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Title: Healthcare responsibilities and conscientious objection.
Author: Cook RJ; Olaya MA; Dickens BM
Source: International Journal of Gynaecology and Obstetrics. 2009 Mar;104(3):249-52.
Abstract: The Constitutional Court of Colombia has issued a decision of international significance clarifying legal duties of providers, hospitals, and healthcare systems when conscientious objection is made to conducting lawful abortion. The decision establishes objecting providers' duties to refer patients to non-objecting providers, and that hospitals, clinics, and other institutions have no rights of conscientious objection. Their professional and legal duties are to ensure that patients receive timely services. Hospitals and other administrators cannot object, because they do not participate in the procedures they are obliged to arrange. Objecting providers, and hospitals, must maintain knowledge of non-objecting providers to whom their patients must be referred. Accordingly, medical schools must adequately train, and licensing authorities approve, non-objecting providers. Where they are unavailable, midwives and perhaps nurse practitioners may be trained, equipped, and approved for appropriate service delivery. The Court's decision has widespread implications for how healthcare systems must accommodate conscientious objection and patients' legal rights.
Language: English
Keywords:
COLOMBIA | CRITIQUE | HEALTH PERSONNEL | HOSPITAL PERSONNEL | ABORTION LAW | COURT DECISION | CONSTITUTION | REFERRAL AND CONSULTATION | HUMAN RIGHTS | ETHICS | Developing Countries | South America, Northern | South America | Latin America | Americas | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Litigation | Political Factors | Sociocultural Factors | Program Activities | Programs | Organization and Administration
Document Number: 341638

Title: Syphilis infection among female sex workers in Colombia.
Author: Mejia A; Bautista CT; Leal L; Ayala C; Prieto F; de la Hoz F; Alzate ML; Acosta J; Sanchez JL
Source: Journal of Immigrant and Minority Health. 2009 Apr;11(2):92-8.
Abstract: OBJECTIVE: To study the epidemiology of Treponema pallidum (syphilis) among female sex workers (FSW) in Santa Fe de Bogota, Colombia. DESIGN: A cross-sectional study was conducted. Participants were interviewed using a standardized questionnaire, which collected socio-demographic characteristics and risk behavior information. Blood samples were screened for syphilis using the VDRL test and the MHATP assay. RESULTS: The prevalence of syphilis was 10.3% (53/514). Adjusted risk factors significantly associated with syphilis were: age (linear increase), education (primary or no education), monthly income (or=4 years), number of clients per week (>or=22), main workplace (street), inconsistent (never) condom use in sex work, previous STI history, and use of illegal drugs. CONCLUSIONS: Effective health education programs for improving the level of knowledge of STI and the promotion of consistent condom use activities along with other appropriate harm reduction activities are urgently required among FSW in Colombia.
Language: English
Keywords:
COLOMBIA | RESEARCH REPORT | PREVALENCE | EPIDEMIOLOGY | WOMEN | SEX WORKERS | SYPHILIS | Developing Countries | South America, Northern | South America | Latin America | Americas | Measurement | Research Methodology | Public Health | Health | Demographic Factors | Population | Sex Behavior | Behavior | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases
Document Number: 331184

Title: 2004-09. The Guyana HIV / AIDS Reduction and Prevention Project. GHARP.
Author: Russell H
Source: Arlington, Virginia, Family Health International [FHI], 2009. 54 p. (USAID Contract No. 504-C-00-04-00109-00)
Abstract: This report outlines the major activities and achievements of the Guyana HIV / AIDS Reduction and Prevention (GHARP) Project (2004-09). A joint project of the Government of Guyana and the US Government, GHARP was funded by PEPFAR through USAID and implemented by Family Health International, Cicatelli Associates Inc., Howard Delafield International, Management Sciences for Health, and The Caribbean Conference of Churches.
Language: English
Keywords:
GUYANA | SUMMARY REPORT | ORPHANS AND VULNERABLE CHILDREN | MOTHERS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV INFECTIONS | AIDS PREVENTION | IMPACT | OBSTACLES | PROGRAM EVALUATION | Developing Countries | South America, Northern | South America | Latin America | Americas | Family and Household | Sociocultural Factors | Parents | Family Relationships | Family Characteristics | Disease Transmission Control | Prevention and Control | Diseases | Viral Diseases | AIDS | Communication | Organization and Administration | Programs
Document Number: 331504

Title: Severity and age of rotavirus diarrhea, but not socioeconomic conditions, are associated with rotavirus seasonality in Venezuela.
Author: Schael IP; Gonzalez R; Salinas B
Source: Journal of Medical Virology. 2009 Mar;81(3):562-7.
Abstract: Rotavirus (RV) epidemiology presents differences between developing and developed countries among which are seasonality, age at first infection, variability of strain in circulation and severity of disease. Since, in Venezuela, we have distinct seasonal patterns of RV occurrence, we examined the epidemiological profile of RV disease associated to these differences by analyzing data from previous studies conducted in Venezuela. Data were collected from children <5 years of age with diarrhea seen in six hospitals located in five cities. Socio-demographic and clinical characteristics of RV illness were analyzed according to RV identification by ELISA assay and the seasonal patterns of RV circulation (marked versus minimal seasonality). A total of 6,742 episodes of diarrhea (1,820 rotavirus positive and 4,922 rotavirus negative) were evaluated: 1,951 in Caracas, Cumana and Pto. Ordaz (minimal seasonality) and 4,791 in Merida and Valencia (marked seasonality). Mean age (months) of children with RV was 8.14 +/- 6.74 and 12.21 +/- 9.62 (P < 0.0001) in areas with minimal and marked seasonality, respectively. RV disease was more frequent (33% vs. 24%; OR = 1.536; 95% CI: 1.36-1.73), more severe (dehydration: 64% vs. 29%; OR = 4.436; 95% CI: 3.61-5.44) and more common in infants than in older children (79% vs. 60%; OR = 2.521; 95% CI: 2.01-3.14) in cities with minimal seasonality than in those with marked seasonality. Socioeconomic conditions were not associated with seasonality. In environments with minimal seasonality, children are infected with RV at younger ages and the disease is more severe regardless of malnutrition and poverty.
Language: English
Keywords:
VENEZUELA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CHILDREN | URBAN POPULATION | PREVALENCE | SEASONAL VARIATION | ROTAVIRUS | SOCIOECONOMIC FACTORS | DIARRHEA | AGE FACTORS | DEMOGRAPHIC FACTORS | South America, Northern | South America | Latin America | Americas | Developing Countries | Research Methodology | Youth | Population Characteristics | Population | Measurement | Population Dynamics | Viral Diseases | Diseases | Economic Factors
Document Number: 330232

10.
Title: [Chlamydia trachomatis infection in females consulting health centres in Maracaibo, Venezuela] Infeccion por Chlamydia trachomatis en mujeres consultantes en Maracaibo,
Author: Arraiz N; Marcucci R; Colina S; Reyes F; Rondon N; Bermudez V; Reyna N
Source: Revista De Salud Publica. 2008 Aug-Oct;10(4):615-24.
Abstract: OBJECTIVE: Evaluating Chlamydia trachomatis infection prevalence in a group of symptomatic and asymptomatic females attending gynaecology services in health centres in Maracaibo in the state of Zulia in Venezuela. METHODOLOGY: 168 patients attending two health centres in Maracaibo were included in this study. Gynaecological evaluation was based on examining the pelvis, deep areas of the vagina and the cervix. Patients were classified into groups according to age and the presence of clinical manifestations. Two DNA amplification assays of endogenous plasmid and the omp1 gene taken from endocervical swabs were used for investigating C. trachomati. RESULTS: 168 patients were evaluated; 81 (48,2 %) were symptomatic and 87 (51,8 %) asymptomatic, A 7,7 % prevalence (p>0.05) was found in the total population (9,9 % prevalence for symptomatic patients and 5,8 % for asymptomatic ones). The 18- 28 year old patient group exhibited the highest prevalence (13,7 %) (p=0.0322). The predominant clinical manifestations were mucopurulent secretion (35,8 %) and cervicitis (21 %). C. trachomatis was detected in 7,1 % of patients having mucopurulent secretion and 23,5 % of cervicitis cases; however, no significant association between infection and individual clinical manifestations was shown (p>0.05). CONCLUSION: Medium C. trachomatis infection prevalence was found In the population being assessed here, the highest frequency being exhibited in young females. This microorganism should be investigated in sexually-active young women, regardless of their symptomatic or asymptomatic status.
Language: Spanish
Keywords:
VENEZUELA | RESEARCH REPORT | PREVALENCE | WOMEN | CHLAMYDIA | EXAMINATIONS AND DIAGNOSES | South America, Northern | South America | Latin America | Americas | Developing Countries | Measurement | Research Methodology | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 341061

11.

Peer Reviewed

Title: Prevalence of lifetime abortion and methods of contraception among female sex workers in Bogota, Colombia.
Author: Bautista CT; Mej�a A; Leal L; Ayala C; Sanchez JL
Source: Contraception. 2008;77(3):209-213.
Abstract: The primary objective was to estimate the lifetime prevalence of abortion and the secondary objective was to describe the use of contraceptive methods among female sex workers (FSW) in Bogota, Colombia. A cross-sectional survey was conducted among FSW. Information on sociodemographic characteristics, contraceptive methods, number of abortions, reasons for abortions and sexual practices was collected. A total of 514 FSW were enrolled. Of these, 264 (53%) had a lifetime abortion. Age, years in sex work and a previous sexually transmitted infection were associated with abortion. A total of 89 FSW(17%) reported no contraception method. Oral contraceptives, use of condoms, female sterilization and intrauterine device insertion were the most common methods of contraception. Women who were poorer, who initiated sex work at a younger age and who reported use of illegal drugs were associated with inconsistent contraception. A high lifetime prevalence of abortion and inconsistent contraception was found among FSW in Bogota. There is a need for effective and practical contraceptive methods of family health planning among FSW in Colombia. (author's)
Language: English
Keywords:
COLOMBIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | SURVEYS | SEX WORKERS | WOMEN | CONTRACEPTIVE METHODS | ABORTION | PREVALENCE | AGE FACTORS | RISK FACTORS | FAMILY PLANNING | Developing Countries | South America, Northern | South America | Latin America | Americas | Research Methodology | Sampling Studies | Studies | Sex Behavior | Behavior | Demographic Factors | Population | Contraception | Fertility Control, Postconception | Measurement | Population Characteristics | Biology
Document Number: 324552 Notification

12.

Peer Reviewed

Title: Being and feeling like a woman: respectability, responsibility, desirability and safe sex among women of Afro-Surinamese and Dutch Antillean descent in the Netherlands.
Author: Bertens MG; Krumeich A; van den Borne B; Schaalma HP
Source: Culture, Health and Sexuality. 2008 Aug;10(6):547-61.
Abstract: The objective of this study was to describe and understand gender roles and the relational context of sexual decision-making and safe sex negotiation among Afro-Surinamese and Dutch Antillean women in the Netherlands. Twenty-eight individual in-depth interviews and eight focus group discussions were conducted. In negotiating safe sex with a partner, women reported encountering ambiguity between being respectable and being responsible. Their independence, autonomy, authority and pride inherent to the matrifocal household give them ample opportunity to negotiate safe sex and power to stand firm in executing their decisions. The need to be respectable burdens negotiation practices, because as respectable, virtuous women there would not be the need to use condoms. Respectable women will only participate in serious monogamous relationships, which are inherently safe. Women's desire to feel like a woman, 'to tame the macho-man' and constrain him into a steady relationship, limits negotiation space because of emotional dependency. Respectability seems to enforce not questioning men's sexual infidelity. In developing STI/HIV prevention programmes this ambiguity due to cultural values related to gender roles should be considered. Raising awareness of power differences and conflicting roles and values may support women in safe-sex decision-making.
Language: English
Keywords:
NETHERLANDS | NETHERLANDS ANTILLES | SURINAME | RESEARCH REPORT | KAP SURVEYS | FOCUS GROUPS | WOMEN | IMMIGRANTS | WOMEN'S STATUS | DECISION MAKING | SAFER SEX | PARTNER COMMUNICATION | GENDER RELATIONS | CONDOM USE | EMOTIONS | Developed Countries | Europe, Western | Europe | Caribbean | Americas | South America, Northern | South America | Latin America | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Collection | Demographic Factors | Population | Migrants | Migration | Population Dynamics | Socioeconomic Factors | Economic Factors | Behavior | Sex Behavior | Interpersonal Relations | Gender Issues | Sociocultural Factors | Risk Reduction Behavior | Psychological Factors
Document Number: 329244

13.

Peer Reviewed

Title: Determinants of late disease-stage presentation at diagnosis of HIV infection in Venezuela: A case-case comparison.
Author: Bonjour MA; Montagne M; Zambrano M; Molina G; Lippuner C
Source: AIDS Research and Therapy. 2008 Apr 16;5:6.
Abstract: Although Venezuela has a National Human Immunodeficiency Virus (HIV) Program offering free diagnosis and treatment, 41% of patients present for diagnosis at a later disease-stage, indicating that access to care may still be limited. Our study aimed to identify factors influencing delay in presenting for HIV-diagnosis using a case-case comparison. A cross-sectional survey was performed at the Regional HIV Reference Centre (CAI), Carabobo Region, Venezuela. Between May 2005 and October 2006 225 patients diagnosed with HIV at CAI were included and demographic, behavioural and medical characteristics collected from medical files. Socio-economic and behavioural factors were obtained from 129 eligible subjects through interviews. "Late presentation" at diagnosis was defined as patients classified with disease-stage B or C according to the 1993 Centers for Disease Control and Prevention (Atlanta, USA) classification, and "early presentation" defined as diagnosis in disease-stage A. Of 225 subjects, 91 (40%) were defined as late presenters. A similar proportion (51/129) was obtained in the interviewed sub-sample. Older age (greater than 30 years), male heterosexuality, lower socio-economic status, perceiving ones partner to be faithful and living greater than or equal to 25km from the CAI were positively associated with late diagnosis in a multivariate model. Females were less likely to present late than heterosexual males (odds ratio=0.23, P=0.06). The main barriers to HIV testing were low knowledge of HIV/AIDS, lack of awareness of the free HIV program, lack of perceived risk of HIV infection, fear for HIV-related stigma, fear for lack of confidentiality at testing site and logistic barriers. Despite the free Venezuelan HIV Program, poverty and barriers related to lack of knowledge and awareness of both HIV and the Program itself were important determinants in late presentation at HIV diagnosis. This study also indicates that women; heterosexual, bisexual and homosexual men might have different pathways totesting and different factors related to late presentation in each subgroup. Efforts must be directed to i) increase awareness of HIV/AIDS and the Program and ii) the identification of specific factors associated with delay in HIV diagnosis per subgroup, to help develop targeted public health interventions improving early diagnosis and prognosis of people living with HIV/AIDS in Venezuela and elsewhere. (author's)
Language: English
Keywords:
VENEZUELA | RESEARCH REPORT | SURVEYS | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | PROGRAM ACCESSIBILITY | UTILIZATION OF HEALTH CARE | HIV TESTING | KNOWLEDGE | AWARENESS | South America, Northern | South America | Latin America | Americas | Developing Countries | Sampling Studies | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Program Evaluation | Programs | Organization and Administration | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Sociocultural Factors
Document Number: 326089

14.
Title: [Challenges of the medical entomology for the surveillance in public health in Colombia: reflections on the state of malaria] Retos de la entomologia medica para la vigilancia en salud publica en Colombia:
Author: Brochero H; Quinones ML
Source: Biomedica. 2008 Mar;28(1):18-24.
Abstract: The relevance of the medical entomology was considered with respect to current framework of malaria control programs in Colombia. A responsibility is indicated for balancing control efforts along with providing information on the malaria vectors. This knowledge must be acquired in order to focus the related activities that are required. The malaria control program must be based on results of local entomological surveillance, and the data must be in a form to give practical answers to questions regarding the control program. Difficulties in undertaking the required studies are described, particularly regarding the taxonomic identification of Colombian Anopheles in Colombia and which of these can be incriminated as malaria vectors.
Language: Spanish
Keywords:
COLOMBIA | RESEARCH REPORT | MALARIA | VECTOR CONTROL | INFORMATION | KNOWLEDGE | Developing Countries | South America, Northern | South America | Latin America | Americas | Parasitic Diseases | Diseases | Disease Transmission Control | Prevention and Control | Sociocultural Factors
Document Number: 328911

15.
Title: [Experience of a pharmacist/activist in Cayenne in 2007: fighting HIV/AIDS through prevention and care. A look at women] Pharmacien et activiste a Cayenne en 2007: face au VIH/SIDA acces a la prevention
Author: Chiron S
Source: Medecine Tropicale. 2008 Oct;68(5):471-7.
Abstract: The author relates her experience as a pharmacist/activist involved in the fight against HIV. She has worked as a health care professional in French Guiana, as an instructor for NGO, and as an activist working with squatters and street people in cooperation with prevention teams. The goal of her action has been to enhance prevention and to enhance social services for the poor and precarious people in particular for women with regard to reproductive health including HIV/AIDS. A record of these activities was kept as a basis for future planning. The data obtained was used to design and implement information, prevention, and risk control measures to assist infected groups with the least access to health care. Based on her experience in the field, the author concludes that effective management of the epidemic crisis in French Guiana will require a radically different strategy from that used in mainland France not only with regard to financial and human resources but also, and above all, to innovative ideas. The author stresses the need to make maximum use of link (network) the city and hospital services taking full advantage of all players involved in patient management and always ensuring that care providers understand the importance of maintaining contact with associations that provide the only direct link with patients in their everyday lives.
Language: French
Keywords:
FRENCH GUIANA | RESEARCH REPORT | ADVOCACY | WOMEN | PHARMACISTS | SOCIAL WELFARE | HEALTH SERVICES | REPRODUCTIVE HEALTH | HIV PREVENTION | AIDS PREVENTION | HEALTH POLICY | Developing Countries | South America, Northern | South America | Latin America | Americas | Communication | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Economic Factors | HIV Infections | Viral Diseases | Diseases | AIDS | Policy | Political Factors | Sociocultural Factors
Document Number: 330503

16.

Title: Eight years of hepatitis B vaccination in Colombia with a recombinant vaccine: Factors influencing hepatitis B virus infection and effectiveness.
Author: de la Hoz F; Perez L; de Neira M; Hall AJ
Source: International Journal of Infectious Diseases. 2008 Mar;12(2):183-189.
Abstract: The objective was to evaluate the effectiveness of a recombinant hepatitis B vaccine used in endemic areas of Colombia, as well as risk factors associated with hepatitis B virus (HBV) infection and carriage after vaccine introduction. A cross-sectional study was carried out in urban and rural areas of the Colombian Amazon, a highly endemic area for hepatitis B infection. Children under 12 years of age and their mothers were selected for the study using one-stage cluster sampling (N = 2145) and were examined for HBV serological markers and antibodies against surface antigen (anti-HBs). There has been a reduction of 60-75% in the prevalence of HBV infection and hepatitis B surface antigen (HBsAg) carriage since HBV vaccination was introduced. Receiving the first dose of HBV vaccine at more than two months after birth was one of the factors associated with HBV carrier status. Maternal HBV infection was also associated with infection in the child. The recombinant Cuban hepatitis B vaccine has contributed to the reduction of the infection in this highly endemic area, though further efforts are required to improve timely vaccination for children at high risk. (author's)
Language: English
Keywords:
COLOMBIA | RESEARCH REPORT | LONGITUDINAL STUDIES | CROSS SECTIONAL ANALYSIS | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CHILDREN | VACCINES | HEPATITIS | RISK FACTORS | AGE FACTORS | ADMINISTRATION AND DOSAGE | PREVALENCE | MOTHER-TO-CHILD TRANSMISSION | Developing Countries | South America, Northern | South America | Latin America | Americas | Studies | Research Methodology | Youth | Population Characteristics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Biology | Drugs | Treatment | Measurement | Transmission | Infections
Document Number: 324962

17.

Title: Domestic violence surveillance system: A model.
Author: Espinosa R; Gutierrez MI; Mena-Munoz JH; Cordoba P
Source: Salud Publica de Mexico. 2008;50 Suppl 1:s12-s18.
Abstract: The objective was to develop a domestic violence surveillance system. The strategies included implementation of a standard digitalized reporting and analysis system along with advocacy with community decision makers, strengthening inter-institutional attention networks, consultation for constructing internal flow charts, sensitizing and training network teams in charge of providing health care in cases of domestic violence and supporting improved public policy prevention initiatives. A total of 6 893 cases were observed using 2004 and 2005 surveillance system data. The system reports that 80% of the affected were women, followed by 36% children under 14 years. The identified aggressors were mainly females' partners. The system was useful for improving victim services. Findings indicate that significant gains were made in facilitating the attention and treatment of victims of domestic violence, improving the procedural response process and enhancing the quality of information provided to policy-making bodies. (author's)
Language: English
Keywords:
COLOMBIA | RESEARCH REPORT | DOMESTIC VIOLENCE | EPIDEMIOLOGY | PREVENTION AND CONTROL | RECORDS | INFORMATION NETWORKS | INFORMATION PROCESSING | DATA COLLECTION | Developing Countries | South America, Northern | South America | Latin America | Americas | Crime | Social Problems | Sociocultural Factors | Public Health | Health | Diseases | Information | Communication | Research Methodology
Document Number: 326083

18.
Title: Sudden onset of verrucous plaques to the face and trunk: a case of cutaneous histoplasmosis in the setting of HIV.
Author: Friedman A; Solomon G; Segal-Maurer S; Pereira F
Source: Dermatology Online Journal. 2008;14(2):19.
Abstract: A 66-year-old Columbian man presented with a 15-day history of generalized weakness, cough, fever, and verrucous, ulcerating plaques of the face, upper chest and back, and arms. The patient proved to be HIV positive. Histopathologic examination showed a diffuse lymphocytic infiltrate coupled with a striking number of yeast forms within macrophages. The clinical presentation and histopathologic alterations are consistent with the diagnosis disseminated Histoplasma capsulatum. This case emphasizes the importance of increasing awareness of histoplasmosis in nonendemic areas as a result of the large subgroup of immunocompromised patients at risk. Disseminated histoplasmosis can be a treatable HIV complication if recognized early, though is unfortunately a harbinger for an overall poor prognosis.
Language: English
Keywords:
COLOMBIA | RESEARCH REPORT | CLINICAL RESEARCH | CASE STUDIES | PERSONS LIVING WITH HIV/AIDS | MEN | DERMATITIS | HIV INFECTIONS | COMPLICATIONS | SIGNS AND SYMPTOMS | FEVER | FATIGUE | HISTOCHEMICAL EFFECTS | LABORATORY EXAMINATIONS AND DIAGNOSES | Developing Countries | South America, Northern | South America | Latin America | Americas | Research Methodology | Studies | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Demographic Factors | Population | Body Temperature | Physiology | Biology | Cytologic Effects | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 328713

19.

Title: Prevalence of sexual dysfunction in female outpatients and personnel at a Colombian hospital: Correlation with hormonal profile.
Author: Garcia S; Moreno S; Aponte H
Source: Journal of Sexual Medicine. 2008 May;5(5):1208-1213.
Abstract: Female sexual dysfunction (FSD) is a multifactorial entity and an underestimated problem with an overall prevalence between 20% and 50%. Prevalence can change according to the diagnostic criteria used, data collection, and others such as psychological and cultural factors. Population studies of FSD are limited, both in Colombia and in other countries. Nevertheless, because of the prevalence found in other studies, FSD can be considered a public health issue that affects the quality of life of women who suffer from it and their partners. The aim was to determine the prevalence of FSD and its correlation with the hormonal profile in female outpatients and female staff at San Jose Hospital (Bogota, Colombia). We performed a cross-sectional study with endocrine measurements. The prevalence of FSD according to the Female Sexual Function Index (FSFI) cutoff points, and androgenic deficiency defined as women with a proportion of free testosterone below 2%. Demographic characteristics, medical history survey, FSFI, and a hormonal profile that included follicle stimulating hormore (FSH), luteinizing hormone (LH), prolactin, estrone, estradiol, sulphate and total dehydroepiandrosterone, androstenedione, sex hormone binding globulin, and total testosterone. Fifty (49.5%; 95% confidence interval [CI]: 39.4-59.6%) out of 101 participants met the criteria for FSD; in those women with sexual activity in the past 4 weeks, the prevalence of FSD was 37.8% (95% CI: 27.3-49.1%). In the hormone evaluation sample, 29 out of 32 women with sexual activity in the past 4 weeks met the criteria for FSD. Our results suggest that there is independence between the FSFI scores and the proportion of free testosterone. Our findings suggest that FSD in our population has a prevalence as high as that previously reported in the literature; however, because of the sample selection criteria, we could not say that our study results may well reflect the prevalence in our general Colombian population. (author's)
Language: English
Keywords:
COLOMBIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | WOMEN | SEXUALITY | HORMONES | PREVALENCE | EXAMINATIONS AND DIAGNOSES | Developing Countries | South America, Northern | South America | Latin America | Americas | Research Methodology | Demographic Factors | Population | Personality | Psychological Factors | Behavior | Endocrine System | Physiology | Biology | Measurement | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 326453

20.
Peer Reviewed

Title: [A comparison of three screening strategies for prevention of perinatal HIV infection in Colombia: a decision analysis model] Comparacion de tres estrategias de tamizaje para la prevencion de la infeccion
Author: Gomez M
Source: Revista Panamericana de Salud P�blica / Pan American Journal of Public Health. 2008 Oct;24(4):256-64.
Abstract: OBJECTIVES: To apply decision analysis to compare the cost-effectiveness of three strategies for HIV screening of pregnant women and to recommend the one most appropriate for the health care system of Colombia. METHODS: An economic study applying decision analysis to three types of HIV screening of expectant women: voluntary, universal, and optional. All the women in Colombia with unknown HIV status who were admitted for child birth were included. The study included all the direct medical costs incurred from the time of testing through the first year following delivery, according to the General System for Healthcare Social Security. Cost-effectiveness ratio and the savings of each of the strategies were compared. RESULTS: For every 10,000 women, the universal strategy detected five cases more than the voluntary strategy and seven cases more than the optional. The universal strategy carried a cost of approximately US$ 17 for each HIV-positive newborn; that is, less than half of that of the voluntary strategy (US$ 38) and less than the optional (US$ 24). According to the bifactorial analysis, the universal screening strategy was less costly than the voluntary and more effective than both of the others, regardless of prevalence, the false-positive rate of each method, and the rate of maternal compliance with screening. CONCLUSIONS: The screening strategy currently in use in Colombia is more costly (in both the medium- and long-term), less effective, and less capable of prevention, than the universal screening strategy. The recommendation to the national health authorities of Colombia is to begin screening all pregnant women for HIV infection using third-generation testing.
Language: Spanish
Keywords:
COLOMBIA | RESEARCH REPORT | COMPARATIVE STUDIES | PREGNANT WOMEN | COST EFFECTIVENESS | SCREENING | HIV INFECTIONS | HIV TESTING | VOLUNTARY COUNSELING AND TESTING | DECISION MAKING | HIV PREVENTION | EVALUATION | Developing Countries | South America, Northern | South America | Latin America | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Evaluation Indexes | Quantitative Evaluation | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Behavior
Document Number: 330333

21.

Peer Reviewed

Title: AIDS-related Histoplasma capsulatum var. capsulatum infection: 25 years experience of French Guiana.
Author: Huber F; Nacher M; Aznar C; Pierre-Demar M; El Guedj M
Source: AIDS. 2008;22(9):1047-1053.
Abstract: Histoplasma capsulatum var. capsulatum infection is a major AIDS-defining illness in French Guiana. Although it affects South and Central American countries, the number of published cases is low. We present the largest series of AIDS-related histoplasmosis. The aim of this work is to describe clinical features and to help optimize investigations in settings where antigen detection methods are not available. Two hundred cases of AIDS-related histoplasmosis, diagnosed in the hospitals of French Guiana, were included retrospectively between 1982 and 2007. At the time of diagnosis, 92% of patients did not receive highly active antiretroviral therapy. CD4 cell count was less than 100 cells/ml for 80% of them. Most patients had fever, lymphadenopathies, and pulmonary and digestive symptoms. Neurological signs and skin/mucosal locations were less common. Other opportunistic infections were associated in 36.6% of cases (mostly tuberculosis). In most of the patients, lactic dehydrogenase was at least four times the normal value, and there was a moderate increase of aspartate aminotransaminase but not alanine aminotransaminase levels. Bone marrow aspirations were useful, but cultures of liver and lymphadenopathy specimens were the most contributive. Following treatment initiation, 17.5% died within a month. Presumptive treatment was started before diagnostic confirmation in 14.3% of the cases. In high prevalence settings, histoplasmosis often revealed AIDS in severely immunodeficient and poorly followed patients. In the absence of a quick sensitive technique, skin smear and fungal tissue cultures are contributive. Nevertheless, given the diagnostic delays and the poor prognosis, presumptive treatment with amphotericin B-containing regimens should be recommended when clinical and epidemiological contexts are evocative. (author's)
Language: English
Keywords:
FRENCH GUIANA | RESEARCH REPORT | EXAMINATIONS AND DIAGNOSES | PERSONS LIVING WITH HIV/AIDS | AIDS | HIV | INFECTIONS | TREATMENT | ANTIGENS | IMMUNOLOGIC FACTORS | South America, Northern | South America | Latin America | Americas | Developing Countries | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Immunity | Immune System | Physiology | Biology
Document Number: 327152

22.

Title: Early sexual maturity among Pume foragers of Venezuela: fitness implications of teen motherhood.
Author: Kramer KL
Source: American Journal of Physical Anthropology. 2008 Jul;136(3):338-50.
Abstract: Because humans have slow life histories, discussions of the optimal age at first birth have stressed the benefits of delayed reproduction. However, given the diversity of ecological, fertility, and mortality environments in which humans live, reproductive maturity is expected to be highly variable. This article uses reproductive histories to examine a pattern of early menarche and first birth among the Pume, a group of South American foragers. Age at menarche and first birth are constructed using both retrospective and cross-sectional data for females over the age of 10 (n = 83). The objectives are first to define these patterns and then discuss their reproductive consequences. On average, Pume girls reach menarche at age 12.9, and give birth to their first child at age 15.3-15.5 (retrospective and cross-sectional data, respectively). This populational average falls several years prior to what often is considered the human norm. Two questions are then considered. What are the infant mortality costs across a mother's reproductive career? How does surviving fertility vary with age at first birth? Results indicate that the youngest of first-time mothers (<14) are four times more likely to loose their firstborns than older first-time mothers (> or =17). Given parity-specific mortality rates, the optimal strategy to minimize infant mortality and maximize reproductive span is to initiate childbearing in the midteens. Women gain no additional advantage in surviving fertility by delaying childbearing until their late teens.
Language: English
Keywords:
VENEZUELA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | INDIGENOUS POPULATION | NATIVE AMERICANS | ADOLESCENT PREGNANCY | MOTHERS | MENARCHE | INFANT MORTALITY | FIRST BIRTH | AGE FACTORS | LIFE STYLE | DIET | South America, Northern | South America | Latin America | Americas | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Ethnic Groups | Cultural Background | Reproductive Behavior | Fertility | Population Dynamics | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Menstruation | Reproduction | Mortality | Pregnancy History | Fertility Measurements | Behavior | Nutrition | Health
Document Number: 328384

23.

Title: In vitro monitoring of Plasmodium falciparum drug resistance in French Guiana: A synopsis of continuous Assessment from 1994 to 2005.
Author: Legrand E; Volney B; Meynard JB; Mercereau-Puijalon O; Esterre P
Source: Antimicrobial Agents and Chemotherapy. 2008 Jan;52(1):288-298.
Abstract: Implemented as one arm of the malaria control program in French Guiana in the early 1990s, our laboratory has since established in vitro profiles for parasite drug susceptibility to a panel of eight antimalarials for more than 1,000 Plasmodium falciparum isolates from infected patients. The quinine-doxycycline combination was introduced in 1995 as the first-line drug treatment against uncomplicated P. falciparum malaria, replacing chloroquine, and the first-line drug combination was changed to the artemether-lumefantrine combination in 2002. Resistance to chloroquine declined 5 years after it was dropped in 1995 as the first-line drug, but unlike similar situations in Africa, there was a rapid halt to this decline. Doxycycline susceptibility substantially decreased from 2002 to 2005, suggesting parasite selection under quinine-doxycycline drug pressure. Susceptibility to mefloquine decreased from 1997 onward. Throughout the period from 1994 to 2005, most isolates were sensitive in vitro to quinine, amodiaquine, and atovaquone. Susceptibility to amodiaquine was strongly correlated with that to chloroquine and to a lesser extent with that to mefloquine and halofantrine. Susceptibilities to mefloquine and to halofantrine were also strongly correlated. There were two alerts issued for in vitro artemether resistance in the period from 2002 to 2003 and again in 2005, both of which could be associated with the presence of an S769N polymorphism in the sarcoplasmic/endoplasmic reticulum calcium ATPase (SERCA)-type P. falciparum ATPase6 (PfATPase6) gene. Analysis of susceptibility to lumefantrine, conducted for the first time in 2005, indicates an alarming rate of elevated 50% inhibitory concentrations. In vitro monitoring of parasite drug susceptibility should be pursued to further document the consequences of specific drug policies on the local parasite population and, in particular, to establish profiles of susceptibility to individual components of drug combinations to provide early warning signs of emerging parasite resistance. (author's)
Language: English
Keywords:
FRENCH GUIANA | RESEARCH REPORT | PROGRESS REPORT | CLINICAL RESEARCH | GENETIC TECHNIQUES | LONGITUDINAL STUDIES | TARGET POPULATION | DRUG RESISTANCE | ANTIMALARIAL DRUGS | IN VITRO | MONITORING | CHROMOSOME ABNORMALITIES | PARASITE CONTROL | South America, Northern | South America | Latin America | Americas | Developing Countries | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Studies | Program Design | Programs | Organization and Administration | Treatment | Malaria | Parasitic Diseases | Diseases | Evaluation | Neonatal Diseases and Abnormalities | Public Health
Document Number: 325612

24.
Title: [Patterns of antiretroviral drug prescription in 997 Colombian patients] Patrones de prescripcion de antirretrovirales en 997 pacientes colombianos.
Author: Machado JE; Alzate JA
Source: Biomedica. 2008 Mar;28(1):78-86.
Abstract: INTRODUCTION: Antiretroviral therapy for treatment of human immunodeficiency virus type 1 (HIV-1) infection has improved steadily since the advent of combination therapy in 1996. OBJECTIVE: The pharmacological therapies of the infection by HIV/AIDS were documented in order to determine if effective treatment regimes were prescribed. MATERIALS AND METHODS: Pharmacological therapies of the human immunodeficiency virus infection were compared in 997 patients affiliated with the health security system, of both sexes and all ages. All had been in treatment for more than three months (July--September 2006) and were distributed in 15 Colombian cities. The data were retrieved from medication consumption files which were maintained by the institutions that had distributed medications to the selected patients. RESULTS: The average age of patients was 37.7+/-13.2 and 82.6% were men. All the patients received between three to five antiretrovirals. The medications most commonly prescribed were nucleoside reverse transcriptase inhibitors (96.4%), nonnucleoside reverse transcriptase inhibitors (54.9%), protease inhibitors (39.8%) and others (0.4%). All of the doses were at recommended levels.The most common combinations were lamivudine-zidovudine-efavirenz (35%), lamivudine-zidovudine+lopinavir/ritonavir (8.4%), abacavir+lamivudine-zidovudine (5.5%), lamivudine-zidovudine+nevirapine (5.2 %) and others (45.9%), consisting of 65 different combinations. CONCLUSIONS: All agents were used at internationally recommended doses and rational prescription patterns prevailed in the initial therapy. However, the use of 69 different associations suggested that after the beginning of treatment, clinicians do not have adequate criteria to prescribe in accordance with international guidelines of antiretroviral therapy; they adopt a variety of options that may be outside of established recommendations.
Language: Spanish
Keywords:
COLOMBIA | RESEARCH REPORT | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | TREATMENT | ANTIRETROVIRAL THERAPY | PRESCRIPTIONS | ANTIRETROVIRAL DRUGS | RECOMMENDATIONS | Developing Countries | South America, Northern | South America | Latin America | Americas | Program Activities | Programs | Organization and Administration | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | Distributional Activities
Document Number: 328910

25.

Peer Reviewed

Title: Malaria diagnosis under field conditions in the Venezuelan Amazon.
Author: Metzger WG; Vivas-Martinez S; Rodriguez I; Goncalves J; Bongard E
Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Jan;102(1):20-24.
Abstract: To improve practical, accurate diagnosis of malaria in the Amazon rainforest of Venezuela, two rapid diagnostic tests (RDT) (OptiMAL-IT and FalciVax) and a laboratory light microscope, used in the field with a battery-operated head lamp as an external light source, were evaluated against the standard laboratory microscope procedure for malaria detection. One hundred and thirty-six Yanomami patients were studied for the presence of malaria parasites. Thirty-three patients (24%) were positive for malaria (Plasmodium falciparum, P. vivax, P. malariae). Twenty-one (64%) of the positive patients had less than 100 parasites/microl. Both RDTs showed poor sensitivity (24.2% for OptiMAL-IT and 36.4% for FalciVax) but good specificity (99% both for OptiMAL-IT and FalciVax). Field and laboratory microscopy showed sensitivities of 94% and 91%, respectively. The k coefficient was 0.90, indicating a high agreement between field and laboratory microscopy. We conclude that (i) adequate slide reading cannot be substituted by either of the two RDTs in the Venezuelan Amazon and (ii) the use of a light source such as that described above makes slide reading more feasible than hitherto in remote areas without electricity. (author's)
Language: English
Keywords:
VENEZUELA | RESEARCH REPORT | EVALUATION | FIELD WORKERS | MALARIA | EXAMINATIONS AND DIAGNOSES | LABORATORY EXAMINATIONS AND DIAGNOSES | EQUIPMENT AND SUPPLIES | South America, Northern | South America | Latin America | Americas | Developing Countries | Health Personnel | Delivery of Health Care | Health | Parasitic Diseases | Diseases | Medical Procedures | Medicine | Health Services
Document Number: 325627

27.
Title: [Concordance between thick blood smear, immunochromatography and polymerase chain reaction for malaria diagnosis] Concordancia entre gota gruesa, inmunocromatografia y reaccion en cadena de la
Author: Montoya AE; Menco J; Osorio N; Zuluaga MA; Duque J; Torres G; Restrepo M
Source: Biomedica. 2008 Jun;28(2):252-61.
Abstract: INTRODUCTION: The rapid and effective diagnosis of malaria is the determining condition for an appropriate treatment and control of the disease. OBJECTIVE: The sensitivity, specificity and the positive and negative predictive values were evaluated in cases of suspected malaria in Colombia in a comparison of a rapid diagnostic test. the PCR test and the thick blood smear-the traditional gold standard. MATERIALS AND METHODS: A group of 100 patients with symptoms compatible with malaria, were included in the study. They were selected from the following Colombian regions: Uraba, Cordoba, lower Cauca, and relatively fewer from other malaria endemic areas of Colombia including the provinces of Valle, Choco in the central west of Colombia and Vichada to the east. To each patient the following three tests were performed: the rapid OptiMAL test, the PCR identification and the thick blood smear. The PCR amplified specific DNA sequences with primers designed to identify the genus Plasmodium, and the two species present in Colombia, P. falciparum and P. vivax. RESULTS: The sensitivity of the rapid test versus the thick smear, for the diagnosis of both species of Plasmodium was 93.9% (95% CI: 87-100%) and the specificity was 94.3% (95% CI:.253 85-100%). The PCR compared with the thick smear showed a sensitivity of 100% (95% CI: 99-100%) and a specificity of 97.1% (95% CI: 90-100%). CONCLUSIONS: The sensitivity and specificity of the three tests did not present statistically significant differences. However, the thick blood smear was recommended as the standard test, mainly due to its low cost.
Language: Spanish
Keywords:
COLOMBIA | RESEARCH REPORT | LABORATORY EXAMINATIONS AND DIAGNOSES | CLIENTS | MALARIA | TESTING | SIGNS AND SYMPTOMS | COST BENEFIT ANALYSIS | Developing Countries | South America, Northern | South America | Latin America | Americas | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Activities | Programs | Organization and Administration | Parasitic Diseases | Diseases | Measurement | Research Methodology | Quantitative Evaluation | Evaluation
Document Number: 328940

28.

Peer Reviewed

Title: Risk factors for high blood pressure among HIV patients in French Guiana [letter]
Author: Nacher M; Basurko C; Vantilcke V; Dufour J; El Guedj M; Vaz T
Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Aug 15;48(5):629-31.
Abstract: French Guiana is the French overseas department where the human immunodeficiency virus (HIV) epidemic is most preoccupying. There are 38 new acquired immunodeficiency syndrome cases per 100,000 inhabitants per year and >1% of HIV-positive pregnant women. Approximately two thirds of the HIV patients are foreign citizens mostly from Haiti. The use of highly active antiretroviral therapy has led to remarkable gains in patient survival. However, HIV and the metabolic complications of highly active antiretroviral therapy seem to increase the risk of cardiovascular diseases, notably high blood pressure. To further improve survival, it is important to better understand these pathologies. The objective of the present study is to determine the risk factors for high blood pressure among patients followed in the hospital cohort of patients followed in the 3 hospitals of French Guiana. (author's)
Language: English
Keywords:
FRENCH GUIANA | RESEARCH REPORT | COHORT ANALYSIS | RETROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | COMPLICATIONS | HYPERTENSION | RISK FACTORS | Developing Countries | South America, Northern | South America | Latin America | Americas | Research Methodology | Studies | Viral Diseases | Diseases | Vascular Diseases | Biology
Document Number: 328265

29.

Title: [Factors affecting how long exclusive breastfeeding lasts] Factores asociados a la lactancia materna exclusiva en poblacion pobre de areas urbanas de Colombia.
Author: Rodriguez-Garcia J; Acosta-Ramirez N
Source: Revista de Salud Publica. 2008 Jan-Feb;10(1):71-84.
Abstract: Objective: Identifying factors associated with exclusive breastfeeding by poor urban women in Colombia. Methodology: A random sample of women living in poor neighborhoods from four Colombian cities (Cali, Cartagena, Medellin and Ibague) was made (survey method), using a cross-sectional design; survival analysis techniques were applied. Results: Bivariate analysis identified hospital bottle use, the women's marital status, and relationship with the head of household as having had a significant effect on the duration of exclusive breastfeeding. Multivariate analysis identified the non-use of bottles in hospital as favoring a longer breast feeding period. Conclusions: Reducing hospital bottle use is readily achievable by health system action; increasing the time mothers spend with their infants is more difficult. A relevant finding was that more mothers were unaware of breastfeeding's maternal benefits than those who were unaware of its benefits for the baby. If mothers were made more aware of the maternal benefits, an increasing number might insist on being the main caregiver and take care of their children for longer periods of time.
Language: Spanish
Keywords:
COLOMBIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | WOMEN | LOW INCOME POPULATION | MARITAL STATUS | HEAD OF HOUSEHOLD | BREASTFEEDING, EXCLUSIVE | TIME FACTORS | BEHAVIOR | KNOWLEDGE | Developing Countries | South America, Northern | South America | Latin America | Americas | Research Methodology | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Nuptiality | Households | Family and Household | Sociocultural Factors | Breastfeeding | Infant Nutrition | Nutrition | Health | Population Dynamics
Document Number: 308955

30.

Peer Reviewed

Title: Malaria mortality in Venezuela: Focus on deaths due to Plasmodium vivax in children.
Author: Rodriguez-Morales AJ; Benitez JA; Arria M
Source: Journal of Tropical Pediatrics. 2008 Apr;54(2):94-101.
Abstract: Morbidity and mortality burden of malaria in the childhood represents a public health threat not only in countries with high levels of transmission, but also in those, such as Venezuela and others in Latin America, with moderate to low transmission. Usually its mortality has been attributed just to Plasmodium falciparum malaria, but the changing patterns of increase in Plasmodium vivax malaria morbidity and mortality are now causing concern. We studied malaria mortality by analyzing different epidemiological variables during a 10-year period in Venezuela, finding mortality rates ranging 0.10-0.36 deaths/100 000 population, with almost a third of deaths in children (less than 10 years old), corresponding 270 deaths to P. falciparum cases and 30 to P. vivax; but along the period with a decrease trend for P. falciparum and an increase trend for P. vivax. (author's)
Language: English
Keywords:
VENEZUELA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CHILDREN | MALARIA | MORTALITY | CHILD MORTALITY | EPIDEMIOLOGY | South America, Northern | South America | Latin America | Americas | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasitic Diseases | Diseases | Population Dynamics | Public Health | Health
Document Number: 325720


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