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From spillover to systems: evidence gaps in One Health preparedness for emerging infectious diseases in Latin America and the Caribbean.

Latin America and the Caribbean are a global hotspot for emerging and re-emerging infectious diseases, yet regional One Health preparedness remains uneven and incompletely operationalized. This narrative Mini Review synthesizes evidence published mainly between 2015 and 2026 on One Health preparedness for emerging infectious diseases in the region, emphasizing how environmental disruption and climate change shape zoonotic and vector-borne spillover risk. Available regional surveys suggest broad professional familiarity with the One Health concept but limited operational implementation, with environmental health frequently identified as the least-integrated domain. We argue that spillover risk-and the failure to detect and contain spillover once it occurs-should be understood as a system-level outcome shaped by ecological disruption, socioeconomic vulnerability, surveillance capacity, and governance, rather than as an isolated biological event: deforestation, agricultural and extractive expansion-including illegal mining and logging-unplanned urbanization, and climate variability generate new human-animal-vector interfaces, while fragmented governance, uneven and poorly decentralized laboratory capacity, and limited reservoir and environmental surveillance leave these interfaces unmonitored. Environmental and climatic drivers are robustly linked to spillover, although the pathways are disease-specific rather than universal, and socioeconomic vulnerability concentrates the resulting burden in Indigenous, rural, and marginalized populations. We identify priority gaps in integrated surveillance, decentralized diagnostics, genomic capacity, reservoir ecology, governance, financing, and equity, and propose an agenda for anticipatory, climate-informed, and context-sensitive preparedness.

Latin America

Genomic exploration of the journey of Plasmodium vivax in Latin America.

Plasmodium vivax is the predominant malaria parasite in Latin America. Its colonization history in the region is rich and complex, and is still highly debated, especially about its origin(s). Our study employed cutting-edge population genomic techniques to analyze whole genome variation from 620 P. vivax isolates, including 107 newly sequenced samples from West Africa, Middle East, and Latin America. This sampling represents nearly all potential source populations worldwide currently available. Analyses of the genetic structure, diversity, ancestry, coalescent-based inferences, including demographic scenario testing using Approximate Bayesian Computation, have revealed a more complex evolutionary history than previously envisioned. Indeed, our analyses suggest that the current American P. vivax populations predominantly stemmed from a now-extinct European lineage, with the potential contribution also from unsampled populations, most likely of West African origin. We also found evidence that P. vivax arrived in Latin America in multiple waves, initially during early European contact and later through post-colonial human migration waves in the late 19th-century. This study provides a fresh perspective on P. vivax's intricate evolutionary journey and brings insights into the possible contribution of West African P. vivax populations to the colonization history of Latin America.

Plasmodium vivax

The landscape of suicide risk factors in Latin America.

Suicide is a leading cause of death globally, with over 75 % of cases occurring in low- and middle-income countries (LMICs). Latin America, a severely underrepresented region in suicide research, has experienced a 6 % increase in its suicide rate from 2010 to 2016, contrasting with a global decline. In this commentary, we provide an overview of the epidemiological, social, and clinical factors influencing suicide in Latin America. We highlight the distinct trends in Latin America compared to other world regions, including the significant disparities in mental health care accessibility. Our review also considers the role of sociocultural factors such as strong family ties, traditional gender norms, and the impact of religiosity on stigma and care-seeking behaviors. Additionally, we address the lack of representation of Latin American populations in genetic studies on suicide, which hinders the identification of relevant biological markers and the development of tailored interventions. We call for increased research on the clinical, genetic, and social determinants of suicide in this region to better understand risk factors and ultimately inform suicide prevention strategies. Addressing this gap is critical for reducing suicide rates in Latin America.

Humans

Problems of venereal infections in Latin America and the Caribbean and means of fighting them.

Rather than providing a comprehensive overview of the sexually transmitted disease (STD) picture in the Americas, this presentation contrasts the STD problem in Latin America and the Caribbean with the situation in both less developed and more developed regions of the world. It also points out three areas of opportunity for improving preventive and curative STD services, specifically: (1) more effective utilization of social security institutions in Latin America, (2) incorporation of STD services into primary health care programs, and (3) development of pilot projects in the smaller Caribbean territories. It is noted, in addition, that the more developed countries of the region are showing increased interest in sexually transmitted diseases. Among other things, the recruitment of a PAHO epidemiologist in venereal diseases on Jamaica--to assist in the development of a national STD program--opens up a new area for PAHO technical assistance which, if successful, may be extended elsewhere.

Central America

The magnitude of malnutrition in Latin America.

Malnutrition, an illness which can easily be prevented and cured with existing resources and technology, is perhaps the most widespread disease in Latin America. However, it is unrecognized as such, and those population groups that suffer most from it are most prone to have their sufferings unrecorded. Two factors contribute to this: (a) the inaccuracy and incomplete coverage of vital statistics, as reflected by underregistration of deaths, insufficient medical certification of registered deaths, and biases both among certifying physicians and in the International Classification of Diseases; and (b) low population coverage by the health care systems and thus by the statistics which they generate. These factors are related to the ideological bias of those statistical systems and to the concepts of causality which they use. Through a review and analysis of "ad hoc" studies on the frequency of malnutrition in Latin America and its incidence in relation to morbidity and mortality, an estimation is made of malnutrition-caused deaths, which would amount to almost one-fifth of deaths from all causes. As overall availability of food in Latin America is adequate, it is held that this continent ultimately has the level of malnutrition that it wishes to have.

Child, Preschool

Changing patterns in dental education in Latin America.

The unsatisfactory dental health situation in the majority of the Latin American population, presently not covered by existing dental services, led to a serious questioning of the educational process directed to prepare human resources in dentistry. At the present time, many dental schools in Latin America are trying to find and implement new teaching methods, different curriculum patterns, and even seeking to define new professional and non-professional profiles, in order to meet the tremendous challenge that requires the formation of a different type of dental health personnel capable of introducing definite changes in the way dentistry is conceived and performed in order to cover the needs of a constantly growing population.

Community Health Services

Challenges of genomic testing for patients and clinicians in Latin America: Foundations of a qualitative multi-country study.

Genomic medicine is expanding across Latin America (LATAM), yet access to essential ancillary services such as genetic counselling remains limited. 'Latin-SEQ' is a study that provides whole exome sequencing (WES) for neuromuscular diseases across 18 countries, aiming to improve diagnostic rates and generate region-specific genetic insights. However, funding constraints exclude genetic counselling and cascade testing, raising concerns about equitable and harm-free care. This paper reports early findings from 'Latin-SEQ Plus,' a mixed-methods study exploring patient and healthcare practitioner (HCP) perspectives on WES and genetic counselling. Data were generated via surveys with patients and HCPs, and participatory workshops with HCPs across six countries. We found that patients strongly valued genetic testing for diagnostic clarity, improved care, and family planning. HCPs acknowledged the diagnostic benefits of WES but highlighted absence of local genetic counselling services, inconsistent pre and post-test practices, and uncertainty in managing incidental findings and variants of uncertain significance (VUS). Psychological impacts related to WES results are not always addressed, underscoring risks of psychological and emotional harm for patients. Access to WES and genetic counselling is limited in LATAM due to financial hardship and the absence of a clear genetic counselling infrastructure. Our findings also reveal a mismatch between patient expectations and HCPs' capacity to deliver comprehensive genomic care. We argue for urgent investment in genetic counselling infrastructure, HCP training, culturally tailored resources, and policy frameworks to support equitable implementation of genomic medicine in LATAM.

Humans

The nutrition problem in Latin America: definition, causes, and remedial actions.

Clinical, dietary, and biochemical surveys have shown that on the whole Latin America faces a serious nutrition problem. This article reviews the nature and extent of that problem, especially its effects on maternal and child health, and suggests various approaches for researchers, health professionals, and political authorities that would contribute to its resolution.

Child

The medical "brain drain" and health priorities in Latin America.

This analysis of the medical brain drain places the problem in the context of the health care infrastructure in the developing world. It emphasizes Latin American social realities as a corrective to the self-interest which characterizes much of the current debate in the United States. It is argued that the same factors constituting emigration "push" factors in Latin America simultaneously underscore the relative unimportance of medical manpower migration compared to other obstacles to health progress. That conclusion is supported by a comparison of the relative damage caused by the brain drain by itself and the damage caused by factors which the brain drain concomitantly symbolizes and flows from: elitist objectives, misdirected priorities, unrealistic policies, and inadequate planning on the part of most Latin American nations. In the absence of urgently needed change in traditional structures, merely closing the gates on foreign medical graduates will not serve to ameliorate health conditions in the region. Those who seek real health improvements for developing nations must address greater challenges than the brain drain.

Allied Health Personnel

[Aanalysis of nursing in Latin America].

The article presents a comprehensive analysis of health and nursing practices and their relationship to the economic structure and dominant means of production in Latin America. The analysis stems from a division of economic history into the following periods: 1900 to 1930, 1930 to 1960, and from the end of 1960 to present. The writer examines the characteristics of economic and social development in each of those periods and correlates them with health and nursing practices. She delves particularly into the predominant forms of nursing practice and the various approaches to training for auxiliary, technical, and professional staff. She seeks to show that both practice and knowledge in the field of health and nursing are related to the process of economic production. She suggests that recognition of this fact would contribute to a better understanding of the problems confronting the health and education sectors and would permit a search for more realistic solutions to the problems.

Economics, Nursing

Tubal occlusion via laparoscopy in Latin America: an evaluation of 8186 cases.

Ease of performance, safety and effectiveness of laparoscopic sterilization techniques are evaluated for 8186 procedures (6995 interval, 680 postabortion and 511 postpartum) performed in Latin America from June 1972 through February 1978. The tubes were occluded via electrocoagulation or application of the spring-loaded clip or the tubal ring. Less than 1% of the procedures were declared technical failures (ie, those which were not completed as planned). For all the tubal occlusion techniques, interval patients had the lowest rate of surgical complications. Pregnancy rates were low for the electrocoagulation and for the tubal ring techniques; patients sterilized by the spring-loaded clip, however, had a significantly higher pregnancy rate.

Actuarial Analysis

[The future of nursing in Latin America].

The authors take up the subject with a retrospective review of the concepts of economic and social development, the health policy that has emerged in the last 25 years, and the salient characteristics of health practice and the training of nursing personnel. They interpret development in the health field and various approaches to the extension of the health services coverage that have been taken in the countries of Latin America through implementation of the strategies of primary care and community participation. Finally, they present several considerations on the future of nursing, with emphasis on a comprehensive view of the profession as an occupation and a social practice, after which they formulate a series of propositions that can serve as a basis for training of the nursing personnel that will be needed to serve society adequately.

Education, Nursing

Demographic growth and health needs in Latin America.

The net effect of the rapid population growth in Latin American countries is an increase in the needs for health services. Nevertheless, the demographic factor is not the only nor the most important consideration in determining how to satisfy these demands in the region. The main contradiction lies between the magnitude of needs for services generated by the adverse living conditions prevalling among the majority of the population, together with a restricted supply of health services, the availability of which varies according to social class. The problem of the increasing demand for medical care, generated by the rapid population growth, should be recognized as originating in the socioeconomic structural conditions prevailing in Latin American countries today which determine, simultaneously, low health levels, deficiencies in the provision of health services, and rapid population growth.

Consumer Behavior