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

{"title":"[Strategic independence: a value model for improving access to plasma-derived medicines in Latin AmericaIndependência estratégica: modelo de valor para melhorar o acesso a hemoderivados na América Latina].","authors":"Juanita Vahos Zambrano, Claudia Vaca González, Ana Yuliana Cortés, Diana Rocío Bernal, Rocío Parra Galvis, Leni von Bonsdorff","doi":"10.26633/RPSP.2025.49","DOIUrl":"https://doi.org/10.26633/RPSP.2025.49","url":null,"abstract":"<p><p>Plasma-derived medicinal products (PDMPs) are essential medicines required for the treatment of congenital, rare, and acquired diseases. At present, the market dynamics of these products have led to high dependence on a few producing countries, causing shortages, stockouts, and problems related to access in general. To help solve this problem, this document proposes a value model for PDMPs from a public health perspective, and considers the prospects, visions, and challenges to implementation in Colombia, as a case study. These proposals seek to contribute to the development of strategic independence in plasma, while promoting equitable access to PDMPs in the Region of the Americas. They are the result of a series of discussions and semi-structured interviews with national and international stakeholders from different public and private sectors, and with leaders of the National University of Colombia and the International Plasma and Fractionation Association (IPFA). It is hoped that these proposals will serve as an example for other countries in the Region to include this issue in their public policy agenda.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e49"},"PeriodicalIF":2.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044718","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":"[Technical cooperation strategies to revitalize immunization programs in priority countries in the AmericasEstratégias de cooperação técnica para revitalização do programa de imunização em países prioritários da Região das Américas].","authors":"Desirée Pastor, Victoria Villavicencio, Regina Durón, Pamela Bravo, Gloria Rey-Benito","doi":"10.26633/RPSP.2025.38","DOIUrl":"https://doi.org/10.26633/RPSP.2025.38","url":null,"abstract":"<p><strong>Objective: </strong>To describe and systematize experiences and lessons learned in the implementation of a Pan American Health Organization (PAHO) technical cooperation strategy in countries at high risk of importation and spread of measles and rubella, with the following objectives: monitoring the progress of vaccination coverage through microplanning, strengthening risk analysis and epidemiological surveillance, and providing a rapid response to outbreaks of vaccine-preventable diseases.</p><p><strong>Methods: </strong>Cross-sectional descriptive study of the interventions carried out by PAHO, with the support of seven epidemiologists who were trained and sent to nine countries in the Region between August and December 2023. The collected data were consolidated and analyzed along four strategic lines: vaccination, epidemiological surveillance, risk analysis, and preparedness for a rapid response to outbreaks. Information was collected through a questionnaire that included qualitative and quantitative data, following up on the work plan of the epidemiologists deployed in the Region.</p><p><strong>Results: </strong>The results of the activities were analyzed on the four strategic lines, using training tools and methodologies to establish intervention plans in the countries visited.</p><p><strong>Conclusions: </strong>The support of the group of consultants in the high-risk countries made an important contribution to strengthening different components of the national immunization program in each country.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e38"},"PeriodicalIF":2.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009316","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":"[Civil registration systems and vital statistics: ethical challenges and proposals for governanceSistemas de registro civil e estatísticas vitais: desafios éticos e propostas de governança].","authors":"Luis Manuel López Dávila, María Angélica Sotomayor Saavedra, Carlos F Méndez, Carmen Alicia Cardozo de Martínez, Estela Quiroz, Lucas Gustavo Gago-Galvagno, María Mabel Garra, Fernanda María Ledesma, Elizabeth María Benites Estupiñan, Adriana Vilma Scrigni, Viviana Lifschitz, Garbiñe Saruwatari Zavala, Mirtha Isabel Andreau de Bennato, Ida Cristina Gubert, Patricia Sorokin","doi":"10.26633/RPSP.2025.47","DOIUrl":"https://doi.org/10.26633/RPSP.2025.47","url":null,"abstract":"<p><p>In today's digital age, health data is increasingly coveted, and having legal rules to protect it is not enough to prevent its incorrect, imprudent, or improper use. Breaches of confidentiality, intrusions, and unrestricted access to personal data and sensitive data are a challenge for Latin American and Caribbean countries. This is due to the coexistence of diverse social actors, unspecific regulatory frameworks, data management aimed at reducing IT risks, inequalities in access, and technological-financial gaps, which can be analyzed from a governance perspective. This further demonstrates the region's inability to achieve an equitable distribution of the resources needed to implement policies that guarantee respect for human rights. It is, therefore, imperative to harmonize development objectives with initiatives to protect confidentiality and prevent data leaks, in order to improve the reputation of institutions in terms of credibility and trust, and to enhance the sustainability of systems that focus on people rather than data.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e47"},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043692","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":"[Mortality coding with ICD-11 in Chile: main results and prospects for implementationCodificação da mortalidade com a CID-11 no Chile: principais resultados e perspectivas de implementação].","authors":"Paulina Vera Montecinos, Jorge Pacheco, Sergio Guinez-Molinos, Daily Piedra, Lorena Velozo, Andrés Fuentes, Marcela Carmona, Alejandra Landabur, Pamela Suárez, Paulina Leighton","doi":"10.26633/RPSP.2025.50","DOIUrl":"https://doi.org/10.26633/RPSP.2025.50","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the usability of the International Classification of Diseases, 11th Revision (ICD-11) and its concordance and comparability with ICD-10, the version in use. ICD-11 introduces greater granularity than ICD-10, is designed for digital environments, and offers improvements over the previous version.</p><p><strong>Methods: </strong>Two thousand medical death certificates for year 2020 were selected by proportional stratified sampling. Two expert coders and a gold standard team coded the records using the official ICD-11 tool. Concordance between gold standard and expert coders was assessed for immediate, underlying, and principal cause of death. Distribution by chapter was compared for ICD-11, ICD-10 in the original database, and ICD-10 mapped from ICD-11.</p><p><strong>Results: </strong>Concordance with clinical accuracy ranged from 37% for principal cause of death to 76% for immediate cause. Agreement on base codes ranged from 73% for principal cause to 86% for immediate and underlying causes. Cohen's kappa for principal cause was 0.68 (95% CI: 0.64 - 0.72) for coder 1 and 0.76 (95%CI: 0.73 - 0.80) for coder 2, which is considered significant concordance. The distribution of principal cause for ICD-10 and for ICD-10 mapped from ICD-11 was similar.</p><p><strong>Conclusions: </strong>There is adequate concordance and comparability between ICD-11 and ICD-10. The tool has high usability, which confirms the feasibility of ICD-11 implementation in Chile, and underlines the need for continuous training and technological improvement.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e50"},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995832","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 digital signatures on death certificates in Peru, 2022-2024Implementação da assinatura digital no atestado de óbito no Peru, 2022-2024].","authors":"Javier Vargas-Herrera, Karim Pardo Ruiz, Héctor Saravia Martínez, Leonardo Rojas-Mezarina","doi":"10.26633/RPSP.2025.45","DOIUrl":"https://doi.org/10.26633/RPSP.2025.45","url":null,"abstract":"<p><p>Civil registration and vital statistics (CRVS) systems support individuals' right to identity and their access to public services, and provide information useful for public health. Peru's CRVS system uses applications that allow online medical certification of vital events. Since this information can be falsified, measures are required to ensure that the information entered is supported and not rejected, for example through the use of digital signatures. This article describes the implementation of digital signatures on death certificates (DSDC) produced online and their relationship with the reporting of deaths in SINADEF, the national system for reporting deaths. The digital signature for DSDCs issued online uses the national electronic identity card (DNIe), which has a cryptographic chip containing a physician's digital certificate, linking a pair of private and public keys. Implementation of the digital signature coincided with the recovery of death reporting levels in 2024. Implementation of the digital signature strengthens security and confidence in the CRVS system, minimizes the risk of false DSDCs, provides citizens with simpler and more secure processes, and helps to reduce under-registration and increase data quality and system efficiency.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e45"},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031358","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":"El papel estratégico de los jefes de enfermería y partería de gobierno en América Latina y el Caribe.","authors":"Bruna Moreno Dias, E Benjamín Puertas","doi":"10.26633/RPSP.2025.48","DOIUrl":"https://doi.org/10.26633/RPSP.2025.48","url":null,"abstract":"","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e48"},"PeriodicalIF":2.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029165","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":"SERPENT-Brasil: a technological tool for snakebite management.","authors":"Jacqueline de Almeida Gonçalves Sachett, Gisele Dos Santos Costa Rocha, Elisangela Silva, Anne Grace Andrade da Cunha Marques, Pedro Ferreira Bisneto, Handerson Silva Pereira, Victor Carlos Pardo Ratis da Silva, Kathleen Maclenny Pereira Carvalho, Lincoln Luís Silva, Manuela Berto Pucca, Wuelton Marcelo Monteiro","doi":"10.26633/RPSP.2025.39","DOIUrl":"https://doi.org/10.26633/RPSP.2025.39","url":null,"abstract":"<p><strong>Objective: </strong>To report on the development and features of a mobile application (app) to guide the public and health professionals on pre-hospital emergency measures after snake envenomation.</p><p><strong>Methods: </strong>This was a four-stage methodological study conducted from June 2020 to July 2022. The app development included creating a mobile resource to guide pre-hospital care and to direct victims to hospitals that have antivenom.</p><p><strong>Results: </strong>The SERPENT-BRASIL app was developed for use on Android and IOS devices with an intuitive interface. It offers online and offline access to information on hospitals and mapping routes via Google Maps. In addition, it allows users to report snake sightings and to request emergency rescue.</p><p><strong>Conclusion: </strong>The SERPENT-BRASIL app improves snakebite management and prevention, eases the burden on health services, and promotes health education. Collection of snake envenomation data contributes to public safety, making the app an essential resource for public safety in Brazil.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e39"},"PeriodicalIF":2.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027957","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":"[Handmade ovitraps and hot water: auxiliary strategy to control <i>Aedes aegypti</i> mosquitoes in ColombiaOvitrampas artesanais e água quente: estratégia auxiliar para o controle de mosquitos <i>Aedes aegypti</i> na Colômbia].","authors":"Katherine Arrieta-Ángel, Keylin Polo-Silva, Natalia Ospino-Sierra, Dayan Corpa-Choperena, Elkin Monterrosa, Isaacs Alemán, Diego Montenegro","doi":"10.26633/RPSP.2025.40","DOIUrl":"https://doi.org/10.26633/RPSP.2025.40","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate handmade ovitraps as a sustainable auxiliary strategy to control <i>Aedes aegypti</i> mosquitoes, in line with the 2030 Agenda for Sustainable Development.</p><p><strong>Methods: </strong>Black and white ovitraps were designed using 0.95 L plastic containers, paper towel, and plastic film. Three treatments were tested: water, water with birdseed, and water with birdseed plus diflubenzuron, for 15 weeks, in Monteria and Ayapel, Colombia. The data were analyzed with Python^®, using ChatGPT. Manual egg counts were compared with counts done by an artificial intelligence (AI) system, and ovicidal methods were evaluated in the laboratory.</p><p><strong>Results: </strong>Ovitraps with birdseed, costing less than USD $0.20, achieved test positivity rates (TPR) above 78.0%, and captured an average of 385 eggs per trap per week. Over the entire study, approximately 100 ovitraps eliminated 67 868 eggs and prevented the development of 48 458 adults (47.2% female). Black traps (TPR: 54.47%) outperformed white traps (TPR: 41.24%), although no significant differences were due to color. Treatment with birdseed and diflubenzuron was the most effective. Manual egg counts were more accurate than AI counts. In addition, the use of hot water (80-100 °C) achieved 100% ovicidal efficacy, outperforming diflubenzuron. The community showed a high level of acceptance and reported significant benefits through mosquito reduction.</p><p><strong>Conclusion: </strong>Handmade ovitraps with paper towel immersed weekly in hot water, are a cost-effective, accessible, environmentally friendly strategy that can be easily integrated into vector control programs in urban and rural areas endemic for arboviral diseases, minimizing the use of insecticides and reducing environmental impacts.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e40"},"PeriodicalIF":2.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036597","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":"Health advocacy strategies to influence policy-making on and regulation of new and emerging tobacco and nicotine products in Latin America and the Caribbean.","authors":"Eric Crosbie, Sierra Wilson, Brian Tran, Beatriz Albuquerque de Figueiredo, Luciana Severini, Gianella Severini, Ernesto M Sebrié","doi":"10.26633/RPSP.2025.31","DOIUrl":"https://doi.org/10.26633/RPSP.2025.31","url":null,"abstract":"<p><strong>Objective: </strong>To document health advocacy strategies to influence public policies regulating new and emerging tobacco and nicotine products in Latin America and the Caribbean.</p><p><strong>Methods: </strong>We analyzed public documents on new and emerging tobacco and nicotine products including news sources and national legislation and interviewed public health advocates in Latin America and the Caribbean. The policy dystopia model was used to assess health advocacy strategies for regulation of these products.</p><p><strong>Results: </strong>Legislative activity on these products mostly occurred in Argentina, Brazil, Chile, Costa Rica, Colombia, Mexico, and Panama. Health advocates engaged in four action-based strategies to influence regulation of these products - coalition management, information management, direct involvement in and access to the policy process, and litigation. Health advocates concentrated on exposing industry deception and providing scientific evidence and country experiences. Health advocacy argument-based strategies exposed the increased use of new and emerging tobacco and nicotine products due to aggressive industry marketing. Advocates argued governments should comply with the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) obligations and its Conference of the Parties (COP) decisions to regulate these products.</p><p><strong>Conclusions: </strong>Applying the policy dystopia model on new and emerging tobacco and nicotine products provides a better understanding of how health advocates can pre-empt industry strategies to undermine WHO FCTC implementation. Unified transnational cooperative and coordinated health advocacy strategies to educate people can strengthen efforts. Promoting WHO FCTC obligations and COP decisions appears to support regulation on new and emerging tobacco and nicotine products and should be replicated elsewhere.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e31"},"PeriodicalIF":2.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042385","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":"Delivering rapid, up-to-date, high-quality evidence is feasible during health emergencies: PAHO living systematic review of 305 COVID-19 potential therapeutics.","authors":"Ariel Izcovich, Sasha Peiris, Gabriel Rada, Fernando Tortosa, Martín Ragusa, Ludovic Reveiz","doi":"10.26633/RPSP.2025.41","DOIUrl":"https://doi.org/10.26633/RPSP.2025.41","url":null,"abstract":"<p><strong>Objective: </strong>To develop a living systematic review to deliver continuous, real-time evidence synthesis in the context of a rapidly evolving landscape of studies on potential therapeutic interventions during the COVID-19 pandemic.</p><p><strong>Methods: </strong>The living systematic review was conducted using the COVID-19 Living Overview of Evidence platform, which aggregates studies from more than 40 sources, including electronic databases and preprint servers. Daily searches identified randomized controlled trials assessing pharmacological interventions for COVID-19. Meta-analytical pooling was applied to derive precise effect estimates, and the GRADE framework was used to assess certainty. The iterative process ensured the continuous integration of new evidence and rapid updates to the review.</p><p><strong>Results: </strong>The review evaluated 305 interventions across 924 randomized controlled trials and included 48 updates from its launch in April 2020. This dynamic process allowed the team to respond promptly to decision-maker queries and deliver reliable information on intervention effectiveness and safety. The outputs of the review supported the development of therapeutic guidelines and informed decision-makers, playing a pivotal role in shaping clinical practices and public health strategies during the pandemic.</p><p><strong>Conclusions: </strong>The living systematic review approach demonstrated how dynamic evidence synthesis can meet the demands of a rapidly evolving global health crisis. By providing decision-makers with timely, high-quality evidence, the process underscored the importance of integrating living reviews into preparedness strategies for future public health emergencies or rapidly evolving fields where new evidence emerges quickly.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e41"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009582","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}