Revista Panamericana De Salud Publica-pan American Journal of Public Health最新文献

{"title":"[Expanding team-based care for hypertension and cardiovascular risk management with HEARTS in the AmericasAmpliação da atenção baseada em equipe para a gestão do risco de hipertensão arterial e doenças cardiovasculares com a iniciativa HEARTS nas Américas].","authors":"Vilma Irazola, Carolina Prado, Andres Rosende, David Flood, Ross Tsuyuki, Carolina Neira Ojeda, Matías Villatoro Reyes, Johanna Otero, IIrmgardt Alicia Wellmann, Ileana Fajardo, Emily Ridley, Esteban Londoño, Gloria Giraldo, Edwin Bolastig, Bruna Moreno Dias, Nicolas Haeberer, Pedro Ordunez","doi":"10.26633/RPSP.2026.47","DOIUrl":"10.26633/RPSP.2026.47","url":null,"abstract":"<p><p>Cardiovascular diseases remain the leading cause of premature morbidity and mortality globally, with hypertension as their main modifiable risk factor. In Latin America and the Caribbean, hypertension affects more than 30% of adults, yet control rates remain alarmingly low. The HEARTS in the Americas Initiative, led by the Pan American Health Organization, promotes a model of team-based care to enhance risk management for hypertension and cardiovascular diseases within primary health care. Team-based care leverages the skills of diverse health professionals, including nurses, pharmacists and community health workers, to optimize resource allocation, task-sharing and care delivery. Evidence underscores the effectiveness of team-based care in improving blood pressure control, reducing hospitalizations and enhancing quality of life through strategies such as periodic follow up and medication titration. Despite its benefits, implementing team-based care faces cultural and systemic barriers. This special report outlines a policy framework to scale team-based care across the Region of the Americas, ensuring equitable access to high-quality, cost-effective prevention and care for cardiovascular diseases.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e47"},"PeriodicalIF":2.2,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Monitoring of sodium content and compliance with national targets for prepackaged foods, Costa Rica, 2015-2022Monitoramento do teor de sódio e conformidade com as metas nacionais para alimentos embalados, Costa Rica, 2015-2022].","authors":"Adriana Blanco-Metzler, Marlene Roselló-Araya, Hilda P Núñez-Rivas, Víctor Villalobos-Daniel, Luis Ernesto Galicia-Cano, Jorge Ernesto Victoria-Restrepo, Fabio da Silva Gomes","doi":"10.26633/RPSP.2026.41","DOIUrl":"10.26633/RPSP.2026.41","url":null,"abstract":"<p><strong>Objective: </strong>To monitor compliance with national sodium reduction targets for prepackaged foods marketed in Costa Rica, and to compare it with current international standards.</p><p><strong>Methods: </strong>Nutritional labeling information was collected from products sold in two supermarket chains in 2022. Sodium content (mg/100 g), sodium energy density (mg/kcal), and compliance with national targets for 2022 and with international standards (Pan American Health Organization, 2022 and 2025; World Health Organization, 2021 and 2024) were analyzed. The results were compared with evaluations performed in 2015 and 2018 (<i>p</i> ≤ 0.05). Photographs of the labels used for comparison were obtained in 2015, 2018, and 2022.</p><p><strong>Results: </strong>A total of 7402 products were registered, of which 872 met the criteria for analysis. The highest sodium levels and greatest variability were observed in condiments (0-32 750 mg/100 g), cured and processed meats (569-4800 mg/100 g), and sauces (0-4050 mg/100 g). Subcategories (stocks, seasonings for rice, ham, sausages, tomato-based sauces, and bread with cheese) exceeded national targets. Bakery products had the lowest sodium levels and the least variability; savory bread and whole wheat bread were within the specified limits. Sodium energy density ranged from 0.8 to 86.0 mg/kcal, with 5 categories exceeding the recommended values. Compliance with national targets was 84.5%; with PAHO recommendations 43.6% and 34.7% (for 2022 and 2025, respectively); and with WHO recommendations 39.2% and 33.3% (for 2021 and 2024, respectively). There were no significant differences between 2022 and the years 2015 and 2018.<b>Conclusions.:</b> There is no evidence of sustained progress in reducing sodium in prepackaged foods in Costa Rica. Mandatory regulatory measures are required to drive improvements in public health.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e41"},"PeriodicalIF":2.2,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independent assessment of the WHO Skin Neglected Tropical Diseases application for leprosy detection.","authors":"Patrícia Deps, Bianca Barros Canhamaque Amorim, Taynah Repsold, Douglas Almonfrey, Rachel Bertolani do Espírito Santo, Rafael Maffei Loureiro, Nkechi Anne Enechukwu, Thiago Zanetti Barreiro, Mecciene Mendes Rodrigues, Andrea Maia Fernandes Fonseca, Gleice Nunes Lima, Marcos César Florian, Jose Antonio Ruiz-Postigo","doi":"10.26633/RPSP.2026.40","DOIUrl":"10.26633/RPSP.2026.40","url":null,"abstract":"<p><strong>Objectives: </strong>To independently evaluate the World Health Organization (WHO) Skin Neglected Tropical Diseases (NTDs) application, focusing on the diagnostic performance of its underlying artificial intelligence model for leprosy detection. The primary objective was to determine the proportion of images in which leprosy appeared among the model's Top-5 diagnostic predictions. The secondary objective was to qualitatively analyze diagnostic error patterns.</p><p><strong>Methods: </strong>A data set of 439 anonymized clinical images from confirmed leprosy cases (1996-2024) was analyzed, spanning the full clinical spectrum (indeterminate, tuberculoid, borderline/dimorphous, and lepromatous/Virchowian forms) and including reactional and atypical presentations. After excluding 16 images due to processing errors, 423 images were retained: 367 classical leprosy lesions and 56 reactional or atypical leprosy-related presentations. All images were evaluated using the WHO desktop version of the visual classifier. Top-5 sensitivity (recall) for leprosy was estimated, alongside a qualitative error analysis focusing on intrapatient inconsistencies and challenging lesion types.</p><p><strong>Results: </strong>The model achieved an overall Top-5 sensitivity (recall) of 84.9%, with higher sensitivity for classical lesions (87.2%) than for reactional or atypical presentations (69.6%). Qualitative review revealed inconsistent predictions for visually similar lesions from the same patient, and misclassifications concentrated among necrotic, inflammatory, and infiltrative lesions.</p><p><strong>Conclusions: </strong>The WHO Skin NTDs application demonstrates substantial promise as a clinical decision-support and educational tool, especially for classical leprosy. Performance gaps for reactional and atypical forms highlight the need for algorithmic refinement. Enhancing data set diversity and integrating patient-level context may improve diagnostic robustness.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e40"},"PeriodicalIF":2.2,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The commensurability of public health indicators - and the unresolved question of the incommensurableComensurabilidade de indicadores em saúde pública e o problema em aberto do incomensurável].","authors":"Rafael Lozano","doi":"10.26633/RPSP.2026.44","DOIUrl":"https://doi.org/10.26633/RPSP.2026.44","url":null,"abstract":"<p><p>This article critically examines commensurability in public health - that is, the possibility of comparing phenomena according to a common standard, using indicators - as well as the scope and limits of such comparability when it is mistaken for complete understanding. It proposes a brief audit framework for constructing and interpreting indicators when commensurability is partial, using the maternal mortality ratio (MMR) as an example. With reference to the MMR, the article shows how definitions, time windows, and the quality of data recording affect comparability across contexts, and how performance pressure may induce reactive administrative or behavioral shifts, which must be empirically assessed. This paper does not argue against measurement or quantitative accountability; rather, it seeks to strengthen them through transparency of assumptions, reporting on quality and uncertainty, and the use of triangulation and auditing when incentives are high. It thus avoids both technocratic drift and the relativism that dismisses measurement on the grounds that it is constructed. It concludes by proposing that dimensions not captured by the indicator - lived experience, dignity, and trajectories of access and care - be granted specific status and formally integrated into the interpretation, through layering of evidence and case reviews.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e44"},"PeriodicalIF":2.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Need, Opportunity, and Accessibility: Application of the NOA method to analyze the effectiveness of the organ transplant system in BrazilNecesidad, oportunidad y accesibilidad: aplicación del método NOA para analizar la eficacia del sistema de trasplante de órganos en Brasil].","authors":"Tadeu Thomé, Ana Menjivar, Paulo Filipe Severino, Valter Duro Garcia, João Luis Erbs Pessoa, Janine Schirmer, Mauricio Beltran Duran, Bartira de Aguiar Roza","doi":"10.26633/RPSP.2026.43","DOIUrl":"https://doi.org/10.26633/RPSP.2026.43","url":null,"abstract":"<p><strong>Objective: </strong>To apply the NOA method, which integrates the dimensions of need, opportunity, and accessibility, to evaluate the effectiveness of kidney, liver, pancreas, heart, and lung transplants in Brazil.</p><p><strong>Methods: </strong>This retrospective cohort study used data from the Brazilian Transplant Registry regarding transplant need (the sum of the number of patients on waiting lists in 2022 and the total number of patients added to the lists in 2023). Opportunity considered the number of transplants from living and deceased donors in Brazil; for the latter, a correction factor derived from data from the Global Observatory on Donation and Transplantation was applied. Accessibility represented the sum of the number of organ transplants from deceased and living donors. A percentage score was generated to measure transplant performance relative to supply in relation to demand. Utilization and completed transplant rates were also estimated.</p><p><strong>Results: </strong>Performance ranged from 10% for kidney transplants, reflecting the mismatch between the waiting list and available grafts, to 64% for heart transplants. The South region had the highest utilization rate, while the North showed low organ availability, technical difficulties, and limited installed capacity.</p><p><strong>Conclusion: </strong>The NOA method is an effective tool for measuring the performance of the donation and transplant system, identifying bottlenecks to guide public policies. In Brazil, it is urgent to implement strategies aimed at reducing regional disparities, strengthening technical capacity, and expanding equity and efficiency in access to transplantation.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e43"},"PeriodicalIF":2.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of telespirometry in primary health care units in Brazil.","authors":"Eliane Viana Mancuzo, Ricardo de Amorim Corrêa, Camila Farnese Rezende, Sabrina de Rezende Ribeiro, Maria Cristina da Paixão, Mayara Santos Mendes, Núbia Cristina Louback Dos Santos, Lidiane Aparecida Pereira de Sousa, Antonio Luiz Pinho Ribeiro","doi":"10.26633/RPSP.2026.33","DOIUrl":"https://doi.org/10.26633/RPSP.2026.33","url":null,"abstract":"<p><p>Spirometry is essential for the diagnosis and follow-up of patients with noncommunicable chronic respiratory diseases; however, it was not available in primary health care in Brazil. This article describes the implementation of telespirometry in primary health care units across 163 Brazilian cities. The program was a collaborative effort between the Brazilian Ministry of Health and the Telehealth Center of the Hospital das Clínicas of the Federal University of Minas Gerais/EBSERH and was conducted in several stages, including team formation and selection of participating municipalities; selection of spirometry equipment; development of software for test transmission; training of nonmedical primary care professionals to perform spirometry and pulmonologists to provide teleconsultations; system implementation; delivery of virtual and onsite training; and continuous monitoring with periodic reevaluation. A total of 163 municipalities were selected according to predefined criteria. Since the implementation of telespirometry on 1 January 2022, 203 technicians have been qualified through virtual and in-person training. By 1 November 2024, a total of 31 982 spirometry tests had been performed. Test quality improved substantially over time, with the proportion of exams classified as category A or B increasing from 54.4% in the first three months to 81.2% in the final three months of the program. These findings indicate that expanding access to spirometry is feasible through a structured, short-term training program combined with close monitoring of primary care staff and a remote quality-control system supported by appropriate electronic resources.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e33"},"PeriodicalIF":2.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[HEARTS Pharmacy: A framework for integrating pharmacists in hypertension and cardiovascular disease risk management in primary careFarmácia HEARTS: um modelo para a integração de farmacêuticos na gestão dos riscos de hipertensão arterial e doenças cardiovasculares na atenção primária].","authors":"Emily Ridley, Donald J DiPette, Stephanie Gysel, Andres Rosende, Norm R C Campbell, Carolina Neira Ojeda, Ricardo Pesenti, Irma Consuelo Sanchez, Vilma Irazola, Ricardo Humberto Ruano Arevalo, María Paz López Olivares, Daniela Cortés Vidal, Mailin Beltran Delgado, Jessenia Zurita, Pedro Ordunez","doi":"10.26633/RPSP.2026.35","DOIUrl":"https://doi.org/10.26633/RPSP.2026.35","url":null,"abstract":"<p><p>HEARTS Pharmacy, a project within the HEARTS in the Americas Initiative, provides a framework to integrate pharmacists into primary health care. Pharmacists are highly respected in health care but face challenges, such as limited scope of practice, regulatory barriers, and insufficient recognition, compounded by social norms that hinder their full potential. This paper presents compelling evidence that pharmacist-led interventions improve blood pressure control, lower cardiovascular risk, and reduce health care costs. It underscores the role of national pharmacy systems in ensuring access to high-quality medications. HEARTS Pharmacy emphasizes the role pharmacists play in team-based care, highlighting their expertise in medication management, patient education, and adherence. This paper advocates policy changes that empower pharmacists with greater responsibility, enabling them to play an active role in patient care. It also recommends actions to fully integrate pharmacists into care teams, positioning them as key players in hypertension control and cardiovascular disease risk management within primary health care.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e35"},"PeriodicalIF":2.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roles and responsibilities of government chief nursing and midwifery officers in the Americas.","authors":"Bruna Moreno Dias, Jordana Salma, Susan R Cooper, Natalia Andrea Henao Murillo, Patsy Edwards Henry, Sonia Abad Vásquez, Edwin Vicente C Bolastig, Eduardo Benjamín Puertas Donoso, Wendy Denise Sealy","doi":"10.26633/RPSP.2026.34","DOIUrl":"https://doi.org/10.26633/RPSP.2026.34","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the roles, responsibilities and scope of current government chief nursing and midwifery officers or equivalent senior leaders in the Region of the Americas.</p><p><strong>Methods: </strong>This was a descriptive observational study. All government chief nursing or midwifery officers or equivalent senior leaders from 35 countries in the Region of the Americas were considered eligible to participate. An online survey was conducted that included items on demographic variables, the officer's roles and responsibilities, and a self-assessment of competencies. Data were analyzed using descriptive statistics, disaggregated by role, subregion and country income level. Content analysis was used for responses to open-ended questions.</p><p><strong>Results: </strong>Twenty eight officers from 28 countries participated in this study, representing 80% of the 35 countries in the Americas. About 82.1% (23/28) of the officers or equivalent leaders were exclusively responsible for nursing issues. Most of the participants had the job title of chief nursing officer (53.6%, 15/28), were female (92.9%, 26/28) and were aged 55-64 years (46.4%, 13/28). Regarding leadership roles, 57.1% (16) of participants reported that their countries had an executive model, with the officer having line authority over nursing or midwifery, or both. The responsibilities of these officers were mainly related to leadership, influence and policy advice. In the self-assessment of competencies, participants rated themselves as less skilled in global health priorities and management.</p><p><strong>Conclusions: </strong>Although the role of a government chief nursing officer or midwifery officer exists in most countries in the Americas, there is a need to further strengthen it. It is important for governments and stakeholders to create a policy environment conducive to empowering these leaders, recognizing their strategic role in the human resources for health agenda, and in expanding the contributions of nursing and midwifery towards achieving more resilient and equitable health systems.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e34"},"PeriodicalIF":2.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hotspot-based integrated serosurveillance of neglected tropical diseases, malaria, and vaccine-preventable diseases in urban Guyana.","authors":"Reza A Niles-Robin, Annastacia Sampson, Olivia Valz, Oneka Scott, Kim E Dickson, Rainier Escalada, Desmond Nicholson, Janice Woolford, Maria Paz Ade, Ronaldo Carvalho Scholte, Ana Luciañez, Pamela Bravo, Gloria Rey-Benito, Silvia Ibarra-Ozcariz, Ana Morice, Martha-Idalí Saboyá-Díaz","doi":"10.26633/RPSP.2026.29","DOIUrl":"https://doi.org/10.26633/RPSP.2026.29","url":null,"abstract":"<p><strong>Objectives: </strong>To assess exposure to lymphatic filariasis (LF), other neglected tropical diseases (NTDs), and malaria, as well as seroprotection against vaccine-preventable diseases (VPDs), using a hotspot-based integrated serosurveillance approach in urban areas of Guyana.</p><p><strong>Methods: </strong>To monitor the impact of interventions on LF transmission, one historically elevated LF hotspot - defined as a previously identified urban community with focal transmission - was selected in each coastal region (Regions III, IV, V, and X). A total of 300 individuals aged ≥6 years were surveyed in each hotspot using convenience sampling. Dried blood spots were tested at the U.S. Centers for Disease Control and Prevention using multiplex bead assay to analyze antigens from 12 pathogens: <i>Wuchereria bancrofti</i> and <i>Brugia malayi</i> (Wb123, Bm14, Bm33), <i>Plasmodium vivax</i> and <i>Plasmodium falciparum</i> (pvMSP1-19, pfMSP1-19), <i>Strongyloides stercoralis</i> (NIE), <i>Taenia solium</i> (rES33, T24H), <i>Chlamydia trachomatis</i> (Pgp3, CT694), <i>Treponema pallidum</i> (rp17, TmpA), and measles, rubella, tetanus, and diphtheria.</p><p><strong>Results: </strong>Reactivity to Wb123 and Bm14 was consistent with previous reports of elevated LF transmission in these regions. Seropositivity to <i>P. falciparum</i> and <i>P. vivax</i> was higher among adults. Seroprotection against measles and rubella was highest among children and older adults, with immunity gaps in young adults. Most participants showed minimal seroprotection against tetanus and diphtheria. Taeniasis and cysticercosis had low seropositivity across all sites. <i>C. trachomatis</i> and <i>T. pallidum</i> antigens showed age-related increases.</p><p><strong>Conclusions: </strong>Hotspot-based integrated serosurveillance using multiplex bead assay provides an efficient, targeted approach to monitor NTDs, malaria, and VPDs. Findings offer valuable insights for programmatic action, although interpretation should consider the hotspot-specific context when extrapolating results.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e29"},"PeriodicalIF":2.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparedness for the emerging risk of yellow fever in the Americas.","authors":"Helena J Chapman, Bienvenido A Veras-Estévez, Elena G Chicaiza-Mora, Concepción Zúniga Valeriano, Reyna M Durón","doi":"10.26633/RPSP.2026.31","DOIUrl":"https://doi.org/10.26633/RPSP.2026.31","url":null,"abstract":"<p><p>Yellow fever is a viral zoonosis of variable geographic distribution in the Americas. With no specific treatment for this vector-borne disease, vaccination is the best prevention available. This flavivirus has been circulating in the Americas since the late 15th century, and over the past decades, the virus has reemerged and is now endemic in 13 countries in South and Central America. Ecosystem changes may have had a role in this reemergence. The International Health Regulations were approved by the World Health Assembly in 2005 as a guidance document to support national policies with important measures for disease control and prevention of new epidemics. This article presents an illustrative case of the efforts of three ministries of health in the Americas (Dominican Republic, Ecuador, and Honduras) to implement international guidelines and reduce yellow fever transmission in the region. Using the One Health framework, we propose selected recommendations for the prevention and control of yellow fever outbreaks.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e31"},"PeriodicalIF":2.2,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}