Pan American Health Organization

About: Pan American Health Organization is a healthcare organization based out in Havana, Cuba. It is known for research contribution in the topics: Population & Public health. The organization has 1500 authors who have published 2263 publications receiving 83705 citations. The organization is also known as: HO Regional Office for the Americas.

Integrative review of managed entry agreements: chances and limitations

Abstract: Managed entry agreements (MEAs) consist of a set of instruments to reduce the uncertainty and the budget impact of new high-priced medicines; however, there are concerns. There is a need to critically appraise MEAs with their planned introduction in Brazil. Accordingly, the objective of this article is to identify and appraise key attributes and concerns with MEAs among payers and their advisers, with the findings providing critical considerations for Brazil and other high- and middle-income countries. An integrative review approach was adopted. This involved a review of MEAs across countries. The review question was ‘What are the health technology MEAs that have been applied around the world?’ This review was supplemented with studies not retrieved in the search known to the senior-level co-authors including key South American markets. It also involved senior-level decision makers and advisers providing guidance on the potential advantages and disadvantages of MEAs and ways forward. Twenty-five studies were included in the review. Most MEAs included medicines (96.8%), focused on financial arrangements (43%) and included mostly antineoplastic medicines. Most countries kept key information confidential including discounts or had not published such data. Few details were found in the literature regarding South America. Our findings and inputs resulted in both advantages including reimbursement and disadvantages including concerns with data collection for outcome-based schemes. We are likely to see a growth in MEAs with the continual launch of new high-priced and often complex treatments, coupled with increasing demands on resources. Whilst outcome-based MEAs could be an important tool to improve access to new innovative medicines, there are critical issues to address. Comparing knowledge, experiences, and practices across countries is crucial to guide high- and middle-income countries when designing their future MEAs.

Maus-tratos contra a criança e o adolescente no Estado de São Paulo, 2009

Abstract: OBJECTIVE: To describe the profile of the reports of child and adolescent abuse in the state of Sao Paulo in 2009, and to analyze possible associated factors. METHODS: A total of 4,085 reports regarding children and adolescents younger than 15 years recorded by the Domestic, Sexual, and Other Interpersonal Violence Surveillance System (Sistema de Vigilância de Violencia Domestica, Sexual e Outras Violencias Interpessoais - VIVA) were analyzed using a logistic regression model. RESULTS: The females comprised 61.4% of the total cases. The most common age group among females was 10 to 14 years (38.8%) and among males was < 5 years (35.8%). Physical abuse accounted for 43.3% of cases in males, and sexual abuse cases accounted for 41.7% of cases in females. The main perpetrators of the abuse were parents (43.8% of the total) and acquaintances (29.4%). Male aggressors were 72.0% of the total. The abuse occurred at home in 72.9% of cases; repeated abuse was reported in 51.4% of cases. Differences between the cases of physical and sexual abuse: a) physical abuse - mostly males (50.9%), parents as perpetrators (48.4%), and women as perpetrators (42.8%), b) sexual abuse - mostly females (77.2%), known aggressors (48.4%), and men as perpetrators (96.1%). Variables associated with physical abuse: male gender (OR: 2.22), age 10-14 years (OR: 1.68), and parents as perpetrators (OR: 2.50). Sexual abuse was associated with female gender (OR: 2.84), age 5-9 years (OR: 1.66), and unknown authors (OR: 1.53). CONCLUSION: Public policies should guarantee that children and adolescents have a healthy and violence-free life. The analysis of the notifications is an important tool to establish prevention strategies.

Follow-up Study of Unknowingly Pregnant Women Vaccinated Against Rubella in Brazil, 2001–2002

Abstract: Brazil conducted mass immunization of women of childbearing age in 2001 and 2002. Surveillance was initiated for vaccination of women during pregnancy to monitor the effects of rubella vaccination on fetal outcomes. Methods. Women vaccinated while pregnant or prior to conception were reported to the surveillance system. Susceptibility to rubella infection was determined by anti-rubella immunoglobulin (Ig) M and IgG immunoassays. Susceptible women were observed through delivery. Live-born infants were tested for anti-rubella IgM antibody; IgM-seropositive newborns were tested for viral shedding and observed for 12 months for signs of congenital rubella syndrome. Incidence of congenital rubella infection was calculated using data from 7 states. Results. A total of 22 708 cases of rubella vaccination during pregnancy or prior to conception were reported nationwide, 20 536 (90%) of which were from 7 of 27 states in Brazil. Of these, 2332 women were susceptible to rubella infection at vaccination. Sixty-seven (4.1%) of 1647 newborns had rubella IgM antibody (incidence rate, 4.1 congenital infections per 100 susceptible women vaccinated during pregnancy [95% confidence interval, 3.2–5.1]). None of the infants infected with rubella vaccine virus was born with congenital rubella syndrome. Conclusions. As rubella elimination goals are adopted worldwide, evidence of rubella vaccine safety aids in planning and implementation of mass adult immunization.