As part of a World Health Organization-led effort to update the empirical evidence base for the leishmaniases, national experts provided leishmaniasis case data for the last 5 years and information regarding treatment and control in their respective countries and a comprehensive literature review was conducted covering publications on leishmaniasis in 98 regional level between 2007 and 2011. Two questionnaires regarding epidemiology and drug access were completed by experts and national program managers. Visceral and cutaneous leishmaniasis incidence ranges were estimated by country and epidemiological region based on reported incidence, underreporting rates if available, and the judgment of national and international experts. Based on these estimates, approximately 0.2 to 0.4 cases and 0.7 to 1.2 million VL and CL cases, respectively, occur each year. More than 90% of global VL cases occur in six countries: India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil. Cutaneous leishmaniasis is more widely distributed, with about one-third of cases occurring in each of three epidemiological regions, the Americas, the Mediterranean basin, and western Asia from the Middle East to Central Asia. The ten countries with the highest estimated case counts, Afghanistan, Algeria, Colombia, Brazil, Iran, Syria, Ethiopia, North Sudan, Costa Rica and Peru, together account for 70 to 75% of global estimated CL incidence. Mortality data were extremely sparse and generally represent hospital-based deaths only. Using an overall case-fatality rate of 10%, we reach a tentative estimate of 20,000 to 40,000 leishmaniasis deaths per year. Although the information is very poor in a number of countries, this is the first in-depth exercise to better estimate the real impact of leishmaniasis. These data should help to define control strategies and reinforce leishmaniasis advocacy. Funding: The Spanish Agency for International Cooperation for Development (AECID) has provided generous support to the WHO Leishmaniasis program since 2005. This support permitted among many other activities regional meetings with the AFRO, EURO, PAHO and SEARO countries, and provided for short term contracts for IDV, MdB, MH and JS related to the preparation of the country profiles. Sanofi provided a grant for a regional meeting with the EMRO countries and various activities related to the control of cutaneous Leishmaniasis in the EMRO region. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist. * E-mail: alvarj@who.int . These authors contributed equally to this work " For a full list of the members of the WHO Leishmaniasis Control Team please see the Acknowledgments section.

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Leishmaniasis Worldwide and Global Estimates of Its Incidence

Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascul...

Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(05)67629-5.pdf

Advances in leishmaniasis.

The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy.Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions. 

https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000001052

Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association

Visceral leishmaniasis (VL) is a systemic protozoan disease that is transmitted by phlebotomine sandflies. Poor and neglected populations in East Africa and the Indian sub-continent are particularly affected. Early and accurate diagnosis and treatment remain key components of VL control. In addition to improved diagnostic tests, accurate and simple tests are needed to identify treatment failures. Miltefosine, paromomycin and liposomal amphotericin B are gradually replacing pentavalent antimonials and conventional amphotericin B as the preferred treatments in some regions, but in other areas these drugs are still being evaluated in both mono- and combination therapies. New diagnostic tools and new treatment strategies will only have an impact if they are made widely available to patients.

http://www.bio.umass.edu/micro/klingbeil/590s/Reading/Leishdiag2007.pdf

Visceral leishmaniasis: what are the needs for diagnosis, treatment and control?

Objective of this study was to assess the relationship between method of delivery and breastfeeding. Using data (2005–2006) from the longitudinal Infant Feeding Practices Study II (n = 3,026) we assessed the relationship between delivery method (spontaneous vaginal, induced vaginal, emergency cesarean, and planned cesarean) and breastfeeding: initiation, any breastfeeding at 4 weeks, any breastfeeding at 6 months, and overall duration. We used SAS software to analyze data using multivariable analyses adjusting for several confounders, including selected demographic characteristics, participants’ pre-delivery breastfeeding intentions and attitude, and used event-history analysis to estimate breastfeeding duration by delivery method. We found no significant association between delivery method and breastfeeding initiation. In the fully adjusted models examining breastfeeding duration to 4 weeks with spontaneous vaginal delivery group as the reference, those with induced vaginal deliveries were significantly less likely to breastfeed [adjusted odds ratio (AOR) = 0.53; 95 % CI = 0.38–0.71]; and no significant relationship was observed for those who had planned or emergency cesarean deliveries. Again, compared with spontaneous vaginal delivery group, those with induced vaginal [AOR = 0.60; 96 % CI = 0.47–0.78] and emergency cesarean [AOR = 0.68; 96 % CI = 0.48–0.95] deliveries were significantly less likely to breastfeed at 6 months. Median breastfeeding duration was 45.2 weeks among women with spontaneous vaginal, 38.7 weeks among planned cesarean, 25.8 weeks among induced vaginal and 21.5 weeks among emergency cesarean deliveries. While no significant association was observed between delivery method and breastfeeding initiation; breastfeeding duration varied substantially with method of delivery, perhaps indicating a need for additional support for women with assisted deliveries.

Breastfeeding practices: does method of delivery matter?

Mental and physical distress and high-risk behaviors among reproductive-age women.

Background: Breastfeeding rates are typically higher among Hispanic women; however, they vary by acculturation status in that those more acculturated are less likely to breastfeed than those who ar

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Association between Acculturation and Breastfeeding among Hispanic Women: Data from the Pregnancy Risk Assessment and Monitoring System

Research shows that maternity care practices are important to promoting breastfeeding in the early post partum period; however, little is known about the association between maternity care practices and breastfeeding among different racial and ethnic groups. We examined the association between maternity care practices and breastfeeding duration to ≥10 weeks overall and among various racial and ethnic groups using data from the Pregnancy Risk Assessment and Monitoring System (PRAMS). PRAMS is a state, population-based surveillance system that collects information on maternal behaviors. We used maternity care practices data from 11 states and New York City with response rates ≥70% from 2004 to 2006. Multiple maternity care practices were examined and the analysis adjusted for demographic characteristics, participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), lifestyle, and infant variables. The outcome variable for multivariable analysis was breastfeeding duration to <10 weeks or ≥10 weeks. PRAMS data show that 22.1% of women did not breastfeed, about 27.7% breastfed for <10 weeks and 50.2% breastfed for ≥10 weeks. Breastfeeding patterns varied with white and Hispanic women reporting highest breastfeeding initiation and duration prevalence. Overall, practices positively associated with ≥10 duration were: breastfeeding initiated within the first hour after birth (adjusted OR [AOR] = 1.29; 95% CI: 1.16–1.45); fed breast milk only (AOR = 2.40; 95% CI: 2.15–2.68); breastfed on demand (AOR = 1.23; 95% CI 1.08–1.40) and receiving telephone support (AOR = 1.20; 95% CI: 1.03–1.39). Maternity care practices associated with breastfeeding to ≥10 weeks varied across three racial/ethnic groups. One practice, that of giving newborns breast milk only, was positively associated with breastfeeding duration of ≥10 weeks across all three groups. Maternity care practices associated with breastfeeding continuation to ≥10 weeks varied by race/ethnicity. For example: breastfeeding within the first hour, baby given a pacifier, and assistance from hospital staff, were significantly associated with breastfeeding duration among black and white women and not Hispanics. The practice of breastfeeding on demand was significantly associated with breastfeeding to ≥10 weeks for black and Hispanic women and not for whites. Hospitals may want to examine the implementation of specific practices in relation to the cultural backgrounds of women to promote breastfeeding.

Maternity Care Practices and Breastfeeding Experiences of Women in Different Racial and Ethnic Groups: Pregnancy Risk Assessment and Monitoring System (PRAMS)

OBJECTIVES The objective of this study was to determine if Spanish language preference was significantly associated with barriers to healthcare services among a nationally representative sample of Hispanic persons in the United States. DESIGN Cross-sectional analysis of secondary data. Differences in outcomes between those responding in Spanish and those responding in English were tested using chi-square analyses and multiple logistic regression models. SETTING Nationally representative sample of US adults responding to the 2005 Behavioral Risk Factor Surveillance System survey. PARTICIPANTS Respondents identifying themselves as Hispanic (n = 20,400). MAIN OUTCOME MEASURES Four health care outcomes including health insurance coverage, having a personal health care provider, forgoing care because of cost, and having a routine check-up within the past five years. RESULTS Those responding in Spanish were less likely to have healthcare coverage, less likely to have a personal healthcare provider, and less likely to have had a routine check-up within the past five years. No difference was found for indicating that cost was a barrier to receiving care in this model. CONCLUSIONS Disparities in healthcare access exist between Hispanic persons in the United States whose language preference is Spanish and those whose language preference is English. In an effort to achieve Healthy People 2010 goals and to provide care to all persons in the United States, barriers to care, such as language preference, should be addressed more fully in our healthcare system.

Indu B. Ahluwalia

Papers

Breastfeeding practices: does method of delivery matter?

Mental and physical distress and high-risk behaviors among reproductive-age women.

Association between Acculturation and Breastfeeding among Hispanic Women: Data from the Pregnancy Risk Assessment and Monitoring System

Maternity Care Practices and Breastfeeding Experiences of Women in Different Racial and Ethnic Groups: Pregnancy Risk Assessment and Monitoring System (PRAMS)

Language preference as a predictor of access to and use of healthcare services among Hispanics in the United States.