Social and demographic characteristics of pregnant women with anemia in Ecuador in 2018

Introducción: la anemia constituye una de las enfermedades carenciales más comunes a nivel global, que afecta principalmente a niños y gestantes. Suele presentarse en el embarazo como proceso fisiológico, sin embargo, ante situaciones carenciales previas se intensifica, afectando el curso del embarazo.  Objetivo: caracterizar los factores sociodemográficos de las gestantes con anemia en Ecuador en el año 2018.Métodos: se realizó un estudio observacional, descriptivo, transversal en las embarazadas con anemia del Ecuador durante el 2018. Para la obtención de la información se emplearon el portal del Instituto Nacional de Estadística y Censo, el Ministerio de Salud Pública y la Encuesta Nacional de Salud y Nutrición de 2018. Los datos descargados fueron curados para extraer los resultados de interés para el estudio. Resultados: aproximadamente el 22,3 % de las gestantes presentaron anemia, donde el 40 % pertenecía al grupo de bajos ingresos (n=27 294) y el 61 % residía en zona rural. El 53 % de las embarazadas con anemia fueron adolescentes; con respecto a los grupos etarios; el 27 % de las gestantes con anemia se encontraban entre los 10 y 14 años.Conclusiones: en Ecuador, en 2018 existió una alta prevalencia de anemia en el embarazo, donde las embarazadas adolescentes, las residentes en zonas rurales y aquellas con menor poder adquisitivo presentaron mayor prevalencia. Introduction: anemia is one of the most common deficiency diseases worldwide, affecting mainly children and pregnant women. It usually occurs during pregnancy as a physiological process; however, in the presence of previous deficiency situations it intensifies, affecting the course of the pregnancy. Objective: to characterize the sociodemographic factors of pregnant women with anemia in Ecuador in 2018.Methods: an observational, descriptive, cross-sectional study was conducted in pregnant women with anemia in Ecuador during 2018. The portal of the National Institute of Statistics and Census (INEC), the Ministry of Public Health (MSP) and the 2018 National Health and Nutrition Survey were used to obtain the information. The downloaded data were curated to extract the results of interest for the study.Results: approximately 22,3 % of pregnant women had anemia, where 40 % belonged to the low incomes class (n=27 294) and 61 % resided in rural area. Fifty-three percent of pregnant women with anemia were adolescents; with respect to age groups, 27 % of pregnant women with anemia were between 10 and 14 years of age.Conclusions: in Ecuador, in 2018 there was a high prevalence of anemia in pregnancy, where adolescent pregnant women, those living in rural areas and those with lower purchasing power had a higher prevalence.

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Acumulación y distribución de biomasa en Leucaena leucocephala (lam) de Wit., durante la fase de establecimiento. I. Repartición de biomasa (Accumulation and distribution of biomass in Leucaena leucocephala (Lam.) de wit during the phase of establishment. II. Repartitioning of biomass)

In the present study, dry matter accumulation and the pattern of distribution between aerial and bellow-ground biomass were studied in three accessions (CIAT 7984, 9438, 18477) of Leucaena leucocephala during 110 days after germination (DAG). Cv. Perú was used as a control plant. The experiment was carried out under glasshouse conditions, where plants were grown in PVC pots (1 m height x 0.20 m diameter). A completed randomized designed was used, in a factorial arrangement of 4 plant materials x 5 harvests (ie. 15, 30, 45, 60 and 110 DAG) x 5 replicates. To estimate biomass accumulation and assimilates distribution within the plant, harvests of individual plants were performed and the dry weight of leaf (LDM), stems (SDM) and root (DMR) at different depths was recorded. Initially, all accessions diverted a high proportion of the available energy in producing root biomass, while by the end of the establishment period relatively more photosynthetic material was used to increase leaf and stem biomass. The MSh was not different (P<0.05) among the lines for two finish court (60 and 110 DDG), the Mst of the line 9438 and the cv Peru was bigger (P<0.05) in comparison to the line 18477, and the MSr of this last one (18477) it was not different statistically (P<0.05) to the 30 and 110 DDG, what suggests a potential under non limited conditions. The distinctive pattern of distribution of forage biomass within the accession 18477, disserves further research in future programs of agronomic improvement

Dry matter production and nutritive value of the shrub legume Cratylia argentea in the Ssouth of Anzoategui state, Venezuela

Con el objetivo de evaluar la adaptación de la leguminosa arbustiva Cratylia argentea a condiciones de sabana bien drenada, se realizó un experimento en el INIA, CIAE-Anzoátegui, desde 1996 hasta 1999, utilizando una colección de 10 accesiones suministrada por el Centro Internacional de Agricultura Tropical (CIAT), Colombia. Las variables medidas fueron: producción de materia seca foliar, (kg MSF/ha/corte), altura de plantas (cm), número de rebrotes después de corte y contenidos (%) de proteína cruda (PC) y de minerales (P, K, Ca y Mg), en época seca y lluviosa. El germoplasma evaluado mostró poca variación en la producción de materia seca foliar, altura de plantas y contenido de proteína cruda y minerales, sin embargo la accesión CIAT 18667 alcanzó los mayores valores de materia seca, tanto en época seca como lluviosa (1086,6 y 2512,8 kg/ha/corte). El mayor número de rebrotes se obtuvo en época lluviosa con la accesión CIAT 18666 (24,7).El contenido de PC promedio fue 18,5%, variando entre épocas. Los contenidos de P y Ca variaron solamente entre épocas y el K y Mg no mostraron ninguna variación. Los resultados obtenidos justifican los esfuerzos de investigación en el futuro con C. argentea como alternativa para integrar a los sistemas de producción bovinos de las sabanas bien drenadas.589 - 594BimestralA collection of ten accessions of the shrub legume Cratylia argentea from CIAT-Colombia was evaluate for adaptability to the well drainage savanna conditions in the south of Anzoátegui state, since 1996 until 1999. Parameters measured were foliar dry matter production (kg MSF/ha/harvest), plant height (cm), regrowth number after harvest, crude protein (PC) and minerals (P, K, Ca, Mg) content (%).The germplasm evaluated showed low variability in foliar dry matter production, plant height, crude protein and minerals content, nevertheless, the accession CIAT 18667 showed the highest foliar dry matter production, in dry and rainy season (1086,6 and 2512,8 kg/ha/harvest). The highest regrowth number (24.7) was obtained in the rainy season on the accession CIAT 18666. The PC contents average was 18,5%, changing between seasons (P<0,01). The P and Ca contents changed only between season while the K and Mg did not show any variation. The results justify the future research with C. argentea as an alternative to integrate the cattle production systems of the well drainage savannas

Potencial de producción de semilla de la leguminosa forrajera Centrosema pascuorum Mart. ex Bentham en la Mesa de Guanipa, estado Anzoátegui, Venezuela

Con el objetivo de evaluar el comportamiento agronómico de una colección de Centrosema pascuorum, valorando en una primera fase la producción de semilla y algunos atributos fenológicos, se realizó un experimento en el Centro de Investigaciones Agrícolas del Estado Anzoátegui, localizado en El Tigre, Venezuela. Se utilizó un diseño de bloques completos al azar con 12 tratamientos (accesiones) y cuatro repeticiones. Las doce accesiones provienen de Venezuela, Brasil, Ecuador, Panamá y Paraguay y son representativas de la distribución natural de la especie. Los datos de producción de semilla se analizaron según el modelo para bloques completos al azar y completamente aleatorizado para análisis de datos de germinación y peso de 100 semillas, comparando las medias, en ambos casos, según la Prueba de Tukey. Se utilizó el intervalo de confianza para agrupar las accesiones en precoces, intermedias y tardías, respecto a floración y fructificación. Se determinó el grado de asociación entre las variables mediante correlaciones lineales simples de Pearson, utilizando solamente los promedios de los parámetros evaluados. Los resultados demuestran que en la Mesa de Guanipa existen condiciones edafoclimáticas adecuadas para la producción de semilla de la mayoría de las accesiones evaluadas, destacándose las accesiones CIAT 5177, 5533 y 25162 por los mayores valores. Las accesiones Venezolanas son de floración precoz a intermedia, de semillas pequeñas, moteadas y con germinación moderada. La característica de floración tardía del testigo australiano, cv Bundey (CIAT 5289) representa una ventaja para la zona, dada la posibilidad de disponer de forraje a finales del período lluvioso, además de producir cantidades aceptables de semilla. Sin embargo, es necesario complementar este trabajo con la producción de materia seca para comparar el comportamiento total de las accesiones

Two levels the nitrogen fertilization, grazing frequency and association with Centrosema Brasilianum in the forage availability of brachiaria brizantha

Con la finalidad de evaluar la disponibilidad de Brachiaria brizantha en función de la fertilización con Nitrógeno y a su asociación con Centrosema brasilianum en condiciones de sabanas bien drenadas se realizó un experimento en la finca Quinto Bueno, al sur del Estado Anzoátegui. Para ello se dispuso de tres parcelas de una hectárea cada una, a las cuales se les asignaron los siguientes tratamientos: T1: B. brizantha sin fertilizar (Testigo), T2: B. brizantha sola fertilizada (46 Kg/ha de N); T3: B. brizantha fertilizada (23 Kg/ha % de N) y asociada con C. brasilianum. Se evaluó producción de materia seca, composición botánica y Proteína cruda en la época seca y lluviosa del año 2000. Se realizó un pastoreo en la época lluviosa, y se midió el efecto de los tratamientos sobre la frecuencia de pastoreo (Fp) en un rebaño de ordeño durante 2 horas cada 5 minutos en 3 días consecutivos en la época lluviosa. Los resultados indicaron que hubo diferencias (P£0,05) entre los tratamientos, siendo mayor la disponibilidad de forraje en los fertilizados (T2:1160; T3: 1021 Kg/MS/ha) que en el testigo (T1: 618 Kg/MS/ha). Los valores de la composición botánica de la gramínea (aproximadamente de 80 %) fue similar en los tratamientos fertilizados; así mismo, la Fp fue de 29,32 y 29,03% para T2 y T3 respectivamente, asociada posiblemente a la aplicación de 46 kg/ha de N y por la presencia del C. brasilianum, siendo mayores que en el mayores al testigo (11,1 %).569 - 571BimestralTo evaluate forage availability of Brachiaria brizantha related to Nitrogen fertilization and its association with Centrosema brasilianum, was established an experiment at “Quinto Bueno” farm, located at well drained savannas of Anzoátegui state south. Three treatments were applied on equal number of plots of one hectare each one; T1: B. brizantha without fertilization (control), T2: B brizantha fertilized with 46 kg/ha de N, and T3: B. brizantha fertilized with 23 kg/ha of N and associated with C. brasilianum. Parameters measured were: dry matter (DM) production, contain of crude protein, botanical composition; and grazing frequency, during june to august period of the rainy season, of year 2000. Grazing frequency (GF) was evaluated according the Garcés and Vera (1992) formula; utilizing 80 cows which were introduced to plots, during three consecutive days, per two hours, and observed each five minutes. It was found significative difference (P£0.05) between treatments; resulting T2 and T3, with dry matter productions of 1160 and 1021 Kg/DM/ ha, respectively; major that T1, which value was 618 kg/DM/ha. Botanical composition was similar in plots T2 and T3. Grazing frequency was 29.32 % and 29.03 % to T2 and T3 respectively, which were associated possibly with levels of nitrogen applied and C brasilianum incorporation