policy and research gaps on access to medicines (ATM) in low- and middle-income countries in Latin America and the Caribbean (LAC), as perceived by policy makers, researchers, NGO and international organization representatives, as part of a global prioritization exercise. Methods: Data collection, conducted between January and May 2011, involved face-to-face interviews in El Salvador, Colombia, Dominican Republic, and Suriname, and an e-mail survey with key-stakeholders. Respondents were asked to choose the five most relevant criteria for research prioritization and to score policy/research items according to the degree to which they represented current policies, desired policies, current research topics, and/or desired research topics. Mean scores and summary rankings were obtained. Linear regressions were performed to contrast rankings concerning current and desired policies (policy gaps), and current and desired research (research gaps). Results: Relevance, feasibility, and research utilization were the top ranked criteria for prioritizing research. Technical capacity, research and development for new drugs, and responsiveness...

New Century, Old Disparities : Gender and Ethnic Earnings Gaps in Latin America and the Caribbean

Ñopo, Hugo
Fonte: Washington, DC: Inter-American Development Bank and the World Bank Publicador: Washington, DC: Inter-American Development Bank and the World Bank
EN_US
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Despite sustained economic growth at the end of the 20th and the beginning of the 21st century, Latin America and the Caribbean still faces high inequality and weak indicators of well-being among certain population groups. Women, people of African ancestry, and indigenous peoples are often at the bottom of the income distribution. The share of female-headed households rose in the past 20 years. By the beginning of the 1990s, women headed 1.2 percent of complete households (households in which both husband and wife are present) and 79.8 percent of single- head households. This book presents a regional overview of gender and ethnic disparities in labor earnings during this last turn of the century. Latin America and the Caribbean provide a rich environment for studying social inequality, because historical inequalities along gender and ethnic lines persist, despite positive indicators of economic development. The extent of inequality and its probable causes vary widely across the many countries in the region. The book adopts a sophisticated econometric methodology for measuring earnings gaps and applies it consistently across and within countries to measure gender and racial or ethnic differences. The analysis includes a dynamic dimension that sheds light on the evolution of earnings gaps over time. The book offers important insights on economic and political strategies that could be adopted to reduce inequality. The reduction of gender-based segregation in the workplace represents an area in which policy interventions can improve the efficiency of labor markets. Determining whether addressing occupational rather than hierarchical segregation is more effective is one of the areas of policy design to which this book aims to make a contribution. Latin America and the Caribbean is also a racially and ethnically diverse region...

¿Países de renta media? Una taxonomía alternativa del desarrollo de América Latina y el Caribe; Middle income countries? An alternative development taxonomy of Latin America and the Caribbean

Tezanos Vázquez, Sergio; Quiñones Montellano, Ainoa
Fonte: Universidad de Zaragoza. Cátedra de Cooperación para el Desarrollo; Red Española de Estudios del Desarrollo Publicador: Universidad de Zaragoza. Cátedra de Cooperación para el Desarrollo; Red Española de Estudios del Desarrollo
Tipo: info:eu-repo/semantics/article; publishedVersion
SPA
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RESUMEN. Aunque no es fácil clasificar a los países en función de sus niveles de desarrollo —principalmente porque el concepto de «desarrollo humano» es complejo y multidimensional—, la clasificación más extendida es precisamente la más sencilla, basada en la renta per cápita. De acuerdo con esta clasificación, la mayoría de los países de América Latina y el Caribe (ALC) se ubican en el estrato medio de la renta mundial. En este artículo proponemos una «taxonomía del desarrollo» alternativa para los países de renta media de ALC. Mediante un análisis de conglomerados identificamos y caracterizamos tres grupos de países en relación con 10 «brechas de desarrollo»: los países más avanzados (México, Chile, Argentina, Venezuela, Uruguay y Brasil), los países de desarrollo intermedio (Panamá, Costa Rica, Colombia, Jamaica, República Dominicana, Ecuador, Perú, Belice, El Salvador, Paraguay y Guyana) y los países con mayores retos de desarrollo (Guatemala, Bolivia, Honduras y Nicaragua).; ABSTRACT. Although it is not asy to classify countries according to their levels of development –mainly because the concept of “human development” is complex and multidimensional –, the most widespread classification is just the simplest one...

Desigualdad, ayuda y crecimiento: impacto macroeconómico de donaciones y créditos de ayuda en América Latina y el Caribe; Inequality, aid and growth: macroeconomic impact of aid grants and loans in Latin America and the Caribbean

Tezanos Vázquez, Sergio; Guijarro Garvi, Marta
Fonte: Cátedra de Cooperación Internacional y con Iberoamérica (COIBA) Publicador: Cátedra de Cooperación Internacional y con Iberoamérica (COIBA)
Tipo: info:eu-repo/semantics/workingPaper; publishedVersion
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RESUMEN. Este artículo analiza el impacto de la Ayuda Oficial al Desarrollo en los países de América Latina y el Caribe a través de un modelo de crecimiento endógeno. Evaluamos la eficacia de la ayuda en relación con la tasa de crecimiento del PIB per capita de la población con renta inferior al noveno decil (“PIB per capita ajustado por la desigualdad”), al objeto de definir de manera precisa el impacto deseado de la ayuda en un ámbito geográfico de elevados niveles de desigualdad. Asimismo, distinguimos el impacto de dos modalidades de ayuda: donaciones y créditos. La estimación econométrica arroja tres conclusiones principales: i) la ayuda resulta eficaz, en términos agregados, cuando se corrige el efecto de las desigualdades de renta; ii) el impacto de los créditos concesionales es mayor que el de las donaciones; y iii) la ayuda resulta más eficaz en los países menos corruptos.; ABSTRACT. This article uses an endogenous growth model to analyze the impact of Official Development Assistance in Latin American and the Caribbean. The model evaluates aid effectiveness in relation to the growth rate of the GDP per capita within the population with lower income than the ninth decile (“inequality-adjusted GDP per capita”)...

Nueva agenda internacional de desarrollo: ¿nuevas perspectivas para América Latina y el Caribe?; New international development agenda: new prospects for Latin America and the Caribbean?

Tezanos Vázquez, Sergio; Domínguez Martín, Rafael
Fonte: Cátedra de Cooperación Internacional y con Iberoamérica (COIBA) Publicador: Cátedra de Cooperación Internacional y con Iberoamérica (COIBA)
Tipo: info:eu-repo/semantics/workingPaper; publishedVersion
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RESUMEN. En los albores del siglo XXI el sistema de cooperación internacional para el desarrollo se ha ido dotando de una nueva arquitectura, sustentada sobre dos agendas internacionales de desarrollo paralelas e íntimamente ligadas: la agenda de objetivos de desarrollo (promovida por NNUU y la estrategia de los ODM), y la agenda sobre eficacia de la ayuda (promovida por el CAD y la UE). La aplicación de esta estrategia ha demostrado el calado suficiente como para afectar a las perspectivas de participación de los países de América Latina y el Caribe en el sistema de cooperación internacional. El presente artículo revisa sucesivamente ambas agendas con la intención de evaluar su congruencia con los retos americanos de desarrollo y desvelar en qué medida afectan a sus perspectivas de participación en un sistema de ayuda al desarrollo cada vez más complejo.; ABSTRACT. Since the dawn of the 21st Century, the international system of development co- operation has being acquiring a new architecture, supported by two parallel and closely related international development agendas: the development goals agenda (promoted by the UN and the MDGs’ strategy), and the aid effectiveness agenda (promoted by the DAC and the EU). The application of this strategy has proved to be sufficiently significant in order to affect the prospects of participation of Latin America and the Caribbean in the co-operation system. This paper shall successively revise both agendas with the intention of assessing the coherence with the American development challenges and revealing to what extend they are affecting its prospects of participation in a development aid system which is getting more complex.

International research capacity building program for health related professionals to study the drug phenomenon in Latin America and the Caribbean

Wright,Maria da Gloria Miotto; Cumsille,Francisco; Padilha,Maria Itayra; Ventura,Carla Arena; Sapag,Jaime; Brands,Bruna; Hamilton,Hayley; Mann,Robert; Khenti,Akwatu
Fonte: Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Publicador: Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2015 EN
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Most Organization of American States member states do not have a cadre of professionals with scientific knowledge and research experience on drugs and related problems. Therefore, the Organization of American States started a partnership, first with the University of Alberta/Canada and then with the Centre for Addiction and Mental Health in Toronto/Canada to train health related professionals to address this problem. The objective is to create a cadre of health and related professionals with scientific and technical research knowledge to enable scientific advances in the area of drug demand reduction. The program requires the development and implementation of a multicentric drug research proposal. The program has produced the following results: nine multicentric drug research studies implemented in 22 countries of Latin America and the Caribbean; 91 participants from 22 countries of Latin America and the Caribbean. This is the only program in the Americas offering continued advanced research training to university faculty and contributing to strengthen the undergraduate and graduates curriculum on drug issues and research capability in Latin America and the Caribbean.

A land cover map of Latin America and the Caribbean in the framework of the SERENA project

Blanco P.D.; Colditz R.R.; Lopez Saldana G.; Hardtke L.A.; Llamas R.M.; Mari N.A.; Fischer A.; Caride C.; Acenolaza P.G.; del Valle H.F.; Lillo-Saavedra M.; Coronato F.; Opazo S.A.; Morelli F.; Anaya J.A.; Sione W.F.; Zamboni P.; Arroyo V.B.
Fonte: Universidade de Medellín Publicador: Universidade de Medellín
Tipo: Article; info:eu-repo/semantics/article
ENG
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Land cover maps at different resolutions and mapping extents contribute to modeling and support decision making processes. Because land cover affects and is affected by climate change, it is listed among the 13 terrestrial essential climate variables. This paper describes the generation of a land cover map for Latin America and the Caribbean (LAC) for the year 2008. It was developed in the framework of the project Latin American Network for Monitoring and Studying of Natural Resources (SERENA), which has been developed within the GOFC-GOLD Latin American network of remote sensing and forest fires (RedLaTIF). The SERENA land cover map for LAC integrates: 1) the local expertise of SERENA network members to generate the training and validation data, 2) a methodology for land cover mapping based on decision trees using MODIS time series, and 3) class membership estimates to account for pixel heterogeneity issues. The discrete SERENA land cover product, derived from class memberships, yields an overall accuracy of 84% and includes an additional layer representing the estimated per-pixel confidence. The study demonstrates in detail the use of class memberships to better estimate the area of scarce classes with a scattered spatial distribution. The land cover map is already available as a printed wall map and will be released in digital format in the near future. The SERENA land cover map was produced with a legend and classification strategy similar to that used by the North American Land Change Monitoring System (NALCMS) to generate a land cover map of the North American continent...

Less than adequate vitamin D status and intake in Latin America and the Caribbean: A problem of unknown magnitude

Mujica, María Fernanda; Olivares, Manuel; Cediel, Gustavo; López de Romaña, Daniel; Cori, Héctor; Brito, Alex
Fonte: The United Nations University Publicador: The United Nations University
Tipo: Artículo de revista
EN
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Artículo de publicación ISI; Background. The prevalence of vitamin D deficiency in Latin America and the Caribbean is unknown. Objective. To examine the prevalence data available on vitamin D deficiency in Latin America and the Caribbean. Methods. A systematic review was conducted in 2011. Studies using biochemical biomarkers and dietary intake estimation were included. Studies conducted in apparently healthy individuals, independently of age, latitude, skin pigmentation, and season of the year at the time of blood collection, were included. Results. A total of 243 studies were identified. The final number of selected studies was 28, including two National Health Surveys (Mexico and Argentina). There are studies that report the vitamin D status of specific subgroups conducted in Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, and Mexico. However, the small sample sizes in these studies and thus the low national representativeness of the reported data do not allow for an accurate assessment of vitamin D status at the regional level. In the majority of the countries with available data, we observed that vitamin D insufficiency was classified as a mild, moderate, or severe public health problem. The only country with a nationally representative sample was Mexico...

Open access and scholarly publishing in Latin America: ten flavours and a few reflections | Acesso livre e publicação acadêmica na América Latina: dez sabores e algumas reflexões

Alperin, Juan Pablo; Public Knowledge Project; Fischman, Gustavo; Willinsky, John
Fonte: Ibict Publicador: Ibict
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; Formato: application/pdf
Publicado em 19/09/2008 POR
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Abstract Throughout this article we argue that many scholars and scientific systems in Latin America and the Caribbean (LAC) share the ethical and epistemological motivations about the importance of increasing the "public presence" of academic research and lay out that many scholars and that many scholars and scientific systems in LAC are well positioned to take advantage of the increasing information and communication technology (ICT) infrastructure and of the growing open access (OA) movement so that the research produced within the region is circulated and shared broadly. The existence of Latin American examples to Willinsky's (2006) ten flavours of OA to journal articles are seen as an indication that OA has taken hold in theregion.Keywords Open Access (OA); Latin America and the Caribbean; Information and Communication Technologies (ICT); knowledge dissemination; Scholarly CommunicationResumo Argumenta-se neste artigo que muitos acadêmicos e sistemas científicos na América Latina e no Caribe compartilham motivações éticas e epistemológicas a respeito da importância de se aumentar a "presença pública" da pesquisa acadêmica e que muitos deles estão bem posicionados para se valer da crescente infra-estrutura de tecnologias de informação e comunicação (TIC)e dos movimentos de Acesso Livre (AL) para que a ciência produzida na região circule e se compartilhe amplamente. A existência de exemplos latino-americanos para a classificação dos dez modelos de Willinsky para artigos de periódicos é vista como indicação de que o AL já se instalou na região.Palavras-chave Acesso Livre (AL); América Latina e Caribe; Tecnologias de Informação e Comunicação (TIC); difusão do conhecimento; comunicação acadêmica

Preliminary analysis of the development of the Carbon Tracker system in Latin America and the Caribbean

JANG,YU WOON; PARK,IL-SOO; HA,SANG-SUB; JANG,SU-HWAN; CHUNG,KYUNG-WON; LEE,GANGWOONG; KIM,WON-HO; CHOI,YONG-JOO; CHO,CHEON-HO
Fonte: Centro de Ciencias de la Atmósfera, UNAM Publicador: Centro de Ciencias de la Atmósfera, UNAM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2014 EN
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The Carbon Tracker system will play a major role in understanding CO2 sinks and sources, gas exchange between the atmosphere and oceans, and gas emissions from forest fires and fossil fuels in Latin America and the Caribbean. This paper discusses the trends in carbon fluxes in the biosphere and ocean, as well as emissions from forest fires and fossil fuel use in the above-mentioned region, using the Carbon Tracker (CT) system. From 2000 to 2009, the mean carbon fluxes for the biosphere, fossil fuel use, wildfires and the ocean in Latin America and the Caribbean were -0.03, 0.41, 0.296, -0.061 Pg C/yr, respectively, and -0.02, 0.117, 0.013, -0.003 Pg C/yr, respectively, in Mexico. The mean net carbon flux for Latin America and the Caribbean was 0.645 Pg C/yr, and 0.126 Pg C/yr for Mexico. The terrestrial sinks in Latin America and the Caribbean are dominated by the forest, agricultural, grass and shrub regions, as well as the Andes mountain range and the net surface-atmosphere fluxes including fossil fuel are dominant in regions around large cities in Mexico, Brazil, Chile, and areas undergoing deforestation along the Amazon River. The results confirm that forest fires are an important source of CO2 in Latin America and the Caribbean. In addition...

Falls among elderly persons in Latin America and the Caribbean and among elderly Mexican-Americans

Reyes-Ortiz,Carlos A.; Al Snih,Soham; Markides,Kyriakos S.
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2005 EN
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OBJECTIVE: To estimate the prevalence of and risk factors for falls among community-dwelling elders in Latin America and the Caribbean and among elderly Mexican-Americans in the southwestern United States. METHODS: Data for the study came from a project called Health, Well-Being, and Aging in Latin America and the Caribbean (Salud, Bienestar y Envejecimiento en América Latina y el Caribe) (the "SABE project") (surveys from seven cities, with a total of 9 765 subjects) and from the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) (1 483 subjects). RESULTS: The overall prevalence of falls across the seven SABE cities and the H-EPESE ranged from 21.6% in Bridgetown, Barbados, to 34.0% in Santiago, Chile. In multiple logistic regression analyses, female gender, increased age, high depressive symptoms, and having any functional limitations were significant independent risk factors for falls in most of the cities studied as well as among the elderly Mexican-Americans. In several of the cities, significant risk factors also included diabetes, urinary incontinence, and arthritis. CONCLUSIONS: The prevalence of falls had a large variation among the countries studied. Some of the risk factors that we identified could be modified so as to help prevent falls in older people in these populations. The factors deserving attention include depressive symptoms...

Health sector reform and reproductive health in Latin America and the Caribbean: strengthening the links

Langer,A.; Nigenda,G.; Catino,J.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2000 EN
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Many countries in Latin America and the Caribbean (LAC) are currently reforming their national health sectors and also implementing a comprehensive approach to reproductive health care. Three regional workshops to explore how health sector reform could improve reproductive health services have revealed the inherently complex, competing, and political nature of health sector reform and reproductive health. The objectives of reproductive health care can run parallel to those of health sector reform in that both are concerned with promoting equitable access to high quality care by means of integrated approaches to primary health care, and by the involvement of the public in setting health sector priorities. However, there is a serious risk that health reforms will be driven mainly by financial and/or political considerations and not by the need to improve the quality of health services as a basic human right. With only limited changes to the health systems in many Latin American and Caribbean countries and a handful of examples of positive progress resulting from reforms, the gap between rhetoric and practice remains wide.

Regional integration and south-south cooperation in health in Latin America and the Caribbean

Carrillo Roa,Alejandra; Santana,José Paranaguá de
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2012 EN
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This paper analyzes whether south-south cooperation is legitimately a recent practice or merely an improved version of previous regional integration processes in Latin America and the Caribbean. The authors reviewed and systematized the historic development of subregional integration processes in Latin America and the Caribbean and focused on health cooperation in the following contexts: the Central American Integration System, the Andean Community of Nations, the Caribbean Community, the Amazon Cooperation Treaty Organization, the Southern Common Market, and the Union of South American Nations. The study concludes that the conceptual and methodologic foundations of south-south cooperation in health were born from and nurtured by the processes of regional integration in Latin America and the Caribbean. This paper posits that regional political and economic integration initiatives bring potential benefits to the health sector and act as an important mechanism to develop south-south cooperation in this domain. The study recommends furthering this type of research to provide information that will allow national and multilateral agencies, or other stakeholders, to formulate and implement better policies for international health cooperation that target reducing inequities and promoting health and well-being for all people.

West Nile virus activity in Latin America and the Caribbean

Komar,Nicholas; Clark,Gary G.
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2006 EN
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OBJECTIVES: West Nile virus (Flavivirus: Flaviviridae; WNV) has spread rapidly throughout the Caribbean Basin since its initial detection there in 2001. This report summarizes our current knowledge of WNV transmission in tropical America. METHODS: We reviewed the published literature and consulted with key public health officials to obtain unpublished data. RESULTS: West Nile virus infections first appeared in human residents of the Cayman Islands and the Florida Keys in 2001, and in apparently healthy Jamaican birds sampled early in 2002. Serologic evidence of WNV infection in 2002 was detected in horses, chickens and resident free-ranging birds in Guadeloupe, the Dominican Republic, and eastern Mexico. In 2003, WNV spread in Mexico and northern Central America, and serologic evidence was detected in the Bahamas, Puerto Rico and Cuba. In 2004, the first serologic evidence of WNV activity in South American ecosystems surfaced in September-October in Colombia and Trinidad, where domestic animals circulated WNV-neutralizing antibodies. CONCLUSIONS: The sparse reports of equine, human and avian disease in Latin America and the Caribbean is puzzling. Isolates are needed to evaluate viral attenuation or other possible explanations for reduced disease burden in tropical ecosystems.

Estimating diabetes and diabetes-free life expectancy in Mexico and seven major cities in Latin America and the Caribbean

Andrade,Flavia
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/07/2009 EN
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OBJECTIVES: To estimate diabetes and diabetes-free life expectancy in seven major cities in Latin America and the Caribbean, plus Mexico as a whole. METHODS: Data from the Survey on Health, Well-being, and Aging in Latin America and the Caribbean (n = 10 602) and the Mexican Health and Aging Study (n = 6 953) on individuals 60 or more years of age were used in this study. Estimates of diabetes and diabetes-free life expectancy were obtained by applying the Sullivan method. RESULTS: Diabetes life expectancy for men 60 years of age was highest in Mexico City (4.5 years) and Bridgetown (3.4 years), and lowest in Havana (1.3 years). Diabetes-free life expectancy for men 60 years of age was highest in Santiago (17.6 years) and lowest in Bridgetown (14.2 years) and São Paulo (14.3 years). For women, diabetes life expectancy was highest in Bridgetown (5.4 years), followed by Mexico City and Havana; but these three cities also had the lowest diabetes-free life expectancy. Women 60 years of age in Buenos Aires had the lowest diabetes life expectancy (2.5 years), and in Santiago, the highest, with a diabetes-free life expectancy of 20.7 years. CONCLUSIONS: Older individuals in Latin America and the Caribbean can expect to live a large proportion of their remaining lives with diabetes. There were also important differences across settings; in particular...

Breast cancer in Latin America and the Caribbean

Robles,Sylvia C; Galanis,Eleni
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2002 EN
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As recently as two decades ago breast cancer was not a significant public health concern in Latin America and the Caribbean (LAC). However, mortality rates from breast cancer have been increasing for at least 40 years in most LAC countries. Socioeconomic development and consequent changes in reproductive behaviors over the past 50 years are thought to have contributed to the increased risk of breast cancer. Socioeconomic development has also increased women's health awareness and therefore the demand for quality services. In industrialized countries, screening and widely available, high-quality treatment protocols are being implemented as the main strategy for breast cancer control. Studies show that out of three available screening methods (mammography, clinical breast examination, and breast self-examination), only mammography for women 50-69 years of age has been effective at reducing mortality, and has done so by an estimated 23%. While there is much controversy about the benefits and cost-effectiveness of mammography screening for women aged 40-49, some countries, including Australia, the United States of America, and four European nations, recommend that physicians assess the need for it on an individual basis. A survey that we conducted of LAC countries shows that most of their breast cancer screening policies are not justified by available scientific evidence. Moreover...

Cost-effectiveness of pneumococcal conjugate vaccination in Latin America and the Caribbean: a regional analysis

Sinha,Anushua; Constenla,Dagna; Valencia,Juan Esteban; O'Loughlin,Rosalyn; Gomez,Elizabeth; de la Hoz,Fernando; Valenzuela,Maria Teresa; Quadros,Ciro A. de
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2008 EN
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OBJECTIVE: In Latin America and the Caribbean, routine vaccination of infants against Streptococcus pneumoniae would need substantial investment by governments and donor organizations. Policymakers need information about the projected health benefits, costs, and cost-effectiveness of vaccination when considering these investments. Our aim was to incorporate vaccine, demographic, epidemiologic, and cost data into an economic analysis of pneumococcal vaccination of infants in Latin America and the Caribbean. METHODS: We previously used a structured literature review to develop regional estimates of the incidence of disease. Cost data were collected from physician interviews and public fee schedules. We then constructed a decision analytic model to compare pneumococcal conjugate vaccination of infants with no vaccination across this region, examining only vaccine's direct effects on children. RESULTS: Pneumococcal vaccination at the rate of diphtheria-tetanus-pertussis vaccine coverage was projected to prevent 9 500 deaths per year in children aged 0 to 5 years in the region, or approximately one life saved per 1 100 infants vaccinated. These saved lives as well as averted cases of deafness, motor deficit, and seizure result in 321 000 disability-adjusted life years (DALYs) being averted annually. At vaccine prices between US$5 and US$53 per dose...

Postal dose audits for radiotherapy centers in Latin America and the Caribbean: trends in 1969-2003

Izewska,Joanna; Vatnitsky,Stanislav; Shortt,Kenneth R.
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2006 EN
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Since 1969 the International Atomic Energy Agency and the World Health Organization (along with the Pan American Health Organization, working with countries in Latin America and the Caribbean) have operated postal dosimetry audits based on thermoluminescent dosimetry (TLD) for radiotherapy centers. The purpose of these audits is to provide an independent dosimetry check of radiation beams used to treat cancer patients. The success of radiotherapy treatment depends on accurate dosimetry. Over the period of 1969 through 2003 the calibration of approximately 5 200 photon beams in over 1 300 radiotherapy centers in 115 countries worldwide was checked. Of these audits, 36% were performed in Latin America and the Caribbean, with results improving greatly over the years. Unfortunately, in several instances large TLD deviations have confirmed clinical observations of inadequate dosimetry practices in hospitals in various parts of the world or even accidents in radiotherapy, such as the one that occurred in Costa Rica in 1996. Hospitals or centers that operate radiotherapy services without qualified medical physicists or without dosimetry equipment have poorer results than do hospitals or centers that are properly staffed and equipped. When centers have poor TLD results...

Variation of cervical cancer incidence in Latin America and the Caribbean

Pierce Campbell,Christine M.; Curado,Maria Paula; Harlow,Siobán D.; Soliman,Amr S.
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2012 EN
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OBJECTIVE: To provide a comprehensive analysis of the descriptive epidemiology of invasive cervical cancer in Latin America and the Caribbean by analyzing quality data from the area's cancer registries, including data that were excluded from the International Agency for Research on Cancer (IARC) publication, Cancer Incidence in Five Continents, Vol. IX (CI5-IX). METHODS: This was a descriptive epidemiologic study that involved 20 cancer registries, 9 of which were included by IARC in CI5-IX, and 11 of which were not. Data on invasive cervical cancers diagnosed from 1998-2002 were obtained from IARC. A cervical cancerspecific quality assessment was performed on all registries whether or not they were included in CI5-IX. Data from 14 registries met quality criteria and were analyzed. Incidence rates were calculated and compared across registries. RESULTS: A substantial variation in incidence rates existed among the registries; agestandardized rates ranged from 14.6-44.0 per 100 000 women per year. Mean cervical cancer incidence rates were 10.4% higher for registries included in CI5-IX than for those excluded; however, this difference was not significant (P = 0.541). CONCLUSIONS: This study compared cervical cancer rates from a more diverse group of Latin American and Caribbean countries than that of the CI5-IX. The heterogeneity found among registries highlights the importance of examining data from as many registries as possible when characterizing risk across a geographic area. Data from developing countries can be used to better understand cancer distribution and enable Region-specific recommendations on cancer control and prevention once data quality has been established

Usefulness for surveillance of hypertension prevalence studies in Latin America and the Caribbean: the past 10 years

Peña,Melissa S. Burroughs; Abdala,Carmen Verônica Mendes; Silva,Luis Carlos; Ordúñez,Pedro
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/07/2012 EN
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OBJECTIVE: To compare the usefulness for surveillance of the peer-reviewed literature on the prevalence of hypertension in Latin America and the Caribbean published from 2001 to 2010 with a previous study of the published literature from 1962 to 2000. METHODS: A bibliographic search was conducted of publications from 2001 to 2010 that examined the prevalence of hypertension using MEDLINE and LILACS databases. The methodology of each paper was evaluated with the same critical appraisal tool used in the previous study. RESULTS: A total of 81 papers were published from 2001 to 2010 on the prevalence of hypertension in Latin America and the Caribbean. Only 24 of these studies met the minimum methodologic criteria for evaluation. While the total number of studies published in the past 10 years exceeds the number published from 1962 to 2000, the percentage of studies that met the minimum methodologic criteria has not substantially increased. In addition to major methodologic shortcomings, less than 46% of the published studies reported rates of awareness, treatment, and control of hypertension. The hypertension prevalence estimates from the peer-reviewed literature range from 7% to 49%. These studies were primarily done in urban centers and are not evenly distributed throughout the region. CONCLUSIONS: The quality and geographic distribution of the published literature on the prevalence of hypertension in Latin America and the Caribbean are inadequate. Research resources and efforts should be directed in the future toward closing this gap.