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.

Prevalence estimates for hypertension in Latin America and the Caribbean: are they useful for surveillance?

Abstract: Objective. To apply a recently proposed model and assessment tool created by the authors for critically evaluating the data available on the prevalence of hypertension in LAC and assessing their usefulness for surveillance. Methods. A bibliographic search to identify all publications that estimated the prevalence of hypertension was performed. Each of the papers located was assessed using a critical appraisal tool. Results. Of the 58 studies published between 1966 and 2000, only 28 of them (48%) met the critical threshold to be considered useful for surveillance purposes. The distribution of the 28 studies in terms of their usefulness for surveillance was as follows: minimally useful, 16 studies; useful, 8 studies; and very useful, 4 studies. Several methodological shortcomings were identified, from inadequate sampling procedures and sample size to the poor quality of the primary data for planning purposes. Discussion. Published studies on the prevalence of hypertension in Latin America and the Caribbean have, as a whole, limited usefulness for surveillance activities.

Combating health care fragmentation through integrated health service delivery networks in the Americas: lessons learned

Abstract: Purpose – This paper aims to: analyze the challenge of health services fragmentation; present the attributes of integrated health service delivery networks (IHSDNs); review lessons learned on integration; examine recent developments in selected countries; and discuss policy implications of implementing IHSDNs.Design/methodology/approach – A literature review, expert meetings, and country consultations (national, subregional, and regional) in the Americas resulted in a set of consensus‐based essential attributes for implementing IHSDNs. The analysis of 11 country case studies on integration allowed for the identification of lessons learned.Findings – Studies suggest that IHSDNs could improve health systems performance. Principal findings include: integration processes are difficult, complex, and long term; integration requires extensive systemic changes and a commitment by health workers, health service managers and policymakers; and, multiple modalities and degrees of integration can coexist within a syst...

Effect of maternal lead burden on infant weight and weight gain at one month of age among breastfed infants.

Abstract: Introduction. Transfer of lead from bone to the bloodstream increases during lactation. However, the effect of maternal lead burden on growth in breastfed newborns is still unknown. This study examined early postnatal growth in a cohort of healthy breastfed newborns in relation to maternal bone lead burden. Methods. Lead levels were measured among 329 mother–infant pairs in umbilical cord blood at birth and in maternal and infant venous blood at 1 month postpartum. Maternal evaluations at 1 month postpartum included lead measures in blood and bone (measured in the tibia and the patella). Blood lead was determined by graphite furnace atomic absorption spectrophotometry. Bone lead was measured by109Cd Kx-radiograph fluorescence instrument. The primary endpoints were attained weight 1 month of age, and weight gain from birth to 1 month of age, which were analyzed in relation to lead biomarkers and relevant covariates by linear regression models. Results. Infants studied had an average weight gain of 33.1 g/day (standard deviation [SD] = 11.6). Mean infant (at 1 month of age) and maternal blood lead levels were 5.6 μg/dL (SD = 3.0) and 9.7 μg/dL (SD = 4.1), respectively. Mean maternal bone lead levels were 10.1 μg of lead/g (SD = 10.3) and 15.29 μg of lead/g (SD = 15.2) of bone mineral for tibia and patella, respectively. Infant blood lead levels were inversely associated with weight gain, with an estimated decline of 15.1 g per μg/dL of blood lead. Children who were exclusively breastfed had significantly higher weight gains; however, this gain decreased significantly with increasing levels of patella lead. The multivariate regression analysis predicted a 3.6-g decrease in weight at 1 month of age per μg of lead per gram bone mineral increase in maternal patella lead levels. Conclusions. Maternal lead burden is negatively associated to infant attained weight at 1 month of age and to postnatal weight gain from birth to 1 month of age. Additional studies are needed to better understand this source of exposure and to develop interventions to minimize its impact.

Has the time come to control hepatitis A globally? Matching prevention to the changing epidemiology

Abstract: Summary. For the first time a global meeting on hepatitis A virus (HAV) infection as vaccine preventable disease was organized at the end of 2007. More than 200 experts from 46 countries gathered to investigate the changing global HAV epidemiology reflecting the increasing numbers of persons at risk for severe clinical disease and mortality from HAV infection. The benefits of childhood and adult hepatitis A (HepA) vaccination strategies and the data needed by individual countries and international health organizations to assess current HepA prevention strategies were discussed. New approaches in preventing HAV infection including universal HepA vaccination were considered. This introductory paper summarizes the major findings of the meeting and describes the changing epidemiology of HAV infections and the impact of HepA vaccination strategies in various countries. Implementation of HepA vaccination strategies should take into account the level of endemicity, the level of the socio-economic development and sanitation, and the risk of outbreaks. A stepwise strategy for introduction of HepA universal immunisation of children was recommended. This strategy should be based on accurate surveillance of cases and qualitative documentation of outbreaks and their control, secure political support on the basis of high-quality results, and comprehensive cost-effectiveness studies. The recognition of the need for increased global attention towards HepA prevention is an important outcome of this meeting.