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1.          Peer Reviewed Title: On the origin of South America HIV-1 C epidemic [letter] Author: de Macedo Brigido LF Source: AIDS. 2009 Feb 20;23(4):543-4. Abstract: In a recent AIDS issue, two articles present sequence analysis to trace the origin of HIV-1 clade C in South America. The authors correctly point out that the density of clade C infection in south Brazil and its phylogenetic relationship to most isolates observed elsewhere in South America places south Brazil as its probable origin. When tracing the origin of the C viruses circulating in Brazil, both groups focused on phylogenic relationships of available/analyzable material. Although reported in the Epidemiology/Social sector, the authors disconnect their findings to potential social and cultural determinants of HIV dissemination, factors that may actually have played a major role in the introduction of HIV-1 clade C in Brazil. Although the precise African origin of the variant is not known, it was first observed in Ethiopia, but it is observed, along with other variants, in many countries of central and east Africa. It is conceivable that the variant migrated southwards through highland areas (including Burundi and Kenya, the putative origin, ascribed by each group, to the South America and Brazilian clade C epidemic) to dominate the epidemic in the south of the continent. Mozambique is one of the countries in the south of Africa where clade C is predominant. In 1975, Mozambique declared its independence from Portugal and Frelimo, a left-oriented liberation movement, took hold of the government. Its support to liberation movements at South Africa and Rhodesia (now Zimbabwe) resulted in an armed rebel movement supported by the white-ruled neighboring countries, causing a civil war that was associated with an exodus of most of the Portuguese community and Mozambicans of Portuguese heritage. Brazil, a former Portuguese colony, has a large community of Portuguese descendants, a fact that may have facilitate a temporary or permanent destiny for some of these emigrants. According to the official Brazilian demographic data center (IBGE), the number of conceded residency for Portuguese nationals surged five-fold in 1975, returning to 1974 levels by 1981. In some areas of the south of Brazil, as in the coast of the state of Santa Catarina, Portuguese descendents are specially noted. Coincidentally, this area includes cities with the highest proportions of clade C infection. Available molecular data may not provide sufficient support for a direct link of the two epidemics and, apart from a threonine at codon 12, most amino acid signatures listed by Bello et al. [1] are not commonly observed among Mozambique sequences available at GenBank. However, these isolates are recent (1999-2004) and may not reflect the variants circulating in late 1970s. An evolving virus in distinct ethnic groups may make the task of tracing its origins and evolution difficult, especially when based exclusively on available, most of the time fragmental, sequence information. The relationship of Mozambique to Brazil, through a 'Portuguese connection', placed the area as the most feasible origin for the Brazilian clade C epidemic. Social and cultural determinants and tangibility of potential routes of dissemination should be incorporated into these studies to allow a more precise picture of HIV epidemic dynamics. (full-text) Language: English Keywords: SOUTH AMERICA | BRAZIL | AFRICA | CRITIQUE | HISTORICAL REVIEW | EPIDEMIOLOGIC METHODS | GENETIC TECHNIQUES | PERSONS LIVING WITH HIV/AIDS | HIV TRANSMISSION | EPIDEMIOLOGY | HUMAN GEOGRAPHY | CULTURE | GENETICS | Latin America | Americas | Developing Countries | South America, Eastern | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Public Health | Geography | Social Sciences | Science | Sociocultural Factors | Biology Document Number: 341168

2.             Peer Reviewed Title: Antiretroviral therapy in resource-limited settings 1996 to 2006: Patient characteristics, treatment regimens and monitoring in sub-Saharan Africa, Asia and Latin America. Author: ART-LINC Collaboration of the International Databases to Evaluate AIDS (IeDEA) Source: Tropical Medicine and International Health. 2008 Jul;13(7):[10] p. Abstract: The objectives were to describe temporal trends in baseline clinical characteristics, initial treatment regimens and monitoring of patients starting antiretroviral therapy (ART) in resource-limited settings. We analysed data from 17 ART programmes in 12 countries in sub-Saharan Africa, South America and Asia. Patients aged 16 years or older with documented date of start of highly active ART (HAART) were included. Data were analysed by calculating medians, interquartile ranges (IQR) and percentages by regions and time periods. Not all centres provided data for 2006 and 2005 and 2006 were therefore combined. A total of 36 715 patients who started ART 1996-2006 were included in the analysis. Patient numbers increased substantially in sub-Saharan Africa and Asia, and the number of initial regimens declined, to four and five, respectively, in 2005-2006. In South America 20 regimes were used in 2005-2006. A combination of 3TC/D4T/NVP was used for 56% of African patients and 42% of Asian patients; AZT/3TC/ EFV was used in 33% of patients in South America. The median baseline CD4 count increased in recent years, to 122 cells/microl (IQR 53-194) in 2005-2006 in Africa, 134 cells/microl (IQR 72-191) in Asia, and 197 cells/microl (IQR 61-277) in South America, but 77%, 78% and 51%, respectively, started with less than 200 cells/microl in 2005-2006. In all regions baseline CD4 cell counts were higher in women than men: differences were 22cells/microl in Africa, 65 cells/microl in Asia and 10 cells/microl in South America. In 2005-2006 a viral load at 6 months was available in 21% of patients Africa, 8% of Asian patients and 73% of patients in South America. Corresponding figures for 6-month CD4 cell counts were 74%, 77% and 81%. The public health approach to providing ART proposed by the World Health Organization has been implemented in sub-Saharan Africa and Asia. Although CD4 cell counts at the start of ART have increased in recent years, most patients continue to start with counts well below the recommended threshold. Particular attention should be paid to more timely initiation of ART in HIV-infected men. (author's) Language: English Keywords: AFRICA, SUB SAHARAN | SOUTH AMERICA | ASIA, SOUTHERN | ASIA, SOUTHEASTERN | RESEARCH REPORT | LONGITUDINAL STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | HIV | AIDS | TREATMENT | SEX FACTORS | Developing Countries | Africa | Latin America | Americas | Asia | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Characteristics | Demographic Factors | Population Document Number: 325423

3.          Peer Reviewed Title: Immigration status and HIV-risk related behaviors among female sex workers in South America. Author: Bautista CT; Mosquera C; Serra M; Gianella A; Avila MM Source: AIDS and Behavior. 2008 Mar;12(2):195-201. Abstract: This study compares immigrant (i.e., foreigner) with non-immigrant (i.e., local/native) HIV-related risk behaviors among female sex workers (FSW) in South America. A total of 1,845 FSW were enrolled in Argentina, Bolivia, Ecuador, and Uruguay. According to their nationality, 10.1% of participants were immigrant FSW. Immigrant FSW were more likely to be younger in Argentina; to work in a disco/bar in Bolivia; to be single and use illegal drugs in Ecuador; and to work in a brothel, consume alcohol, and have sex with foreign clients in Uruguay. HIV-related sexual and drug use behaviors were more common among immigrant FSW in Bolivia, Ecuador, and Uruguay. Country-specific HIV/STI prevention and control programs should be developed for immigrant FSW populations in South America. (author's) Language: English Keywords: SOUTH AMERICA | RESEARCH REPORT | KAP SURVEYS | COMPARATIVE STUDIES | IMMIGRANTS | SEX WORKERS | FOREIGNERS | WOMEN IN DEVELOPMENT | HIV TRANSMISSION | RISK BEHAVIOR | SEX BEHAVIOR | RESIDENT STATUS | ALCOHOL USE AND ABUSE | DRUG USE AND ABUSE | Latin America | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Migrants | Migration | Population Dynamics | Demographic Factors | Population | Behavior | Nationality | Population Characteristics | Economic Development | Economic Factors | HIV Infections | Viral Diseases | Diseases | Residence Characteristics | Population Distribution | Geographic Factors Document Number: 325245

4.          Peer Reviewed Title: On the origin of HIV-1 subtype C in South America. Author: Fontella R; Soares MA; Schrago CG Source: AIDS. 2008 Oct 1;22(15):2001-11. Abstract: OBJECTIVE: Our aim was to investigate the monophyletic status of the HIV-1C that circulates in South America and its phylogenetic relationships with other HIV-1C populations around the world in order to shed light on its the geographic origins as well as the place of introduction in the continent. METHODS: Fifty-one sequences from South America and 46 from non-South American countries, including samples from Africa and Asia, were obtained from the Los Alamos National Laboratory. The data analyzed corresponded to the entire protease and two-thirds of the polymerase domain from the reverse transcriptase. Phylogenetic analyses using maximum likelihood and Bayesian inference were performed in Phylogenetic Analysis Using Parsymony, PHYlogenetic inferences using Maximum Likelihood, and MrBayes. RESULTS: Samples from South America formed a monophyletic group independent of the method used. The bootstrap support of South American HIV-1C was higher than 60% in maximum likelihood trees and its posterior probability was 99% in the Bayesian analysis. These results indicate the monophyletic nature of the South American HIV-1C. Moreover, in all trees estimated, a sequence from Kenya was the most closely related to the South American clade, followed by two from Ethiopia. All South American sequences from countries other than Brazil showed closer phylogenetic relatedness to Brazilian samples, indicating that HIV-1C was introduced in South America in Brazil. CONCLUSION: Our results indicate that the entry of HIV-1C in South America occurred in a single episode or in multiples episodes of genetically related viruses, possibly from an eastern African country. HIV-1C was then disseminated to the remaining South American countries from Brazil. Language: English Keywords: SOUTH AMERICA | RESEARCH REPORT | LABORATORY PROCEDURES | TESTING | HIV | LABORATORY EXAMINATIONS AND DIAGNOSES | Latin America | Americas | Developing Countries | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Research Methodology | HIV Infections | Viral Diseases | Diseases Document Number: 329334

5.          Peer Reviewed Title: Uncommon hepatitis B virus and/or hepatitis C virus occult infection in HIV-positive patients with abnormal level of hepatic enzyme [letter] Author: Laufer N; Cassino L; Bolcic F; Moretti F; Reynoso R; Bouzas MB; Cahn P; Salomon H; Quarleri J Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Oct 1;49(2):233-4. Abstract: Language: English Keywords: SOUTH AMERICA | CRITIQUE | PERSONS LIVING WITH HIV/AIDS | CLIENTS | HEPATITIS | LIVER DYSFUNCTION | HEPATIC EFFECTS | LABORATORY PROCEDURES | Latin America | Americas | Developing Countries | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329004

6.          Peer Reviewed Title: Once-daily atazanavir/ritonavir versus twice-daily lopinavir/ritonavir, each in combination with tenofovir and emtricitabine, for management of antiretroviral-naive HIV-1-infected patients: 48 week efficacy and safety results of the CASTLE study. Author: Molina JM; Andrade-Villanueva J; Echevarria J; Chetchotisakd P; Corral J; David N; Moyle G; Mancini M; Percival L; Yang R; Thiry A; McGrath D Source: Lancet. 2008 Aug 23;372(9639):646-655. Abstract: Atazanavir/ritonavir is as effective as lopinavir/ritonavir, with a more favourable lipid profile and less gastrointestinal toxicity, in treatment-experienced HIV-1-infected patients. We compared these two combinations directly in treatment-naive patients. In this open-label, international non-inferiority study, 883 antiretroviral-naive, HIV-1-infected patients were randomly assigned to receive atazanavir/ritonavir 300/100 mg once daily (n=440) or lopinavir/ritonavir 400/100 mg twice daily (n=443), in combination with fixed-dose tenofovir/emtricitabine 300/200 mg once daily. Randomisation was done with a computer-generated centralised randomisation schedule and was stratified by baseline levels of HIV RNA (viral load) and geographic region. The primary endpoint was the proportion of patients with viral load less than 50 copies per mL at week 48. The main efficacy analysis was done by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00272779. At week 48, 343 (78%) of 440 patients receiving atazanavir/ritonavir and 338 (76%) of 443 patients receiving lopinavir/ritonavir had achieved a viral load of less than 50 copies per mL (difference 1.7%, 95% CI -3.8 to 7.1). Mean increases from baseline in CD4 cell count were similar (203 cells per microL in the atazanavir/ritonavir group vs 219 cells per microL in the lopinavir/ritonavir group). 25 (6%) patients in the atazanavir/ritonavir group and 26 (6%) in the lopinavir/ ritonavir group were virological failures by week 48. Only two patients, both in the atazanavir/ritonavir group, had non-polymorphic protease inhibitor resistance mutations emerge on treatment, which conferred phenotypic resistance to atazanavir in one patient. Serious adverse events were noted in 51 (12%) of 441 patients in the atazanavir/ritonavir group and in 42 (10%) of 437 patients in the lopinavir/ritonavir group. Fewer patients in the atazanavir/ritonavir group than in the lopinavir/ritonavir group experienced grade 2-4 treatment-related diarrhoea (10 [2%] vs 50 [11%]) and nausea (17 [4%] vs 33 [8%]). Grade 2-4 jaundice was seen in 16 (4%) of 441 patients in the atazanavir/ritonavir group versus none of 437 patients in the lopinavir/ritonavir group; grade 3-4 increases in total bilirubin were seen in 146 (34%) of 435 patients on atazanavir/ritonavir and in one (<1%) of 431 patients on lopinavir/ritonavir. In treatment-naive patients, atazanavir/ritonavir once-daily demonstrated similar antiviral efficacy to lopinavir/ritonavir twice-daily, with less gastrointestinal toxicity but with a higher rate of hyperbilirubinaemia. Language: English Keywords: AFRICA | ASIA | EUROPE | NORTH AMERICA | SOUTH AMERICA | RESEARCH REPORT | CLINICAL TRIALS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL DRUGS | TREATMENT | SAFETY | SIDE EFFECTS | ADMINISTRATION AND DOSAGE | Developing Countries | Developed Countries | Americas | Latin America | Clinical Research | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Drugs Document Number: 308342

7.          Peer Reviewed Title: Forty days and forty nights: a biocultural perspective on postpartum practices in the Amazon. Author: Piperata BA Source: Social Science and Medicine. 2008 Oct;67(7):1094-1103. Abstract: The immediate postpartum period is recognized as a special time in many societies and is commonly associated with food and work restrictions. The logic of food restrictions during a period of increased energy and protein needs has been challenged, but few data are available to test the impact of these practices on the diets of lactating women. In the eastern Amazon the immediate postpartum period is referred to as resguardo, lasts for 40-41 days and includes food taboos and work restrictions. Taking a biocultural perspective, this paper combines data on the beliefs and attitudes surrounding the practice of resguardo with quantitative data on the actual dietary intakes and activity patterns of a cohort of 23 lactating women followed from birth through 15 months postpartum. This paper addresses three topics: (1) shared ideals regarding resguardo; (2) adherence to food and work restrictions; and (3) the impact of these practices on women's dietary intakes and energy expenditure. The results show that the majority of women adhered to food taboos and work restrictions. During resguardo energy expenditure in physical activity was lower, reducing women's energy needs and allowing them to devote more time to infant care. However, energy intakes were also lower. The reduction in dietary intake was impacted more by work restrictions and the loss of women in subsistence tasks during resguardo than by adherence to food taboos. In addition to altering maternal energetic strategies, resguardo served an important social function by reinforcing bonds and, for young women, marking the transition to womanhood. Language: English Keywords: SOUTH AMERICA | RESEARCH REPORT | MOTHERS | POSTPARTUM | DIET | NUTRITION | CALORIC INTAKE | TABOO | LACTATION | BELIEFS | ATTITUDES | Latin America | Americas | Developing Countries | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Puerperium | Reproduction | Health | Culture | Maternal Physiology | Physiology | Biology | Psychological Factors | Behavior Document Number: 308017

8.    Title: Essentialism, equality, and empowerment: concepts of gender and schooling in the HIV and AIDS epidemic. Author: Unterhalter E; Boler T; Aikman S Source: In: Gender equality, HIV, and AIDS. A challenge for the education sector edited by Sheila Aikman, Elaine Unterhalter, and Tania Boler. Oxford, United Kingdom, Oxfam GB, 2008. :11-32. Abstract: The HIV and AIDS epidemic is often described as 'a feminised epidemic'. The term refers to some features of the epidemiology, in that in many countries which are experiencing generalised epidemics,1 the numbers of women infected are significantly higher than the numbers of men. During the early years of an HIV epidemic, the virus is contained within certain key populations such as men who have sex with men, sex workers, and injecting drug users. This type of epidemic is known as a concentrated epidemic and is typical of the epidemics found in most parts of Europe,North America, South America, and Asia. In these regions, the greatest burden of infection is among men.However, in sub-Saharan African countries experiencing generalised HIV epidemics,women now make up 57 per cent of infections, with some 17 million women living with HIV at the end of 2003 (UNAIDS 2007).The situation is particularly acute among young people in Southern Africa, with studies suggesting that young women are two to seven times more likely to be infected with HIV than young men are. The term 'feminised epidemic' is also sometimes used as shorthand to signal that unequal gender relations are associated with HIV infections, as either cause or consequence.The reports of UNESCO, the UNAIDS Inter-Agency Task Team on Education, and the Global Campaign for Education urge us with generalisations to 'recognise that gender issues are key to the problem of HIV and AIDS'. What these reports point to is that many women cannot act to protect themselves by requesting men to use condoms or requiring men to reduce their numbers of sexual partners. Such forms of female vulnerability are seen as a manifestation of the gender issues at the heart of the epidemic. In addition, the term 'gender issues' often signals that many women who are infected or affected take on extra burdens of care within households, without shifts in gender relations within the family, community, or society (Voluntary Service Overseas 2006). However, the term 'feminised epidemic', despite its usefulness in directing attention to some aspects of women's needs, is also immensely problematic, in that it associates the actions of women, not men,with the epidemic, and suggests that all women are similarly vulnerable, ill,or burdened with responsibility.While in many countries these terms apply to a large number of women, it is important to scrutinise these over-generalised and one-dimensional characterisations. In this chapter we place the 'feminised epidemic' within the context of a broader examination of concepts of women and gender associated with research and policy on education, HIV, and AIDS.But before turning to an exploration of these important distinctions, some background on the education-sector response to the epidemic is necessary. (excerpt) Language: English Keywords: EUROPE | ASIA | NORTH AMERICA | SOUTH AMERICA | LITERATURE REVIEW | EPIDEMIOLOGY | GENDER ISSUES | WOMEN | HIV | AIDS | WOMEN'S EMPOWERMENT | EPIDEMICS | EDUCATION | Developed Countries | Developing Countries | Americas | Latin America | Public Health | Health | Sociocultural Factors | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Women's Status | Socioeconomic Factors | Economic Factors Document Number: 330170

9.    Peer Reviewed Title: Association of pfcrt but not pfmdr1 alleles with chloroquine resistance in Iranian isolates of Plasmodium falciparum. Author: Zakeri S; Afsharpad M; Kazemzadeh T; Mehdizadeh K; Shabani A Source: American Journal of Tropical Medicine and Hygiene. 2008;78(4):633-640. Abstract: This study was designed to analyze the Plasmodium falciparum chloroquine resistance transporter (pfcrt) and P. falciparum multidrug resistance 1 (pfmdr1) mutations as markers of chloroquine (CQ) resistance in 200 blood samples collected from malaria patients in south-eastern Iran during 2002-2005. Among these, 25 (post-treatment) fulfilled the 28-day follow-up study. A high number of Iranian P. falciparum (97%) strains harbored quadruple mutations at codons 76T, 220S, 326D, and 356L. All post-treatment isolates harbored the mutant allele 76T, but low rates of the mutant allele 86Y (44%) of the pfmdr1 gene were detected. No wild haplotype of pfcrt (72-CVMNKAQNIR-371) was found in post-treatment samples; however, 56% of clinical "failure" samples carried the wild type of pfmdr1 (NYSND). The present results suggest a strong association between pfcrt 76T, but not pfmdr1 86Y mutation and in vivo CQ resistance. Furthermore, we found the CQ resistance-associated SVMNT haplotype, which previously had beenseen in South American isolates. Although Iran is located more proximally to Southeast Asia than to South America, no CQ resistance-associated CVIET haplotye has been observed in this region. Therefore, these results were not consistent with the earlier presumed spread of CQR parasites from Southeast Asia to Africa via the Indian subcontinent. In conclusion, P. falciparum mutations associated with resistance to CQ are abundant in south-eastern Iran and this finding strongly supports that CQ as the first line drug is inadequate for treatment of uncomplicated falciparum malaria in Iran. (author's) Language: English Keywords: IRAN | SOUTH AMERICA | RESEARCH REPORT | DATA ANALYSIS | COMPARATIVE STUDIES | MALARIA | LABORATORY PROCEDURES | DRUG RESISTANCE | PARASITES | ANTIMALARIAL DRUGS | Developing Countries | Middle East | Latin America | Americas | Research Methodology | Studies | Parasitic Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment | Biology Document Number: 325910

10.    Title: Health priority setting in the Southern Cone: Action needed on lifestyle risk factors. Author: World Bank. Disease Control Priorities Project Source: [Washington, D.C.], World Bank, Disease Control Priorities Project, [2007]. [5] p. Abstract: Noncommunicable diseases (NCDs)-such as cardiovascular disease, diabetes, cancer, and mental health disorders-are a significant cause of illness, disability, and death in the Southern Cone of South America. In Argentina, the biggest killer is cardiovascular disease (CVD), and in Bolivia, Chile, Peru, and Uruguay, cancer kills more people than any other condition. In all Southern Cone countries, road traffic injuries are on the rise and represent a significant source of both death and disability. This fact sheet will focus on five conditions that are responsible for most of the death and disability in five Southern Cone countries (Argentina, Bolivia, Chile, Peru, and Uruguay). These are cardiovascular disease, cancer, overconsumption of alcohol as a risk factor in liver cirrhosis, road traffic injuries, and depression and suicide. (excerpt) Language: English Keywords: SOUTH AMERICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | POPULATION | CHRONIC DISEASES | CARDIOVASCULAR EFFECTS | CANCER | ALCOHOL USE AND ABUSE | LIVER CIRRHOSIS | ACCIDENTS AND INJURIES | AUTOMOBILES | DEPRESSION | SUICIDE | CAUSES OF DEATH | PREVALENCE | Latin America | Americas | Developing Countries | Research Methodology | Diseases | Physiology | Biology | Neoplasms | Behavior | Health | Transportation | Economic Factors | Mental Disorders | Mortality | Population Dynamics | Demographic Factors | Measurement Document Number: 325120

11.             Title: Safety, immunogenicity, and protective efficacy of two doses of RIX4414 live attenuated human rotavirus vaccine in healthy Brazilian infants. Author: Araujo EC; Clemens SA; Oliveira CS; Justino MC; Rubio P Source: Jornal de Pediatria. 2007 May-Jun;83(3):217-224. Abstract: The objective was to determine the safety, immunogenicity and efficacy of two doses of rotavirus vaccine in healthy Brazilian infants. A randomized, multicenter, double-blind, placebo-controlled trial was conducted in Brazil, Mexico and Venezuela. Infants received two oral doses of vaccine or placebo at 2 and 4 months of age, concurrently with routine immunizations, except for oral poliomyelitis vaccine (OPV). This paper reports results from Belém, Brazil, where the number of subjects per group and the viral vaccine titers were: 194 (104.7 focus forming units - FFU), 196 (105.2 FFU), 194 (105.8 FFU) and 194 (placebo). Anti-rotavirus (anti-RV) antibody response was assessed in 307 subjects. Clinical severity of gastroenteritis episodes was measured using a 20-point scoring system with a score of = 11 defined as severe GE. The rates of solicited general symptoms were similar in vaccine and placebo recipients. At 2 months after the second dose, a serum IgA response to RV occurred in 54.7 to 74.4% of vaccinees. No interference was seen in the immunogenicity of routine vaccines. Vaccine efficacy against any rotavirus gastroenteritis (RVGE) was 63.5% (95%CI 20.8-84.4) for the highest concentration (105.8 FFU). Efficacy was 81.5% (95%CI 44.5-95.4) against severe RVGE. At its highest concentration (105.8 FFU), RIX4414 provided 79.8% (95%CI 26.4-96.3) protection against severe RVGE by G9 strain. RIX4414 was highly immunogenic with a low reactogenicity profile and did not interfere with seroresponse to diptheria, tetanus, pertussis, hepatitis B and Hib antigens. Two doses of RIX4414 provided significant protection against severe GE caused by RV. (author's) Language: English Keywords: SOUTH AMERICA | RESEARCH REPORT | CLINICAL TRIALS | INFANT | ROTAVIRUS | PREVENTION AND CONTROL | VACCINES | ADMINISTRATION AND DOSAGE | AGE FACTORS | PRODUCT APPROVAL | IMMUNOLOGICAL EFFECTS | SAFETY | Latin America | Americas | Developing Countries | Clinical Research | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Treatment | Legislation | Political Factors | Sociocultural Factors | Immunity | Immune System | Physiology | Biology | Public Health Document Number: 319434

12.    Peer Reviewed Title: Lessons from a multisite international trial in the Caribbean and South America of an HIV-1 canarypox vaccine (ALVAC-HIV vCP1452) with or without boosting with MN rgp 120. Author: Cleghorn F; Pape JW; Schechter M; Bartholomew C; Sanchez J Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2007 Oct 1;46(2):222-230. Abstract: The first multicenter, international National Institutes of Allergy and Infectious Diseases (NIAID)-sponsored HIV vaccine trial took place in Brazil, Haiti, Peru and Trinidad. This randomized, double-blind, placebo-controlled, phase 2 trial evaluated the safety and immunogenicity of a clade B-derived, live canarypox HIV vaccine, vCP1452. vCP1452 was administered alone or with a heterologous boost of MN rgp120 glycoprotein. The trial was pivotal in deciding whether these vaccines advanced to phase 3 efficacy trials. Forty seronegative volunteers per site were randomized to ALVAC alone, ALVAC plus MN rgp120, or placebo in a 0, 1, 3, and 6 month schedule. Immunogenicity was assayed by chromium-release cytotoxic T lymphocyte (CTL) responses; interferon-gamma (IFN-y) enzyme-linked immunosorbent spot assays (ELISpot); lymphocyte proliferation assays (LPA); neutralization; and enzyme-linked immunosorbent assays (ELISA). Enrollment and follow-up were excellent. Both vaccines were well tolerated. Neutralizing antibody to the laboratory-adapted MN strain was detected. Cellular immune responses, as measured by CTL, ELISpot, and LPA, did not differ between vaccines and placebos. The observation of disappointing immunogenicity in this and a parallel domestic study has informed future vaccine development. Equally important, challenges to doing an integrated trial across countries, cultures, languages, and differing at-risk populations were overcome. The identification of specific safety, ethical, logistic, and immunological issues in this trial established the foundation for current larger international studies. (author's) Language: English Keywords: CARIBBEAN | SOUTH AMERICA | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | VACCINES | HIV PREVENTION | ANTIBODIES | Americas | Developing Countries | Latin America | Clinical Research | Research Methodology | Studies | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Immunologic Factors | Immunity | Immune System | Physiology | Biology Document Number: 320657

13.             Peer Reviewed Title: Cohort profile: Caribbean, Central and South America Network for HIV research (CCASAnet) collaboration within the International Epidemiologic Databases to Evaluate AIDS (IeDEA) programme. Author: McGowan CC; Cahn P; Gotuzzo E; Padgett D; Pape JW Source: International Journal of Epidemiology. 2007;36(5):969-976. Abstract: The HIV/AIDS epidemic has evolved in its third decade to be an unprecedented human catastrophe of global scale and importance. Although an historic response for change and intervention has led to decreased rates of new infections and HIV-associated mortality in many communities, the enormity of the pandemic continues to overwhelm already constrained resources everywhere. Improved understanding of antiretroviral therapy (ART) responses and viral and host characteristics, both within and between diverse settings and populations, is needed to guide initiatives in HIV prevention and treatment worldwide. The merging of existing clinical and research data related to HIV infection and its associated disorders answers questions that currently cannot be addressed using randomized trials or single sources of data. Cohorts such as MACS, WIHS, HIVRN, EuroSida and the Swiss HIV Cohort have produced important observations regarding the epidemiology and long-term outcomes of HIV-infected individuals residing in North America and Europe, both before and after the era of highly active antiretroviral therapy (HAART). Assessments of short-term response to HAART in recently expanded single-site programmes have been reported globally. Collaborations such as TAHOD and ART-LINC have allowed short-term evaluation of antiretroviral programmes in resource-limited settings from several continents, and recently, comparisons of outcomes in the first year of ART between low- and high-income countries have been reported. (excerpt) Language: English Keywords: CARIBBEAN | CENTRAL AMERICA | SOUTH AMERICA | RESEARCH REPORT | EVALUATION | EPIDEMIOLOGY | COHORT ANALYSIS | DATA COLLECTION | CHILD | ADOLESCENTS | PERSONS LIVING WITH HIV/AIDS | AIDS | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | DATA SOURCES | INTERNATIONAL COOPERATION | PROGRAM ACTIVITIES | TREATMENT | Americas | Developing Countries | Latin America | Public Health | Health | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Political Factors | Sociocultural Factors | Programs | Organization and Administration Document Number: 321782

14.             Peer Reviewed Title: Efficacy of the human rotavirus vaccine RIX4414 in malnourished children. Author: Perez-Schael I; Salinas B; Tomat M; Linhares AC; Guerrero ML Source: Journal of Infectious Diseases. 2007 Aug 15;196(4) Abstract: The effect of nutritional status on protective efficacy of a live attenuated human rotavirus vaccine (RIX4414) was studied. Vaccine protection was evaluated through a secondary analysis of data from an efficacy study conducted in Brazil, Mexico, and Venezuela. Vaccine efficacy against rotavirus gastroenteritis (RVGE) was similar in well-nourished and malnourished infants: 74.1% (95% confidence interval [CI], 52.2%-86.2%) and 73% (95% CI, 11.2%-92.3%) for severe RVGE and 60.9% (95% CI, 37.4%-75.4%) and 61.2% (95% CI, 10.4%-83.1%) for RVGE of any severity, respectively. RIX4414 significantly decreased the rate of RVGE regardless of nutritional status, which suggests that this patient group can also benefit from rotavirus vaccination. (author's) Language: English Keywords: SOUTH AMERICA | RESEARCH REPORT | INFANT | NUTRITION INDEXES | MALNUTRITION | GASTROINTESTINAL EFFECTS | ROTAVIRUS | VACCINES | CONTRACEPTIVE USE-EFFECTIVENESS | IMMUNIZATION | Latin America | Americas | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Nutrition Disorders | Diseases | Physiology | Biology | Viral Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Contraceptive Effectiveness | Contraception | Family Planning | Primary Health Care Document Number: 318618

15.          Peer Reviewed Title: Negotiating antiretroviral drug prices: The experience of the Andean countries. Author: Seoane-Vazquez E; Rodriguez-Monguio R Source: Health Policy and Planning. 2007 Mar;22(2):63-72. Abstract: This study analyses the effect of the Andean countries' June 2003 negotiation of antiretroviral drug (ARV) prices. The objectives were to assess the problems faced during the negotiation process, to evaluate the impact of the negotiation on ARV prices, and to identify factors that could make it difficult for countries to implement the results of the negotiation. Price information of ARVs purchased by public programmes during 2004 was collected from the ministries of health. A survey of the ministries of health was conducted using a questionnaire with information related to the countries' health care and drug regulations and policies. Interviews with a convenient sample of key Andean health authorities and other stakeholders were also conducted. Study results show that the negotiation did achieve lower prices and higher quality and bioequivalence standards for ARVs. However, in general, the public health care programmes of the six countries analysed did not purchase ARVs from the companies that participated in the negotiation, nor did they base purchases on the prices or quality and bioequivalence criteria established in the negotiation. Prices paid by the Andean countries' public programmes in 2004 were a weighted average of 65% higher than the negotiated prices; and this difference in negotiated prices vs. actual prices represented 39.5% of the programmes' ARV expenditures in 2004, or US$18 million in ARV expenditures. The successful development and implementation of multinational price negotiations requires that participant countries coordinate pharmaceutical regulations and policies, and pool procurement processes. (author's) Language: English Keywords: SOUTH AMERICA | RESEARCH REPORT | ANTIRETROVIRAL DRUGS | PROGRAM ACCESSIBILITY | PRICES | HEALTH POLICY | PUBLIC SECTOR | EXPENDITURES | INTERNATIONAL COOPERATION | STANDARDS | Latin America | Americas | Developing Countries | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration | Commerce | Macroeconomic Factors | Economic Factors | Policy | Political Factors | Sociocultural Factors | Financial Activities | Research Methodology Document Number: 315881

16.    Peer Reviewed Title: [Tuberculin skin test to estimate the prevalence of Mycobacterium tuberculosis infection in indigenous populations in the Americas: a literature review] Teste tuberculinico na estimativa da prevalencia de infeccao por Mycobacterium tuberculosis em populacoes indigenas do continente americano: uma revisao da literatura. Author: Basta PC; Camacho LA Source: Cadernos de Saude Publica. 2006 Feb;22(2):245-254. Abstract: A systematic review was conducted on articles reporting tuberculin surveys to estimate the prevalence and annual risk of tuberculosis infection (ARI) in indigenous peoples of the Americas. MEDLINE and LILACS databases were searched using the following combination of descriptors: "tuberculosis", "South American Indians", "North American Indians", "tuberculin skin test", "PPD", "risk assessment", and "BCG vaccine". Longitudinal and cross-sectional studies published from 1974 to 2004 were selected if the outcome was Mycobacterium tuberculosis infection defined by tuberculin reactions = 5mm or = 10mm. From a total of 54 candidate studies generated with the descriptors, 16 were selected for review. Altogether, they comprised 13,186 individuals, 50% of whom were below 15 years of age. Estimates of prevalence of tuberculosis infection ranged from 0% to 93.4%, whereas the ARI ranged from 0% to 35.4%. Analysis of heterogeneity in environmental conditions and methods of infection assessment in the studies showed that the tuberculin test is useful for clinical decisions (e.g., to initiate chemoprophylaxis), and that tuberculin surveys are useful to assess tuberculosis control measures among indigenous peoples. (author's) Language: Portuguese Keywords: NORTH AMERICA, NORTHERN | SOUTH AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | LONGITUDINAL STUDIES | CROSS SECTIONAL ANALYSIS | NATIVE AMERICANS | TESTING | TUBERCULOSIS | LABORATORY EXAMINATIONS AND DIAGNOSES | PREVALENCE | VACCINES | Americas | Developed Countries | Latin America | Developing Countries | Research Methodology | Studies | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Measurement | Infections | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 316704

17. Peer Reviewed Title: Seroprevalence of and risk factors for HIV-1 infection among female commercial sex workers in South America. Author: Bautista CT; Sanchez JL; Montano SM; Laguna-Torres A; Suarez L Source: Sexually Transmitted Infections. 2006 Aug;82(4):311-316. Abstract: Assessment of HIV prevalence and associated risk behaviours among female commercial sex workers (FCSW) across major cities in South America. Seroepidemiological, cross sectional studies of 13 600 FCSW were conducted in nine countries of South America during the years 1999--2002. Participants were recruited in brothels, massage parlours, hotels, and streets where anonymous questionnaires and blood samples were collected. HIV infection was determined by enzyme linked immunosorbent assay (ELISA) screening and western blot confirmatory tests. The overall HIV seroprevalence was 1.2% (range 0.0%--4.5%). The highest HIV seroprevalences were reported in Argentina (4.5%) and Paraguay (2.6%); no HIV infected FCSW were detected in Venezuela and Chile. Consistent predictors of HIV seropositivity were: (1) a previous history of sexually transmitted infections (STI, AORs = 3.8--8.3), and (2) 10 years or more in commercial sex work (AORs = 2.2--24.8). In addition, multiple (>3) sexual contacts (AOR = 5.0), sex with foreigners (AOR = 6.9), use of illegal drugs (AOR = 3.2), and marijuana use (AOR = 8.2) were associated with HIV seropositivity in Southern Cone countries. Consistently low HIV seroprevalences were detected among FCSW in South America, particularly in the Andean region. Predictors of HIV infection across the continent were STI and length of commercial sex work; however, use of illegal drugs, especially marijuana, and sexual contacts with foreigners were also found to be associated risk factors in the Southern Cone region. Interventions for the control of HIV and other STI need to be region and country specific; drug use appears to have an ever increasing role in the spread of HIV among heterosexually active populations. (author's) Language: English Keywords: SOUTH AMERICA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | SEX WORKERS | WOMEN | HIV INFECTIONS | LABORATORY PROCEDURES | PREVALENCE | RISK FACTORS | SEX BEHAVIOR | DRUG USE AND ABUSE | SEXUALLY TRANSMITTED DISEASE PREVENTION | Developing Countries | Latin America | Americas | Research Methodology | Behavior | Demographic Factors | Population | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Biology | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections Document Number: 305985

18. Peer Reviewed Title: Mortality of HIV-1-infected patients in the first year of antiretroviral therapy: comparison between low-income and high-income countries. [Mortalidad en pacientes infectados por VIH-1 durante el primer año de tratamiento antirretroviral: comparación entre países de bajos y altos ingresos] Author: Braitstein P; Brinkhof MW; Dabis F; Schechter M; Boulle A Source: Lancet. 2006 Mar 11;367(9513):817-824. Abstract: Highly active antiretroviral therapy (HAART) is being scaled up in developing countries. We compared baseline characteristics and outcomes during the first year of HAART between HIV-1-infected patients in low-income and high-income settings. 18 HAART programmes in Africa, Asia, and South America (low-income settings) and 12 HIV cohort studies from Europe and North America (high-income settings) provided data for 4810 and 22 217, respectively, treatment-naïve adult patients starting HAART. All patients from high-income settings and 2725 (57%) patients from low-income settings were actively followed-up and included in survival analyses. Compared with high-income countries, patients starting HAART in low-income settings had lower CD4 cell counts (median 108 cells per µL vs 234 cells per µL), were more likely to be female (51% vs 25%), and more likely to start treatment with a non-nucleoside reverse transcriptase inhibitor (NNRTI) (70% vs 23%). At 6 months, the median number of CD4 cells gained (106 cells per µL vs 103 cells per µL) and the percentage of patients reaching HIV-1 RNA levels lower than 500 copies/mL (76% vs 77%) were similar. Mortality was higher in low-income settings (124 deaths during 2236 person-years of follow-up) than in high-income settings (414 deaths during 20 532 person-years). The adjusted hazard ratio (HR) of mortality comparing low-income with high-income settings fell from 4.3 (95% CI 1.6-11.8) during the first month to 1.5 (0.7-3.0) during months 7-12. The provision of treatment free of charge in low-income settings was associated with lower mortality (adjusted HR 0.23; 95% CI 0.08-0.61). Patients starting HAART in resource-poor settings have increased mortality rates in the first months on therapy, compared with those in developed countries. Timely diagnosis and assessment of treatment eligibility, coupled with free provision of HAART, might reduce this excess mortality. (author's) Spanish Abstract: En los países en desarrollo se están difundiendo gradualmente los tratamientos antirretrovirales altamente activos (HAART, highly active antiretroviral therapy). Se comparan las características iniciales con los resultados durante el primer año de tratamiento antirretroviral altamente activo entre pacientes infectados por VIH-1 de países de altos y bajo ingresos. Dieciocho programas HAART en África, Asia y América del Sur (lugares de bajos ingresos) y 12 estudios de cohorte sobre VIH realizados en Europa y América del Norte (lugares de altos ingresos) aportaron, respectivamente, datos sobre 4810 y 22.217 pacientes adultos sin tratamiento previo que iniciaron el tratamiento antirretroviral altamente activo. Todos los pacientes de los países de altos ingresos y 2725 (57%) pacientes de los países de bajos ingresos se sometieron a un seguimiento activo y fueron incluidos en análisis de sobrevida. En comparación con los pacientes de los países de altos ingresos, los pacientes de bajos ingresos que iniciaron su tratamiento antirretroviral altamente activo presentaron recuentos de linfocitos CD4 inferiores (recuento medio de 108 linfocitos por µl versus 234 linfocitos por µl), mayoritariamente eran mujeres (51% versus 25%), y tenían más probabilidades de iniciar tratamiento con un inhibidor no nucleósido de la transcriptasa inversa (NNRTI, non-nucleoside reverse transcriptase inhibitor) (70% versus 23%). A los 6 meses se incrementó el recuento medio de linfocitos CD4 (106 linfocitos por µl versus 103 linfocitos por µl) y los porcentajes de pacientes que alcanzaron niveles de ARN de VIH-1 inferiores a 500 copias/ml (76% versus 77%) fueron similares. La tasa de mortalidad fue mayor en los países de bajos ingresos (124 muertes cada 2236 personas/años de seguimiento) que en los de altos ingresos (414 muertes cada 20.532 personas/años). La razón de riesgo (HR, hazard ratio) ajustada de mortalidad comparativa entre los países de bajos y altos ingresos cayó del 4,3 (intervalo de confianza [IC] 95%: 1,6 - 11,8) durante el primer mes, al 1,5 (0,7 a 3,0) durante los meses 7 a 12. La provisión de tratamiento gratuito en los países de bajos ingresos se asoció a menor mortalidad (razón de riesgo ajustada 0,23; IC 95%: 0,08 a 0,61). Los pacientes que inician el tratamiento antirretroviral altamente activo en los países de bajos recursos presentan mayores tasas de mortalidad durante los primeros meses del tratamiento que los pacientes de países desarrollados. El diagnóstico oportuno y la evaluación de las opciones terapéuticas asociados a la prestación gratuita del tratamiento antirretroviral altamente activo podrían reducir esta mortalidad excesiva. (del autor) Language: English Keywords: DEVELOPED COUNTRIES | AFRICA | ASIA | SOUTH AMERICA | RESEARCH REPORT | COMPARATIVE STUDIES | HIGH INCOME POPULATION | LOW INCOME POPULATION | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | TREATMENT | DEATH RATE | Developing Countries | Latin America | Americas | Studies | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | HIV Infections | Viral Diseases | Diseases | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 299371

19. Peer Reviewed Title: The Acre Project: the epidemiology of malaria and arthropod-borne virus infections in a rural Amazonian population. Author: da Silva-Nunes M; Malafronte RD; Luz BD; de Souza EA; Martins LC Source: Cadernos de Saude Publica. 2006 Jun;22(6):1325-1334. Abstract: The authors describe the baseline malaria prevalence and arbovirus seroprevalence among 467 subjects in an ongoing cohort study in rural Amazonia. Most subjects (72.2%) reported one or more previous episodes of malaria, and 15.6% had been hospitalized for malaria, but only 3.6% of individuals five years or older had malaria parasites detected by microscopy (10 with Plasmodium vivax and 4 with P. falciparum). Antibodies to Alphavirus, Orthobunyavirus, and/or Flavivirus were detected by hemagglutination inhibition (HI) in 42.6% of subjects aged five years or older, with a higher seropositivity rate among males (49.2%) than females (36.2%). Since 98.9% of subjects had been immunized for yellow fever, the presence of cross-reactive antibodies to dengue and other Flaviviruses cannot be ruled out, but at least 12 subjects (3.3%) with IgM antibodies to dengue virus detected by ELISA had a putative recent exposure to this virus. (author's) Language: English Keywords: SOUTH AMERICA | SUMMARY REPORT | EPIDEMIOLOGY | PREVALENCE | RURAL AREAS | MALARIA | DENGUE | ANTIBODIES | EXPOSURE | Latin America | Americas | Developing Countries | Public Health | Health | Measurement | Research Methodology | Geographic Factors | Population | Parasitic Diseases | Diseases | Viral Diseases | Immunologic Factors | Immunity | Immune System | Physiology | Biology | Risk Factors Document Number: 316729

20. Peer Reviewed Title: Challenges in the control of gonorrhea in South America and the Caribbean: monitoring the development of resistance to antibiotics. [Desafíos en el control de la gonorrea en América del Sur y el Caribe: control de la evolución de la resistencia a los antibióticos] Author: Dillon JR; Ruben M; Li H; Borthagaray G; Márquez C Source: Sexually Transmitted Diseases. 2006 Feb;33(2):87-95. Abstract: The objective of this study was to ascertain the antimicrobial susceptibility of Neisseria gonorrhoeae isolates from 6 South American and 13 Caribbean countries participating in the Gonococcal Antimicrobial Surveillance Program (GASP) from 1990 to 1999. A GASP network of laboratories was launched in the Americas and the Caribbean during the 1990s. Standardized methods and interpretative criteria were established for the isolation of N. gonorrhoeae, strain identification, and determination, and quality control of antimicrobial susceptibility. Two countries (Argentina and Uruguay) maintained continuous surveillance during the study period. Some countries gathered data periodically and several others were unable to initiate antimicrobial surveillance as a result of lack of resources. The percentage of penicillin-resistant N. gonorrhoeae isolated in the region over the decade varied considerably (1.0-11.9% carried chromosomal resistance and 17.9-38.8% produced ß-lactamase) with an overall trend to declining numbers of penicillin-resistant isolates. For tetracycline, 7.4% to 36.3% carried chromosomal resistance, whereas 12.0% to 27.4% carried plasmid-mediated resistance. There were no reports of ciprofloxacin-resistant isolates, although N. gonorrhoeae with decreased susceptibility to ciprofloxacin and azithromycin as well as spectinomycin-resistant isolates were identified in some countries. (author's) Spanish Abstract: El objetivo de este estudio fue establecer la susceptibilidad antimicrobiana de los aislados de Neisseria gonorrhoeae de 6 países de América del Sur y 13 del Caribe que participaron en el Programa de Vigilancia Antimicrobiana Gonocócica (GASP, Gonococcal Antimicrobial Surveillance Program) desde 1990 a 1999. En la década del 90 se creó una red GASP de laboratorios en las Américas y el Caribe. Se establecieron métodos estandarizados y criterios interpretativos para el aislamiento del N. gonorrhoeae, la identificación de cepas y la determinación y el control de calidad de la susceptibilidad antimicrobiana. Dos países (Argentina y Uruguay) mantuvieron vigilancia continua durante el período de estudio. Algunos países reunieron datos periódicamente y varios otros no pudieron iniciar la vigilancia antimicrobiana debido a la falta de recursos. El porcentaje de N. gonorrhoeae resistente a la penicilina, aislado en la región durante la década, varió considerablemente (el 1,0 al 11,9% era portador de resistencia cromosómica y el 17,9 al 38,8% produjo ß-lactamasa) con una tendencia global hacia cifras decrecientes de aislados resistentes a la penicilina. Para la tetraciclina, el 7,4% al 36,3% era portador de resistencia cromosómica, mientras que el 12,0% a 27,4% era portador de resistencia mediada por plásmidos. No se encontraron informes de aislados resistentes a la ciprofloxacina, aunque en algunos países se identificaron N. gonorrhoeae con susceptibilidad disminuida a la ciprofloxacina y la azitromicina al igual que aislados resistentes a la espectinomicina. (del autor) Language: English Keywords: SOUTH AMERICA | CARIBBEAN | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | GONORRHEA | PREVENTION AND CONTROL | ANTIBIOTICS | DRUG RESISTANCE | MONITORING | LABORATORY EXAMINATIONS AND DIAGNOSES | Latin America | Americas | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Evaluation | Examinations and Diagnoses Document Number: 296246

21.    Title: Vaccines for preventing malaria (SPf66) (Review). Author: Graves P; Gelband H Source: Cochrane Database of Systematic Reviews. 2006;(2):[28] p.. ID: CD005966 Abstract: A malaria vaccine is badly needed. SPf66 was one of the earliest vaccines developed. It is a synthetic peptide vaccine containing antigens from the blood stages of malaria linked together with an antigen from the sporozoite stage, and is targeted mainly against the blood (asexual) stages. The objectives were to assess the effect of SPf66 malaria vaccines against Plasmodium falciparum, P. vivax, P. malariae, and P. ovale in preventing infection, disease, and death. We searched the Cochrane Infectious Diseases Group Specialized Register (September 2005), CENTRAL (The Cochrane Library 2005, Issue 3), MEDLINE (1966 to September 2005), EMBASE (1980 to September 2005), LILACS (1982 to September 2005), Science Citation Index (1981 to September 2005), and reference lists of articles. We also contacted organizations and researchers in the field. Randomized and quasi-randomized controlled trials comparing SPf66 vaccine with placebo or routine antimalarial control measures in people of any age receiving an artificial challenge or natural exposure to malaria infection (any species). Two people independently assessed trial quality and extracted data, including adverse events. Results were expressed as relative risks (RR) with 95% confidence intervals (CI). Ten efficacy trials of SPf66 involving 9698 participants were included. Results with SPf66 in reducing new episodes of P. falciparum malaria were heterogeneous: it was not effective in four African trials (RR 0.98, 95% CI 0.90 to 1.07; 2371 participants) or in one Asian trial (RR 1.06, 95% CI 0.90 to 1.25; 1221 participants). In four trials in South America the number of first attacks with P. falciparum was reduced by 28% (RR 0.72, 95% CI 0.63 to 0.82; 3807 participants). It did not reduce episodes of P. vivax malaria or admission to hospital with severe malaria. Trials have not indicated any serious adverse events with SPf66 vaccine. There is no evidence for protection by SPf66 vaccines against P. falciparum in Africa. There is a modest reduction in attacks of P. falciparum malaria following vaccination with SPf66 in South America. There is no justification for further trials of SPf66 in its current formulation. Further research with SPf66 vaccines in South America or with new formulations of SPf66 may be justified. (author's) Language: English Keywords: AFRICA | ASIA | SOUTH AMERICA | RESEARCH REPORT | LITERATURE REVIEW | DATA COLLECTION | DATA ANALYSIS | TESTING | MALARIA | VACCINES | PROGRAM EFFECTIVENESS | Developing Countries | Latin America | Americas | Research Methodology | Measurement | Parasitic Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration Document Number: 307791

22. Peer Reviewed Title: Human schistosomiasis. Author: Gryseels B; Polman K; Clerinx J; Kestens L Source: Lancet. 2006 Sep 23;368(9541):1106-1118. Abstract: Schistosomiasis or bilharzia is a tropical disease caused by worms of the genus Schistosoma. The transmission cycle requires contamination of surface water by excreta, specific freshwater snails as intermediate hosts, and human water contact. The main disease-causing species are S haematobium, S mansoni, and S japonicum. According to WHO, 200 million people are infected worldwide, leading to the loss of 1.53 million disability-adjusted life years, although these figures need revision. Schistosomiasis is characterised by focal epidemiology and over-dispersed population distribution, with higher infection rates in children than in adults. Complex immune mechanisms lead to the slow acquisition of immune resistance, though innate factors also play a part. Acute schistosomiasis, a feverish syndrome, is mostly seen in travellers after primary infection. Chronic schistosomal disease affects mainly individuals with longstanding infections in poor rural areas. Immunopathological reactions against schistosome eggs trapped in the tissues lead to inflammatory and obstructive disease in the urinary system (S haematobium) or intestinal disease, hepatosplenic inflammation, and liver fibrosis (S mansoni, S japonicum). The diagnostic standard is microscopic demonstration of eggs in the excreta. Praziquantel is the drug treatment of choice. Vaccines are not yet available. Great advances have been made in the control of the disease through population-based chemotherapy but these required political commitment and strong health systems. (author's) Language: English Keywords: AFRICA | SOUTH AMERICA | RESEARCH REPORT | SCHISTOSOMIASIS | SIGNS AND SYMPTOMS | TREATMENT | EXAMINATIONS AND DIAGNOSES | Developing Countries | Latin America | Americas | Parasitic Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 307512

23. Title: The World Bank and malaria treatment [letter] [El Banco Mundial y el tratamiento de la malaria [carta]] Author: Lambo E Source: Lancet. 2006 Jul 15;368(9531):197. Abstract: I read the Viewpoint by Amir Attaran and colleagues and the subsequent response from the World Bank with great interest and surprise. For any debate on global health challenges to be truly credible, it must reflect the current situation on the ground. Although such a criticism of the World Bank might have caused a certain resonance had it been published a year ago, the fact is that, since April 25, 2005, when the World Bank launched its Malaria Booster Programme, it agreed to provide millions of dollars to help countries scale up malaria control. Designed to "boost" country efforts and fill the implementation gaps, this programme will enable countries to roll out their strategic plans effectively. The Booster Programme has already been introduced in Benin, Ethiopia, Zambia, Nigeria, Democratic Republic of Congo, and the Senegal River basin--including Senegal, Guinea, Mali, and Mauritania. Other countries will soon follow. (excerpt) Spanish Abstract: Leí, con gran interés y cierta sorpresa, el Viewpoint redactado por Amir Attaran y colaboradores y la consiguiente respuesta del Banco Mundial. Para que un debate sobre los desafíos mundiales en salud sea verdaderamente creíble, debe reflejar la situación actual en las bases. Aunque una crítica de esta naturaleza del Banco Mundial podría haber logrado cierta repercusión si se hubiese publicado hace un año, es cierto que desde el 25 de abril de 2005, cuando la institución lanzó su Programa de refuerzo a la lucha contra la malaria, el Banco acordó ceder millones de dólares para ayudar a los países a reforzar el control de la malaria. El programa, que fue diseñado para “reforzar” los esfuerzos de cada país y solucionar los problemas de implementación, permitirá a los países poner en práctica sus planes estratégicos con eficacia. El Programa de refuerzo ya se introdujo en Benin, Etiopía, Zambia, Nigeria, la República Democrática del Congo y la cuenca del río Senegal (incluido Senegal, Guinea, Mali y Mauritania). Otros países se incluirán pronto. (extracto) Language: English Keywords: SOUTH AMERICA | CRITIQUE | WORLD BANK | MALARIA | TREATMENT | PROGRAM EFFECTIVENESS | Latin America | Americas | Developing Countries | International Agencies | Organizations | Political Factors | Sociocultural Factors | Parasitic Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration Document Number: 303471

24.    Peer Reviewed Title: Advice from a medical expert through the Internet on queries about AIDS and hepatitis: analysis of a pilot experiment. Author: Marco J; Barba R; Losa JE; Martinez de la Serna C; Sainz M Source: PLoS Medicine. 2006 Jul;3(7):e256. Abstract: Advice from a medical expert on concerns and queries expressed anonymously through the Internet by patients and later posted on the Web, offers a new type of patient--doctor relationship. The aim of the current study was to perform a descriptive analysis of questions about AIDS and hepatitis made to an infectious disease expert and sent through the Internet to a consumer-oriented Web site in the Spanish language. Questions were e-mailed and the questions and answers were posted anonymously in the ''expert-advice'' section of a Web site focused on AIDS and hepatitis. We performed a descriptive study and a temporal analysis of the questions received in the first 12 months after the launch of the site. A total of 899 questions were received from December 2003 to November 2004, with a marked linear growth pattern. Questions originated in Spain in 68% of cases and 32% came from Latin America (the Caribbean, Central America, and South America). Eighty percent of the senders were male. Most of the questions concerned HIV infection (79%) with many fewer on hepatitis (17%). The highest numbers of questions were submitted just after the weekend (37% of questions were made on Mondays and Tuesdays). Risk factors for contracting HIV infection were the most frequent concern (69%), followed by the window period for detection (12.6%), laboratory results (5.9%), symptoms (4.7%), diagnosis (2.7%), and treatment (2.2%). Our results confirm a great demand for this type of ''ask-the-expert'' Internet service, at least for AIDS and hepatitis. Factors such as anonymity, free access, and immediate answers have been key factors in its success. (author's) Language: English Keywords: SPAIN | LATIN AMERICA | SOUTH AMERICA | CENTRAL AMERICA | CARIBBEAN | RESEARCH REPORT | PILOT PROJECTS | MEN | INTERNET | AIDS | HIV INFECTIONS | HEPATITIS | Europe, Southwestern | Europe | Developed Countries | Americas | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Information Networks | Communication | Viral Diseases | Diseases Document Number: 306521

25. Title: Tuberculosis control in Bolivia, Chile, Colombia and Peru: Why does incidence vary so much between neighbors? Author: Sobero RA; Peabody JW Source: International Journal of Tuberculosis and Lung Disease. 2006 Nov;10(11):1292-1295. Abstract: In 2003, Peru and Bolivia reported the highest annual tuberculosis (TB) incidence rates in the Americas. Neighboring Colombia and Chile had lower annual incidence rates despite their proximity. The objective was to determine what factors contribute to differences in TB incidence rates among Chile, Colombia, Bolivia and Peru. Multiple sources of literature dating between 1990 and 2005 were used and World Health Organization TB control guidelines were consulted for policy level comparisons. Comprehensive implementation of the DOTS strategy is the main factor explaining the differences in TB incidence rates, even after considering socio-economic factors. Cross-national comparisons suggest ways to improve regional DOTS implementation. (author's) Language: English Keywords: SOUTH AMERICA | RESEARCH REPORT | LITERATURE REVIEW | EPIDEMIOLOGIC METHODS | CROSS-CULTURAL COMPARISONS | TARGET POPULATION | PREVALENCE | TUBERCULOSIS | COMMUNICABLE DISEASE CONTROL | WHO | ANTIBIOTICS | USER COMPLIANCE | Latin America | Americas | Developing Countries | Research Methodology | Comparative Studies | Studies | Program Design | Programs | Organization and Administration | Measurement | Infections | Diseases | Health Services | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Drugs | Treatment | Medical Procedures | Medicine | Behavior Document Number: 310193

26. Title: Weaning practices of the Makushi of Guyana and their relationship to infant and child mortality: A preliminary assessment of international recommendations. Author: Wilson W; Milner J; Bulkan J; Ehlers P Source: American Journal of Human Biology. 2006 May-Jun;18(3):312-324. Abstract: The World Health Organization (WHO) recommends exclusive breastfeeding (EBF) for the first 6 months of life, primarily because of potential immunological benefits which are deemed to outweigh nutritive costs for infants. This recommendation is controversial, as studies of the relationship between the term of EBF and infant and child health have produced conflicting results. The purpose of this paper is to evaluate the relationship between the term of EBF and infant and child mortality among a group of swidden-horticulturalists in lowland South America. Consistent with the WHO, we hypothesized that EBF < 6 months will compromise the survival of the infant or child. This relationship was assessed via recall data generated in 2001 in structured interviews with 60 Makushi Amerindian women in Guyana's North Rupununi region. The data were analyzed with t-tests, Fisher's exact test, and logistic regression. The results do not support our hypothesis; the term of EBF is not found to be related to infant or child mortality. This is surprising given the potential for contamination in nonbreast-milk foods in this environment. Notably, this is occurring among mothers who are not energetically stressed. We propose that the apparent lack of benefit of EBF = 6 months is due to insufficient energy supply from breast milk alone, which may predispose the child to morbidity when subsequently stressed. This study concurs with others which revealed no significant benefits to the infant of EBF > 6 months, and the recognition that universal recommendations must be situated within local ecological contexts. (author's) Language: English Keywords: GUYANA | SOUTH AMERICA | RESEARCH REPORT | WHO | RECOMMENDATIONS | DATA ANALYSIS | BREASTFEEDING, EXCLUSIVE | CHILD MORTALITY | WEANING | South America, Northern | Latin America | Americas | Developing Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Research Methodology | Breastfeeding | Infant Nutrition | Nutrition | Health | Mortality | Population Dynamics | Demographic Factors | Population Document Number: 307068

27. Title: Twenty years of "human trafficking" - experiences at the women's shelter, HELP. Interview with Ms. Rutsuko Shoji. [Veinte años de "tráfico de personas": experiencias en el refugio de mujeres HELP. Entrevista a Rutsuko Shoji] Source: Women's Asia 21: Voices from Japan. 2005 Summer;(15):4-13. Abstract: As part of its 100th anniversary in 1986, the Japan Woman’s Christian Temperance Union’s (JWCTU) founded a temporary shelter for women called “The House in Emergency of Love and Peace (HELP).” Since its inception, HELP has been providing a temporary shelter for hundreds of non-Japanese victims of human trafficking. Ms. Rutsuko Shoji had worked at HELP for years (since the early nineties) and is presently the director at JWCTU’s Step House, a short-term boarding house for single women. In light of her vast experience at HELP and elsewhere, we interviewed Ms. Shoji to hear her perspectives on historical developments regarding human trafficking as well as support methods for victimized women in Japan. (author's) Spanish Abstract: Como parte de su centésimo aniversario en 1986, la Unión de Templanza Cristiana de Mujeres (JWCTU, Japan Woman's Christian Temperance Union) fundó un refugio para mujeres denominado HELP (The House in Emergency of Love and Peace). Desde su inicio, HELP ha brindado refugio temporal a cientos de víctimas no japonesas del tráfico de personas. Rutsuko Shoji trabajó en HELP durante años (desde comienzos de la década del noventa) y actualmente es directora del refugio transitorio de la JWCTU, una pensión que alberga a mujeres solas durante períodos breves. A la luz de su vasta experiencia en HELP y otros refugios, entrevistamos a Rutsuko Shoji para conocer su perspectiva sobre los desarrollos históricos vinculados al tráfico humano y los métodos de apoyo a las mujeres víctimas de tráfico en Japón. (del autor) Language: English Keywords: JAPAN | THAILAND | SOUTH AMERICA | SUMMARY REPORT | WOMEN | SEXUAL TRAFFICKING | GROUP HOMES | HUMAN RIGHTS | DOMESTIC VIOLENCE | Developed Countries | Asia, Eastern | Asia | Developing Countries | Asia, Southeastern | Latin America | Americas | Demographic Factors | Population | Crime | Social Problems | Housing | Residence Characteristics | Population Distribution | Geographic Factors Document Number: 284672

28. Title: The fluid border: children crossing borders in the Americas. [La frontera fluida: los niños que cruzan las fronteras en el continente americano] Author: Collinson A Source: Women and Environments. 2005 Fall-Winter;:25-27. Abstract: After losing his mother on the perilous journey from Cuba to the United States in November 1999, Elian Gonzalez, became a symbol of Cuban-U.S. relations, parental rights, nationality and nation, and immigrant children in need of protection. The ensuing controversy over Gonzalez's fate led to increased U.S. media coverage of children from Latin America and the Caribbean, and fueled debates over the state of children in U.S. immigration laws. The plight of 'the littlest immigrants' was examined in The New York Times on November 3, 2003 in an article which described Mexican children who cross the Mexico-U.S. border alone to be reunited with their biological parents who are living in the United States. The article stated that "Mexican consular authorities report they have repatriated more than 9 800 unaccompanied Mexican minors caught crossing illegally in the first nine months of this year." On February 24, 2004, U.S. National Public Radio ran a similar story interviewing border guards who had caught children and infants packed into trunks, dashboards, special containers in gas tanks, and -- in one case -- into a three-foot high piñata accompanied by 'coyotes' (adults paid to smuggle others into the United States). (excerpt) Spanish Abstract: Elian González perdió a su madre en el peligroso trayecto desde Cuba a Estados Unidos en noviembre de 1999 y se convirtió en un símbolo de las relaciones cubano-estadounidenses, los derechos de los padres, las ideas de nacionalidad y nación y los niños inmigrantes que necesitan protección. La consiguiente polémica sobre el destino de González derivó en una mayor cobertura del tema de los niños de América Latina y el Caribe por parte de los medios de difusión estadounidenses y avivó los debates sobre la condición de los niños en la legislación sobre inmigración de Estados Unidos. Un artículo sobre las difíciles circunstancias de los “inmigrantes más pequeños” del número del 3 de noviembre de 2003 de The New York Times describió la situación de los niños mexicanos que cruzan la frontera entre México y Estados Unidos solos para reunirse con sus padres biológicos que viven en este país. El artículo declara que “las autoridades consulares mexicanas informan que han repatriado a más de 9800 menores mexicanos que no estaban acompañados por un adulto aprehendidos cuando cruzaban ilegalmente durante los primeros nueve meses del año". El 24 de febrero de 2004, la Radio Pública Nacional de Estados Unidos (U.S. National Public Radio) relató una historia similar en las entrevistas a la policía de frontera que había aprehendido a niños y a bebés escondidos dentro de maleteros, tableros de mando, contenedores especiales en tanques de gas y, en un caso, en el interior de una piñata de 90 cm acompañado de “coyotes” (adultos pagados para pasar a otros de contrabando a Estados Unidos). (extracto) Language: English Keywords: NORTH AMERICA | SOUTH AMERICA | CRITIQUE | CHILDREN | ILLEGAL MIGRANTS | MIGRANT WORKERS | BORDER CROSSING | ADOPTION | MASS MEDIA | WAR | NATIONALITY | HUMAN RIGHTS | Americas | Developed Countries | Latin America | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Migrants | Migration | Population Dynamics | Labor Force | Human Resources | Economic Factors | International Migration | Child Rearing | Behavior | Communication | Political Factors | Sociocultural Factors Document Number: 302425

29. Title: Strategic gender mainstreaming in Oxfam GB. Author: Dawson E Source: Gender and Development. 2005 Jul;13(2):80-89. Abstract: This article describes and assesses a strategy to mainstream gender issues in the South America region of Oxfam GB, both in its programme and in the organisation?s internal systems and procedures. The experience shows that relating gender equality to strategic thinking is key to its effective incorporation into a programme. If staff do not see gender equality as a central part of what they are meant to be working on, they are unlikely to dedicate time to it. This depends both on managerial clarity and written plans. (author's) Language: English Keywords: SOUTH AMERICA | RESEARCH REPORT | EVALUATION | WOMEN IN DEVELOPMENT | NONGOVERNMENTAL ORGANIZATIONS | ADMINISTRATIVE PERSONNEL | GENDER ISSUES | INEQUALITIES | SOCIAL CHANGE | ORGANIZATION AND ADMINISTRATION | GOALS | PERFORMANCE IMPROVEMENT | Latin America | Americas | Developing Countries | Economic Development | Economic Factors | Organizations | Political Factors | Sociocultural Factors | Socioeconomic Factors | Planning | Management Document Number: 315447

30. Peer Reviewed Title: Intrarectal quinine for treating Plasmodium falciparum malaria: a systematic review. [Quinina intrarrectal para el tratamiento de la malaria por Plasmodium falciparum: revisión sistémica] Author: Eisenhut M; Omari A; MacLehose HG Source: Malaria Journal. 2005 May 18;4(1):24. Abstract: In children with malaria caused by Plasmodium falciparum, quinine administered rectally may be easier to use and less painful than intramuscular or intravenous administration. The objective of this review was to compare the effectiveness of intrarectal with intravenous or intramuscular quinine for treating falciparum malaria. All randomized and quasi-randomized controlled trials comparing intrarectal with intramuscular or intravenous quinine for treating people with falciparum malaria located through the following sources were included: Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS and CINAHL. Trial quality was assessed and data, including adverse event data, were extracted. Dichotomous data were analysed using odds ratios and continuous data using weighted mean difference. Eight randomized controlled trials (1,247 children) fulfilled the inclusion criteria. The same principal investigator led seven of the trials. Five compared intrarectal with intravenous quinine, and six compared intrarectal with intramuscular treatment. No statistically significant difference was detected for death, parasite clearance by 48 hours and seven days, parasite and fever clearance time, coma recovery time, duration of hospitalization and time before drinking began. One trial (898 children) reported that intrarectal was less painful than intramuscular administration. No difference in the effect on parasites and clinical illness was detected for the use of intrarectal quinine compared with other routes, but most trials were small. Pain during application may be less with intrarectal quinine. Further larger trials, in patients with severe malaria and in adults, are required before the intrarectal route could be recommended. (author's) Spanish Abstract: En los niños con malaria causada por Plasmodium falciparum, la quinina por vía rectal probablemente resulte más fácil de usar y menos dolorosa que por vía intramuscular o endovenosa. El objetivo de esta evaluación fue comparar la eficacia de la quinina intrarrectal con la quinina endovenosa o intramuscular para el tratamiento de la malaria provocada por P. falciparum. Se incluyeron todos los estudios clínicos aleatorizados o cuasialeatorizados que comparaban las tres vías de administración para este tratamiento seleccionados de las siguientes fuentes: Registro Especializado del Grupo Cochrane de Enfermedades Infecciosas (Cochrane Infectious Diseases Group Specialized Register), CENTRAL, MEDLINE, EMBASE, LILACS y CINAHL. Se analizó la calidad de los estudios clínicos y se extrajeron datos, incluida la información sobre eventos adversos. Los datos dicotómicos se analizaron mediante el uso de odds ratios y los continuos mediante la diferencia ponderada de la media. Ocho estudios clínicos controlados aleatorizados (1.247 niños) cumplieron con los criterios de inclusión. El mismo investigador principal dirigió siete de esos estudios. Cinco de ellos compararon la quinina por vía intrarrectal con la quinina por vía endovenosa y seis la compararon con el tratamiento intramuscular. No se detectó una diferencia estadísticamente significativa para mortalidad, eliminación del parásito a las 48 horas y a los siete días, tiempo de eliminación del parásito, tiempo de desaparición de la fiebre, tiempo de recuperación del coma, duración de la internación y tiempo antes de comenzar la ingesta de líquidos. Un estudio clínico (898 niños) comunicó que la administración intrarrectal fue menos dolorosa que la intramuscular. No se detectaron diferencias en cuanto al efecto sobre los parásitos y la enfermedad clínica para el uso de la quinina intrarrectal en comparación con las otras vías de administración, pero casi todos los estudios habían incluído una muestra pequeña. El dolor puede ser menor por vía intrarrectal. Es necesario realizar estudios adicionales más amplios en pacientes con malaria grave y en adultos antes de que se pueda recomendar la vía intrarrectal. (del autor) Language: English Keywords: AFRICA | AFRICA, SUB SAHARAN | AFRICA, NORTH | ASIA | SOUTH AMERICA | RESEARCH REPORT | CHILD | MALARIA | TREATMENT | DRUGS | SIDE EFFECTS | Developing Countries | Latin America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases Document Number: 290292

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