Vertical stratification of arthropods in the dry ecosystems of Colombian Guyana: morphological patterns and their ecological implications / Estratificación vertical de artrópodos en ecosistemas secos de la Guayana colombiana: patrones morfológicos y sus implicaciones ecológicas

Abstract Introduction: Despite growing interest by the ecosystems derived from the Guyanese formations, the vertical structure of the communities and relationships of the biota with the climatic conditions in these ecosystems are unknown. Objective: Characterize the structure and vertical composition of the arthropod fauna associated with three of the most representative ecosystems of the Northern area of the serranía de La Lindosa in Colombia based on morphological and ecological parameters. Methods: The arthropod fauna was sampled, from the subsurface soil level to the shrub and tree stratum. The fauna was determined up to the level of family or supraspecific group and the values of Alfa and Beta diversity were determined. Body length measurements were made, and the coloration and trophic level of each group were determined. Results: The composition and diversity of the arthropod fauna was different in each ecosystem and vertical stratum and most of the groups in all the ecosystems studied present low abundances. Groups of phytophagous and predatory habits were frequent in all ecosystems and the highest biomass of arthropod fauna comes from groups of polyphagous habits, of medium size and great abundance. Light and dark colorations are the most frequent in landscape-scale. Conclusion: The ecosystems studied are characterized by the low values of diversity and replacement and the large number of non-shared groups that apparently respond to the microclimatic characteristics; however, there are some generalities on a landsc ape scale such as the greater richness and abundance of groups in the intermediate strata, the greater proportion of groups with phytophagous habits and medium body sizes, and the predominance of dark colorations in the lower strata.

Resumen Introducción: A pesar del interés que despiertan los ecosistemas derivados de las formaciones guyanesas, se desconoce la estructura vertical de las comunidades y las relaciones de la biota con las condiciones climáticas. Objetivo: Caracterizar la estructura y composición vertical de la artropofauna asociada a tres de los ecosistemas más representativos de la zona norte de la serranía de La Lindosa en Colombia, con base en parámetros morfológicos y ecológicos. Métodos: Se muestreó la artropofauna, desde el nivel del suelo subsuperficial hasta los estratos arbustivos y arbóreos, y se identificó hasta el nivel de familia o grupo supraespecífico. Se determinaron los valores de diversidad Alfa y Beta, se realizaron mediciones de la longitud corporal y se determinó la coloración y el nivel trófico de cada grupo. Resultados: La composición y diversidad de la artropofauna fue diferente en cada ecosistema y estrato vertical y la mayoría de los grupos de artrópodos en todos los ecosistemas estudiados presentan abundancias bajas. Los grupos de hábitos fitófagos y depredadores fueron frecuentes en todos los ecosistemas y la mayor biomasa de artropofauna proviene de grupos de hábitos polífagos, de tamaño medio y de gran abundancia. Las coloraciones claras y oscuras son las más frecuentes a escala de paisaje. Conclusión: Los ecosistemas estudiados se caracterizan por los bajos valores de diversidad y recambio y por la gran cantidad de grupos no compartidos que aparentemente responden a las características microclimáticas; sin embargo, existen algunas generalidades a escala de paisaje como la mayor riqueza y abundancia de grupos en los estratos intermedios, la mayor proporción de grupos de hábitos fitófagos y tallas corporales medianas y el predominio de coloraciones oscuras en los estratos inferiores.

An Assessment of the Accuracy of Creatinine Measurements in Guyana

ABSTRACT Background: The incidence of chronic kidney disease (CKD) is relatively high in Guyana. Estimated glomerular filtration rate (eGFR) reporting allows for early-stage CKD identification when therapeutic interventions can prevent CKD progression. Accurate creatinine measurements are essential for valid eGFR calculations. Objective: This study was undertaken to assess the accuracy of creatinine measurements in Guyana prior to implementing routine eGFR reporting. Methods: Sixteen Guyanese laboratories participated in this study. Each laboratory received a common set of blinded human serum samples (n = 3) containing clinically relevant creatinine concentrations, assigned by an international reference method (ID-GCMS). Laboratories performed repeated measurements of creatinine in each sample. These data were used to calculate bias, precision and total error (TE) for each creatinine method. Linear regression was used to compare measured creatinine results to assigned reference sample values and to post-analytically correct calibration bias, a priori, for recent patient results from each laboratory. Patient eGFR profiles were compared before and after bias correction. Results: The mean across samples CV and bias for all labs were 9% (range 2.5%-39.3%) and 11% positive (range 0.4%-29.1%), respectively. The mean TE was 28.6%. If the mean TE from a subset of the better performing laboratories (CV < 7%) was to apply nationally, an 'all stage' eGFR misclassification rate of 36% would result. Conclusion: There is a pressing need to improve the accuracy of creatinine measurements in Guyana as, at this time, routine reporting of eGFR by Guyanese laboratories cannot be recommended based on the accuracy data presented in this study.

Factors Influencing the Postgraduate Training Choices of Medical Interns and Junior Medical Officers at the Georgetown Public Hospital Corporation, Guyana

ABSTRACT Objective: To determine the specialty preferences and the reasons for those choices among medical interns and junior medical doctors at the Georgetown Public Hospital Corporation (GPHC), Guyana. Methods: A cross-sectional study of recent medical graduates at GPHC using anonymous self-administered questionnaires was used. Results: Of the study population of 66, 60 of the questionnaires that were filled were returned (response rate of 91.5%). The females comprised 60% of the respondents and 98% of the respondents were interested in Postgraduate Medical Education (PGME). Paediatrics was the most popular programme (25% of the respondents) followed by internal medicine (21%), and the main reason among the respondents for their choice of training programme was personal interest (69%). Gender differences occurred in paediatrics and ophthalmology where the females were predominant, and in orthopaedics and anaesthesia, where the males were predominant. Conclusion: To ensure an adequate and balanced medical specialists workforce for the future, information on medical graduates' perceptions and preferences of PGME and the factors influencing their choices is important to policy planners and medical educators and efforts must be made to correct any of the maldistributions noted.

Prevalence and Risks of Syphilis among Commercial Sex Workers in Georgetown, Guyana

ABSTRACT Objective: To determine the knowledge attitude and practice (KAP) and prevalence of syphilis and to investigate the sexual health practices and constraints among commercial sex workers (CSWs) in Guyana. Methods: The participants were randomly selected from CSWs participating in support group meetings held in Georgetown and Berbice. The survey was cross-sectional, and SPSS 20.0 was used to perform the data analysis. Results: The majority (92.9%) of CSWs tested negative for syphilis, whereas two (2.9%) of the five (7.1%) reactive Venereal Disease Research Laboratory cases indicated prior history of syphilis infection. In the study, 54.3% of participants always used condoms, whereas 74.3% did not use drugs and only 2.9% consumed alcohol every day. The participants had a fair KAP towards syphilis but few misconceptions exist. Stigma and discrimination was identified as the major constraint faced by male sex workers, and 97.1% of CSWs indicated that they preferred giving up sex work. Conclusion: Syphilis was not prevalent among the selected CSWs in Georgetown and Berbice. Prevention programmes should be continued through the support groups to maintain and increase safe sexual practices among female sex workers. Strategies should also be tailored to provide rehabilitation to the CSWs, especially for those willing to give up sex work.

Critical care medicine in the French Territories in the Americas: Current situation and prospects / La medicina intensiva en los territorios franceses de la Región de las Américas: situación actual y perspectivas / Medicina intensiva nos territórios ultramarinos franceses nas Américas: situação atual e perspectivas

ABSTRACT Hospitals in the French Territories in the Americas (FTA) work according to international and French standards. This paper aims to describe different aspects of critical care in the FTA. For this, we reviewed official information about population size and intensive care unit (ICU) bed capacity in the FTA and literature on FTA ICU specificities. Persons living in or visiting the FTA are exposed to specific risks, mainly severe road traffic injuries, envenoming, stab or ballistic wounds, and emergent tropical infectious diseases. These diseases may require specific knowledge and critical care management. However, there are not enough ICU beds in the FTA. Indeed, there are 7.2 ICU beds/100 000 population in Guadeloupe, 7.2 in Martinique, and 4.5 in French Guiana. In addition, seriously ill patients in remote areas regularly have to be transferred, most often by helicopter, resulting in a delay in admission to intensive care. The COVID-19 crisis has shown that the health care system in the FTA is unready to face such an epidemic and that intensive care bed capacity must be increased. In conclusion, the critical care sector in the FTA requires upgrading of infrastructure, human resources, and equipment as well as enhancement of multidisciplinary care. Also needed are promotion of training, research, and regional and international medical and scientific cooperation.

RESUMEN Los hospitales en los territorios franceses de la Región de las Américas funcionan según las normas francesas e internacionales. El objetivo de este artículo es describir distintos aspectos de los cuidados intensivos en los territorios franceses. Para ello, hemos revisado los datos oficiales sobre el tamaño de la población y el número de camas de las unidades de cuidados intensivos (UCI), así como la bibliografía sobre algunos aspectos específicos de las UCI, en los territorios franceses. Las personas que viven en los territorios franceses, o que están de visita en ellos, están expuestas a riesgos específicos: principalmente traumatismos graves causados por el tránsito, envenenamiento por mordeduras, heridas de bala o por apuñalamiento, y enfermedades infecciosas tropicales emergentes. La atención de estos traumatismos y enfermedades puede requerir conocimientos específicos y cuidados intensivos. Sin embargo, no hay suficientes camas de UCI en los territorios franceses. De hecho, hay 7,2 camas de UCI por 100 000 habitantes en Guadalupe, 7,2 en Martinica y 4,5 en Guayana Francesa. Además, los pacientes gravemente enfermos que viven en zonas remotas a menudo tienen que ser trasladados, normalmente por helicóptero, lo que retrasa su ingreso en la unidad de cuidados intensivos. La crisis de la COVID-19 ha puesto de manifiesto que el sistema de atención de salud en los territorios franceses no está preparado para enfrentarse a una epidemia de estas dimensiones y que debe aumentarse la capacidad hospitalaria de las unidades de cuidados intensivos. En conclusión, el sector de los cuidados intensivos en los territorios franceses tiene que mejorar su infraestructura, recursos humanos y equipamiento, así como perfeccionar la atención multidisciplinaria. También es necesario promover la capacitación, la investigación y la cooperación médica y científica, tanto regional como internacional.

RESUMO Os hospitais nos territórios ultramarinos franceses nas Américas funcionam segundo os padrões franceses e internacionais. O objetivo deste artigo é descrever os diversos aspectos da atenção intensiva nesta região. Analisamos os dados oficiais relativos ao tamanho da população e ao número de leitos de unidade de terapia intensiva (UTI) nestes territórios junto com uma revisão da literatura científica sobre as características particulares destes centros de terapia intensiva. Os residentes locais ou visitantes dos territórios ultramarinos franceses nas Américas são expostos a riscos específicos, sobretudo acidentes de trânsito graves, envenenamentos por animais peçonhentos, ferimentos por armas brancas ou armas de fogo e doenças infecciosas tropicais emergentes que requerem conhecimento especializado e atenção intensiva. Porém, não há leitos suficientes de UTI nos territórios ultramarinos franceses nas Américas: são 7,2 leitos de UTI por 100.000 habitantes em Guadalupe, 7,2 na Martinica e 4,5 na Guiana Francesa. Ademais, em áreas remotas, os pacientes em estado crítico frequentemente precisam ser transferidos por helicóptero, o que causa demora na internação em UTI. A crise da COVID-19 demonstra o despreparo do sistema de saúde para enfrentar a pandemia e a necessidade de aumentar o número de leitos de UTI nestes territórios. Em conclusão, é imprescindível modernizar a infraestrutura e os equipamentos, capacitar melhor os recursos humanos e melhorar a atenção multidisciplinar. Incentivar a formação profissional, pesquisa e cooperação médico-científica regional e mundial é também fundamental.

Exploring the determinants and outcomes of intimate partner violence during pregnancy for Guyanese women: Results from a nationally representative cross-sectional household survey / Análisis de los determinantes y las consecuencias de la violencia de pareja durante el embarazo en mujeres de Guyana: resultados de una encuesta domiciliaria transversal representativa a nivel nacional / Conhecendo os determinantes e os desfechos da violência por parceiro íntimo contra mulheres na gravidez na Guiana: resultados de uma pesquisa transversal domiciliar com representatividade nacional

ABSTRACT Objective. To determine predictors associated with physical violence during pregnancy, and to determine the relationship between exposure to intimate partner violence during pregnancy and women's health and suicide ideation in Guyana. Methods. A secondary data analysis of a cross-sectional household survey. Multivariate logistic regression models were fitted to the data to estimate the association between physical violence during pregnancy, controlling partner behavior, and other predictors. Ordered logistic regression models were fitted to estimate the association between physical violence during pregnancy and women's health, and lifetime physical partner violence and overall health. Logistic regression models were fitted to estimate associations between physical violence during pregnancy and lifetime physical partner violence and overall health and suicide ideation. Results. The prevalence of lifetime physical/sexual intimate partner violence was 38.8%, current physical/sexual intimate partner violence 11.1%, and violence during pregnancy 9.2%. Controlling partner behavior was significantly and positively associated with maternal experience of physical violence during pregnancy. Experiencing physical partner violence during pregnancy, but not lifetime physical partner violence, was associated with significantly increased odds of poor overall health. Physical violence during pregnancy and lifetime physical violence were both significantly associated with increased odds of suicide ideation. Conclusions. The prevalence of violence during pregnancy in Guyana is high and is associated with adverse health outcomes. These findings suggest the need for intimate partner violence prevention, and for integrating intimate partner violence screening and treatment into antenatal care, reproductive health services, and maternal and child health programs and services to identify and treat at-risk women.

RESUMEN Objetivo. Determinar los factores predictivos relacionados con la violencia física durante el embarazo y determinar la relación entre la exposición a la violencia de pareja durante el embarazo y la ideación suicida y la salud de las mujeres en Guyana. Métodos. Se realizó un análisis secundario de los datos obtenidos de una encuesta domiciliaria transversal. Se adaptaron modelos multifactoriales de regresión logística a los datos para calcular la asociación entre la violencia física durante embarazo, comportamiento controlador de la pareja y otros factores predictivos. Se emplearon modelos ordenados de regresión logística para calcular la asociación entre la violencia física durante el embarazo y la salud de la mujer, y la violencia de pareja a lo largo de la vida y la salud en general. Se aplicaron modelos de regresión logística para calcular la asociación entre la violencia física durante el embarazo y la violencia de pareja a lo largo de la vida y la ideación suicida y la salud en general. Resultados. La prevalencia de la violencia física o sexual infligida por la pareja a lo largo de la vida fue 38,8%, la violencia física o sexual infligida por la pareja en la actualidad fue 11,1% y la violencia durante el embarazo fue 9,2%. El comportamiento controlador de la pareja mostró una asociación positiva y significativa con una experiencia materna de violencia física durante el embarazo. Sufrir violencia física durante el embarazo, aunque no a lo largo de la vida, se asoció significativamente con mayores probabilidades de un estado de salud general deficiente. Tanto la violencia física durante el embarazo como la violencia física a lo largo de la vida se asociaron significativamente con mayores probabilidades de ideación suicida. Conclusiones. La prevalencia de la violencia durante el embarazo en Guyana es alta y está relacionada con consecuencias adversas en materia de salud. Estos resultados ponen de manifiesto la necesidad de prevenir la violencia de pareja y de integrar su detección y tratamiento en la atención prenatal, los servicios de salud reproductiva y los programas y servicios de salud maternoinfantil para detectar y tratar a las mujeres en riesgo.

RESUMO Objetivo. Determinar as variáveis preditivas associadas à violência física contra mulheres na gravidez e avaliar a relação entre exposição à violência por parceiro íntimo na gravidez e saúde e ideação suicida em mulheres na Guiana. Métodos. Foi realizada uma análise dos dados secundários de uma pesquisa transversal domiciliar. Modelos de regressão logística multivariada foram ajustados ao conjunto de dados para estimar a associação entre violência física na gravidez, controlando-se o efeito do comportamento do parceiro e outras variáveis preditivas. Modelos de regressão logística ordinal foram ajustados para estimar a associação entre violência física na gravidez e saúde das mulheres e violência física por parceiro íntimo ao longo da vida e saúde geral. Modelos de regressão logística foram ajustados para estimar a associação entre violência física na gravidez e violência física por parceiro íntimo ao longo da vida e saúde geral e ideação suicida. Resultados. Observou-se uma prevalência de 38,8% de violência física/sexual por parceiro íntimo ao longo da vida, 11,1% de violência física/sexual por parceiro íntimo no momento presente e 9,2% de violência física/sexual na gravidez. Controlando-se o efeito do comportamento do parceiro, verificou-se uma associação positiva significativa com experiência materna de violência física na gravidez. Sofrer violência física por parceiro íntimo na gravidez, mas não violência física por parceiro íntimo ao longo da vida, foi associado a uma chance significativamente maior de saúde geral ruim. Verificou-se uma associação significativa entre violência física na gravidez e violência física ao longo da vida e uma maior chance de ideação suicida. Conclusões. A prevalência da violência contra mulheres na gravidez na Guiana é alta e está associada a desfechos de saúde adversos. Esses resultados apontam para a necessidade de prevenir a violência por parceiro íntimo e integrar a avaliação da violência por parceiro íntimo e o tratamento das mulheres aos serviços de assistência pré-natal e de saúde reprodutiva e programas e serviços de saúde materno-infantil para identificar e tratar as mulheres em risco.

ASPECTOS AUTO-ECOLÓGICOS DE Bryconops giacopinii (IGUANODECTIDAE) DE LA SERRANÍA DE LA LINDOSA, SAN JOSÉ DE GUAVIARE, COLOMBIA / Auto-ecological traits of Bryconops giacopinii (Iguanodectidae) from la Serranía de La Lindosa, San José de Guaviare, Colombia

RESUMEN La relación longitud-peso y el factor de condición (K) son utilizados como descriptores de los aspectos auto-ecológicos de los peces, porque aportan información sobre el crecimiento, reproducción y bienestar. Por tanto, su caracterización podría ser de gran utilidad en la evaluación de poblaciones de peces en sistemas acuáticos afectados por diferentes niveles de intervención. El objetivo principal de este estudio fue la caracterización y descripción de la relación longitud-peso, factor de condición y dieta de Bryconops giacopinii en seis localidades en la Serranía de La Lindosa durante un ciclo anual (estación seca y lluviosa). Los peces (n= 333) fueron medidos, pesados, y su estómago fue removido para la identificación de los ítems alimenticios. Los individuos presentaron un crecimiento alométrico positivo durante ambas estaciones climáticas, sin diferencias significativas en el factor de condición durante el cambio estacional. Por otra parte, se identificaron 17 tipos diferentes de ítems alimenticios, la mayoría de ellos artrópodos terrestres. La frecuencia y ocurrencia de estos ítems no siguió ningún patrón temporal ni espacial. B. giacopinii presentó una dieta generalista, con un alto consumo de insectos terrestres. Los resultados obtenidos evidencian la estrecha relación entre esta especie y el bosque de ribera, demostrando la importancia que presentan estos corredores biológicos para el mantenimiento de la comunidad acuática y su conservación. Esta información aporta al conocimiento biológico de esta especie de interés comercial y puede ser utilizada en la comparación con otras poblaciones presentes en otras cuencas. B. giacopinii es una especie con un papel ecológico importante, por lo tanto, estudios de su relación con el ecosistema podrían ser relevantes y necesarios.

ABSTRACT Length-weight relationship and condition factor (K) have been used as a fish biological descriptor, because they provide information about growth, reproduction, and welfare. Therefore, these parameters can be used in the assessments of fish populations inhabiting aquatic systems affected by different levels of intervention. The main objective of this study was the depiction and description of the length-weight relationship, condition factor and diet of Bryconops giacopinii in six sites at Serranía La Lindosa over one annual cycle (dry and wet seasons). Fish (n = 333) were measured, weighted, and the stomach was removed to identify prey items. Fish displayed a positive allometric growth during both seasons, without differences in the condition factor during the seasonal change.On the other hand, 17 prey items were identified; most of them terrestrial arthropods. The frequency and occurrence of these items did not follow a temporal or spatial pattern. B. giacopinii displayed a generalist diet, with a high consumption rate of terrestrial insects. The obtained results show the strong relationships between this species and the riparian forest, proving the importance of this biological corridors to the maintenance of the aquatic community and its conservation. This information contributes to the biological knowledge of this species out commercial interest and can be used to compare other populations in other basis. B. giacopinii is a species with an important ecological role. Therefore, research of its relationship with the ecosystem could be of great relevance and necessity.

Diversity of dung beetles (Coleoptera: Scarabaeidae) of the northern zone from Serranía de La Lindosa, Guaviare-Colombia / Diversidad de escarabajos coprófagos (coleoptera: scarabaeidae) de la zona norte de la serranía de la lindosa, guaviare-colombia

RESUMEN Se estudió la composición faunística de los escarabajos coprófagos en cuatro sitios de muestreo en la zona norte de la Serranía de La Lindosa en el Departamento del Guaviare, evaluando la diversidad y la estructura de los ensamblajes que se compararon con trabajos realizados en otras zonas de la Guyana biogeográfica. Los resultados muestran valores bajos en la diversidad, propios de zonas con baja disponibilidad de recursos y gran exigencia climática y el predominio de especies de hábito de nidificación cavadora sobre especies residentes y rodadoras. La composición de la fauna presenta gran número de especies comunes con otras áreas de la región, similar a las afinidades encontradas para otros taxones que apoyan los nexos de estas serranías colombianas con los escudos guyanés y brasileño.

ABSTRACT Faunal composition of the coprophagous beetles was studied in four sampling sites in the northern area from the Serranía de La Lindosa in Guaviare, testing diversity values and structure of the assemblages that were compared with other research done in any other areas of Biogeographical Guyana. The results showed low diversity values, typical of areas with low availability of resources and extreme climatic conditions and showed the predominance of species with nesting digging habit over resident and rolling species. The fauna composition presents a large number of common species with any other areas of the region, as occur as other affinities found for other taxa that support the links of these Colombian mountains to the Guyanese and Brazilian shields.

A Study on Trends and Patterns of Leprosy in Guyana during a Ten year Period, 2007-2016

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an acid-fast, rod-shaped bacillus. This study reports the trends of leprosy in Guyana during the year 2007-2016. This is a retrospective study conducted by analyzing records of all cases registered with Guyana Hansen's Disease Control Programme (GHDCP) during the ten year period. A total of 265 patients data were analyzed in this study. Mean age ± standard deviation (SD) of leprosy patients was 34.5 ± 17 (95% CI 32.5-36.6). There was a noticeable overall increase in the number of leprosy cases throughout the years 2007 to 2016. The trend of PB cases on the other hand, revealed noticeable increase from 9.9% in 2007 to 12.7% in 2016 similarly percentage of multibacillary (MB) cases also showed an increase from 9.4% in 2007 to 14.1% in 2016 (p=0.61). Significantly more cases were recorded for MB (71.9%; 95% CI 66.1-77.2) (p < 0.001) than Paucibacillary (PB) (26.6%; 95% CI 21.4-32.3) (p < 0.001). Within MB, significantly more cases were with LL (28.5%; 95% CI 23.1- 34.3) followed by BL (13.9%; 95% CI 9.9-18.6) (p < 0.001). However, the highest proportion of childhood leprosy and a considerable number of new cases could witness the active transmission of the disease and the existence of new infections within the country. This study therefore provides an insight into the trends of leprosy in Guyana and the result should be considered important to create awareness and reinforcement of policies towards leprosy care.

Scale-up of collaborative TB/HIV activities in Guyana / Ampliar las actividades de colaboración contra la tuberculosis y la infección por el VIH en Guyana

ABSTRACT Objective To assess scale-up of recommended tuberculosis (TB)/HIV activities in Guyana and to identify specific strategies for further expansion. Methods Medical records and clinic registers were reviewed at nine TB clinics and 10 HIV clinics. At TB clinics, data were collected on HIV testing and antiretroviral therapy (ART) for patients with TB/HIV; at HIV clinics, data were collected on intensified case finding (ICF), tuberculin skin test (TST) results, and provision of isoniazid preventive therapy (IPT). Results At TB clinics, among 461 patients newly diagnosed with TB, 419 (90.9%) had a known HIV status and 121 (28.9%) were HIV-infected. Among the 63 patients with TB/HIV, 33 (52.4%) received ART. Among the 45 patients with TB/HIV for whom dates of HIV diagnosis were available, 38 (84.4%) individuals knew their HIV status prior to TB diagnosis. At HIV clinics, among 127 patients eligible to receive a TST, 87 (68.5%) received a TST, 66 (75.9%) had a TST result, seven (10.6%) had a newly positive result, two had a previously positive result, and six of nine patients with positive results (66.7%) received IPT. ICF could not be assessed because of incomplete or discrepant documentation. Conclusions An in-depth evaluation of TB/HIV activities successfully identified areas of success and remaining challenges. At TB clinics, HIV testing rates are high; further scale-up of ART for persons with TB/HIV is needed. At HIV clinics, use of TST to focus IPT is a feasible and efficient strategy; improving rates of annual TST screening will allow for further expansion of IPT.

RESUMEN Objetivo Evaluar la ampliación de las actividades recomendadas contra la tuberculosis (TB) y la infección por el VIH en Guyana y definir estrategias específicas para nuevas expansiones. Métodos Se examinaron los expedientes médicos y registros clínicos de nueve consultorios de atención de la TB y diez consultorios de atención de la infección por el VIH. En los consultorios de atención de la tuberculosis, se recopilaron datos sobre las pruebas de detección del VIH y el tratamiento antirretroviral (TAR) para pacientes con TB e infección por el VIH; en los consultorios de atención de la infección por VIH, se recopilaron datos a partir de una búsqueda intensiva de casos, los resultados de la prueba de la tuberculina y la provisión de tratamiento preventivo con isoniazida. Resultados En los consultorios de atención de la tuberculosis, de 461 pacientes recién diagnosticados con tuberculosis, 419 (90,9%) conocían su estado con respecto a la infección por el VIH y 121 (28,9%) estaban infectados por el virus. De los 63 pacientes con TB e infección por el VIH, 33 (52,4%) recibieron TAR. De los 45 pacientes con TB e infección por el VIH cuya fecha de diagnóstico de la infección por el VIH se conocía, 38 (84,4%) supieron de su estado con respecto a la infección por el VIH antes de recibir el diagnóstico de la tuberculosis. En los consultorios de atención de la infección por el VIH, de 127 pacientes que reunían los requisitos para la prueba de la tuberculina, 87 (68,5%) recibieron la prueba, 66 (75,9%) tuvieron un resultado, siete (10,6%) tuvieron un resultado positivo nuevo, dos habían tenido un resultado positivo anteriormente, y seis de nueve pacientes con resultados positivos (66,7%) recibieron tratamiento preventivo con isoniazida. No pudo evaluarse la búsqueda intensiva de casos debido a que la documentación estaba incompleta o era discrepante. Conclusiones Una evaluación exhaustiva de las actividades contra la TB y la infección por el VIH permitió determinar las áreas donde se había tenido éxito y los retos pendientes. En los consultorios de atención de la tuberculosis, las tasas de realización de pruebas de detección del VIH son elevadas; se necesita ampliar el alcance del TAR para llegar a las personas con TB e infección por el VIH. En los consultorios de atención de la infección por el VIH, el uso de la prueba de la tuberculina para focalizar la búsqueda intensiva de casos es una estrategia factible y eficaz; el mejoramiento de las tasas de tamizaje anual con la prueba de la tuberculina permitirá ampliar la búsqueda intensiva de casos.

Exposición a la publicidad de tabaco y consumo de tabaco en adolescentes en América del Sur / Tobacco advertisement exposure and tobacco consumption among youths in South America

Resumen: Objetivo: Este estudio evalúa la relación estadística entre la exposición a la publicidad de tabaco y el tabaquismo en los adolescentes de América del Sur. Material y métodos: Usando datos de la Encuesta Mundial de Tabaquismo en Jóvenes (GYTS) se estudiaron los niveles de exposición a nivel de escuela, ante distintos tipos de publicidad, además se evaluaron los comportamientos asociados al tabaquismo durante la experimentación y consumo. La muestra total fue de 134 073 jóvenes de Argentina, Bolivia, Chile, Perú, Brasil, Uruguay, Surinam, Colombia, Guyana, Ecuador, Paraguay y Venezuela que se combinaron en el análisis. Resultados: La exposición a la publicidad está positiva y significativamente asociada a un incremento en las probabilidades de que los jóvenes experimenten con el cigarrillo al menos una vez en sus vidas. Para los fumadores activos, la exposición a la publicidad está positiva y significativamente asociada con el número de cigarrillos fumados. Conclusiones: La publicidad de productos de tabaco debe ser controlada fuertemente o eliminada totalmente en varios países de Sudamérica.

Abstract: Objective: To assesses the statistical association between exposure to tobacco marketing and tobacco consumption among adolescents in South America, by using data from the Global Youth Tobacco Survey. Materials and methods: Using data from the Global Youth Tobacco Survey (GYTS), the exposure to tobacco marketing at the school level was studied from advertising in TV, radio, massive public events and street advertisement. Tobacco behaviour was considered. The total pooled sample used was 134 073 youths from Argentina, Bolivia, Chile, Peru, Brazil, Uruguay, Suriname, Colombia, Guyana, Ecuador, Paraguay and Venezuela. Results: The exposure to tobacco marketing is positively and significantly associated to the probability of youths experimenting with tobacco (at least once in their lifetime). For regular smokers, exposure to tobacco marketing is positively and significantly associated to smoking intensity. Conclusions: These results call for the implementation of strong restrictions on tobacco advertisement of various types in South American countries.

A new species of Panaqolus (Siluriformes: Loricariidae) from the rio Branco

A new species of Panaqolus is described from material from the Takutu River and the mainstem rio Branco. The new species is diagnosed from congeners by its color pattern consisting of dark and light bars on the body, bands on the fins, and with dots and vermiculations absent (vs. no bars in P. albomaculatus , P. nix , P. nocturnus , and P. koko , vs. fins unbanded in P. albomaculatus , P. dentex , P. koko , and P. nix , and vs. dots and vermiculations present in P. albivermis and P. maccus ). The new species is diagnosed from barred species of Panaqolus by its specific bar number and orientation and color pattern on its head, with bars oriented in a anteroventral-posterodorsal direction (vs. anterodorsal-posteroventral bars in P. gnomus ), having consistently 5 bars (n = 4) on the trunk that do not increase with size (vs. number increasing with size in P. purusiensis and vs. 6-12 in P. changae ), and the color pattern on the head of straight lines extending from posterior to the eye to the snout margin, splitting in the middle portion of the line in larger specimens (vs. small, dense reticulate lines in P. changae ). Biogeographically, we infer that the new species ancestrally originated in the Amazon river, dispersing to the Takutu River after the Amazon captured part of the Proto-Berbice.

Uma espécie nova de Panaqolus é descrita do rio Branco e seu afluente, rio Tacutu. A nova espécie é diagnosticada de suas congêneres pelo padrão de colorido composto por barras escuras e claras alternadas no corpo e nadadeiras, não formando máculas ou vermiculações nas nadadeiras (vs. sem barras no corpo em P. albomaculatus , P. nix , P. nocturnus , e P. koko , e vs. sem barras nas nadadeiras em P. albomaculatus , P. dentex , P. koko , e P. nix , e vs. máculas e vermiculações presentes em P. albivermis e P. maccus ). A nova espécie é diagnosticada das espécies de Panaqolus com barras pelo número e orientação das barras e pelo padrão de colorido cefálico, com as barras orientadas posterodorsalmente (vs. posteroventralmente em P. gnomus ), pela presença de cinco barras (n = 4) no tronco que não aumentam com o tamanho (vs. número aumentando com o tamanho em P. purusiensis e vs. 6-12 barras em P. changae ), e o padrão de colorido cefálico composto por linhas retas da margem posterior do olho à margem do focinho, dividida medianamente em indivíduos maiores (vs. linhas pequenas e vermiculadas em P. changae ). Nos inferimos que a nova espécie originou-se ancestralmente no rio Amazonas, dispersando para o rio Tacutu após o Amazonas capturar parte do Proto-Berbice.

Dung beetles of the tribe Phanaeini (Coleoptera: Scarabaeidade: Scarabaeinae) from Roraima state, Northern Brazil: checklist and key to species / Os besouros rola-bostas da tribo Phanaeini (Coleoptera: Scarabaeidae: Scarabaeinae) do estado de Roraima, Norte do Brasil: lista e chave para as espécies

Phanaeini comprises about 160 species in 12 genera restricted to the Americas. Since the diversity of this tribe remains little known in several regions of Brazil, this study presents a guide to its 13 species with presence in the biologically rich and largely unexplored state of Roraima: Coprophanaeus (Coprophanaeus) abas (MacLeay, 1819), C. (C.) dardanus (MacLeay, 1819), C. (C.) gameziArnaud, 2002, C. (C.) jasius (Olivier, 1789), C. (Megaphanaeus) lancifer (Linnaeus, 1767), Oxysternon (Oxysternon) conspicillatum conspicillatum Werber, 1801, O. (O.) durantoniArnaud, 1984, O. (O.) ebeninum (Nevinson, 1890), O. (O.) festivum viridanum (Olsoufieff, 1924), O. (O.) silenus chicheryiArnaud, 2001, Phanaeus (Notiophanaeus) bispinusBates, 1868, P. (N.) bordoniArnaud, 1996 (first record from Brazil), and Sulcophanaeus faunus (Fabricius, 1775). The species of Dendropaemon were not considered herein because the genus is presently under taxonomic revision.

Phanaeini abrange cerca de 160 espécies pertencentes a 12 gêneros restritos ès Américas. Como a diversidade desta tribo permanece pouco conhecida em diversas regiões do Brasil, este estudo apresenta um guia de identificação das 13 espécies com registro de ocorrência no estado biologicamente rico e amplamente inexplorado de Roraima: Coprophanaeus (Coprophanaeus) abas (MacLeay, 1819), C. (C.) dardanus (MacLeay, 1819), C. (C.) gameziArnaud, 2002, C. (C.) jasius (Olivier, 1789), C. (Megaphanaeus) lancifer (Linnaeus, 1767), Oxysternon (Oxysternon) conspicillatum conspicillatum Werber, 1801, O. (O.) durantoniArnaud, 1984, O. (O.) ebeninum (Nevinson, 1890), O. (O.) festivum viridanum (Olsoufieff, 1924), O. (O.) silenus chicheryiArnaud, 2001, Phanaeus (Notiophanaeus) bispinusBates, 1868, P. (N.) bordoniArnaud, 1996 (que aqui é reportado pela primeira vez no Brasil), e Sulcophanaeus faunus (Fabricius, 1775). As espécies do gênero Dendropaemon não foram incluídas no trabalho por estarem em processo de revisão taxonômica.

Assessment of provider competence and quality of maternal/newborn care in selected Latin American and Caribbean countries / Evaluación de la competencia de los proveedores y la calidad de la atención materna y del recién nacido en países de América Latina y el Caribe

OBJECTIVE: To obtain a snapshot of the maternal and newborn care provided by different types of maternal and child health providers in Latin America and the Caribbean (LAC) to 1) better inform advocacy and programmatic strategies and interventions to improve the quality of those services in the region, and 2) determine the need for more rigorous study of the issues. METHODS: A rapid assessment of 83 health workers providing antepartum, intrapartum, and immediate postpartum and newborn care (within two hours of birth) in eight LAC countries was conducted in November and December of 2011. Health workers were observed by two-person expert maternal/newborn clinician teams using pretested forms based on international quality-of-care standards. A total of 105 care encounters were observed, primarily in urban, public, referral-level settings. Providers of care included obstetricians, midwives, generalist physicians, medical residents, registered nurses, auxiliary nurses, and students of medicine, midwifery, and nursing. RESULTS: Hand washing, as an indicator of quality of antepartum care, was observed in only 41% of the observed encounters. Labor management often lacked certain elements of respectful maternity care across all provider groups. Several clinical tasks of high importance in the identification and prevention of common complications of antepartum, intrapartum, and immediate postpartum/newborn care were not documented as performed during the observation periods. Providers self-reported limited competence (ability to perform to a defined level of proficiency) in manual removal of the placenta, bimanual compression of the uterus, and newborn resuscitation. CONCLUSIONS: The findings suggest that 1) the quality of maternal and newborn care and 2) the competence of maternal and child health providers in the diverse selection of LAC countries that were studied require substantial attention.

OBJETIVO: Obtener una visión panorámica de la atención materna y del recién nacido prestada por diferentes tipos de proveedores de salud maternoinfantil en América Latina y el Caribe para 1) fundamentar mejor las estrategias e intervenciones de promoción de la causa y programáticas con objeto de mejorar la calidad de esos servicios en la región, y 2) determinar la necesidad de estudios más rigurosos sobre estos temas. MÉTODOS: En noviembre y diciembre del 2011, se llevó a cabo una evaluación rápida de 83 trabajadores sanitarios que prestaban atención antes del parto, intraparto, y posparto inmediata y del recién nacido (durante las dos horas posteriores al parto) en ocho países de América Latina y el Caribe. Los trabajadores sanitarios fueron observados por equipos de dos clínicos expertos en atención materna y del recién nacido mediante el empleo de instrumentos previamente puestos a prueba y basados en estándares internacionales de calidad de la atención. Se observaron 105 encuentros de atención que tuvieron lugar principalmente en centros de atención urbanos, públicos y de derivación. Los proveedores de atención fueron obstetras, parteras, médicos generalistas, médicos residentes, personal de enfermería titulado, personal auxiliar de enfermería, y estudiantes de medicina, partería y enfermería. RESULTADOS: El lavado de las manos, como indicador de la calidad de la atención antes del parto, solo se observó en 41% de los encuentros observados. El manejo del parto a menudo carecía de ciertos elementos de atención respetuosa a la maternidad en todos los grupos de proveedores. Durante los períodos de observación, no se pudo comprobar la realización de diversas tareas clínicas de alta importancia para detectar y prevenir las complicaciones comunes de la atención antes del parto, intraparto, y posparto inmediata y del recién nacido. Los proveedores autonotificaron limitada competencia (capacidad para operar a un nivel definido de habilidad) en la extracción manual de la placenta, la compresión bimanual del útero y la reanimación del recién nacido. CONCLUSIONES: Los resultados indican que 1) la calidad de la atención materna y del recién nacido y 2) la competencia de los proveedores de salud maternoinfantil en los países de América Latina y el Caribe estudiados requieren considerable atención.

Determining the Community Prevalence of Acute Gastrointestinal Illness and Gaps in Surveillance of Acute Gastroenteritis and Foodborne Diseases in Guyana.

Guyana is an English-speaking country in South America and, culturally, it is part of the Caribbean. Objective of this study was to determine the community prevalence and true burden and economic impact of acute gastroenteritis (AGE) and foodborne diseases (FBDs) in Guyana. A cross-sectional population-based survey was conducted in 7 of the 10 regions in Guyana during August and November 2009 to capture the high- and low-AGE season respectively. Overall, 1,254 individual surveys were administered at a response rate of 96.5%. The overall monthly prevalence of self-reported cases of AGE was 7.7% (97 cases) (95% CI 6.3-9.3), and the yearly incidence was 1.0 episodes per person-year. The highest monthly prevalence of AGE was observed in region 4 (8.9%) and in children aged 1-4 year(s) (12.7%). Of the 97 AGE cases, 23% sought medical care; 65% reported spending time at home due to their illness [range 1-20 day(s), mean 2.7 days], of whom 51% required other individuals to look after them while ill. The maximum number of stools per 24 hours ranged from 3 to 9 (mean 4.5), and number of days an individual suffered from AGE ranged from 1 to 21 day(s) (mean 2.7 days). The burden of syndromic AGE cases in the population for 2009 was estimated to be 131,012 cases compared to the reported 30,468 cases (76.7% underreporting), which implies that, for every syndromic case of AGE reported, there were additional 4.3 cases occurring in the community. For every laboratory-confirmed case of FBD/AGE pathogen reported, it was estimated that approximately 2,881 more cases were occurring in the population. Giardia was the most common foodborne pathogen isolated. The minimum estimated annual cost associated with the treatment for AGE was US$ 2,358,233.2, showing that AGE and FBD pose a huge economic burden on Guyana. Underreporting of AGE and foodborne pathogens, stool collection, and laboratory capacity were major gaps, affecting the surveillance of AGE in Guyana.

Guianacara dacrya, a new species from the rio Branco and Essequibo River drainages of the Guiana Shield (Perciformes: Cichlidae)

Describimos una especie nueva de Guianacara de las cuencas del río Essequibo y el río Branco en Guyana y el norte de Brasil. Guianacara dacrya, especie nueva, puede distinguirse de todos sus congéneres por la presencia de una barra infraorbital modificada y por la forma única del margen lateral de la placa dentada de la mandíbula faríngea inferior. Adicionalmente, Guianacara dacrya se distingue de G. stergiosi, G. owroewefi, G. sphenozona y G. geayi por poseer una barra medio-lateral fina, de G. cuyunii por poseer membranas branquistegales grises y de G. oelemariensis por poseer dos supraneurales. La especie nueva se distingue de la mayoría de sus congéneres por la presencia de manchas blancas en la porción espinosa de la aleta dorsal, la posición de la mancha medio-lateral, la presencia de filamentos en la aleta dorsal, anal y en algunos casos en la caudal, y de al menos las especies venezolanas por varias características morfométricas. Guianacara dacrya se conoce de las cuencas del ríos Essequibo, Takutu e Ireng en Guyana y posiblemente del río Uraricoera en la cuenca del río Branco en Brasil. Se presenta una clave de especies.

A new species of Guianacara is described from tributaries of the Essequibo River and the rio Branco in Guyana and northern Brazil. Guianacara dacrya, new species, can be diagnosed from all congeners by the possession of a unique infraorbital stripe and by the shape of the lateral margin of the lower pharyngeal jaw tooth plate. Guianacara dacrya can be further distinguished from G. geayi, G. owroewefi, G. sphenozona and G. stergiosi by the possession of a thin midlateral bar, from G. cuyunii by the possession of dusky branchiostegal membranes and from G. oelemariensis by the possession of two supraneurals. This species differs from most congeners by the presence of white spots on the spiny portion of the dorsal fin, the placement of the midlateral spot, the presence of filaments on the dorsal, anal and in rare cases the caudal-fin and from at least the Venezuelan species by several morphometric variables. Guianacara dacrya is known from the Essequibo, Takutu and Ireng River basins of Guyana and possibly from the rio Uraricoera in the rio Branco basin in Brazil. A key to the species is provided.

Lebiasina yepezi, a new Lebiasininae (Characiformes: Lebiasinidae) from the Serra Parima-Tapirapecó mountains

Lebiasina yepezi, a new Lebiasininae with a conspicuous color pattern, is described. The new species is endemic of the headwaters of the rio Negro, rio Branco, and rio Orinoco in the Serra Parima-Tapirapecó Mountains, at the border of Brazil and Venezuela. The new species is readily distinguished from all other Lebiasininae by the presence of four black longitudinal stripes on the trunk, and the triangular shaped dorsal surface of the mesethmoid, lacking lateral projections. The unusual color pattern is contrasted with those of other lebiasinin, as well as members of the pyrrhulinin genus Nannostomus. A close relationship between Lebiasina yepezi and the Gran Sabana (Venezuela) species is suggested based in color pattern features. The present contribution corresponds to a further refutation of the type locality of L. intermedia, as suggested on its description, since Lebiasinins, except L. bimaculata, L. boruca, and L. festae, do not occur in low land waters.

Lebiasina yepezi, um novo Lebiasininae com um conspícuo padrão de colorido, é descrito. A nova espécie é endêmica das cabeceiras do rio Negro, rio Branco e rio Orinoco, na Serra Parima-Tapirapecó, ao longo da fronteira entre Brasil e Venezuela. A nova espécie é prontamente diferenciada das demais espécies pela presença de quatro faixas longitudinais escuras ao longo do corpo, e a superfície dorsal do mesetmoide com o formato triangular, não apresentando projeções laterais. O padrão de colorido incomum é comparado com o dos demais Lebiasininae e também com o dos Pyrrhulininae do gênero Nannostomus. Uma próxima relação é proposta entre Lebiasina yepezi e as espécies da Gran Sabana (Venezuela) com base em caracteres de colorido. A presente contribuição corresponde a mais uma refutação da localidade-tipo de L. intermedia conforme sugerida na descrição daquela espécie, uma vez que os lebiasiníneos, com exceção de L. bimaculata, L. boruca e L. festae, não ocorrem em rios de terras baixas.

Implementation of a standardized HIV patient monitoring system in Guyana / Establecimiento de un sistema estandarizado de vigilancia de los pacientes infectados por el VIH en Guyana

OBJECTIVE: To describe the process used to implement a comprehensive, standardized, and reliable national system for data collection for HIV care and treatment in Guyana; to provide examples of the program-level data resulting from implementation; and to highlight the monitoring benefits for national programs. METHODS: In 2007, Guyana's Ministry of Health and other key stakeholders adapted the World Health Organization's generic HIV care and antiretroviral therapy (ART) patient monitoring guidelines to fit the Guyana context, which included modifying the patient chart, patient registers, and cross-sectional and cohort reports. Following initial training and feedback from clinical staff, a national patient monitoring system (PMS) was finalized, piloted, and implemented at all care and treatment sites. Thereafter, sites received monthly supportive supervisory visits to review data collection and validate reports. RESULTS: Implementation of the PMS enabled analysis of cohort data for patients on ART. After 12 months, 79 percent of a combined national cohort of all 50 patients who started ART in June 2007 were alive and on first-line ART regimens. After six years, 58 percent of the first (April 2002) cohort of ART patients in the country were alive and on ART, with only two (8 percent) patients on second-line regimens. CONCLUSIONS: Implementation of a national PMS for standardized data collection and reporting across multiple clinical sites ultimately provided important and reliable information on utilization of services, patient outcomes, and survival rates on treatment. These data are used at the national level to monitor the efficacy of the HIV care and treatment program. Successful implementation requires early inclusion of all committed stakeholders and a dedicated human resource team to ensure sustainability of the system.

OBJETIVO: Describir el proceso utilizado con el objeto de poner en práctica un sistema nacional integral, estandarizado y confiable de recopilación de datos sobre la atención y el tratamiento de la infección por el VIH en Guyana; suministrar ejemplos de los datos que se obtuvieron mediante el programa durante la ejecución; y subrayar las ventajas de la vigilancia para los programas nacionales. MÉTODOS: En el 2007, el Ministerio de Salud de Guyana y otros actores claves adaptaron al contexto de Guyana las directrices básicas de la Organización Mundial de la Salud sobre el seguimiento de los pacientes con VIH que reciben atención y tratamiento antirretrovírico; la adaptación implicó modificaciones en el expediente clínico, el registro de los pacientes, los informes transversales y los informes de cohortes. Después de una capacitación inicial y la retroalimentación por parte del personal médico, se finalizó un sistema nacional de seguimiento de los pacientes, que se puso a prueba y se puso en marcha en todos los centros de atención y tratamiento. Posteriormente, se realizaron visitas mensuales de supervisión y apoyo a los centros, con el fin de examinar la recopilación de los datos y validar los informes. RESULTADOS: La ejecución del programa de vigilancia de los pacientes permitió el análisis de los datos de las cohortes de pacientes en tratamiento antirretrovírico. Después de 12 meses, se encontró que 79 por ciento de una cohorte nacional combinada de los 50 pacientes que comenzaron tratamiento antirretrovírico en junio del 2007 estaban vivos y recibían tratamiento con antirretrovíricos de primera línea. Después de seis años, 58 por ciento de la primera cohorte de pacientes tratados con antirretrovíricos en el país (abril del 2002) estaban vivos, continuaban el tratamiento y solo dos pacientes (8 por ciento) recibían medicamentos de segunda línea. CONCLUSIONES: La ejecución de un programa nacional de supervisión de los pacientes con recopilación y notificación estandarizada de los datos en múltiples centros clínicos suministró en último término información importante y confiable sobre la utilización de los servicios, el desenlace clínico de los pacientes y las tasas de supervivencia con el tratamiento. Estos datos se usan a escala nacional con el fin de vigilar la eficacia del programa de atención y tratamiento de la infección por el VIH. La ejecución eficaz del programa exige la participación temprana de todos los actores claves comprometidos y un equipo de recursos humanos dedicado a velar por la sostenibilidad del sistema.

The nutritional vulnerability of older Guyanese in residential homes / Vulnerabilidad nutricional de los ancianos guyaneses en los hogares de ancianos

OBJECTIVE: To assess the nutritional status, functional ability and food intake of older Guyanese in residential care. METHODS: Eighty-four residents of one public and two private homes underwent an anthropometric and functional ability assessment including height, weight, armspan, arm and calf circumferences and handgrip strength. Food intake in two private homes was measured over seven days by direct weighing and the use of consumption units. RESULTS: The overall prevalence of underweight was 26.2% and of overweight was 17.8% but the prevalence of underweight was higher in the public home (29.3% underweight and 17.2% overweight in the public home, and 19.2% underweight and 19.2% overweight in the private home). Mean handgrip strength was 26 kg in males and 17.7 kg in females. The nutritional adequacy of the diet provided by one of the homes was poor with the food providing less than 50% of the required amount of zinc and vitamins A, D and C. Neither home met the requirement for energy. CONCLUSION: A high prevalence of malnutrition exists in a public home for the elderly and, to a lesser degree, in two private homes. In the context of a rapidly ageing population and tight financial constraints, the challenge of providing an adequate diet must be given priority.

Objetivo: Evaluar el estatus nutricional, la capacidad funcional, y la ingestión de alimentos de ancianos guyaneses en el cuidado residencial. Métodos: Ochenta y cuatro residentes de dos hogares privados y uno público fueron sometidos a una evaluación antropométrica y de su capacidad funcional, que incluyó altura, peso, medida de la distancia de los brazos abiertos, brazos, circunferencias de la pantorrilla, y fuerza del puño. La ingestión de alimentos en dos hogares privados fue medida durante siete días mediante el peso directo y el uso de unidades de consumo. Resultados: La prevalencia general del bajo peso corporal fue de 26.2% y la del peso corporal excesivo de 17.8%, pero la prevalencia del bajo peso fue más alta en el hogar público (29.3% de bajo peso frente a 17.2% de peso excesivo en el hogar público, y 19.2% de bajo peso frente a 19.2% de peso excesivo en el hogar público). La fuerza media del puño fue 26 kg en los hombres y 17.7 kg en las mujeres. La adecuación nutricional de la dieta suministrada por uno de los hogares fue pobre, formada por alimentos que proveían menos del 50% de las cantidades requeridas de zinc y vitaminas A, D, y C. Ninguno de los hogares satisfacía los requerimientos energéticos. . Conclusion: En el hogar público para los ancianos, la prevalencia de la malnutrición es alta en grado alarmante, y lo mismo ocurre, en menor grado, en los dos hogares privados. En el contexto de una población que se avejenta rápidamente y que experimenta serias limitaciones financieras, hay que dar prioridad al reto de suministrar una dieta adecuada.