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

{"title":"Social participation in health: analysis of progress and challenges for the Region of the Americas.","authors":"Ernesto Báscolo, Carina Vance, Mart Leys, Andrés Coitiño","doi":"10.26633/RPSP.2024.70","DOIUrl":"10.26633/RPSP.2024.70","url":null,"abstract":"<p><p>This article analyzes the state of social participation in health in the Region of the Americas, framing it within the regional context and commitments assumed by the Member States of the Pan American Health Organization. It aims to provide regional input to the discussion of a resolution on social participation for universal health coverage, health, and well-being at the 77th World Health Assembly in 2024. In the Americas, social participation has evolved from a utilitarian approach to a fundamental aspect of health system governance, enshrined within legal frameworks and recognized as a citizen's right. Regional resolutions emphasize inclusive policies and intersectoral action to tackle health inequities, meanwhile the World Health Organization handbook on social participation underscores the need for inclusive governance mechanisms and addressing power imbalances. Informed by Member States' recommendations and scientific literature, the article emphasizes the importance of addressing power imbalances, strengthening legal frameworks, and enhancing capacities of governments and populations. It stresses adapting social participation mechanisms to diverse cultural contexts and ensuring meaningful community involvement in decision-making. Finally, the article advocates for a comprehensive approach to social participation grounded in principles of equity, democracy, and human rights; and fundamentally as an essential component of the primary health care approach. It calls for integrating social participation into health system governance, policy dialogues, capacity-building, and evaluation to ensure effective participatory processes.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e70"},"PeriodicalIF":2.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976520","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":"From national and regional commitments to global impact: artificial intelligence for equitable public health at the G20.","authors":"Jarbas Barbosa da Silva, Nísia Trindade Lima, Ana Estela Haddad, Socorro Gross Galiano, Sebastian Garcia Saiso, Mary Lou Valdez, James Fitzgerald, Mariana Faria Teixeira, Ernesto Bascolo, Daniel Rodriguez, Luis Jimenez McInnis, Judit Rius Sanjuan, Myrna Marti, Daniel Luna, Paula Kohan, Marcelo D'Agostino","doi":"10.26633/RPSP.2024.73","DOIUrl":"https://doi.org/10.26633/RPSP.2024.73","url":null,"abstract":"","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e73"},"PeriodicalIF":2.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890023","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":"Investigating under-reported human papillomavirus genotypes in Grenadian women through self-sampling for cervical cancer screening.","authors":"Frances McGill, Paul J Fields, Aví Bahadoor-Yetman, Erin Salter Manglardi, Ronelle Bailey, Kritika Padala, Jessica Lendore, Tiffany John-Ballantyne, Sasha Lake","doi":"10.26633/RPSP.2024.62","DOIUrl":"10.26633/RPSP.2024.62","url":null,"abstract":"<p><strong>Objective: </strong>To compare the adequacy, agreement, and acceptability of Papanicolaou testing (cytology) for cervical cancer screening using self-collected samples compared to physician-collected samples in Grenada in the Caribbean. Furthermore, the study identifies the human papillomavirus (HPV) genotypes present among asymptomatic women testing positive for HPV, the etiologic cause of cervical cancer.</p><p><strong>Methods: </strong>Participants were divided into two groups and two cervical samples were collected from the women in each group: a self-collected sample and a physician-collected sample. Cervical specimens were tested for cytology and HPV. HPV genotyping was performed on positive specimens.</p><p><strong>Results: </strong>Self-collected samples were adequate and in agreement with physician-collected samples, showing no difference between the two sampling methods. Oncogenic high-risk HPV genotypes were identified in cervical samples which were positive for atypical squamous cells and low-grade squamous intraepithelial lesions. The high-risk HPV genotypes found, notably HPV 45 and 53, differed from those most commonly reported. Although the commonly reported high-risk genotypes HPV 16 and 18 were found, so were 31, 33, 35, 52, 66, 68, and 82.</p><p><strong>Conclusions: </strong>Using self-collection facilitated the discovery of unexpected HPV genotypes among asymptomatic women in Grenada. These findings add new information to the literature regarding cervical cancer and neoplasia screening and HPV genotypes in the Caribbean. This genotype information may impact surveillance of women with low-grade lesions, HPV vaccine selection, and possibly further vaccine research. Research regarding HPV in Caribbean pathology samples of cervical neoplasia and cancer is needed.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e62"},"PeriodicalIF":2.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752602","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":"Status of the national immunization technical advisory groups in the Americas: recommendations for improvement.","authors":"Miguel Betancourt-Cravioto, Ruby Trejo Varón, Francisco Becerra-Posada, Carlos Espinal","doi":"10.26633/RPSP.2024.63","DOIUrl":"10.26633/RPSP.2024.63","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the structure and operation of national immunization technical advisory groups (NITAGs) in Latin America and the Caribbean and to make recommendations for improvement.</p><p><strong>Methods: </strong>A convenience sample of six current and eight former NITAG members representing 12 countries in the region were invited in 2022 to answer a web-based questionnaire on NITAG structure, organization, and procedures. The questionnaire used indicators similar to those in the Joint Reporting Form on Immunization. Participants were also asked about the role their NITAGs played in coronavirus disease 2019 (COVID-19) immunization policies.</p><p><strong>Results: </strong>Brazil, Dominican Republic, and Venezuela (Bolivarian Republic of) reported not having an active NITAG. The nine active NITAGs are structured and organized according to World Health Organization and Pan American Health Organization recommendations, with variations between countries. Most NITAGs include representatives of the five recommended medical specialties with the participation of additional members possible. Only Bolivia (Plurinational State of) and Mexico have no explicit policy for managing members' potential conflicts of interest. All NITAGs have an exclusively technical advisory role and generally meet once a quarter. Usually, NITAGs are asked by health ministries to analyze issues and make recommendations. All NITAGs, except for Peru's, actively participated in supporting decision-making for immunization policy on COVID-19.</p><p><strong>Conclusions: </strong>NITAGs have successfully supported vaccine policy-making through evidence-based recommendations. However, improvement in their structure, operation, and transparency is needed to help them keep up with the rapidly evolving field of immunization. Research on the impact of NITAGs is important to support the development of recommendations for improvement.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e63"},"PeriodicalIF":2.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752603","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":"[Evaluation of Implementation of the HEARTS Initiative in a Rural Community in Venezuela, 2023Avaliação da implementação da iniciativa HEARTS em uma comunidade rural da Venezuela, 2023].","authors":"Maritza Durán, Eunice Ugel, Héctor Ojeda-Cáceres, Andrea Bonelli, Manuela Saglimbeni, Elio Rodríguez Araque, Corina González Galasso, Alejandra Yñiguez, César González, Diego Ramos, Edgar Rivera","doi":"10.26633/RPSP.2024.53","DOIUrl":"10.26633/RPSP.2024.53","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the implementation of HEARTS strategies in a community in the Bolivarian Republic of Venezuela.</p><p><strong>Methods: </strong>Quasi-experimental study evaluating the cascade of care, driving factors, and maturity and performance indicators four months after implementation of the HEARTS initiative in 52 patients with high blood pressure (BP) in the community of La Marroquina. The data were processed using SPSS^® Statistics, version 25.0. Student's t-distribution and chi-square tests were applied to determine statistical significance.</p><p><strong>Results: </strong>Fifty patients, 63.5% of them with a low educational level and low or very low socioeconomic status, completed the four-month monitoring period. At baseline, 11.5% had controlled BP and 40.4% initiated monotherapy. By the fourth month, 100% of patients with high BP had been diagnosed, 92% had received treatment, and 52% had achieved control of their BP. Seventy-two percent were receiving combined therapy. Seventy percent of the hypertensive individuals maintained blood pressure levels <140/90 mmHg. The maturity index score was 4 of 5, and the performance index was classified as incipient.</p><p><strong>Conclusion: </strong>This work shows that, in a short time, a good maturity index was achieved through the implementation, by medical and supervised non-medical personnel, of a standardized protocol for diagnosis, treatment, and monitoring of high blood pressure in a rural population. Rates of diagnosis, treatment, and BP control improved, with incipient performance results. Sustaining this initiative will have a major impact on the health of this population. Its implementation as a national public health policy is recommended.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e53"},"PeriodicalIF":2.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752601","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":"[Calculation of the alcohol <i>per capita</i> consumption in Brazil: using national dataCálculo del indicador del consumo de alcohol per cápita en Brasil: uso de datos nacionales].","authors":"Paula Carvalho de Freitas, Luiza Eunice Sá da Silva, Patrícia Pereira Vasconcelos de Oliveira, Ellen de Cássia Dutra Pozzetti Gouvêa, Inês Fronteira, Isis Eloah Machado, Deborah Carvalho Malta, Paulo Ferrinho","doi":"10.26633/RPSP.2024.54","DOIUrl":"10.26633/RPSP.2024.54","url":null,"abstract":"<p><strong>Objective: </strong>To calculate the alcohol <i>per capita</i> consumption (APC) in Brazil (Brazil APC) using national data and to establish the Brazil APC as gold standard for the country, replacing the indicator previously calculated by the World Health Organization (WHO) based on international data.</p><p><strong>Method: </strong>The Brazilian public data sources necessary for calculating the recorded APC were selected, and the alcohol concentration was defined by beverage category. For the variables of tourist APC and unrecorded APC, which are unavailable in Brazil, estimates from the United Nations (UN) and the WHO were used. The Brazil APC indicator was calculated and compared to the indicator produced by the WHO through analysis of the medians obtained for the period from 2005 to 2020.</p><p><strong>Results: </strong>The national alcohol consumption indicator was 9.2 liters <i>per capita</i> in 2005, reaching 9.8 in 2020. The WHO indicator showed a consumption of 8.4 liters <i>per capita</i> in 2005, decreasing until 2016 and slightly increasing to 7.8 in 2020.</p><p><strong>Conclusion: </strong>The Brazil APC was calculated based on national sources and showed a distinct trend compared to the WHO indicator, which showed a decrease. The regular and transparent provision of this indicator through government channels will support the development of policies to address alcohol consumption in the country.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e54"},"PeriodicalIF":2.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11248727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620885","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":"Introducing the concept of digitally smart health facilities: a vision for the future.","authors":"Jarbas Barbosa da Silva, Rhonda Sealey-Thomas, Ciro Ugarte, Sebastian Garcia Saisó, James Fitzgerald, Ernesto Bascolo, Amalia Del Riego, Ana Rivière Cinnamond, Leah-Marie Richards, Myrna Marti, Ana Estela Haddad, Marcelo D'Agostino","doi":"10.26633/RPSP.2024.74","DOIUrl":"10.26633/RPSP.2024.74","url":null,"abstract":"","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e74"},"PeriodicalIF":2.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11248721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620886","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":"National and regional population attributable fractions for anemia risk factors (iron, folate, and vitamin B12) in Belize: potential impact of fortification.","authors":"Jorge Rosenthal, Clinton J Alverson, Natalia Largaespada-Beer, Gail Pa Kauwell, Lynn B Bailey, Julio J Sabido, Melissa Diaz, Jennifer L Williams, Kevin Bernard","doi":"10.26633/RPSP.2024.61","DOIUrl":"10.26633/RPSP.2024.61","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the national and regional population attributable fraction (PAF) and potential number of preventable anemia cases for three nutritional risk factors (iron, red blood cell folate [RBCF], and vitamin B12 deficiencies) among women of childbearing age in Belize.</p><p><strong>Methods: </strong>A national probability-based household and micronutrient survey capturing sociodemographic and health information was conducted among 937 nonpregnant Belizean women aged 15-49 years. Blood samples were collected to determine hemoglobin, ferritin, alpha-1-glycoprotein (AGP), RBCF, and vitamin B12 status. All analyses used sample weights and design variables to reflect a complex sample survey. Logistic regression was used to determine adjusted prevalence risk (aPR) ratios, which were then used to estimate national and regional PAF for anemia.</p><p><strong>Results: </strong>The overall prevalence of anemia (hemoglobin <12 g/dL) was 21.2% (95% CI [18.7, 25.3]). The prevalence of anemia was significantly greater among women with iron deficiency (59.5%, 95% CI [48.7, 69.5]) compared to women without iron deficiency (15.2%, 95% CI [12.2, 18.3]; aPR 3.9, 95% CI [2.9, 5.1]). The three nutritional deficiencies examined contributed to 34.6% (95% CI [22.1, 47.1]) of the anemia cases. If all these nutritional deficiencies could be eliminated, then an estimated 5 953 (95% CI [3 807, 8 114]) anemia cases could be prevented.</p><p><strong>Conclusions: </strong>This study suggests that among women of child-bearing age in Belize, anemia cases might be reduced by a third if three modifiable nutritional risk factors (iron, RBCF, and vitamin B12 deficiencies) could be eliminated. Fortification is one potential strategy to improve nutritional status and reduce the burden of anemia in this population.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e61"},"PeriodicalIF":2.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555401","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":"[Declaration of allergens on food labels: overview of Latin AmericaDeclaração de alergênicos na rotulagem de alimentos: panorama da América Latina].","authors":"Patricia Caro, Clara Elvers","doi":"10.26633/RPSP.2024.58","DOIUrl":"10.26633/RPSP.2024.58","url":null,"abstract":"<p><strong>Objective: </strong>Identify countries that have legislation on mandatory declarations of food allergens, irradiated foods, and transgenic foods on the nutritional labels of packaged foods.</p><p><strong>Methods: </strong>Exploratory study reviewing the health regulations and technical standards for foods in Latin American countries in order to gather information on declarations of allergens, trace allergens, irradiated foods, and transgenic foods. The information search was carried out through the countries' government web pages. Presentation of the results is descriptive and narrative.</p><p><strong>Results: </strong>Of the 19 countries reviewed, 89% require a declaration of allergens on their nutrition labeling, 76% have legislation that explicitly require a statement on trace allergens, and 82% follow <i>Codex Alimentarius</i> recommendations with some modifications of food categories.</p><p><strong>Conclusions: </strong>Three pending challenges in the Region are: requiring statements on allergens as a food safety measure; making progress toward improved labeling of trace allergens; and ensuring universal availability of epinephrine.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e58"},"PeriodicalIF":2.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11205258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459045","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":"[Social medicine and the social sciences in Latin America: conceptual tensions for the transformation of public health in the 20th centuryMedicina social e ciências sociais na América Latina: tensões conceituais para a transformação da saúde pública no século XX].","authors":"Arachu Castro","doi":"10.26633/RPSP.2024.56","DOIUrl":"10.26633/RPSP.2024.56","url":null,"abstract":"<p><p>The development of public health in Latin America during the 20th century combined, early on, the social medicine framework on the social, political, and environmental origins of disease with the contributions of medical anthropological fieldwork. Despite the hegemony of the medical model, the surge of the preventive medicine framework further legitimized the involvement of social scientists in the study of the multicausality of disease. However, the limitations brought by the preventive medicine model's lack of historical and political contextualization gave way to the Latin American social medicine movement, which was grounded in historical materialism, and the development of both critical epidemiology and critical medical anthropology.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"48 ","pages":"e56"},"PeriodicalIF":2.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11205259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459046","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}