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

{"title":"El Niño in the Americas, 2026-2027: public health risks and preparedness priorities.","authors":"","doi":"10.26633/RPSP.2026.78","DOIUrl":"https://doi.org/10.26633/RPSP.2026.78","url":null,"abstract":"","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e78"},"PeriodicalIF":1.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631388","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":"Diphtheria in the Americas: strengthening routine immunization, surveillance, and outbreak readiness.","authors":"","doi":"10.26633/RPSP.2026.77","DOIUrl":"10.26633/RPSP.2026.77","url":null,"abstract":"","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e77"},"PeriodicalIF":1.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631338","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":"[Spread and persistence of chikungunya in the Brazilian Northeast (2015-2023): A spatiotemporal analysisAnálisis espaciotemporal de la expansión y la persistencia del chikunguña en el noreste de Brasil (2015-2023)].","authors":"Suzanne Santos de Lima, Amanda Priscila de Santana Cabral Silva, Carlos Feitosa Luna, Wayner Vieira de Souza, Cynthia Braga","doi":"10.26633/RPSP.2026.66","DOIUrl":"10.26633/RPSP.2026.66","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the spatiotemporal dynamics of chikungunya incidence in municipalities in the Brazilian Northeast from 2015 to 2023.</p><p><strong>Methods: </strong>Ecological time-series study of probable cases of chikungunya reported to Brazil's Notifiable Diseases Information System (SINAN). Monthly trends were assessed by joinpoint regression analysis with estimation of the monthly percent change (MPC) and 95% confidence intervals (95% CIs). High-risk space-time clusters were identified using a Poisson-based scan statistic (relative risk [RR], <i>p</i> < 0.05).</p><p><strong>Results: </strong>A total of 769 986 cases were reported in 2015-2023, mostly in the states of Ceará (27.9%), Bahia (25.3%), and Pernambuco (14.5%). Explosive outbreaks occurred in 2016, 2017, and 2022, interspersed with periods of low transmission. The temporal analysis revealed high initial MPC estimates, e.g., in Maranhão (127.4%; 95% CI: 112.5-172.6). In 2022, explosive outbreaks occurred once again, particularly in Alagoas (MPC = 342.4%; 95% CI: 187.2-557.3) and Piauí (MPC = 242.9%; 95% CI: 162.6-441.8). Significant space-time clusters were identified, 70% of which began in 2016. A disconnect was observed between geographic spread and magnitude of risk: the highest RR (45.5; 95% CI: 43.7-47.3) occurred in a cluster in Bahia in 2020, whereas the largest cluster involved 431 municipalities across four states in 2016.</p><p><strong>Conclusion: </strong>The dynamics of chikungunya in the Brazilian Northeast were characterized by spatiotemporal heterogeneity, with shifting epicenters and persistent pockets of high risk, providing further evidence of the need for integrated, regionalized surveillance and control to address sustained transmission in high-risk pockets and interstate clusters.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e66"},"PeriodicalIF":1.7,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607121","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":"[Childhood cancer in Uruguay: A public-private partnership that delivers equity, science, and resultsCâncer infantil no Uruguai: uma parceria público-privada que promove a equidade, a ciência e os resultados].","authors":"Guzmán Nion, Carolina Pagés, Victoria Lafluf, Sofía de Villa, Andrés Batalla, Anaulina Silveira, Guillermo Chantada, Luis Castillo","doi":"10.26633/RPSP.2026.61","DOIUrl":"10.26633/RPSP.2026.61","url":null,"abstract":"<p><p>Pediatric cancer poses a public health challenge, especially in low- and middle-income countries. Uruguay, a high-income country, has achieved an overall 5-year survival rate of over 79.6% among pediatric patients. The clinical results exceed the 60% target set by the World Health Organization (WHO)'s Global Initiative for Childhood Cancer (GICC). The model is fully aligned with WHO's CureAll strategy, emphasizing universal coverage at no cost to the patient and the integration of psychosocial support. The purpose of this report is to outline the structure of the care model for children and adolescents with cancer in Uruguay, in the context of the GICC guidelines.Uruguay's National Integrated Health System guarantees universal coverage. Under specific legislation, a strategic partnership has been established between the State Health Services Administration (ASSE) and the Pérez Scremini Foundation (FPS) for the management of the national referral center. The FPS provides care for approximately 70% of pediatric cancer patients in partnership with the public children's hospital. It has mixed financing: ASSE contributes approximately 35% of the budget, covering general hospital supplies and services, while the FPS relies on donations to fund the remaining 65%, including home-based care and the administration of benefits. This structure ensures operational independence and the ability to make rapid investments without losing the support and nationwide coverage provided by the public system.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e61"},"PeriodicalIF":1.7,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607187","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":"[ICD<b>-11 coding of hospital discharges in Chile: Main results and prospects for implementation</b>Codificação de altas hospitalares com a CID-11 no Chile: principais resultados e perspectivas de implementação].","authors":"Sergio Guinez-Molinos, Paulina Vera Montecinos, Jorge Pacheco Jara, Daily Piedra Suárez, Paulina Leighton Quinchao, Jaime González Díaz, Katri Kontio","doi":"10.26633/RPSP.2026.68","DOIUrl":"10.26633/RPSP.2026.68","url":null,"abstract":"<p><strong>Objective: </strong>> To compare concordance between physicians and coders in their assignment of diagnoses under International Classification of Diseases, 11th Revision (ICD-11).</p><p><strong>Methods: </strong>A pilot study was conducted at San Juan de Dios Hospital in Curicó, Chile, between March and June 2025, incorporating ICD-11 coding into the clinical services of internal medicine and psychiatry. Eight physicians and two coders were trained in the use of ICD-11, and the domestically developed \"Deisy CIE-11\" platform was used to validate diagnoses. A total of 457 hospital discharges were analyzed, comparing diagnostic coding performed by physicians, coders, and a national reference expert.</p><p><strong>Results: </strong>For the principal diagnoses, concordance was 96% (439/457) between physicians and coders and 93% (424/457) between physicians and the national reference expert. For secondary diagnoses, concordance exceeded 90% in all fields evaluated. Cohen's kappa coefficient for concordance between physicians and coders was 0.963. The main errors were associated with omissions in postcoordination and incorrect assignment of the external cause code. The national reference expert reviewed 100% of the records for which information was available.</p><p><strong>Conclusions: </strong>The pilot study demonstrated a high level of diagnostic concordance among physicians, coders, and the national reference expert in the assignment of diagnostic codes to hospital discharges. However, significant gaps were identified in postcoordination, the recording of external causes, and the standardization of review criteria. These findings provide preliminary evidence to inform future strategies for implementing ICD-11 in hospital morbidity coding.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e68"},"PeriodicalIF":1.7,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607195","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":"Systematic review of impact of mandatory front-of-package nutrition labeling on behavioral and cognitive outcomes and inequalities.","authors":"Ornella Moreno-Mattar, Mariana Gutiérrez-Zamora, Joana Morrison, Lucinda Cash-Gibson, Juan M Pericàs, Joan Benach","doi":"10.26633/RPSP.2026.63","DOIUrl":"10.26633/RPSP.2026.63","url":null,"abstract":"<p><strong>Objectives: </strong>To synthesize empirical evidence about the effects of mandatory front-of-package nutrition labeling policies on behavioral and cognitive outcomes related to food choice, and on socioeconomic and demographic inequalities in these outcomes.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. The following databases were searched for publications in English and Spanish: MEDLINE on Ovid, ScienceDirect, Scopus and LILACS. The search had no date restrictions. Two reviewers independently screened titles, abstracts and the full text of articles, with disagreements resolved by a third reviewer. Studies were eligible for inclusion if they evaluated the implementation of mandatory front-of-package labeling and reported relevant outcomes. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, the Risk of Bias in Non-Randomized Studies of Interventions tool and the Newcastle-Ottawa Scale. Findings were synthesized narratively.</p><p><strong>Results: </strong>Seven studies met the inclusion criteria, covering four countries with mandatory labeling policies (Chile, Colombia, Ecuador and Mexico). The studies used diverse designs, including interrupted time-series, natural experiments, experiments and cross-sectional surveys. Octagonal warning labels were associated with increased awareness and understanding, as well as reduced purchase or selection of products high in sugar, sodium or saturated fat. Evidence of socioeconomic and demographic inequalities was heterogeneous and insufficient to establish consistent patterns across population groups.</p><p><strong>Conclusions: </strong>Mandatory front-of-package nutrition labeling policies, especially octagonal warning labels, improve intermediate outcomes such as consumer awareness and food choices. The limited empirical evidence from heterogeneous evaluations provides little insight into long-term health impacts or socioeconomic and demographic inequalities.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e63"},"PeriodicalIF":1.7,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607200","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":"Anemia crisis among children in Peru: a scoping review.","authors":"Kenia Lobo, Cinthya Vásquez-Velásquez, Parminder S Suchdev, Melissa F Young, Hannah Rogers, Elena Cyrus, Kevin Beguiristain, Clayton Swords, Sarah Lavari, Yogi Parmar, Gustavo F Gonzales, Chris A Rees","doi":"10.26633/RPSP.2026.58","DOIUrl":"10.26633/RPSP.2026.58","url":null,"abstract":"<p><strong>Objective: </strong>To synthesize the existing literature on the etiologic mechanisms of anemia, challenges in anemia measurement, and diagnostic criteria among children in Peru.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews was followed. PubMed, Web of Science, Scopus, Embase, and the Latin American and Caribbean Health Sciences Literature databases were searched for relevant studies published from 1990 to 2024. Two reviewers independently screened and extracted data from included publications. Etiologic proportions were pooled from heterogeneous studies. Data were analyzed from February 3 to August 1, 2025.</p><p><strong>Results: </strong>The scoping review included 55 studies comprising data on 4 688 221 children. Twenty studies focused on high-altitude populations and 35 on causal mechanisms of anemia, with some studies addressing both; 45 were cross-sectional (82%). Sample sizes ranged from small community studies (9 children) to large nationally representative studies (2 087 768 children). Eight studies did not report sample size. Five studies used existing databanks for spatial analyses or clustering methods to estimate anemia prevalence. Reported causes of anemia according to the findings of individual regional studies were: parasitic infections (53.0%), iron deficiency (14.0%), vitamin B-12 deficiency (13.0%), inflammation (8.0%), folate deficiency (0.2%), and unknown causes (36.0%), although estimates were not directly comparable across studies. Measurement approaches varied, with HemoCue portable hemoglobinometers used in 56.0% of studies. Use of altitude correction formulas was associated with an average increase of more than 30 percentage points in reported anemia prevalence.</p><p><strong>Conclusions: </strong>This scoping review found that anemia in Peruvian children is multifactorial, with regional studies identifying diverse etiologic mechanisms, most commonly parasitic infections and iron deficiency; nationally representative data are lacking. Variability in diagnostic methods, particularly in altitude adjustment, and limited comparability may complicate prevalence estimates. Standardized and validated approaches to anemia assessment are urgently needed to support context-specific interventions and effectively address the childhood anemia burden in Peru.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e58"},"PeriodicalIF":1.7,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449019","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":"Assessing vaccination coverage quality in Jamaica during COVID-19 using vcqiR: insights from the 2022 MICS.","authors":"Anya Cushnie, Dale A Rhoda, Caitlin B Clary, Jennifer Brustrom, Mary Kay Trimner, Federica Bertacchini, Paola Ojeda, Martha Velandia-González","doi":"10.26633/RPSP.2026.49","DOIUrl":"10.26633/RPSP.2026.49","url":null,"abstract":"<p><strong>Objective: </strong>This analysis aimed to identify the underlying causes of gaps in routine immunization coverage observed during the COVID-19 pandemic recovery phase by applying the open-source Vaccination Coverage Quality Indicators package in R (vcqiR), addressing limitations in Multiple Indicator Cluster Surveys (MICS) that often omit quality metrics based on detailed vaccination date analysis.</p><p><strong>Methods: </strong>This secondary analysis examined vaccination doses and dates from the Jamaica 2022 MICS (MICS4), for 570 children ages 12-23 months and 24-35 months. Specific indicators included coverage, timeliness, dropouts, and missed opportunities for simultaneous vaccinations (MOSVs).</p><p><strong>Results: </strong>Vaccination coverage for first-year-of-life (1YL) doses exceeded 83% for both age cohorts. Coverage for MMR1 showed substantial catch-up from 12-23 months to 24-35 months, achieving the 95% target. However, MMR2 coverage lagged substantially (37.2% for 12-23 months and 61.9% for 24-35 months), indicating significant attrition in the second year of life. In the 12-23 month cohort, crude coverage of Penta3 was 89%, but only 70% had three valid doses. Most 1YL doses were administered in a timely manner (within 28 days), but premature administration was observed. MOSVs were negligible for 1YL doses but were frequent and mostly uncorrected for 18-month boosters, especially MMR2.</p><p><strong>Conclusions: </strong>The findings complement the MICS4 report and confirm robust early infant immunization delivery but identify programmatic gaps in second year-of-life retention plus the need to strengthen adherence to minimum age interval rules. These results provide detailed evidence necessary to inform targeted interventions and guide the design of future coverage surveys.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e49"},"PeriodicalIF":1.7,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448983","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":"Vaccination Coverage Quality Indicators (VCQI): a flexible open-source tool for survey data analysis.","authors":"Dale A Rhoda, Caitlin B Clary, Mary Kay Trimner, Mia Yu, Jennifer Brustrom, Marcela Contreras, M Carolina Danovaro-Holliday, Martha Velandia-González","doi":"10.26633/RPSP.2026.60","DOIUrl":"10.26633/RPSP.2026.60","url":null,"abstract":"<p><p>The World Health Organization (WHO) and Pan American Health Organization (PAHO) make statistical software scripts freely available to conduct standardized analysis of vaccination coverage surveys. The software and accompanying documentation are named the Vaccination Coverage Quality Indicators (VCQI). The software examines data from child vaccination records and caregiver recall to calculate indicators of vaccination access, coverage, continuity, and quality. VCQI produces output tables and figures that may be copied directly into reports and presentations, as well as survey response data sets augmented with child-level outcome indicator variables calculated according to WHO guidance. It can analyze data from routine immunization surveys, post-campaign coverage surveys, and maternal tetanus coverage surveys. VCQI may be used for either the primary analysis of data from new surveys or secondary analysis of earlier surveys. It can analyze data from USAID Demographic and Health Surveys, UNICEF Multiple-Indicator Cluster Surveys, or WHO Expanded Programme on Immunization surveys. Future versions of VCQI may be extended to analyze data from electronic immunization registries. VCQI has been available as a set of Stata scripts since 2015, and as of 2025, the core routine immunization indicators are also available as a new R package named vcqiR. To publicize VCQI's features and capabilities and to celebrate the milestone of R package availability, the authors share this special report to describe the VCQI vision and design, discuss analyses and insights available from it, and map our vision of what the future may hold for flexible standardized analysis of vaccination coverage data.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e60"},"PeriodicalIF":1.7,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437613","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":"Reinforcing measles control in the Americas amid mass gatherings: detection, response, and traveler health implications.","authors":"","doi":"10.26633/RPSP.2026.72","DOIUrl":"https://doi.org/10.26633/RPSP.2026.72","url":null,"abstract":"","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"50 ","pages":"e72"},"PeriodicalIF":1.7,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13335556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437632","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}