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Intersectionality, racism, and mental health of migrants arriving at borders in Latin America: a qualitative study based on in-depth interviews with key informants of the cases of Ecuador and Chile
(Elsevier BV, 2025-04)
Teresita Rocha-Jiménez
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Irene Torres
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CABIESES VALDES, BALTICA BEATRIZ
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Daniel F. López-Cevallos
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Mercedes Mercado-Órdenes
Scopus© Citations 1 1
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Latin America Cutaneous Oncology Management (LACOM) I: The Role of Skin Care in Oncology Patients and Survivors
(SanovaWorks, 2025-02-01)
Daniel Alcalá Pérez
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Ana Sofia Acosta Madiedo
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Sebastian Andreani
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Anneke Andriessen
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Hebert Cárdenas
2
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Setting up regional diagnostic reference levels for pediatric computed tomography in Latin America: preliminary results, challenges and the work ahead
(2023)
Lina Cadavid
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Lina Karout
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Mannudeep K. Kalra
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Flavio Morgado
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María Antonieta Londoño
Scopus© Citations 4 2
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Unequal Access and Use of Health Care Services among Settled Immigrants, Recent Immigrants, and Locals: A Comparative Analysis of a Nationally Representative Survey in Chile
(2022)
Marcela Oyarte
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CABIESES VALDES, BALTICA BEATRIZ
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Isabel Rada
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Alice Blukacz
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Manuel Espinoza
<jats:p>Globally, and particularly in the Latin American region, international migration continues to grow. Access and use of health care services by migrants vary according to their country of origin and residence time. We aimed to compare the access and use of health care services between international migrants (including settled migrants from Peru, Argentina, Bolivia, Ecuador; Emerging migrants from Venezuela, Dominican Republic, Colombia, Haiti; and migrants from other countries) and the Chilean population. After performing a secondary data analysis of population-based nationally representative surveys (CASEN 2011–2017), access and use patterns (insurance, complementary insurance, non-consultation, and non-treatment coverage) were described and compared among settled immigrants, recent emerging immigrants, others, and locals. Immigrants had a significantly higher uninsured population compared to locals. Specifically, in CASEN 2017, 19.27% of emerging (95% CI: 15.3–24.1%), 11.79% of settled (95% CI: 10.1–13.7%), and 2.25% of locals (95% CI: 2.1–2.4%) were uninsured. After 2013, settled and recent emerging migrants showed higher percentages of non-consultation. Collaborative and interculturally relevant strategies from human rights and equity perspectives are needed. Initiatives with a particular focus on recent immigrants can contribute to reducing the existing disparities in health care access and use with locals due to lack of insurance and treatment coverage.</jats:p>
9Scopus© Citations 10
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Lessons Learned from the Educational Experience during COVID-19 from the Perspective of Latin American University Students
(2023)
Karla Lobos
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COBO RENDÓN, RUBIA CONSUELO
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Diego García-Álvarez
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Jorge Maldonado-Mahauad
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Carola Bruna
<jats:p>The COVID-19 pandemic impacted the educational context. University students were exposed to an educational transition from a face-to-face context to emergency remote teaching (ERT). This change affected the educational experience of students and teachers in general, and impacted their educational performance, as well as their emotional and mental health, among other aspects. However, learning from the successes during the ERT and reflecting on good and bad practices will allow us to configure effective learning scenarios that respond to the new normal. The objective of this paper is to describe and present the lessons learned during ERT from the experience of university students in Latin America who have already returned to face-to-face instruction. The study used a qualitative inductive approach and a phenomenographic design. The sample consisted of 640 undergraduate students (63% women) of higher education who experienced online education during the year 2021 and a face-to-face modality during the first semester of 2022, belonging to universities in Chile, Venezuela, and Ecuador. The results suggest that new learning scenarios should consider specific pedagogical practices, including active, collaborative, meaningful, and problem-based strategies, together with a diversity of feedback practices. It is concluded that the ERT brought good practices that should guide university educational policies.</jats:p>
5Scopus© Citations 19
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Frequency of NMOSD misdiagnosis in a cohort from Latin America: Impact and evaluation of different contributors
(2022)
Edgar Carnero Contentti
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Pablo A López
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Juan Criniti
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Ricardo Alonso
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Berenice Silva
<jats:sec><jats:title>Background:</jats:title><jats:p> Neuromyelitis optica spectrum disorder (NMOSD) misdiagnosis (i.e. the incorrect diagnosis of patients who truly have NMOSD) remains an issue in clinical practice. We determined the frequency and factors associated with NMOSD misdiagnosis in patients evaluated in a cohort from Latin America. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> We retrospectively reviewed the medical records of patients with NMOSD, according to the 2015 diagnostic criteria, from referral clinics in six Latin American countries (Argentina, Chile, Paraguay, Colombia, Ecuador, and Venezuela). Diagnoses prior to NMOSD and ultimate diagnoses, demographic, clinical and paraclinical data, and treatment schemes were evaluated. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> A total of 469 patients presented with an established diagnosis of NMOSD (73.2% seropositive) and after evaluation, we determined that 56 (12%) patients had been initially misdiagnosed with a disease other than NMOSD. The most frequent alternative diagnoses were multiple sclerosis (MS; 66.1%), clinically isolated syndrome (17.9%), and cerebrovascular disease (3.6%). NMOSD misdiagnosis was determined by MS/NMOSD specialists in 33.9% of cases. An atypical MS syndrome was found in 86% of misdiagnosed patients, 50% had NMOSD red flags in brain and/or spinal magnetic resonance imaging (MRI), and 71.5% were prescribed disease-modifying drugs. </jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p> NMOSD misdiagnosis is relatively frequent in Latin America (12%). Misapplication and misinterpretation of clinical and neuroradiological findings are relevant factors associated with misdiagnosis. </jats:p></jats:sec>
11Scopus© Citations 14
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Ambiente alimentar e excesso de peso em escolares: uma revisão sistemática sul-americana
(2022)
Najla de Oliveira Cardozo
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Alex Harley Crisp
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PINHEIRO FERNANDES, ANNA CHRISTINA
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Angela Cristina Bizzotto Trude
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Jacqueline Araneda-Flores
<sec> <title>Objetivo.</title> Identificar e compilar os achados de estudos observacionais que analisaram a relação de fatores do ambiente alimentar escolar e individuais de consumo na escola com excesso de peso em escolares da América do Sul no período de 2011 a 2021. </sec> <sec> <title>Métodos.</title> A pesquisa foi realizada em cinco bases de dados (PubMed, Web of Science, SciELO, Scopus e LILACS) e no Google Scholar, além de consulta a especialistas. Foram selecionados estudos observacionais com escolares de 5 a 19 anos, realizados na América do Sul, que usaram medidas objetivas para avaliar excesso de peso, como o índice de massa corporal (Organização Mundial da Saúde e/ou International Obesity Task Force), em associação a fatores do ambiente alimentar escolar e individuais de consumo na escola. O protocolo foi registrado na plataforma PROSPERO (CRD42020212383). </sec> <sec> <title>Resultados.</title> Dos 906 registros identificados, 13 estudos transversais (um da Argentina, um do Equador e 11 do Brasil) foram incluídos na revisão. As prevalências variaram de 7,5% a 32,5% para sobrepeso e 1,7% a 28,0% para obesidade. Fatores do ambiente alimentar escolar, dos domínios político e físico (como educação alimentar e nutricional insatisfatória e indisponibilidade de refeições preparadas na escola) se associaram com maiores prevalências de excesso de peso. Fatores individuais relacionados à adesão ao programa de alimentação escolar (como consumo da alimentação oferecida pela escola ao invés de lanche trazido de casa) se associaram a menores prevalências de excesso de peso. </sec> <sec> <title>Conclusões.</title> São escassos os estudos sul-americanos enfocando a associação entre fatores do ambiente alimentar escolar e/ou individuais e excesso de peso em escolares. As evidências restritas a contextos locais ou regionais incentivam novos estudos de abrangência nacional. </sec>
Scopus© Citations 3 10 1
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Antimicrobial stewardship programs in adult intensive care units in Latin America: Implementation, assessments, and impact on outcomes
(2021)
Rodolfo E. Quirós
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Ana C. Bardossy
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Patricia Angeleri
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Jeannete Zurita
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Washington R. Aleman Espinoza
<jats:title>Abstract</jats:title><jats:sec id="S0899823X21000805_as1"><jats:title>Objective:</jats:title><jats:p>To assess the impact of antimicrobial stewardship programs (ASPs) in adult medical–surgical intensive care units (MS-ICUs) in Latin America.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as2"><jats:title>Design:</jats:title><jats:p>Quasi-experimental prospective with continuous time series.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as3"><jats:title>Setting:</jats:title><jats:p>The study included 77 MS-ICUs in 9 Latin American countries.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as4"><jats:title>Patients:</jats:title><jats:p>Adult patients admitted to an MS-ICU for at least 24 hours were included in the study.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as5"><jats:title>Methods:</jats:title><jats:p>This multicenter study was conducted over 12 months. To evaluate the ASPs, representatives from all MS-ICUs performed a self-assessment survey (0–100 scale) at the beginning and end of the study. The impact of each ASP was evaluated monthly using the following measures: antimicrobial consumption, appropriateness of antimicrobial treatments, crude mortality, and multidrug-resistant microorganisms in healthcare-associated infections (MDRO-HAIs). Using final stewardship program quality self-assessment scores, MS-ICUs were stratified and compared among 3 groups: ≤25th percentile, >25th to <75th percentile, and ≥75th percentile.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as6"><jats:title>Results:</jats:title><jats:p>In total, 77 MS-ICU from 9 Latin American countries completed the study. Twenty MS-ICUs reached at least the 75th percentile at the end of the study in comparison with the same number who remain within the 25th percentile (score, 76.1 ± 7.5 vs 28.0 ± 7.3; <jats:italic>P</jats:italic> < .0001). Several indicators performed better in the MS-ICUs in the 75th versus 25th percentiles: antimicrobial consumption (143.4 vs 159.4 DDD per 100 patient days; <jats:italic>P</jats:italic> < .0001), adherence to clinical guidelines (92.5% vs 59.3%; <jats:italic>P</jats:italic> < .0001), validation of prescription by pharmacist (72.0% vs 58.0%; <jats:italic>P</jats:italic> < .0001), crude mortality (15.9% vs 17.7%; <jats:italic>P</jats:italic> < .0001), and MDRO-HAIs (9.45 vs 10.96 cases per 1,000 patient days; <jats:italic>P</jats:italic> = .004).</jats:p></jats:sec><jats:sec id="S0899823X21000805_as7"><jats:title>Conclusion:</jats:title><jats:p>MS-ICUs with more comprehensive ASPs showed significant improvement in antimicrobial utilization.</jats:p></jats:sec>
Scopus© Citations 25 1
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Tool to monitor tobacco control policy implementation: the Tobacco Control Scale in Latin America. Adaptation process and pilot study
(2021)
Ariadna Feliu
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Cristina Martinez
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PERUGA URREA, ARMANDO
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Luk Joossens
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Eduardo Bianco
<jats:sec><jats:title>Background</jats:title><jats:p>Monitoring tobacco control policy implementation is one of the keys for tobacco consumption reduction in Latin America (LA). This study reports on the adaptation of the Tobacco Control Scale (TCS) for use in LA countries and the level of tobacco control policy implementation in this region according to the scale.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Ecological cross-sectional survey. The questionnaire to measure tobacco control policies was a translated (into Spanish and Portuguese) and adapted version of the last TCS as used in Europe. The resulting TCS-LA maintains the same structure as the original TCS, with eight policy domains and 100 points (pts) as maximum score; however, four policy domains were adapted because the exact same rationale could not be applied. At least two non-governmental tobacco control experts were contacted per country to answer the TCS-LA.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Informants from 17 out of 18 countries completed the questionnaire. Using the TCS-LA, Panama (70 pts), Uruguay (68 pts) and Ecuador (61 pts) exhibited the strongest tobacco control policies, while Guatemala (32 pts), Bolivia (30 pts) and Dominican Republic (29 pts) have implemented a lower number of tobacco control policies. Eight countries reached 50% of the TCS-LA total possible score, indicating a relatively good implementation level of tobacco control policies.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Panama, Uruguay and Ecuador are the tobacco control policy leaders in LA; however, tobacco control in the region has room for improvement since nine countries have a total score under 50 pts. The TCS is a feasible and adaptable tool to monitor tobacco control in other WHO regions beyond Europe.</jats:p></jats:sec>
Scopus© Citations 5 1 1
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Detection of heterogeneous vancomycin intermediate resistance in MRSA isolates from Latin America
(2020)
Betsy E Castro
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Maritza Berrio
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Monica L Vargas
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Lina P Carvajal
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Lina V Millan
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Vancomycin is a common first-line option for MRSA infections. The heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) phenotype is associated with therapeutic failure. However, hVISA isolates are usually reported as vancomycin susceptible by routine susceptibility testing procedures.</jats:p></jats:sec><jats:sec><jats:title>Objectives</jats:title><jats:p>To detect and characterize the hVISA phenotype in MRSA isolates causing infections in nine Latin American countries.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We evaluated a total of 1189 vancomycin-susceptible MRSA isolates recovered during 2006–08 and 2011–14. After an initial screening of hVISA using glycopeptide-supplemented agar strategies, the detection of hVISA was performed by Etest (GRD) and Macro-method (MET). Isolates deemed to be hVISA were subjected to population analysis profile/AUC (PAP/AUC) and WGS for further characterization. Finally, we interrogated alterations in predicted proteins associated with the development of the VISA phenotype in both hVISA and vancomycin-susceptible S. aureus (VSSA) genomes.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 39 MRSA isolates (3.3%) were classified as hVISA (1.4% and 5.6% in MRSA recovered from 2006–08 and 2011–14, respectively). Most of the hVISA strains (95%) belonged to clonal complex (CC) 5. Only 6/39 hVISA isolates were categorized as hVISA by PAP/AUC, with 6 other isolates close (0.87–0.89) to the cut-off (0.9). The majority of the 39 hVISA isolates exhibited the Leu-14→Ile (90%) and VraT Glu-156→Gly (90%) amino acid substitutions in WalK. Additionally, we identified 10 substitutions present only in hVISA isolates, involving WalK, VraS, RpoB and RpoC proteins.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The hVISA phenotype exhibits low frequency in Latin America. Amino acid substitutions in proteins involved in cell envelope homeostasis and RNA synthesis were commonly identified. Our results suggest that Etest-based methods are an important alternative for the detection of hVISA clinical isolates.</jats:p></jats:sec>
3 1Scopus© Citations 14

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