An analysis of traffic accidents and children: the case of Uruguay
"Despite the fact that traffic accidents result in high economic costs and large numbers of fatalities in developing countries, only in the last five years have the countries of the region begun to establish specialized agencies devoted to fully addressing the problem. Establishing an agency, however, is not a solution in and of itself. As proposed in previous ECLAC [Economic Commission for Latin America] documents, all levels of Government (both legislative and judiciary), together with the public and private sectors must take coordinated and decisive action. This action must be combined with the active involvement of civil society. Technical studies to help uncover the real situation of road safety in the region, collect statistics and propose policies for action are examples of the coordinated efforts and partnerships that should be undertaken throughout the region. In the case of Uruguay, the National Traffic Safety Agency was created with the passage of Law 18,133 in May 2007 under the Executive Branch to ‘…regulate and oversee traffic and road safety in the entire national territory…’ Similarly, Law 18,191 or the ‘National Traffic and Road Safety Act’ was passed in November 2007. These two laws were a milestone in the fight against traffic accidents in Uruguay, since according to official statistics from the Ministry of the Interior, over 400 people were killed and over 20,000 were injured in traffic accidents in 2007. This epidemic, which most often affects individuals under 35 years of age, is linked to poverty, social exclusion and causes considerable economic losses. Estimates for the year 2000 made by the National Commission for the Prevention of Traffic Accidents, under the Ministry of Transport and Public Works (MTOP), show that yearly spending for traffic accidents reached US $927 million, equivalent to 4.5% of the country’s GDP for that year." [emphasis in original] [Bulletin FAL, No. 279, 11/ 2009]
Community acquired Methicillin-resistant Staphylococcus aureus, Uruguay
A novel, multidrug-resistant Staphylococcus aureus clone (Uruguay clone) with a non–multidrug-resistant phenotype caused a large outbreak, including 7 deaths, in Montevideo, Uruguay. The clone was distinct from the highly virulent community clone represented by strain MW2, although both clones carried Panton-Valentine leukocidin gene and cna gene. [publication summary] [Emerging Infectious Diseases, Vol. 11, No. 6, June 2005, pp.973-976]
Control program against hydatidosis and the decreased prevalence in Uruguay
Cystic hydatidosis/echinococcosis is an important zoonosis caused by the tapeworm Echinococcus granulosus. Hydatidosis is a serious parasitic disease in Uruguay, and in 1991 a new national control program was implemented by the national commission against hydatidosis (CHLCH). In 1991 (before the control program), farm and town dogs were examined for the prevalence of the parasite in Tacuarembó, Uruguay, using fecal samples of farm dogs after an arecoline purgation and samples of small intestine of town dogs obtained by necropsy. The prevalence of E. granulosus was 23 and 4% in farm and town dogs, respectively. In order to evaluate the impact of the control program, two surveys on ovine hydatidosis were carried out in Tacuarembó before and during the national control program. Sheep were examined in 1991–1992 (before the control program) and 1999 (during the control program). Both prevalence and intensity of E. granulosus infection increased with age in both 1991–1992 and 1999. The prevalence of ovine hydatidosis was 41.6 and 8.5% in 1991–1992 and 1999, respectively. The prevalence of fertile cysts in sheep more than 4 years old was 7.3% and 2.3% in 1991–1992 and 1999, respectively. The remarkable decreased prevalence of ovine hydatidosis suggested the successful control program by CHLCH in Uruguay. [author abstract] [International Congress Series 1267 (2004): 98–104]
Economic impact of pneumococcal conjugate vaccination in Brazil, Chile, and Uruguay
Objectives: To evaluate the economic impact of vaccination with the pneumococcal 7-valent conjugate vaccine (PCV7) in Brazil, Chile, and Uruguay. Methods: A decision analytic model was constructed to compare pneumococcal vaccination of children 0–5 years old with no vaccination in Brazil, Chile, and Uruguay. Costs and health outcomes were analyzed from the societal perspective. Vaccine, demographic, epidemiologic, and cost data were incorporated into this economic analysis. Results: At the rate of diphtheria-tetanus-pertussis (DTP) vaccine coverage and a vaccine price of US$ 53 per dose, PCV7 was projected to prevent 23 474 deaths per year in children under 5 years old in the three countries studied, thus averting 884 841 disability-adjusted life years (DALYs) yearly. To vaccinate the entire birth cohort of the three countries, total vaccine costs would be US$ 613.9 million. At US$ 53 per dose, the cost per DALY averted from a societal perspective would range from US$ 664 (Brazil) to US$ 2 019 (Chile). At a cost of US$ 10 per dose, vaccine cost is lower than the overall cost of illness averted (US$ 125 050 497 versus US$ 153 965 333), making it cost effective and cost-saving. Conclusions: The results of this study demonstrate that the incorporation of PCV7 vaccine at US$ 53 per dose confers health benefits at extra costs. It is unclear whether vaccination at the current price is affordable to these countries. [author abstract] [Rev Panam Salud Publica, 2008; 24(2): 101–12]
Equity of access to health care for older adults in four major Latin American cities
Objectives: To identify if older adults have equitable access to health services in four major Latin American cities and to determine if the inequities that are found follow the patterns of economic inequality in each of the four nations studied. Methods: Data from persons age 60 and over in the cities of São Paulo, Brazil (n = 2 143); Santiago, Chile (n = 1 301); Mexico City, Mexico (n = 1 247); and Montevideo, Uruguay (n = 1 450) were collected through a collaboration led by the Pan American Health Organization. For our study, three process indicators of access (availability, accessibility, and acceptability) and one indicator of actual health services use (visit to a medical doctor in the past 12 months) were analyzed by wealth quintiles, health insurance type, education, health status, and demographic characteristics. Results: Each of the four cities had a different level of access to care, and those levels of access were only weakly related to per capita national wealth. Given the relatively high level of wealth inequality in Brazil and the lower level in Uruguay, older persons in São Paulo had better-than-expected equity in access to care, while older persons in Montevideo had less equity than expected. Inequity in Mexico City was driven primarily by low levels of health insurance coverage. In Santiago, inequity followed socioeconomic status more than it did health insurance. Conclusions: In the four cities studied, health insurance and the operation of health systems mediate the link between economic inequality and inequitable access to health care. Therefore, special attention needs to be paid to equity of access in health services, independent of differences in economic inequality and national wealth. [author abstract] [Rev Panam Salud Publica, 2005; 17(5/6): 394–409]
Etiology of Children’s Diarrhea in Montevideo, Uruguay: Associated Pathogens and Unusual Isolates
We studied microorganisms associated with infant diarrhea in a group of 256 children admitted to a public pediatric hospital in Montevideo, Uruguay. Diagnostic procedures were updated to optimize detection of potential pathogens, which were found in 63.8% of cases, and to be able to define their characteristics down to molecular or antigenic type. Coinfection with two or more agents was detected in more than one-third of positive studies. Escherichia coli enteric virotypes, especially enteropathogenic E. coli (EPEC), were shown to be prevalent. Rotavirus, Cryptosporidium, Campylobacter (mainly Campylobacter jejuni), and Shigella flexneri were also often identified. Enterotoxigenic E. coli, Salmonella, and Giardia lamblia were sporadically recognized. Unusual findings included two enteroinvasive E. coli strains, one Shigella dysenteriae 2 isolate, and a non-O:1 Vibrio cholerae culture. EPEC bacteria and S. flexneri (but not Salmonella) showed unusually frequent antimicrobial resistance, especially towards beta-lactam antibiotics, which is the subject of ongoing work. [author abstract] [Journal of Clinical Microbiology, Vol. 39, No. 6, June 2001, pp.2134–2139]
Health in the Americas 2007: Uruguay
As a health agency, the Pan American Health Organization’s core discipline is epidemiology, which enables the measurement, definition, and comparison of health problems and conditions and their distribution from the perspectives of population, geography, and time. This publication on Uruguay addresses the issue of health as a human right, taking into account both the individual and community contexts, and examines various critical determinants of health, including those of a biological, social, cultural, economic, and political nature. That examination reveals the existence of gaps, disparities, and inequities that persist in Uruguay, especially those related to access to basic services, health, nutrition, housing, and adequate living conditions as well as to the lack of opportunities for human development—all of which contribute to the greater vulnerability to diseases and health risks of some population groups. [Adapted from the preface of Health in the Americas 2007]
Lead Contamination in Uruguay: The "La Teja" Neighborhood Case
"The understanding of environmental risks associated with lead contamination in Uruguay improved as data on lead concentrations in blood and soil samples accumulated. The growing scientific evidence, along with press reports and court cases, increased awareness and concern among Uruguayans for lead-induced health risks... As a consequence, new research studies on Uruguayan populations became available, including some that had gone unpublished for several years. Some interdisciplinary study results were officially communicated to the public as they became available, particularly those designed to prevent environmental health risks to children." [D.M. Whitacre (ed.), Reviews of Environmental Contamination and Toxicology. Springer, 2008, pp.93-115]
Serologic evidence of human metapneumovirus circulation in Uruguay
First identified in 2001, the human metapneumovirus (hMPV), is a respiratory tract pathogen that affects young children, elderly, and immunocompromised patients. The present work represents the first serologic study carried out in Uruguay. It was performed with the purpose of obtaining serological evidence of hMPV circulation in Uruguay and to contribute to the few serologic reports described until now. Sixty nine serum samples collected between 1998 and 2001 by vein puncture from patients without respiratory symptoms or underlying pathology aged 6 days to 60 years were examined using an indirect immunofluorescence assay (IFA). The global seropositivity rate of the samples was 80% (55/69). Rates of 60% (15/25) and 91% (40/44) were observed for the pediatric and adult cohorts, respectively. Results obtained from a longitudinal analysis of 6 children aged 6 days to 18 months are discussed. These results are a clear evidence of hMPV circulation in Uruguay, at least since 1998, and reinforce the previous data on worldwide circulation of this virus. [author abstract] [Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 100(7): 715-718, November 2005]
Socio-Economic Impact of Disability in Latin America: Chile and Uruguay
"Although policies to include people with disabilities have been introduced in many developed countries, little evidence has been provided based on measured effects in LDCs [Less Developed Countries]. By using information on two national representative household surveys for Chile and Uruguay in 2003, the paper provides pioneering evidence on the impact of the economic opportunities of individuals with disabilities in these countries. These two Latin American countries provide some ground to understand the opportunities in the access to education, participation, earnings and unemployment that those individuals with disabilities (or living in a household with members with disabilities) have." [Departamento de Economía, Universidad de Chile, 21 July 2006]
The Challenge of Implementation of Preventive Programs in a Developing Country: Experiences, Situations, and Perspectives in Uruguay
In recent years, Uruguay has seen an alarming increase in the percentage of persons with human immunodeficiency virus infection/acquired immunodeficiency syndrome who are injection drug users (IDUs) and their sex partners, which has consequently contributed to the rate of perinatal transmission. Development of preventive harm reduction and risk reduction strategies has become imperative. These strategies must be suitable for a developing country and focused on its population of IDUs. These strategies must include, as a preliminary step, a comprehensive analysis of the current local legal system and knowledge about the kinds of drugs used, the ways in which they are used, and their effects on public health. The conclusions of some studies and a pilot program that Institute of Social Research and Development, Instituto de Investigación y Desarrollo Social, Uruguay, implemented in 2001 have pointed to new avenues for the control of the epidemic spread among IDUs and to their social environment. [author abstract] [Clinical Infectious Diseases 2003; 37 (Suppl 5): S422–6]
The Impact of Prenatal Care on Birthweight: The Case of Uruguay
This study analyzes prenatal care and birthweight in Uruguay. These data are unique since they represent a population of poor women who gave birth in a health care system that provides both prenatal and obstetric care free of charge. This study finds a positive effect of increased prenatal care use on birthweight, and the marginal effect is similar to that found in studies using US data. The results highlight the usefulness of existing methodologies for estimating the effect of prenatal care on birthweight and the importance of extending these methodologies to data from countries other than the US. [publication abstract] [Department of Economics, University of the Republic, Uruguay, July 2005]
Uruguay on the World Stage: How Child Health Became an International Priority
The evolution of international health has typically been assessed from the standpoint of central institutions (international health organizations, foundations, and development agencies) or of one-way diffusion and influence from developed to developing countries. To deepen understanding of how the international health agenda is shaped, I examined the little-known case of Uruguay and its pioneering role in advancing and institutionalizing child health as an international priority between 1890 and 1950. The emergence of Uruguay as a node of international health may be explained through the country’s early gauging of its public health progress, its borrowing and adaptation of methods developed overseas, and its broadcasting of its own innovations and shortcomings. [author abstract] [American Journal of Public Health, Vol 95, No. 9, pp. 1506-1517 (September 2005)]
WHO-AIMS Report on Mental Health System in Uruguay
"Uruguay, as most countries of the Americas, has a mental health policy. Financing is mainly oriented towards mental hospitals. A human rights review body exists, but there were no inspection either in mental hospitals or in community-based psychiatric inpatient units during the last year. A specific effort in order to collect data on involuntary admissions, restraint and seclusion and to provide training on human rights to staff should be done. In Uruguay, the mental health system has all types of mental health facilities; however some need to be strengthened and improved. A mental health authority exists in the public sector. The majority of beds are still provided by mental hospitals, despite the fact that during the last ten years the government has reduced the numbers of beds in mental hospitals and promoted the building of community based psychiatric inpatient units. The aim of the mental health authority is to reduce inpatient care and to improve the primary health care, which is weak. Few facilities are devoted to children and adolescents. Regarding treatment, psychotropic medicines are available in all facilities and 43% of the population has free access to them. There are not enough human resources to provide all patients psychosocial interventions." [WHO and Ministry of Health, Montevideo, Uruguay, 2006]

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