Revista Panamericana de Salud Pública, Volume: 2, Issue: 2, Published: 1997
  • La prevención de las enfermedades cardiovasculares: Declaración de Cataluña Artículos

  • Leptospira interrogans in a canine population of Greater Buenos Aires: variables associated with seropositivity Artículos

    Rubel, Diana; Seijo, Alfredo; Cernigoi, Beatriz; Viale, Alberto; Wisnivesky-Colli, Cristina

    Abstract in Spanish:

    Se determinó la seroprevalencia de leptospirosis en una población canina suburbana con el objeto de analizar la asociación entre distintas variables individuales y ambientales y la seropositividad a leptospirosis. El estudio, de diseño transversal, se llevó a cabo durante julio de 1992 en un barrio del Gran Buenos Aires en el que viven unos 9 500 habitantes y una población canina de unos 2 000 animales. Se estudió una muestra aleatoria de 223 perros, de cada uno de los cuales se obtuvo una muestra de sangre. La ficha epidemiológica del animal se obtuvo por encuesta al ama de casa. Las determinaciones serológicas se realizaron por microaglutinación frente a 10 serotipos de Leptospira interrogans. Se halló seropositividad en 57% de los 223 perros examinados; 82% de los sueros positivos coaglutinaron con dos o más serotipos. Los serotipos detectados con mayor frecuencia fueron canicola y pyrogenes. La seroprevalencia en hembras fue menor que en machos (P <0,05) y entre los cachorros de menos de 1 año de edad, menor que en los animales de mayor edad (P <0,01). El callejeo del perro y la presencia de agua estancada frente a la vivienda del propietario fueron los factores de riesgo más importantes entre los que se estudiaron. Las asociaciones de la seropositividad con el contacto con un basural, con el comportamiento de caza del perro y con la presencia de roedores en la vivienda no fueron estadísticamente significativas. Se discuten distintas medidas de control.

    Abstract in English:

    We determined the seroprevalence of leptospirosis in a suburban canine population for the purpose of analyzing the association between different individual and environmental variables and seropositivity for leptospirosis. The study, which was cross-sectional, was performed in July 1992 in a neighborhood of Greater Buenos Aires with approximately 9 500 inhabitants and a canine population of around 2 000 animals. We studied a random sample of 223 dogs and obtained a blood sample from each. Each animals epidemiologic history was obtained by interviewing the housewife. Serologic measurements were performed by the microagglutination technique with the use of 10 different serotypes of Leptospira interrogans. Of the 223 dogs that were tested, 57% showed seropositivity; 82% of the positive sera coagglutinated with two or more serotypes. The most frequently detected serotypes were canicola and pyrogenes. Seroprevalence in females was less common than in males (P <0,05) and in puppies less than 1 year old it was less common than in older animals (P <0,01). Street behavior in the dog and the presence of stagnant water in front of the owners dwelling were the most important of the risk factors examined. The associations between seropositivity on the one hand and contact with trash deposits, hunting behavior and the presence of rodents inside the dwelling on the other were not statistically significant. Different control measures are discussed.
  • Factors associated with initiation of breast-feeding in the Dominican Republic Articles

    Bautista, Leonelo E.

    Abstract in Spanish:

    Las relaciones entre el inicio del amamantamiento y sus determinantes varían en distintas poblaciones, pero su conocimiento es fundamental para orientar los programas de promoción de la lactancia materna. Los datos de la Encuesta Demográfica y de Salud de 1991 de la República Dominicana se usaron para identificar factores asociados con el inicio del amamantamiento en una muestra aleatoria de mujeres en edad fértil. Aproximadamente 93% de 2 714 madres informaron haber iniciado el amamantamiento en su último niño nacido vivo menor de 5 años y no hubo cambios importantes en este porcentaje en los últimos 5 años. Se realizó un análisis de regresión logística mediante el cual se calcularon valores de la razón de posibilidades (odds ratio (psi), en inglés) como medidas de asociación. Las madres que tuvieron alguna enfermedad durante el embarazo (psi = 2,3), las que tuvieron niños con bajo peso al nacer (psi = 2,9), las primíparas (psi = 1,9) y las de nivel de ingresos medio (psi = 1,6) y alto (psi = 2,1) tuvieron un riesgo significativamente mayor de no iniciar el amamantamiento. Estas mujeres deberían constituir grupos prioritarios en los programas de promoción de la lactancia materna.

    Abstract in English:

    The determinants of initiating breast-feeding vary among different populations, but knowledge of them is of fundamental importance for guiding programs to promote breast-feeding. Data from the Demographic and Health Survey of 1991 in the Dominican Republic were used to identify factors associated with the initiation of breast-feeding in a random sample of women of reproductive age. Approximately 93% of 2 714 mothers reported having begun to breast-feed their last live-born child who was currently under 5 years of age, and that percentage had not changed substantially in the past 5 years. A logistic regression analysis was done in which odds ratios (psi) were calculated as measures of association. Women who had suffered some type of illness during pregnancy (psi = 2.3), those whose child had a low birthweight (psi = 2.9), primiparas (psi = 1.9), and those with medium (psi = 1.6) or high (psi = 2.1) income levels showed a significantly higher risk of not starting to breast-feed. These women should be considered priority groups by breast-feeding promotion programs.
  • Efficacy of the 17D yellow fever vaccine: an epidemiologic evaluation in health services

    Guerra, Henrique Leonardo; Sardinha, Tânia Mara; Rosa, Amélia P.A.T.; Costa, Maria Fernanda Lima e

    Abstract in Portuguese:

    O objetivo do presente estudo foi avaliar a efetividade da vacina antiamarílica 17D nas condições de sua utilização pelos serviços de saúde pública. Em 1989, um estudo prospectivo não-concorrente foi desenvolvido em Bocaiúva, Estado de Minas Gerais, Brasil, 6 meses após vacinação em massa da população. A população-alvo do estudo foi constituída por estudantes matriculados no primeiro grau em todas as escolas situadas em Bocaiúva. O grupo exposto foi constituído por uma amostra probabilística simples de estudantes vacinados (n = 173) e o grupo não-exposto foi constituído por todos aqueles não submetidos à vacinação (n = 55). Os soros foram examinados pelo teste da neutralização em camundongos; estes exames foram realizados às cegas, ou seja, o examinador desconhecia a situação vacinal do paciente. Os resultados da sorologia foram os seguintes: entre os vacinados, 75% eram soropositivos, 17% soronegativos e 7% apresentaram exame inconclusivo; entre os não-vacinados estes resultados foram de 9, 87 e 4%, respectivamente. A razão de soropositividades entre vacinados e não-vacinados, ajustada pela idade, foi 7,6 (IC95%: 3,4 a 16,7). A fração da soropositividade atribuível à vacinação, ajustada pela idade, foi 86,8% (IC95%: 70,6 a 94,0). Os resultados mostram que a efetividade da vacinação, definida através da soropositividade para o vírus, ficou abaixo dos níveis esperados para a vacina 17D. Isto pode ter sido conseqüência de falhas operacionais na conservação ou aplicação da vacina. Nossos resultados apontam para a necessidade de avaliações sistemáticas na rotina dos serviços de saúde após a utilização em massa da vacina.

    Abstract in English:

    The purpose of this study was to evaluate the efficacy of the 17D yellow fever vaccine in the conditions under which it is used in public health services. In 1989, a nonconcurrent prospective study was carried out in Bocaiúva, Minas Gerais State, Brazil, 6 months after mass vaccination of the population. The study population was made up of first-grade students from all the schools in Bocaiúva. The exposed group consisted of a simple random sample of vaccinated students (n = 173) and the unexposed group consisted of all those who had not been vaccinated (n = 55). Serum samples were examined with the neutralization test in mice; these tests were conducted blind, that is, the examiner did not know the vaccination status of the subject. The serology results were as follows: of those vaccinated, 75% were seropositive, 17% were seronegative, and 7% showed an inconclusive result; in the unvaccinated children, these results were 9%, 87%, and 4%, respectively. The age-adjusted seropositivity ratio between vaccinated and unvaccinated children was 7.6 (95%CI: 3.4 to 16.7). The proportion of seropositivity attributable to vaccination, adjusted for age, was 86.8% (95%CI: 70.6 to 94.0). The results showed that the efficacy of the vaccine, defined by means of seropositivity for the virus, was below the levels expected for the 17D vaccine. This may have been due to operational failures in the conservation or application of the vaccine. The results point to the need for routine systematic evaluations by the health services after mass utilization of the vaccine.
  • Production of scientific articles on health in six Latin American countries, 1973-1992 Articles

    Pellegrini Filho, Alberto; Goldbaum, Moisés; Silvi, John

    Abstract in Spanish:

    Con objeto de observar las tendencias de la investigación sobre salud en América Latina, se analizó la producción de artículos resultantes de investigaciones biomédicas, clínicas y de salud pública originadas en Argentina, Brasil, Chile, Cuba, México y Venezuela de 1973 a 1992, inclusive. De la base de datos del Institute for Scientific Information (ISI) se recuperaron 41 238 artículos con primeros autores residentes en esos países. Esta producción se analizó por área de estudio, tipo de investigación, país, número de autores e instituciones que participaron en la investigación, y citaciones recibidas por cada artículo. Se hizo también un análisis de 95 artículos en epidemiología seleccionados de 570 publicados por autores de los seis países en 11 revistas de salud pública de gran prestigio internacional. Los resultados muestran que el número de trabajos publicados aumentó 117% entre el primero y último quinquenios. La investigación clínica tuvo la distribución más homogénea entre los países y la de salud pública, la más concentrada (60,7% se originó en el Brasil). Los artículos de investigación biomédica y de salud pública tuvieron un incremento relativamente mayor que los de investigación clínica a lo largo del período. Se observó una disminución relativa de artículos de un solo autor -lo que sugiere trabajo en equipo más frecuente- y un aumento de artículos con autores vinculados a dos o más instituciones nacionales o extranjeras, lo cual indica mayor cooperación entre instituciones y países. En promedio, las citaciones recibidas por artículo fueron tres, lo que corresponde a menos de la mitad de las que reciben los artículos de la base del ISI (7,78). En cuanto al subconjunto de los 95 artículos de epidemiología, la gran mayoría (96%) trataban de enfermedades infecciosas o del área maternoinfantil, mientras que en la literatura internacional 78% de los artículos estaban dedicados a las enfermedades crónicas. En este conjunto se observó más cooperación con instituciones extranjeras y un índice de 4,36 citaciones por artículo. Se concluye que, pese a las limitaciones inherentes a este tipo de estudio, se pudieron notar algunas tendencias generales del desarrollo de la investigación en los seis países con mayor producción científica de América Latina y formular hipótesis sobre los factores que determinan esas tendencias. Tomados con cautela, los resultados de estudios de este tipo pueden ser de gran valor al definir políticas de ciencia y tecnología de salud.

    Abstract in English:

    The production of articles resulting from biomedical, clinical, and public health studies that originated in Argentina, Brazil, Chile, Cuba, Mexico, and Venezuela from 1973 through 1992 was analyzed to discover trends in health research in Latin America. From the database of the Institute for Scientific Information (ISI), 41 238 articles with first authors who resided in those countries were extracted. These articles were analyzed by subject area, type of study, country, number of authors and institutions that participated in the investigation, and citations received by each article. Also analyzed were 95 articles in epidemiology selected from a pool of 570 published by authors from the six countries in 11 public health journals that enjoy international prestige. The results showed that the number of published works increased by 117% between the first and last five-year periods within the study period. Clinical research was distributed the most evenly among the countries, and public health research was the most concentrated (60.7% originated in Brazil). The numbers of biomedical and public health research articles showed relatively more growth than those reporting on clinical research throughout the period. A relative decrease was found in articles by only one author, which suggests a greater frequency of team efforts, and an increase was seen in articles with authors tied to two or more national or foreign institutions, which indicates greater cooperation between institutions and countries. The average number of citations received by each article was three, which was less than half the number received per article in the ISI database (7.78). Regarding the subset of 95 articles in epidemiology, the great majority (96%) dealt with infectious diseases or maternal and child health, while in the international literature 78% of such articles were about chronic diseases. This group of articles gave evidence of more cooperation with international institutions and had a citation index of 4.36 per article. It is concluded that, despite the inherent limitations, this type of study reveals some general trends in the development of research in the six Latin American countries with the greatest scientific production and makes it possible to formulate hypotheses on the factors that influence these trends. Taken with the proper caution, the results of studies like this one can be of great value in defining health science and technology policies.
  • Renacimiento de la terapia antisentido Instantáneas

  • El asma en niños de áreas urbanas Instantáneas

  • La estatura infantil en el medio rural Instantáneas

  • Acerca de la propuesta de utilizar la marihuana con fines medicinales Instantáneas

  • Repercusión cardíaca de las emociones negativas suscitadas en la vida cotidiana Instantáneas

  • Las personas sin hogar: problema de salud pública Instantáneas

  • Relación entre anticuerpos contra Chlamydia y enfermedad inflamatoria pelviana Instantáneas

  • Integrated management of childhood illness Current Topics

    Abstract in Spanish:

    Millones de defunciones en niños menores de 5 años se podrían prevenir en países en desarrollo si se aplicaran las medidas de control y los tratamientos eficaces que se usan normalmente en países desarrollados. Conscientes de la necesidad de hacer frente a las principales causas de enfermedad y muerte en la infancia (infecciones respiratorias agudas, enfermedades diarreicas, desnutrición, malaria y enfermedades prevenibles por medio de la vacunación) mediante una iniciativa global, la OMS y el UNICEF han desarrollado una estrategia conocida por Atención Integrada de las Enfermedades Prevalentes de la Infancia (Integrated Management of Childhood Illness, IMCI). Sus oficinas regionales para las Américas, que son la OPS y el UNICEF-TACRO, han aceptado los objetivos y actividades descritos en el presente informe a fin de reorientar su labor y dirigirla hacia el mejoramiento del estado de salud infantil en este hemisferio.
  • The use of opioid analgesics to alleviate cancer pain Temas de Actualidad

    De Lima, Liliana

    Abstract in English:

    Many cancer patients die after a prolonged period of deterioration marked by intense physical and emotional suffering. However, in an effort to control the illegal market, many countries have adopted regulations that restrict or prohibit the therapeutic use of opioid analgesics, which could improve the quality of life of these patients. The World Health Organization has responded to this problem by making palliative care a priority of its Cancer Program. The countries have been urged to establish measures and governmental policies that will make opioid analgesics more accessible for alleviating cancer pain.
  • The eradication of malaria in Puerto Rico Temas de Actualidad

    Miranda Franco, Rafael; Casta Vélez, Alfredo

    Abstract in English:

    For decades, malaria was a serious public health problem in Puerto Rico. In 1962, that country became the first tropical territory in the Americas, and possibly in the world, to receive certification from WHO for having eradicated malaria and having declared itself free of the disease. This report chronicles the tremendous effort that was dedicated to the eradication campaign in Puerto Rico, which took place in the first part of this century.
Organización Panamericana de la Salud Washington - Washington - United States
E-mail: contacto_rpsp@paho.org