PLoS Neglected Tropical diseases August 16, 2021 https://doi.org/10.1371/journal.pntd.0009697
Chagas disease, also known as American trypanosomiasis, is a neglected tropical disease transmitted by triatomine insects, first identified in 1909. Chagas disease affects approximately 6–7 million peop...le globally and is highly prevalent in Latin America where most cases are reported. However, there is increasing evidence that Chagas disease is now an important public health issue outside the “classical” endemic countries due to population migration. Our understanding of Chagas disease, including its pathologies and factors relating to progression, remains to date limited, and is also challenged by lack of diagnosis and highly effective treatment. This systematic review aims to describe studies with Chagas patients receiving antiparasitic treatment. Databases were searched for relevant studies published after 1997, and the results of these searches were screened.
more
With the growing prevalence of type 2 diabetes, particularly in emerging countries, its management in the context of available resources should be considered. International guidelines, while comprehensive and scientifically valid, may not be appropriate for regions such as Asia, Latin America or Afr...ica, where epidemiology, patient phenotypes, cultural conditions and socioeconomic status are different from America and Europe. Although glycaemic control and reduction of micro- and macrovascular outcomes remain essential aspects of treatment, access and cost are major limiting factors; therefore, a pragmatic approach is required in restricted-resource settings. Newer agents, such as sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in particular, are relatively expensive, with limited availability despite potentially being valuable for patients with insulin resistance and cardiovascular complications. This review makes a case for the role of more accessible second-line treatments with long-established efficacy and affordability, such as sulfonylureas, in the management of type 2 diabetes, particularly in developing or restricted-resource countries.
more
En diciembre de 2019 se identificaron los primeros casos del nuevo coronavirus -COVID-19 a nivel global en Wuhan, China. El 11 de marzo de 2020, la Organización Mundial de la Salud -OMS declaró al COVID-19 como pandemia mundial. Si bien la enfermedad se extendió lentamente a los países de Améri...ca Latina y el Caribe -ALC al principio, desde finales del mes de febrero el número de casos confirmados ha aumentado exponencialmente, acercándonos a 2,0 millones de casos confirmados y 124.667 muertos (al 19 de mayo de 2020).
more
El objetivo de esta nota conceptual y del marco que describe es la eliminación de un grupo de enfermedades transmisibles y los efectos negativos sobre la salud que generan que juntos crean una carga tangible en las personas afectadas, sus familias y comunidades, y en los sistemas de atención de sa...lud en toda la Región. Aunque no hay consenso sobre las mejores medidas que se deben usar para la salud de las personas y de acuerdo con la situación epidemiológica de un país, es habitual medir la carga de enfermedad mediante las tasas de enfermedad (incidencia, prevalencia, etc.), las tasas de mortalidad por enfermedad específica, las tasas de morbilidad y mortalidad comparativas, la distribución geográfica y los años de vida ajustados en función de la discapacidad (AVAD)…. Se analiza la situación epidemiológica actual, incluidos los datos sobre tasas de enfermedad o distribución geográfica para las enfermedades del cuadro 1. Hotez et al. (2008) fueron los primeros en examinar y comparar la carga de los AVAD en América Latina y el Caribe para las ETD, la infección por el VIH/sida, la malaria y la tuberculosis como era hace unos diez años atrás. Aunque la carga regional de tuberculosis, malaria y enfermedades infecciosas desatendidas (EID) es algo menor a la de hace diez años, se sigue perdiendo la posibilidad de trabajar (y de asistir a la escuela) debido a la enfermedad y muerte prematura o discapacidad, y la necesidad de acelerar los esfuerzos para eliminar las enfermedades es evidente en todas las comunidades en situación de vulnerabilidad.
more
El objetivo de esta nota conceptual y del marco que describe es la eliminación de un grupo de enfermedades transmisibles y los efectos negativos sobre la salud que generan que juntos crean una carga tangible en las personas afectadas, sus familias y comunidades, y en los sistemas de atención de sa...lud en toda la Región. Aunque no hay consenso sobre las mejores medidas que se deben usar para la salud de las personas y de acuerdo con la situación epidemiológica de un país, es habitual medir la carga de enfermedad mediante las tasas de enfermedad (incidencia, prevalencia, etc.), las tasas de mortalidad por enfermedad específica, las tasas de morbilidad y mortalidad comparativas, la distribución geográfica y los años de vida ajustados en función de la discapacidad (AVAD)…. Se analiza la situación epidemiológica actual, incluidos los datos sobre tasas de enfermedad o distribución geográfica para las enfermedades del cuadro 1. Hotez et al. (2008) fueron los primeros en examinar y comparar la carga de los AVAD en América Latina y el Caribe para las ETD, la infección por el VIH/sida, la malaria y la tuberculosis como era hace unos diez años atrás. Aunque la carga regional de tuberculosis, malaria y enfermedades infecciosas desatendidas (EID) es algo menor a la de hace diez años, se sigue perdiendo la posibilidad de trabajar (y de asistir a la escuela) debido a la enfermedad y muerte prematura o discapacidad, y la necesidad de acelerar los esfuerzos para eliminar las enfermedades es evidente en todas las comunidades en situación de vulnerabilidad.
more
The aim of this paper is to investigate how doctors working in primary health care in Latin American address patients with common mental disorders and to investigate how stigma can affect their clinical decisions
PLoSONE 13(11):e0206440.https://doi.org/10.1371/journal.pone.0206440
Regional indicators to measure progress towards zero discrimination
UNAIDS 2018 | Guidance
All countries in the Latin American and Caribbean (LAC) region are expected to report on these indicators for the year 2022.
Болезнь Шагаса, известная также как американский трипаносомоз, — потенциально опасное для жизни заболевание, вызываемое простейшим паразитом Trypanosoma cruzi.
This paper summarizes the findings for the Latin American and Caribbean countries of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. It presents an overview of the provision of mental health services in the region; describes key exp...eriences in Argentina, Belize, Brazil, Chile, Cuba, Jamaica and Mexico; and discusses the lessons learned in developing community mental health care.
more
In the course of implementing a recently funded network of hubs for building capacities in mental health service development, training, and research (RedeAmericas), the peer support workers are being introduced into the mental health workforce in three Latin American countries for the very first tim...e. They will be part of a team, along with community mental health workers, that provides a modified Critical Time Intervention to individuals with severe psychiatric disorders living in the community. This article reviewed the background of this increasingly widespread development, and discussed its merits, as well as potential obstacles within local contexts.
more
April 2022 Volume 35 Issue 2 e00152-21
Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where t...he disease is endemic, congenital CD (cCD) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
more
Research and Reports in Tropical Medicine 2022:13 25–40.
Chagas disease (CD) is caused by the parasite Trypanosoma cruzi, and it is endemic in Central, South America, Mexico and the South of the United States. It is an important cause of early mortality and morbidity, and it is associated with po...verty and stigma. A third of the cases evolve into chronic cardiomyopathy and gastrointestinal disease. This review proposes strategies to address challenges faced by non-endemic countries
more
While much progress has been achieved over the past year, the Region of the Americas has stubbornly remained the epicenter of the COVID-19 pandemic. PAHO is launching its 2021 COVID-19 Response Strategy and Donor Appeal to continue supporting Latin American and Caribbean countries and territories i...n their fight against COVID-19. This document outlines PAHO’s regional strategy for the year 2021 to sustain and scale-up the response to COVID‑19 pandemic in the Americas, suppress the community transmission of the virus and mitigate the longer-term health impact of the pandemic.
US$ 239 million is needed to support critical response efforts in the Americas between 1 January and 31 December 2021
more
Front. Public Health, 02 July 2019 Sec. Infectious Diseases: Epidemiology and Prevention
Volume 7 - 2019 | https://doi.org/10.3389/fpubh.2019.00166
Chagas disease (CD) is an anthropozoonosis caused by the protozoan parasite Trypanosoma cruzi, that affects about 6–8 million people worldwide (1) a...nd causes approximately 50,000 deaths per year. Another 65–100 million people are living in areas at risk for infection worldwide (2–4). Even though over a century has passed since its discovery, CD remains one of the leading public health problems for most Latin American countries
more
Rev. Latino-Am. Enfermagem 2019;27:e3086 DOI: 10.1590/1518-8345.2608.3086
Principaux faits
D’après les estimations, 6 à 7 millions de personnes dans le monde sont infectées par Trypanosoma cruzi (T. Cruzi), le parasite responsable de la maladie de Chagas. La plupart de ces personnes vivent en Amérique latine.
La transmission à l’être humain se fait principalem...ent, en Amérique latine, par l’intermédiaire d’un insecte appelé triatome, qui peut être porteur de T. cruzi.
Parmi les autres modes de transmission de la maladie de Chagas, figurent : la transmission orale (par voie alimentaire), la transfusion de sang ou de produits sanguins, la transmission mère-enfant (congénitale), la transplantation d’organes et les accidents de laboratoire.
La maladie de Chagas ne touchait auparavant que des zones rurales de la Région des Amériques, et surtout de l’Amérique latine. Ces dernières décennies, toutefois, les mouvements de population ont fait que la plupart des personnes infectées sont des habitants de zones urbaines (urbanisation) et que la maladie s’est propagée à d’autres continents (où T. cruzi se transmet par des voies non vectorielles).
L’infection à T. cruzi est curable si un traitement est instauré rapidement après l’infection.
Chez les personnes infectées de façon chronique, un traitement antiparasitaire peut éventuellement prévenir ou enrayer la progression de la maladie, et éviter sa transmission, notamment de la mère à l’enfant.
Jusqu’à 30 % des personnes infectées de façon chronique présentent des troubles cardiaques, et jusqu’à 10 % d’entre elles souffrent de troubles digestifs et/ou neurologiques, ce qui peut imposer un traitement particulier.
Les principales méthodes de prévention de la maladie de Chagas en Amérique latine sont la lutte antivectorielle ainsi que d’autres stratégies visant à réduire la transmission vectorielle.
Dans le monde entier, le dépistage sanguin joue un rôle crucial dans la prévention de l’infection par transfusion ou transplantation d’organes.
Il est essentiel de détecter et de traiter l’infection chez les femmes et les filles en âge de procréer, ainsi que de soumettre tout nouveau-né et ses frères et sœurs à un dépistage dans le cas où la mère est infectée et n’a jamais reçu de traitement antiparasitaire.
Certains facteurs socio-économiques et environnementaux influent fortement sur la maladie de Chagas, dont la propagation et les différentes dimensions interdépendantes justifient la nécessité de mettre en œuvre des stratégies de lutte multisectorielles.
Quelques pays ont mis en place la notification et la surveillance des cas aigus et chroniques et des voies de transmission actives, qui sont essentielles à la lutte contre la maladie de Chagas.
more
BMJ Glob Health 2017;2:e000345. doi:10.1136/bmjgh-2017-000345. WHO's 2020 milestones for Chagas disease include having all endemic Latin American countries certified with no intradomiciliary Trypanosoma cruzi transmission, and infected patients under care. Evaluating the variation in historical expo...sure to infection is crucial for assessing progress and for understanding the priorities to achieve these milestones.
more