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INTRODUCTION: Guatemalan lay midwives are well-respected community leaders in a country that lacks the institutional capacity to meet healthcare needs related to pregnancy, newborns, and COVID-19. Thus, Guatemalan lay midwives, who attend the majority of births in their country and who attend most births at home, are in an optimal position to offer frontline support to pregnant women and newborns regarding the global pandemic. The primary objective of this program of study was to dispel myths about COVID-19 and to provide culturally relevant educational activities to low-literacy Guatemalan lay midwives about issues related to the virus, such as signs and symptoms, risks to the mother and fetus, which patients are most vulnerable, appropriate responses, benefits and side-effects of the vaccine, timing of the vaccine, how the virus interacts with breastfeeding, and breastfeeding recommendations. METHODS: In a partnership among the Guatemalan Ministry of Health, expert faculty at the University of Utah College of Nursing, and Madre y Niño, a non-profit organization from the US, evidence-based educational activities about COVID-19 were offered orally in the native language of participants. Two hundred and ten lay midwives attended educational sessions at 11 locations throughout the remote Peten department. Educational activities included repetition, storytelling, and role plays. A pretest-post-test evaluation of 10 questions with 24 correct answers was used to determine if the educational activities changed lay midwife knowledge about COVID-19. Participants were given essential birth supplies and laminated COVID Reminder Cards, which were designed to increase visual literacy, to encourage knowledge retention after the educational sessions. RESULTS: Participants showed a significant increase in knowledge scores (possible 0-24) from prescores 7.09 (standard deviation (SD)=3.06) to 15.20 (SD=4.61), Student's t-test p<0.001. In addition, a significantly higher proportion of participants mistakenly thought COVID-19 passed through breast milk on the pretest (70.1%) compared to post-test (8.4%) (McNemar test, p<0.001). Regarding breastfeeding, 12.6% of participants knew on the pretest that women with COVID-19 who breastfeed should wear a mask and wash their hands compared to 74.3% of participants who knew these recommendations on the post-test (Wilcoxon signed-rank test, p<0.001). Finally, 2% of participants knew on the pretest that pregnant women with COVID-19 should take a low-dose aspirin compared to 67% of participants on the post-test (χ² (1)=194.7, p<0.001). CONCLUSION: These essential primary care providers misunderstood many critical issues related to COVID-19, pregnancy, and newborns. Culturally relevant educational activities provided orally in the native language of participants dispelled myths about the virus and significantly improved lay midwife knowledge. Providing evidence-based educational activities in a culturally relevant format is critical to protecting remote, vulnerable populations, such as pregnant Guatemalan women and newborns, during a global pandemic.

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INTRODUCTION: Comadronas attend most births in rural and urban Guatemala where the maternal mortality rate (MMR) is highest in Latin America. Information has been published regarding rural comadronas' response to obstetrical emergencies. Understanding urban comadronas' response to obstetrical emergencies is essential to addressing Guatemala's MMR. METHODS: A total of 17 urban comadronas participated in one, 34-min focus group to share their knowledge, practices, and attitudes regarding obstetrical emergencies. We used the long table to analyze the content to develop a matrix of themes. RESULTS: Five themes emerged. Urban comadronas receive consistent training, have hospital transportation, and feel confident in their knowledge, but they lack equipment and feel hospital providers disrespect them. Still, the joy of attending births outweighs the challenges they face. DISCUSSION: Urban comadronas described a different experience of responding to obstetrical emergencies than rural comadronas. Distinct approaches are needed to provide culturally congruent support for urban and rural comadronas when responding to obstetrical emergencies.

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Low and middle-income countries, such as Guatemala, shoulder a disproportionate share of cervical cancer, a preventable disease in high income countries. Tangible obstacles, such as lack of access to health care, cultural differences, and insufficient infrastructure, and facilitators, such as being Ladino, married, and educated, have been identified in the literature related to cervical cancer prevention. The aim of this survey was to explore barriers and facilitators to cervical cancer prevention, comparing rural Indigenous and urban Ladino populations. We surveyed 139 women in two health clinics. Participants answered questions about demographic information, cervical cancer knowledge, and health care behaviors. We analyzed survey data with four bivariate models. Our results suggest vulnerable populations, such as rural Indigenous women who are single, illiterate, and lack education, face higher cervical cancer risk. Partnerships should be formed with health promotors and lay midwives to educate and encourage vulnerable populations to prevent cervical cancer.

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BACKGROUND: Studies examining the association between in utero Zika virus (ZIKV) exposure and child neurodevelopmental outcomes have produced varied results. METHODS: We aimed to assess neurodevelopmental outcomes among normocephalic children born from pregnant people enrolled in the Zika in Pregnancy in Honduras (ZIPH) cohort study, July-December 2016. Enrollment occurred during the first prenatal visit. Exposure was defined as prenatal ZIKV IgM and/or ZIKV RNA result at enrollment. Normocephalic children, >6 months old, were selected for longitudinal follow-up using the Bayley Scales of Infant and Toddler Development (BSID-III) and the Ages & Stages Questionnaires: Social-Emotional (ASQ:SE-2). RESULTS: One hundred fifty-two children were assessed; after exclusion, 60 were exposed and 72 were unexposed to ZIKV during pregnancy. Twenty children in the exposed group and 21 children in the unexposed group had a composite score <85 in any of the BSID-III domains. Although exposed children had lower cognitive and language scores, differences were not statistically significant. For ASQ:SE-2 assessment, there were not statistically significant differences between groups. CONCLUSIONS: This study found no statistically significant differences in the neurodevelopment of normocephalic children between in utero ZIKV exposed and unexposed. Nevertheless, long-term monitoring of children with in utero ZIKV exposure is warranted. IMPACT: This study found no statistically significant differences in the neurodevelopment in normocephalic children with in utero Zika virus exposure compared to unexposed children, although the exposed group showed lower cognitive and language scores that persisted after adjustment by maternal age and education and after excluding children born preterm and low birth weight from the analysis. Children with prenatal Zika virus exposure, including those normocephalic and have no evidence of abnormalities at birth, should be monitored for neurodevelopmental delays. Follow-up is important to be able to detect developmental abnormalities that might not be detected earlier in life.

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Objective: Pain, stress, and diabetes mellitus (DM) are common complaints for Guatemalans seeking health care. Because acupuncture therapy (AT) is a low-cost, effective treatment for these concerns, it was offered to Guatemalans during a health care mission as an adjunct to primary care. The purpose of this study was to gather feedback about providing AT in this context and to describe the lessons that were learned. Materials and Methods: A pretest single-arm exploratory study design was used, collecting demographic data and administering a pretest to patients referred for AT. Patients received AT according to presenting symptoms, except patients with DM, who were treated with a previously developed auricular AT protocol. After AT, all patients received adhesive seeds for self-administered auricular acupressure, along with a printed diagram, showing where and how to apply them, and a symptom-tracking form. Results: AT was given to 11 patients (1 had DM; 10 did not). Most were female (9; 82%), older (average 59.27 years; range: 40-81 years), and had little education (average 4 years; range: 0-12 years). Complaints were pain (11; 100%), insomnia (6; 55%), anxiety (4; 36%), depression (7; 64%), and stress (3; 27%). More than 50% had seen health care providers (6; 55%). One person had AT previously and 3 people requested more information about AT before receiving it. Conclusions: Reporting high symptom burdens, most patients were unfamiliar with AT. AT ceased when the licensed acupuncturist contracted COVID. Patients will be followed in 2023 and AT will be given to collect data on feasibility, satisfaction, and possible implementation.

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There is scarce information related to transplacental antibody transfer against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with different homologous and heterologous vaccination schemes. This study aimed to correlate the magnitude of transplacental transfer anti-SARS-CoV-2 antibodies in different homologous and heterologous schemes. An observational cross-sectional study was developed to identify pregnant women vaccinated against SARS-CoV-2. They were questioned about their immunization status; blood samples from the mother, umbilical cord during labor, and the newborn 72 h after birth were taken to measure anti-S1 and anti-S2 specific IgG antibodies for SARS-CoV-2. We recruited 104 women with a median age of 29 (SD 1.17). We found antibodies in all newborns with vaccinated mothers. Homologous BNT162b2 mRNA regimen had the highest mean (SD) antibody titers (AU/mL) in maternal (994.93 (3.08), p = 0.039), umbilical cord (1316.43 (2.79), p = 0.016), and newborn (1192.02 (3.55), p = 0.020) blood. The generalized linear model showed a positive effect over antibodies with at least one dose in maternal (ß = -1.1, p = 0.002) and newborn (ß= -0.717, p = 0.044) blood, and with two doses (ß = -0.684, p = 0.026) in umbilical cord blood. In conclusion, antibodies were detected in all vaccinated women and their newborns. Transfer of antibodies was found from the first dose, and the levels increased with the number of vaccine doses. Vaccination should be encouraged in pregnant women with any available scheme.

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The impact of Zika virus (ZIKV) infection on pregnancies shows regional variation emphasizing the importance of studies in different geographical areas. We conducted a prospective study in Tegucigalpa, Honduras, recruiting 668 pregnant women between July 20, 2016, and December 31, 2016. We performed Trioplex real-time reverse transcriptase-PCR (rRT-PCR) in 357 serum samples taken at the first prenatal visit. The presence of ZIKV was confirmed in seven pregnancies (7/357, 2.0%). Nine babies (1.6%) had microcephaly (head circumference more than two SDs below the mean), including two (0.3%) with severe microcephaly (head circumference [HC] more than three SDs below the mean). The mothers of both babies with severe microcephaly had evidence of ZIKV infection. A positive ZIKV Trioplex rRT-PCR was associated with a 33.3% (95% CI: 4.3-77.7%) risk of HC more than three SDs below the mean.

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Abstract: The tropical dry forest is under constant threat from many anthropic activities which are conducted indiscriminately, modifying the forest, and therefore, affecting species that are closely related to its phenology, such as longhorned beetles (Cerambycidae). The spatio-temporal variation of the cerambycid diversity in two fragments of tropical dry forest (Reserva Campesina la Montaña and La Flecha) in the Caribbean region of Colombia was analyzed. At each locality, four squared plots were delimited, and the beetles were collected with fruit traps, beating sheets and manual capture, and with light traps in the center. Five hundred eighty-seven specimens representing 128 species were collected, of which members of the tribe Ectenessini (Cerambycinae) were the most abundant. At the subfamily level, Cerambycinae was the most abundant (465 specimens) and diverse (73 species), followed by Lamiinae and Prioninae. The highest values of richness (110 species), abundance (428), biomass (21.18 g), and as well as the highest values of true diversity (1D= 73.44, 2D= 34.30) were found during the first precipitations. Regarding beta diversity, temporal variation was determined and mainly explained by a high percentage of turnover (> 70%). Lastly, the high diversity of Cerambycidae was associated with high values of relative humidity and canopy cover during the rainy season. This showed that the structure of the cerambycid community in the tropical dry forest of the Caribbean region of Colombia depends on these variables, which are closely related to precipitation.

Resumo: A floresta seca tropical está sob constante ameaça devido às muitas atividades antrópicas que são realizadas indiscriminadamente, modificando a floresta e, portanto, afetando espécies que se encontram muito relacionadas com a sua fenologia, tais como os besouros serra-pau (Cerambycidae). Foi analisada a variação espaço-temporal da diversidade de cerambícidos em dois fragmentos de floresta seca tropical ("Reserva campesina La Montaña e La Flecha") na região caribenha da Colômbia. Em cada localidade, quatro quadrantes foram delimitados e os besouros foram coletados usando armadilhas com isca de fruta, guarda-chuva entomológico, captura manual e armadilhas de luz. Quinhentos e oitenta e sete espécimes, de 128 espécies foram coletados, sendo os membros da tribo Ectenessini (Cerambycinae) os mais abundantes. Ao nível de subfamília, Cerambycinae foi a mais abundante (465 espécimes) e diversa (73 espécies), seguida de Lamiinae e Prioninae. Os valores mais altos de riqueza (110 espécies), abundância (428) e biomassa (21.18 g) foram encontrados durante as primeiras chuvas, assim como os valores mais altos de diversidade verdadeira (1D= 73.44, 2D= 34.30). Em relação à diversidade beta, a variação temporal foi determinada e principalmente explicada por uma alta porcentagem de substituição (> 70%). Por último, uma alta diversidade de Cerambycidae foi associada com altos valores de humidade relativa e cobertura vegetal durante a temporada de chuva, mostrando que a estrutura da comunidade de Cerambycidae na floresta seca tropical da Colômbia depende dessas variáveis, as quais são muito relacionadas com a precipitação.

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Since its 2013 emergence in the Americas, Chikungunya virus (CHIKV) has posed a serious threat to public health. Early and accurate diagnosis of the disease, though currently lacking in clinics, is integral to enable timely care and epidemiological response. We developed a dual detection system: a CHIKV antigen E1/E2-based enzyme-linked immunosorbent assay (ELISA) and a lateral flow test using high-affinity anti-CHIKV antibodies. The ELISA was validated with 100 PCR-tested acute Chikungunya fever samples from Honduras. The assay had an overall sensitivity and specificity of 51% and 96.67%, respectively, with accuracy reaching 95.45% sensitivity and 92.03% specificity at a cycle threshold (Ct) cutoff of 22. As the Ct value decreased from 35 to 22, the ELISA sensitivity increased. We then developed and validated two lateral flow tests using independent antibody pairs. The sensitivity and specificity reached 100% for both lateral flow tests using 39 samples from Colombia and Honduras at Ct cutoffs of 20 and 27, respectively. For both lateral flow tests, sensitivity decreased as the Ct increased after 27. Because CHIKV E1/E2 are exposed in the virion surfaces in serum during the acute infection phase, these sensitive and specific assays demonstrate opportunities for early detection of this emerging human pathogen.

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The percentage of agricultural land cover effect on water quality in Culiacan River basin is studied in this research. The basin contains only intensive cropland as primary economic activity with 60% of the total area. Mathematical relationships between percentages of cropland and total phosphorus (TP) and total nitrogen (TN) concentrations were established. Sampling sites in middle and lower basin and water quality information during 2013-2018 were considered, and percentages of cropland were obtained by geospatial methods including variable area buffers. During rainy season, coefficients of determination were less than 0.2, although quantified nutrient concentration was higher, related to point sources of pollution in the basin. During dry season, coefficients of determination were higher than 0.76 and 0.90 for TN and TP, respectively, with an exponential mathematical trend. Results suggest that intensive agriculture practices generate accelerated loss of soil consolidation, which is transported to water bodies. These soils are in continuous contact with fertilizers and pesticides, mostly organophosphates which have been transported by runoff and underground flows. Using the information generated will help to establish environmental management plans, and to improve environmental diagnosis and effect in countries where there is not enough historical cartographic information and/or water quality data.

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Two new species of Elaphidiini from Colombia are described: Sphaerion costae sp. nov., and Mephritus costae sp. nov. The keys to species of Sphaerion Audinet-Serville, 1834 and Mephritus Pascoe, 1866 are translated and modified to include the new species. Chromatic variations of Mephritus apicatus (Linsley, 1935) are reported. Moreover, the geographical distribution is expanded for 12 species of Elaphidiini.

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Two new species of Elaphidiini from Colombia are described: Sphaerion costae sp. nov., and Mephritus costae sp. nov. The keys to species of Sphaerion Audinet-Serville, 1834 and Mephritus Pascoe, 1866 are translated and modified to include the new species. Chromatic variations of Mephritus apicatus (Linsley, 1935) are reported. Moreover, the geographical distribution is expanded for 12 species of Elaphidiini.(AU)

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Abstract Two new species of Elaphidiini from Colombia are described: Sphaerion costae sp. nov., and Mephritus costae sp. nov. The keys to species of Sphaerion Audinet-Serville, 1834 and Mephritus Pascoe, 1866 are translated and modified to include the new species. Chromatic variations of Mephritus apicatus (Linsley, 1935) are reported. Moreover, the geographical distribution is expanded for 12 species of Elaphidiini.

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Introduction: The Guatemalan maternal mortality rate is among the highest in Latin Americans, and lay midwives (LMs) attend home births. The study's purpose was to explore LMs' knowledge of, attitudes toward, and practices regarding obstetrical complications and emergencies. Method: In the remote Peten region, a descriptive ethnographic study held focus group discussions before education programs to teach/boost LMs' awareness about obstetrical complications. The long-table approach of analyses developed a matrix of common themes. Results: Nearly 200 LMs participated in 11 groups. Six themes emerged: LMs attribute their knowledge to God, recognize signs of obstetrical danger, want more training and equipment, encounter resistance from a patriarchal culture, feel fear and despair in addressing obstetrical complications/emergencies, and experience arduous logistics in emergency hospital transfers. Discussion: Contrary to published literature, LMs were able to verbalize basic knowledge of obstetrical complications. Information learned can guide future, action-research studies to address the maternal mortality rate in resource-poor settings.

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A new species of Gnomidolon from Colombia is described and illustrated: Gnomidolon franciscoi sp. nov.; and the previous key for the genus is modified to include the new species. The male of Gnomidolon hamatumLinsley, 1935 is described and illustrated for the first time. Additionally, a chromatic variation in some species of Hexoplonini from Colombia is reported and the geographical distribution of four species is expanded.(AU)

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A new species of Gnomidolon from Colombia is described and illustrated: Gnomidolon franciscoi sp. nov.; and the previous key for the genus is modified to include the new species. The male of Gnomidolon hamatumLinsley, 1935 is described and illustrated for the first time. Additionally, a chromatic variation in some species of Hexoplonini from Colombia is reported and the geographical distribution of four species is expanded.

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INTRODUCTION: Guatemala's Maternal Mortality Rate is 65th highest in the world at 120 deaths per 100,000 births. Contributing to the problem is traditional birth attendants (TBAs) attend most births yet lack knowledge about obstetrical emergencies. Government trainings in existence since 1955 have not changed TBA knowledge. Government trainings are culturally insensitive because they are taught in Spanish with written material, even though most TBAs are illiterate and speak Mayan dialects. The purpose of the observational study was to evaluate the effect of an oral training, that was designed to be culturally sensitive in TBAs' native language, on TBAs' knowledge of obstetrical emergencies. METHODS: one hundred ninety-one TBAs participated. The study employed a pretest-posttest design. A checklist was used to compare TBAs' knowledge of obstetrical emergencies before and after the training. FINDINGS: the mean pretest score was 5.006±SD 0.291 compared to the mean posttest score of 8.549±SD 0.201. Change in knowledge was a P value of 0.00. DISCUSSION: results suggest an oral training that was designed to be culturally sensitive in the native language improved TBAs' knowledge of obstetrical emergencies. Future trainings should follow a similar format to meet the needs of illiterate audiences in remote settings.

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Although the recent Zika virus (ZIKV) epidemic in the Americas and its link to birth defects have attracted a great deal of attention, much remains unknown about ZIKV disease epidemiology and ZIKV evolution, in part owing to a lack of genomic data. Here we address this gap in knowledge by using multiple sequencing approaches to generate 110 ZIKV genomes from clinical and mosquito samples from 10 countries and territories, greatly expanding the observed viral genetic diversity from this outbreak. We analysed the timing and patterns of introductions into distinct geographic regions; our phylogenetic evidence suggests rapid expansion of the outbreak in Brazil and multiple introductions of outbreak strains into Puerto Rico, Honduras, Colombia, other Caribbean islands, and the continental United States. We find that ZIKV circulated undetected in multiple regions for many months before the first locally transmitted cases were confirmed, highlighting the importance of surveillance of viral infections. We identify mutations with possible functional implications for ZIKV biology and pathogenesis, as well as those that might be relevant to the effectiveness of diagnostic tests.

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