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Peer Reviewed

Title: Can a clinical prediction tool guide HIV-testing decisions? Experience at a national hospital in Guatemala.
Author: Anderson MR; Samayoa B; O'Sullivan LF; Fletcher J; Arathoon E
Source: International Journal of STD and AIDS. 2009 Jan;20(1):30-4.
Abstract: The USA and international recommendations no longer emphasize using risk factors to target groups for HIV-testing. Using a Guatemalan database of HIV tests, we developed a clinical prediction rule to guide decisions on HIV-testing. Prior to HIV-testing, data were collected on demographics, risk factors and prior testing. Based on a theoretical construct incorporating demographics, known HIV risk factors and symptoms, we developed a logistic regression model to predict HIV seropositivity. Between 2000 and 2005, 16,471 tests were performed, of which 19.8% were positive. The algorithm successfully predicted 1883 of 2489 HIV-positive tests (sensitivity 76%, likelihood ratio [LR]-positive 2.45) and 6282 of 9086 HIV-negative tests (specificity 69%, LR-negative 0.35). Although the model indices are robust, applying the model in a clinical setting would have little impact on improving selective testing practices. Our findings support current recommendations for universal HIV-testing, not selective testing based on risk factors. Before these recommendations can be adopted widely in Guatemala, treatment access needs to be assured and protections put in place for people diagnosed with HIV infection.
Language: English
Keywords:
GUATEMALA | RESEARCH REPORT | METHODOLOGICAL STUDIES | CLINICAL RESEARCH | MATHEMATICAL MODEL | STATISTICAL REGRESSION | HIV TESTING | HOSPITALS | DECISION MAKING | RISK ASSESSMENT | PROBABILITY | Central America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Theoretical Models | Data Analysis | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Health Facilities | Behavior | Evaluation | Statistical Studies
Document Number: 330715

Title: PRISM tools for assessing, monitoring, and evaluating RHIS performance.
Author: Aqil A; Lippeveld T
Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2009 Mar. [32] p. (MS-09-34USAID Cooperative Agreement No. GPO-A-00-03-00003-00)
Abstract: PRISM Framework and its tools applications have expanded since 2004. Now it has been applied in Pakistan, Uganda, South Africa, Mexico, Paraguay, Honduras, Haiti, China and Cote d'Ivore for assessment and evaluation. It has been applied in diverse countries of Africa, Asia, Latin America and Carribean continents. While these applications showed the strengths and appropriateness of PRISM Framework and its tools in identifying strengths and weaknesses of the routine information systems, they brought some challenges to attention. First, to make a distinction between RHIS performance indicators -accuracy, timeliness and completeness, from their counterpart processes. Second, to keep minimum variables in various tools for triangulation of information to avoid respondent's burden of filling the details. Third, better measurement of use of information. Thus, there was a need to revise the PRISM tools. Uganda PRISM evaluation in 2007 for testing its reliability and validity also helped to make the revisions. PRISM tools version 3.0 meets old and new challenges in assessing, monitoring and evaluation of RHIS.
Language: English
Keywords:
PAKISTAN | MEXICO | HONDURAS | HAITI | CHINA | PARAGUAY | SOUTH AFRICA | UGANDA | SUMMARY REPORT | EVALUATION | INFORMATION PROCESSING | DATA COLLECTION | MANAGEMENT | PROGRAM ACTIVITIES | Developing Countries | Asia, Southern | Asia | North America | Americas | Central America | Latin America | Caribbean | Asia, Eastern | South America, Central | South America | Africa, Southern | Africa, Sub Saharan | Africa | Africa, Eastern | Information | Research Methodology | Organization and Administration | Programs
Document Number: 339994

Title: Experience with side effects among users of injectables, the IUD, and oral contraceptive pills in four urban areas of Honduras.
Author: Barden-O'Fallon J; Speizer I; Rodriguez F; Calix J
Source: Health Care For Women International. 2009 Jun;30(6):475-83.
Abstract: Contraceptive side effects are often the most commonly reported reason for method discontinuation, particularly of modern methods. We use data from eight focus groups and 800 exit interviews to examine women's experiences with contraceptive side effects in four urban areas of Honduras. Ease of treatment and differences in motivation to avoid pregnancy are suggested explanations for why side effects cause some women to continue and others to discontinue. Although side effects are a common reason for discontinuation in this population, less than half of the surveyed women were informed about potential side effects by a health worker on the day of the interview.
Language: English
Keywords:
HONDURAS | RESEARCH REPORT | FOCUS GROUPS | URBAN AREAS | HEALTH PERSONNEL | WOMEN | ORAL CONTRACEPTIVES, SIDE EFFECTS | INJECTABLES | IUD SIDE EFFECTS | PROGRAM ACCEPTABILITY | Developing Countries | Central America | Latin America | Americas | Data Collection | Research Methodology | Geographic Factors | Population | Delivery of Health Care | Health | Demographic Factors | Contraceptive Safety | Safety | Public Health | Contraceptive Methods | Contraception | Family Planning | IUD | Program Evaluation | Programs | Organization and Administration
Document Number: 341018

Title: Guatemala: Using supply chain modeling and simulation to analyze the Ministry of Health supply chain.
Author: Gibney J; Sanchez A; Lamadrid C
Source: Arlington, Virginia, John Snow [JSI], DELIVER, 2009 Mar. 38 p. (USAID Contract No. GPO-I-01-06-00007-00)
Abstract: This activity analyzed the characteristics of the integrated logistics system in three departments in Guatemala: Solol�, Totonicap�n, and Jutiapa. This paper identifies some of the obstacles to achieving contraceptive availability for the underserved and vulnerable populations; it also offers options for improving equity in access for family planning commodities. The study identifies elements in the Ministry of Public Health and Social Welfare�s (MSPAS) logistics system that could impede the availability and accessibility of contraceptives. By using supply chain simulation and optimization modeling software, with geographic information system tools, the authors propose system-related solutions that could improve the performance of the overall MSPAS.
Language: English
Keywords:
GUATEMALA | RECOMMENDATIONS | GOVERNMENT AGENCIES | LOGISTICS | HEALTH SERVICES EVALUATION | CONTRACEPTIVE AVAILABILITY | OBSTACLES | NEEDS | CONTRACEPTIVE DISTRIBUTION | PERFORMANCE IMPROVEMENT | GEOGRAPHY | INFORMATION RETRIEVAL SYSTEMS | TRANSPORTATION | Central America | Latin America | Americas | Developing Countries | Organizations | Political Factors | Sociocultural Factors | Management | Organization and Administration | Program Evaluation | Programs | Contraception | Family Planning | Economic Factors | Distributional Activities | Program Activities | Social Sciences | Science | Data Storage and Retrieval | Information Processing | Information
Document Number: 331663

Title: HIV seroprevalence and associated risk factors among male inmates at the Belize Central Prison.
Author: Gough E; Edwards P
Source: Revista Panamericana de Salud P�blica / Pan American Journal of Public Health. 2009 Apr;25(4):292-299.
Abstract: To determine the seroprevalence of HIV and identify associated risk factors among inmates at the Belize Central Prison, managed by the Kolbe Foundation, Belize. METHODS: A voluntary sample of 623 participants was obtained from the male inmate population incarcerated during the period from 15 January to 5 March 2005. HIV serostatus was determined on location using the Abbott Determine Assay for HIV-1/2 for screening, and the MedMira MiraWell Rapid HIV-1/2 Test for confirmatory testing. Remaining serum was tested by ELISA at the Central Medical Laboratory, Belize. Demographic and risk behavior data were collected using an interviewer administered pre-tested questionnaire. A multivariate logistic regression was used to adjust for potential confounders and to identify independent associations with HIV seropositivity. RESULTS:Of the 623 inmates in the sample, 25 tested positive for HIV-1/2 antibody for a seroprevalence of 4.0% (95% Confidence Interval 2.7, 6.0). After adjustment for confounding, HIV serostatus was positively associated with male-to-male sexual activity outside prison, age, and district of residence before current incarceration. CONCLUSIONS: The seroprevalence in the Central Prison was almost twice that estimated for the adult population of Belize in 2004 (2.4%). However, the social variables of importance to inmates appeared to reflect the epidemic in the general population, with the exception that male-to-male sex outside prison is likely more important to the male inmate population in Belize. The findings suggest that HIV is likely contracted by most inmates before their incarceration, largely due to same-sex activity.
Language: English
Keywords:
BELIZE | RESEARCH REPORT | SAMPLING STUDIES | PRISONERS | MEN | HIV INFECTIONS | PREVALENCE | RISK FACTORS | VOLUNTARY COUNSELING AND TESTING | SEX BEHAVIOR | CONDOM USE | DRUG USE AND ABUSE | Developing Countries | Central America | Latin America | Americas | Studies | Research Methodology | Crime | Social Problems | Sociocultural Factors | Demographic Factors | Population | Viral Diseases | Diseases | Measurement | Health | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Behavior | Risk Reduction Behavior
Document Number: 341875

Title: Reconsidering childhood undernutrition: can birth spacing make a difference? An analysis of the 2002-2003 El Salvador National Family Health Survey.
Author: Gribble JN; Murray NJ; Menotti EP
Source: Maternal and Child Nutrition. 2009 Jan;5(1):49-63.
Abstract: It is well understood that undernutrition underpins much of child morbidity and mortality in less developed countries, but the causes of undernutrition are complex and interrelated, requiring a multipronged approach for intervention. This paper uses a subsample of 3853 children under age 5 from the most recent family health survey in El Salvador to examine the relationship between birth spacing and childhood undernutrition (stunting and underweight). While recent research and guidance suggest that birth spacing of three to five years contributes to lower levels of infant and childhood mortality, little attention has been given to the possibility that short birth intervals have longer-term effects on childhood nutrition status. The analysis controls for clustering effects arising from siblings being included in the subsample, as well as variables that are associated with household resources, household structure, reproductive history and outcomes, and household social environment. The results of the multiple regression analyses find that in comparison to intervals of 36-59 months, birth intervals of less than 24 months and intervals of 24-35 months significantly increase the odds of stunting (<24 months Odds Ratio (OR) = 1.52; 95% confidence interval (CI): 1.21-1.92; 25-36 months OR = 1.30; 95% CI: 1.05-1.64). Other factors related to stunting and underweight include standard of living index quintile, child's age, mother's education, low birthweight, use of prenatal care, and region of the country where the child lives. Policy and program implications include more effective use of health services and outreach programs to counsel mothers on family planning, breastfeeding, and well child care.
Language: English
Keywords:
EL SALVADOR | RESEARCH REPORT | ANTHROPOMETRY | CHILDREN | CHILD HEALTH | CHILD DEVELOPMENT | CHILD NUTRITION | BIRTH SPACING | BIRTH INTERVALS | LOW BIRTH WEIGHT | FAMILY PLANNING | BREASTFEEDING | NEEDS | PROGRAM EVALUATION | Developing Countries | Central America | Latin America | Americas | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Biology | Nutrition | Fertility Measurements | Fertility | Population Dynamics | Birth Weight | Body Weight | Physiology | Infant Nutrition | Economic Factors | Programs | Organization and Administration
Document Number: 329593

Title: A case study of reproductive health supplies in Nicaragua.
Author: Indacochea CM; Leahy E
Source: Washington, D.C., Population Action International, 2009 Jun. 36 p.
Abstract: This paper, together with five additional case studies from other countries and information from other sources, provides an evidence base for national level advocacy. Each case study is written with generalist advocates in mind. These can include, but are not limited to, civic leaders, parliamentarians, faith-based leaders, and community leaders. This report provides overview of how RH supplies, specifically contraceptives and condoms, are programmed, managed and funded in Nicaragua. It presents a distillation of information on policies, systems, budgets and key actors to help raise awareness of experienced advocates -- who may lack technical knowledge about contraceptives -- so that they strategically choose advocacy actions and targets. This information should also facilitate collaboration and coordination with advocacy efforts at the global and regional levels. Information and issues from one country may be useful to other countries facing similar challenges. (Excerpt)
Language: English
Keywords:
NICARAGUA | SUMMARY REPORT | CASE STUDIES | RESEARCH METHODOLOGY | REPRODUCTIVE HEALTH | EQUIPMENT AND SUPPLIES | CONTRACEPTIVE DISTRIBUTION | HEALTH POLICY | PUBLIC SECTOR | LOGISTICS | MANAGEMENT | FINANCIAL ACTIVITIES | ADVOCACY | PROMOTION | KNOWLEDGE | Developing Countries | Central America | Latin America | Americas | Studies | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Distributional Activities | Program Activities | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Macroeconomic Factors | Economic Factors | Communication | Marketing
Document Number: 331430

Peer Reviewed

Title: Humanizing access to modern contraceptive methods in national hospitals in Guatemala, Central America.
Author: Kestler E; Barrios B; Hernandez EM; del Valle V; Silva A
Source: Contraception. 2009 Jul;80(1):68-73.
Abstract: BACKGROUND: The overall situation in Guatemala, Central America, regarding programs caring for women's reproductive health has been lagging behind for some decades. Since the year 2000, 56% of Guatemalan families have lived below the poverty line. Guatemala has one of the highest fertility rates (lifetime births per woman) in Latin America and the Caribbean countries, comparable to those observed in less developed countries in Africa. Considering the lack of sex education, poor access to effective contraceptive methods and issues of unwanted pregnancy, Guatemalan women engage in illegal and unsafe abortions, which often causes harm and sometimes death. A key strategy designed to improve women's health is through free and informed access to contraceptive methods that are effective and accepted by Guatemalan women. STUDY DESIGN: From July 1, 2003, to December 31, 2006, specially hired trained facilitators visited 22 public hospitals for 1 week to train corresponding physician staff in postabortion counseling, enabling them to assist patients to select and use an effective contraceptive method. To monitor the progress achieved, the trained facilitators returned 4 weeks later. The main purpose of the training was to focus in strengthening the understanding and technical capacity of the hospital staff to implement postabortion contraceptive counseling and to enable women to obtain an effective contraceptive method prior to hospital discharge. RESULTS: Out of 22 hospitals, 21 managed to improve their record for counseling patients admitted for postabortion complications, from 31% to 96%. Furthermore, the percentage of women being discharged from the hospital with an effective contraceptive method rose from 20% to 64% from 2003 to 2006. CONCLUSION: The successful results obtained during this study to meet postabortion demands by Guatemalan women point out to the urgent need for the government to expand this initiative within the national health system, including health centers nationwide. This is one of the worldwide recommendations previously made by the World Health Organization.
Language: English
Keywords:
GUATEMALA | RESEARCH REPORT | POSTABORTION CARE | CONTRACEPTION | COUNSELING | HOSPITALS | HEALTH SERVICES | PROGRAM ACCESSIBILITY | Central America | Latin America | Americas | Developing Countries | Delivery of Health Care | Health | Family Planning | Clinic Activities | Program Activities | Programs | Organization and Administration | Health Facilities | Program Evaluation
Document Number: 341581

10.

11.

Title: Adolescent childbearing in Nicaragua: a quantitative assessment of associated factors.
Author: Lion KC; Prata N; Stewart C
Source: International Perspectives on Sexual and Reproductive Health. 2009 Jun;35(2):91-96.
Abstract: Data from the 2001 Nicaragua Demographic and Health Survey were used to examine the sexual and reproductive behavior of 3,142 females ages 15-19. Age at sexual debut and age at first birth were assessed using life table analysis, and the impacts of various factors on these measures were then examined in Cox proportional hazard models. Among sexually active females, current use of modern contraceptives was examined using logistic regression analysis. Rural residence, rising levels of education, and greater wealth were associated with older age at sexual debut. Having had first sex before age 15 was associated with an increased risk of having an earlier first birth, whereas having first had sex at age 16 or later was associated with a decreased risk. Among sexually active females, current use of a modern method was positively associated with being married or in a stable union and with having given birth, and negatively associated with lacking health care autonomy and wanting a baby within two years.
Language: English
Keywords:
NICARAGUA | RESEARCH REPORT | DEMOGRAPHIC AND HEALTH SURVEYS | LIFE TABLE METHOD | ADOLESCENTS, FEMALE | REPRODUCTIVE BEHAVIOR | FIRST INTERCOURSE | FIRST BIRTH | MATERNAL AGE | CONTRACEPTIVE USAGE | EDUCATIONAL STATUS | MARITAL STATUS | Developing Countries | Central America | Latin America | Americas | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Demographic Analysis | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Fertility | Sex Behavior | Behavior | Pregnancy History | Fertility Measurements | Parental Age | Contraception | Family Planning | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Nuptiality
Document Number: 339885

12.

Peer Reviewed

Title: High rates of STD and sexual risk behaviors among Garifunas in Honduras.
Author: Paz-Bailey G; Morales-Miranda S; Jacobson JO; Gupta SK; Sabin K; Mendoza S; Paredes M; Alvarez B; Monterroso E
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51 Suppl 1:S26-34.
Abstract: BACKGROUND: Honduras has the highest concentration of HIV and AIDS cases in Central America, with an estimated adult HIV prevalence of 1.5%. Prevalence is higher among certain ethnic groups such as the Garifuna with a reported HIV prevalence of 8%. METHODS: A biological and behavioral survey was conducted on a stratified random sample of the Garifuna population in Honduras, using computer-assisted interviews. Blood was tested for HIV, herpes simplex type 2 (HSV-2), and syphilis; urine was tested for Chlamydia trachomatis, Neisseria gonorrhoea, Trichomonas vaginalis, and Mycoplasma genitalum. RESULTS: We enrolled a total of 817 participants, 41% female and 51% male. Estimated prevalences and 95% confidence intervals (CI) were: HIV, 4.5% (95% CI: 3.0 to 6.6), HSV-2, 51.1% (95% CI: 46.7 to 55.6), and syphilis seropositivity, 2.4% (95% CI: 1.4 to 4.0). Sexually transmitted infections in urine were: chlamydia, 6.8% (95% CI: 4.7 to 9.7), gonorrhea, 1.1% (95% CI: 0.4 to 2.9), trichomoniasis, 10.5% (95% CI: 8.1 to 13.6), and Mycoplasma genitalium, 7.1% (95% CI: 5.1 to 9.9). Consistent condom use was low with stable (10.6%) and casual (41.4%) partners. In multivariate analysis, HIV was associated with rural residence. HSV-2 was associated with female sex, older age, and syphilis seropositivity. CONCLUSIONS: We found a moderate prevalence of HIV and a high prevalence of HSV-2 among the Garifunas. HSV-2 may increase the vulnerability of these populations to HIV in the future. Intervention strategies should emphasize sexually transmitted infection control and condom promotion, specifically targeting the Garifuna population.
Language: English
Keywords:
HONDURAS | RESEARCH REPORT | DATA ANALYSIS | BEHAVIOR | HIV | SEXUALLY TRANSMITTED DISEASES | CONDOM USE | PROMOTION | Developing Countries | Central America | Latin America | Americas | Research Methodology | HIV Infections | Viral Diseases | Diseases | Reproductive Tract Infections | Infections | Risk Reduction Behavior | Marketing | Economic Factors
Document Number: 341324

13.

Title: Nicaragua: Combining demand- and supply-side incentives.
Author: Regalia F; Castro L
Source: In: Performance incentives for global health: potential and pitfalls [by] Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group. Washington, D.C., Center for Global Development, 2009. :215-235.
Abstract: A conditional cash transfer program should incorporate both demand-side and supply-side performance incentives. Significant improvements are seen in immunizations, growth monitoring, and reductions in stunting. Two-phase impact evaluation does not disentangle the individual impacts of demand-side and supply-side incentives, but its results suggest that a well-targeted strategy of supply-side performance incentives could, on its own, be enough to achieve and maintain high levels of health care service use among poor rural populations.
Language: English
Keywords:
NICARAGUA | RESEARCH REPORT | LOW INCOME POPULATION | IMMUNIZATION | DELIVERY OF HEALTH CARE | HEALTH SERVICES | INCENTIVES | POVERTY | PROGRAM ACTIVITIES | MONITORING | PROGRAM EVALUATION | Developing Countries | Central America | Latin America | Americas | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Primary Health Care | Health | Policy | Political Factors | Sociocultural Factors | Programs | Organization and Administration | Evaluation
Document Number: 331458

14.

Peer Reviewed

Title: The UALE Project: decline in the incidence of HIV and sexually transmitted infections and increase in the use of condoms among sex workers in Guatemala.
Author: Sabido M; Giardina F; Hernandez G; Fernandez VH; Monzon JE; Ortiz R; Montoliu A; Casabona J
Author: UALE team
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51 Suppl 1:S35-41.
Abstract: OBJECTIVES: To assess the impact of a multilevel sexually transmitted infections (STI)/HIV prevention and treatment intervention on the incidence of STIs and HIV, the use of condoms, and HIV knowledge among sex workers (SWs). METHODS: An open-enrolment cohort of 1554 SWs attending STI clinics integrated within the primary health care system of Escuintla, Guatemala. They were offered 6 monthly STI/HIV screening, condom promotion, education, and community-based interventions. We evaluated trends in condom use, HIV-related knowledge, and STI/HIV incidence using generalized estimating equations. RESULTS: For over three and a half years, there was a significant increase in the proportion of consistent condom use from the baseline visit through the third follow-up visit (94.29%-99.11% with new clients and 90.36%-97.22% with regular clients) and in HIV-related knowledge (95.99%-97.22%). Except for syphilis, we observed a significant decline in gonorrhoea, chlamydia, trichomoniasis, and candidiasis in each follow-up visit, from 11.30 per 100 person-years, 10.71 per 100 person-years, 6.88 per 100 person-years, and 8.23 per 100 person-years in the first follow-up visit to 6.44 per 100 person-years, 6.21 per 100 person-years, 4.81 per 100 person-years, and 6.17 per 100 person-years in the third follow-up visit, for each STI, respectively. HIV global incidence was 0.41 per 100 person-years, and it significantly declined from 1.85 per 100 person-years (2005) to 0.42 per 100 person-years (2008). CONCLUSIONS: Although a longer follow-up would be needed, the results suggest that the intervention was feasible and has been shown to be effective in reducing STI and HIV incidence and in increasing condom use with clients and HIV-related knowledge.
Language: English
Keywords:
GUATEMALA | RESEARCH REPORT | KAP SURVEYS | COHORT ANALYSIS | CLINICAL RESEARCH | LONGITUDINAL STUDIES | SEX WORKERS | WOMEN IN DEVELOPMENT | HIV PREVENTION | CONDOM USE | SEXUALLY TRANSMITTED DISEASE PREVENTION | SCREENING | SEX EDUCATION | COMMUNITY HEALTH SERVICES | PREVALENCE | Central America | Latin America | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Sex Behavior | Behavior | Economic Development | Economic Factors | HIV Infections | Viral Diseases | Diseases | Risk Reduction Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Education | Primary Health Care | Measurement
Document Number: 341106

15.
Peer Reviewed

Title: Experience of a pediatric HIV clinic in Guatemala City.
Author: Samayoa B; Anderson MR; Grazioso C; Rivera BE; Harrison M; O'Brien W; Arathoon E
Source: Revista Panamericana de Salud P�blica / Pan American Journal of Public Health. 2009 Jan;25(1):51-5.
Abstract: OBJECTIVES: To describe the clinical experience of a Guatemalan pediatric HIV clinic and referral center, and fill the gap in literature available on pediatric HIV in Guatemala, a country facing a growing HIV epidemic. METHODS: Analyses were performed on data available from the clinical databases maintained by the Clinica Familiar Luis Angel Garcia within the Hospital General San Juan de Dios in Guatemala City, Guatemala. RESULTS: From January 1997-June 2006, a total of 536 children (individuals under 13 years of age) were registered at the clinic, 54% of them female. At the initial visit, 241 were known to be HIV infected, while 295 were known to have been exposed to HIV, but were of undetermined infection status. Of the 295 with undetermined status, serostatus was determined in 173, and 57 (33%) were HIV positive. The patients came from all 24 departments of Guatemala, but the majority (64%) was from Guatemala City. Most had perinatal exposure; three patients had been sexually exposed to HIV (all male); and the mode of infection could not be determined for six children. In the cohort of children whose infection status was initially undetermined, the provision of antiretroviral (ARV) medication (both pre- and neonatal), in addition to Cesarean section, was associated with an odds ratio of 0.06 for HIV infection (P < 0.001) when compared to children who had no interventions. Highly active antiretroviral therapy (HAART) was administered to 167 HIV-infected children. There were 44 known deaths in this cohort; no deaths occurred among the children who were not infected. CONCLUSIONS: Pediatric HIV/AIDS is present in all parts of Guatemala. Programs to prevent mother to child transmission and to provide appropriate treatment to families living with HIV/AIDS must be a public health priority.
Language: English
Keywords:
GUATEMALA | RESEARCH REPORT | DATA ANALYSIS | LITERATURE REVIEW | CHILDREN | CHILD HEALTH | HIV INFECTIONS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | TREATMENT | Central America | Latin America | Americas | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health | Viral Diseases | Diseases | Disease Transmission Control | Prevention and Control | Medical Procedures | Medicine | Health Services | Delivery of Health Care
Document Number: 341541

16.

Peer Reviewed

Title: Nurse auxiliaries as providers of intrauterine devices for contraception in Guatemala and Honduras.
Author: Vernon R
Source: Reproductive Health Matters. 2009 May;17(33):51-60.
Abstract: Nurse auxiliaries staff the majority of primary health service delivery outlets in low-income countries, particularly in rural areas with high unmet need for contraception. Yet often service delivery guidelines prohibit them from providing contraceptive methods such as the intrauterine device (IUD). Operations research in Guatemala and Honduras in 1997-2005, described in this paper, have shown that nurse auxiliaries can provide IUDs in a safe and clinically appropriate fashion, which can help improve women's choice of methods and decrease costs in health centres with physicians and professional nurses, and health posts. Empowering these health workers requires commitment at the health system and policy levels to a long-term strategy in which small pilot studies are first conducted, followed by phased scaling-up of the strategies, which can require several years. Training can be conducted both in high volume clinics or on-site in health posts. Simple measures such as mentioning the method during counselling and to users of different services and providing women and communities with printed materials have been effective in increasing requests for IUDs. These studies also showed that nurse auxiliaries can take on other reproductive health services, such as contraceptive injections.
Language: English
Keywords:
GUATEMALA | HONDURAS | CRITIQUE | OPERATIONS RESEARCH | PARAMEDICAL PERSONNEL | IUD | INJECTABLES | TRAINING PROGRAMS | NEEDS | COST EFFECTIVENESS | Central America | Latin America | Americas | Developing Countries | Research Methodology | Program Evaluation | Programs | Organization and Administration | Health Personnel | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Education | Economic Factors | Evaluation Indexes | Quantitative Evaluation | Evaluation
Document Number: 341668

17.

Title: Prevalence of diarrhoeagenic Escherichia coli in children from Leon, Nicaragua.
Author: Vilchez S; Reyes D; Paniagua M; Bucardo F; Mollby R; Weintraub A
Source: Journal of Medical Microbiology. 2009 May;58(Pt 5):630-7.
Abstract: Diarrhoeal disease is a public health problem worldwide, mostly affecting children in developing countries. In Nicaragua, diarrhoea is the second greatest cause of infant mortality. During the period March 2005 to September 2006, a total of 526 faecal samples from children aged 0-60 months (381 with and 145 without diarrhoea) from Leon, Nicaragua, were studied. In order to detect five different diarrhoeagenic Escherichia coli pathotypes simultaneously [enterotoxigenic E. coli (ETEC), enteroaggregative E. coli (EAEC), enteropathogenic E. coli (EPEC), enterohaemorrhagic E. coli (EHEC) and enteroinvasive E. coli (EIEC)], a mixture of eight primer pairs was used in a single PCR. At least one diarrhoeagenic E. coli pathotype was detected in 205 samples (53.8%) of the diarrhoea group and in 77 samples (53.1%) in the non-diarrhoea group. ETEC was detected significantly more often in children with diarrhoea (20.5%) than in children without diarrhoea (8.3%) (P=0.001). Atypical EPEC, EIEC and EAEC were detected with slightly lower frequencies in children with (16.0, 0.8 and 27.8%, respectively) than in children without (20.7, 1.4 and 33.1%, respectively) diarrhoea. EHEC was only detected in children with diarrhoea (2.1%). In conclusion, ETEC continues to be an important agent associated with diarrhoea in children from Leon, Nicaragua. Although not very frequent, the only findings that were 100% associated with diarrhoea were ETEC estA (4.7%) and EHEC (2.1%). Nevertheless, EAEC and EPEC were also frequent pathotypes in the population under study. In children with severe diarrhoea, more than half had EAEC, ETEC or EPEC, and EAEC was the most prevalent pathotype.
Language: English
Keywords:
NICARAGUA | RESEARCH REPORT | CLINICAL RESEARCH | CLASSIFICATION | CHILDREN | CLIENTS | DIARRHEA | SIGNS AND SYMPTOMS | BACTERIAL AND FUNGAL DISEASES | PREVALENCE | LABORATORY PROCEDURES | Developing Countries | Central America | Latin America | Americas | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Diseases | Infections | Measurement | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342354

18.

Title: How to be reasonably sure a client is not pregnant. [Checklist].
Author: Family Health International [FHI]
Source: Research Triangle Park, North Carolina, FHI, 2008. [2] p.
Abstract: In order to help nonmenstruating clients safely initiate their method of choice, Family Health International (FHI) developed a simple checklist for use by family planning providers. Although originally the Pregnancy Checklist was developed for use by family planning providers, it can also be used by other health care providers who need to determine whether a client is not pregnant. For example, pharmacists may use this checklist when prescribing certain medications that should be avoided during pregnancy (e.g., certain antibiotics or anti-seizure drugs). The checklist is endorsed by the World Health Organization (WHO) and is based on criteria established by WHO for determining with reasonable certainty that a woman is not pregnant. Evaluation of the checklist in family planning clinics has demonstrated that the tool is very effective in correctly identifying women who are not pregnant. Furthermore, recent studies in Guatemala, Mali, and Senegal have shown that use of the checklist by family planning providers significantly reduced the proportion of clients being turned away due to menstrual status and improved women's access to contraceptive services.
Language: English
Keywords:
GUATEMALA | MALI | SENEGAL | SUMMARY REPORT | PREGNANT WOMEN | PREGNANCY TESTS | RELIABILITY | MEDICINE | DRUGS | SIDE EFFECTS | TREATMENT | FAMILY PLANNING | WHO | PROGRAM ACCESSIBILITY | Central America | Latin America | Americas | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Health Services | Delivery of Health Care | Health | Measurement | Research Methodology | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Program Evaluation | Programs | Organization and Administration
Document Number: 331506

19.

Title: Achieving the MDGs: The contribution of family planning. Guatemala.
Author: Futures Group International. Health Policy Initiative
Source: Washington, D.C., Futures Group International, Health Policy Initiative, [2008]. [2] p.
Abstract: The Millennium Development Goals (MDGs) -- a set of eight important, timebound goals ranging from reducing poverty by half to providing universal primary education -- represent a blueprint for global development agreed to by member states of the United Nations and international development institutions. However, achieving them will be a major challenge for Guatemala and many other developing countries that are not "on track" to meet the goals by the target date of 2015. In Guatemala and other Latin American countries, one major factor contributing to the challenge is the continued rapid growth of the population. The number of people in need of health, education, economic, and other services is large and increasing, which, in turn, means that the amount of resources, personnel, and infrastructure required to meet the MDGs is also increasing. In light of this fact, development efforts in support of the MDGs should not overlook the importance and benefits of slowing population growth. This brief looks at how one strategy -- meeting the need for family planning -- can reduce population growth and make achieving the MDGs more affordable in Guatemala, in addition to directly contributing to the goals of reducing child mortality and improving maternal health.
Language: English
Keywords:
GUATEMALA | SUMMARY REPORT | GOALS | POVERTY | FAMILY PLANNING | REPRODUCTIVE HEALTH | EDUCATION | CHILD MORTALITY | MATERNAL HEALTH | MALARIA PREVENTION | HIV PREVENTION | AIDS PREVENTION | HIV/FP INTEGRATION | ENVIRONMENTAL PROTECTION | Central America | Latin America | Americas | Developing Countries | Planning | Organization and Administration | Socioeconomic Factors | Economic Factors | Health | Mortality | Population Dynamics | Demographic Factors | Population | Malaria | Parasitic Diseases | Diseases | HIV Infections | Viral Diseases | AIDS | Natural Resources | Environment
Document Number: 331543

20.

Title: Achieving the MDGs: The contribution of family planning. Honduras.
Author: Futures Group International. Health Policy Initiative
Source: Washington, D.C., Futures Group International, Health Policy Initiative, [2008]. [2] p.
Abstract: The Millennium Development Goals (MDGs) -- a set of eight important, timebound goals ranging from reducing poverty by half to providing universal primary education -- represent a blueprint for global development agreed to by member states of the United Nations and international development institutions. However, achieving them will be a major challenge for Honduras and many other developing countries that are not "on track" to meet the goals by the target date of 2015. In Honduras and other Latin American countries, one major factor contributing to the challenge is the continued rapid growth of the population. The number of people in need of health, education, economic, and other services is large and increasing, which, in turn, means that the amount of resources, personnel, and infrastructure required to meet the MDGs is also increasing. In light of this fact, development efforts in support of the MDGs should not overlook the importance and benefits of slowing population growth. This brief looksat how one strategy -- meeting the need for family planning -- can reduce population growth and make achieving the MDGs more affordable in Honduras, in addition to directly contributing to the goals of reducing child mortality and improving maternal health.
Language: English
Keywords:
HONDURAS | SUMMARY REPORT | GOALS | FAMILY PLANNING | CHILD MORTALITY | MATERNAL HEALTH | POVERTY | NEEDS | DISEASE PREVENTION | EDUCATION | PREVENTION AND CONTROL | Developing Countries | Central America | Latin America | Americas | Planning | Organization and Administration | Mortality | Population Dynamics | Demographic Factors | Population | Health | Socioeconomic Factors | Economic Factors | Diseases
Document Number: 331544

21.

Title: Guatemala Congress establishes policy monitoring board. New board will monitor implementation of FP / RH and HIV policies.
Author: Futures Group International. Health Policy Initiative
Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2008 Mar. [2] p. (Stories from the Field)
Abstract: Policies are not always implemented after they are adopted, and often do not achieve desired results. As part of a pilot test of a new tool designed to assess policy implementation, the Health Policy Initiative evaluated the Social Development and Population Policy in Guatemala. The study's findings prompted the Congress of Guatemala to establish a monitoring board for reproductive health (RH), which will monitor the implementation of RH laws, find new funding sources, and spread RH awareness.
Language: English
Keywords:
GUATEMALA | SUMMARY REPORT | WOMEN | FAMILY PLANNING | REPRODUCTIVE HEALTH | HIV INFECTIONS | HEALTH POLICY | MONITORING | HIV/FP INTEGRATION | IMPLEMENTATION | Central America | Latin America | Americas | Developing Countries | Demographic Factors | Population | Health | Viral Diseases | Diseases | Policy | Political Factors | Sociocultural Factors | Evaluation | Programs | Organization and Administration
Document Number: 331542

22.

Title: AWARENESS Project. Comparison of Standard Days Method user tools.
Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project
Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Feb. [67] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00)
Abstract: The Guatemalan Ministry of Public Health and Social Assistance (MOH) collaborated with Georgetown University Institute for Reproductive Health (IRH) to conduct a study comparing two service delivery tools for providing the Standard Days Method� (SDM). The tools were CycleBeads� and a user card printed on paper with an image of CycleBeads and instructions for use. The study, implemented by APROVIME, a local NGO experienced in family planning service delivery research, compared provider and user perspectives, correct use, couple communication, and costs. (excerpt)
Language: English
Keywords:
GUATEMALA | TECHNICAL REPORT | FERTILITY AWARENESS | FAMILY PLANNING, BEHAVIORAL METHODS | DELIVERY OF HEALTH CARE | PROGRAM EVALUATION | FAMILY PLANNING TRAINING | CONTRACEPTIVE METHOD ACCEPTABILITY | KNOWLEDGE | CONTRACEPTION CONTINUATION | PARTNER COMMUNICATION | MEN'S INVOLVEMENT | COST EFFECTIVENESS | Central America | Latin America | Americas | Developing Countries | Family Planning | Health | Programs | Organization and Administration | Training Programs | Education | Contraceptive Usage | Contraception | Sociocultural Factors | Interpersonal Relations | Behavior | Evaluation Indexes | Quantitative Evaluation | Evaluation
Document Number: 327637

23.

Title: AWARENESS Project. Guatemala country report, 2002-2007.
Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project
Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Jan. [21] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00)
Abstract: With a population of 12 million, Guatemala is the largest country in Central America. Contraceptive prevalence in 2002 was relatively low, at 43% for women aged 15-49, and was even lower among rural (under 35%) and indigenous women (24%). In 2002, the Ministry of Health (MOH) and the Social Security Institute (IGGS) requested assistance from the AWARENESS Project to expand contraceptive choice through the integration of fertility awareness-based methods (FAM) into the method mix. The program functioned in USAID priority zones including the largely indigenous departments of the Altiplano (Quetzaltenango, Solola, and Huehuetenango), Santa Rosa, Chimaltenango, and Alta Verapaz. It focused primarily on building evidence for the future scale-up of the Standard Days Method� (SDM), while also assessing the effectiveness and feasibility of the TwoDay Method � (TDM). IRH used a diversified strategy to build the evidence base for FAM and subsequently establish the necessary support and conditions for scale up. With approximately 200 trainers and 2000 trained SDM providers, Guatemala has substantial capacity for offering SDM services. In the last three years, more than 13,000 women began using the SDM, most of whom previously had not used family planning. The SDM also is supported in norms and gradually is being included in management information and logistics systems, pre- and in-service training, and communication strategies. (excerpt)
Language: English
Keywords:
GUATEMALA | TECHNICAL REPORT | FERTILITY AWARENESS | FAMILY PLANNING, BEHAVIORAL METHODS | CONTRACEPTIVE METHOD ACCEPTABILITY | INTEGRATED PROGRAMS | FAMILY PLANNING TRAINING | FAMILY PLANNING PROGRAMS | GOVERNMENT PROGRAMS | SOCIAL MARKETING | CLINICAL DISTRIBUTION | Central America | Latin America | Americas | Developing Countries | Family Planning | Family Planning, Behavioral Methods | Contraceptive Usage | Contraception | Programs | Organization and Administration | Training Programs | Education | Marketing | Economic Factors | Distributional Activities | Program Activities
Document Number: 327621

24.

Title: AWARENESS Project. Honduras country report, 2001-2007.
Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project
Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Jan. [13] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00)
Abstract: In 2001, IRH and ASHONPLAFA conducted an introduction study to test the feasibility of SDM integration into existing services. Positive results led to expanding access to the SDM within MOH and ASHONPLAFA services in six of 18 departments in Honduras. To introduce the SDM into the MOH, IRH collaborated with Centro de Vida y Educaci�n Familiar (CEVIFA), a Catholic organization already working with the MOH to provide the Billings method. Program strategy focused on expanding SDM access to all 27 ASHONPLAFA and 150 MOH clinics in five key departments through research to establish best practices; partnership with CEVIFA; support for fertility awareness-based methods with UNFPA through CEVIFA; and demand creation for the SDM through awareness-raising activities. The introduction study showed that the SDM could be integrated into routine services; there was sufficient demand; and training providers and introducing SDM into clinic services improved client choice and quality of services. The primary reason for discontinuation after long-term use is desire for pregnancy. Based on these results, ASHONPLAFA and the MOH expanded access to the SDM within their services. With UNFPA support, CEVIFA has integrated the SDM into MOH services and systems in five departments (in addition to the pilot study sites). At the national level, primarily as a result of CEVIFA?s effective advocacy, the MOH included the SDM in its national norms, protocols, MIS, logistics systems, and IEC materials, as well as the curriculum of the national university nursing schools. (excerpt)
Language: English
Keywords:
HONDURAS | SUMMARY REPORT | FERTILITY AWARENESS | FAMILY PLANNING, BEHAVIORAL METHODS | CONTRACEPTIVE USAGE | FAMILY PLANNING EDUCATION | AWARENESS | PROGRAM ACCESSIBILITY | PROGRAM ACTIVITIES | CAPACITY BUILDING | Central America | Latin America | Americas | Developing Countries | Family Planning | Contraception | Education | Knowledge | Sociocultural Factors | Program Evaluation | Programs | Organization and Administration | Program Sustainability
Document Number: 327623

25.

Title: AWARENESS Project. Mali country report, 2006-2007.
Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project
Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Jan. [16] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00)
Abstract: Mali, a large, landlocked country in western sub-Saharan Africa, has high fertility and low contraceptive use. Only 8% of married women use any method of contraception, with 6% using modern methods. Its approximately 13 million people are mainly Muslim (90%), and 80% live in rural areas with limited access to family planning services. The total fertility rate was seven children per woman in 2006, compared to an average of five in Africa. The government of Mali (GOM) actively promotes family planning and contraceptive security as part of improving quality of life. Unlike other countries in the AWARENESS Project, the GOM committed to national integration of the Standard Days Method� (SDM) without undertaking a pilot study. A relative newcomer to the AWARENESS Project, Mali began implementing project activities in 2006, utilizing the SDM and LAM as an approach to repositioning family planning. (excerpt)
Language: English
Keywords:
GUATEMALA | TECHNICAL REPORT | FERTILITY AWARENESS | FAMILY PLANNING, BEHAVIORAL METHODS | FAMILY PLANNING PROGRAMS | FAMILY PLANNING EDUCATION | FAMILY PLANNING POLICY | PROGRAM EVALUATION | FAMILY PLANNING TRAINING | CAPACITY BUILDING | AWARENESS | Central America | Latin America | Americas | Developing Countries | Family Planning | Education | Population Policy | Social Policy | Policy | Political Factors | Sociocultural Factors | Programs | Organization and Administration | Training Programs | Program Sustainability | Knowledge
Document Number: 327639

26.

Title: AWARENESS Project. Nicaragua country report, 2003-2007.
Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project
Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Jan. [18] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00)
Abstract: In 2003, IRH and MSH formed a partnership to support the Nicaragua Ministry of Health (MOH) in incorporating the standard days method (SDM) into its family planning services. The integration and sustainability plan focused on five strategic areas: training, commodities, services, research, and advocacy. The Strategy for Community Delivery of Contraceptive Supplies in communities with poor access guided the SDM initiative. This national strategy aimed to increase access to services in areas with low coverage relative to demand. IRH and MSH presented the SDM to MOH officials as a viable option to increase contraceptive options and improve overall family planning services in the country. The MOH accepted the proposal for implementation, with the condition that the team first carry out a demonstration study. One of the project objectives was to increase the quality and availability of family planning. Part of IRH's mission is to support governments and nongovernmental organizations (NGOs) in the incorporation of fertility awareness-based methods into existing programs. IRH, therefore, provided technical assistance to MSH in Nicaragua for training; an initial donation of CycleBeads� and information, education, and communication (IEC) materials; and design support for a local strategy to ensure SDM sustainability in the public sector and NGO programs. (excerpt)
Language: English
Keywords:
NICARAGUA | SUMMARY REPORT | FERTILITY AWARENESS | FAMILY PLANNING, BEHAVIORAL METHODS | DELIVERY OF HEALTH CARE | FAMILY PLANNING PROGRAMS | FAMILY PLANNING PROGRAM ADMINISTRATION | FAMILY PLANNING TRAINING | AWARENESS | CAPACITY BUILDING | PROGRAM DEVELOPMENT | IMPLEMENTATION | PROGRAM EFFECTIVENESS | Central America | Latin America | Americas | Developing Countries | Family Planning | Health | Training Programs | Education | Knowledge | Sociocultural Factors | Program Sustainability | Programs | Organization and Administration | Program Evaluation
Document Number: 327640

27.

Title: Long-term use of Standard Days method: Experience of operations research study participants.
Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project
Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Feb. [22] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00)
Abstract: This long-term follow-up (LTFU) study sought to learn more about Standard Days Method� (SDM) use beyond the six or 12 month follow-up period of a series of 14 operations research (OR) studies in six countries. The LTFU study followed participants of OR studies in Benin, Ecuador, Honduras, and two sites in India for up to 24 additional months to determine long-term continuation and effectiveness patterns, reasons for discontinuation, and whether women use the SDM to achieve pregnancy if their fertility intentions change. The 1,183 participants represented wide variability in geographic location, service delivery mode, age, parity, education level and ever use of contraception. Significant loss to follow-up at the point of transition between the OR and LTFU studies and the retrospective nature of the LTFU questions were taken into consideration in data analysis. (excerpt)
Language: English
Keywords:
BENIN | ECUADOR | HONDURAS | INDIA | RESEARCH REPORT | FOLLOW-UP STUDIES | FAMILY PLANNING, BEHAVIORAL METHODS | CONTRACEPTIVE USE-EFFECTIVENESS | CONTRACEPTION CONTINUATION | PREGNANCY RATE | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | South America, Western | South America | Latin America | Americas | Central America | Asia, Southern | Asia | Studies | Research Methodology | Family Planning | Contraceptive Effectiveness | Contraception | Contraceptive Usage | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population
Document Number: 327647

28.

Title: Better service for the client and the community: strengthening HIV training in Belize.
Author: IntraHealth International. Capacity Project
Source: Chapel Hill, North Carolina, IntraHealth International, Capacity Project, 2008 Aug. [2] p. (Voices No. 22)
Abstract: The Capacity Project is helping universities in Belize, Costa Rica, El Salvador, Guatemala, Nicaragua and Panama to improve HIV-related pre-service education. The University of Belize faculty, under the leadership of Dr. Shirlene Smith-Augustine and Gabriel Carrillo, worked with Project staff on this initiative and began helping to build capacity to develop the training center they envisioned. The goal was for the university to offer training and refresher courses on counseling and testing to providers from public and private health services and to strengthen the integration of HIV into the curriculum.
Language: English
Keywords:
BELIZE | PROGRESS REPORT | EVALUATION | NURSES AND NURSING | HEALTH PERSONNEL | HIV PREVENTION | CAPACITY BUILDING | UNIVERSITIES | TRAINING PROGRAMS | COUNSELING | VOLUNTARY COUNSELING AND TESTING | Central America | Latin America | Americas | Developing Countries | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Program Sustainability | Programs | Organization and Administration | Schools | Education | Clinic Activities | Program Activities | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services
Document Number: 308933

29.

30.

Peer Reviewed

Title: High divergence within the major HIV type 1 subtype B epidemic in Panama.
Author: Ahumada-Ruiz S; Casado C; Toala-Gonzalez I; Flores-Figueroa D; Rodriguez-French A; Lopez-Galindez C
Source: AIDS Research and Human Retroviruses. 2008 Nov;24(11):1461-6.
Abstract: The first molecular epidemiology study of human immunodeficiency virus type 1 (HIV-1) in Panama has been performed with plasma samples from 66 AIDS patients infected by different transmission routes and obtained from distinct locations. All samples were amplified by RT-PCR and sequenced in gag (p17) and env (C2-C4) genes. Phylogenetic analyses revealed that 64 (97%) of the samples belong to subtype B. We also identified the presence of two CRF, one CRF12_BF and one CRF02_AG. The most notable feature of the subtype B epidemic in Panama was the large genetic distance among isolates with a mean of 15.2% but reaching up to 31.3 % in env, indicating an epidemic with a long period of evolution.
Language: English
Keywords:
PANAMA | RESEARCH REPORT | LABORATORY PROCEDURES | PERSONS LIVING WITH HIV/AIDS | AIDS | BLOOD | TESTING | TRANSMISSION | EPIDEMIOLOGY | Central America | Latin America | Americas | Developing Countries | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Hemic System | Physiology | Biology | Measurement | Research Methodology | Infections | Public Health
Document Number: 329743


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