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.

Burden of acute gastrointestinal illness in the Metropolitan region, Chile, 2008.

Abstract: The purpose of this study was to determine the magnitude and distribution of acute gastrointestinal illness (GI) in the Chilean population, describe its burden and presentation, identify risk factors associated with GI and assess the differences between a 7-day, 15-day and a 30-day recall period in the population-based burden of illness study design. Face-to-face surveys were conducted on 6047 randomly selected residents in the Metropolitan region, Chile (average response rate 75·8%) in 2008. The age-adjusted monthly prevalence of GI was 9·2%. The 7-day recall period provided annual incidence rate estimates about 2·2 times those of the 30-day recall period. Age, occupation, healthcare system, sewer system, antibiotic use and cat ownership were all found to be significant predictors for being a case. This study expands on the discussion of recall bias in retrospective population studies and reports the first population-based burden and distribution of GI estimates in Chile.

Maternal and congenital syphilis in selected Latin America and Caribbean countries: a multi-country analysis using data from the Perinatal Information System

Abstract: Background: Maternal syphilis has an important impact on reproductive health. In 2010, World Health Organization (WHO)/Pan American Health Organization (PAHO) member countries approved the Strategy and Plan of Action for Elimination of Mother-to-Child Transmission of HIV and Congenital Syphilis in the Americas by 2015. This paper aims to describe epidemiological and programmatic characteristics related to maternal and congenital syphilis in selected countries of Latin America and Caribbean for the period 2010-12. Methods: The report is based on a multi-country, quantitative and qualitative analysis from data collected from several sources, representing a compilation of country reports from nine countries as part of the 2012 mid-term evaluation of the Strategy. Data was collected based on standardised procedures at country level. Results: Results are variable among countries. All countries have a strategic national plan to eliminate congenital syphilis, with some distinct characteristics for each country. Protocols and guidelines for the management and treatment of maternal and congenital syphilis in all countries were updated between 2011 and 2013. A high rate of missing information for all countries for some indicators was noticed. Conclusions: The main limitation of the analyses is the huge amount of missing data. Countries must continue to be supported to build capacity for collecting high-quality data on intervention coverage and inequities, and to use it as a basis for decisions about how best to reach women and children with interventions. A high level political commitment is necessary to put into practice the Regional Initiative to Eliminate Congenital Syphilis, with the support of Health Ministries.

Small for Dates: Evaluation of Different Diagnostic Methods

Abstract: Ninety-four high-risk pregnancies were studied weekly in a prospective and longitudinal study. Uterine height, biparietal diameter (BPD), cranial perimeter (CrP) and abdominal perimeter (AbP) were measured. Amniotic fluid volume (AFV) was assessed. Of the sample selected, 58 neonates were appropriate for gestational age and 36 were small-for-date (17 symmetrical and 19 asymmetrical). The sensitivity values in diagnosis of small-for-dates were: 67% for BPD, 42% for CrP, 94% for AbP, 56% for Uterine Height and 28% for AFV. The specificity for the five variables ranged from about 91% to 100%. If we consider symmetrical and asymmetrical retardation separately, the sensitivity values for the former were: 94%, 77%, 100%, 77% and 24% for BPD, CrP, AbP, Uterine Height and AFV respectively. For symmetrical retardation, the sensitivity values were: 43%, 11%, 90%, 37% and 32% for BPD, CrP, AbP, Uterine Height and AFV respectively. The fetal cranial measurements were the only ones to demonstrate a different pattern of evolution in symmetrical and asymmetrical small-for-dates. This is therefore a useful measurement in making a differential diagnosis between both retardations. The earliest diagnoses were made in the symmetrical small-for-date group.

The Impact of the State Children’s Health Insurance Program’s Unborn Child Ruling Expansions on Foreign-Born Latina Prenatal Care and Birth Outcomes, 2000–2007

Abstract: The 2002 "unborn child ruling" resulted in State Children's Health Insurance Program (SCHIP) expansion for states to cover prenatal care for low-income women without health insurance. Foreign-born Latinas who do not qualify for Medicaid coverage theoretically should have benefited most from the policy ruling given their documented low rates of prenatal care utilization. This study compares prenatal care utilization and subsequent birth outcomes among foreign-born Latinas in six states that used the unborn child ruling to expand coverage to those in ten states that did not implement the expansion. This policy analysis examines cross-sectional pooled US natality data from the pre-enactment years (2000-2003) versus post-enactment years (2004-2007) to estimate the effect of the UCR on prenatal care utilization and birth outcome measures for foreign-born Latinas. Then using a difference-in-difference estimator, we assessed these differences across time for states that did or did not enact the unborn child ruling. Analyses were then replicated on a high-risk subset of the population (single foreign-born Latinas with lower levels of education). The SCHIP unborn child ruling policy expansion increased PNCU over time in the six enacting states. Foreign-born Latinas in expansion enacting states experienced increases in prenatal care utilization though only the high-risk subset were statistically significant. Birth outcomes did not change. The SCHIP unborn child ruling policy was associated with enhanced PNC for a subset of high-risk foreign-born Latinas.