Latin America Countries Research Articles

Sex and authorship in global cancer research

IntroductionResearch is an essential pillar of cancer control and key in shaping regional cancer control agendas. Imbalances in science and technology in terms of lack of female participation have been...

Pandemic risks in PPPs: comparative analysis within developing countries

Globally, Public-private partnerships (PPPs) become a widely adopted method for advancing large-scale infrastructure projects. However, the inherent uncertainties and risks associated with these projects represent a significant managerial challenge, particularly when confronted with unforeseen events such as those triggered by COVID-19. This paper aims to identify and assess risk associated with the pandemic in PPPs in developing nations through a specific form of mixed-methods research, an embedded multiple-case study, involving the PPP programs in two developing countries in Central Asia and Latin America. Through a comprehensive analysis of risk assessment (including probability, severity, and impact) and applying Kendall’s concordance and Cronbach’s alpha tests with the SPSS 26 tool, a comparative examination of these risks between the two countries is conducted. Complementary, the embedded cases were analyzed through the triangulation of project reports, governmental websites, SPV’s websites, and interviews. The findings reveal variations in risk perception and priorities, with less mature PPP programs displaying higher risk aversion and concerns regarding project disruptions; and more developed programs seeking to address short-term liquidity challenges. Risk management strategies are proposed for PPP decision-makers to face unforeseen events more effectively.

Analizando las reglas del juego. Características y efectos de las elecciones primarias presidenciales en Honduras

Objective/Context: What characteristics does the presidential primary system adopt? And what are the effects of the primaries on the Honduran political system? Honduras is among the precursor countries in Latin America to adopt the primary system as a mechanism of internal democracy within party structures to select their presidential, legislative, and municipal candidates. Although parties are not obliged to use primaries to select their candidates, the law mandates it for those political groups that have more than one internal movement. Thus, over the years, after eight experiences—in some political parties—the system has become established. The objective of this work is to analyze the origin of the presidential primary system in Honduras, its characteristics, and its effects on the political system. Methodology: This involves analyzing all primary elections held since their adoption to the present. Conclusions: the evidence indicates that, while the primary election system has allowed for the resolution of internal conflicts within parties, it has also contributed to the consolidation of political clientelism in the country. Originality: this work provides tools for analyzing the process of selecting presidential candidates in a political context of low programmatic competition, clientelism, and high personalism.

Global trends in carbapenem- and difficult-to-treat-resistance among World Health Organization priority bacterial pathogens: ATLAS surveillance program 2018–2022

ObjectivesTo report trends in carbapenem resistance and difficult-to-treat resistance (DTR) among clinical isolates of Gram-negative priority pathogens collected by the ATLAS global surveillance program from 2018 to 2022. MethodsReference broth microdilution testing was performed in a central laboratory for 79,214 Enterobacterales, 30,504 Pseudomonas aeruginosa, and 13,500 Acinetobacter baumannii-calcoaceticus complex isolates collected by a constant set of 157 medical centres in 49 countries in Asia Pacific (APAC), Europe (EUR), Latin America (LATAM), Middle East-Africa (MEA), and North America (NA) regions. MICs were interpreted by 2023 CLSI M100 breakpoints. β-lactamase genes were identified for meropenem-nonsusceptible (MIC ≥2 mg/L) Enterobacterales isolates. ResultsCarbapenem-resistant Enterobacterales (CRE) detection increased (P < 0.05) in APAC, EUR, LATAM, and MEA regions and decreased in NA, while annual DTR percentages increased in all five regions. Carbapenem-resistant P. aeruginosa (CRPA; decreased in MEA region) and carbapenem-resistant A. baumannii-calcoaceticus complex (CRAB; decreased in MEA region and increased in EUR) remained relatively stable over time in all regions, although notably, annual percentages of CRAB and DTR A. baumannii-calcoaceticus complex isolates were consistently >25 percentage points lower in NA than in other regions. For all regions except NA, the majority of changes in CRE percentages could be attributed to hospital-acquired infections. Among meropenem-nonsusceptible Enterobacterales, KPC was the most frequent carbapenemase in NA and EUR each year. NDM was the most prevalent carbapenemase detected in 2022 in other global regions. ConclusionCRE, CRPA, CRAB, and DTR rates vary among global regions over time highlighting the need for continuing surveillance to inform treatment strategies and antimicrobial stewardship.

Do remittances mitigate poverty? Evidence from selected countries in Africa, Asia and Latin America

The overall objective of the Sustainable Development Goals is to end poverty in all its manifestations by 2030. To achieve this, international remittance inflows have been identified as crucial external financing, especially for developing countries, to secure the resources needed to improve the living conditions of the poor in these countries. It is on this premise that this study investigates the nexus between remittances and poverty in selected countries in Asia, Africa and Latin America, given that these regions receive the highest amount of remittances globally. The study uses annual data on 38 top recipients of remittances between 1990 and 2021. To ensure the robustness of the results, the study employs two indicators of poverty: household consumption expenditure and poverty headcount. On the methodological front, the study addresses the issue of cross-sectional dependence in a panel study and also corrects for endogeneity, using both static and dynamic methods of analysis, respectively. Empirical findings from the cross-sectional dependence test confirm the interdependence of countries in the study. Interestingly, the study confirms the optimistic view that remittance reduces poverty in the selected countries. This finding is consistent for the two poverty indicators regardless of the methodology adopted. The study concludes that remittance inflows play a pivotal role in alleviating poverty in the selected countries. Based on the findings, governments in the three regions are advised to devise appropriate policies and structures that can support and channel the proceeds from remittances to productive ventures to reduce the incidence of poverty in their respective countries.

Prevalence, drug resistance, and genotypic diversity of the RDRio subfamily of Mycobacterium tuberculosis in Ecuador: a retrospective analysis for years 2012-2016.

A major sublineage within the Mycobacterium tuberculosis (MTB) LAM family characterized by a new in-frame fusion gene Rv3346c/55c was discovered in Rio de Janeiro (Brazil) in 2007, called RDRio, associated to drug resistance. The few studies about prevalence of MTB RDRio strains in Latin America reported values ranging from 3% in Chile to 69.8% in Venezuela, although no information is available for countries like Ecuador. A total of 814 MTB isolates from years 2012 to 2016 were screened by multiplex PCR for RDRio identification, followed by 24-loci MIRU-VNTR and spoligotyping. A total number of 17 MTB RDRio strains were identified, representing an overall prevalence of 2.09% among MTB strains in Ecuador. While 10.9% of the MTB isolates included in the study were multidrug resistance (MDR), 29.4% (5/17) of the RDRio strains were MDR. This is the first report of the prevalence of MTB RDRio in Ecuador, where a strong association with MDR was found, but also a very low prevalence compared to other countries in Latin America. It is important to improve molecular epidemiology tools as a part of MTB surveillance programs in Latin America to track the transmission of potentially dangerous MTB stains associated to MDR TB like MTB RDRio.

Food insecurity and sociodemographic factors in Latin America during the COVID-19 pandemic.

To understand the association of food insecurity with sociodemographic factors in a sample population in Latin America during the COVID-19 pandemic. This was a multicenter cross-sectional study conducted in 10 countries in Latin America using an online survey through various digital platforms from October 14, 2020 to February 15, 2021. Statistical analysis of data was performed by applying descriptive statistics, chi-square test, and logistic regression analysis. Of a total of 6 357 surveys, 58.2% of respondents experienced food security, 29.3% were slightly food insecure, 9.2% were moderately food insecure, and 3.3% were severely food insecure. Concerning the association food insecurity and sociodemographic variables, there is a significant association in the variables studied, including area of residence, education level, occupation, number of persons in the household, household with children younger than 10 years of age, and socioeconomic level. These findings indicate that sociodemographic factors associated with food insecurity during the COVID-19 pandemic in Latin America were rural residence; complete and incomplete basic and secondary schooling; occupation (homemaker, unemployed, and self-employed); low, medium-low, and medium socioeconomic level; household with more than four persons; and household with children younger than 10 years of age.

Plays and practices as micropolitics in State social institutions.

The aim of this essay is to analyze plays as a central element in the practices that construct micropolitics within the social institutions of the State. The main concepts addressed are: plays, practices, and micropolitics. The analysis focuses on institutions within social fields, emphasizing material size. The hypothesis posits that the size of the organization is inversely proportional to the development of plays within the institutions. This discussion takes place in a context marked by a strong detachment from the public and the state, exacerbating profound social inequalities, nihilism, and aporophobia, alongside a crisis of legitimacy of public institutions in the face of the advance of non-democratic ideas in democratically elected governments in several countries in Latin America and other continents.

Pan American League of Associations for Rheumatology Recommendations for the Treatment of Psoriatic Arthritis.

Psoriatic arthritis (PsA) is chronic disease that compromises multiple domains and might be associated with progressive joint damage, increased mortality, functional limitation, and considerably impaired quality of life. Our objective was to generate evidence-based recommendations on the management of PsA in Pan American League of Associations for Rheumatology (PANLAR) countries. We used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach to adapt the 2019 recommendations of the European Alliance of Associations for Rheumatology. A working group consisting of rheumatologists from various countries in Latin America identified relevant topics for the treatment of PsA in the region. The methodology team updated the evidence and synthesized the information used to generate the final recommendations. These were then discussed and defined by a panel of 31 rheumatologists from 15 countries. Theses guidelines report 15 recommendations addressing therapeutic targets, use of antiinflammatory agents and corticosteroids, treatment with disease-modifying antirheumatic drugs (conventional synthetic, biologic, and targeted synthetic), therapeutic failure, optimization of biologic therapy, nonpharmacological interventions, assessment tools, and follow-up of patients with PsA. Here we present a set of recommendations to guide decision making in the treatment of PsA in Latin America, based on the best evidence available, considering resources, medical expertise, and the patient's values and preferences. The successful implementation of these recommendations should be based on clinical practice conditions, healthcare settings in each country, and a tailored evaluation of patients.

Latin American Consensus on the Treatment of Head and Neck Cancer.

Head and neck squamous cell carcinoma (HNSCC) is well known as a serious health problem worldwide, especially in low-income countries or those with limited resources, such as most countries in Latin America. International guidelines cannot always be applied to a population from a large region with specific conditions. This study established a Latin American guideline for care of patients with head and neck cancer and presented evidence of HNSCC management considering availability and oncologic benefit. A panel composed of 41 head and neck cancer experts systematically worked according to a modified Delphi process on (1) document compilation of evidence-based answers to different questions contextualized by resource availability and oncologic benefit regarding Latin America (region of limited resources and/or without access to all necessary health care system infrastructure), (2) revision of the answers and the classification of levels of evidence and degrees of recommendations of all recommendations, (3) validation of the consensus through two rounds of online surveys, and (4) manuscript composition. The consensus consists of 12 sections: Head and neck cancer staging, Histopathologic evaluation of head and neck cancer, Head and neck surgery-oral cavity, Clinical oncology-oral cavity, Head and neck surgery-oropharynx, Clinical oncology-oropharynx, Head and neck surgery-larynx, Head and neck surgery-larynx/hypopharynx, Clinical oncology-larynx/hypopharynx, Clinical oncology-recurrent and metastatic head and neck cancer, Head and neck surgery-reconstruction and rehabilitation, and Radiation therapy. The present consensus established 48 recommendations on HNSCC patient care considering the availability of resources and focusing on oncologic benefit. These recommendations could also be used to formulate strategies in other regions like Latin America countries.

Assessing the impact of a multidimensional approach and an 8-component bundle in reducing incidences of ventilator-associated pneumonia across 35 countries in Latin America, Asia, the Middle East, and Eastern Europe

BackgroundVentilator associated pneumonia (VAP) occurring in the intensive care unit (ICU) are common, costly, and potentially lethal. MethodsWe implemented a multidimensional approach and an 8-component bundle in 374 ICUs across 35 low and middle-income countries (LMICs) from Latin-America, Asia, Eastern-Europe, and the Middle-East, to reduce VAP rates in ICUs. The VAP rate per 1000 mechanical ventilator (MV)-days was measured at baseline and during intervention at the 2nd month, 3rd month, 4–15 month, 16–27 month, and 28–39 month periods. Results174,987 patients, during 1,201,592 patient-days, used 463,592 MV-days. VAP per 1000 MV-days rates decreased from 28.46 at baseline to 17.58 at the 2nd month (RR = 0.61; 95% CI = 0.58–0.65; P < 0.001); 13.97 at the 3rd month (RR = 0.49; 95% CI = 0.46–0.52; P < 0.001); 14.44 at the 4–15 month (RR = 0.51; 95% CI = 0.48–0.53; P < 0.001); 11.40 at the 16–27 month (RR = 0.41; 95% CI = 0.38–0.42; P < 0.001), and to 9.68 at the 28–39 month (RR = 0.34; 95% CI = 0.32–0.36; P < 0.001). The multilevel Poisson regression model showed a continuous significant decrease in incidence rate ratios, reaching 0.39 (p < 0.0001) during the 28th to 39th months after implementation of the intervention. ConclusionsThis intervention resulted in a significant VAP rate reduction by 66% that was maintained throughout the 39-month period.

Opportunities and challenges of lupus care in Latin America, the Middle East, and Asia-Pacific: A call to action.

Lupus remains a disease with a low prioritisation in the national agendas of many countries in Latin America, the Middle East, and Asia-Pacific, where there is a dearth of rheumatologists and limited access to new or even standard lupus treatments. There is thus an important need for education, advocacy, and outreach to prioritise lupus in these regions to ensure that patients receive the care they need. This article reviews some of the specific challenges facing the care and management of people with lupus in these regions and suggests strategies for improving patient outcomes. Specifically, we review and discuss (with a focus on the aforementioned regions) the epidemiology of lupus; economic costs, disease burden, and effects on quality of life; barriers to care related to disease assessment; barriers to effective treatment, including limitations of standard treatments, high glucocorticoid use, inadequate access to new treatments, and low adherence to medications; and strategies to improve lupus management and patient outcomes. We hope that this represents a call to action to come together and act now for the lupus community, policymakers, health authorities, and healthcare professionals to improve lupus management and patient outcomes in Latin America, the Middle East, and Asia-Pacific.

De la epidemiología de la actividad física a la epidemiología crítica de las prácticas corporales: una propuesta desde Latinoamérica.

This essay aims to analyze the epidemiology of physical activity as a practical and epistemological field in dispute, based on the theoretical framework of international critical epidemiology. From this scientific point of view, the epidemiology of physical activity is radically marked by epistemological-health colonialism. This brand is expressed in the theoretical-practical distance from critical epidemiological thinking formulated in the global south, producing an artificial regional dependency and deep frustration in those who want to generate transformations in contemporary ways of living. It is suggested that a critical epidemiology of body practices is possible and necessary. In other words, the epidemiology developed in the countries of Latin America and the Caribbean can dialectically understand the determination, distribution and social reproduction of the phenomenon of bodily practices, since it resumes its critical formulations and intercultural science.

The Enterics for Global Health (EFGH) Shigella Surveillance Study in Pakistan.

The Enterics for Global Health (EFGH) Shigella surveillance study is a longitudinal multicountry study that aims to estimate incidence rates and document consequences of Shigella diarrhea within 7 countries in Africa, Asia, and Latin America. In addition to a high incidence of childhood diarrhea, Pakistan is facing a problem of antimicrobial resistance in urban and peri-urban areas of Karachi. In Pakistan, EFGH will be conducted in Karachi, which is one of the metropolitan cities bordering the Arabian Sea and has a diverse population of 1.6 million according to the 2017 population census. The study aims to enroll 1400 children aged 6-35 months over 2 years (2022-2024) from 6 health care facilities (Abbasi Shaheed Hospital, Khidmat-e-Alam Medical Centre, Sindh Government Hospital Korangi 5, Sindh Government Hospital Ibrahim Hyderi, Ali Akbar Shah VPT Center, and Bhains Colony VPT Center) situated in Nazimabad and Bin-Qasim town. Moreover, population enumeration and health care utilization surveys from a defined catchment area of health facilities will be conducted to estimate the Shigella diarrhea incidence rates. The study will provide critical data to policy-makers about the burden of Shigella and antimicrobial resistance, which is essential for planning Shigella vaccine trials.

Economic Sustainability is the Road to Follow Towards the Future that is Changing

It is certainly singular that a large part of Western and Eastern society has experienced in the last two years a sudden rise in inflation and there has been great concern about the development and control of the rise in prices. A sudden but not unexpected increase in fossil fuels, in the face of a delay in renewable energy. Apart from the incidence of delays that favored the phenomenon, it must be said that there is a relationship between humanity's strategic objective for full neutrality with the environment and the quality of the development of economies - that is, we will be able to achieve the strategic objective of neutrality if the development of the global economy is also sustainable and supported. Well, the global picture does not seem to correspond to this evidence. Because many countries in Africa, Latin America and others have been grappling with high inflation for a long time. Furthermore, after the ruffle of inflation driven by international costs, we can see that half the globe is grappling with long-term deflation, certainly not affected by the short-term inflation caused by the costs of fossil fuels. Starting from China, which has been sending waves of deflation for some time, and from Europe itself, which welcomes them through the drop in prices of exported products and at the same time the drop in export prices in Europe for reasons of competitiveness. We ask ourselves how it is possible that international cost inflation is compatible with long-term deflation in Europe. Well, international cost inflation increases but tends to decrease when a new price equilibrium is reached. Unlike classical long-term inflation and deflation, which arise due to problems in the unbalanced economy that last over time and are subject to constant acceleration that depends on the state of the economy at the time of its occurrence. It is not easy to bend the sprint of prices, except with the recessive strategy that rebalances the economy and cuts the monetary anomaly at the root. The co-presence of inflation and deflation is not surprising. But only when the growth of inflation depends on the increase in international prices and therefore almost seems to add algebraically to the coexisting classical monetary anomalies (deflation and inflation). Beyond this hypothesis, inflation and deflation cannot coexist. Beyond this hypothesis, inflation and deflation cannot coexist.

Determinan Penerimaan Pajak Penghasilan Badan: Studi Negara Amerika Latin

Latin America as a region with great natural resource potential, still has a narrow tax base due to problems of law enforcement, tax incentives and tariff reductions. The corporate income tax that significantly increases revenue in the Latin America/LAC in 2019 around 3.7 percent of GDP is interesting to study. Therefore, this research was conducted to examine the determinants of corporate income tax revenue in the Latin American. This study uses panel data on 12 countries in Latin America in 2008-2018. The statistical method used is a quantitative method with multiple linear regression. Based on testing, the panel-corrected standard error estimation model is the best model. The results show that all independent variables simultaneously affect tax revenue. The variables of economic growth, FDI inflows, land area, and trade openness partially have significant positive effect on corporate income tax revenues. Meanwhile, the tax attractiveness index variable has significant negative effect on corporate income tax revenue in Latin American. Based on the results of this study, it is necessary to review the international trade policies in the Latin American because trade openness still tends to have no effect and even weaken the positive relationship between FDI inflows and corporate income tax revenues.

Energy imbalance gap was associated with body mass index and sex in Latin American adolescents-results from the ELANS study.

Energy imbalance gap (EIG) is defined as the average daily difference between energy intake (EI) and energy expenditure (EE). This study aimed to examine the associations between EIG and sociodemographic and anthropometric variables in the adolescent population of eight Latin America countries. A total of 680 adolescents aged 15 to 18 were included in this study. The estimation of EI was based on two non-consecutive 24-h dietary recalls. EE was predicted from Schofield equations using physical activity level obtained through the long version of the International Physical Activity Questionnaire. Sociodemographic data and anthropometric measurements were also obtained. A descriptive analysis and multilevel linear regression models were used to examine associations between variables. The mean EI, EE, and EIG were 2091.3 kcal, 2067.8 kcal, and 23.5 kcal, respectively. Argentina had the highest EI and EIG, whereas Chile had the lowest EI and EIG. Males had a higher EI (2262.4 kcal) and EE (2172.2 kcal) than females (1930.1 kcal and 2084.5 kcal), respectively (p < 0.05). Overweight subjects had a lower EIG than did underweight and normal-weight subjects (p < 0.05). Subjects with low socioeconomic status (SES) had a lower EE (2047.0 kcal) than those with a high SES (2164.2 kcal) (p < 0.05). Sex and BMI were associated with EIG in adolescents from Latin America.

Digital manipulation and mass mobilization over the long run: evidence from Latin America

False information flows through social media are a worldwide phenomenon, affecting Latin America in particular, where more than 70% of internet users report growing concern regarding the circulation of fake news, especially through social media platforms. Although the academic literature has studied how governments may be incentivized to disseminate false information, it has concentrated in the electoral context mostly. In this sense, the impact of disinformation on mass mobilization patterns has been less explored, although it is relevant: manipulation through social media can reduce citizens' inclination to protest by directly influencing their preferences or beliefs about the government, acting as a preventive digital repression tool. In fact, governments have efficiently used it in the short run; however, it has not been established if this strategy could work in the long run. Hence, this article explores the long-term relationship between manipulation by the government through social media and the occurrence of mass mobilization to determine whether they are cointegrated. Drawing on the most recent literature on digital repression, manipulation, and mass mobilization and by applying a panel cointegration methodology in nine countries in Latin America (2000–2021), we find that the variables are cointegrated. In addition, we explore the causal (Granger) effect and find a unidirectional link that goes from social media manipulation to mass mobilization.

Bamboo as a Sustainable Building Material for Innovative, Low-Cost Housing Construction

Bamboo is commonly used as a construction material in low-cost housing projects located in tropical and subtropical countries. This practice is especially prevalent in rural areas where bamboo grows naturally and families have experience working with it. Bamboo can be a sustainable building material for homes, even in cases where houses need to be resistant to earthquakes or storms. The traditional bahareque technology was enhanced in Costa Rica and Colombia to make it earthquake resistant. After the year 2000, this technology was transferred to several other countries in Latin America and Asia, gaining recognition as an innovative building technique. Many successful examples of bamboo housing constructions can be found in various countries, where modern architectural solutions are combined with innovative bamboo methods. Local communities can play a crucial role in bamboo processing, allowing residents to actively participate in the construction of their homes under technical supervision. This emphasizes the social sustainability aspect associated with bamboo. Ensuring the durability of bamboo housing constructions is paramount for the longevity of the houses, highlighting the need for technical assistance for self-builders and resident groups. With proper organization, bamboo housing has the potential to become part of the social production of housing.

Protecting vulnerability. An international comparison of social workers as street-level bureaucrats during the COVID-19 lockdown

Protecting vulnerability. An international comparison of social workers as street-level bureaucrats during the COVID-19 lockdown