RESUMO
OBJECTIVES: To estimate the cumulative incidence rate of acute pesticide poisoning in the year 2000 among Nicaraguan subjects over 15 years of age. METHODS: Data on pesticide exposure and health effects were assessed in a nationally representative survey. Based on self-reported cases, we estimated the 1-year incidence rate and the number of expected cases of acute pesticide poisonings in Nicaragua. RESULTS: Among the 3169 survey respondents, we identified 72 persons who self-reported one episode of acute pesticide poisoning in 2000. Of these, 65 cases (90%) were related to occupational exposure, five (7%) to domestic exposure and two (3%) to intentional exposure. The cumulative incidence rate/100 individuals of pesticide poisonings in Nicaragua in 2000 was 2.3 (95% CI 1.7 to 2.8). This corresponds to 66 113 cases (95% CI 51 017 to 81 210). The highest rate was found among males in rural areas, particularly among farmers and agricultural workers. CONCLUSION: This study demonstrates an extremely high risk of acute pesticide poisoning in Nicaragua. Considering this, comprehensive measures should be implemented to reduce adverse health effects.
Assuntos
Agricultura , Países em Desenvolvimento , Praguicidas/intoxicação , Adolescente , Adulto , Idoso , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Nicarágua/epidemiologia , Exposição Ocupacional , Razão de Chances , Sistema de Registros , Risco , Saúde da População Rural , Adulto JovemRESUMO
AIMS: To evaluate the association of acute organophosphate (OP) poisoning with chronic sensory and motor neurological impairment. METHODS: This study concerns the third of a series of three examinations of hand strength and vibration thresholds in a two year period after acute OP poisoning among 48 Nicaraguan men. The first two examinations were performed at hospital discharge and seven weeks after poisoning, and the present examination two years later. Twenty eight cattle ranchers and fishermen who had never experienced pesticide poisoning were examined as controls, also three times over the two year period. The poisonings were categorised as caused by "non-neuropathic" OPs and "neuropathic" OPs, each subdivided in moderate and severe poisonings. RESULTS: Men poisoned with OP insecticides had persistent reduced hand strength. We previously reported weakness at hospital discharge for OP poisoned in all categories that worsened seven weeks later for those severely poisoned with neuropathic OPs. Strength improved over time, but the poisoned were still weaker than controls two years after the poisoning, most noticeably among the subjects most severely poisoned with neuropathic OPs. Also, index finger and toe vibration thresholds were slightly increased at the end of the two year period, among men with OP poisonings in all categories, but patterns of onset and evolvement of impairment of vibration sensitivity were less clear than with grip and pinch strength. CONCLUSIONS: Persistent, mainly motor, impairment of the peripheral nervous system was found in men two years after OP poisoning, in particular in severe occupational and intentional poisonings with neuropathic OPs. This finding is possibly due to remaining organophosphate induced delayed polyneuropathy.
Assuntos
Força da Mão , Inseticidas/intoxicação , Doenças Profissionais/induzido quimicamente , Compostos Organofosforados , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Transtornos de Sensação/induzido quimicamente , Doença Aguda , Adolescente , Adulto , Doença Crônica , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Limiar SensorialRESUMO
This paper summarizes experiences from long-term ongoing cooperation between Swedish research institutions and institutions at the National Universities in Nicaragua and Costa Rica. 24 researchers and teachers from the Central American institutions and ten Swedish research students have been trained. In addition to three full doctoral and three licentiate (two-year PhD program) theses, the two programs have so far published 15 articles in English-language, international, refereed journals and about three times as many abstracts for conferences in more than ten countries. A "sandwich" model for training is recommended, where the southern researchers come to the wealthier partner for collaborative analyses and write-ups of the publications, while spending 50-75% of their time in their home countries for data collection. Such collaboration should be planned for a time span of at least eight years and include substantial numbers of researchers and students. Means to minimize the risk of brain drain are suggested. The collaboration has been important for the globalization of the research cultures at the participating institutions and has trained international experts.
Assuntos
Saúde Ambiental , Intercâmbio Educacional Internacional , Saúde Ocupacional , Pesquisa/educação , Costa Rica , Nicarágua , Suécia , Toxicologia/educaçãoRESUMO
We have described suggestive linkage between microsatellite markers within the cytogenetic region 18q21-23 and SLE, a region where linkage with other autoimmune diseases has also been detected. The Bcl-2 gene located within this region, is a candidate gene because of its role in apoptosis, a physiological mechanism that could be deregulated in autoimmune disease. Furthermore, several studies have found abnormalities of Bcl-2 expression in SLE patients. We therefore sought to determine if the Bcl-2 gene is involved in SLE by studying members of a large cohort of Mexican SLE patients (n = 378) and 112 Swedish simplex families. Using a microsatellite marker and two single nucleotide polymorphisms located within the gene, we were unable to detect association between Bcl-2 and SLE in either population. We also tested whether combinations of alleles of the Bcl-2 and IL-10.G microsatellites would increase the risk for SLE. Our results do not support such hypothesis. Our findings suggest that linkage between SLE and the 18q21-23 region is due to a gene other than Bcl-2.
Assuntos
Genes bcl-2 , Lúpus Eritematoso Sistêmico/genética , Alelos , Sequência de Bases , Estudos de Casos e Controles , Estudos de Coortes , Primers do DNA/genética , Feminino , Frequência do Gene , Ligação Genética , Genótipo , Humanos , Interleucina-10/genética , Lúpus Eritematoso Sistêmico/imunologia , Masculino , México , Repetições de Microssatélites , Polimorfismo de Nucleotídeo Único , SuéciaRESUMO
OBJECTIVE: To study the contribution of the IL10 gene to the susceptibility to systemic lupus erythematosus (SLE). METHODS: Analysis by fluorescent-semiautomated genotyping of a dinucleotide repeat located in the promoter region of the IL10 locus (microsatellite G). RESULTS: No significant difference was found in the frequencies of the microsatellite alleles of 330 Mexican patients with SLE compared to 368 controls from the same population. Two-point linkage analyses were carried out using 13 Mexican, 13 Swedish, and 8 Icelandic families with 2 or more cases with SLE. No linkage was revealed between IL10 and SLE, using a variety of parameter settings. CONCLUSION: Our results do not support that the IL10 gene contributes to the susceptibility to SLE in the populations we studied.
Assuntos
Interleucina-10/genética , Lúpus Eritematoso Sistêmico/genética , Repetições de Dinucleotídeos/genética , Feminino , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Humanos , Lúpus Eritematoso Sistêmico/imunologia , Masculino , México , Repetições de Microssatélites , Regiões Promotoras Genéticas/genéticaRESUMO
Systemic lupus erythematosus is a disease of unknown etiology. Multiple genetic factors are believed to be involved in its pathogenesis. In addition, and due to genetic heterogeneity, these factors and/or their combinations may be different in different ethnic groups, while some might be shared between populations. We have performed genome scans in multicase families from three different population groups, two from Northern Europe, with a high degree of homogeneity, and the third from a recently admixed population of Mexican Mestizos. Although our family material is relatively small, the results presented here show that using family sets from well defined populations are sufficient to detect susceptibility loci for SLE. Our results also reveal the chromosomal regions most likely to contain susceptibility genes for SLE.
Assuntos
Genoma Humano , Lúpus Eritematoso Sistêmico/genética , Etnicidade/genética , Feminino , Técnicas Genéticas , Genética Populacional , Humanos , Islândia/epidemiologia , Indígenas Norte-Americanos/genética , Escore Lod , Lúpus Eritematoso Sistêmico/epidemiologia , Masculino , México/epidemiologia , Suécia/epidemiologia , Estados Unidos/epidemiologia , População Branca/genéticaRESUMO
A questionnaire in Spanish (with yes/no answers) was developed in order to study effects of neurotoxic agents in groups of workers in Nicaragua. Since many workers in Latin America are illiterate, the questions were read to the subjects. The questionnaire initially contained 34 questions, which were reduced to 16 after studying whether the questions were interpreted in the intended way by the subjects, whether the answers were reasonably reproducible over a 3-week period, and whether the questions discriminated between groups exposed to different neurotoxic agents (mercury, lead, organic solvents, and organophosphate insecticides) and nonexposed groups. In total, 851 male workers in Nicaragua and Venezuela participated in the evaluation. The questionnaire is submitted for use in the monitoring of groups exposed to neurotoxic agents, particularly in Latin America. The authors welcome further evaluation.