Present and Future of Birth Defects Surveillance in the Americas

Birth defects contribute substantially to the burden of morbidity and mortality in the Region of the Americas. Numerous efforts exist to raise awareness of this problem and to implement surveillance in health and government sectors. However, there is still a long way to go. In this regard, for several years, countries have been taking actions to coordinate efforts, while strengthening and establishing strategic alliances to achieve significant results. The extensive history of efforts aimed at responding to the situation of birth defects in the Region includes actions in health care, epidemiology, legislation, and investigation, with participation from the scientific and technical community, government, and civil society. After taking into account all these aspects, the Pan American Health Organization/Latin American Center for Perinatology, Women, and Reproductive Health (PAHO/CLAP/WR), together with the World Bank, decided to create a document summarizing the regional situation of birth defects from an epidemiological and programmatic perspective, to analyze the challenges and offer countries guidance to address birth defects, their determinants, and consequences, with the ultimate goal of helping to “leave no one behind.” This publication was made possible by financial support from the United States Agency for International Development—USAID.

The Role of Vancomycin and Metronidazole for the Treatment of Clostridium difficile–Associated Diarrhea

For the treatment of Clostridium difficile–associated diarrhea (CDAD), metronidazole and vancomycin remain the most commonly used agents. The major advantage of metronidazole is its low cost, while the advantage of oral vancomycin is a more favorable pharmacokinetic profile. The epidemiology and clinical severity of CDAD have changed due to the emergence of a hypervirulent strain (BI/NAP1/027). In 2010, the Infectious Diseases Society of America/Society for Health Care Epidemiology of America expert panel defined severe CDAD and recommended oral vancomycin to treat these patients. Metronidazole remains the preferred agent for treatment of mild to moderate CDAD.