Latin America And The Caribbean Countries Research Articles

Nasopharyngeal carriage of Streptococcus pneumoniae in Latin America and the Caribbean: A systematic review and meta-analysis.

Streptococcus pneumoniae is a leading cause of morbidity and mortality globally, causing bacteremic pneumonia, meningitis, sepsis, and other invasive pneumococcal diseases. Evidence supports nasopharyngeal pneumococcal carriage as a reservoir for transmission and precursor of pneumococcal disease. To estimate the pneumococcal nasopharyngeal burden in all age groups in Latin America and the Caribbean (LAC) before, during, and after the introduction of pneumococcal vaccine conjugate (PVC). Systematic literature review of international, regional, and country-published and unpublished data, together with reports including data from serotype distribution in nasopharyngeal carriage in children and adults from LAC countries following Cochrane methods. The protocol was registered in PROSPERO database (ID: CRD42023392097). We included 54 studies with data on nasopharyngeal pneumococcal carriage and serotypes from 31,803 patients. In children under five years old, carriage was found in 41% and in adults over 65, it was 26%. During the study period, children under five showed a colonization proportion of 34% with PCV10 serotypes and 45% with PCV13 serotypes. When we analyze the carriage prevalence of PCV serotypes in all age groups between 1995 and 2019, serotypes included in PCV10 and those included in PCV13, both showed a decreasing trend along analysis by lustrum. The data presented in this study highlights the need to establish national surveillance programs to monitor pneumococcal nasopharyngeal carriage to monitor serotype prevalence and replacement before and after including new pneumococcal vaccines in the region. In addition, to analyze differences in the prevalence of serotypes between countries, emphasize the importance of approaches to local realities to reduce IPD effectively.

Addressing the burden of cervical cancer for Indigenous women in Latin America and the Caribbean: a call for action

Cervical cancer, primarily caused by human papillomavirus (HPV) infection, poses a significant global health challenge. Due to higher levels of poverty and health inequities, Indigenous women worldwide are more vulnerable to cervical cancer than their non-Indigenous counterparts. However, despite constituting nearly 10% of the population in Latin America and the Caribbean (LAC), the true extent of the burden of cervical cancer among Indigenous people in this region remains largely unknown. This article reviews the available information on cervical cancer incidence and mortality, as well as HPV infection prevalence, among Indigenous women in LAC. The limited existing data suggest that Indigenous women in this region face a heightened risk of cervical cancer incidence and mortality compared to non-Indigenous women. Nevertheless, a substantial knowledge gap persists that must be addressed to comprehensively assess the burden of cervical cancer among Indigenous populations, especially through enhancing cancer surveillance across LAC countries. Numerous structural, social and cultural barriers hindering Indigenous women’s access to HPV vaccination and cervical cancer screening worldwide have been identified and are reviewed in this article. The discussion highlights the critical role of culturally sensitive education, community engagement, and empowerment strategies in overcoming those barriers. Drawing insights from the success of targeted strategies in certain high-income countries, the present article advocates for research, policies and healthcare interventions tailored to the unique context of LAC countries.

Prospective Study of Homologous Recombination Repair Gene Mutation Prevalence in Patients With Advanced Prostate Cancer From Latin America: Challenges and Future Approaches.

The prevalence of homologous recombination repair gene mutations (HRRm) in patients with metastatic castration-resistant prostate cancer (mCRPC) in Latin America and the Caribbean (LAC) is unknown. Prevalence of homologous Recombination repair (HRR) gene mutatiOns in patientS with metastatic castration resistant ProstatE Cancer in LaTin America (PROSPECT) aimed to determine this prevalence and to describe the demographic and clinical characteristics of the participants. This was a prospective, cross-sectional, multicenter study across 11 cancer centers in seven LAC countries. After informed consent, all eligible participants underwent genomic testing by provided blood samples for germline HRR testing; they also provided PC tissue blocks if available for somatic HRR testing. Between April 2021 and April 2022, 387 patients (median age, 70 years [49-89], 94.3% Eastern Cooperative Oncology Group 0-1) with mCRPC were enrolled in the study. Almost 40% of them had a family history of cancer, and the overall time from their initial PC and mCRPC diagnosis was 3 years and 1 year, respectively. The overall prevalence of germline HRRm was 4.2%. The mutations detected included the genes CHEK2 (n = 4, 1%), ATM (n = 3, 0.8%), BRCA2 (n = 3, 0.8%), BRIP1 (n = 2, 0.5%), RAD51B (n = 2, 0.5%), BRCA1 (n = 1, 0.3%), and MRE11 (n = 1, 0.3%). The prevalence of somatic HRRm could not be assessed because of high HRR testing failure rates (79%, 199/251) associated with insufficient DNA, absence of tumor cells, and poor-quality DNA. Despite the study's limitations, to our knowledge, PROSPECT was the first attempt to describe the prevalence of HRRm in patients with PC from LAC. Notably, the germline HRRm prevalence in this study was inferior to that observed in North American and European populations. The somatic HRR testing barriers identified are being addressed by several projects to improve access to HRR testing and biomarker-based therapies in LAC.

Challenges for climate change adaptation in Latin America and the Caribbean region

The limited success of international efforts to reduce global warming at levels established in the Paris Agreement, and the increasing frequency and strength of climate impacts, highlight the urgent need of adaptation, particularly in developing countries. Unfortunately, current levels of adaptation initiatives are not enough to counteract the observed impacts and projected risks from climate change in Latin America and the Caribbean (LAC). In this paper, we review and highlight relevant issues that have limited the capacity to transform climate knowledge and parties’ ambitions into action in the region. Current vulnerabilities and climatic impact-drivers in LAC are diverse, complex, and region-specific and their effects are expected to be exacerbated by climate change. However, the advancement of regional and domestic climate agendas has been hindered by scientific gaps, political support, institutional capacity, and financial, technical, human, and economic limitations that are common to many LAC countries. Transforming climate data into multidimensional metrics with useful thresholds for different sectors and understanding their contribution for feasible adaptation strategies are delayed by regional and local conundrums such as lack of inclusive governance, data availability, equity, justice, and transboundary issues. We discuss ways to move forward to develop local and regional climate resilient development actions and a more sustainable future in LAC. The climate science community in LAC needs to strengthen its local, national, and international connections and with decision/policymakers and society to establish a three-way engagement by proposing suitable adaptation actions and international negotiations to reduce the risks and vulnerability associated with climate extremes, climate variability and climate change in the region. The discussions and insights presented in this work could be extrapolated to other countries in the Global South.

Food-Based Dietary Guidelines for Infants in Latin America and the Caribbean: A Systematic Review.

Food-based dietary guidelines (FBDGs) are tools for promoting healthy eating habits. For the population of children under two years old in Latin America and the Caribbean (LAC), there is a lack of reviews analyzing the quality of these guidelines. The objective of this systematic review is to evaluate publicly available FBDGs for the population under two years old in LAC until mid-2023. Guidelines aimed at caregivers of children were included, sourced from government websites in LAC countries and the Food and Agriculture Organization (FAO) portal. Documents targeted at healthcare professionals were excluded. For qualitative analysis, the Agree II guidelines assessment tool and the FAO guide principles for developing healthy and sustainable diets were used. The results showed that more recently released and revised FBDGs with a greater number of pages obtained better scores in both assessments. Additionally, out of the 32 LAC countries, only 13 had these FBDGs available on websites for public access. As a limitation, this study faced challenges in standardizing the searches on government websites. The authors emphasize the need to develop FBDGs for the population under two years old that align with current health and sustainability needs and promote health education.

Epilepsy Care in Latin America and the Caribbean: Overcoming Challenges and Embracing Opportunities.

The burden of epilepsy in the Latin America and the Caribbean (LAC) region causes a profound regional impact on the health care system and significantly contributes to the global epilepsy burden. As in many other resource-limited settings worldwide, health care professionals and patients with epilepsy in LAC countries face profound challenges due to a combination of factors, including high disease prevalence, stigmatization of epilepsy, disparities in access to care, limited resources, substantial treatment gaps, insufficient training opportunities for health care providers, and a diverse patient population with varying needs. This article presents an overview of the epidemiology of epilepsy and discusses the principal obstacles to epilepsy care and key contributors to the epilepsy diagnosis and treatment gap in the LAC region. We conclude by highlighting various initiatives across different LAC countries to improve epilepsy care in marginalized communities, listing strategies to mitigate treatment gaps and facilitate better health care access for patients with epilepsy by enhancing the epilepsy workforce.

Fiscal Consolidation and Income Inequality in Latin America and the Caribbean

This paper estimates the effects of past fiscal consolidations in Latin America and the Caribbean (LAC) on income inequality. For the 13 LAC countries with fiscal consolidation episodes identified by the narrative approach, one percent of GDP fiscal consolidation increases the disposable Gini coefficient by 0.12 percentage point on average in five years. The size of the effect tends to be larger for tax-based consolidations and for non-commodity exporters but broadly similar during booms and slumps.

Зарубежные эксперты о процессах внутриполитической трансформации в странах Латинской Америки в третьем десятилетии XXI века

The article’s introduction includes the main prerequisites for internal political transformation’s process in Latin America and the Caribbean (LAC). The study’s purpose is to identify new trends in the largest countries’ domestic policies in the region in the third decade of the 21st century. The study’s materials are used mainly by Spanish-speaking authors and Spanish-speaking news agencies who most closely and fully know the situations in LAC countries, the objective data from reports of the various UN structures, and independent Englishspeaking researchers invited to Latin American universities. The article’s methodological basis was the scientific principle of objectivity, which it made possible from the available array of information to identify the main directions of transformation taking place in LAC countries in the study period. The systematic approach’s application made it possible to identify the main events in LAC countries that characterize the multi-vector transformation trends. The article’s author identified further perspectives for LAC countries development with the help of special historicalcomparative and historical-genetic methods. The study’s results were the author’s conclusions that the domestic policy of big Latin American countries in the third decade of the 21st century is characterized by a tendency of “catching up” development. There is a noted instability of the domestic political course in the political system of these Latin American countries (from a liberal to a conservative course and vice versa), and the economic models’ frequent change does not give the desired result. The social problems are caused by the main population’s poverty, especially the indigenous one, and these problems cannot be resolved due to transnational migration of the population and transnational crime (from drug trafficking to human trafficking and weapons). All this explains the diversity of the internal political transformation in Latin American countries.

Compliance with eye and foot preventive care in people with self-reported diabetes in Latin America and the Caribbean: Pooled, cross-sectional analysis of nine national surveys

AimsTo estimate the proportion of people with self-reported diabetes receiving eye and foot examinations in Latin America and the Caribbean (LAC). MethodsCross-sectional analysis of national health surveys in nine countries. Adults aged 25–64 years with self-reported diabetes. We quantified the proportion who reported having an eye examination in the last two years or a foot examination in the last year. We fitted multilevel Poisson regressions to assess socio-demographic (age and sex) and clinical (oral hypoglycemic medication and insulin treatment) variables associated with having had examinations. ResultsThere were 7435 people with self-reported diabetes included in the analysis. In three countries (Chile [64%; 95% CI: 56%-71%], British Virgin Islands [58%; 95% CI: 51%-65%], and Brazil [54%; 95% CI: 50%-58%]), >50% of people with diabetes reported having had an eye examination in the last two years. Fewer participants (<50% across all countries) reported having had a foot examination in the last year, with Ecuador having the lowest proportion (12%; 95% CI: 8%-17%). Older people, and those taking oral medication or insulin, were more likely to have eye/foot examinations. ConclusionsThe proportion of eye and foot examinations in people with self-reported diabetes across nine countries in LAC is low.

Barriers to early diagnosis and management of oral cancer in Latin America and the Caribbean.

This study aimed to explore perceived barriers to early diagnosis and management of oral cancer, as well as potential pathways for improvement in Latin America and the Caribbean (LAC). This cross-sectional study used a self-administered online questionnaire created via the Research Electronic Data Capture platform. The survey was distributed to health professionals trained in Oral Medicine, Oral Pathology, Oral and Maxillofacial Surgery, and Dentists with clinical and academic expertise in oral potentially malignant disorder (OPMD) and oral cancer. Data obtained were systematically organized and analyzed descriptively using Microsoft Excel. Twenty-three professionals from 21 LAC countries participated. Major barriers included the limited implementation of OPMD and oral cancer control plans (17.4%), low compulsory reporting for OPMD (8.7%) and oral cancer (34.8%), unclear referral pathways for OPMD (34.8%) and oral cancer (43.5%), and a shortage of trained professionals (8.7%). Participants endorsed the utility of online education (100%) and telemedicine (91.3%). The survey highlights major perceived barriers to early diagnosis and management of OPMD and oral cancer in LAC, as well as potential avenues for improvement.

Concordance between essential medicines lists and diabetes guidelines in Latin America and the CaribbeanConcordância entre as listas de medicamentos essenciais e diretrizes para diabetes na América Latina e no Caribe

Conduct an analysis to determine the existence and updating of national essential medicines lists (EMLs) and clinical practice guidelines (CPGs) for the treatment of diabetes in Latin America and the Caribbean (LAC); and compare the medicines included in each country's list and guidelines both with each other and with those of the World Health Organization (WHO). Cross-sectional study. EMLs and CPGs for diabetes were found on the websites of the Pan American Health Organization and national health authorities. Medicines were noted and analyzed according to pharmacological group, based on the fourth level of nomenclature of the Anatomical Therapeutic Chemical (ATC) classification system. F1 scoring was used to assess the proximity of EMLs to the WHO Model List of Essential Medicines (MLEM). Of the total number of countries, 87.2% have EMLs, and 91% have CPGs (78% and 45% updated in the last five years, respectively). Compared to the six hypoglycemic groups of the MLEM, the EMLs had a median (range) of 6 (4-13) and an F1 score of 0.80; This indicates proper alignment. CPGs had a median (range) of 12 (1-12) hypoglycemic drugs compared to eight in the WHO guidelines. CPGs had a median of 15 more drugs than their respective EMLs. While most LAC countries have EMLs and CPGs for diabetes, the lack of concordance among them limits their effectiveness. It is necessary to align the processes and criteria for the development of these two tools for policymaking on medicines.

India and Latin America: Potential Partners in a Changing World

India’s relations with Latin America and the Caribbean (LAC) have seen an effective change in the last few years. The change reflects the ‘energetic’ foreign policy of India and its increasing dynamism in global politics. The Latin American and the Caribbean region, so far overlooked by India, is increasingly becoming one of the focal points of its various foreign policy overtures. This article draws attention to the growing significance of the Latin American region for India both in terms of resources and a political-diplomatic partnership. Given the recent setbacks of the pandemic, followed by the Ukraine war and the rising tensions between the United States and China, Latin American countries are looking for strategic partners without aligning themselves with any power. While India has growing relations with some LAC countries and has signed several strategic partnerships, it needs to engage with the region much more. Several economic factors favour an increased engagement. Positive perceptions about India in the region also help.

Estrategias para la prevención primaria y secundaria del cáncer gástrico: consenso chileno de panel de expertos con técnica Delfi

IntroductionGastric cancer (GC) is the first cause of cancer-related death in Chile and 6th in Latin America and the Caribbean (LAC). Helicobacter pylori (H. pylori) is the main gastric carcinogen, and its treatment reduces GC incidence and mortality. Esophageal-gastro-duodenoscopy (EGD) allows for the detection of premalignant conditions and early-stage GC. Mass screening programs for H. pylori infection and screening for premalignant conditions and early-stage GC are not currently implemented in LAC. The aim of this study is to establish recommendations for primary and secondary prevention of GC in asymptomatic standard-risk populations in Chile. MethodsTwo on-line synchronous workshops and a seminar were conducted with Chilean experts. A Delphi panel consensus was conducted over 2 rounds to achieve>80% agreement on proposed primary and secondary prevention strategies for the population stratified by age groups. Results10, 12, and 12 experts participated in two workshops and a seminar, respectively. In the Delphi panel, 25 out of 37 experts (77.14%) and 28 out of 52 experts (53.85%) responded. For the population aged 16-34, there was no consensus on non-invasive testing and treatment for H. pylori, and the use of EGD was excluded. For the 35-44 age group, non-invasive testing and treatment for H. pylori is recommended, followed by subsequent test-of-cure using non-invasive tests (stool antigen test or urea breath test). In the ≥45 age group, a combined strategy is recommended, involving H. pylori testing and treatment plus non-invasive biomarkers (H. pylori IgG serology and serum pepsinogens I and II); subsequently, a selected group of subjects will undergo EGD with gastric biopsies (Sydney Protocol), which will be used to stratify surveillance according to the classification Operative Link for Gastritis Assessment (OLGA); every 3 years for OLGA III-IV and every 5 years for OLGA I-II. ConclusionA “test-and-treat” strategy for H. pylori infection based on non-invasive studies (primary prevention) is proposed in the 35-44 age group, and a combined strategy (serology and EGD) is recommended for the ≥45 age group (primary and secondary prevention). These strategies are potentially applicable to other countries in LAC.

The Political Ecology of Climate Remedies in Latin America and the Caribbean: Comparing Compliance between National and Inter-American Litigation

Abstract The climate crisis will continue to affect human and natural systems across Latin America and the Caribbean (LAC). Undoubtedly, this jeopardizes entire communities’ enjoyment of human rights. In that context, the Inter-American Human Rights System (IAHRS) is expected to respond, particularly since its organs have jurisdiction to order remedies over most LAC countries, provided they determine a rights violation. Despite the growing number of domestic human rights-based climate cases in the region, the organs of the IAHRS have yet to adjudicate and order remedies in a case concerning the climate crisis. Against this backdrop, this article inquires how to understand climate remedies from a political ecology perspective to capture the LAC climate litigation experience. Additionally, the article asks what the challenges of implementing such remedies may be. To answer these questions, first, it compares the remedial approaches of domestic courts in six finally decided climate-related cases with those of the Inter-American Court of Human Rights (IACtHR) in ‘anti-extractivist’ cases. Second, it applies a political ecology lens to understand the elements that might hinder the implementation of the identified remedies. The article argues that the socioeconomic cost for States largely determines remedial compliance in domestic climate litigation and the IACtHR’s anti-extractivist litigation. Ultimately, the aim is to anticipate the future of climate remedies and their effectiveness at the IACtHR based on present climate litigation in LAC.

Retraction of health science articles by researchers in Latin America and the Caribbean: A scoping review.

We aimed to conduct a scoping review to assess the profile of retracted health sciences articles authored by individuals affiliated with academic institutions in Latin America and the Caribbean (LAC). We systematically searched seven databases (PubMed, Scopus, Web of Science, Embase, Medline/Ovid, Scielo, and LILACS). We included articles published in peer-reviewed journals between 2003 and 2022 that had at least one author with an institutional affiliation in LAC. Data were collected on the year of publication, study design, authors' countries of origin, number of authors, subject matter of the manuscript, scientific journals of publication, retraction characteristics, and reasons for retraction. We included 147 articles, the majority being observational studies (41.5%). The LAC countries with the highest number of retractions were Brazil (n = 69), Colombia (n = 16), and Mexico (n = 15). The areas of study with the highest number of retractions were infectology (n = 21) and basic sciences (n = 15). A retraction label was applied to 89.1% of the articles, 70.7% were retracted by journal editors, and 89.1% followed international retraction guidelines. The primary reasons for retraction included errors in procedures or data collection (n = 39), inconsistency in results or conclusions (n = 37), plagiarism (n = 21), and suspected scientific fraud (n = 19). In conclusion, most retractions of scientific publications in health sciences in LAC adhered to international guidelines and were linked to methodological issues in execution and scientific misconduct. Efforts should be directed toward ensuring the integrity of scientific research in the field of health.

Las acciones climáticas de América Latina y el Caribe y la cooperación relacionada con China. Climate actions in Latin America and the Caribbean and related cooperated with China

Over recent years, climate change has been a key issue of global concern to the world and the countries in Latin America and the Caribbean (LAC) which have shown increasing interest and actively joined and participated in the global climate governance agreements. Many LAC countries have taken the initiative to propose their own carbon neutrality goals and take measures such as accelerating the energy transition, restoring ecosystems, and cooperating with China in renewable energy sectors, which have led to admirable results. Historical and cultural traditions, as well as economic development needs, are the driving forces for LAC countries’ emphasis on addressing the climate issue. In the future, countries in the region will continue to work towards the goal of carbon neutrality and further strengthen the implementation of relevant policies. However, persistent, creative efforts are called for to overcome the socio-economic challenges brought by the COVID-19 pandemic to achieve carbon neutrality targets. To achieve the goal of carbon neutrality, the governments of LAC countries must continue to adhere to green policies, build social consensus, and increase capital investment. Cooperation within and beyond the region is needed to consolidate the ability of sustainable development and make up for the shortcomings of capital and technology in some countries to assist countries in jointly achieving carbon neutrality goals.

Testicular cancer mortality in Latin America and the Caribbean: trend analysis from 1997 to 2019

BackgroundIn the last decades, an increasing incidence of testicular cancer has been observed in several countries worldwide. Although mortality rates have been variable in many countries, little information is available from Latin America and the Caribbean (LAC). Therefore, we examined mortality trends of testicular cancer in the last two decades.MethodsAge-standardized mortality rates (ASMR) of testicular cancer per 100,000 men-years were estimated using the World Health Organization mortality database from 1997 to 2019. We examined the mortality trends and computed annual percent change (APC) for all ages and the following age groups, 15–29, 30–44, 15–44, and ≥ 45 years.ResultsTen countries had mortality rates greater than 0.43 per 100,000 men, with the highest rates for Chile, Mexico, and Argentina. Significant increases in mortality rates were observed in Argentina, Brazil Colombia, and Mexico in all ages, and < 45 years, while Colombia, Ecuador, Mexico, and Peru reported significant downward trends in males aged ≥ 45 years. Only Chile showed significant decreases for all ages and age groups studied.ConclusionMortality by testicular cancer increased among LAC countries in males of all ages and across age groups. A reduction in mortality rates was observed only in Chilean males of all ages and in men ≥ 45 years in several countries. Strengthening of early detection among symptomatic males may decrease the mortality by this neoplasm.

Transnational organized crime in Latin America: Current trends and prospects for military crime-fighting operations

Transnational organized crime (TOC) is among the most pressing new challenges to international security due to both its direct economic and social repercussions and the threat it poses to the very institution of the sovereign state. This problem is particularly acute in the countries of Latin America and the Caribbean (LAC), which are marked by exceedingly high rates of TOC activity and influence of cross-border criminal groups. This study identifies current trends in the development of TOC in the region, as well as the approaches of the Latin American countries to combating it. In the first section the author advances a hypothesis that TOC is not an anomaly, but an integral part and an attribute of globalization. From this point of view, cross-border criminal groups may be perceived as a specific kind of TNCs. The second section considers the key trends and specific features of organized crime development in LAC countries. The author shows that cross-border criminal groups and TNCs share a number of common traits. In particular, their activities contribute to the erosion of national sovereignty as they seek to oust states from their sphere of interests by both legal and illegal means. The third section examines the current approaches of LAC countries to combating cross-border criminal groups. The author emphasizes the growing role of the armed forces in fighting organized crime, and the increasing militarization of public security on the whole. On the one hand, this trend towards the ‘policialization’ of armed forces shows that the authorities of Latin American states recognize the threat posed by cross-border criminal groups. On the other hand, it indicates their inability to counter this threat effectively. The author concludes that the TOP problem is unsolvable within the existing system of public relations in LAC countries, since it is rooted in the very nature of the current model of globalization.

Human Resources for Care in Latin America and the Caribbean: Current Needs and Future Demands

ObjectivesTo estimate the current gap and the necessary supply of human resources for care (HRC) for older people experiencing severe care dependence in Latin America and the Caribbean (LAC). DesignSimulation study using previous estimations of severe care dependence for LAC countries. Setting and ParticipantsOlder people (aged 65+) experiencing severe care dependence in 26 countries of LAC. MethodsWe calculated the current gap and the necessary supply of HRC in 2020, 2035, and 2050 assuming a mix of complementary human resources, in line with regional standards for long-term care (LTC) schemes, and differing levels of care coverage. ResultsConsidering 100% coverage of LTC services for the population aged 65+ experiencing severe care dependence, the region will need almost 5 million people working full-time in the sector. This figure is expected to increase to more than 14 million by 2050. Nurse assistants and nurses will be the professional profiles in highest demand. In addition, the region requires 2 million rehabilitation professionals in 2020, and this figure will increase to more than 6 million in 2050. Conclusions and ImplicationsThe rapid aging process in LAC will bring several challenges and opportunities to the region. Countries should start designing strategies to reduce the current gaps of HRC to meet older people's care needs in the coming years, in terms of both quantity and competencies, to help ensure that their human rights are met.

Mental health data available in representative surveys conducted in Latin America and the Caribbean countries: a scoping review

BackgroundMental health data from Latin America and the Caribbean countries (LACC) national and international surveys are essential for public health surveillance. This review aimed to identify and describe available mental...