Long-Term Outcomes of a Cohort of Hypertensive Subjects in Rural Ecuador

Background: In contrast with the abundance of global epidemiological descriptive data on cardiovascular diseases and their risk factors, information on the outcomes of real populations prospectively followed up in their life and care settings is much rarer, especially in low-income countries.Objectives: This study sought to evaluate the feasibility and the overall results of a hypertension control program, based mainly on a network of community nonprofessional health promoters, in the poor rural region of Borbon (Ecuador).Methods: This is a prospective cohort study describing the results of a program of hypertension diagnosis, treatment and follow-up from 2004 to 2015 in the area, carried out mainly by the health promoters.Results: The number of hypertensive patients identified and followed over the years increased from 1,024 in 2004 to 1,733 in 2015. The percentage of patients with no visits during a year was reduced to <10%, whereas the proportion of hypertensive subjects attending all 4 scheduled annual checks approached and, in some years, exceeded 50%. From 2004 to 2015, the proportion of patients at high or very high cardiovascular risk progressively decreased from 26.6% in 2004 to 17.5% in 2015 (p for trend <0.01), whereas the proportion of hypertensive patients at low or very low risk increased from 30.4% in 2004 to 45.0% in 2015 (p for trend <0.01).Conclusions: In a poor, disadvantaged area, a strategy of control mainly based on the involvement and responsibility of community health promoters (with health professionals as supporters more than direct actors) can achieve adequate follow-up of the population of hypertensive patients and improve their global cardiovascular risk level.HighlightsHypertension is increasingly recognized as a major cause of cardiovascular mortality and morbidity also in low-income countries, but little is known about how to face this common risk factor with limited economic and professional resources, particularly in remote rural areas.In a poor disadvantaged area of the equatorial forest, hypertension diagnosis and control, mainly by nonprofessional local health promoters, can ensure adequate follow-up of the hypertensive population.Over more than 10 years, the global cardiovascular risk has progressively declined.Noncommunicable chronic diseases such as hypertension can be managed by giving local health promoters a pivotal role

Innovaciones y lecciones aprendidas en torno al control del FocR4T

Participantes: Lorena Medina, Especialista de Sanidad Agropecuaria e Inocuidad de los Alimentos (SAIA) Gabriel Rodriguez Marqués, Representante del IICA en Paraguay y Belice. Luis Pocasangre, Representante CATIE Marco Zapata, Representante del IICA Daniel Acevedo, Especialista de ventas, LATAM Sur Doctora Monica Betancour, Investigadora de la dirección de AgrosaviaEncuentro virtual | Innovaciones y lecciones aprendidas en torno al control del FocR4T

Fish oil replacement by different microalgal products in microdiets for early weaning of gilthead sea bream (Sparus aurata, L.)

The aim of this study was to determine if algal products rich in DHA or ARA are able to completely replace fish oil in microdiets for marine fish larvae, gilthead seabream and if extra supplementation with EPA may further enhance larval performance. For that purpose, 20day-old gilthead seabream larvae of 5.97 +/- 0.4mm mean total length and 0.12 +/- 0.001mg mean dry body weight were fed with five microdiets tested by triplicate: a control diet based on sardine oil; a diet containing AquaGrow (R) DHA (diet DHA) to completely substitute the sardine oil; a diet containing AquaGrow (R) ARA (diet ARA); a diet containing both products, AquaGrow (R) DHA and AquaGrow (R) ARA to completely substitute the fish oil; and, a diet containing both products, AquaGrow (R) DHA and AquaGrow (R) ARA, together with an EPA source. Temperature, air and salinity activity tests were also performed to detect larval resistance to stress. At the end of the experiment, final survivals did not differ among groups. The microorganism produced DHA was able to completely replace fish oil in weaning diets for gilthead seabream without affecting survival, growth or stress resistance, whereas the inclusion of microorganism produced ARA did not improve larval performance. Moreover, addition of EPA to diets with total replacement of fish oil by microorganism produced DHA and ARA, significantly improved growth in terms of body weight and total length. The results of this study denoted the good nutritional value of microorganisms produced DHA as a replacement of fish oil in weaning diets for gilthead seabream, without a complementary addition of ARA. However, dietary supplementation of EPA seems to be necessary to further promote larval performance