Dengue outbreaks in Brazil and Latin America: the new and continuing challenges.

OBJECTIVES: To compare the number of suspected cases, severe cases, and deaths of dengue in 2023 and 2024 in Brazil and Latin America; and to describe its epidemiological profile. DESIGN: Observational study. METHODS: The data regarding dengue was retrieved from the Brazilian Ministry of Health website. The Chi-square test was used to compare the proportion of dengue cases in 2023 and 2024 according to gender, race, and age range. The odds ratio and the 95% confidence intervals were used to describe the data. The Spearman correlation test was used to compare the number of suspected cases, severe cases, and deaths of dengue with the number of distributed vaccines against dengue. RESULTS: Dengue is one of the most common zoonoses in Latin America. In 2023, Brazil registered a total of 1,658,814 suspected cases of dengue with 1094 deaths. For 2024, a total of 1,978,372 suspected cases of dengue were reported only until the 11th epidemiological week, with 656 deaths. When comparing dengue cases reported in 2024 and 2023, there is an increase in suspected cases, with 20% more cases reported during the first 11 epidemiological weeks of 2024 than in the entire 52 epidemiological weeks of 2023. At the same time, in 2024, the Pan American Health Organization reported suspected cases in 20 Latin American countries, with 3073 cases of severe dengue and 1187 deaths. In Brazil, a different racial profile for dengue was described since Black people [OR = 1.56 (95% CI = 1.54-1.57)], Mixed individuals [OR = 1.36 (95% CI = 1.35-1.37), and Indigenous peoples [OR = 1.77 (95% CI = 1.70-1.85)] were more likely to be suspected cases of dengue in 2024 compared to 2023. Also, a positive correlation between the distributed vaccines with deaths due to dengue and the number of severe cases was described. CONCLUSION: Brazil was responsible for more than 50% of suspected cases and deaths from dengue compared to the other Latin American countries in 2024. Furthermore, there is a different racial profile for dengue in Brazil, as Black people, Mixed individuals, and Indigenous peoples were more likely to be suspected cases of dengue in 2024 compared to 2023.

Estimated Population-Level Impact of Pneumococcal Conjugate Vaccines Against All-Cause Pneumonia Mortality Among Unvaccinated in 5 Latin American Countries.

BACKGROUND: Pneumococcal conjugate vaccines (PCVs) provide strong direct protection in children, while limited data are available on their indirect effect on mortality among older age groups. This multicountry study aimed to assess the population-level impact of pediatric PCVs on all-cause pneumonia mortality among children ≥5 years of age, and invasive pneumococcal disease (IPD) cases in Chile. METHODS: Demographic and mortality data from Argentina, Brazil, Chile, Colombia, and Mexico were collected considering the ≥ 5-year-old population, from 2000 to 2019, with 1 795 789 deaths due to all-cause pneumonia. IPD cases in Chile were also evaluated. Time series models were employed to evaluate changes in all-cause pneumonia deaths during the postvaccination period, with other causes of death used as synthetic controls for unrelated temporal trends. RESULTS: No significant change in death rates due to all-cause pneumonia was detected following PCV introduction among most age groups and countries. The proportion of IPD cases caused by vaccine serotypes decreased from 29% (2012) to 6% (2022) among people aged ≥65 years in Chile. DISCUSSION: While an effect of PCV against pneumonia deaths (a broad clinical definition that may not be specific enough to measure indirect effects) was not detected, evidence of indirect PCV impact was observed among vaccine-type-specific IPD cases.

Exploring Differences in Dietary Diversity and Micronutrient Adequacy between Costa Rican and Mexican Adolescents.

Diet diversity becomes especially relevant during adolescence to satisfy the adequate micronutrient intake. Diet diversity (DD) and micronutrient probability of adequacy (PA) were studied in 818 Costa Rican (CR) and 1202 Mexican (MX) adolescents aged 13-18 years. DD was compared using the Minimum Dietary Diversity (MDD) score. Receiver-operating characteristic (ROC) curves were employed to identify the optimal MDD for each sample from the respective countries. The mean MDD for the overall CR sample was 4.17 ± 1.43 points, and for the MX sample, the mean MDD was 4.68 ± 1.48 points. The proportion of adolescents with a DD was significantly higher in Costa Rica than in Mexico (66.5% vs. 55.6%; p < 0.0001). Also, DD was higher in rural Costa Rican adolescents, while no difference was found in the MX adolescents by area of residence. CR adolescents reported significantly higher PA than MX participants for 6 of the 11 micronutrients assessed. The calcium PA in MX adolescents was significantly higher than in the CR sample (MX: 0.84 vs. CR: 0.03; p < 0.0001), while low PA was obtained for iron in both countries (CR: 0.01 vs. MX: 0.07; p < 0.0001). In Costa Rica and Mexico, nutritional interventions and assessing the compliance of food-fortifying programs are needed to improve the PA of diverse micronutrients.

Micro- and Macronutrient Intake and Food Group Frequency Consumed by Subjects with Cognitive Impairment and Dementia in Latin America: A Systematic Review.

BACKGROUND: Nutrition has relevant role in the pathogenesis of dementia. However, in Latin American Countries (LAC), it is unknown which type of diet the subjects with dementia and cognitive dysfunction have. OBJECTIVE: The main purpose of this study was to determine micro- and macronutrients and food frequency intake among the LAC population with mild cognitive impairment (MCI) and dementia. METHODS: A systematic review using PubMed, Cochrane, Lilacs, and Scielo databases. Energy intake as well as micro- and macronutrients intake were analyzed using a random-effect model and presented in a forest plot. RESULTS: Nine articles were included, an estimated energy intake of 1598.47 kcal (95% CI 1351.07-1845.88) was obtained. A daily consumption of 73.64 g/day (95% CI 64.07-83.2) of protein; 262.17 g/day (95% CI 214.51-309.93) of carbohydrates, and 57.91 g/day (95% CI 49.16-66.66) of fats were reported. A micronutrients daily intake consumption of 201.35µg/day of vitamin B9 (95% CI 125.32-277.38); 5.61µg/day of vitamin B12 (95% CI 2.53-8.70), and 139.67 mg/day of vitamin C (95% CI 59.33-220.02). Mineral intake of 637.32 mg/day of calcium (95% CI 288.54-986.11) and 9 mg/day of iron (95% CI 2.28-15.71) was obtained. A low intake of fruits and vegetables was found. CONCLUSION: Individuals with MCI and dementia from LAC have a nutritional deficiency characterized by a lower intake of fruits and vegetables, a high consumption of carbohydrates and protein, adequate fats intake and vitamins B12, vitamin C, and iron consumption, but a low intake of vitamin B9 and calcium.

Culturally adapting an evidence-based parenting intervention for the Chilean context: Balancing fidelity, context, and cultural relevance.

The dissemination of evidence-based parent training (PT) interventions remains extremely limited in Latin American countries. This is concerning when considering the high prevalence of child maltreatment associated with punitive parenting practices across countries in the region. Furthermore, efforts to disseminate PT interventions must be conducted by adhering to the core parenting components that have established effectiveness for such interventions, while ensuring contextual and cultural relevance for focus populations. In this manuscript, we describe the cultural adaptation of an evidence-based PT intervention in the context of Chile. This initial phase of adaptation was informed by the theoretical tenets of the Ecological Validity Model of cultural adaptation (Bernal et al., J. Abnorm. Child Psychol., 23, 1995, 67). According to findings from a qualitative thematic analysis conducted with five interventionists in training, therapists perceived that the intervention's core components were relevant to Chilean caregivers who participated in the parenting program. Interventionists also provided specific suggestions to enhance the intervention's contextual and cultural relevance. This investigation illustrates the importance of culturally adapting evidence-based interventions according to comprehensive cultural adaptation frameworks, prior to engaging in large-scale dissemination of adapted interventions in Latin American contexts.

Dynamics and Co-movements Between the COVID-19 Outbreak and the Stock Market in Latin American Countries: An Evaluation Based on the Wavelet-Partial Wavelet Coherence Model.

The COVID-19 outbreak and the global uncertainty it causes produce an apparent panic in stock markets. Efforts to explain the economic spillover effects of COVID-19 can guide authorities to design a control policy against the financial impacts of pandemics. The paper examines the effects of the COVID-19 cases on the stock markets in the emerging Latin American countries of Argentina, Brazil, Chile, Colombia, Mexico, and Peru. The paper employs a continuous partial wavelet methodology to observe lead-lag relations between the daily variables of new COVID-19 cases and the stock market index for each Latin American country. Brazilian new COVID-19 cases led the Bovespa (BVSP) index to decline during the whole period, except February and June 2020, at one month-two month-frequency band. The wavelet and phase difference analyses indicate that, except for Brazil, COVID-19 cases did not affect the stock market indexes adversely during the whole sample period but did affect the stock exchange markets negatively during some sub-sample periods of the entire sample of each country. Dynamics of Latin American stock exchange markets in the short and long run can be explained by some other parameters of real and financial sectors and COVID-19 cases.

Minireview: Epidemiological impact of arboviral diseases in Latin American countries, arbovirus-vector interactions and control strategies.

Mosquitoes are the most crucial insects in public health due to their vector capacity and competence to transmit pathogens, including arboviruses, bacterias and parasites. Re-emerging and emerging arboviral diseases, such as yellow fever virus (YFV), dengue virus (DENV), zika virus (ZIKV), and chikungunya virus (CHIKV), constitute one of the most critical health public concerns in Latin America. These diseases present a significant incidence within the human settlements increasing morbidity and mortality events. Likewise, among the different genus of mosquito vectors of arboviruses, those of the most significant medical importance corresponds to Aedes and Culex. In Latin America, the mosquito vector species of YFV, DENV, ZIKV, and CHIKV are mainly Aedes aegypti and Ae. Albopictus. Ae. aegypti is recognized as the primary vector in urban environments, whereas Ae. albopictus, recently introduced in the Americas, is more prone to rural settings. This minireview focuses on what is known about the epidemiological impact of mosquito-borne diseases in Latin American countries, with particular emphasis on YFV, DENV, ZIKV and CHIKV, vector mosquitoes, geographic distribution, and vector-arbovirus interactions. Besides, it was analyzed how climate change and social factors have influenced the spread of arboviruses and the control strategies developed against mosquitoes in this continent.

Coastline variability of several Latin American cities alongside Pacific Ocean due to the unusual "Sea Swell" events of 2015.

This study aims to report the short-term coastline dynamics and inundation limits of coastal cities along the Eastern Pacific due to the sea swell events that occurred during April to May 2015. The multi-temporal satellite datasets from Landsat such as Enhanced Thematic Mapper (L7 ETM+) and Operational Land Imager/Thermal Infrared Sensor (L8 OLI/TIRS) of different periods before and after the swell events were used to identify the shoreline changes. The satellite images were pre-processed using ERDAS imagine 9.2, and the coastline was digitized in ArcGIS 10.4.1 for ten cities spread across from Mexico to Chile (in Pacific coast) using the spectral water indices, and the shoreline change rate and erosion/accretion pattern at each transect were estimated using the statistical parameters embedded in Digital Shoreline Analysis System (DSAS). The maximum erosion and accretion were observed in El Salvador (268 m) and Huatulco (Mexico) (115 m), respectively. Likewise, the maximum inundation was observed in El Salvador with 268 m and Acapulco (Mexico) with 254 m, and the tide gauge data suggest a possible relation to the bathymetry and the geomorphological conditions of the coast. Overall, the results indicate that the Eastern Pacific Ocean side sea swell events has led to extreme coastal flooding in recent years due to the increase in the mean sea level and the unpredictable variation in El Niño/Southern Oscillation events. Graphical abstract.

Significant differences in access to tests and treatments for multiple myeloma between public and private systems in Latin America. Results of a Latin American survey. GELAMM (Grupo de Estudio Latino Americano de Mieloma Múltiple).

The incidence of multiple myeloma (MM) has increased in the last 20 years, particularly in middle and low-middle income countries. Access to diagnostic and prognostic tests and the availability of effective care is highly variable globally. Latin America represents 10% of the world population, distributed in countries of varied size, population, and socio-economic development. In the last decade, great improvements have been made in the diagnosis and treatment of MM. Applying these advances in real life is a challenge in our region. Local data regarding MM standards of care and outcomes are limited. A survey was carried out among hematologists from 15 Latin American countries to describe access to MM diagnostic and prognostic tests and the availability of effective care options. This study provides real-world data for MM in our region, highlighting striking differences between public and private access to essential analyses and therapeutic options.

Key factors associated with uncontrolled asthma - the Asthma Control in Latin America Study.

Objective: This study aimed to estimate asthma control at specialist treatment centers in four Latin American countries and assess factors influencing poor asthma control.Methods: Patients aged ≥12 years with an asthma diagnosis and asthma medication prescription, followed at outpatient specialist centers in Argentina, Chile, Colombia, and Mexico, were included. The study received all applicable ethical approvals. The Asthma Control Test (ACT) was used to classify patients as having controlled (ACT 20-25) or uncontrolled (ACT ≤19) asthma. Frequency and statistical tests were used to assess the association between hospital admissions/exacerbations/emergency department (ED) visits and uncontrolled asthma; multivariate logistic regression was used to assess the association of uncontrolled asthma with clinical/demographic variables.Results: A total of 594 patients were included. Overall controlled-asthma prevalence was 43.4% (95% confidence interval [CI]: 39.0, 47.4). Patients with uncontrolled asthma were more likely to be women (adjusted odds ratio [aOR]: 1.85; p = 0.003), non-white (aOR: 2.14; p < 0.001), obese (aOR: 1.71; p = 0.036), to have a low monthly family income (aOR: 1.75; p = 0.004), to have severe asthma (aOR:1.59; p = 0.26), and, compared with patients with controlled asthma, to have a higher likelihood of asthma exacerbations (34.5% vs. 15.9%; p < 0.001), hospital admissions (6.9% vs. 3.1%; p = 0.042), and ED visits (34.5% vs. 15.9%; p < 0.001) due to asthma.Conclusions: Even in specialist ambulatory services, fewer than half of patients were classified as having controlled asthma. The proportion of uncontrolled patients varied according to clinical and demographic variables.

FRAX-based intervention and assessment thresholds in seven Latin American countries

Age-specific intervention and assessment thresholds were developed for seven Latin American countries. The intervention threshold ranged from 1.2% (Ecuador) to 27.5% (Argentina) at the age of 50 and 90 years, respectively. In the Latin American countries, FRAX offers a substantial advance for the detection of subjects at high fracture risk.INTRODUCTION:Intervention thresholds are proposed using the Fracture Risk Assessment (FRAX) tool. We recommended their use to calculate the ten-year probability of fragility fracture (FF) in both, men and women with or without the inclusion of bone mineral density (BMD). The purpose of this study is to compute FRAX-based intervention and BMD assessment thresholds for seven Latin American countries in men and women ≥ 40 years.METHODS:The intervention threshold (IT) was set at a 10-year probability of a major osteoporotic fracture (MOF) equivalent to a woman with a prior FF and a body mass index (BMI) equal to 25.0 kg/m2 without BMD or other clinical risk factors. The lower assessment threshold was set at a 10-year probability of a MOF in women with BMI equal to 25.0 kg/m2, no previous fracture and no clinical risk factors. The upper assessment threshold was set at 1.2 times the IT.RESULTS:For the seven LA countries, the age-specific IT varied from 1.5 to 27.5% in Argentina, 3.8 to 25.2% in Brazil, 1.6 up to 20.0% in Chile, 0.6 to 10.2% in Colombia, 0.9 up to 13.6% in Ecuador, 2.6 to 20.0% in Mexico, and 0.7 up to 22.0% in Venezuela at the age of 40 and 90 years, respectively.CONCLUSIONS:In the LA countries, FRAX-based IT offers a substantial advance for the detection of men and women at high fracture risk, particularly in the elderly. The heterogeneity of IT between the LA countries indicates that country-specific FRAX models are appropriate rather than a global LA model (AU)

Effect sizes and cut-off points: a meta-analytical review of burnout in latin American countries.

Burnout is a highly prevalent globalized health issue that causes significant physical and psychological health problems. In Latin America research on this topic has increased in recent years, however there are no studies comparing results across countries, nor normative reference cut-offs. The present meta-analysis examines the intensity of burnout (emotional exhaustion, cynicism and personal accomplishment) in 58 adult nonclinical samples from 8 countries (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Peru and Venezuela). We found low intensity of burnout but there are significant differences between countries in emotional exhaustion explained by occupation and language. Social and human service professionals (police officers, social workers, public administration staff) are more exhausted than health professionals (physicians, nurses) or teachers. The samples with Portuguese language score higher in emotional exhaustion than Spanish, supporting the theory of cultural relativism. Demographics (sex, age) and study variables (sample size, instrument), were not found significant to predict burnout. The effect size and confidence intervals found are proposed as a useful baseline for research and medical diagnosis of burnout in Latin American countries.

FRAX-based intervention and assessment thresholds in seven Latin American countries.

Age-specific intervention and assessment thresholds were developed for seven Latin American countries. The intervention threshold ranged from 1.2% (Ecuador) to 27.5% (Argentina) at the age of 50 and 90 years, respectively. In the Latin American countries, FRAX offers a substantial advance for the detection of subjects at high fracture risk. INTRODUCTION: Intervention thresholds are proposed using the Fracture Risk Assessment (FRAX) tool. We recommended their use to calculate the ten-year probability of fragility fracture (FF) in both, men and women with or without the inclusion of bone mineral density (BMD). The purpose of this study is to compute FRAX-based intervention and BMD assessment thresholds for seven Latin American countries in men and women ≥ 40 years. METHODS: The intervention threshold (IT) was set at a 10-year probability of a major osteoporotic fracture (MOF) equivalent to a woman with a prior FF and a body mass index (BMI) equal to 25.0 kg/m2 without BMD or other clinical risk factors. The lower assessment threshold was set at a 10-year probability of a MOF in women with BMI equal to 25.0 kg/m2, no previous fracture and no clinical risk factors. The upper assessment threshold was set at 1.2 times the IT. RESULTS: For the seven LA countries, the age-specific IT varied from 1.5 to 27.5% in Argentina, 3.8 to 25.2% in Brazil, 1.6 up to 20.0% in Chile, 0.6 to 10.2% in Colombia, 0.9 up to 13.6% in Ecuador, 2.6 to 20.0% in Mexico, and 0.7 up to 22.0% in Venezuela at the age of 40 and 90 years, respectively. CONCLUSIONS: In the LA countries, FRAX-based IT offers a substantial advance for the detection of men and women at high fracture risk, particularly in the elderly. The heterogeneity of IT between the LA countries indicates that country-specific FRAX models are appropriate rather than a global LA model.

Diabetes, a global public health challenge with a high epidemiological and economic burden on health systems in Latin America.

This manuscript presents the results of an analysis that highlights the challenges of diabetes as a global public health problem. The analysis was conducted in two phases: the first phase deals with primary data and results of a longitudinal study to provide evidence on the Mexican case. Regarding epidemiological changes between 2014 and 2016, there is an increase of 9-13% (p < .001). Comparing the economic burden from epidemiological changes in 2014 versus 2016 (p < .05), there is a 26% increase. The total amount spent on diabetes in 2015 (US dollars) was $ 8,974,662,570. This includes $ 3,981,426,810 in direct costs and $ 4993,235,752 in indirect costs. The second phase emphasises the analysis of diabetes as a major global public health challenge in the Americas. For this purpose a comparative analysis of epidemiological trends was carried out in seven selected Latin American countries (LACs). The results of both phases showed evidence leading to the conclusion that if the risk factors and models of health care remain as they currently are in LACs, there will be a high economic impact to patients' pockets and to health systems, which could lead to financial collapse.

Vascular Dysfunction in Mother and Offspring During Preeclampsia: Contributions from Latin-American Countries.

Pregnancy is a physiologically stressful condition that generates a series of functional adaptations by the cardiovascular system. The impact of pregnancy on this system persists from conception beyond birth. Recent evidence suggests that vascular changes associated with pregnancy complications, such as preeclampsia, affect the function of the maternal and offspring vascular systems, after delivery and into adult life. Since the vascular system contributes to systemic homeostasis, defective development or function of blood vessels predisposes both mother and infant to future risk for chronic disease. These alterations in later life range from fertility problems to alterations in the central nervous system or immune system, among others. It is important to note that rates of morbi-mortality due to pregnancy complications including preeclampsia, as well as cardiovascular diseases, have a higher incidence in Latin-American countries than in more developed countries. Nonetheless, there is a lack both in the amount and impact of research conducted in Latin America. An impact, although smaller, can be seen when research in vascular disorders related to problems during pregnancy is analyzed. Therefore, in this review, information about preeclampsia and endothelial dysfunction generated from research groups based in Latin-American countries will be highlighted. We relate the need, as present in many other countries in the world, for increased effective regional and international collaboration to generate new data specific to our region on this topic.

Niveles de Optimismo: Diferencias entre adultos de países latinoamericanos / Levels of Optimism: Differences between adults in Latin American countries

Resumen El optimismo disposicional es la variable dentro de la Psicología Positiva que más se ha estudiado en distintos entornos, pues se presenta como relacionada y predictora de otras variables y entornos de salud. El presente estudio se dedicó a conocer si existían diferencias significativas en los niveles de Optimismo medidos a través del Life Orientation Test (LOT-R) en función del país de residencia que tenían las personas, en una muestra accidental de 464 personas de Argentina, México y Chile. No se encontraron diferencias significativas en la dimensión Optimismo pero sí en la dimensión Pesimismo, en donde Argentina presenta los mayores niveles. Además, se detectaron diferencias significativas en 2 de los ítems de la dimensión Optimismo, en la que los residentes mexicanos presentaban mejores niveles, y en un ítem de la dimensión Pesimismo. Los resultados son limitados al estudio que se realizó, pero destacan la importancia de realizar más estudios en temas que los gobiernos actuales están trabajando para mejorar la calidad de vida de las personas, que puede estar directamente influenciada por variables positivas como el Optimismo.

Abstract Dispositional optimism is the variable within Positive Psychology that has been studied in different environments, as it is presented as related and predictor of psychological variables and health environments. The present study investigated whether there were significant differences in Optimism levels measured through the Life Orientation Test (LOT-R) according to the country of residence of the people, in an accidental sample of 464 people from Argentina, Mexico and Chile. No significant differences were found in the Optimism dimension, but in the Pessimism dimension, where Argentina presents the highest levels. In addition, significant differences were detected in 2 of the items in the Optimism dimension, where Mexican residents presented themselves with better levels, and in an item of the dimension Pessimism. The results are limited to the study that was carried out but they emphasize the importance of carrying out more studies in subjects that the present governments are working to improve the quality of life of the people that can be directly influenced by positive variables like Optimism.

Attributes of patient-centered primary care associated with the public perception of good healthcare quality in Brazil, Colombia, Mexico and El Salvador.

This study evaluated primary care attributes of patient-centered care associated with the public perception of good quality in Brazil, Colombia, Mexico and El Salvador. We conducted a secondary data analysis of a Latin American survey on public perceptions and experiences with healthcare systems. The primary care attributes examined were access, coordination, provider-patient communication, provision of health-related information and emotional support. A double-weighted multiple Poisson regression with robust variance model was performed. The study included between 1500 and 1503 adults in each country. The results identified four significant gaps in the provision of primary care: not all respondents had a regular place of care or a regular primary care doctor (Brazil 35.7%, Colombia 28.4%, Mexico 22% and El Salvador 45.4%). The communication with the primary care clinic was difficult (Brazil 44.2%, Colombia 41.3%, Mexico 45.1% and El Salvador 56.7%). There was a lack of coordination of care (Brazil 78.4%, Colombia 52.3%, Mexico 48% and El Salvador 55.9%). Also, there was a lack of information about healthy diet (Brazil 21.7%, Colombia 32.9%, Mexico 16.9% and El Salvador 20.8%). The public's perception of good quality was variable (Brazil 67%, Colombia 71.1%, Mexico 79.6% and El Salvador 79.5%). The primary care attributes associated with the perception of good quality were a primary care provider 'who knows relevant information about a patient's medical history', 'solves most of the health problems', 'spends enough time with the patient', 'coordinates healthcare' and a 'primary care clinic that is easy to communicate with'. In conclusion, the public has a positive perception of the quality of primary care, although it has unfulfilled expectations; further efforts are necessary to improve the provision of patient-centered primary care services in these four Latin American countries.

Economic Impact of Meningococcal Outbreaks in Brazil and Colombia.

Background. The impact of meningitis outbreaks is substantial. We aim to calculate the costs of meningococcal outbreaks in Brazil and Colombia from the healthcare system perspective. Methods. A review of the literature was performed on costs associated with meningococcal outbreak in Latin America. Structured interviews capturing information about the use of resources, expenses allocated to treatment of infection, immunization campaigns, and response activities during the outbreak and disease surveillance pre- and postoutbreak were directed at local health authorities in Brazil and Colombia to foster a greater understanding of the economic impact of meningococcal outbreaks. All costs were expressed in 2014 US values. Results. The Vila Brandina outbreak in Brazil reported 3 cases that were associated with a total investigation and outbreak management cost of $34 425 ($11 475 per notified case), representing 2.7 more than the annual gross domestic product per capita in Brazil. In contrast, the outbreak in Cartagena de Indias in Colombia reported 6 cases at a cost of the disease response phase of $735 or 9.5% of the annual gross domestic product per capita ($123 per notified case). For the disease surveillance phase, the costs ranged from $3935 (in Cartagena de Indias) to $6667 (in Vila Brandina). Serogroups B and C were responsible for the majority of meningococcal outbreaks reported in Brazil and Colombia. Conclusions. Findings of this study underscore the importance of meningococcal disease in the region. Future research should focus on a more detailed investigation of costs of meningococcal outbreaks covering all phases of an outbreak.

Public communication of science in Mexico: past, present and future of a profession.

In this article, we offer an analysis of the evolution of the professional field of public communication of science in Mexico, particularly at the National Autonomous University of Mexico, the influences it has received from other countries, the impact it has on Mexican society and some of its relationships with other Latin American countries. We present examples of successful programmes in different mass media and an analysis of the evolution and diversification of science communicators over the last four decades.

Salud: entre la actividad física y el sedentarismo / Health: between physical activity and sedentariness

El presente artículo se centra en el rol que desempeña la actividad física (AF) en la salud pública, destacando el papel en la prevención de la morbimortalidad producto de las enfermedades crónicas asociadas a la nutrición y muertes prematuras. La evidencia de asociación entre la actividad física y salud, ampliamente sustentada dentro de la literatura científica, justifica su consideración dentro de los programas de promoción de la salud a nivel mundial. La estrategia de búsqueda se focalizó en las reseñas históricas de los beneficios de la actividad física, como factor que subyace en el concepto de vida saludable. En este sentido se hace hincapié en la relación entre la inactividad física y la existencia de ciertos tipos de enfermedades cardio-metabólicas, la posible asociación entre la AF y las funciones cognoscitivas y la aparición del sobrepeso y obesidad el cual constituyen en la actualidad, un problema de salud pública a nivel mundial. De igual manera se plantea dentro de la revisión analizada, el efecto de los cambios demográficos que propician la conducta sedentaria, las diversas metodologías empleadas para la evaluación de la A.F. y el sedentarismo, especialmente las encuestas diseñadas al efecto; datos sobre el nivel de la misma y conducta sedentaria en diferentes grupos de edad y algunos países latinoamericanos, consideraciones sobre las disposiciones legales que norman la actividad física especialmente en el ámbito escolar y, finalmente, ciertas estrategias urbanas e intervenciones empleadas en distintos grupos de edad para aminorar el efecto del sedentarismo(AU)

This article focuses on the role played by physical activity (PA) on public health, highlighting the role in preventing morbidity and mortality from chronic diseases, associated with quality of nutrition and premature deaths. Evidence of the association between physical activity and health, widely supported in the scientific literature, justify its consideration within the global health promotion programs. The research strategy focuses on the historical reviews of the benefits of physical activity, as a factor underlying the concept of healthy life. In this sense emphasis on relationship between physical inactivity and the existence of certain types of cardio-metabolic diseases, the possible association between P.A. and cognitive functions and the occurrence of overweight and obesity, which are now worldwide public health problems, were surveyed. Similarly, the review intends to summarize the effect of demographic changes that encourage sedentary behavior, different methodologies to assess P.A. and sedentariness, its current status in different groups of ages and in some Latin America countries, considerations for the legal provisions governing the physical activity, especially at school age and, finally, certain urban strategies and interventions employed in different age groups to lessen the effect of the sedentary lifestyle(AU)