scholarly journals Chagas disease prevalence in pregnant women: migration and risk of congenital transmission

2016 ◽  
Vol 10 (09) ◽  
pp. 895-901 ◽  
Author(s):  
Rodolfo A Kolliker-Frers ◽  
Ivan Insua ◽  
Gabriela Razzitte ◽  
Francisco Capani
Keyword(s):  
Pregnant Women ◽  
Chagas Disease ◽  
Latin American ◽  
The United States ◽  
Serological Tests ◽  
Cross Sectional ◽  
Congenital Transmission ◽  
The Public ◽  
Endemic Areas ◽  
The Impact

Introduction: Argentina has been a preferential target for Bolivian immigrants for decades. The relatively recent migratory flux includes Germany, France, the United States, Australia, Japan, and some Latin American countries. The aim of this cross-sectional study was to describe the prevalence of Chagas disease in pregnant women, analyzing the Bolivian-specific Chagas prevalence as the main contributor of migratory populations from Chagas disease-endemic areas to Buenos Aires city, Argentina, and to evaluate the impact of these migrant influxes on the process of the "urbanization" of the disease in reference hospital José Maria Ramos Mejia (JMRM). Methodology: Overall, 21,332 pregnant women (100%) between 15 and 49 years of age derived from the public maternity service of JMRMH were studied. Serology data was obtained from registered serological diagnosis data, consisting of three different serological tests performed at the Public Parasitology Unit. Results: Although general prevalence decreased during the analyzed period, the specific prevalence of pregnant women from Bolivian origin showed a sustained growth during 1983–2013. Solely 5% of the total pregnant women population from Bolivia contributed to one third of the total Chagas prevalence. Conclusions: This study showed that a cohort of pregnant women from Bolivia who attended JMRMH during the period 1983–2007 constituted a population at risk for congenital transmission. Increased migration from endemic areas of Bolivia might potentially increase the prevalence of Chagas disease among pregnant women. In addition, this study highlights the importance to analyze specific prevalence according to endemic areas to determine the profiles of potential hidden prevalence.

scholarly journals American Society of Clinical Oncology–Sponsored Oncology Student Interest Groups in Latin America

2020 ◽  
pp. 1439-1445
Author(s):  
Andrea Anampa-Guzmán ◽  
Andrea Denise Brito-Hijar ◽  
Cristian Antonio Gutierrez-Narvaez ◽  
Anthony Raul Molina-Ruiz ◽  
Victor Simo-Mendoza ◽  
...  
Keyword(s):  
Latin America ◽  
Interest Groups ◽  
Student Perceptions ◽  
Latin American ◽  
Medical Oncology ◽  
The United States ◽  
Student Interest ◽  
Training Experience ◽  
Cross Sectional ◽  
The Impact

PURPOSE To describe the characteristics of the members of the ASCO-sponsored Oncology Student Interest Groups (OSIGs) in Latin America. METHODS This was a multicenter cross-sectional study. We surveyed 97 OSIG members from three medical schools in Peru and Mexico. We administered a 60-question survey covering topics including personal background, oncology training experience, and professional practice expectations and preferences. RESULTS A little more than one half of the surveyed OSIG members were female. More than one half had a visa to visit the United States and had an advanced level of English. One half of the OSIG members were also ASCO members. Most participants agreed or strongly agreed that participation in their OSIG increased their interest in cancer-related specialties (94%) and provided professional networking opportunities (94%) and that it was accessible to all students (91%). Most participants believed that their OSIG had sufficient resources to carry out its activities. Students were asked to rate their interest when they entered medical school versus at the time of the survey. Most of the members were strongly interested in pursuing surgical oncology. The majority of members were somewhat interested or very interested in palliative care and medical oncology. CONCLUSION To our knowledge, this is the first study that provides data on medical student perceptions of the Latin American OSIGs sponsored by ASCO. Student perceptions of medical oncology and the impact of OSIGs were generally positive. Given the shortages of oncology specialists in Latin American and elsewhere, strategies to engage medical students in the pursuit of cancer-related careers are becoming increasingly essential.

Trypanosoma cruzi infection in Latin American pregnant women living outside endemic countries and frequency of congenital transmission: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Valeria Colombo ◽  
Andrea Giacomelli ◽  
Giovanni Casazza ◽  
Laura Galimberti ◽  
Cecilia Bonazzetti ◽  
...  
Keyword(s):  
Trypanosoma Cruzi ◽  
Pregnant Women ◽  
Chagas Disease ◽  
Latin American ◽  
Transmission Rate ◽  
Congenital Infection ◽  
Health Concern ◽  
Congenital Transmission ◽  
Global Rate ◽  
Cruzi Infection

Abstract Background Chagas disease, as a consequence of globalization and immigration, is no more restricted to Central and Latin America. Therefore, congenital transmission represents a growing public health concern in non-endemic countries. Methods The aim of this study was to assess the prevalence of Trypanosoma cruzi infection in pregnant Latin American (LA) women living outside endemic countries and the rate of congenital transmission. Data were extracted from studies indexed in PubMed, Scopus, Embase, Lilacs and SciELO databases without language restriction. Two investigators independently collected data on study characteristics, diagnosis, prevalence of infection in pregnant women and congenital infection rate. The data were pooled using a random effects model. Results The search identified 1078 articles of which 29 were eligible regarding prevalence of T. cruzi infection among pregnant women and 1795 articles of which 32 were eligible regarding the congenital transmission rate. The estimated pooled prevalence of T. cruzi infection in LA pregnant women was 4.2% [95% confidence interval (CI): 3.0–5.5]. The prevalence of T. cruzi infection in pregnant women from Bolivia was 15.5% (95% CI: 11.7–19.7) and 0.5% (95% CI: 0.2–0.89) for those coming from all other LA countries. The estimated global rate of congenital transmission was 3.5% (95% CI: 2.5–4.5); excluding poor-quality studies, the rate of congenital transmission was 3.8% (95% CI: 2.4–5.1). Conclusions Prevalence of Chagas disease among LA pregnant women living outside endemic countries is high, particularly in Bolivian women. The rate of vertical transmission of T. cruzi infection is similar to the rate reported in South and Central American countries.

#60: Knowledge of Diagnosis and Management of Chagas-related Heart Disease Among Pediatric Cardiologists in the United States

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S21-S21
Author(s):  
Sanchi Malhotra ◽  
Imran Masood ◽  
Noberto Giglio ◽  
Jay Pruetz ◽  
Pia Pannaraj
Keyword(s):  
United States ◽  
Differential Diagnosis ◽  
Heart Disease ◽  
Chagas Disease ◽  
Latin American ◽  
The United States ◽  
Educational Programs ◽  
Childbearing Age ◽  
American Patient ◽  
The Impact

Abstract Background Chagas disease is a highly pathogenic infection with a prevalence of approximately 5.7 million cases worldwide and greater than 300,000 cases in the United States. Up to 40% of immigrants to the United States are from highly endemic Latin American countries. An estimated 40,000 women of childbearing age in the United States are infected, with a 1–5% risk of vertical transmission. The impact of this disease is extensive, often life-long, and difficult to eradicate. The purpose of our study was to better understand current knowledge and experience among pediatric cardiologists in the United States with the cardiac presentations of Chagas disease to determine where to focus educational programs and critical content. Methods We prospectively disseminated a 19-question survey to pediatric cardiologists via the PediHeart, WSOPC, and Pediatric CHF listservs three times between September and November 2019. The survey included demographic, multiple-choice and Likert-scale questions. We used Qualtrics to ensure anonymity. Respondents outside of the United States were excluded. Results Of 140 responses received, 120 cardiologists treated pediatric patients in the United States. Over half (62.5%) of respondents served a >10% Latin American patient population. Most providers (87%) had not seen a case of Chagas disease in their practice; however, most (72%) also had never tested for Chagas. In response to the statement: “I feel comfortable recognizing cardiac presentations of Chagas disease in children”, (85%) of respondents disagreed. Most respondents selected that they would not include Chagas on their differential diagnosis for cardiac presentations that included conduction anomalies, myocarditis, and/or apical aneurysms (Figure 1). However, when considering patients who recently immigrated from Latin American nations, inclusion of Chagas in the differential diagnosis increased. In response to the statement: “If I was offered a lecture on Chagas-related heart disease, I would be likely to attend,” 87% of respondents agreed. Conclusions In our sample of pediatric cardiologists, very few had seen cases of Chagas disease, albeit very few tested for it or included it in their differential diagnosis. However, most individuals agreed that education on Chagas disease would be worth-while. Education could help ensure these cases are not missed in pediatrics. Future analysis should focus on changes in provider knowledge and/or testing as the incidence grows, or as educational programs are implemented.

THE INSTITUTIONAL EFFECTS OF LEADERSHIP: THE UNITED STATES GENERAL ACCOUNTING OFFICE AND ITS AUDIT REPORT REVIEW PROCESS

1994 ◽  
Vol 21 (1) ◽  
pp. 255-273 ◽  
Author(s):  
Onker N. Basu
Keyword(s):  
United States ◽  
Review Process ◽  
Field Research ◽  
The United States ◽  
Organizational Leaders ◽  
Audit Report ◽  
The Public ◽  
General Accounting Office ◽  
Audit Team ◽  
The Impact

In accounting research, the role of organizational leaders has been underrepresented. The limited research dealing with leadership issues has focused on the impact of leadership on micro activities such as performance evaluation, budget satisfaction, and audit team performance. The impact of leadership on the structure of accounting and audit systems and organizations has been ignored. This paper focuses on the impact that past Comptrollers General have had on the working and structure of one federal audit agency, the United States General Accounting Office (GAO). In addition, it also focuses on the influence of the two most recent Comptrollers General on one important audit related activity, i.e., the audit report review process. Using qualitative field research methods, this paper documents how the organizational leadership impacts its long-term audit practices and thereby influences auditing, especially in the public sector.

scholarly journals Assessing the Risk of Democratic Reversal in the United States: A Reply to Kurt Weyland

2021 ◽  
pp. 1-6
Author(s):  
Matias López ◽  
Juan Pablo Luna
Keyword(s):  
United States ◽  
Comparative Analysis ◽  
Boolean Algebra ◽  
Qualitative Comparative Analysis ◽  
The United States ◽  
American Democracy ◽  
Institutional Dynamics ◽  
The Public ◽  
Original Analysis ◽  
The Impact

ABSTRACT By replying to Kurt Weyland’s (2020) comparative study of populism, we revisit optimistic perspectives on the health of American democracy in light of existing evidence. Relying on a set-theoretical approach, Weyland concludes that populists succeed in subverting democracy only when institutional weakness and conjunctural misfortune are observed jointly in a polity, thereby conferring on the United States immunity to democratic reversal. We challenge this conclusion on two grounds. First, we argue that the focus on institutional dynamics neglects the impact of the structural conditions in which institutions are embedded, such as inequality, racial cleavages, and changing political attitudes among the public. Second, we claim that endogeneity, coding errors, and the (mis)use of Boolean algebra raise questions about the accuracy of the analysis and its conclusions. Although we are skeptical of crisp-set Qualitative Comparative Analysis as an adequate modeling choice, we replicate the original analysis and find that the paths toward democratic backsliding and continuity are both potentially compatible with the United States.

scholarly journals Current knowledge of Chagas-related heart disease among pediatric cardiologists in the United States

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanchi Malhotra ◽  
Imran Masood ◽  
Noberto Giglio ◽  
Jay D. Pruetz ◽  
Pia S. Pannaraj
Keyword(s):  
United States ◽  
Differential Diagnosis ◽  
Heart Disease ◽  
Chagas Disease ◽  
Latin American ◽  
Current Knowledge ◽  
Parasitic Infection ◽  
The United States ◽  
Cardiac Complications ◽  
The U.S

Abstract Background Chagas disease is a pathogenic parasitic infection with approximately 8 million cases worldwide and greater than 300,000 cases in the United States (U.S.). Chagas disease can lead to chronic cardiomyopathy and cardiac complications, with variable cardiac presentations in pediatrics making it difficult to recognize. The purpose of our study is to better understand current knowledge and experience with Chagas related heart disease among pediatric cardiologists in the U.S. Methods We prospectively disseminated a 19-question survey to pediatric cardiologists via 3 pediatric cardiology listservs. The survey included questions about demographics, Chagas disease presentation and experience. Results Of 139 responses, 119 cardiologists treat pediatric patients in the U.S. and were included. Most providers (87%) had not seen a case of Chagas disease in their practice; however, 72% also had never tested for it. The majority of knowledge-based questions about Chagas disease cardiac presentations were answered incorrectly, and 85% of providers expressed discomfort with recognizing cardiac presentations in children. Most respondents selected that they would not include Chagas disease on their differential diagnosis for presentations such as conduction anomalies, myocarditis and/or apical aneurysms, but would be more likely to include it if found in a Latin American immigrant. Of respondents, 87% agreed that they would be likely to attend a Chagas disease-related lecture. Conclusions Pediatric cardiologists in the U.S. have seen very few cases of Chagas disease, albeit most have not sent testing or included it in their differential diagnosis. Most individuals agreed that education on Chagas disease would be worth-while.

scholarly journals Impact of temperature and relative humidity on the transmission of COVID-19: a modelling study in China and the United States

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043863
Author(s):  
Jingyuan Wang ◽  
Ke Tang ◽  
Kai Feng ◽  
Xin Lin ◽  
Weifeng Lv ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Relative Humidity ◽  
Human Mobility ◽  
The United States ◽  
Reproductive Number ◽  
Cross Sectional ◽  
The Usa ◽  
Higher Temperature ◽  
Potential Impact ◽  
The Impact

ObjectivesWe aim to assess the impact of temperature and relative humidity on the transmission of COVID-19 across communities after accounting for community-level factors such as demographics, socioeconomic status and human mobility status.DesignA retrospective cross-sectional regression analysis via the Fama-MacBeth procedure is adopted.SettingWe use the data for COVID-19 daily symptom-onset cases for 100 Chinese cities and COVID-19 daily confirmed cases for 1005 US counties.ParticipantsA total of 69 498 cases in China and 740 843 cases in the USA are used for calculating the effective reproductive numbers.Primary outcome measuresRegression analysis of the impact of temperature and relative humidity on the effective reproductive number (R value).ResultsStatistically significant negative correlations are found between temperature/relative humidity and the effective reproductive number (R value) in both China and the USA.ConclusionsHigher temperature and higher relative humidity potentially suppress the transmission of COVID-19. Specifically, an increase in temperature by 1°C is associated with a reduction in the R value of COVID-19 by 0.026 (95% CI (−0.0395 to −0.0125)) in China and by 0.020 (95% CI (−0.0311 to −0.0096)) in the USA; an increase in relative humidity by 1% is associated with a reduction in the R value by 0.0076 (95% CI (−0.0108 to −0.0045)) in China and by 0.0080 (95% CI (−0.0150 to −0.0010)) in the USA. Therefore, the potential impact of temperature/relative humidity on the effective reproductive number alone is not strong enough to stop the pandemic.

scholarly journals High Incidence of Zika or Chikungunya Infection among Pregnant Women Hospitalized Due to Obstetrical Complications in Northeastern Brazil—Implications for Laboratory Screening in Arbovirus Endemic Area

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 744
Author(s):  
Iracema J. A. A. Jacques ◽  
Leila Katz ◽  
Marília A. Sena ◽  
Ana B. G. Guimarães ◽  
Yasmim L. Silva ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Clinical Data ◽  
Obstetric Complications ◽  
Northeastern Brazil ◽  
Serological Tests ◽  
Pregnancy And Childbirth ◽  
Obstetrical Complications ◽  
Risk Pregnancy ◽  
Endemic Areas ◽  
A Prospective Study

The diagnostic of arbovirus-related obstetric complications in high-risk pregnancy and childbirth care is challenging, especially in endemic areas. We conducted a prospective study to track active or recent Zika (ZIKV), dengue (DENV), or chikungunya (CHIKV) virus infection among hospitalized pregnant women (PW) with obstetric complications in a hospital at the epicenter of Zika outbreak and ZIKV-related microcephaly in Brazil. Clinical data and blood samples were collected at enrollment and 10 days after the admission of study participants, between October 2018 and May 2019. Further clinical data were extracted from medical records. Samples were screened by molecular and serological tests. Out of 780 participants, 93.1% (95% CI: 91.1–94.7%) presented previous DENV exposure (IgG). ZIKV, CHIKV, and/or DENV laboratory markers of recent or active infection were detected in 130 PW, yielding a prevalence of 16.6% (95% CI: 14.2–19.5%); 9.4% (95% CI: 7.4–11.7%), 7.4% (95% CI: 5.7–9.7%), and 0.38% (95% CI: 0.1–1.2%) of CHIKV, ZIKV, and DENV infections, respectively. Most ZIKV infections were detected by molecular assays (89.6%), while CHIKV infections were detected by serology (95.9%). Our findings highlight the need for arbovirus infections screening in PW with obstetrical complications, potentially associated to these infections in endemic areas regardless of the signs or symptoms suggestive of arboviral disease.

scholarly journals 31. Influenza Vaccination During Pregnancy: A Descriptive Cross-sectional Survey of the Knowledge, Beliefs, and Attitudes of Mexican Gynecologists and Family Physicians

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S39-S39
Author(s):  
Erika Z Lopatynsky-Reyes ◽  
Sue Ann Costa-Clemens ◽  
Enrique Chacon-Cruz ◽  
Michael Greenberg
Keyword(s):  
Influenza Vaccination ◽  
Pregnant Women ◽  
Latin American ◽  
Vaccine Coverage ◽  
Family Physicians ◽  
Morbidity And Mortality ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Beliefs And Attitudes ◽  
In Pregnancy

Abstract Background Influenza in pregnancy is associated with elevated morbidity and mortality. Influenza vaccines are both safe and effective in pregnancy, supporting routine use in this population. Even though influenza vaccination in Mexico is recommended for pregnant women, there are no publications of influenza vaccine coverage in pregnancy. This is the first Latin American survey done only in physicians aiming to assess the knowledge, beliefs, and attitudes that Mexican Obstetrics-Gynecologists (OBG) and Family Physicians (FP) have towards influenza and influenza immunization during pregnancy. Methods A cross-sectional survey was conducted, both paper-based and online. The questionnaire was composed of 35 questions, which addressed general knowledge of influenza, recommendations for vaccination during pregnancy, and beliefs and attitudes concerning the acceptability of the vaccine in pregnant women. Results A total of 206 completed surveys were available, 98 (47.6%) from OBG, 108 (52.4%) from FP. Regarding current practicing medical institutions, 76 (37%), 69 (34%), 31 (14.5%), 30 (14.5%) reported working for the Mexican Institute of Social Security, Private Sector, Secretariat of Health, or a combination of all respectively, representing an estimated 2,472 daily pregnancy consultations. About a quarter (26.2%) reported not having a notion that influenza is more severe among pregnant women. More than half (51.5%) ignored the potential side effects of influenza infection on the fetus. The majority (56.8%) did not know when vaccination during pregnancy should occur. Pregnancy as a risk factor for developing influenza complications was known only in 48.1%. Also, 46.1 % believed that vaccination only confers protection to the mother, but not to the fetus. Nevertheless, 96.1% considered that immunization against influenza during pregnancy is a safe and effective preventive intervention. A results’ summary is shown in Figure-1. Conclusion Based on this survey, current knowledge of OBG and FP for influenza morbidity and mortality during pregnancy, and the importance of influenza vaccination in pregnant women, is poor. Mandatory recommendations to educate medical providers regarding influenza vaccination during pregnancy in Mexico are necessary, even as imperative for CME credits. Disclosures All Authors: No reported disclosures

scholarly journals The impact of lockdown policy on depressive symptoms among pregnant women in China: mediating effects of internet use and family support

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Yongjie Zhou ◽  
Ruoxi Wang ◽  
Lei Liu ◽  
Ting Ding ◽  
Lijuan Huo ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Pregnant Women ◽  
Family Support ◽  
Parental Support ◽  
Structural Equation ◽  
Internet Use ◽  
Western China ◽  
Maternal Depressive Symptoms ◽  
Cross Sectional ◽  
The Impact

Abstract Background Although more and more attention has been paid to the psychological consequences of the lockdown policy amongst pregnant women, the underlying mechanism linking the lockdown policy to maternal depression has not been studied in the context of China. This study aimed to explore the association between the lockdown policy and maternal depressive symptoms, and whether such association was mediated by internet use and/or family support. Methods This cross-sectional study used multi-stage sampling techniques in central and western China. Data were collected from 1266 pregnant women using a structtured questionnaire that measured internet use, family support, and depressive symptoms. The Patient Health Questionnaire-9 (PHQ-9) was used to measure depressive symptoms. Internet use was measured by length of usage and varierity of purpose for internet use. Family support was measureed by spousal support and parental support. The structural equation modelling was employed to conduct mediation analysis to test the specificity of the hypothetical paths. Results Overall, 527 respondents (41.63%) presented depressive symptoms. The lockdown policy was negatively associated with depressive symptoms in pregnant women (β = − 0.925, 95% CI = −1.510, − 0.360). The impact of the lockdown policy on depressive symptoms was partially mediated by internet use (β = 1.589, 95% CI = 0.730, 2.807) and family support (β = − 0.162, 95% CI = − 0.341, − 0.017), accounting for 42.67% of the total effect. Conclusions The lockdown policy was generally associated with fewer depressive symptoms in pregnant women. The lockdown policy increased maternal depressive symptoms through increased internet use, but decreased maternal depressive symptoms through enhanced family support. The findings suggest that the psychological consequence of the lockdown policy may vary across different populations, and warrant the need to take into consideration the features of subgroups.

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