scholarly journals Systematic Review Estimating the Burden of Dementia in the Latin America and Caribbean Region: A Bayesian Approach

2021 ◽  
Vol 12 ◽  
Author(s):  
Yawen Xiang ◽  
Kimberly Vilmenay ◽  
Adrienne N. Poon ◽  
Shant Ayanian ◽  
Christopher F. Aitken ◽  
...  
Keyword(s):  
Systematic Review ◽  
Latin America ◽  
Bayesian Approach ◽  
Epidemiological Studies ◽  
Population Based ◽  
Population Projections ◽  
Caribbean Region ◽  
Age Group ◽  
Middle Income ◽  
Latin America And Caribbean

Background: The global burden of dementia has increasingly shifted to low- and middle-income regions that lack essential data for monitoring epidemiological progression, and policy and planning support. Drawing upon data that have emerged since the last known estimates published in 2015, this study aims to update dementia estimates in the Latin America and Caribbean (LAC) region for the years 2020, 2030, and 2050 through the application of a recently validated Bayesian approach for disease estimates useful when data sources are scarce.Methods: A comprehensive parallel systematic review of PubMed, EMBASE, PsycINFO, Global Health, and LILACS was conducted to identify prospective population-based epidemiological studies on dementia published in English from 2013 to 2018 in LAC. English and non-English data cited by a recent review on dementia estimates in LAC were also examined for additional data. A Bayesian normal-normal hierarchical model (NNHM) was developed to estimate age-specific and age-adjusted dementia prevalence in people aged 60+. Using age-specific population projections from the UN, the total number of people affected by dementia for the years 2020, 2030, and 2050 were estimated.Results: 1,414 studies were identified, of which only 7 met the inclusion criteria. The studies had 7,684 participants and 1,191 dementia cases. The age-standardized prevalence of all forms of dementia in LAC was 8% (95% CI: 5–11.5%) in people aged 60+. The estimated prevalence varied with age, increasing from 2.5% (95% CI: 0.08–4.0%) in the 60-69 age group, to 9.4% (95% CI: 5.4–13.2%) in the 70–79 age group and 28.9% (95% CI: 20.3–37.2%) in the ≥80 age group. The number of people age 60 and older living with dementia in LAC in 2020 was estimated at 6.86 (95% CI: 4.3–9.8) million, 9.94 (95% CI: 6.16–14.15) million in 2030, and 19.33 (95% CI: 12.3–13.6) million in 2050.Conclusion: We project an upward disease trajectory for dementia in LAC countries. The projection is likely an underestimation of the true dementia burden given the underrepresentation of rural and socio-economically deprived populations. More research is urgently needed to improve the accuracy of disease estimates, guide clinicians to improve evaluations for earlier recognition of dementia, and support the development of effective policies for improving dementia prevention, diagnosis and clinical management in LAC's diverse and aging communities.

scholarly journals The landscape of COVID-19 clinical trials in Latin America and the Caribbean: assessment and challenges

2020 ◽  
Vol 44 ◽  
pp. 1
Author(s):  
Sarah Carracedo ◽  
Ana Palmero ◽  
Marcie Neil ◽  
Anisa Hasan-Granier ◽  
Carla Saenz ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Latin America ◽  
Caribbean Region ◽  
Middle Income ◽  
Middle Income Countries ◽  
Treatment And Prevention ◽  
Latin America And Caribbean ◽  
The Caribbean ◽  
Clinical Trials Registry ◽  
Robust Evidence

A considerable number of clinical trials is being conducted globally in response to the COVID-19 pandemic, including in low- and middle-income countries such as those in the Latin America and Caribbean region (LAC). Yet, an abundance of studies does not necessarily shorten the path to find safe and efficacious interventions for COVID-19. We analyze the trials for COVID-19 treatment and prevention that are registered from LAC countries in the International Clinical Trials Registry Platform, and identify a trend towards small repetitive non-rigorous studies that duplicate efforts and drain limited resources without producing meaningful conclusions on the safety and efficacy of the interventions being tested. We further assess the challenges to conducting scientifically sound and socially valuable research in the LAC region in order to inform recommendations to encourage clinical trials that are most likely to produce robust evidence during the pandemic.

scholarly journals Proton Therapy in Lower-Middle-Income Countries: From Facts and Reality to Desire, Challenges and Limitations

2021 ◽  
Author(s):  
Sandra Ileana Pérez Álvarez ◽  
Francisco Javier Lozano Ruiz ◽  
Federico Maldonado Magos ◽  
Aida Mota García
Keyword(s):  
Latin America ◽  
Human Resources ◽  
Health Expenditure ◽  
Caribbean Region ◽  
Middle Income ◽  
Proton Beam Radiotherapy ◽  
Middle Income Countries ◽  
Ideal Candidate ◽  
Geographic Coverage ◽  
Latin America And Caribbean

Around 50% of cancer patients will require radiotherapy (RT) and 10–15% of these patients could be eligible for proton beam radiotherapy (PBT). Dosimetric advantages are undeniable, mainly in pediatric and reirradiation scenarios. Though, PBT facilities are scarce worldwide and the IAEA has reported 116 functional particle facilities, of which 98 are PBT, virtually absent in low- and middle-income countries (LMIC). The Latin America and Caribbean region represent a unique opportunity for a PBT center, as there are currently no functional facilities and current RT needs are significant. The challenges can be summarized as high initial investment and maintenance, geographic coverage, required baseline technology and certification, over-optimistic workload, unclear rates and reimbursement, unmet business plan and revenue expectations, and lack of trained human resources. Investment costs for a PBT facility are estimated to be at around 140 million euros; therefore, this seems unsuitable for LMIC. Mexico’s geographical advantage, GDP, baseline technologies and high demand for RT makes it an ideal candidate. Nevertheless, a PBT center would account for a third of Mexico’s annual health expenditure for 2020. Enormous efforts must be made by both the private sector and governmental authorities to provide funding.

Meta-Analysis and Time Series Modeling Allow a Systematic Review of Primary HIV-1 Drug-Resistant Prevalence in Latin America and Caribbean

2015 ◽  
Vol 13 (2) ◽  
pp. 125-142 ◽  
Author(s):  
Antonio Coelho ◽  
Ronald Moura ◽  
Ronaldo Silva ◽  
Anselmo Kamada ◽  
Rafael Guimaraes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Time Series ◽  
Latin America ◽  
Meta Analysis ◽  
Drug Resistant ◽  
Time Series Modeling ◽  
Latin America And Caribbean ◽  
Hiv 1

Financial Access of Latin America and Caribbean Firms: What Are the Roles of Institutional, Financial, and Economic Development?

2021 ◽  
pp. 097265272110153
Author(s):  
Lan Khanh Chu
Keyword(s):  
Economic Development ◽  
Latin America ◽  
Jel Classification ◽  
Caribbean Region ◽  
Country Level ◽  
Level Data ◽  
Latin America And Caribbean ◽  
The Impact ◽  
Moderating Role

This article examines the impact of institutional, financial, and economic development on firms’ access to finance in Latin America and Caribbean region. Based on firm- and country-level data from the World Bank databases, we employ an ordered logit model to understand the direct and moderating role of institutional, financial, and economic development in determining firms’ financial obstacles. The results show that older, larger, facing less competition and regulation burden, foreign owned, and affiliated firms report lower obstacles to finance. Second, better macro-fundamentals help to lessen the level of obstacles substantially. Third, the role of institutions in promoting firms’ inclusive finance is quite different to the role of financial development and economic growth. JEL classification: E02; G10; O16; P48

Global epidemiology of SARS-CoV-2 infection: a systematic review and meta-analysis of standardized population-based seroprevalence studies, Jan 2020-Oct 2021

2021 ◽  
Author(s):  
Isabel Bergeri ◽  
Mairead Whelan ◽  
Harriet Ware ◽  
Lorenzo Subissi ◽  
Anthony Nardone ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Population Based ◽  
Control Measures ◽  
Middle Income ◽  
Global Epidemiology ◽  
Using Data ◽  
Demographic Subgroups ◽  
Over Time

Background COVID-19 case data underestimates infection and immunity, especially in low- and middle-income countries (LMICs). We meta-analyzed standardized SARS-CoV-2 seroprevalence studies to estimate global seroprevalence. Objectives/Methods We conducted a systematic review and meta-analysis, searching MEDLINE, Embase, Web of Science, preprints, and grey literature for SARS-CoV-2 seroprevalence studies aligned with the WHO UNITY protocol published between 2020-01-01 and 2021-10-29. Eligible studies were extracted and critically appraised in duplicate. We meta-analyzed seroprevalence by country and month, pooling to estimate regional and global seroprevalence over time; compared seroprevalence from infection to confirmed cases to estimate under-ascertainment; meta-analyzed differences in seroprevalence between demographic subgroups; and identified national factors associated with seroprevalence using meta-regression. PROSPERO: CRD42020183634. Results We identified 396 full texts reporting 736 distinct seroprevalence studies (41% LMIC), including 355 low/moderate risk of bias studies with national/sub-national scope in further analysis. By April 2021, global SARS-CoV-2 seroprevalence was 26.1%, 95% CI [24.6-27.6%]. Seroprevalence rose steeply in the first half of 2021 due to infection in some regions (e.g., 18.2% to 45.9% in Africa) and vaccination and infection in others (e.g., 11.3% to 57.4% in the Americas high-income countries), but remained low in others (e.g., 0.3% to 1.6% in the Western Pacific). In 2021 Q1, median seroprevalence to case ratios were 1.9:1 in HICs and 61.9:1 in LMICs. Children 0-9 years and adults 60+ were at lower risk of seropositivity than adults 20-29. In a multivariate model using data pre-vaccination, more stringent public health and social measures were associated with lower seroprevalence. Conclusions Global seroprevalence has risen considerably over time and with regional variation, however much of the global population remains susceptible to SARS-CoV-2 infection. True infections far exceed reported COVID-19 cases. Standardized seroprevalence studies are essential to inform COVID-19 control measures, particularly in resource-limited regions.

The HIV/AIDS epidemic in the Latin America and Caribbean Region

AIDS ◽  
2002 ◽  
Vol 16 ◽  
pp. S1-S2 ◽  
Author(s):  
Bernhard Schwartländer ◽  
Roel Coutinho ◽  
Luiz Loures
Keyword(s):  
Latin America ◽  
Caribbean Region ◽  
Aids Epidemic ◽  
Latin America And Caribbean ◽  
Hiv Aids

The risk of mortality among people with type 2 diabetes in Latin America: A systematic review and meta-analysis of population-based cohort studies

2019 ◽  
Vol 35 (4) ◽  
pp. e3139 ◽  
Author(s):  
Rodrigo M. Carrillo-Larco ◽  
Noël C. Barengo ◽  
Leonardo Albitres-Flores ◽  
Antonio Bernabe-Ortiz
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Latin America ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Population Based ◽  
Risk Of Mortality

scholarly journals Fostering a Collaborative Atmospheric Chemistry Research Community in the Latin America and Caribbean Region

2016 ◽  
Vol 97 (10) ◽  
pp. 1929-1939 ◽  
Author(s):  
Marcos Andrade-Flores ◽  
Nestor Rojas ◽  
Megan L. Melamed ◽  
Olga L. Mayol-Bracero ◽  
Michel Grutter ◽  
...  
Keyword(s):  
Air Pollution ◽  
Latin America ◽  
Atmospheric Chemistry ◽  
Rural Areas ◽  
Urban Areas ◽  
Caribbean Region ◽  
Rapid Urbanization ◽  
Chemistry Research ◽  
Latin America And Caribbean ◽  
Andean Glaciers

Abstract In 2013, the international Commission on Atmospheric Chemistry and Global Pollution (iCACGP) and the International Global Atmospheric Chemistry (IGAC) Project Americas Working Group (iCACGP/IGAC AWG) was formed to build a cohesive network and foster the next generation of atmospheric scientists with the goal of contributing to a scientific community focused on building collective knowledge for the Americas. The Latin America–Caribbean (LAC) region shares common history, culture, and socioeconomic issues but, at the same time, it is highly diverse in its physical and human geography. The LAC region is unique because approximately 80% of its population lives in urban areas, resulting in high-density hotspots of urbanization and vast unpopulated rural areas. In recent years, most countries of the region have experienced rapid growth in population and industrialization as their economies emerge. The rapid urbanization, the associated increases in mobile and industrial sources, and the growth of the agricultural activities related to biomass burning have degraded air quality in certain areas of the LAC region. Air pollution has negative implications for human health, ecosystems, and climate. In addition, air pollution and the warming caused by greenhouse gases could impact the melting of Andean glaciers, an important source of freshwater. To better understand the links between air pollution and climate, it is necessary to increase the number of atmospheric scientists and improve our observational, analytical, and modeling capacities. This requires sustained and prioritized funding as well as stronger collaboration within the LAC region.

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