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PubMedDate not supplied

[The sources of histoplasmosis infection on the Isla de la Juventud, Cuba].

The purpose of this work is to report the isolation of Histoplasma capsulatum, etiologic agent of histoplasmosis, from soil in sites inhabited by bats and chicken in the Island of Youth, Cuba. The fungus was cultured from four species of cave dwelling bats too. The identification of H. capsulatum was done by mycelial to yeast conversion and exoantigen test. It is pointed out the epidemiological value of some of these isolations in caves of great importance from the archaeological, speleological or tourist point of view, and the potential risk that they represent to human health. The authors conclude with some recommendation to prevent the infection with H. capsulatum in people who have to keep in contact with those environments.

Animals↗

PubMedDate not supplied

Isolation and identification of adenovirus in hospitalized children, under five years, with acute respiratory disease, in Havana, Cuba.

Nine Adenovirus (Ad) strains isolated in Cuba, from 128 nasopharingeal swab specimens of children below five years old, with acute respiratory diseases, during 1996 and 1997, were studied by restriction enzyme analysis of genomic DNA with two endonucleases BamH I and Sma I. All different fragment patterns were compared with the respective prototypes. The identified adenoviruses were Ad 1 (n=4), Ad 2 (n=1) and Ad 6 (n=4). Males were more frequently infected than females. The analysis of the occurrence of these Adenovirus strains of subgenus C revealed that Ad 1 and Ad 6 were the predominant serotypes in 1996 and in 1997, respectively.

Acute Disease↗

PubMed2001

Transmission of tuberculosis in Havana, Cuba: a molecular epidemiological study by IS6110 restriction fragment length polymorphism typing.

The combination of molecular and conventional epidemiological methods has improved the knowledge about the transmission of tuberculosis in urban populations. To examine transmission of tuberculosis in Havana, Cuba, with DNA fingerprinting, we studied 51 out of 92 Mycobacterium tuberculosis strains isolated from tuberculosis patients who resided in Havana and whose infection was culture-confirmed in the period from September 1997 to March 1998. Isolates from 28 patients (55%) had unique IS6110 restriction fragment length polymorphism (RFLP) patterns, while isolates from 23 others (45%) had identical patterns and belonged to 7 clusters. Three clusters consisting of six, five and two cases were each related to small outbreaks that occurred in a closed setting. Three other clustered cases were linked to a large outbreak that occurred in another institution. Younger patients were more correlated to clustering than older ones. The finding that 45% of the isolates had clustered RFLP patterns suggests that recent transmission is a key factor in the tuberculosis cases in Havana. The IS6110 RFLP typing made it possible to define the occurrence of outbreaks in two closed institutions.

Adult↗

PubMed2006

Variation of snail's abundance in two water bodies harboring strains of Pseudosuccinea columella resistant and susceptible to Fasciola hepatica miracidial infection, in Pinar del Río Province, Cuba.

The abundance of freshwater snails in two rural sites of Pinar del Río, Cuba, which harbor Pseudosuccinea columella susceptible and resistant to miracidia of Fasciola hepatica was followed for one year. Susceptible snails were found in the most anthropic site (IPA) whereas the resistant population inhabited the most preserved one (El Azufre). Only two snail species coexisted with P. columella at IPA site (Physa cubensis and Tarebia granifera) while five species were found at El Azufre, including an endemic from that province (Hemisinus cubanianus). Populations of both resistant and susceptible snails showed stable densities throughout the year, although the susceptible strain attained higher abundance. The highest densities were observed in April-May 2004 for the susceptible population whereas the resistant strain attained its highest abundance in January 2004. No record of Fossaria cubensis was made and the thiarid T. granifera occurred only at low densities. One of the sampled sites (IPA) meets all the conditions for the first report of P. columella naturally infected with larvae of F. hepatica.

Animals↗

PubMedDate not supplied

[Public health in Cuba and its international experience (1959-2005)].

The past 42 years of Cuba's healthcare system have been characterized, among other things, by broad-based international experience and projects, which began in 1962 with the deployment of the first Cuban medical mission to Algeria. Since then, it has collaborated with more than 101 countries in Asia, Africa and Latin America, providing aid missions to areas suffering from natural disasters and sending medical staff to regions where they did not exist before. It has also helped some countries draw up medical development plans according to their specific needs. Cooperation with human resource training and development has also been carried out, with the result that hundreds of thousands of youths have been able to start their medical studies in countries all over the Americas and in some nations from Asia and Africa.

Cuba↗

PubMed2003

[Fluoride in drinking water in Cuba and its association with geological and geographical variables].

OBJECTIVE: To determine the association between different concentrations of the fluoride ion in drinking water and some geological and geographical variables in Cuba, by using a geographic information system. METHODS: From November 1998 to October 1999 we studied the fluoride concentration in the sources of drinking water for 753 Cuban localities that had at least 1 000 inhabitants. For the information analysis we utilized the MapInfo Professional version 5.5 geographic information system, using the overlaying method. The study variables were the concentration of the fluoride ion in the water sources, the geological characteristics of the area, the alignments (geological characteristics that were found together), the types of water sources, and whether an area was a plain or mountainous. The results were grouped by locality and municipality. RESULTS: In 83.1% of the localities, the water samples were collected from wells and springs, and the remaining 16.9% came from dams and rivers. Of the 753 localities studied, 675 of them (89.6%) had low or medium fluoride concentrations (under 0.7 mg/L). The eastern region of the country was the one most affected by high fluoride concentrations in the waters, followed by the central region of the country. The majority of the localities with high natural fluoride concentrations were in areas located on Cretaceous volcanic arc rocks. The presence of fluoride in the drinking waters was related to the alignments with the earth's crust, in rock complexes of volcanic-sedimentary origin and of intrusive origin and also in carbonate rocks. However, the highest fluoride concentrations generally coincided with rock complexes of volcanic-sedimentary origin and of intrusive origin. All the localities with high fluoride concentrations in the water were associated with wells. CONCLUSIONS: The fluoride concentration is low or medium in the drinking water sources for 89.6% of the Cuban localities with at least 1 000 inhabitants. Geological and geographical characteristics can help identify areas with optimal or high concentrations of the fluoride ion in the drinking water.

Cuba↗

PubMed2004

[Factors associated with the presence of tuberculosis in patients with acquired immunodeficiency syndrome in Cuba].

OBJECTIVES: To determine the factors associated with the development of tuberculosis in patients with acquired immunodeficiency syndrome (AIDS) and to identify the most frequent symptoms and signs of tuberculosis in this group of patients. METHODS: This retrospective observational case-control study was carried out with 143 patients diagnosed with AIDS who were discharged from the Pedro Kourí Institute of Tropical Medicine, which is in the city of Havana, Cuba, between January 1997 and March 2001. The cases were 72 patients with AIDS and some clinical form of tuberculosis, while the control group was made up of the first 71 AIDS patients without tuberculosis who were discharged. The following variables were evaluated: AIDS stage before the study, serious opportunistic infections suffered before the diagnosis of tuberculosis (pulmonary pneumocystosis, cerebral toxoplasmosis, systemic candidiasis, isosporiasis, and recurrent pneumonia), concentration of CD4+ T lymphocytes, and clinical symptoms and signs of tuberculosis. The primary data were taken from the clinical files of the patients. We calculated the frequency of the nominal qualitative variables and the crude odd ratios (ORs) and their 95% confidence intervals (CIs). The statistical association among the variables was determined with the chi-square test with Yates correction. The individual effect of each variable was assessed through multivariate logistic regression analysis. The level of statistical significance was 0.05. RESULTS: Tuberculosis in this group of patients showed a statistically significant association with: being ill with AIDS before the study (OR = 3.57; 95% CI: 1.78 to 7.17); a history of pulmonary pneumocystosis (OR = 4.73; 95% CI: 1.51 to 15.76), cerebral toxoplasmosis (OR = 6.22; 95% CI: 1.21 to 42.99), or systemic candidiasis (OR = 11.29; 95% CI: 1.40 to 246.5); and having CD4+ T lymphocyte concentrations lower than 200 cells/mm(3). However, the logistic regression showed a significant association only with the history of systemic candidiasis (OR = 10.47; 95% CI: 1.06 to 103.5; P = 0.0446). The symptoms associated with the clinical diagnosis of tuberculosis were hemoptysis (OR = 7.54; 95% CI: 1.88 to 170.34), fever of unknown origin (OR = 13.38; 95% CI: 5.55 to 32.96), night sweats (OR = 21.95; 95% CI: 4.66 to 142.43), and weight loss (OR = 3.52; 95% CI: 1.65 to 7.55). The associated signs were regional lymphadenopathies (OR = 10.00; 95% CI: 1.22 to 220.3), hepatomegaly (OR = 5.44; 95% CI: 1.76 to 17.95), and splenomegaly (OR = 5.08; 95% CI: 1.63 to 16.83). CONCLUSIONS: The symptoms and signs seen most frequently in the patients with AIDS and tuberculosis are the characteristics of tuberculosis in patients without AIDS. In patients with AIDS, tuberculosis can be associated with other diseases whose symptoms are similar to those of tuberculosis. Nevertheless, these results indicate that the traditional symptoms of tuberculosis can help diagnose tuberculosis in this group of patients.

Adult↗

PubMed2005

Cardiovascular disease and associated risk factors in Cuba: prospects for prevention and control.

OBJECTIVES: An adequate description of the trends in cardiovascular disease (CVD) is not available for most of the developing world. Cuba provides an important exception, and we sought to use available data to offer insights into the changing patterns of CVD there. METHODS: We reviewed Cuban public health statistics, surveys, and reports of health services. RESULTS: CVD has been the leading cause of death since 1970. A 45% reduction in heart disease deaths was observed from 1970 to 2002; the decline in stroke was more limited. There are moderate prevalences of all major risk factors. CONCLUSIONS: The Cuban medical care system has responded vigorously to the challenge of CVD; levels of control of hypertension are the highest in the world. Nonindustrialized countries can decisively control CVD.

Cardiovascular Diseases↗

PubMed1987

Mortality differentials among persons born in Cuba, Mexico, and Puerto Rico residing in the United States, 1979-81.

This paper examines the mortality experience in 1979-81 of three first generation Hispanic subpopulations in the United States, as defined by area of birth (Cuba, Mexico, Puerto Rico). Numerators were derived from National Center for Health Statistics (NCHS) mortality tapes, which included codes for selected places of birth appearing on the death certificate. Denominators were based on decennial census data for these migrant populations from the 1980 census. Generally, mortality is relatively high among Cuban-born, Mexican-born and Puerto Rican-born adolescents and young adults, particularly males, largely due to violent deaths. Aged migrants, despite their disadvantaged socioeconomic status, exhibit relatively low death rates from heart disease and cancer.

Adolescent↗

PubMed1980

Workers' and community participation and democratic control in Cuba.

This article is a historical and current analysis and description of the evolution of worker, community, and popular participation and democratic control in Cuba since 1958. It contains: (a) an analysis of the political developments in the Cuban Revolution that led to the establishment of direct forms of democracy at the work-place and in the community; (b) a detailed analysis and account of how workers participate and control the processes of production and distribution of goods and services; and (c) an in-depth account and analysis of how people living in neighborhoods, rural and urban districts, municipalities, and provinces control the different levels and branches of the state apparatus--People's Power--and also how they participate in the implementation--through mass organizations--of state policies. The responsibilites, modus operandi, and relationships of the Communist Party, the trade unions, and other mass organizations, and the organs of People's Power, are also described and analyzed. The opportunities and problems, successes and failures, and strengths and weaknesses of the Cuban road to socialism and democracy are detailed. It is concluded that the Cuban Revolution has enhanced democracy most dramatically through the Cuban people's substantial involvement, participation, and control of their own lives.

Civil Disorders↗

PubMed1983

Agricultural research and human nutrition: a comparative analysis of Brazil, Cuba, Israel, and the United States.

A tentative theoretical explanation of modern nutritional vulnerability is derived from an original study of agricultural science as part of the social process in societies distinguished by the extent to which their form of production (specifically reproduction of labor) falls within or outside the world of commodities. The selected case studies--the United States, Israel, Brazil, and Cuba--are characterized also by advanced agricultural research, remarkable agricultural productivity, and, with the exception of Brazil, a satisfactory state of public nutrition. This particular selection thus lays the basis for a holistic investigation of malnutrition which considers the mode of production as the appropriate unit of analysis. As a theoretical, not statistical, account of nutritional status variations in a variety of social environments, the study employs a two-dimensional comparison of agricultural research orientation and impact, on the one side, and of predominant modes of reproduction of labor, on the other. It is proposed that, independently of agricultural productivity effects of research, structural nutritional vulnerability prevails where the strictly capitalist commodity--labor power--is sold below its value, and because, in the framework of capitalist production, science is biased against subsistence food crops that are used restrictively in reproduction of labor. This bias is rooted not in the nature of such crops, but in their role in determining the value of labor power, which as expressed by wage, stands in inverse proportion to profit.

Agriculture↗

PubMed2005

"No one left abandoned": Cuba's national health system since the 1959 revolution.

In spite of the economic hardships during the 1990s, Cuba has achieved health indicators that are among the best in the world. This article describes the development of the Cuban health system over more than four decades and analyzes its dynamics. Four stages can be identified. The system's foundations were laid during the first post-revolutionary decade (1959--1970) and consolidated during the succeeding decade (1970--1979). In the third stage, from 1980 onward, the system reached its full expansion with the development of family medicine. Following the crisis of the 1990s, a fourth stage began with reforms and adjustments to the new situation after the collapse of the Soviet Union. Today, health care continues to be of high quality and free for all Cubans. It remains exclusively in the hands of the public sector, and privatization is not an option. This is exactly the opposite of what is happening in other parts of the world where public services are underfunded and people are made to believe that privatization is the only way to ensure high-quality care.

Cuba↗

PubMed1991

Human immunodeficiency virus in Cuba: the public health response of a Third World country.

This article describes Cuba's effort to develop a comprehensive program for control of its human immunodeficiency virus (HIV) epidemic. The program consists of multiple interventions, including blood donor screening, a ban on imported blood and blood products, widespread semicompulsory screening of defined and general populations, research and clinical trials on treatment and diagnostic methods, and health education in the press, radio, television, workplace, and schools. The most controversial of the program's measures has been the treatment of HIV antibody-positive persons (both asymptomatic and clinically ill) through what Cubans term a "sanatorial regimen," consisting of admission into an institutional setting where both preventive and curative treatment is offered, and where residents have limited contact with their families, neighborhoods, friends, and the rest of society. The Cuban HIV control program merits studying because of the comprehensiveness of the measures in a poor country; the special experience of screening large, mostly healthy populations; its potential contribution to understanding the natural history of the disease due to the early identification and follow-up of HIV antibody-positive individuals; and the cultural, political, and socioeconomic conditions that give rise to a different epidemiologic profile of the disease and to an apparent societal consensus on the controversial issue of institutional semiconfinement.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Early Spanish physicians and hospitals in Cuba.

Very little is known about the early history of medicine in the Caribbean. Five hundred years ago medicine practitioners from Europe started to settle in the New World. Hospitals were built in very rudimentary houses to care for the sick. Diseases were received and transmitted by the new settlers. The author, a philatelist and a Columbus scholar, uses postage stamps to highlight the introduction of European medicine in Cuba.

Cuba↗

PubMedDate not supplied

Expanding global distribution of rotavirus serotype G9: detection in Libya, Kenya, and Cuba.

Serotype G9 may be the fifth most common human rotavirus serotype, after serotypes G1 to G4. In three cross-sectional studies of childhood diarrhea, we have detected serotype G9 rotaviruses for the first time in Libya, Kenya, and Cuba. Serotype G9 constituted 27% of all rotaviruses identified, emphasizing the reemergence of serotype G9 and suggesting that future human rotavirus vaccines will need to protect against disease caused by this serotype.

Child↗

PubMed1981

Eosinophilic meningoencephalitis in Cuba, caused by Angiostrongylus cantonensis.

Five cases of eosinophilic meningoencephalitis presumed to be caused by the rat lungworm, Angiostrongylus cantonensis, are reported from localities in or near Havana, Cuba. The first typical case occurred in 1973. Lungworms identified as A. cantonensis were found in rats from the same localities. The clinical picture in the Cuban cases, as in cases from other countries, is that of a self-limiting disease without apparent sequelae.

Angiostrongylus↗

PubMed1981

First record of angiostrongylus cantonensis in Cuba.

The occurrence of human eosinophilic meningoencephalitis in several localities of Havana, Cuba, prompted a search for the rat lungworm, Angiostrongylus cantonensis, in the same localities. Twenty rats (Rattus norvegicus) and about 370 terrestrial mollusks (70 slugs, Veronicella cubensis, and about 300 snails, mostly Bradybaena similaris) were collected in six communities of the Province of Havana, and in the gardens of the Pedro Kouri Institute for Tropical Medicine in Havana City. Adult lungworms were found in 12 of the rats and larvae were recovered from a large number of pooled lots of the mollusks. Observations on the morphology and life history of the parasites confirmed the presence of A. cantonensis in the American region.

Angiostrongylus↗

PubMed1990

Dengue hemorrhagic fever in Cuba, 1981: a retrospective seroepidemiologic study.

In Cuba, 2 epidemics of dengue virus occurred: 1 caused by DEN-1 in 1977 and 1 caused by DEN-2 in 1981. The latter was associated with cases of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). To study viral risk factors for DHF/DSS, a retrospective seroepidemiological survey was conducted in Cerro, a densely populated district in Havana City. The prevalence of plaque reduction neutralizing antibodies to DEN-1 and DEN-2 viruses was measured in 1,295 individuals (children and adults). Of these, 43.7% were immune to DEN-1 virus and 23.6% to DEN-2 virus. Of those individuals who were immune, 26.1% were immune to DEN-1 virus only, 6% to DEN-2 virus only, and 17.6% to both viruses. The DEN-2 virus infection rate in DEN-1 immune individuals was 3.8 times higher than in non-immune individuals. The 5 DHF/DSS cases in the sample had evidence of DEN-1 virus plus DEN-2 virus infections. Three were children and 2 were young adults. No cases were found in individuals infected with DEN-1 virus or DEN-2 virus only. Children infected by DEN-1 virus followed by DEN-2 virus had a high risk of acquiring DHF/DSS. Blacks and whites were equally infected with DEN-1 and DEN-2 viruses.

Adolescent↗