Browsing by Autor "Rita Revollo"

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Contraception and Condom Use Among Bolivian Female Sex Workers: Relationship-Specific Associations Between Disease Prevention and Family Planning Behaviors
(Taylor & Francis, 2013) Eileen A. Yam; Freddy Tinajeros; Rita Revollo; Kara Richmond; Deanna Kerrigan; Sandra G. García
We examined data from a clinic-based survey of 1,222 Bolivian female sex workers (FSWs) to assess whether use of nonbarrier modern contraception is associated with less consistent condom use with clients and noncommercial partners. Women who were using nonbarrier modern contraception were less likely than nonusers to consistently use condoms with noncommercial partners (AOR 0.393, 95% CI 0.203-0.759, p = .005). With clients, this inverse association did not hold. Public health professionals must consider both disease prevention and pregnancy prevention needs in this vulnerable population, and messages should be tailored to encourage dual method use with all partners.
Demonstrating Public Health at Work: A Demonstration Project of Congenital Syphilis Prevention Efforts in Bolivia
(Lippincott Williams & Wilkins, 2006) Sandra G. García; Freddy Tinajeros; Rita Revollo; Eileen A. Yam; Kara Richmond; Claudia Dı́az-Olavarrieta; Daniel Grossman
Based on these findings, by mid-2006, the Bolivian Ministry of Health will offer the ICS tests in rural ANC settings.
Early deterioration of iron status among a cohort of Bolivian infants
(Wiley, 2016) Rachel M. Burke; Paulina A. Rebolledo; Anna Aceituno; Rita Revollo; Volga Iñiguez; Mitchel Klein; Carolyn Drews‐Botsch; Juan S. León; Parminder S. Suchdev
Iron deficiency (ID) and iron deficiency anemia (IDA) are major contributors to infant and maternal morbidity worldwide. There is limited longitudinal data on iron status in young infants and on methods to adjust iron biomarkers for inflammation. We aimed to quantify the prevalence of inflammation-adjusted ID, anemia, and IDA over the first year in a cohort of Bolivian infants and their mothers. Healthy mother-infant dyads were recruited from two peri-urban hospitals. Infants provided three blood draws (2, 6-8, and 12-18 months; N = 160); mothers provided two blood draws (1 and 6-8 months postpartum [plus third anemia measurement at 12-18 months]; N = 250). Blood was analyzed for hemoglobin, ferritin, soluble transferrin receptor, C-reactive protein (CRP), and alpha(1)-acid glycoprotein (AGP). Iron biomarkers were adjusted for inflammation using CRP and AGP; hemoglobin cutoffs were adjusted for altitude. Inflammation (elevated CRP or AGP) was 17% among toddlers 12-18 months of age. ID (inflammation-adjusted ferritin) increased with age (<1%, 56%, and 79% at each blood draw), as did anemia and IDA (anemia: 70%, 76%, and 81%; IDA: <1%, 46%, and 68%). Maternal ID declined from the first to second assessment (39% vs. 27%). Inflammation-adjusted ID prevalence was up to 15 percentage points higher than unadjusted estimates. The high prevalence of ID, anemia, and IDA in this cohort of Bolivian infants beginning at 6-8 months of age suggests that early interventions may be necessary in vulnerable populations.
Effect of infant feeding practices on iron status in a cohort study of Bolivian infants
(BioMed Central, 2018) Rachel M. Burke; Paulina A. Rebolledo; Anna Aceituno; Rita Revollo; Volga Iñiguez; Mitchel Klein; Carolyn Drews‐Botsch; Juan S. León; Parminder S. Suchdev
Effects of Inflammation on Biomarkers of Vitamin A Status among a Cohort of Bolivian Infants
(Multidisciplinary Digital Publishing Institute, 2018) Rachel M. Burke; Ralph D. Whitehead; Janet Figueroa; Denis R. Whelan; Anna Aceituno; Paulina A. Rebolledo; Rita Revollo; Juan S. León; Parminder S. Suchdev
Globally, vitamin A deficiency (VAD) affects nearly 200 million children with negative health consequences. VAD can be measured by a retinol-binding protein (RBP) and serum retinol concentrations. Their concentrations are not always present in a 1:1 molar ratio and are affected by inflammation. This study sought to quantify VAD and its impact on infant mortality and infectious morbidity during the first 18 months of life in a cohort of mother-infant dyads in El Alto, Bolivia, while accounting for the previously mentioned measurement issues. Healthy mother-infant dyads (<i>n</i> = 461) were enrolled from two hospitals and followed for 12 to 18 months. Three serum samples were collected (at one to two, six to eight, and 12 to 18 months of infant age) and analyzed for RBP, and a random 10% subsample was analyzed for retinol. Linear regression of RBP on retinol was used to generate RBP cut-offs equivalent to retinol <0.7 µmol/L. All measures of RBP and retinol were adjusted for inflammation, which was measured by a C-reactive protein and alpha (1)-acid glycoprotein serum concentrations using linear regression. Infant mortality and morbidity rates were calculated and compared by early VAD status at two months of age. Retinol and RBP were weakly affected by inflammation. This association varied with infant age. Estimated VAD (RBP < 0.7 µmol/L) decreased from 71.0% to 14.8% to 7.7% at two, six to eight, and 12 to 18 months of age. VAD was almost nonexistent in mothers. Early VAD was not significantly associated with infant mortality or morbidity rates. This study confirmed a relationship between inflammation and vitamin A biomarkers for some subsets of the population and suggested that the vitamin A status in early infancy improves with age and may not have significantly affected morbidity in this population of healthy infants.
[Health-worker barriers to syphilis screening in pregnant women in Bolivia's Los Andes network].
(National Institutes of Health, 2017) Freddy Tinajeros; Lucila Rey Ares; Vanessa Elías; Ludovic Revéiz; F. Galán Sánchez; Martha Mejía; Rosalinda Hernández; Rita Revollo
Syphilis screening is not being done according to Bolivia's strategy for the elimination of congenital syphilis, and is not done on more than half of pregnant women in prenatal care with perinatal clinical history records. This is not perceived by health professionals and can become a barrier to syphilis screening in pregnant women.
P3.79 Barriers for syphilis screening in bolivia
(2017) Tinajeros Freddy; Rita Revollo; Lucila Rey Ares; Vanessa Elías; Ludovic Revéiz
<h3>Introduction</h3> Syphilis is a global problem, with an estimated incidence of 12 million people infected each year and is a public health problem in Bolivia. This can result in fetal death, perinatal death, or severe neonatal infections. However, simple and cost-effective options for screening and treatment during pregnancy can reduce these complications. <h3>Methods</h3> For the present study, mixed methods (qualitative and quantitative) were used, however the quantitative results are presented in the summary. The data were collected through a review of the prenatal control clinical records, from which data such as syphilis test results, results records, and treatment in the perinatal history were extracted. The data extracted from the medical records of the 8 health centres of the Los Andes Network were input into an Excel database and analysis was performed using Epi Info 7. <h3>Results</h3> Of 294 clinical records reviewed, we observed that on average, 55.4% of patients had syphilis results attached to their clinical histories. The lowest percentage in any centre was 13.3% and the highest was 62.1%. The percentages for each centre were: Alto Lima III 61.7%, Alto Lima IV 45.8%, Ambulatory Reference Centre (ARC) 61.1%, German Busch 62.1%, Huayna Potosí 67.3%, Puerto Mejillones 40.0%, Santa Rosa de Lima 13.3% and Villa Ingenio 51.1%. Significant differences (p<0.05) were observed among the establishments of the first level of complexity without laboratory (46.8%, 95% CI: 37.9–55.3) and the second level centres with laboratory (63.5%, 95% CI 49.7–74.5). This suggests that the syphilis test is more likely to be performed in the second level than in the first level and that the results are recorded in the clinical records, mainly on the perinatal card. <h3>Conclusion</h3> Failure to record results in the medical records could result in a pregnant woman being screened for syphilis without results and with the consequent risk that if she gives birth in a different health centre, she may not receive adequate treatment or necessary follow-up to the newborn. The sensitisation and monitoring to be implemented by the health personnel in each centre and a deeper discussion on the subject of syphilis can become catalysts for the health system. The sharing of the results of the study could allow the implementation of corrective measures to improve the monitoring of syphilis screening.
Prevalence and Predictors of Iron Deficiency in Bolivian Infants
(Wiley, 2015) Rachel M. Burke; Rita Revollo; Volga Iñiguez; Juan S. León; Parmi Suchdev
Iron deficiency (ID) in infancy can cause cognitive and developmental deficits that may be irreversible after the age of 2. The goals of this study were to quantify the prevalence of ID among 6‐month‐old infants in a high‐altitude population of Bolivia and identify modifiable risk factors of ID. Healthy infants were recruited from 2 hospitals in El Alto, Bolivia, and followed from 1 to 6 months of age. Blood taken at 6 months was analyzed for ferritin (Fer), C‐Reactive Protein (CRP), and alpha(1)‐acid‐glycoprotein (AGP). Fer values were adjusted for inflammation using internal correction factors (defined by elevated CRP and AGP), and ID was defined as corrected Fer < 12 µg/L. The following risk factors for Fer‐defined ID were initially considered: preterm birth (PTB; <37 weeks), sex, stunting (length‐for‐age Z < ‐ 2), recent diarrheal or respiratory infection, exclusive breastfeeding (EBF; defined as no complementary feeding or formula as of the 6‐month visit), maternal anemia, maternal age, maternal education, maternal employment, access to private toilet. The prevalence of ID at 6 months was 41% (67 of 163 infants assessed). Backwards elimination logistic regression identified only EBF as a significant (p < 0.05) predictor of ID at 6 months (OR: 4.7, 95% CI: 1.6 – 13.7). These results indicate that initiation of complementary feeding after 6 months (22% of this sample) increases risk of ID in this population, implying that infants may need iron supplementation prior to this time. Other interventions, such as prenatal iron supplementation and delayed cord clamping, need further exploration.
Sífilis materna y congénita en cuatro provincias de Bolivia
(Instituto Nacional de Salud Pública, 2007) Rita Revollo; Freddy Tinajeros; Carolina Hilari; Sandra G. García; Lourdes Zegarra; Claudia Dı́az-Olavarrieta; Carlos J Conde-González
Rapid syphilis tests constitute an important tool to strengthen early diagnosis of syphilis during pregnancy. Preventing congenital and maternal syphilis in Bolivia remains a public health priority.
The Co-occurrence of Intimate Partner Violence and Syphilis among Pregnant Women in Bolivia
(Mary Ann Liebert, Inc., 2009) Claudia Dı́az-Olavarrieta; Kate Wilson; Sandra G. García; Rita Revollo; Kara Richmond; Francisco Paz; Lorena P. Chavez
There is a significant association between history of partner violence and a positive syphilis test among pregnant women, suggesting that syphilis can be an important negative health consequence of IPV. Bolivia's new maternal and infant health program in antenatal clinics, which includes universal syphilis screening, should also provide screening and follow-up care for IPV.
Using a monitoring and evaluation framework to improve study efficiency and quality during a prospective cohort study in infants receiving rotavirus vaccination in El Alto, Bolivia: the Infant Nutrition, Inflammation, and Diarrheal Illness (NIDI) study
(BioMed Central, 2017) Anna Aceituno; Kaitlyn K. Stanhope; Paulina A. Rebolledo; Rachel M. Burke; Rita Revollo; Volga Iñiguez; Parminder S. Suchdev; Juan S. León
Vitamin A Deficiency and Mother‐Infant Correlations in Bolivia
(Wiley, 2015) Alexander Cattran; Rachel M. Burke; Adam C. Lipus; Rita Revollo; Volga Iñiguez; Juan S. León; Parminder S. Suchdev
Vitamin A deficiency (VAD) affects an estimated one‐third of preschool‐aged children in developing countries and is an important contributor to global child mortality. The goal of this analysis was to identify risk factors of VAD in a cohort of Bolivian infants. Healthy infants (n=163) were recruited from 2 hospitals in El Alto, Bolivia, and followed from 1 to 6 months of age. Blood specimens taken at 6 months were analyzed for retinol‐binding protein (RBP) levels (VAD defined as RBP < 0.7 µmol/L), C‐Reactive Protein (CRP), and alpha(1)‐acid glycoprotein (AGP). Potential covariates in logistic regression models of VAD included infant gender, stunting (length‐for‐age Z score < ‐2), iron deficiency (ferritin< 12 μg/L), acute respiratory or diarrheal illness, breastfeeding, maternal age, maternal vitamin A supplementation, maternal employment, and access to private toilets. Elevated CRP (>5 mg/L) and AGP (>1 g/L) were included in all models to account for inflammation. Prevalence of VAD was 25%. Backwards elimination indicated maternal age (OR: 4.6, 90% CI: [1.8‐11.4] for 25‐30 vs. 20‐25 years), maternal employment (0.4 [0.2‐0.9]) and elevated CRP (3.1 [1.2‐7.9]) were significantly associated with VAD using an alpha of 10%. These results suggest that sociodemographics may be an important risk factor for VAD, while inflammation also affects measures of VAD. A limitation of this study is the small sample size and subsequent lack of power, which will be improved as data collection continues.