Search Results (111)

The Latin American and Caribbean (LAC) region faces persistent challenges of inequality, climate change vulnerability, and deteriorating air quality. The Aburrá Valley, where Medellín is located, is a narrow tropical valley with complex topography, strong thermal inversions, and unstable atmospheric conditions, all of which exacerbate the accumulation of pollutants. In Medellín, ${\mathrm{NO}}_2$ concentrations have remained nearly unchanged over the past eight years, consistently approaching critical thresholds, despite the implementation of air quality control strategies. These persistent high concentrations are closely linked to the variability of the atmospheric boundary layer (ABL) and are often intensified by prolonged dry periods. This study focuses on a representative street canyon in Medellín that has undergone recent urban interventions, including the construction of new public spaces and pedestrian areas, without explicitly considering their impact on ${\mathrm{NO}}_x$ dispersion. Using Computational Fluid Dynamics (CFD) simulations, this work evaluates the influence of urban morphology on ${\mathrm{NO}}_x$ accumulation. The results reveal that areas with high Aspect Ratios (AR > 0.65) and dense vegetation exhibit reduced wind speeds at the pedestrian level—up to 40% lower compared to open zones—and higher ${\mathrm{NO}}_2$ concentrations, with maximum simulated values exceeding 50 μg/m³. This study demonstrates that the design of pedestrian corridors in complex urban environments like Medellín can unintentionally create pollutant accumulation zones, underscoring the importance of integrating air quality considerations into urban planning. The findings provide actionable insights for policymakers, emphasizing the need for comprehensive modeling and field validation to ensure healthier urban spaces in cities affected by persistent air quality issues. Full article

Approximately 10% of the US Black diaspora were born either in Latin America and the Caribbean (LAC) or Sub-Saharan Africa (SSA), projected to account for a third of the Black US diaspora by 2060. Yet, details on foreign-born Black women’s labor and delivery (L&D) characteristics, such as the type of birth attendant, remain scarce. We used the National Center for Health Statistics 2016 to 2020 Natality data (n = 2,041,880). The associations between detailed maternal nativity (DMN) and the type of attendant at birth (i.e., physician, certified nurse-midwife (CNM), certified professional midwife (CPM)) among US-born, LAC-born, and SSA-born Black women were examined using multivariate multinomial regression. The study revealed that LAC-born women were more likely to have a CNM during birth than US-born Black women, but Haitian-born and Jamaican-born women had lower odds of having a certified professional midwife (CPM) at birth. When compared to US-born Black women, Cameroonian-born women had decreased odds of having either a CNM or CPM during birth. Findings suggest that DMN could be an indicator of cultural preferences in maternity care. There is a need for further investigation beyond DMN and comprehensive data collection methods for future research to understand the specific needs and preferences of different ethnocultural groups to improve maternity care and prevent adverse maternal health outcomes. Full article

Healthcare accessibility is among the most critical challenges affecting millions, reflecting profound geospatial disparities in Latin America. This study aims to evaluate healthcare service geospatial accessibility patterns, comparing the geospatial coverage between public and private healthcare facilities in Santiago district, Panama. We first apply the Two-Step Floating Catchment Area (2SFCA) method and its extended variant (E2SFCA) to calculate geospatial accessibility indexes at public and private healthcare facilities. We then use Getis–Ord Gi* and Local Moran geospatial statistical analysis to identify significant clusters of high and low accessibility. The results reveal that public healthcare facilities still offer higher geospatial coverage than private healthcare facilities, with higher geospatial accessibility in the central zone and lower geospatial accessibility in the south zone of Santiago. These findings highlighted the location of new healthcare facilities in zones with lower geospatial accessibility coverage. This study provides reproducible methodological tools for other geographical contexts. It also contributes to improving decision-making and formulating public policies to reduce spatial disparities in healthcare services in Panama and other Caribbean and Latin American countries. Full article

Background: The Port of Santa Marta, located on Colombia’s northern Caribbean coast, plays a vital role in the country’s maritime trade, particularly in the export of agricultural and perishable goods. This raises the question: how competitive is Santa Marta’s container terminal compared to national and regional ports, and what strategic factors shape its performance within the Colombia and Latin American maritime logistics system? Methods: This study evaluates the port’s competitiveness by applying Porter’s Extended Diamond Model. A mixed-methods ap-proach was employed, combining structured surveys and interviews with port stakeholders and operational data analysis. A competitiveness matrix was developed and examined using standardized residuals and L1 regression to identify critical performance gaps and strengths. Results: The analysis reveals several competitive advantages, including the port’s strategic location, natural deep-water access, and advanced infrastructure for refrigerated cargo. It also benefits from skilled labour and proximity to global shipping routes, such as the Panama Canal. Nonetheless, challenges remain in storage capacity, limited road connectivity, and insufficient public investment in hinterland infrastructure. Conclusions: While the Port of Santa Marta shows strong maritime capabilities and spe-cialized services, addressing its land-side and institutional constraints is essential for positioning it as a resilient, competitive logistics hub in the Latin American and Caribbean region. Full article

This study develops a multidimensional classification of Latin American and Caribbean countries based on a multidimensional set of economic, social, technological, and environmental indicators. This study develops a multidimensional assessment of the performance of Latin American and Caribbean countries, taking into account the following indicators for the period 2017–2022: education expenditure (% of GDP), health expenditure (% of GDP), GDP per capita (constant USD), CO₂ emissions per capita (metric tons), energy consumption per capita (kWh), internet users (% of population), mobile phone subscriptions (per 100 inhabitants), and the Global Innovation Index (GII). Initially, through the application of principal component analysis (PCA), the objective was to reduce the complexity of the data set and reveal the main structural dimensions. Subsequently, cluster analysis was used to classify countries according to shared development patterns. To achieve this, the average of the indicators for the 2017–2022 period was used as a basis, which enabled the reduction in short-term distortions and the capture of structural trends. The results reveal the existence of distinct groups, with countries with higher levels of digital connectivity, investment in human capital, and economic dynamism experiencing more favorable development conditions. Full article

Background/Objectives: Cancer is a multifactorial disease. Evidence suggests that 30% to 50% of cancer incidence is linked to unhealthy behaviors. It is therefore important that dietary recommendations, including population-based dietary guidelines, and public policies be designed to support and facilitate healthier choices. We evaluated the alignment between the updated Chilean Food-Based Dietary Guidelines (FBDGs) and cancer prevention recommendations from the World Cancer Research Fund (WCRF/AICR) and the Latin America and the Caribbean Code Against Cancer (LAC-Code). Methods: A qualitative content analysis was performed based on the dissemination and technical documents from the updated Chilean FBDGs (2023), the WCRF/AICR and the LAC Code. A first set of codes was developed to evaluate the relevance of the messages with cancer prevention recommendations, and a second one aimed to characterize the food and diet recommendations included in cancer prevention recommendations and the Chilean FBDGs. Furthermore, we compared the 10 Chilean FBDG messages with the WCRF/AICR and the LAC Code recommendations. Results: The updated Chilean FBDG messages met most of the categories included. Four out of ten of the Chilean FBDG messages were directly aligned with LAC Code and the WCRF/AICR recommendations, five had an indirect relationship, and one was not related to any cancer recommendation. Conclusions: Our study suggests that the updated Chilean FBDG messages are most often indirectly aligned with the worldwide and the Latin American region cancer prevention recommendations over the role of diet, nutrition and physical activity in cancer risk among the general population. Full article

Marine heatwaves (MHWs) are increasingly affecting tropical seas, causing mass coral bleaching and mortality in the wider Caribbean (WC) and eastern tropical Pacific (ETP). This leads to significant coral loss, reduced biodiversity, and impaired ecological functions. Climate models forecast a troubling future for Latin American coral reefs, but downscaled projections for the WC and ETP remain limited. Understanding regional temperature thresholds that threaten coral reef futures and restoration efforts is critical. Our goals included analyzing historical trends in July–August–September–October (JASO) temperature anomalies and exploring future projections at subregional and country levels. From 1940 to 2023, JASO air and ocean temperature anomalies showed significant increases. Projections indicate that even under optimistic scenario 4.5, temperatures may exceed the +1.5 °C air threshold beyond pre-industrial levels by the 2040s and the +1.0 °C ocean threshold beyond historical annual maximums by the 2030s, resulting in severe coral bleaching and mortality. Business-as-usual scenario 8.5 suggests conditions will become intolerable for coral conservation and restoration by the 2030s, with decadal warming trends largely surpassing historical rates, under unbearable conditions for corals. The immediate development of regional and local adaptive coral reef conservation and restoration plans, along with climate change adaptation and mitigation strategies, is essential to provide time for optimistic scenarios to materialize. Full article

Background and Objectives: The pancreas receives blood through a complex network of multiple branches, primarily originating from the celiac trunk (CeT) and the superior mesenteric artery (SMA). This blood supply is structured into three main arterial groups, each serving different regions of the pancreas to effectively support its endocrine and exocrine functions. Materials and Methods: The databases Medline, Scopus, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Latin American and the Caribbean Literature in Health Sciences (LILACS) were searched until January 2025. Methodological quality was evaluated using an assurance tool for anatomical studies (AQUA). Pooled prevalence was estimated using a random effects model. Results: A total of sixteen studies met the established selection criteria in this study for meta-analysis. Pancreatic irrigation variants presented a prevalence of 11.2% (CI: 7–14%) and a heterogeneity of 88.2%. The other studies were analyzed by subgroups, showing statistically significant differences in the following subgroups: (1) sample type—a larger sample of images analyzed in the included studies (p = 0.312), which did not show statistically significant differences; (2) geographical region (p = 0.041), which showed a greater presence in the Asian population studied, and this was statistically significant; and (3) sex (male or female) (p = 0.12), where there were no statistically significant differences. Conclusions: The discovery of variations in pancreatic irrigation is common due to the numerous blood vessels involved in supplying this vital organ. Understanding different vascular patterns (such as those from the splenic and mesenteric arteries) is crucial for surgical interventions on the pancreas. For transplant patients, a thorough vascular analysis of both the donor and recipient is essential. Variations can impact blood flow and compatibility, potentially leading to transplant rejection if not addressed. To enhance outcomes, it is recommended to develop more accurate imaging tools for pre-surgical analysis, necessitating ongoing research in this area. Full article

Deprivation indices are used to monitor health inequities. However, their theoretical underpinnings have been based on the context of Western industrialized countries, which have distinct social and historical backgrounds compared to Latin America and the Caribbean and countries in the Global South. Following the Latin American Social Determination of Health perspective, particularly the category Modes of Living supported by the construct of precarity, we aimed to develop an index of precarity in the modes of living at the department level in Colombia and assess its geographical distribution and potential value for public health. We conducted an ecological cross-sectional study with national administrative records. We developed a precarity index through Principal Component Analysis and performed spatial autocorrelation analyses and regression models with child mortality indicators. Our final index comprised twenty indicators representing four dimensions of the modes of living and power relations. We found precarity not to distribute randomly in Colombia, with a center-periphery divide and higher precarity observed in the country’s margin. We also found an association of our index with under-five mortality (SMR = 1.19; 95%CI 1.08–1.31) and infant mortality (SMR = 1.13; 95%CI 1.00–1.26). Our index highlights the relevance of considering the modes of living when devising deprivation indices or similar measures from Colombia or Latin America. This approach may provide different perspectives on the health-disease process and potential value for public health planning. Full article

Antimicrobial resistance (AMR) represents a major threat to health with significant global economic and safety implications. One of the major drives of this resistance is the misuse and overuse of antimicrobials. Background/Objectives: In this sense, WHO proposed to it members to estimate the antimicrobial consumption (AMC) at each country level, in order to help local authorities in their decision making related to AMR control. Although this program is already installed worldwide, in the American continent, the rate of countries’ inclusion has been delayed. This paper describes the efforts of Latin American & Caribbean countries in terms of AMC local assessment. Methods: AMC data collection was done as per the GLASS tool proposed by WHO. Analysis was performed using Daily Defined Dose each one thousand inhabitants day (DID) for global, therapeutical group or each antibiotic. Access, Watch and target Reserve (AWaRe) WHO classification was applied after data collection. Results: 13 countries were included during the period 2019–2022. The global DID ranged from 2.55 DID to 36.26 DID. The trend of this consumption did downward along the years. One of the factors than impacted the AMC was the COVID-19 pandemic. The most problematic antimicrobial misuse was seen in certain beta lactams and macrolides, like ceftriaxone and azithromycin. Regarding the AWaRe classification, 5 out of 13 countries accomplished the target until 2023 of 60% consumption for “Access antimicrobial’s group by 2023). This data helped local health managers to propose changes for better control of the AMR problem (ceftriaxone usage limitations in Peru, antimicrobial law in Argentina, etc.). Conclusions: The first steps towards AMC country’s assessment has been initiated. The present work provided essential inputs to local health authorities for decision making related to AMR control. It will be necessary to keep applying this results in regulate antibiotic usage at country level, as well as enrolling more countries in the AMC project. Full article

Various techniques have been used for the molecular identification of Mycobacterium leprae (M. leprae). The aim of this review was to identify the relationship between the molecular presence of M. leprae and the process of infection and/or illness of contact of leprosy cases. A systematic review was carried out by searching the Medical Literature Analysis and Retrieval System Online (MEDLINE), Cochrane Library, Embase, Scopus, Web of Science and the Latin American and Caribbean Health Sciences Literature (LILACS) databases in January 2024. The studies were selected by two pairs of reviewers. Observational cross-sectional, case–control and cohort studies were included. A descriptive synthesis of the results by category was carried out. A total of 443 studies were identified, and 36 were included in the review. Twelve molecular targets were tested to identify the presence of the bacillus. A relationship was established between the identification of M. leprae DNA and factors related to the index case, housing characteristics, living conditions, epidemiology and anti-PGL-1 serology. None of the studies identified evaluated the molecular viability of M. leprae among contacts. The detection of M. leprae DNA alone does not necessarily predict the development of infection or clinical illness among contacts. Full article

Oropouche virus (OROV) is an orthobunyavirus endemic in the Brazilian Amazon that has caused numerous outbreaks of febrile disease since its discovery in 1955. During 2024, Oropouche fever spread from the endemic regions of Brazil into non-endemic areas and other Latin American and Caribbean countries, resulting in 13,014 confirmed infections. Similarly to other orthobunyaviruses, OROV can undergo genetic reassortment events with itself as well as other viruses. This occurred during this current outbreak, resulting in novel strains with increased pathogenicity and levels of transmission. For the first time, pregnant women with Oropouche fever have sustained poor perinatal outcomes, including miscarriage, fetal demise, stillbirths and malformation syndromes including microcephaly. In July 2024, PAHO issued an Epidemiological Alert warning of the association of OROV with vertical transmission. OROV has now been identified in the fetal blood, cerebrospinal fluid, placenta and umbilical cords, and fetal somatic organs including the liver, kidneys, brain, spleen, heart, and lungs using nucleic acid and antigen testing. Perinatal autopsy pathology has confirmed central nervous system infection from OROV in infants with congenital infection including microcephaly, ventriculomegaly, agenesis of corpus callosum, and neuronal necrosis. The latest data from Brazil show 3 confirmed cases of OROV vertical transmission; 2 cases of fetal death; 1 case of congenital malformation; and ongoing investigations into the role of OROV in 15 cases of fetal death, 3 cases of congenital malformations and 5 spontaneous miscarriages. This Commentary discusses the mechanisms and significance of development of novel reassortant strains of OROV during the current outbreak and their recent recognition as causing vertical infection and adverse perinatal outcomes among pregnant women with Oropouche fever. Full article

This paper analyzes the development and consolidation of anticommunist discourse in the General Conferences of the Latin American Episcopate (CELAM), from Rio de Janeiro to Aparecida. It adopts a critical perspective to examine the construction of the “messianic fraternity” myth—an ideological narrative contrasting Christian ideals of community and redemption with Marxist principles of class struggle and revolution, which served as a central axis for the Church’s rejection of communism in Latin America. Grounded in a critical analysis of the CELAM’s final documents, this study identifies the theological, political, and social underpinnings of this stance, situating it within the historical and geopolitical dynamics that positioned the Church as a key counterforce to Marxism in the region. It also examines how anticommunist positions shaped pastoral strategies, particularly in relation to social movements like liberation theology, and reinforced an episcopal identity centered on defending Christian values against a perceived global ideological threat. This analysis highlights the Church’s internal tensions and contradictions and the broader impact of its anticommunist stance on Latin America’s sociopolitical and religious dynamics in the twentieth century. Full article

In this article, we explore the racialized construction of migrants by the Carabineros, the Chilean national police. Based on a qualitative case study, we show that the representations of Latin American and Caribbean migrants by members of this institution are racialized and mostly framed on ideas of a historically constructed superiority. Drawing on interviews with police personnel from different units in Santiago, Chile, we show how the historical state racist policies on migration and systemic institutional racism are embedded in the Carabineros’ discourse, who represent the state and law in their everyday interactions with migrants. Historically, this institution continues to be a strongly hierarchical and militarized police force, whose mission has been to defend territorial integrity and the moral, socio-historical, and cultural national identity, as well as to uphold the most important values of the so-called Chilenidad. We argue that the Chilean police frame their racialized representations of Latin American and Caribbean migrants within systemic institutional racism and socio-historical tropes, particularly from racialized, class, and moral perspectives that reproduce anti-immigrant sentiments and illustrate the ways in which migrants have been historically criminalized and treated in everyday life. Full article

The food–energy–water (FEW) nexus has emerged as an alternative for managing resources in the food, energy, and water systems. However, there are limited case studies applying this approach in the Latin American and Caribbean region. This region stands to benefit significantly from the FEW nexus approach due to its heavy reliance on hydropower for electricity generation and unevenly distributed and poorly managed water resources. In this study, an urban FEW nexus framework was used in the Otun River Watershed (ORW) to evaluate changes in food, energy, and water demand for four scenarios. Additionally, regional climate models (RCMs) were used to forecast water availability in the ORW from 2030–2039. The results show that water demand could increase by 16% and energy demand will increase by roughly 15% for scenario 2, while water demand in scenario 3 will likely remain unchanged in relation to the current conditions (base scenario). Enhancing water resources management in the ORW will involve a variety of measures, including: implementing practices to reduce water losses in distribution systems, developing green infrastructure and decentralized wastewater systems, and embracing urban and peri-urban farming. Successful application of urban FEW nexus solutions requires involvement from stakeholders across the food, energy, and water systems. Full article