Multidrug-resistant tuberculosis in HIV-negative patients,Buenos Aires,Argentina

Initial multidrug-resistant (MDR) tuberculosis (TB) in HIV-negative patients treated at a Buenos Aires referral hospital from 1991 to 2000 was examined by using molecular clustering of available isolates. Of 291 HIV-negative MDRTB patients, 79 were initially MDR. We observed an ascending trend of initial MDRTB during this decade (p=0.0033). The M strain, which was responsible for an institutional AIDS-associated outbreak that peaked in 1995 to 1997, caused 24 of the 49 initial MDRTB cases available for restriction fragment length polymorphism. Of those, 21 were diagnosed in 1997 or later. Hospital exposure increased the risk of acquiring M strain-associated MDRTB by approximately two and a half times. The emergence of initial MDRTB among HIV-negative patients after 1997 was apparently a sequel of the AIDS-related outbreak. Because the prevalence of M strain-associated disease in the study population did not level out by the end of the decade, further expansion of this disease is possible.     

Campylobacteriosis in a low-income community in Buenos Aires, Argentina

The authors describe the problem of campylobacteriosis in a low-income community located in southern Buenos Aires. Homes in the area were classified according to their total number of inhabitants, the number of children and animals living in the house and the amount of poultry meat consumed. Samples were taken from all the different types of homes that had been identified in order to isolate, identify and type Campylobacter sp., using the modified Skirrow technique, bio-chemical tests and the Lior technique respectively. The prevalences found were 16.96% in dogs, 20% in cats and 40% in poultry. The pathogens isolated were Campylobacter jejuni type II in 94.44% of the cases and Campylobacter upsaliensis in 5.55% of the cases. In poultry meat, 92.85% of the samples were positive (23.07% for type I and 76.92% for type II). The incidence of diarrhoea in children caused by C. jejuni was 0.4/1000 children/month (type I in all cases). A high prevalence of C. jejuni type II was detected in pets and in poultry meat. The source of infection in children may have been poultry meat.     

Molecular epidemiology of Mycobacterium tuberculosis, Buenos Aires, Argentina

To analyze the molecular epidemiology of Mycobacterium tuberculosis strains at a hospital in Buenos Aires, Argentina, and mutations related to multidrug-resistant and extensively drug-resistant tuberculosis, we conducted a prospective case-control study. Our findings reinforce the value of incorporating already standardized molecular methods for rapidly detecting resistance.     

Tobacco use among high school students in Buenos Aires, Argentina

OBJECTIVES: This study assessed the prevalence and correlates of tobacco use among high school students in Buenos Aires, Argentina. METHODS: Anonymous, self-administered questionnaires were given to 3909 8th and 11th graders in a stratified random sample of 49 public and private schools. The instrument included items from American surveys, translated and validated among Argentinean teens. Multiple logistic regression analysis was used to estimate possible effects on smoking behavior of environment, students' personal characteristics, and their knowledge, beliefs, and attitudes regarding smoking. RESULTS: Of 8th and 11th graders, 20% and 43%, respectively, were classified as current smokers. Overall, 29% of males and 32% of females were current smokers. Students attending public schools were more likely to smoke than those in private schools (P < .05). Current smoking was associated with having a best friend who smokes, reporting that more than 50% of friends of the same sex smoke, having positive attitudes and beliefs toward smoking, and having a positive intention to smoke within the next year (all P < .001). CONCLUSIONS: Over 20% of the 8th graders in our sample were current smokers; prevention efforts must therefore start early.     

Epidemiology of latrodectism in the province of Buenos Aires, Argentina]

Epidemiological data related to Latrodectus bites over a 10-year period (1979-1988) in Buenos Aires Province, Argentina, are presented. Data on distribution of accidents by year, month, sex, residence of person bitten and general symptomatology are given. Statistical analysis showed a mean of 28.1 bites cases per year, 80% in males, most of whom were farm workers. The Latrodectus bites were localized in arms, pelvic waist and legs. Forty-six per cent of bitten persons visit the clinic within 1 to 3 hours after the incident, and only 15% capture the animal responsible for the accident.     

Occupational exposures, environmental tobacco smoke, and lung cancer

BACKGROUND: There is uncertainty regarding the association of occupational exposures with lung cancer. We have studied the association between 52 high-risk job titles and lung cancer incidence in a large prospective study, with more than 200,000 participants followed for more than 6 years and 809 incident cases of lung cancer. METHODS: Hazard ratios and 95% confidence intervals were computed by the Cox proportional-hazard regression model, adjusting for country, age, sex, social class, diet, physical activity, and smoking habits. We used a CAREX-based job-exposure matrix to infer exposure to lung carcinogens. False-positive report probability was calculated as a measure of potentially false-positive results. RESULTS: Eighteen occupations, mainly related with agriculture, constructions, and metal processing, were associated with increased risk. In addition, incidence tended to increase with the number of hazardous jobs reported. When the occupations were classified according to the presumed exposure to specific carcinogenic agents, the hazard ratios were 1.5 (95% confidence interval = 1.2-1.9) for asbestos, 1.4 (1.1-1.8) for heavy metals, 1.4 (1.1-1.8) for polycyclic aromatic hydrocarbons, and 1.6 (1.2-2.1) for work-related environmental tobacco smoke. The estimated population attributable risk for employment in at least 1 at-risk job was 16% in men and 12% in women. CONCLUSIONS: This large prospective study suggests that exposure to occupational lung carcinogens is still a problem, with such exposures producing moderate to large increases in risk.     

Occupational exposures and lung cancer in New Caledonia

Aims: To study the associations between occupational exposures and the risk of lung cancer in New Caledonia.

Methods: All cases diagnosed between January 1993 and December 1995 (228 lung cancers) and 305 population controls were included. Detailed information on lifetime job history, smoking, and other potential risk factors was collected by interview. Occupational exposures were assessed from the questionnaires by an industrial hygienist, without knowledge of case-control status.

Results: No significant association was found with exposures related to nickel mining and refining, the main industrial activity in the territory. Among men, an excess risk of lung cancer was found for bus and truck drivers. Increased risks were also observed in men with the highest level of cumulative exposure to cleaning products and inorganic fertilisers. Exposure to field dust was associated with lung cancer risk in both sexes, and risk increased with cumulative exposure level. In some areas tremolite asbestos derived from local outcroppings was used as a whitewash. The association between exposure to field dust and lung cancer was limited to men and women exposed to this whitewash—that is, living in areas where the soil may contain tremolite.

Conclusion: This study shows several associations between occupational exposures and lung cancer. The findings suggest that exposure to tremolite fibres from cultivated fields may increase the risk of lung cancer in New Caledonia.

     

Control of Aedes aegypti with temephos in a Buenos Aires cemetery, Argentina

The efficacy of a larvicide, temephos, for controlling Ae. aegypti was evaluated in a cemetery in Buenos Aires, Argentina. Breeding sites decreased from 18.4% in the first study period (Nov 1998 to May 1999, without temephos) to 2.2% in the second period (Nov 1999 to May 2000, two applications), and to 0.05% in the third one (Nov 2000 to May 2001, five applications). Ovitraps with eggs decreased from 17% in the first period to 5.8% in the second period, and to 2.9% in the third one. Results suggest that, in Buenos Aires, Ae. aegypti populations are highly susceptible to temephos. It is recommended to limit the use of temephos to prevent potential epidemics rather than for routine control.     

Child feeding practices and household food insecurity among low-income mothers in Buenos Aires, Argentina

This qualitative study of low-income mothers in Buenos Aires, Argentina, examines the influence of socio-economic conditions, organizational structures, family relationships, and food insecurity on child feeding practices and weight status. Thirty-eight mothers of preschool children living in urban Buenos Aires participated in four focus group discussions. The results indicated that many mothers were aware that obesity may be detrimental to the child's health, but most of them are unclear about the specific consequences. Maternal employment, family pressures, food insecurity and financial worries seem to influence child feeding practices. These findings have important implications for developing strategies for nutritional assistance that could benefit the health of children and provide opportunities for educational programs that are directed to nutritional awareness in Buenos Aires, Argentina. The right to eat regularly and properly is an obligation of the State and must be implemented taking into account the notion of food sovereignty and respecting the importance of preserving the culture and eating habits of a country and its diverse population groups.     

Runoff-Related Endosulfan Contamination and Aquatic Macroinvertebrate Response in Rural Basins Near Buenos Aires,Argentina

Information in the open literature about the fate and effects of pesticides in small streams from agricultural areas of Argentina is very rare. The objective of the present work was to study the pesticide contamination and potential biological effects in basins that have undergone intense agricultural activity, mainly related to the cultivation of soybeans. Three streams (Maguire, Helves, and Horqueta) with a low-flow discharge (0.1 and 0.2 m³/s) in March close to the city of Arrecifes were studied during the period of maximum insecticide application, between February and April 2001. Various sampling devices were installed to trap suspended particles, runoff, and floodwater plus sediment throughout the study period. The suspended-particle samples were analyzed for the insecticides endosulfan (END), chlorpyrifos, and cypermethrin. Water chemistry and the macroinvertebrate communities were assessed on four occasions and the organismic drift was measured continuously. Following a 184-mm rainfall on March 1, 2001, -endosulfan concentrations up to 318 and 43 µg/kg were measured from suspended-particle samples from Horqueta and Helves, respectively. No END contamination was detected in Maguire. Chlorpyrifos and cypermethrin were not detected in any of the streams. A significant decrease in the average macroinvertebrate species density was observed in Horqueta (from 12.8 ± 0.5 to 9 ± 0.7 species; ANOVA, p < 0.05) and Helves (from 10.8 ± 1.7 to 3.3 ± 1.3 species; p < 0.001) following the same rainfall event at the beginning of March, while the species density in Maguire remained constant at 7.9 ± 0.3 species. The runoff primarily reduced species abundances of Odonata and Ephemeroptera significantly (p < 0.01) in Horqueta and Helves but not in Maguire. A greater drift of Smicridae (Trichoptera) and Ephemeroptera occurred in Helves and Horqueta during this runoff event, while no changes in the macroinvertebrate drift were detectable in Maguire. This study highlights the potential pesticide effects on macroinvertebrate communities in Argentinian rural streams. It is suggested that a small wetland area formed by Maguire between the agriculturally used catchment and the sampling site contributes to the absence of contamination and effects at this site.     

Drug consumption and health equity in the Metropolitan Area of Buenos Aires, Argentina]

OBJECTIVE: To assess the level of equity in drug consumption patterns in the Metropolitan Area of Buenos Aires, Argentina, given the transformation of the Argentine pharmaceutical market since the deregulation of the country's economy in 1991. Methodology: For this study, data from secondary statistical sources were processed and analyzed. The secondary sources used were two household surveys that contained a module on the utilization of health services and the associated expenditures. The surveys had been designed by the Ministry of Health and were applied in the Metropolitan Area of Buenos Aires in 1989 and 1995. RESULTS: There was a socially regressive increase in out-of-pocket expenditures on drugs between 1989 and 1995, in a market where average drug prices doubled in the midst of relaxed price controls and more open imports. The regressive character of drug expenditures was shown in the growth in direct spending for drug purchases, the increase in the proportion of private health expenditures devoted to drugs, and the unequal increase among the different economic strata in the proportion of family income going toward drugs. CONCLUSIONS: Out-of-pocket expenditures on drugs are an efficient indicator of equity for studying the financial protections that urban Argentines have when they become ill. This kind of indicator of financial equity could help improve the regulatory framework of the pharmaceutical market by incorporating social evaluation criteria along with analyses of pharmaceutical safety and therapeutic efficacy.     

The HIV/AIDS epidemic and changes in injecting drug use in Buenos Aires, Argentina

This article discusses the changes in injecting drug use from 1998 to 2003 in Buenos Aires, Argentina. The Rapid Situation Assessment and Response methodology was used to obtain the information. Quantitative and qualitative techniques were triangulated: 140 current IDUs and 35 sex partners of injection drug users (IDUs) were surveyed; 17 in-depth interviews with the surveyed IDUs and 2 focus groups were held, as well as ethnographic observations. The way in which risk and care practices among injecting drug users changed and the influence of the HIV/ AIDS epidemic on this process are described. In recent years, the frequency of injection practices and sharing of injecting equipment has decreased, while injecting drug use is a more hidden practice in a context of increasing impact of the disease in the injecting drug use social networks and changes in the price and quality of drugs. Knowledge about these changes helps build harm reduction activities oriented to IDUs in their particular social context.