Browsing by Autor "Patrick Van der Stuyft"

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Brote epidémico de denguevirus 2, genotipo Jamaica, en Bolivia
(Instituto Nacional de Salud Pública, 1998) Alberto Gianella; Marianne Pirard; Anaí Holzman; Marleen Boelaert; Frank Fernández-Ortiz; Carlos Peredo; J L Pelegrino; Patrick Van der Stuyft
Objetivo. Confirmar la presencia de brote de dengue en la ciudad de Santa Cruz, Bolivia, así como identificar el denguevirus causal, estimar la tasa de ataque y determinar la proporción de infecciones sintomáticas. Material y métodos. En marzo de 1997 se realizó una encuesta seroepidemiológica con muestreo aleatorio en un distrito céntrico de la ciudad. Se obtuvo información sobre episodios de enfermedad aguda, antecedentes de cuadro febril reciente y muestras de sangre venosa. Se determinó la presencia de IgM antidengue con el método MAC ELISA y se procedió a la tipificación del virus con tecnología de reacción en cadena de la polimerasa. Resultados. Se detectaron anticuerpos IgM en 6.5% de los adultos (IC95% 3.4-9.6) y 5.1% de los niños (IC 95% 2.0-8.2). El virus circulante fue identificado como dengue serotipo 2, genotipo Jamaica. Menos de la mitad de los niños infectados tuvieron una infección sintomática, contra casi 90% de los adultos. Conclusiones. La tasa de ataque estimada es compatible con una epidemia de dengue en Santa Cruz. La introducción del serotipo 2 - Jamaica en el país aumenta el riesgo de dengue hemorrágico.
Collaboration between private pharmacies and national tuberculosis programme: an intervention in Bolivia
(Wiley, 2005) Michel Lambert; R Delgado; Geneviève Michaux; A. Vols; Niko Speybroeck; Patrick Van der Stuyft
The first phase of the intervention proved effective in reducing the availability of the main TB drugs in pharmacies, and in improving referral of clients seeking TB drugs. Key factors in this success were not specific to Bolivia, and collaboration between private pharmacies and public services appears possible in that respect. However, collaboration with pharmacies does not seem an efficient way to increase the number of patients screened for TB, and to shorten delays to TB diagnosis and treatment.
Delays to treatment and out-of-pocket medical expenditure for tuberculosis patients, in an urban area of South America
(Maney Publishing, 2005) Michel Lambert; R Delgado; Geneviève Michaux; Anna Volz; Niko Speybroeck; Patrick Van der Stuyft
Short delays to treatment are important for the control of tuberculosis (TB). National Tuberculosis Programmes provide free diagnosis and treatment for smear-positive patients, so that the patients' out-of-pocket medical expenditure could be almost nil. The factors associated with delays in starting treatment, and the pre-treatment out-of-pocket medical expenditure for TB patients, have now been investigated in the Bolivian city of Cochabamba. Bolivia is the Latin American country with the highest incidence of TB. It is covered by a national TB programme that provides free diagnosis and free treatment for smear-positive patients. Structured interviews with 144 smear-positive patients enrolled in this programme revealed median patient, provider and total delays of 3.6, 6.2 and 12.9 weeks, respectively. The total delays were longer for the female patients than for the male, and for patients who consulted private doctors than for the other patients. When the first healthcare provider was a doctor, the median provider delay was 4.9 weeks in the public sector but 7.2 weeks in the private. The median out-of-pocket medical expenditure per patient, which was U.S.$13.2 overall, was much higher for those who consulted a private doctor than for those who did not (U.S.$21.9 v. U.S.$5.4, respectively; P<0.001). It appears that interventions targeting doctors (in both the private and public sectors) are likely to have a larger impact on the shortening of delays in TB treatment than interventions targeting patients. They could also reduce unnecessary out-of-pocket expenditure.
HEARTS Calidad: Marco de políticas para fortalecer el manejo de la hipertensión arterial y del riesgo cardiovascular en la atención primaria de salud. Perspectivas desde HEARTS en las Américas.
(Pan American Health Organization, 2026) Esteban Londoño; Reena Gupta; Patrick Van der Stuyft; Martin Heine; Gloria Patricia Giraldo; Grace Marie Ku; Jeffrey Brettler; Andrés Rosende; V Irazola; Jerry Toelsie
HEARTS in the Americas is the largest-scale implementation of the WHO's global initiative, with 33 countries participating, 28 having adopted standardized clinical pathways, and about 10 000 primary healthcare facilities engaged. Despite progress, fragmented care, limited availability of validated blood pressure devices, restricted access to essential medicines, and weak quality assurance systems continue to hinder hypertension control and cardiovascular risk management. In response, PAHO and participating countries co-developed the HEARTS Quality Framework. Grounded in regional implementation, this model synthesizes global evidence and lessons from Latin America and the Caribbean. Co-designed by Ministries of Health, care providers, and international experts, it translates HEARTS strategies into actionable system-level objectives. Clearly defined outcome indicators and implementation targets promote institutionalization, quality improvement, and primary healthcare strengthening- supporting HEARTS scale-up and equitable outcomes. With appropriate contextualization, the HEARTS Quality Framework provides a practical roadmap for countries beyond the Region to advance primary healthcare-based chronic disease care.
Incidence of Surgical-Site Infections and the Validity of the National Nosocomial Infections Surveillance System Risk Index in a General Surgical Ward in Santa Cruz, Bolivia
(Cambridge University Press, 2003) Lorena Soleto; Marianne Pirard; Marleen Boelaert; Remberto Peredo; Reinerio Vargas; Alberto Gianella; Patrick Van der Stuyft
SSIs cause considerable morbidity in Santa Cruz. Appropriate nosocomial infection surveillance and control should be introduced. The NNIS System risk index did not discriminate between patients at low and high risk for SSI in this hospital setting, but a risk score based on local cutoff points performed substantially better.
Readiness to deliver integrated cardiovascular, kidney and metabolic care in primary healthcare: phase II of HEARTS 2.0 in 26 countries in the Americas
(BMJ, 2026) Pedro Ordunez; Andrés Rosende; Jeffrey Brettler; Esteban Londoño; Patrick Van der Stuyft; Ramon Martinez-Piedra; Libardo Rodríguez; Mariana Lisbeth Rodriguez de la Cerda; Kerry-Ann Renaud-Thomas; Vicente Aleixandre Benites-Zapata
WHO's Global HEARTS is the largest worldwide effort to improve hypertension control through standardised care. HEARTS in the Americas is its regional adaptation. To address the rising burden of cardiovascular, kidney and metabolic conditions, the initiative launched HEARTS 2.0, aiming to promote integrated care, reduce fragmentation and improve quality, access and health outcomes. In phase I, an expert-led consensus identified 45 evidence-based interventions for inclusion in an expanded Clinical Pathway. This report presents findings from phase II on the readiness of 26 Latin American and Caribbean countries to implement these interventions. We used a cross-sectional design and a structured, self-administered questionnaire completed by national implementation teams. It systematically assessed the availability, feasibility, time required and key barriers for each proposed intervention. While many interventions, especially for risk assessment and non-pharmacological treatments, are considered feasible in many countries, their current availability is limited due to ongoing shortages of diagnostics, medicines and infrastructure. Over the next 3 years, 18 countries are projected to implement >30 of the 45 interventions, four countries aim to implement 20-30 and four expect to implement fewer than 20. While primary health systems in most HEARTS-implementing countries do not yet appear ready to deliver integrated cardiovascular, kidney and metabolic care, the scale-up of HEARTS 2.0 presents a strong opportunity to advance this integration. As health systems worldwide face the challenge of increasing multimorbidity in their patients and fragmented care delivery systems, this assessment offers a practical tool for planning and action.
Street Youths Are the Only High-Risk Group for HIV in a Low-Prevalence South American Country
(Lippincott Williams & Wilkins, 2005) Marie‐Laurence Lambert; Faustino Torrico; Claire Billot; Deogatias Mazina; Marleen Boelaert; Patrick Van der Stuyft
In a low-prevalence setting where intravenous drug use is uncommon, street youths are a threat for the expansion of the HIV epidemic. We argue that HIV prevention in this population requires a comprehensive approach to their health and social problems.
The validity of serologic tests for <i>Trypanosoma cruzi</i> and the effectiveness of transfusional screening strategies in a hyperendemic region
(Wiley, 2005) Marianne Pirard; Naomi Iihoshi; Marleen Boelaert; Paulino Basanta; Francisco Gomez Lopez; Patrick Van der Stuyft
Routine blood donor screening for T. cruzi with a single test results in unacceptable numbers of false-negative samples in highly endemic areas or in at risk population groups. Adding a second test seems mandatory, but which one to choose depends on local cost components and feasibility.
Urbanisation of yellow fever in Santa Cr uz, Bolivia
(Elsevier BV, 1999) Patrick Van der Stuyft; Alberto Gianella; M Pirard; Juan Manuel Sánchez Céspedes; Jacyr Lora; Carlos Peredo; Pelegrino Jl; V. Vorndam; Marleen Boelaert