Regions Of Central America Research Articles

Climate Driven Egg and Hatchling Mortality Threatens Survival of Eastern Pacific Leatherback Turtles

Egg-burying reptiles need relatively stable temperature and humidity in the substrate surrounding their eggs for successful development and hatchling emergence. Here we show that egg and hatchling mortality of leatherback turtles (Dermochelys coriacea) in northwest Costa Rica were affected by climatic variability (precipitation and air temperature) driven by the El Niño Southern Oscillation (ENSO). Drier and warmer conditions associated with El Niño increased egg and hatchling mortality. The fourth assessment report of the Intergovernmental Panel on Climate Change (IPCC) projects a warming and drying in Central America and other regions of the World, under the SRES A2 development scenario. Using projections from an ensemble of global climate models contributed to the IPCC report, we project that egg and hatchling survival will rapidly decline in the region over the next 100 years by ∼50–60%, due to warming and drying in northwestern Costa Rica, threatening the survival of leatherback turtles. Warming and drying trends may also threaten the survival of sea turtles in other areas affected by similar climate changes.

Testing method for measuring corrosion resistance of surface mount chip resistors

Surface mount chip resistors are amongst the simplest and most inexpensive of all components used in electronic circuits and systems. Typically, resistor failure modes include open circuits, resistive shorts or variations in resistance indicating parametric drift or intermittent failure, which in some applications result in overall system failure. Corrosion is currently believed to be the number one failure mechanism for chip resistors deployed in developing markets such as Central and Latin America, Asia, India and Pacific regions where aggressive corrosive conditions are prevalent. The objective of this study is to develop a test to identify or screen out corrosion-susceptible parts. Ten precision chip resistors types representative of resistors in contemporary printed circuit board assemblies are subjected to a well-defined multi-stress screen which comprises thermal cycling and mixed flowing gas exposure. The combination of thermal cycling and corrosive gas exposure is shown to provide an acceptable acceleration test to identify corrosion-susceptible parts by replicating field failures. Currently, no other test method exists which is capable of replicating field failures.

A New Evaluation of Seismic Hazard for the Central America Region

A new evaluation of seismic hazard in Central America has been carried out as part of the cooperation project named RESIS II under the auspices of the Norway Cooperation Agency (NORAD). Several seismic‐hazard experts from Costa Rica, Guatemala, Honduras, Nicaragua, El Salvador, Panama, Norway, and Spain participated in the study, which was aimed at obtaining results suitable for seismic design purposes. The analysis started with a thorough revision of the national seismic catalogs from which a catalog for Central America has been compiled and homogenized to moment magnitude, M w. Seismotectonic models proposed for the region were revised, and a new regional zonation was proposed, taking into account seismotectonic data, seismicity, focal mechanisms, and GPS observations. Besides, ground‐motion prediction equations (GMPEs) for subduction, volcanic, and crustal zones were revised, and the most suitable ones were calibrated with Central American strong‐motion data. Subsequently, a seismic‐hazard analysis was developed in terms of peak ground acceleration (PGA) and spectral accelerations SA ( T ) for periods of 0.1, 0.2, 0.5, 1, and 2 s, by means of the probabilistic seismic‐hazard assessment (PSHA) approach. As a result, different hazard maps were obtained for the quoted parameters, together with uniform hazard spectra (UHS) for six of the capital cities of Central America. Disaggregation was also carried out in these capitals for the target motion given by the PGA and SA (1 s) and obtained for return periods of 500 years and 2500 years. Therefore, the control earthquakes for motions of short and long periods were derived. This is the first study developed in Central America at a regional scale after 10 years. Online Material: Table of the largest Central American earthquakes in historical times.

Analysis of the SNPforID 52-plex markers in four Native American populations from Venezuela

The SNPforID 52-plex single nucleotide polymorphisms (SNPs) were analyzed in four native Venezuelan populations: Bari, Pemon, Panare and Warao. None of the population-locus combinations showed significant departure from Hardy–Weinberg equilibrium. Calculation of forensic and statistical parameters showed lower values of genetic diversity in comparison with African and European populations, as well as other, admixed populations of neighboring regions of Caribbean, Central and South America. Significant levels of divergence were observed between the four Native Venezuelan populations as well as with other previously studied populations. Analysis of the 52-plex SNP loci with Structure provided an optimum number of population clusters of three, corresponding to Africans, Europeans and Native Americans. Analysis of admixed populations indicated a range of membership proportions for ancestral populations consisting of Native American, African and European components. The genetic differences observed in the Native American groups suggested by the 52 SNPs typed in our study are in agreement with current knowledge of the demographic history of the Americas.

Anxiolytic effects of repeated treatment with an essential oil from Lippia alba and (R)-(-)-carvone in the elevated T-maze

Lippia alba (Mill.) N.E. Brown (Verbenaceae) is widely used in different regions of Central and South America as a tranquilizer. The plant's anxiolytic properties, however, merit investigation. The present study evaluated the effects of repeated daily (14 days) intraperitoneal (ip) treatment with an essential oil (EO) from a chemotype of L. alba (LA, chemotype II, 12.5 and 25 mg/kg; N = 6-8) and (R)-(-)-carvone (25 mg/kg; N = 8-12), the main constituent of this chemotype, on male Wistar rats (weighing 250 g at the beginning of the experiments) submitted to the elevated T-maze (ETM). The ETM allows the measurement of two defensive responses: inhibitory avoidance and one-way escape. In terms of psychopathology, these responses have been related to generalized anxiety and panic disorder, respectively. Treatment with the EO impaired ETM avoidance latencies, without altering escape, in a way similar to the reference drug diazepam (P < 0.05) (avoidance 2: control = 84.6 ± 35.2; EO 12.5 mg/kg = 11.8 ± 3.8; EO 25 mg/kg = 14.6 ± 2.7; diazepam = 7 ± 2.1). (R)-(-)-carvone also significantly altered this same response (P < 0.05; avoidance 1: control = 91.9 ± 31.5; carvone = 11.6 ± 1.8; diazepam = 8.1 ± 3.3). These results were not due to motor changes since no significant effects were detected in an open field. These observations suggest that LA exerts anxiolytic-like effects on a specific subset of defensive behaviors that have been implicated in generalized anxiety disorder, and suggest that carvone is one of the constituents of LA responsible for its action as a tranquilizer.

The Evolution of Neurosurgery in Central America

s E s HISTORY In the second half of the 20th century, the first signs of neurosurgery were discovered in different regions of Central America. During archeological explorations in the 1920s and 1940s y Morley from Princeton University, human skulls were unearthed hat had trephinations indicating the reossification of the borders, uggesting the cicatrization or healing process of patients after hysical confrontations or tribal disputes. These skulls were probaly from the period between 400 and 900 AD, before Spanish coloniation. Thesefindingswere similar tofindings amongMayan, Zapoeca, Azteca, and Inca populations that lived inMesoamerica and the ndes. Theuse of sharpobjectsmadeof jade and animal bones by all he different civilizations showed there was a common purpose.

Coccidioidomycosis

Coccidioidomycosis is a fungal infection endemic to the southwestern United States as well as the regions of Mexico, Central America, and South America. Although the majority of infected persons experience self-limited respiratory infections, severe pneumonias and extrapulmonary disseminated disease are responsible for considerable morbidity and mortality, particularly among those with occupational exposures, immunosuppression, and certain high-risk ethnic groups. In this review, we discuss the epidemiology as well as the diagnosis and current therapy of this protean illness.

A Prognostic Index for Acute and Lymphoma Type Adult T-Cell Leukemia/Lymphoma

Abstract 1582▪▪This icon denotes a clinically relevant abstract Background:Adult T-cell leukemia/lymphoma (ATL) is a peripheral T-cell malignancy caused by human T-lymphotropic virus type I (HTLV-1). HTLV-1 is endemic to the southwestern region of Japan, Caribbean basin, Central and South America, and western Africa. A previous report by the Japan Clinical Oncology Group-Lymphoma Study Group (JCOG-LSG) identified five prognostic factors: advanced performance status (PS), high lactic dehydrogenase (LDH), age of 40 years or older, total involved lesions, and hypercalcemia, based on an analysis of 854 patients with newly diagnosed ATL registered between 1983 and 1987. The JCOG-LSG then proposed 4 clinical subtypes: acute, lymphoma, chronic, and smoldering types. In general, the prognosis of acute and lymphoma type ATL is similarly very poor, whereas that of the chronic and smouldering types is better. It has come to the attention of clinicians that there are diverse clinical courses and treatment outcomes among patients with acute and lymphoma type ATL. Therefore, it is necessary to establish a prognostic index (PI) for a risk-adapted approach and improving the quality of clinical trials. The aim of this study was to develop the first PI for acute and lymphoma type ATL (ATL-PI). Patients and Methods:We conducted a nationwide retrospective survey of ATL patients who were newly diagnosed between January 2000 and December 2009, and 1,270 patients with acute and lymphoma type were registered. Fully eligible 807 individuals excluding patients who have received allogeneic hematopoietic stem cell transplantation were used for this analysis, and randomly split the dataset into training (n=404) and validation (n=403) samples. We applied a multivariable fractional polynomial model using continuous variables, and then developed the simplified one using dichotomizing variables. Results:The overall median survival time (MST) for 807 patients was 7.7 months. The Ann Arbor stage (I - II vs. III - IV), performance status (0–1 vs. 2–4), and the three continuous variables of age, serum albumin, and soluble interleukin-2 receptor (sIL-2R) were identified as independent prognostic factors in the training sample. Using these variables, a prognostic model was devised to identify three groups at different levels of risk. In the validation sample, MSTs were 3.6, 7.3, and 16.2 months for patients at high, intermediate, and low risk, respectively (p<0.0001).ATL-PI = 0.65 (if Stage = III or IV) + 0.35 (if PS > 1) + 0.016 × Age (years) − 0.36 × Albumin (g/dL) + 0.37 × log10 (sIL2R (U/mL)) [Display omitted] To make the scoring system simpler and clinically practicable, we also simplified the original ATL-PI by dichotomizing age at 70 years, serum albumin at 3.5 g/dL, and sIL-2R at 20,000 U/mL and subsequently fitted a multivariate Cox model based on these dichotomizations in the training sample. Then, we derived a simplified ATL-PI as follows:Simplified ATL-PI = 2 (if Stage = III or IV) + 1 (if PS > 1) + 1 (if Age > 70) + 1 (if Albmin < 3.5) + 1 (if sIL2R > 20,000)The scores from 0 to 2 were categorized into low risk group, 3 and 4 into intermediate risk, and from 5 to 6 into high risk group. This classification yielded a good separation of OS curves (p<0.0001), and high concordance to the original ATL-PI in the validation sample. Conclusion:We identified 5 prognostic factors in acute and lymphoma type ATL using a multivariable fractional polynomial model, and further simplified it with minimal loss of the original index. The ATL-PI enables us to distinguish 3 different groups by predicting OS at the time of diagnosis. The ATL-PI, the first PI for acute and lymphoma type ATL, may be a promising platform in consideration of the choice of optimal treatment by risk-stratification and for well-controlled clinical trials. Disclosures:No relevant conflicts of interest to declare.

Occupational asthma induced by exposure to lima bean (Phaseolus lunatus)

We report the first case of occupational asthma (OA) due to the exposure to vapors from boiling Phaseolus lunatus in a food processing industry. Phaseolus lunatus, commonly known as the lima bean or butter bean, belongs to the Leguminosae family and is native of the Central America and Andean regions.

World Distribution of Heterobostrychus aequalis Waterhouse (Coleoptera: Bostrychidae)

Heterobostrychus aequalis is a major pest of seasoned hardwood. It attacks many timber and wood from other plant species and caused damage to a broad range of wood products. Their attacks are confined to starch-rich sapwood and often unsuspected until the emergence hole and frass is produced. The repeated introduction of this pest into new areas indicates that it is poorly inspected and ignored. In some cases, this species succeed in establishing its population in the wild. Hence, by providing the world wide distribution of this pest could be the pioneer step in developing better prevention, monitoring, quarantine and control programmes. From the review, it was found that H. aequalis distribute dominantly in tropical and sub-tropical areas. It is widely distributed in Asia, particularly Southeast Asia to Oceania, some parts of Africa, Central America and Caribbean region. The distribution map derived indicates the limits of distribution for H. aequalis to be 40° north and south of the equator. The recent reports and records showed that this pest is potentially becoming a high-risk pest and can establish its population whenever the condition is favourable.

Description of early larval stages of Upogebia vasquezi (Gebiidea: Upogebiidae) reared in laboratory

Upogebia vasquezi inhabits the western Atlantic in the regions of southern Florida, the Bahamas, Central America and Brazil (from the States of Maranhão to São Paulo). Its occurrence has been extended to the coastal region of the State of Pará (northern Brazil). There are few descriptions of the larval development of the 116 known species of Upogebia. The present study offers the first description and illustrations of the first two larval stages (zoeas I and II) of U. vasquezi reared in laboratory. The larval features of U. vasquezi were compared with those of two other species of Upogebia, revealing very similar morphological characteristics among species in zoea I. The main variation in this larval stage was in the segmentation of the maxillulary endopod. In zoea II, the number of setae on the scaphognathite was different among some species of Upogebia. The present study contributes to the available literature on the identification of thalassinidean larvae.

Species delimitation in the continental forms of the genus Epicrates (Serpentes, Boidae) integrating phylogenetics and environmental niche models.

Until recently, the genus Epicrates (Boidae) presented only one continental species, Epicrates cenchria, distributed in Central and South America, but after a taxonomic revision using morphologic characters five species were recognized: E. cenchria, E. crassus, E. maurus, E. assisi, and E. alvarezi. We analyzed two independent data sets, environmental niche models and phylogeny based on molecular information, to explore species delimitation in the continental species of this genus. Our results indicated that the environmental requirements of the species are different; therefore there are not evidences of ecological interchangeability among them. There is a clear correlation between species distributions and the major biogeographic regions of Central and South America. Their overall distribution reveals that allopatry or parapatry is the general pattern. These evidences suggest that habitat isolation prevents or limits gene exchange among them. The phylogenetic reconstruction showed that the continental Epicrates are monophyletic, being E. alvarezi the sister species for the remaining two clades: E. crassus - E. assisi, and E. maurus - E. cenchria. The clade grouping the continental Epicrates is the sister taxon of the genus Eunectes and not of the Caribbean Epicrates clade, indicating that the genus is paraphyletic. There is a non-consistent pattern in niche evolution among continental Epicrates. On the contrary, a high variation and abrupt shifts in environmental variables are shown when ancestral character states were reconstructed on the sequence-based tree. The degree of genetic and ecological divergence among continental Epicrates and the phylogenetic analyses support the elevation to full species of E. cenchria, E. crassus, E. maurus, E. assisi, and E. alvarezi.

Combining chloroplast and nuclear microsatellites to investigate origin and dispersal of New World sweet potato landraces

We analysed a representative collection of New World sweet potato landraces (329 accessions from Mexico to Peru) with both chloroplast and nuclear microsatellite markers. Both kinds of markers supported the existence of two geographically restricted genepools, corresponding to accessions from the north-western part of South America and accessions from the Caribbean and Central America region. Our conservative cpSSRs markers revealed that the divergence between the two haplotype groups is associated with numerous mutation events concerning various markers, supporting the idea that this divergence may be ancient, predating domestication. For both kinds of markers, we found no significant difference in diversity between the two genepools and detected region-specific alleles in both groups. Previous studies have favoured the hypothesis of a single domestication of this crop. Our analysis suggests at least two independent domestications, in Central/Caribbean America and in the north-western part of South America. Sweet potato was then dispersed from these centres throughout tropical America. Comparison of nuclear and chloroplast data suggests that exchanges of clones and sexual reproduction were both important processes in landrace diversification in this clonally propagated crop. Our analysis provides useful tools for rationalizing the conservation and use of sweet potato germplasm collections.

O5-S2.05 Role of regional reference laboratories for sexually transmitted infections in improvement of second generation HIV surveillance experience from the Central America Region

BackgroundWHO/UNAIDS recommends National HIV/AIDS and Sexually Transmitted Infection STI) Control Programs to implement integrated HIV, STI and behavioural surveillance to assess the disease burden, and to monitor the temporal trends...

Peperitas en Costa Rica

El presente trabajo describe petrográfica y genéticamente, una serie de hallazgos de peperitas como ejem-plos de coexistencia espacial y temporal del magmatismo con la sedimentación en Costa Rica. Los casos se presentanen complejos ígneos básicos (ofiolitas) variando desde mezclas incompletas (megabloques de radiolaritas con diabasasen el Complejo de Nicoya) hasta mezclas completas en varios grados de calizas pelágicas del Maastrictiano-Paleoceno (Formación Golfito) o del Paleoceno con basaltos (Subcomplejo Quepos o Formación Tulín) para dar peperitas bre-choides y bulbosas. Dentro del arco Oligo-Mioceno, se tienen ejemplos a lo largo de la cordillera de Talamanca y susestribaciones, así como en las llanuras de Sarapiquí, representados por peperitas brechoides, fluidales y bulbosas encuerpos de lava latiandesíticos (Formación Pacacua) o chimeneas peperíticas brechoides en ignimbritas (MiembroMata de Limón), o posibles peperitas brechoides en los depósitos de flujos de lava del prospecto minero de Crucitas(Formación Cureña), o simples posibles peperitas brechoides en flujos de lava andesíticas (Formación Pacacua en Tala-manca), o como brechas hidroclásticas con fragmentos de composición dacítica de Carbonal en Guanacaste, justamenteentre las playas Cabuyal y Naranjo. Todas ellas serían los equivalentes proximales del vulcanismo explosivo, efusivoy subvolcánico (domos endógenos y criptodomos) y su concomitancia con la sedimentación fluvial. En el Cuaternario,un ejemplo se da en la base de la Formación Tiribí al contacto con el lacustre de Palmares. Se incluyen en el presentetrabajo, además, casos posibles o potenciales. Se espera que la descripción e interpretación de este tipo de rocas ayudea su identificación en otras regiones de Costa Rica y Centroamérica en general, así como una fuente potencial para laprospección de metales valiosos.

Phylogeographic structure of Teretrius nigrescens (Coleoptera: Histeridae) predator of the invasive post harvest pest Prostephanus truncatus (Coleoptera: Bostrichidae)

The invasive larger grain borer Prostephanus truncatus (Horn) is the most important pest of farm-stored maize in Africa. It was introduced into the continent from Mesoamerica in the late 1970s and by 2008 had spread to at least 18 countries. Classical biological control using two populations of the predator Teretrius nigrescens Lewis achieved long-term and cost effective control in warm-humid areas, but not in cool and hot-dry zones. The present study investigated the phylogenetic relationships between geographical populations of the predator. Ten populations of T. nigrescens were studied using randomly amplified polymorphic DNA polymerase chain reaction (RAPD-PCR), sequence analysis of mitochondrial Cytochrme oxydase 1 (mtCOI) gene and ribosomal internally transcribed spacers (ITS) 1, 5.8S and ITS2. The mtCOI variation revealed two clades associated with geographical regions in Central America. It also reveals a significant isolation by distance between populations and considerable genetic shifts in laboratory rearing. RAPD-PCR did not reveal any potential SCAR diagnostic markers. The ITS variation mainly involved insertions and deletions of simple sequence repeats even within individuals. This study reveals the existence of two different mitochondrial lineages of the predator, associated with the geographical origin of populations distinguishable by fixed mutations on the mtCOI gene. The populations of T. nigrescens released in Africa belonged to two different clades from Meso America, namely south (released in West Africa) and north (released in eastern Africa). However, more polymorphic markers are required to clarify the observations in demographic time scales.

Economics of Establishing and Producing Pitaya in Southern Florida: A Stochastic Budget Analysis

Pitaya (Hylocereus spp.), a climbing vine of cactus species native to the tropical forest regions of Mexico, Central America, and South America, has gained the attention of many southern Florida growers. Between 2006 and 2010, pitaya production has grown 6-fold. Several factors are responsible for the increased attention being given to this crop; chief among these is the promise of high net returns stemming from the current strong demand for the fruit within an increasing U.S.–Asian population and among mainstream health-conscious U.S. consumers who are lured by the high antioxidant properties and other reported health benefits associated with the fruit. However, the downside risk associated with producing and marketing the fruit needs also to be taken into consideration before dedicating a significant amount of resources to large-scale plantings of pitaya. This article provides information on the financial feasibility of establishing and operating a 5-acre pitaya orchard in southern Florida and assesses the risks of doing so. In conducting our analysis, we use deterministic and stochastic budgeting models, including stochastic yields and prices, to calculate the financial returns. Both the deterministic and simulation risk analysis results suggest that operating a pitaya orchard would likely be profitable over a 20-year planning horizon. Despite the favorable outcome of the analysis, southern Florida growers are advised to proceed with caution, as the market for the crop could easily be oversupplied by domestic and foreign competitors.

Modelling risk hurricane elements in potentially affected areas by a GIS system

In the last decade, modelling hurricanes in potentially affected areas using geographical information systems (GIS) and geospatial cyberinfrastracture (GCI) has become a major topic of research. Despite some basic approaches, some unsolved questions are still under discussion. The disastrous effects of hurricanes on communities are well known, however there is a need to better understand the hazard contributions of the different components related to a hurricane, such as storm surges, floods and high winds. In this paper, the selected approach is to determine an onset zoning from a set of attributes that are considered to govern the hurricane while examining the influence of each individual component that produces the final exposure. To this end, this study assesses the different components using parameters derived from topography, bathymetry and hurricane physical indexes. Key attributes are the river network, the topography, the wetness index and the offline bathymetry. Complementary data include the CMORPH rain dataset and the hurricane track together with its structure model, both based on National Oceanic and Atmospheric Administration (NOAA) datasets. Total hazard results were then overlaid with population data in the overall assessment of elements at risk. The approach, which made use of a number of available global and free datasets, was then validated on a regional basis using ground data collected by the World Food Programme (WFP) over the study area (Central America region) for a specific hurricane.

Improvements to water purification and sanitation infrastructure may reduce the diarrheal burden in a marginalized and flood prone population in remote Nicaragua

BackgroundThe isolated northern region of Nicaragua has one of the highest rates of diarrheal disease in Central America. Political and environmental hardships faced by inhabitants of this region are contributing factors to this health inequity. The aim of this study was to assess the relationship between water and latrine infrastructure and the prevalence of diarrhea in this region.MethodsA population-based, cross-sectional survey of women of reproductive age was conducted in the Sahsa region of northern Nicaragua in July, 2009. Households were selected by two stage cluster sampling methodology. A questionnaire was administered in Spanish and Miskito with assessment of household and socioeconomic conditions, sanitation practices, and health care access. Diarrhea prevalence differences at the household level over a two week reporting period were estimated with a standardized instrument which included assessment of water treatment and latrine use and maintenance.ResultsThere were 189 women enrolled in the current study. The use of water purification methods, such as chlorine and filters, and latrine ownership were not associated with reduced prevalence of household diarrhea in the two week reporting period. Latrine overflow, however, was associated with an increased prevalence of diarrhea during the same two week period [adjusted prevalence difference and 95% CI: 0.19 (0.03, 0.36)].ConclusionsSimple, low cost interventions that improve water and latrine infrastructure may reduce the prevalence of diarrheal disease in the isolated regions of Nicaragua and Central America.

Using Historical Vital Statistics to Predict the Distribution of Under-Five Mortality by Cause

Cause-specific mortality data is essential for planning intervention programs to reduce mortality in the under age five years population (under-five). However, there is a critical paucity of such information for most of the developing world, particularly where progress towards the United Nations Millennium Development Goal 4 (MDG 4) has been slow. This paper presents a predictive cause of death model for under-five mortality based on historical vital statistics and discusses the utility of the model in generating information that could accelerate progress towards MDG 4. Over 1400 country years of vital statistics from 34 countries collected over a period of nearly a century were analyzed to develop relationships between levels of under-five mortality, related mortality ratios, and proportionate mortality from four cause groups: perinatal conditions; diarrhea and lower respiratory infections; congenital anomalies; and all other causes of death. A system of multiple equations with cross-equation parameter restrictions and correlated error terms was developed to predict proportionate mortality by cause based on given measures of under-five mortality. The strength of the predictive model was tested through internal and external cross-validation techniques. Modeled cause-specific mortality estimates for major regions in Africa, Asia, Central America, and South America are presented to illustrate its application across a range of under-five mortality rates. Consistent and plausible trends and relationships are observed from historical data. High mortality rates are associated with increased proportions of deaths from diarrhea and lower respiratory infections. Perinatal conditions assume importance as a proportionate cause at under-five mortality rates below 60 per 1000 live births. Internal and external validation confirms strength and consistency of the predictive model. Model application at regional level demonstrates heterogeneity and non-linearity in cause-composition arising from the range of under-five mortality rates and related mortality ratios. Historical analyses suggest that under-five mortality transitions are associated with significant changes in cause of death composition. Sub-national differentials in under-five mortality rates could require intervention programs targeted to address specific cause distributions. The predictive model could, therefore, help set broad priorities for interventions at the local level based on periodic under-five mortality measurement. Given current resource constraints, such priority setting mechanisms are essential to accelerate reductions in under-five mortality.