The prevalence of dengue infection is increasing globally. There are few prospective population-based surveillance studies of the immunological and inflammatory consequences of exposure to dengue ...virus in young children.
To study the association between serologically confirmed prior medical diagnosis of dengue infection and blood measures of systemic inflammation with dengue virus immunoglobulin G levels.
A population-based study of healthy three-year old children living in Havana, Cuba.
865 individuals provided a blood sample. Fourteen (1.6%) had a prior medical diagnosis of dengue infection, and 851 individuals had no prior medical diagnosis. There was no difference in the serum immunoglobulin G titres between these groups (Mann-Whitney test, p = 0.49). Total white cell count, blood neutrophil and eosinophil counts were linearly associated with a dengue immunoglobulin G value above the median value.
There was no difference between the dengue immunoglobulin G titres in young children who had previously had clinically proven dengue infection compared to those who had no diagnosis of prior infection. This may be a consequence of a relatively high prevalence of sub-clinical infection. A higher dengue immunoglobulin G level was positively associated with a range of inflammatory biomarkers, although these data cannot demonstrate a causal association.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The Trivers-Willard hypothesis suggests that populations respond to scarcity by decreasing the ratio of males to females at livebirth. Cuba experienced an extreme economic depression in the 1990s ...called the "special period." Using time-series analysis, the authors studied the impact of this event on the male:female sex ratio at birth in Cuba from 1960 to 2008. From 1990 to 1993, the per capita gross domestic product in Cuba decreased by 36%. By use of a definition of the special period from 1991 to 1998, there was a prolonged increase in the male:female ratio of livebirths during this period of economic depression (P < 0.001), from 1.06 at baseline to a peak of 1.18. This association persisted when using alternative definitions of the duration of economic depression in sensitivity analyses. Once the period of economic depression was over, the male:female ratio returned to the baseline value. These data suggest that, in Cuba, contrary to the Trivers-Willard hypothesis, the human population responded to conditions of scarcity by increasing the ratio of males to females at livebirth. These data may be relevant in the modeling of demographic projections in countries that experience prolonged economic depression and in understanding adaptive human reproductive responses to environmental change.
Abstract Background The increase in prevalence of obesity is a possible risk factor for asthma in developed countries. As the people of Cuba experienced an acute population-based decrease in weight ...in the 1990s, we tested the hypothesis that national weight loss and subsequent weight gain was associated a reciprocal changes in asthma mortality. Methods Data were obtained on mortality rates from asthma and COPD in Cuba from 1964 to 2014, along with data on prevalence of obesity for this period. Joinpoint analysis was used to identify inflexion points in the data. Results Although the prevalence of obesity from 1990 to 1995 decreased from 14% to 7%, over the same time period the rate of asthma mortality increased from 4.5 deaths per 100,000 population to 5.4 deaths per 100,000 population. In 2010, the obesity prevalence subsequently increased to 15% in 2010, while the asthma mortality rate dropped to 2.3 deaths per 100,000 population. The optimal model for fit of asthma mortality over time gave an increasing linear association from 1964 to 1995 (95% confidence interval for inflexion point: 1993 to 1997), followed by a decrease in asthma mortality rates from 1995 to 1999 (95% confidence interval for inflexion point: 1997 to 2002). Conclusions These national data do not support the hypothesis that population-based changes in weight are associated with asthma mortality. Other possible explanations for the large decreases in asthma mortality rates include changes in pollution or better delivery of medical care over the same time period.
Objective
Low birthweight is associated with a decreased risk of childhood leukemia and an increased risk of both cardiovascular disease and all‐cause mortality in adult life. Possible biological ...mediators include systemic innate immunity and inflammation. We tested the hypothesis that birthweight was inversely associated with serum high sensitivity C reactive protein assay (hsCRP), a measure of both innate immunity and systemic inflammation.
Methods
Data on birthweight and current anthropometric measures along with a range of exposures were collected at 1 and 3 years of age in a population‐based cohort study of young children living in Havana, Cuba. A total of 986 children aged 3‐years‐old provided blood samples that were analyzed for serum hsCRP levels.
Results
Nearly 49% of children had detectable hsCRP levels in their serum. Lower birthweight was linearly associated with the natural log of hsCRP levels (beta coefficient −0.70 mg L−1 per kg increase in birthweight, 95% CI: −1.34 to −0.06). This was attenuated but still present after adjustment for the child's sex and municipality (−0.65 mg L−1 per kg birthweight; 95% CI: −1.38 to +0.08). There were no associations between growth from birth or anthropometric measures at 3 years and systemic inflammation.
Conclusions
Birthweight was inversely associated with serum hsCRP levels in children aged 3 years living in Cuba. These observations provide a potential mechanism that is present at the age of 3 years to explain the association between low birthweight and both decreased childhood leukemia and increased cardiovascular disease in adults.
RESUMEN Introducción: La violencia se ha convertido en un problema para la salud pública a nivel mundial y Cuba no está exenta, existen estudios aislados sin que se exploren las variables asociadas. ...En Cuba no se dispone de instrumentos validados para explorar la violencia en sus diferentes escenarios y tipos de violencia en niños a partir de su exposición a la misma. El objetivo fue diseñar y validar un instrumento para la identificación de la exposición a la violencia en niños. Métodos: Investigación de desarrollo de tecnología, participaron 480 alumnos de sexto grado de 11 años a 13 años quienes respondieron el cuestionario en modalidad test-retest con 30 días entre ellas. Se evaluó la validez de contenido por medio de un grupo de expertos utilizando los criterios de Moriyama; de constructo por análisis factorial confirmatoria; la consistencia interna por coeficiente alfa de Cronbach y estabilidad temporal por prueba de comparación de media de rangos con signos de Wilcoxon y p asociada. Resultados: Instrumento validado para el estudio de la exposición a la violencia como víctimas y observadores de violencia con las dimensiones: violencia física, violencia psicológica, violencia sexual y violencia por negligencia y abandono en la casa, escuela y comunidad. Todos los ítems cumplieron con criterios de Moriyama, se justificó la estructura de constructo. Las dimensiones lograron coeficientes aceptables a buenos de consistencia interna (0,60 <= α <= 0,82), se cumplió con la estabilidad temporal (p > 0,05). Las conclusiones fueron que el instrumento diseñado y validado para explorar la exposición a la violencia como víctima y observadores en los escenarios casa, escuela y comunidad en las variables; violencia física, psicológica, sexual y por negligencia cumplió sus objetivos para el cual fue diseñado.
Fernandez et al agree with Wilcox and Baird, who gave thought-provoking comments on their paper, that evidence from studies of human sex ratios at birth is mixed and difficult to interpret. Their ...initial objective in trying to understand the findings of their study was, indeed, to test the Trivers-Willard hypothesis that periods of scarcity were associated with an increase in the proportion of females at livebirth. Contrary to expectation, they found a large increase in the number of males at livebirth during the 1990s in Cuba. They were unable to explain this finding and, although they considered and cannot exclude the possibility of sex-specific abortion, they think this unlikely to be the main explanation for their findings.
There are limited epilepsy mortality data from developing countries and Latin America in particular. We examined national epilepsy mortality data from Cuba and contrasted them with comparable data ...from England and Wales. National epilepsy mortality data for Cuba between the years 1987 and 2010 were obtained from the Medical Records and Health Statistics Bureau of the Cuban Public Health Ministry (www.sld.cu/sitios/dne/) with the corresponding mortality data from England and Wales obtained from the UK Office of National Statistics (ONS, www.ons.gov.uk). Indirect standardization with calculation of a standardized mortality ratio (SMR) was used to compare trends.
The overall trend was of a slight decrease in mortality rates over the 23 years in Cuba, with higher mortality rates primarily occurring in young people. Annual age-adjusted rates were consistently lower in Cuba than those seen in England and Wales, with the SMR ranging from 0.35 (95% confidence interval (CI): 0.30 to 0.48) in 2007 to 1.00 (95% CI: 0.85 to 1.15) in 1994.
Cuban epilepsy mortality rates are consistently lower than those of England and Wales. Reasons for this disparity in mortality rates are not immediately apparent but are likely to be multifactorial.
We aimed to establish a national cystic fibrosis (CF) registry for Cuba, a developing country.
Regional centres that deliver care for all CF patients provided information for a national database.
The ...prevalence of CF in Cuba is 26.3 cases per 1,000,000 population. The median age at diagnosis is 2 years, and the median age of the total population was 15 years. Of those aged 16 years or older, the prevalence of Pseudomonas aeruginosa infection was 46%, the prevalence of Staphylococcus aureus infection was 36%, and 80% of individuals were receiving oral azithromycin. The commonest gene mutation was F508del which was observed in 50% of patients.
These data demonstrate that it is possible to establish a national CF registry in a developing country such as Cuba. This provides baseline data to permit evaluation of health care delivery enable the spread of good clinical practice nationally.
•These data demonstrate the establishment of a national cystic fibrosis registry in Cuba, a developing country.•The data provide a summary of the prevalence of disease, demographics, microbiology and genotype of all individuals with a diagnosis of cystic fibrosis who live in Cuba.
The prevalence of asthma and allergic diseases in Cuban children is high, but little is known about adverse reactions to foods.
To determine the prevalence, incidence and risk factors for adverse ...reaction to foods in children.
Population-based cohort study carried out in Havana, Cuba, in a three-year period. Parents of 1543 children provided medical and lifestyle information from the first to the third year of age, which was collected using a questionnaire. An adverse reaction to foods was defined by medical diagnosis reported by the parents or caregivers.
Annual cumulative incidence was 5.7%, 1.9% and 0.8%, whereas annual prevalence was 5.7%, 4% and 2.5% at 1, 2 and 3 years of age, respectively; 8% of infants had experienced an adverse reaction to foods when they turned 3 years of age. Cow milk was the most commonly implicated food. Main risk factors were allergenic food consumption, use of antibiotics, factors related to the presence of allergens, maternal history of overweight during pregnancy and allergy to insect bites.
Adverse reaction to food is a significant clinical problem in children from Havana. Modifiable risk factors were identified, the understanding of which will help to direct effective intervention strategies.
ABSTRACT INTRODUCTION Cirrhosis of the liver is a chronic disease that is widespread and irreversible. It represents the final stage of numerous diseases that affect the liver. By the end of 2017, it ...was the 11th most common cause of death, with a loss of 41.4 million years of disability-adjusted life years, which represent 2.1% of the total years of life lost in the global mortality burden. In Cuba, cirrhosis and other chronic liver diseases have been among the top 10 causes of death for several decades, their rates consistently increasing, from 576 deaths in 1970 (6.7 per 100,000 population) to 1738 in 2017 (15.5 per 100,000 population), with a risk of death that is 4.6 times higher in men. OBJECTIVE Characterize deaths from cirrhosis of the liver in Cuba from 1987 to 2017. METHODS An ecological time-series study was conducted for 1987 to 2017 using information obtained from the mortality database of the Medical Records and Health Statistics Bureau of Cuba’s Ministry of Public Health. The study universe consisted of all deceased persons in the country whose underlying cause of death was cirrhosis of the liver. Both general mortality rates and specific mortality were calculated by age group, sex and etiological classification using adjusted and crude rates. Rates were age-adjusted using the direct method, and the population from the 2002 Census of Population and Housing was considered as the standard population. Percentages and means were also calculated according to selected variables and the relative risk of death due to the disease according to sex, age group and etiological classification. The trend and forecast for mortality rates were estimated for this disease. RESULTS The crude mortality rate from cirrhosis of the liver was 9.0 per 100,000 population for the period. Those aged ≥75 years had the highest risk of death (48.3 per 100,000 population). The crude and adjusted mortality rates were almost double for men (12.4 vs. 5.6 and 11.7 vs. 5.6 per 100,000 population, respectively), as was the total relative risk of death, which was 2.2 times higher. Nonalcoholic cirrhosis accounted for 71.6% of deaths. By the end of 2017, risk of death from cirrhosis had climbed to 14.8 per 100,000 population (adjusted rate: 10.6 per 100,000 population), a signal that mortality had progressively increased over the 31 years analyzed. In addition, forecasts predict that death rates will continue their gradual increase, reaching 19.2 per 100,000 population in 2025. CONCLUSIONS Deaths from cirrhosis of the liver constitute a substantial health burden in Cuba. The upward trend and forecast, in addition to increased risk of mortality in men and older adults, are similar to those reported internationally. The finding that most of these deaths result from nonalcoholic cirrhosis should be further studied, as formulation of effective public health strategies depends largely on attaining a better understanding of the etiology, progression and social determinants of the disease.
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