Western Honduras Research Articles

Population-based Study of Gastric Cancer Survival and Associations in Rural Western Honduras.

Two-thirds of global cancer occur in low/middle income countries (LMICs). Northern Central America is the largest LMIC region in the western hemisphere, and lack cancer registries to guide cancer control. We conducted a gastric cancer (GC) survival study in rural western Honduras, characterized as having among the highest GC incidence rates in Latin America. The cohort of incident GC diagnosed between 2002-2015 was studied with active follow-up, with household visits. The regional gastric cancer registry was primary for case identification, with completeness examination with hospital data and national death certificates. Cox regression models were used for survival calculations. Survival follow-up was achieved in 741/774 patients (95.7%). Household interviews were conducted in 74.1% (n=549). 65.7% were male, median age at diagnosis was 64 years, 24.5% were <55. 43.9% of tumors had pyloric obstruction. 45.2%, 43.2%, and 7.3% of histology was intestinal, diffuse, and mixed, respectively. 24.7% patients received treatment. 5-year survival rates were 9.9% for both males and females, 7.7% for age <45, and 7.9% for diffuse GC. Median survival time was 4.8 months (95%CI,4.2-5.6). In the final Cox regression model including age, sex, Lauren subtype, and poverty index, only treatment was significantly associated with survival (HR 2.43, 95%CI,1.8-3.2). Markedly low gastric cancer 5-year survival rates are observed in rural Central America. The majority of patients present with advanced disease, and a minority have access to therapy. The findings have implications for cancer control in the Central America LMICs and for U.S. Latino populations.

Analysis of dry matter and bromatological compounds of fruit and vegetable products from western Honduras

Este trabajo se centra en la evaluación del rendimiento de 23 productos hortofrutícolas de la región del Occidente de Honduras, se determinó materia seca y contenido de humedad en las materias primas, en una muestra de 100 (g) de fruta fresca, de igual manera se determinó mediante análisis bromatológico, en una muestra de materia seca del 100 (g), se estableció el porcentaje de participación de proteína, hidratos de carbono, extracto etéreo o lipídico, fibra y ceniza de cada producto estudiado, se evaluó preparando dos repeticiones de cada muestra y/o tratamiento, a 105 grados celsius y tiempo entre seis (6 hr) a (12 hr), diseñando el potencial predictivo relativa de un modelo exponencial, está denotada, los R² igual o mayor si su nivel de significación es 0.05, el correspondiente nivel de confianza mayor igual a 0.95, obteniendo el siguiente resultado. La cebolla nombre científico (Allium cepa) variedad amarilla o Vidalia, R² = 0.9848, potencial de predicción de un modelo exponencial está denotada R² entre más cercana a 1 es mejor es el modelo de ecuación exponencial, papa sin cáscara (Solanum tuberosum), potencial de predicción R² = 0.9865, mango verde tierno (Mangifera indica), R² = 0.9734, Fresa (Fragaria × ananassa), R² = 0.9785, papa con cáscara (Solanum tuberosum), R² = 0.9616, Tomate (Solanum lycopersicum), variedad Cherokee, R² = 0.964, Zanahoria con cáscara (Daucus carota), R² = 0.9621, Chile (Capsicum annuum), variedad Jalapeño, R² = 0.9674, Piña con cáscara (Ananas comosus), variedad azucaron, R² = 0.9548, Melón con cáscara (Cucumis melo), variedad cantaloupe, R² = 0.9548; Intervalo de confianza a 95%, se debe mejorar los protocolos, para lograr eficiencia en la predicción ejemplo manzana verde importada (Granny Smith), la potencia predictiva relativa de un modelo exponencial está denotada por R² = 0.9409, chayote (Sechium edule), R² = 0.9167, chile morrón de color verde (Capsicum annuum), predicción estadística de R² = 0.9058, Aguacate (Persea Americana) variedad Hass, R² = 0.9135, Sandía con cáscara (Citrullus lanatus), R² = 0.9406. En las siguientes muestras del ensayo es necesario mucha más investigación, ya que el potencial predictivo relativo de un modelo exponencial, está por debajo de 90%, lo más recomendable es hacer más repeticiones en nuevas investigaciones para optimizar el modelo de predicción de la curva exponencial, Rambután pulpa (Nephelium lappaceum), potencial de predicción de R² = 0.6879, piña pulpa (Ananas comosus), variedad azucaron, R² = 0.8332, Rambután con cáscara (Nephelium lappaceum), R² = 0.8002, esto probablemente debido a que los tiempos de peso de muestras no fueron eficientes, temperatura del horno no homogénea, muestras más cercanas a la resistencia del horno experimentan mayor pérdida de humedad, por lo cual se debe establecer los protocolos adecuados para lograr un experimento con mayor nivel de confianza, para las muestras por debajo de 95%. Con la estimación de las variables térmicas como ser calor específico y la conductividad térmica encontramos que existe una relación directa con el contenido de agua de la materia prima, de igual modo no existe ninguna relación con el porcentaje de materia seca de estas materias primas; mismos que son un aporte para ser utilizados como datos primarios en análisis termodinámicos cuando son transformadas estas materias primas agrícolas.

Assessment of handling practices for maize by farmers and marketers in food-insecure regions of Western Honduras

The objective of this study was to understand the maize production chain in the Republic of Honduras, and to identify potential obstacles hindering grain end-quality. Seventy-one municipalities across six departments of Western Honduras were surveyed: Copán, Intibucá, La Paz, Lempira, Ocotepeque, and Santa Bárbara. A total of 871 surveys were collected, out of which 725 were from rural areas and 146 from urban areas. The sampling design reflected population density and population-based indicators from USAID's Feed the Future initiative, such as poverty level and prevalence of underweight non-pregnant females between the ages of 15 and 49. Further, indicators associated with underdevelopment in children were also considered. Survey instruments designed for either maize farmers or maize marketers were used to collect data including seed source, type planted, intercropping, time of harvest, drying and storage practices, quality control, and consumption patterns. Farmers preferred to plant criolla (native) maize (81–96%), although non-native varieties were also grown and consumed (3–13%). Following harvest, sun drying is the most used method (14–40%) for moisture control. Farmers reported maize spoilage resulting primarily from inadequate drying and pest damage (56–82%). Although aware of this, up to 28% of the producers reported not performing preventive grain inspections in the course of storage. Maize marketers typically sourced their grain within the department (33–71%), with a smaller fraction (0–8%) also obtaining maize from other departments or neighboring countries. Mirroring farmers, visual quality checks by marketers occurred primarily at initial storage (36–69%) and decreased in frequency as storage time lengthened. Given that both studied groups of farmers and marketers continue to rely on traditional practices, and corrective rather than preventive measures, the likelihood of low-quality product and risk for mycotoxin contamination is exacerbated. Based on these findings, achieving food security for the region of study will require a transformation in pre- and post-harvest handling practices.

Local food system and household responses to external shocks: the case of sustainable coffee farmers and their cooperatives in Western Honduras during COVID-19

IntroductionThe COVID-19 pandemic lockdowns (people confined to home, with movement restrictions) presented an external shock to livelihoods and food systems worldwide, most severely affecting vulnerable households in low-income countries. While evidence is available regarding how COVID-19 generally affected low-income countries, the specific dynamics of local food-system responses and sustainably-certified coffee farm households has not been examined, despite them being usually deemed to be more resilient to shocks. This research examines how local food systems in Honduras changed during lockdowns, how certified coffee households coped with the shock, especially food insecurity, and the potential role of coffee cooperatives in increasing households’ resilience under future shocks and stressors.MethodsWe applied a mixed-methods approach that combined a structured household survey with semi-structured qualitative interviews with 91 households, 6 cooperative representatives, and 18 food-system representatives.ResultsWe found that coffee-income-dependent households experienced greater food insecurity during lockdown than coffee households with diversified incomes. Before lockdown the local food system was highly dependent on external fresh food from outside the state. Food suppliers changed altered fresh-food procurement strategies, mostly to maintain fresh-food availability at the beginning of the pandemic. However, more than half the interviewed households lacked confidence regarding food security, amid rising food prices and local shortages. Certified coffee cooperatives supported their members by providing food assistance, cash transfers, and credit.DiscussionSome of these strategies are difficult to maintain where crises are recurrent and that may render households more vulnerable to future extreme events. Rather, coffee cooperatives could diversify and support their members in growing and marketing additional food crops. This could be a key approach for boosting local food security and strengthening the local food system.

Presence, Co-Occurrence, and Daily Intake Estimates of Aflatoxins and Fumonisins in Maize Consumed in Food-Insecure Regions of Western Honduras.

Foodborne mycotoxins are a significant food safety risk in developing countries. Our objective was to determine the occurrence of and exposure levels to aflatoxins (AFs) and fumonisins (FBs) in maize intended for human and animal consumption in food-insecure regions of western Honduras. Total AFs and FBs were quantified with a monoclonal antibody-based affinity spectrofluorimetric method. FBs were detected in 614/631 samples of maize destined for human consumption at 0.3 to 41 mg/kg (mean, 2.7 mg/kg). Of the 614 positive samples, 147 had FB levels exceeding the U.S. Food and Drug Administration (FDA) advisory threshold of 4.0 mg/kg. AFs were detected in 109/631 samples of maize for human consumption with concentrations between 1.0 and 490 µg/kg (mean, 10 µg/kg). AF levels in 34 samples exceeded the FDA regulatory limit (i.e., 20 µg/kg). The average probable daily intake of AFs in western Honduras ranged from 0 to 260 ng/kg body weight/day, and for FBs, the average probable daily intake ranged from 17 to 53 μg/kg body weight/day. AFs and FBs co-occurred in 106/631 samples with 60 samples containing both toxins at levels greater than the FDA regulatory levels. Samples of maize intended for animal feed had significantly higher AF (mean, 22 µg/kg) and FB (mean, 7.6 mg/kg) contamination levels than those observed in samples destined for human consumption. Thus, the maize supply chain in western Honduras is contaminated with mycotoxins at levels that pose health risks to both humans and livestock. More effective mycotoxin surveillance and implementation of effective mitigation strategies are needed to reduce mycotoxin contamination and exposure.

Farmer-producer organizations during the COVID-19 pandemic: Examining the role of organization-producer relationships on coping, resiliency, and effectiveness

During the COVID-19 pandemic, farmer-producer organizations continued to serve their members. This qualitative study aimed to understand how agricultural farmer-producer organizations assisted their members in bearing the consequences of the COVID-19 pandemic in western Honduras. Through semi-structured interviews with 20 farmer-producer association affiliates and thematic coding of their responses, eight coping mechanism themes were identified: (a) continuous training, (b) seeking and securing external funding for investment, (c) new and safe agricultural markets, (d) value-added food, (e) stable and competitive prices, (f) advocacy for temporary mobility permits, (g) agricultural, financial, and food aid packages, and (h) emotional support. Members felt that these efforts were effective. However, the stability of the farmer-producer organizations was contingent upon the engagement and commitment of the members themselves. Practitioners and farmer-producer organizations can use this study to strengthen formalized social networks in Honduras and similar economic and productive environments. However, further research is still needed to identify the factors which motivate agricultural individuals to engage in farmer-producer organizations.

Trans-Holocene Bayesian chronology for tree and field crop use from El Gigante rockshelter, Honduras.

El Gigante rockshelter in western Honduras provides a deeply stratified archaeological record of human-environment interaction spanning the entirety of the Holocene. Botanical materials are remarkably well preserved and include important tree (e.g., ciruela (Spondias), avocado (Persea americana)) and field (maize (Zea mays), beans (Phaseolus), and squash (Cucurbita)) crops. Here we provide a major update to the chronology of tree and field crop use evident in the sequence. We report 375 radiocarbon dates, a majority of which are for short-lived botanical macrofossils (e.g., maize cobs, avocado seeds, or rinds). Radiocarbon dates were used in combination with stratigraphic details to establish a Bayesian chronology for ~9,800 identified botanical samples spanning the last 11,000 years. We estimate that at least 16 discrete intervals of use occurred during this time, separated by gaps of ~100-2,000 years. The longest hiatus in rockshelter occupation was between ~6,400 and 4,400 years ago and the deposition of botanical remains peaked at ~2,000 calendar years before present (cal BP). Tree fruits and squash appeared early in the occupational sequence (~11,000 cal BP) with most other field crops appearing later in time (e.g., maize at ~4,400 cal BP; beans at ~2,200 cal BP). The early focus on tree fruits and squash is consistent with early coevolutionary partnering with humans as seed dispersers in the wake of megafaunal extinction in Mesoamerica. Tree crops predominated through much of the Holocene, and there was an overall shift to field crops after 4,000 cal BP that was largely driven by increased reliance on maize farming.

Gendered adaptations to climate change in the Honduran coffee sector

Despite the principal role of coffee exports in rural Latin American livelihoods, the literature on gender and climate adaptation in agriculture has paid little attention to this sector. This paper examines gender differences in on-farm and off-farm climate adaptation measures undertaken by smallholder coffee farmers in Western Honduras. We conducted 29 qualitative interviews with women and men coffee farmers in three coffee-dependent villages in Intibucá. We find that participants, regardless of gender, use few on-farm climate adaptation measures, and increasingly rely on off-farm activities such as waged employment and international migration to complement their coffee-based livelihoods. We also find that women farmers utilize fewer adaptation measures due to a gender asset gap and the gender division of labor in coffee-producing households. We conclude that women's limited access to the means of production in coffee-producing communities and their responsibilities for domestic labor impede community resilience to climate change.

Prevalence of Obesity and Metabolic Syndrome in the High Cardiovascular Risk Setting of Rural Western Honduras.

To determine the prevalence of obesity and metabolic syndrome (MS) in the population older than 45 years in rural Western Honduras and contribute to the limited literature on MS in Central America. Descriptive cross-sectional study conducted in the District of Copan. The study includes 382 men and women aged 45 to 75 years. With proper consent, anthropometric parameters, blood pressure, blood sugar, and lipid profile were evaluated. MS was diagnosed by using the National Cholesterol Education Program Criteria - Adult Panel Treatment III (NCEP-ATP III). Data were stored in REDCap (Research Electronic Data Capture) and analyzed with STATA14. Data were collected on 382 patients; of these, 38% were male and 62% female. The prevalence of obesity was 24.1% for both sexes. The prevalence of MS was 64.9%. Prevalence in males and females was 54% and 71%, respectively. Notable parameters were elevated triglycerides (71%), low High-density lipoprotein cholesterol (HDL-C) (63.4%), and abdominal obesity (56.8%). In men, the distribution of MS was more homogeneous, with a mean result of 80% amongst all ages. The overall prevalence of obesity and MS is severely underestimated in rural Honduras. The most remarkable parameter for MS was high triglycerides (71%). Sixty-nine percent of the population has above-normal Body Mass Index (BMI). Public health efforts to control comorbidities and tackle risk factors in this population should take utmost priority.

A Climate Change Vulnerability Assessment Design Framework: The Case of Small-scale Farmers in Western Honduras

Climate change is now affecting every known society. Small-scale farmers in low-income countries are especially vulnerable to climate change because they depend heavily on rain, seasonality patterns, and known temperature ranges. Prioritizing the efforts of building climate change resilience and adaptive capacity for small-scale farmers is essential in achieving Sustainable Development Goals 13, 1, and 2. An important first step towards those efforts is to assess the climate change vulnerability among the population. We propose a Climate Change Vulnerability Assessment Framework Design Framework (CCVA-DF) to guide the design of innovative digital CCVA solutions to enhance the adaptive capacity and climate change resilience of small-scale farmers. The framework outlines modern methods for vulnerability data collection and processing through Remote Sensing and GIS, advanced spatial analysis and modeling for measuring vulnerabilities, and visual analytics to support decision-making in the planning and implementation of suitable interventions. The framework is instantiated into a web application that is used by a real-world organization for transforming household resilience in Western Honduras. The CCVA-DF showcases novel measures of vulnerability using geospatial technology. It provides guidelines to design digital vulnerability assessment tools that can be used by researchers and practitioners worldwide to tackle climate change challenges.

Indigenous tradition, change, and uncertainty in western Honduras: how Lenca potters maintain craft production livelihoods in the face of socioeconomic development

ABSTRACT For the indigenous Lenca people of western Honduras, pottery production represents an economically and spiritually important tradition. Historically exchanged in regional trade networks, pottery is still produced today. However, this tradition is changing due to socioeconomic and political development. Lenca pottery has shifted from utilitarian wares to more aesthetic pieces favored by tourists – a change encouraged by state constructions of national identity. Promotion of what are considered ‘marketable’ indigenous crafts and attractions in the tourism industry has resulted in misconceptions among domestic and international tourists regarding distinct indigenous tradition – like Lenca pottery. Drawing on nine months of fieldwork in the Lenca community of La Campa, Lempira, this research note examines how contemporary pottery tradition may be shaped by state constructions of indigenous heritage and identity, which are reproduced through the national tourism industry. Through the application of neoliberal multiculturalism, this work explores how these political processes restrict Lenca craft producers from benefitting from tourism. To conclude, this article presents empirical evidence suggesting that despite these obstacles, Lenca artisans in La Campa maintain pottery production as a livelihood through innovative choices in altering selling and production methods.

S1612 High Seroprevalence of Helicobacter pylori and CagA/VacA Virulence Factors in Northern Central America

Introduction: Helicobacter pylori (Hp) infection is the leading cause of gastric cancer (GC). Northern Central America is the principal LMIC region in the Western Hemisphere and has among the highest GC incidence. We examined the Hp seroprevalence and active infection, and the Hp virulence factors VacA/CagA positivity of healthy individuals in the region using a novel validated Hp assay. Methods: Healthy volunteers from Western Honduras and Central Guatemala were recruited. The novel Hp Multiplex assay was used to evaluate 13 Hp antigens (CagA, VacA, GroEl, UreA, HP0231, HP0305, NapA, HpaA, HcpC, HP1564, Catalase, Cad, HyuA). Per protocol, Hp positivity was defined as positivity for ≥4 antigens, and active infection was defined as positivity to a combination of 2 out of the 4 antigens (VacA, GroEl, HcpC, HP1564). Descriptive statistics for continuous variables and frequencies for categorical variables were computed. Categorical variables were compared using Chi2. Results: Overall, 1,143 adults were tested with the multiplex assay (Guatemala n=444, Honduras=699). The mean age was 54.2±14.5 years, 46.2% were male, 60% of individuals were from rural settings and 56% lived above >1000 meters. Hp seropositivity was 87%, and 83% had active Hp infection. CagA and VacA seropositivity was 82% and 75% respectively. No significant differences were noted according to country, age group, gender, or rural/urban location. The most frequent occupations were domestic work and agriculture (40% and 19% respectively). Around half (53%) of individuals had a refrigerator, and 34% had an electric or gas stove. 44% and 16% were either current or former tobacco smokers in Guatemala and Honduras, respectively. 43% noted alcohol use (Table). Conclusion: An extremely high seroprevalence of Hp and CagA/VacA is observed in Honduras and Guatemala and is representative of Northern Central America. This correlates with the high burden of GC in the region, and has implications for regional prevention programs as well as immigrant populations in the U.S. Table 1. - General characteristics of population (N=1,143) Total Guatemala Honduras N 1143 444 699 Age, mean (SD) 54.2 (14.5) 55.4 (10.7) 53.4 (16.5) Age, categories 18-45 309 (27.0%) 90 (20.3%) 219 (31.3%) 45-54 297 (26.0%) 138 (31.1%) 159 (22.7%) 55-64 269 (23.5%) 122 (27.5%) 147 (21.0%) >65 268 (23.4%) 94 (21.2%) 174 (24.9%) Sex Female 615 (53.8%) 255 (57.4%) 360 (51.5%) Male 528 (46.2%) 189 (42.6%) 339 (48.5%) Rural setting 683 (59.8%) 272 (61.3%) 411 (58.8%) Altitude (mamsl), mean (SD) 1087.9 (453.7) 1250.8 (644.6) 983.4 (209.2) Altitude ( >1000mamsl) 641 (56.4%) 272 (61.3%) 369 (53.3%) Occupation Professional 38 (3.3%) 9 (2.0%) 29 (4.1%) Technician 39 (3.4%) 2 (0.5%) 37 (5.3%) Artisan or vendor 239 (20.9%) 182 (41.0%) 57 (8.2%) Construction 44 (3.8%) 21 (4.7%) 23 (3.3%) Agriculture 221 (19.3%) 54 (12.2%) 167 (23.9%) Household/domestic work 457 (40.0%) 144 (32.4%) 313 (44.8%) Other or not available 105 (9.2%) 32 (7.2%) 73 (10.4%) BMI, median (IQR) 25.7 (22.7, 29.7) 27.4 (23.9, 30.7) 24.8 (21.9, 28.7) BMI, categories Underweight 36 (3.2%) 5 (1.1%) 31 (4.5%) Normal 471 (41.9%) 148 (33.6%) 323 (47.3%) Overweight 352 (31.3%) 155 (35.2%) 197 (28.8%) Obese 264 (23.5%) 132 (30.0%) 132 (19.3%) Tobacco smoker 310 (27.1%) 196 (44.1%) 114 (16.3%) Recent antibiotic use 78 (6.8%) 55 (12.4%) 23 (3.3%) Refrigerator use 608 (53.2%) 200 (45.0%) 408 (58.4%) Alcohol 488 (42.7%) 321 (72.3%) 167 (23.9%) Electric or gas stove 387 (33.9%) 265 (59.7%) 122 (17.5%) H. pylori serostatus (positive) 993 (86.9%) 387 (87.2%) 606 (86.7%) H. pylori active infection 949 (83.0%) 378 (85.1%) 571 (81.7%) CagA status (positive) 941 (82.4%) 402 (90.7%) 539 (77.1%) VacA status (positive) 861 (75.4%) 368 (83.1%) 493 (70.5%)

Cultures of Creativity: Hieroglyphic Innovation in the Classic Maya Lowlands

Classic Maya hieroglyphic writing displays a coherence across time and space that points to intensive, sustained communication among scribes about what they were writing and how. Yet we know little about what scribal transmission looked like on the ground or what knowledge scribes were conveying among themselves. This article examines the monumental hieroglyphic corpora from two communities, at Copan in western Honduras and at Palenque in Chiapas, Mexico, to illustrate local processes of innovation and exchange that shaped participation in regional transmission. I argue that distinct ‘cultures of creativity’ developed at Copan and Palenque from local elites’ varying understanding of their position in the Maya world and the nature of hieroglyphic inventions. These case studies attest to the multi-faceted nature of scribal production and exchange within a hieroglyphic tradition that remained largely coherent despite never being centrally administered. In addition, the study's palaeographic methods suggest possibilities for tracing dynamics of cultural innovation and transmission in the ancient past at multiple scales of society.

New records and range expansion of &lt;i&gt;Norops sagrei&lt;/i&gt; (Squamata: Dactyloidae) in Honduras highlight the importance of citizen science in documenting non-native species

Populations of Norops sagrei, an anole lizard native to Cuba, the Bahamas, and the Cayman Islands, are established in northern Honduras. Here, we report seven new records in six departments for this species in northern, western, central, and southern Honduras, summarize the invasion progress of N. sagrei in the country, and comment on the importance of citizen science in the documentation of non-native species.

Western Honduras Copán Population-Based Cancer Registry: Initial Estimates and a Model for Rural Central America.

PURPOSEPopulation-based cancer registries (PBCRs) are critical for national cancer control planning, yet few low- and middle-income countries (LMICs) have quality PBCRs. The Central America Four region represents the principal LMIC region in the Western hemisphere. We describe the establishment of a PBCR in rural Western Honduras with first estimates for the 2013-2017 period.METHODSThe Western Honduras PBCR was established through a collaboration of academic institutions and the Honduras Ministry of Health for collection of incident cancer data from public and private health services. Data were recorded using the Research Electronic Data Capture (REDCap) web-based platform with data monitoring and quality checks. Crude and age-standardized rates (ASRs) were calculated at the regional level, following WHO methodology.RESULTSThe web-based platform for data collection, available ancillary data services (eg, endoscopy), and technical support from international centers (United States and Colombia) were instrumental for quality control. Crude cancer incidence rates were 112.2, 69.8, and 154.6 per 100,000 habitants overall, males, and females, respectively (excluding nonmelanoma skin cancer). The adjusted ASRs were 84.2, 49.6, and 118.9 per 100,000 overall habitants, males, and females, respectively. The most common sites among men were stomach (ASR 26.0, 52.4%), colorectal (ASR 5.11, 10.15%), and prostate (ASR 2.7, 5.4%). The most common sites in women were cervix (ASR 34.2, 36.7%), breast (ASR 11.2, 12.3%), and stomach (ASR 10.8, 11.7%).CONCLUSIONThe Copán-PBCR represents a successful model to develop cancer monitoring in rural LMICs. Innovations included the use of the REDCap platform and leverage of Health Ministry resources. This provides the first PBCR data for Honduras and the Central America Four and confirms that infection-driven cancers, such as gastric and cervical, should be priority targets for cancer control initiatives.

AMANTADINE FOR POST-EXPOSURE PROPHYLAXIS IN COVID-19 IN WESTERN HONDURAS

TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: Low –to-middle-income countries (LMIC) have been struggling throughout the coronavirus disease 2019 (COVID-19) pandemic with overwhelmed hospital system and lack of access for novel therapeutics. Remdesivir, the only antiviral approved by the FDA for the treatment of COVID-19, needs to be given intravenously thus requiring admission to the hospital. This might not be feasible for health systems overwhelmed by the viral disease. Amantadine is a drug that has been utilized mainly for patients with neurological diseases, such as Parkinson’s disease. Although it is more commonly used for neurological diseases, it has also been reappropriated for viral illness like H1N1. There have been observational studies noting that patients who take amantadine regularly have not developed the disease and it has even been utilized a therapeutic in patients with known COVID-19 disease with apparent success. The need for cheap, outpatient medications for COVID-19 is paramount and amantadine seems to be a viable option. We sought to describe the characteristics of patients who took amantadine as a post-exposure prophylactic (PEP) medication. METHODS: We conducted a prospective, observational pilot study of patients who visited a covid clinic in a rural area of Western Honduras, from September 1st, 2020 to October 31st 2020. Patients were included if they were older than18 years of age, with mild disease symptoms and had a positive COVID-19 RT-PCR test. Patients included in the study received the A77 protocol, which consist of amantadine 100 mg bid in the first 7 days of disease for a period of 7 days. Oxygen Saturation, C-Reactive Protein(CRP) and Blood Count samples were measured each day while they were on the protocol. RESULTS: A total of 26 patients were enrolled in the A77 PEP protocol, with a median age of 51 years, 19 were male and 7 were female. The median time for protocol initiation was three days after symptoms first appeared. Average oxygen saturation was 95% on room air, the mean CRP level was 28 mg/L. Most patients had no comorbidities with only 2 having diabetes mellitus and one with systemic lupus erythematosus. Home oxygen supplementation was used in 5 patients in the protocol and only 1 patient was hospitalized. CONCLUSIONS: We enrolled 26 patients with mild, confirmed COVID-19 to A77 PEP protocol, with a median age of 51 years. Most of the patients started A77 on their third day of illness, and most maintained a SpO2 of 95% during the course of the trial, with only 5 patients requiring supplemental oxygen and one requiring hospitalization.Amantadine seemed to be an effective therapeutic avenue in preventing patients with COVID-19 to advance to moderate or severe disease. It also seemed to be effective in preventing admission to the hospital. Our findings echo similar studies of amantadine being an effective PEP for patients with COVID-19.We are limited by a small sample size and lack of control group, but our findings can be utilized as hypothesis generating for larger studies regarding the role of amantadine in PEP for COVID-19. CLINICAL IMPLICATIONS: Amantadine seems to be an effective PEP medication for patients with COVID-19, which can be crucial for LMIC struggling with the pandemic and acquisition vaccines. More rigorous studies are required to confirm its effectiveness. DISCLOSURES: No relevant relationships by Balduino Carcamo, source=Web Response No relevant relationships by Orlando Garner, source=Web Response No relevant relationships by Eleazar Montalvan, source=Web Response No relevant relationships by Maria Pineda, source=Web Response

Ornithine decarboxylase (ODC1) gene variant (rs2302615) is associated with gastric cancer independently of Helicobacter pylori CagA serostatus.

The primary cause of gastric cancer is chronic infection with Helicobacter pylori (H. pylori), particularly the high-risk genotype cagA, and risk modification by human genetic variants. We studied 94 variants in 54 genes for association with gastric cancer, including rs2302615 in ornithine decarboxylase (ODC1), which may affect response to chemoprevention with the ODC inhibitor, eflornithine (difluoromethylornithine; DFMO). Our population-based, case-control study included 1366 individuals (664 gastric cancer cases and 702 controls) from Western Honduras, a high incidence region of Latin America. CagA seropositivity was strongly associated with cancer (OR = 3.6; 95% CI: 2.6, 5.1). The ODC1 variant rs2302615 was associated with gastric cancer (OR = 1.36; p = 0.018) in a model adjusted for age, sex, and CagA serostatus. Two additional single nucleotide polymorphisms (SNPs) in CASP1 (rs530537) and TLR4 (rs1927914) genes were also associated with gastric cancer in univariate models as well as models adjusted for age, sex, and CagA serostatus. The ODC1 SNP association with gastric cancer was stronger in individuals who carried the TT genotype at the associating TLR4 polymorphism, rs1927914 (OR = 1.77; p = 1.85 × 10-3). In conclusion, the ODC1 variant, rs2302615, is associated with gastric cancer and supports chemoprevention trials with DFMO, particularly in individuals homozygous for the T allele at rs1927914.

Household food insecurity and health in a high-migration area in rural Honduras

Household food insecurity (HFI) is a significant problem in the developing world. Relationships between HFI and nutrition, physical growth, and development have been elucidated; less is known about the non-nutritional impacts among individuals living in rural areas in low-income countries. The aim of this study was to determine if HFI is a risk factor for suboptimal mental health and overall health in rural Honduras. In a population of 24,696 adults with 176 isolated villages in western Honduras, we collected data on household food insecurity and physical and mental health outcome measures. Using logistic regression with and without adjusting for village and household level unobservables invariant across individual respondents, we show that females (OR: 1.11, p <0.01)), indigenous people (OR: 2:00, p < 0.01), and those planning to migrate (OR: 1.24, p <0.01) have higher odds of experiencing food insecurity. The risks of food insecurity and poor health were mitigated among respondents living where they were born and having multi-generations of relatives living in the same village—a measure of the opportunity and availability of social networks. Living in a food insecure compared to a food secure household was associated with 77 percent higher odds of being depressed, 35 percent higher odds of low overall mental health, and 20 percent higher odds for low overall health.

A uniquely patterned new species of Emesis from Honduras (Riodinidae).

Emesis eleanorae Gallardo & Grishin n. sp. is described from western Honduras. It differs from other species of Emesis Fabricius, 1807 in having a row of prominent iron-gray crescent-shaped postdiscal spots on both wings above, outlined by paler areas basad and mirrored as merlot-colored spots below, with the largest by the forewing costa, and in its females being bright golden-orange in color. Genomic sequence analysis of Emesis reveals that the new species belongs to the subgenus Aphacitis Hübner, [1819] and is sister to the clade containing Emesis diogenia Prittwitz, 1865 and Emesis heteroclita Stichel, 1929, and the clade of these three species is sister to Emesis vulpina Godman & Salvin, 1886.

The Role of Coffee Organizations as Agents of Rural Governance: Evidence from Western Honduras

Territorial governance is the development strategy that encourages the integration of different actors in the rural environment around common interests. Producer organizations emerge as the appropriate means to unify leadership and consensus to overcome market barriers. These producer networks also influence other dimensions of development, to give way to true governance processes. This paper examines the notion of governance agents associated with the production fabric and the extent to which these agents impact the production efficiency and the level of well-being of those who inhabit the territory. For this purpose, the determinants of a governance model are analyzed in a coffee-growing territory made up of 92 municipalities, located in western Honduras. The analysis is based on a panel of data on the number of cooperatives, rural boards, production parameters, and endowments of public goods grouped into 16 indicators at the municipal level. The data set was subjected to structural equation modeling (SEM), given its statistical capacity to explain complex interrelated phenomena. The main result is the definition of a governance model associated with the coffee territory. This model describes an endogenous pattern of interactions between its four components. This statistical configuration broadens the understanding of the role that governance agents play in fostering a kind of virtuous circle in favor of rural development.