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Purpose: Using an intersectionality framework, we compared stigma and HIV care and treatment outcomes across transgender and cisgender women sex workers living with HIV in the Dominican Republic (DR). Methods: In 2018-2019, data were collected in Santo Domingo, DR, using interviewer-administered surveys among 211 cisgender women and 100 transgender women. We used t-tests and chi-square tests to examine differences in sex work stigma, HIV stigma, and HIV care and treatment. Results: Transgender participants reported more anticipated HIV stigma (mean=13.61, standard deviation [SD]=2.39) than cisgender participants (mean=12.96, SD=2.21; p=0.018), but there were no statistically significant differences for internalized or enacted HIV stigma. Cisgender participants reported more anticipated sex work stigma (cisgender: mean=50.00, SD=9.22; transgender: mean=44.02, SD=9.54; p<0.001), but transgender women reported more enacted (cisgender: mean=49.99, SD=9.11; transgender: mean=59.93, SD=4.89; p<0.001) and internalized sex work stigma (cisgender: mean=50.00, SD=8.80; transgender: mean=57.84, SD=8.34; p<0.001), with no significant differences in resistance to sex work stigma. Cisgender women were significantly more likely to have received HIV care (cisgender: 99.53%, transgender: 91.00%, p<0.001), be currently taking antiretroviral therapy (cisgender: 96.21%, transgender: 84.00%, p<0.001), and be virally suppressed (cisgender: 76.19%, transgender: 64.00%, p=0.025). Conclusions: Transgender participants consistently had poorer HIV care and treatment outcomes compared with cisgender participants. Differences in stigma experiences between transgender and cisgender participants depended on the type of stigma. Findings reflect the intersectional nature of distinct types and forms of stigma among sex workers. Understanding the shared and unique experiences of transgender and cisgender women will improve HIV care engagement and viral suppression.

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INTRODUCTION: Current protocols aim to prevent some infant GBS infection through screening and peripartum antibiotics, however such strategies cannot be widely implemented in resource-limited settings. On the other hand, maternal vaccines in development against Group B Streptococcus (GBS) can provide a feasible universal approach. The success of any vaccine will depend on uptake in the population. Rates of maternal GBS colonization in the Dominican Republic (DR) and Caribbean region are among the highest in the world, but little is known about attitudes towards maternal vaccines in this region. METHODS: A cross-sectional, multicenter, mixed-methodology survey evaluated facilitators and barriers to maternal immunization and acceptability of a hypothetical Group B Streptococcus vaccine among pregnant women in three hospitals in the DR. RESULTS: Six-hundred and fifty women completed the survey of whom 85 % had never heard of GBS. Following receipt of information about GBS and a vaccine, 94 % of women stated that they would be likely or very likely to receive a vaccine. Being 18 years or younger was associated with a lower likelihood of GBS vaccine receipt (AOR 0.32, 95 % CI 0.14-0.69). Being born in the DR was associated with a higher likelihood of GBS vaccine receipt (AOR 2.73, 95 % CI 1.25-5.97). Among women who were unlikely to receive the vaccine, uncertainty about potential harm from a novel vaccine was the prominent theme elicited from free text responses. CONCLUSION: There was a high level of acceptance of a future GBS vaccine among this sample of pregnant women in the DR. However, knowledge of vaccines and vaccine-preventable diseases was low, and most women had concerns about the safety of new vaccines. Interventions that strengthen existing maternal immunisation infrastructures, including increasing education of pregnant women about vaccines, will aid the successful implementation of a future GBS vaccine.

Assuntos

Complicações Infecciosas na Gravidez , Gestantes , Infecções Estreptocócicas , Vacinas Estreptocócicas , Streptococcus agalactiae , Humanos , Feminino , Gravidez , República Dominicana , Adulto , Estudos Transversais , Infecções Estreptocócicas/prevenção & controle , Vacinas Estreptocócicas/imunologia , Vacinas Estreptocócicas/administração & dosagem , Streptococcus agalactiae/imunologia , Adulto Jovem , Gestantes/psicologia , Complicações Infecciosas na Gravidez/prevenção & controle , Adolescente , Inquéritos e Questionários , Vacinação/psicologia , Vacinação/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos

RESUMO

BACKGROUND: Dengue fever remains a significant public health challenge in tropical and subtropical regions, with its transmission dynamics being influenced by both environmental factors and human mobility. The Dominican Republic, a biodiversity hotspot in the Caribbean, has experienced recurrent dengue outbreaks, yet detailed understanding of the virus's transmission pathways and the impact of climatic factors remains limited. This study aims to elucidate the recent transmission dynamics of the dengue virus (DENV) in the Dominican Republic, utilizing a combination of genomic sequencing and epidemiological data analysis, alongside an examination of historical climate patterns. METHODS: We conducted a comprehensive study involving the genomic sequencing of DENV samples collected from patients across different regions of the Dominican Republic over a two-year period. Phylogenetic analyses were performed to identify the circulation of DENV lineages and to trace transmission pathways. Epidemiological data were integrated to analyze trends in dengue incidence and distribution. Additionally, we integrated historical climate data spanning several decades to assess trends in temperature and their potential impact on DENV transmission potential. RESULTS: Our results highlight a previously unknown north-south transmission pathway within the country, with the co-circulation of multiple virus lineages. Additionally, we examine the historical climate data, revealing long-term trends towards higher theoretical potential for dengue transmission due to rising temperatures. CONCLUSION: This multidisciplinary study reveals intricate patterns of dengue virus transmission in the Dominican Republic, characterized by the co-circulation of multiple DENV lineages and a novel transmission pathway. The observed correlation between rising temperatures and increased dengue transmission potential emphasizes the need for integrated climate-informed strategies in dengue control efforts. Our findings offer critical insights for public health authorities in the Dominican Republic and similar settings, guiding resource allocation and the development of preparedness strategies to mitigate the impacts of climate change on dengue transmission.

Assuntos

Clima , Vírus da Dengue , Dengue , Filogenia , Sorogrupo , República Dominicana/epidemiologia , Dengue/epidemiologia , Dengue/transmissão , Dengue/virologia , Humanos , Vírus da Dengue/genética , Vírus da Dengue/classificação , Surtos de Doenças

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and middle-income countries, key constraints such as dense traffic flows, jams, and pollution constitute frequent issues that potentially explain many negative consequences in terms of (e.g.) efficiency, sustainability, and mobility safety. In this regard, recent evidence supports the idea that fostering public transportation is crucial to offering solutions for this difficult panorama. However, transport mode-related choices and shifts have been proven to depend highly on key perceptions and needs of potential users. The aim of this study was to analyze a set of key users' perceptions, usage, and perceived quality of public transportation in the Dominican Republic, as well as to explore the most relevant features for Dominicans from the "desired quality" paradigm. For this research at a national level, data retrieved from a nationwide sample of 1254 inhabitants of the Dominican Republic was used, proportional to the ONE census in terms of sex, age, habitat, and region. Overall, the results show that the general quality of transportation is 6.70 points out of 10. The use of public transportation in the Dominican Republic has a medium-low rating and is very focused on urban buses (41 %) and public cars (27.1 %). Nonetheless, the metro remains the most highly rated means of transport (M = 8.75). Concerning the quality variables analyzed, the highest scores are for accessibility (M = 7.08) and frequency of service (M = 6.99). Further, Dominicans focus on improving comfort, vehicle conditions, and safety. This study constitutes a first approximation to the desired quality of public transportation for Dominican Citizens, which may help policymakers scope user-based needs in public transportation systems and encourage a more frequent (and friendlier) public transport use in the country.

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BACKGROUND: Dr. Ney Bienvenido Arias Lora emerged not only as a pioneer in neurosurgery but a community leader in the Dominican Republic (DR), contributing significantly to a region where both fundamental and neurosurgical resources were scarce. This account aims to shed light on the remarkable life and career of Dr. Arias Lora, emphasizing the critical role he played in establishing and advancing neurosurgery in the DR. METHODS: This paper relies on original bibliographic materials, providing an in-depth analysis of Dr. Arias Lora's life. Through a thorough examination of his career, we aim to highlight his pioneering efforts in the Caribbeans where neurosurgical expertise was nearly nonexistent during his time. RESULTS: Dr. Arias Lora, born in 1926, and became the first neurosurgeon in the DR in 1959. He played a pivotal role in establishing the Neurosurgery Residency Program at the Hospital Salvador B. Gautier and was instrumental in the development of neurosurgery training in his home country and the Caribbeans. Beyond his medical contributions, Dr. Arias Lora served as an educator, authoring significant works, and holding prestigious academic positions. His legacy is reflected in the "Dr. Ney Arias Lora Traumatology Hospital" in Santo Domingo, a testament to his dedication to neurosurgery and public service. CONCLUSIONS: Dr. Ney Bienvenido Arias Lora's life and achievements stand as a testament to the transformative impact dedicated individuals can have on the advancement of neurosurgery. Despite the intricacies inherent in the field of neurosurgery and broader societal challenges, his story serves as an inspiration.

Assuntos

Neurocirurgiões , Neurocirurgia , História do Século XX , República Dominicana , Neurocirurgia/história , Neurocirurgiões/história , História do Século XXI , Humanos

RESUMO

Introduction: During the summer of 2019 and within the framework of a social dentistry program carried out in the low-income town of San Francisco de Macorís (Dominican Republic), a descriptive study was carried out on oral health-related quality of life (OHRQoL), aiming to find out the oral health status of a population of children in the aforementioned Dominican city. Objective: The aim of this study was to describe the oral health status of a child population and its relationship with the quality of life perceived by these children in the aforementioned population of San Francisco de Macorís in order to develop an specific oral health program taking into account not only the existing oral health status but also the perceptions and feelings of the child population in this regard. Method: A descriptive cross-sectional study was carried out on a representative sample of children who were examined on their oral health status, following WHO guidelines, by professionals from the University of Seville (Spain) together with professionals from private practice (USA) and students from the Universidad Católica Nordestana (UCNE, Dominican Republic). Likewise, the children's parents voluntarily completed the Oral Quality of Life questionnaire COHIP-19 in its culturally adapted Spanish version. Results: For this purpose, 94 children with a mean age of 10.34 (SD 3.38) were observed in our study following WHO recommendations for oral health studies and evaluating OHQoL using the specific questionnaire validated in Spanish COHIP-19 in its short format (SF). The results show a state of oral health with a significant prevalence of caries (80.9%) and a DMFT of 1.70 (SD 1.90). The OHQoL perceived by these children shows that pain, bad breath or feeling sad because of the condition of their teeth were the factors with the worst evaluation score. Conclusions: The conclusion that mainly emerges from this study is that caries continues to be the main problem to be solved (more than other variables studied, such as malocclusion or fluorosis), and this ailment also causes pain, dysfunction, and bad breath and is therefore perceived as a problem to be solved in the children of this Dominican city.

RESUMO

The case involves a 23-year-old Dominican woman's admission to Hospital Docente Nuestra Señora De la Altagracia for an elective cesarean section at 38 weeks gestation with conjoined twins. Despite effective treatment for syphilis in the third trimester, her medical history complicated the situation. The twins, thoraco-omphalopagus conjoined, share vital organs and exhibit congenital anomalies, posing unique diagnostic and management challenges. This case contributes to the scarce literature on conjoined twins, especially in the Dominican Republic. It highlights the complexities of diagnosis, prognosis, and management strategies for such rare cases. This emphasizes the importance of ongoing research and medical intervention in addressing these challenges.

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The sustainable development goals (SDGs) were established by the United Nations as an international call to eradicate poverty, safeguard the environment, and guarantee that everyone lives in peace and prosperity by 2030. The SDGs aim to balance growth and sustainability in three dimensions: social, economic and environmental. However, in the post-pandemic era, when resources for public development policies are scarce, nations face the problem of prioritizing which SDGs to pursue. A lack of agreement is one of the determinants of low performance levels of the SDGs, and multicriteria decision analysis tools can help in this task, which is especially relevant in developing countries that are falling behind in achieving the SDGs. To test the feasibility and appropriateness of one of these tools, the Fuzzy Logarithm Methodology of Additive Weights, we apply it to prioritize the SDGs in the Dominican Republic, to see if the priorities established are consistent. Seventeen experts were surveyed, and the main result was that Decent work and economic growth was the most important goal for the country. Our findings, consistent with the literature, show the path to similar applications in other developing countries to enhance performance levels in the achievement of the SDGs.

RESUMO

This report provides a summary of childhood cancer and the efforts made in the Dominican Republic to address child and adolescent cancer in line with the World Health Organization's Global Initiative for Childhood Cancer. Information was obtained by review of recent local and international literature on pediatric oncology. As a result of the Global Initiative, a meeting was held by the Council of Ministers of Health of Central America to support the development of national pediatric cancer plans for each country. The objectives of these plans are to improve overall survival and quality of care for children with cancer through early detection, diagnosis, and treatment. In the Dominican Republic, several steps have been taken in the past 5 years to enhance diagnosis and care of children with cancer. For example, the National Committee of Childhood Cancer, headed by the Ministry of Public Health and including relevant stakeholders, was established to develop the national childhood cancer plan. In addition, a campaign was launched to raise awareness of childhood cancer, and the first early detection manual and public policy on child and adolescent cancer were published. A government initiative has been working to improve the hospital infrastructure and expand the pediatric cancer center, and a national course on early detection of pediatric cancers has been held. In 2023, the National Strategic Childhood Cancer Plan 2023-2030 was launched in the Dominican Republic. The plan will help policy-makers, implementers, researchers, and advocates enhance diagnosis and care of children with cancer.

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En este informe se presenta un resumen del cáncer infantil y las medidas adoptadas por República Dominicana para abordar el cáncer en la población infantil y adolescente en consonancia con la Iniciativa Mundial contra el Cáncer Infantil de la Organización Mundial de la Salud. La información se obtuvo mediante el análisis de las publicaciones nacionales e internacionales recientes sobre oncología pediátrica. Como resultado de la Iniciativa Mundial, el Consejo de Ministros de Salud de Centroamérica celebró una reunión para brindar apoyo a la elaboración de planes nacionales sobre el cáncer infantil para cada país. Los objetivos de estos planes son mejorar la supervivencia general y la calidad de la atención que se presta a la población infantil con cáncer mediante la detección temprana, el diagnóstico y el tratamiento. En los últimos cinco años, República Dominicana ha adoptado varias medidas para mejorar el diagnóstico y la atención prestada a la población infantil con cáncer. Así, por ejemplo, se creó el Comité Nacional de Cáncer Infantil, encabezado por el Ministerio de Salud e integrado por las partes interesadas pertinentes, para elaborar el plan nacional sobre el cáncer infantil. Además, se puso en marcha una campaña de sensibilización sobre el cáncer infantil y se publicaron el primer manual de detección precoz y la primera política pública sobre el cáncer en la población infantil y adolescente. Mediante una iniciativa gubernamental se ha buscado mejorar la infraestructura hospitalaria y ampliar el centro de atención a pacientes oncológicos pediátricos, al tiempo que se ha impartido un curso nacional sobre detección precoz del cáncer infantil. En el 2023, República Dominicana puso en marcha el Plan Estratégico Nacional sobre Cáncer Infantil 2023-2030. Este plan será útil a los responsables de la formulación de políticas, las personas encargadas de su ejecución, los investigadores y los promotores para mejorar el diagnóstico y la atención prestada a la población infantil con cáncer.

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Este relatório fornece um resumo sobre o câncer infantil e os esforços da República Dominicana para enfrentar a doença em crianças e adolescentes, em consonância com a Iniciativa Global para o Câncer Infantil da Organização Mundial da Saúde. As informações foram obtidas por meio de uma revisão da literatura local e internacional recente sobre oncologia pediátrica. Em consequência da Iniciativa Global, o Conselho de Ministros da Saúde da América Central se reuniu para apoiar a elaboração de planos nacionais de câncer pediátrico para cada país. Os objetivos desses planos são melhorar a sobrevida global e a qualidade da atenção a crianças com câncer por meio de detecção, diagnóstico e tratamento precoces. Na República Dominicana, várias medidas foram tomadas nos últimos cinco anos para melhorar o diagnóstico e a atenção a crianças com câncer. Por exemplo, o Comitê Nacional de Câncer Infantil, que é chefiado pelo Ministério da Saúde e inclui as partes interessadas pertinentes, foi criado para elaborar o plano nacional de câncer infantil. Foi lançada uma campanha de conscientização sobre o câncer infantil no país. Além disso, foram publicados o primeiro manual de detecção precoce e a política pública de câncer infantojuvenil. Uma iniciativa do governo vem trabalhando para melhorar a infraestrutura hospitalar e ampliar o centro de câncer pediátrico e ministrou um curso nacional sobre a detecção precoce de cânceres pediátricos. Em 2023, foi lançado o Plano Estratégico Nacional de Câncer Infantil 2023­2030 na República Dominicana. O plano ajudará formuladores de políticas, implementadores, pesquisadores e defensores da causa a aprimorar o diagnóstico e a atenção a crianças com câncer.

RESUMO

Extensive research has shown that breastfeeding offers many benefits to children, including advantages in lifelong health, physical development, cognitive function, behavior, and brain development, compared to those not breastfed. In the Dominican Republic, the prevalence of exclusive breastfeeding among infants aged 0-6 months remains low, and the lack of a surveillance system has made it challenging to measure the impact of breastfeeding on early childhood development (ECD). This study aims to address the effect of ever breastfeeding on ECD. We conducted secondary data analysis from the Dominican System for Measuring Early Childhood Development (SIMEDID), a screening tool adapted and validated to the Dominican context that measures four areas of development: gross-motor, fine-motor, language, and socioemotional development. The data from SIMEDID can be cross-analyzed with other datasets generated by the National Institute for Early Childhood Comprehensive Care (INAIPI) that include information about breastfeeding. The children were evaluated during the standardization study of SIMEDID. To determine the breastfeeding impact, we: 1) conducted an analysis of covariance using ECD scores as dependent variables and ever breastfed as the independent variable, with age and sex as covariates (previously confirmed with an analysis of variance indicating the relevance of age and sex at birth in ECD); 2) analyzed the relative risk (RR) of developmental delay by breastfeeding status. We studied a sample of 699 Dominican children aged 12-36 months who receive services at INAIPI (the government institution responsible for administering comprehensive early childhood services). The results show that ever breastfed children had higher scores in overall ECD than those who were not; higher scores in language and fine motor development primarily drove this effect. The never breastfed group had a greater risk of developmental delay in fine motor and socioemotional development. These findings underscore the importance of promoting and supporting breastfeeding to improve child neurodevelopmental outcomes. This is particularly relevant in low-resource settings, where mothers may need additional support. Moreover, the study's results provide evidence of SIMEDID's validation, which can help inform future research and evidence-based decision-making toward optimal ECD in similar contexts.

Assuntos

Aleitamento Materno , Desenvolvimento Infantil , Humanos , Lactente , Desenvolvimento Infantil/fisiologia , Feminino , República Dominicana , Masculino , Pré-Escolar , Análise de Dados Secundários

RESUMO

We employ a multidisciplinary approach, integrating genomics and epidemiology, to uncover recent dengue virus transmission dynamics in the Dominican Republic. Our results highlight a previously unknown north-south transmission pathway within the country, with the co-circulation of multiple virus lineages. Additionally, we examine the historical climate data, revealing long-term trends towards higher theoretical potential for dengue transmission due to rising temperatures. These findings provide information for targeted interventions and resource allocation, informing as well towards preparedness strategies for public health agencies in mitigating climate and geo-related dengue risks.

RESUMO

OBJECTIVES: We discuss key health challenges currently faced by countries in the Central America and Dominican Republic region after the COVID-19 pandemic. We highlight the influence of socioeconomic determinants for the challenging public health dynamics observed and the crucial roles that regional cooperation and health economic research can have for tackling such challenges. METHODS: We present a descriptive overview of the current situation of public finances and its effect on government capacity to improve social expenditure. We also discuss the impact of the COVID-19 pandemic crisis on social dynamics and living conditions in the region. RESULTS: Our analysis suggests that the interplay between all these factors is likely to have important consequences for health systems and population health in the post-pandemic period. Previous examples of successful cross-country cooperation in the region indicate the great potential that these initiatives have for supporting health system resilience against current challenges. Technical cooperation must be informed by (currently unavailable) research evidence that can guide decision making, especially health economic research to support national health resource allocation policies. Areas identified as priorities for applied health economic research include both macro and microeconomic analyses. CONCLUSIONS: Central America and the Dominican Republic face significant health challenges post-pandemic. Our article emphasizes the great potential that regional technical cooperation, informed by further health economic research, has to improve public policies and health governance in the region.

Assuntos

COVID-19 , Pandemias , Humanos , República Dominicana , Países em Desenvolvimento , América Central , COVID-19/epidemiologia

RESUMO

Theraphosidae is the most speciose mygalomorph family, and its species are usually fossorial, but arboreal species are known in various subfamilies. One of these subfamilies, Aviculariinae, is composed exclusively of arboreal forms and is distributed in the Americas and the Caribbean. Seven genera of this subfamily were described in 2017, including the monotypic genus Antillena Bertani, Huff & Fukushima, 2017, which is endemic to the Dominican Republic. It presents some remarkable features concerning genitalia shape both in male and female, distinct from all other aviculariine species. Herein, we describe the second species of Antillena, A. miguelangelisp. nov., along with field-note observations and new records for Antillena rickwesti Bertani & Huff, 2013. Males of the new species have a longer and slender embolus on the bulb, and the keels are poorly developed. Females have the spermathecae plateau-shaped with its distal sclerotized half of an elliptical appearance. The new species also represents the first record of this genus from the northern region of Hispaniola.

RESUMO

ABSTRACT This report provides a summary of childhood cancer and the efforts made in the Dominican Republic to address child and adolescent cancer in line with the World Health Organization's Global Initiative for Childhood Cancer. Information was obtained by review of recent local and international literature on pediatric oncology. As a result of the Global Initiative, a meeting was held by the Council of Ministers of Health of Central America to support the development of national pediatric cancer plans for each country. The objectives of these plans are to improve overall survival and quality of care for children with cancer through early detection, diagnosis, and treatment. In the Dominican Republic, several steps have been taken in the past 5 years to enhance diagnosis and care of children with cancer. For example, the National Committee of Childhood Cancer, headed by the Ministry of Public Health and including relevant stakeholders, was established to develop the national childhood cancer plan. In addition, a campaign was launched to raise awareness of childhood cancer, and the first early detection manual and public policy on child and adolescent cancer were published. A government initiative has been working to improve the hospital infrastructure and expand the pediatric cancer center, and a national course on early detection of pediatric cancers has been held. In 2023, the National Strategic Childhood Cancer Plan 2023-2030 was launched in the Dominican Republic. The plan will help policy-makers, implementers, researchers, and advocates enhance diagnosis and care of children with cancer.

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RESUMEN En este informe se presenta un resumen del cáncer infantil y las medidas adoptadas por República Dominicana para abordar el cáncer en la población infantil y adolescente en consonancia con la Iniciativa Mundial contra el Cáncer Infantil de la Organización Mundial de la Salud. La información se obtuvo mediante el análisis de las publicaciones nacionales e internacionales recientes sobre oncología pediátrica. Como resultado de la Iniciativa Mundial, el Consejo de Ministros de Salud de Centroamérica celebró una reunión para brindar apoyo a la elaboración de planes nacionales sobre el cáncer infantil para cada país. Los objetivos de estos planes son mejorar la supervivencia general y la calidad de la atención que se presta a la población infantil con cáncer mediante la detección temprana, el diagnóstico y el tratamiento. En los últimos cinco años, República Dominicana ha adoptado varias medidas para mejorar el diagnóstico y la atención prestada a la población infantil con cáncer. Así, por ejemplo, se creó el Comité Nacional de Cáncer Infantil, encabezado por el Ministerio de Salud e integrado por las partes interesadas pertinentes, para elaborar el plan nacional sobre el cáncer infantil. Además, se puso en marcha una campaña de sensibilización sobre el cáncer infantil y se publicaron el primer manual de detección precoz y la primera política pública sobre el cáncer en la población infantil y adolescente. Mediante una iniciativa gubernamental se ha buscado mejorar la infraestructura hospitalaria y ampliar el centro de atención a pacientes oncológicos pediátricos, al tiempo que se ha impartido un curso nacional sobre detección precoz del cáncer infantil. En el 2023, República Dominicana puso en marcha el Plan Estratégico Nacional sobre Cáncer Infantil 2023-2030. Este plan será útil a los responsables de la formulación de políticas, las personas encargadas de su ejecución, los investigadores y los promotores para mejorar el diagnóstico y la atención prestada a la población infantil con cáncer.

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RESUMO Este relatório fornece um resumo sobre o câncer infantil e os esforços da República Dominicana para enfrentar a doença em crianças e adolescentes, em consonância com a Iniciativa Global para o Câncer Infantil da Organização Mundial da Saúde. As informações foram obtidas por meio de uma revisão da literatura local e internacional recente sobre oncologia pediátrica. Em consequência da Iniciativa Global, o Conselho de Ministros da Saúde da América Central se reuniu para apoiar a elaboração de planos nacionais de câncer pediátrico para cada país. Os objetivos desses planos são melhorar a sobrevida global e a qualidade da atenção a crianças com câncer por meio de detecção, diagnóstico e tratamento precoces. Na República Dominicana, várias medidas foram tomadas nos últimos cinco anos para melhorar o diagnóstico e a atenção a crianças com câncer. Por exemplo, o Comitê Nacional de Câncer Infantil, que é chefiado pelo Ministério da Saúde e inclui as partes interessadas pertinentes, foi criado para elaborar o plano nacional de câncer infantil. Foi lançada uma campanha de conscientização sobre o câncer infantil no país. Além disso, foram publicados o primeiro manual de detecção precoce e a política pública de câncer infantojuvenil. Uma iniciativa do governo vem trabalhando para melhorar a infraestrutura hospitalar e ampliar o centro de câncer pediátrico e ministrou um curso nacional sobre a detecção precoce de cânceres pediátricos. Em 2023, foi lançado o Plano Estratégico Nacional de Câncer Infantil 2023-2030 na República Dominicana. O plano ajudará formuladores de políticas, implementadores, pesquisadores e defensores da causa a aprimorar o diagnóstico e a atenção a crianças com câncer.

RESUMO

Since African Swine Fever (ASF) was detected in the Dominican Republic in July 2021, it has negatively impacted the country's swine industry. Assessing the epidemiological situation is crucial to helping local authorities and industry stakeholders control the disease. Here, data on 155 reported outbreaks in the Dominican Republic from November 2022 to June 2023 were evaluated. Descriptive spatiotemporal analysis was performed to characterize disease distribution and spread, and between-herd R0 was calculated for the study period. The Knox test and a space-time permutation model were used to evaluate clustering. Data on clinical presentation, biosecurity measures, and suspected reasons for introduction were categorized and summarized. The majority (78%) of outbreaks occurred on backyard farms which generally had low biosecurity. Across farm types, the majority of pigs were still alive at the time of depopulation. Spatiotemporal findings and R0 estimates suggest an endemic pattern of disease geographically located centrally within the country. Clustering was detected even at small temporal and spatial distances due to outbreaks amongst neighboring backyard farms. These results provide critical information on the current state of the ASF epidemic in the Dominican Republic and will aid government officials and swine industry leaders in developing effective ASF control strategies.

RESUMO

OBJECTIVE: Food security interventions with people living with HIV (PLHIV) are needed to improve HIV outcomes. This process evaluation of a pilot intervention involving urban gardening and peer nutritional counselling with PLHIV assesses feasibility, acceptability and implementation challenges to inform scale-up. DESIGN: Mixed methods were used, including quantitative data on intervention participation and feasibility and acceptability among participants (n 45) and qualitative data from a purposive sample of participants (n 21). Audio-recorded interviews were transcribed and coded using a codebook developed iteratively. SETTING: An HIV clinic in the northwest-central part of the Dominican Republic. RESULTS: The intervention was feasible for most participants: 84 % attended a garden workshop and 71 % established an urban garden; 91 % received all three core nutritional counselling sessions; and 73 % attended the cooking workshop. The intervention was also highly acceptable: nearly, all participants (93-96 %) rated the gardening as 'helpful' or 'very helpful' for taking HIV medications, their mental/emotional well-being and staying healthy; similarly, high percentages (89-97 %) rated the nutrition counselling 'helpful' or 'very helpful' for following a healthy diet, reducing unhealthy foods and increasing fruit/vegetable intake. Garden barriers included lack of space and animals/pests. Transportation barriers impeded nutritional counselling. Harvested veggies were consumed by participants' households, shared with neighbours and family, and sold in the community. Many emphasised that comradery with other PLHIV helped them cope with HIV-related marginalisation. CONCLUSION: An urban gardens and peer nutritional counselling intervention with PLHIV was feasible and acceptable; however, addressing issues of transportation, pests and space is necessary for equitable participation and benefit.

Assuntos

Jardins , Infecções por HIV , Humanos , Jardinagem , República Dominicana , Estudos de Viabilidade , Aconselhamento

RESUMO

BACKGROUND: In this article, I utilize the concept of the Plantationocene as an analytical framework to generate a holistic and historical understanding of the present-day struggles of a mostly Haitian migrant workforce on sugar plantations in the Dominican Republic. METHODS: Inspired by Paul Farmer's methodology, I combine political economy, history, and ethnography approaches to interpret the experiences of sugarcane cutters across historical and contemporary iterations of colonial, post-colonial, and neo-colonial practices over the course of five centuries. RESULTS: My findings elucidate the enduring power of capitalism, implicating corporate and state elites, as the structural scaffolding for acts of racialized violence that condition the life-and-death circumstances of Black laborers on Caribbean plantations to this day. Although today's sugarcane cutters may suffer differently than their enslaved or wage labor ancestors on the plantation, I argue that an unfettered racialized pattern of lethal exploitation is sustained through the structural violence of neoliberalism that links present conditions with the colonial past. CONCLUSIONS: Ultimately, this paper contributes understandings of the plantationocene's enduring effects in the global south by demonstrating how imperialist arrangements of capitalism are not a distant memory from the colonial past but instead are present yet hidden and obscured while relocated and reanimated overseas to countries like the Dominican Republic, where American capitalists still exploit Black bodies for profit and power.

Assuntos

Etnicidade , Açúcares , Humanos , República Dominicana , Haiti , Capitalismo

RESUMO

The main study objective was to determine the extent to which the quality of institutionalized healthcare, sociodemographic factors of obstetric patients, and institutional factors affect maternal mortality in the Dominican Republic. COM-Poisson distribution and the Pearson correlation coefficient were used to determine the relationship of predictor factors (i.e., hospital bed rate, vaginal birth rate, teenage mother birth rate, single mother birth rate, unemployment rate, infant mortality rate, and sex of child rate) in influencing maternal mortality rate. The factors hospital bed rate, teenage mother birth rate, and unemployment rate were not correlated with maternal mortality. Maternal mortality increased as vaginal birth rates and infant death rates increased whereas it decreased as single mother birth rates increased. Further research to explore alternate response variables, such as maternal near-misses or severe maternal morbidity is warranted. Additionally, the link found between infant death and maternal mortality presents an opportunity for collaboration among medical specialists to develop multi-faceted solutions to combat adverse maternal and infant health outcomes in the DR.

Assuntos

Mortalidade Infantil , Mortalidade Materna , Gravidez , Lactente , Criança , Feminino , Adolescente , Humanos , República Dominicana/epidemiologia , Atenção à Saúde , Morte do Lactente

RESUMO

OBJECTIVE: The purpose of this interdisciplinary study was to determine Dominican adolescents' preferences for the content, functionality (i.e. food's glycemic index list, and amount of insulin based on foods' carbohydrate count), and design of a culturally and linguistically relevant mobile application (app) for type 1 diabetes mellitus (T1DM) self-management. The app would facilitate T1DM self-management education and support by addressing providers' challenges in monitoring patients' disease progression and promoting patient adherence to recommended lifestyle changes. Findings inform an app development process that considers the linguistic and cultural values, norms, and structures of people with T1DM and their providers in the Dominican Republic. METHODS: Phone interviews were conducted with 23 adolescents (14 to 18 years of age), using a semistructured questionnaire. The research team conducted the data analysis using NVivo through a deductive and inductive approach. RESULTS: The findings suggest that, regardless of the context, adolescents with T1DM desire similar features and functionalities in a self-management app. Overall, participants preferred an app with a graphic format that has accessible information, a straightforward design, and instructional videos. Participants also desired that an app provide information and reminders about proper eating and insulin administration timing and be a vehicle to access a social network to foster mutual support and encouragement. CONCLUSIONS: Our study highlights adolescents' perspectives on components for inclusion in an app for T1DM self-management. Participants' recommendations for the app's potential usability, contents, and design features will be used to guide the development of a new app to promote engagement and foster better health outcomes.

Assuntos

Diabetes Mellitus Tipo 1 , Aplicativos Móveis , Autogestão , Humanos , Adolescente , Diabetes Mellitus Tipo 1/terapia , República Dominicana , Insulina/uso terapêutico

RESUMO

Dengue has broadened its global distribution substantially in the past two decades, and many endemic areas are experiencing increases in incidence. The Dominican Republic recently experienced its two largest outbreaks to date with 16,836 reported cases in 2015 and 20,123 reported cases in 2019. With continued increases in dengue transmission, developing tools to better prepare healthcare systems and mosquito control agencies is of critical importance. Before such tools can be developed, however, we must first better understand potential drivers of dengue transmission. To that end, we focus in this paper on determining relationships between climate variables and dengue transmission with an emphasis on eight provinces and the capital city of the Dominican Republic in the period 2015-2019. We present summary statistics for dengue cases, temperature, precipitation, and relative humidity in this period, and we conduct an analysis of correlated lags between climate variables and dengue cases as well as correlated lags among dengue cases in each of the nine locations. We find that the southwestern province of Barahona had the largest dengue incidence in both 2015 and 2019. Among all climate variables considered, lags between relative humidity variables and dengue cases were the most frequently correlated. We found that most locations had significant correlations with cases in other locations at lags of zero weeks. These results can be used to improve predictive models of dengue transmission in the country.