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.

The burden of pneumococcal disease among Latin American and Caribbean children: review of the evidence

Abstract: OBJECTIVE: To conduct a comprehensive review of data on pneumococcal disease incidence in Latin America and the Caribbean and project the annual number of pneumococcal disease episodes and deaths among children < 5 years of age in the region. METHODS: We carried out a systematic review (1990 to 2006) on the burden of pneumococcal disease in children < 5 years of age in the region. We summarized annual incidence rates and case fatality ratios using medians and interquartile ranges for invasive pneumococcal disease (IPD) (including all-IPD and separately abstracting pneumococcal meningitis, pneumonia, bacteremia, and sepsis data), pneumonia (all cause and radiologically confirmed), and acute otitis media by age group: < 1 year, < 2 years, and < 5 years. We modeled age-specific cumulative incidence of disease obtained from standard Kaplan-Meier analysis and projected data to obtain regional estimates of disease burden. We adjusted burden estimates by serotype coverage, vaccination coverage, and vaccine efficacy to estimate the number of cases and deaths averted. RESULTS: Of 5 998 citations identified, 26 papers from 10 countries were included. The estimated annual burden of pneumonia, meningitis, and acute otitis media caused by pneumococcus in children < 5 years of age ranged from 980 000 to 1 500 000, 2 600 to 6 800, and 980 000 to 1 500 000, respectively. An estimated 12 000 to 28 000 deaths due to pneumococcal disease occur in the region annually. Pneumococcal conjugate vaccine could save 1 life per 1 100 and prevent 1 case per 13 children vaccinated. CONCLUSION: A substantial burden of pneumococcal disease in the region is potentially preventable with pneumococcal conjugate vaccines and should be considered in regional vaccine decision making. Results are limited by the very few studies, conducted in selected settings, included in this review.

Yellow Fever Outbreaks in Unvaccinated Populations, Brazil, 2008-2009

Abstract: Due to the risk of severe vaccine-associated adverse events, yellow fever vaccination in Brazil is only recommended in areas considered at risk for disease. From September 2008 through June 2009, two outbreaks of yellow fever in previously unvaccinated populations resulted in 21 confirmed cases with 9 deaths (case-fatality, 43%) in the southern state of Rio Grande do Sul and 28 cases with 11 deaths (39%) in Sao Paulo state. Epizootic deaths of non-human primates were reported before and during the outbreak. Over 5.5 million doses of yellow fever vaccine were administered in the two most affected states. Vaccine-associated adverse events were associated with six deaths due to acute viscerotropic disease (0.8 deaths per million doses administered) and 45 cases of acute neurotropic disease (5.6 per million doses administered). Yellow fever vaccine recommendations were revised to include areas in Brazil previously not considered at risk for yellow fever.

A model for enhancing evidence-based capacity to make informed policy decisions on the introduction of new vaccines in the Americas: PAHO's ProVac initiative.

Abstract: New and underutilized vaccines are becoming available to combat important public health challenges. Each year, rotavirus is estimated to cause approximately 111 million episodes of gastroenteritis, which requires home care, 25 million clinic visits, 2 million hospitalizations, and approximately 440,000 deaths in children younger than 5 years of age worldwide. Children in the poorest countries account for 82% of rotavirus deaths. An estimated 16,000 deaths by rotavirus-induced diarEditor’s note: The thoughtful article by Dr. Andrus and his colleagues in describing the utility of the Pan American Health Organization’s (PAHO’s) ProVac model1 reminds us of the startling childhood and adult disease statistics. Whether it is the 440,000 gastroenteritis annual deaths in children younger than age 5 or the 32,000 annual deaths from papillomavirus—with more than 80% in poor and developing countries—these numbers are staggering. Examples such as the experience in Mexico that was described by Santos et al.2 show the ProVac model can work very well. The authors suggest that three essential factors need to be addressed if agencies and governments are to attain a sustainable impact: decisions should be nationally based; evidence used to support the decisions must be broad-based; and infrastructure must be in place to support a nationally based process. The ProVac program objectives are rather aggressive, with just a five-year horizon to achieve a series of ambitious goals. At the same time, PAHO is honest: the organization recognizes it has little choice but to move in this direction. PAHO can serve as a model for the rest of the developing world. Lessons learned in the ProVac experience will serve many others well as they attempt a similar, if not more aggressive approach.

Adolescent Health in the Caribbean: A Regional Portrait

Abstract: Objectives. This study assessed youth health in the Caribbean Community and Common Market countries and describes the prevalence of health-related factors. Methods. We used a self-administered classroom questionnaire; questions addressed general health, health care, nutrition, sexual history, drug use, mental health, violence, family characteristics, and relationships with others. Results. Most youths reported good health; however, 1 in 10 reported a limiting disability or significant health problems. Violence was a pervasive concern. Of those who reported history of sexual intercourse, many reported that their first intercourse was forced, and nearly half reported that they were aged 10 years or younger when they first had intercourse. Conclusions. Although most young people are healthy, problems indicate the importance of monitoring trends and designing effective youth health programs.