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        <title>Registro bibliográfico </title>
        <link>https://bvssan.incap.int/biblio?q=&amp;filter=indexed_database%3A%22REPINCAP%22</link>
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   <title><![CDATA[Evaluating the World Health Organization’s Hearts Model for Hypertension and Diabetes Management: A Pilot Implementation Study in Guatemala]]></title>
   <author><![CDATA[Global Health, INCAP/CIIPEC]]></author>
   <link>https://bvssan.incap.int/biblio/resource/?id=biblioref.referencesource.1587013</link>
   <description><![CDATA[The World Health Organization HEARTS Technical Package is a widely implemented global initiative to improve the primary care management of cardiovascular disease risk factors. The study’s objective is to report outcomes from a pilot implementation trial of integrated hypertension and diabetes management based on the HEARTS model in Guatemala.<br /><br />El paquete técnico HEARTS de la Organización Mundial de la Salud es una iniciativa global ampliamente implementada para mejorar la gestión de atención primaria de los factores de riesgo de enfermedades cardiovasculares. El objetivo del estudio es informar los resultados de una prueba piloto de implementación del manejo integrado de la hipertensión y la diabetes basado en el modelo HEARTS en Guatemala.]]></description>
   <guid isPermaLink="false">1587013</guid>
   <pubDate>Thu, 06 Feb 2025 00:00:00 UTC</pubDate>
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   <title><![CDATA[Expanding team-based care for hypertension and cardiovascular risk management with HEARTS in the Americas]]></title>
   <author><![CDATA[Irazola, Vilma, Prado, Carolina, Rosende,  Andres, Wellmann, Irmgardt Alicia, Flood, David, Tsuyuki, Ross, Ojeda, Carolina Neira, Villatoro Reye, Matías, Otero, Johanna, Fajardo, Ileana, Ridley, Emily, Londoño, Esteban, Giraldo, Gloria, Bolastig, Edwin, Moreno Dias, Bruna, Haeberer, Nicolas, Ordunez, Pedro]]></author>
   <link>https://bvssan.incap.int/biblio/resource/?id=biblioref.referencesource.1606948</link>
   <description><![CDATA[Cardiovascular diseases remain the leading cause of premature morbidity and mortality globally, with hypertension as their main modifiable risk factor. In Latin America and the Caribbean, hypertension affects more than 30% of adults, yet control rates remain alarmingly low. The HEARTS in the Americas Initiative, led by the Pan American Health Organization, promotes a model of team-based care to enhance risk management for hypertension and cardiovascular diseases within primary health care. Team-based care leverages the skills of diverse health professionals, including nurses, pharmacists and community health workers, to optimize resource allocation, task-sharing and care delivery. Evidence underscores the effectiveness of team-based care in improving blood pressure control, reducing ospitalizations and enhancing quality of life through strategies such as periodic follow up and medication titration. Despite its benefits, implementing team-based care faces cultural and systemic barriers. This special report outlines a policy framework to scale team-based care across the Region of the Americas, ensuring equitable access to high-quality, cost-effective prevention and care for cardiovascular diseases]]></description>
   <guid isPermaLink="false">1606948</guid>
   <pubDate>Wed, 25 Jun 2025 00:00:00 UTC</pubDate>
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   <title><![CDATA[Effectiveness of intrapartum azithromycin to prevent infections in planned vaginal births in low-income and middle-income countries: a post-hoc analysis of data from a multicentre, randomised, double-blind, placebo-controlled trial]]></title>
   <author><![CDATA[Carlo, Waldemar A, Tita, Alan T N, Moore, Janet L, Mazariegos, Manolo et al]]></author>
   <link>https://bvssan.incap.int/biblio/resource/?id=biblioref.referencesource.1606991</link>
   <description><![CDATA[Background In 2023, the Azithromycin Prevention in Labor Use (A-PLUS) trial showed intrapartum azithromycin reduces maternal sepsis or death in women with planned vaginal delivery in low-resource settings, but whether it reduces maternal infection is unknown. We aimed to evaluate the effectiveness of intrapartum azithromycin in reducing maternal infection.  Methods We performed a post-hoc analysis of the multicentre, facility-based, randomised, double-blind, placebocontrolled A-PLUS trial. This trial compared prophylactic intrapartum single oral dose of 2 g azithromycin versus placebo on maternal morbidity and mortality in low-resource settings in southeast Asia and Africa from Sept 9, 2020, to Aug 18, 2022. The trial enrolled women in labour at 28 weeks’ gestation (or later) at eight sites in the Democratic Republic of the Congo, Kenya, Zambia, Bangladesh, India, Pakistan, and Guatemala and found that azithromycin reduced the incidence of maternal sepsis or death. The primary outcome of the present analysis was the incidence of any maternal infection in the azithromycin versus placebo groups, which was defined as one or more of these infections after randomisation: chorioamnionitis, endometritis, perineal or caesarean wound infection, abdominopelvic abscess, mastitis or breast abscess, and other infections. Any neonatal infection was also analysed. All analyses were by intention to treat in all those with data available for that outcome. Relative risks (RRs) and 95% CIs were estimated with a Poisson model adjusted for treatment group and site. Subgroup analyses included a two-way interaction test between intervention group and subgroup. A-PLUS was registered at ClinicalTrials.gov, number NCT03871491. Findings 29278 women were randomly assigned to groups: 14590 to receive azithromycin, 14688 to receive placebo. Baseline characteristics were similar between the azithromycin and placebo groups (43·3% vs 43·4% primiparous,
8·5% vs 8·7% high risk for infection). The presence of any maternal infection occurred less often in the azithromycin group (580 [4·0%] of 14558) compared with the placebo group (824 [5·6%] of 14661 women; RR 0·71, 95% CI 0·64–0·79, p<0·0001). Any neonatal infection did not differ between treatment groups. Adverse events were not detected. Interpretation Among women planning vaginal delivery, this analysis provides evidence indicating that intrapartum azithromycin is associated with a lower incidence of maternal infections than placebo]]></description>
   <guid isPermaLink="false">1606991</guid>
   <pubDate>Wed, 25 Jun 2025 00:00:00 UTC</pubDate>
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   <title><![CDATA[Evaluating the World Health Organization’s HEARTS Model for Hypertension and Diabetes Management: A Pilot Implementation Study in Guatemala]]></title>
   <author><![CDATA[Wellmann, Irmgardt Alicia, Ayala, Luis  Fernando, Palacios, Eduardo, Donis, Rocío, Ramírez-Zea, Manuel, Flood, David]]></author>
   <link>https://bvssan.incap.int/biblio/resource/?id=biblioref.referencesource.1607180</link>
   <description><![CDATA[Background: The World Health Organization HEARTS Technical Package is a widely implemented global initiative to improve the primary care management of cardiovascular disease risk factors. The study’s objective is to report outcomes from a pilot implementation trial of integrated hypertension and diabetes management based on the HEARTS model in Guatemala. Methods. We conducted a single-arm pilot implementation trial over six months from October 2023 to May 2024 in 11 Guatemalan Ministry of Health primary care facilities in two districts. The pilot evaluated a package of five HEARTS-aligned implementation strategies to improve the pharmacological treatment of hypertension and diabetes. The primary outcomes were feasibility and acceptability, measured through 20 structured interviews with Ministry of Health employees and by examining enrolment and retention data. Secondary outcomes included a suite of implementation and clinical outcomes, including treatment rates. When baseline data were available, we analyzed secondary outcomes as the net change from baseline or using an interrupted time series approach.  Results. The study enrolled 964 patients, of whom 58.8% had hypertension only, 30.4% had diabetes only, and 10.8% had both conditions. Surveys on feasibility and acceptability among Ministry of Health staff had a median score of 5.0 (IQR: 5.0 to 5.0) and 5.0 (IQR range: 4.8 to 5.0), respectively, exceeding the prespecified benchmark of ≥3.5. Both districts achieved the prespecified benchmark of enrolling ≥25 hypertension patients and ≥25 diabetes patients. Only 36% of patients attended a follow-up visit within three months, lower than the prespecified benchmark of ≥75%. Monthly treatment rates during the pilot increased by 22.3 (95% CI: 16.2 to 28.4; P < 0.001) and 3.5 (95% CI: –1.6 to 8.7; P = 0.17) patients per month for hypertension and diabetes, respectively. Conclusions. Implementation of an integrated hypertension and diabetes model based on HEARTS was generally feasible and acceptable in the Ministry of Health in Guatemala. Findings can refine national scale-up in Guatemala and inform HEARTS implementation projects in other settings]]></description>
   <guid isPermaLink="false">1607180</guid>
   <pubDate>Wed, 25 Jun 2025 00:00:00 UTC</pubDate>
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   <title><![CDATA[Cost-effectiveness of intrapartum azithromycin to prevent maternal infection, sepsis, or death in low-income and middle-income countries: a modelling analysis of data from a randomised, multicentre, placebo-controlled trial]]></title>
   <author><![CDATA[Patterson, Jackie K, Neuwahl, Simon, Mazariegos, Manolo]]></author>
   <link>https://bvssan.incap.int/biblio/resource/?id=biblioref.referencesource.1607329</link>
   <description><![CDATA[Background Sepsis is one of the leading causes of maternal mortality globally. In 2023, the Azithromycin Prevention in Labor Use (A-PLUS) trial showed intrapartum azithromycin for women planning a vaginal birth reduced the risk of maternal sepsis or death and infection. We aimed to evaluate the cost-effectiveness of intrapartum azithromycin for pregnant people planning a vaginal birth in low-income and middle-income countries (LMICs) using A-PLUS trial data.
Methods We compared the benefits and costs of intrapartum azithromycin versus standard care across 100 000 model simulations using data from the A-PLUS trial and a probabilistic decision tree model that included 24 mutually exclusive scenarios. A-PLUS was a randomised, double-blind, placebo-controlled trial that enrolled 29 278 women in labour at 28 weeks’ gestation or more at eight sites in the Democratic Republic of the Congo, Kenya, Zambia, Bangladesh, India, Pakistan, and Guatemala. Women randomly assigned to azithromycin received a single intrapartum 2 g oral dose. In this cost-effectiveness analysis, we considered the cost of azithromycin treatment and its effects on a composite outcome of maternal infection, sepsis, or death and its individual components, and health-care use. Our
analysis had a health-care sector perspective. We summarised results as an average and 95% CI of the model simulations. We also conducted sensitivity analyses. A-PLUS was registered at ClinicalTrials.gov, number NCT03871491.
Findings In model simulations, intrapartum azithromycin resulted in 1592·0 (95% CI 1139·7 to 2024·1) cases of maternal infection, sepsis, or death averted per 100 000 pregnancies, yielding 248·5 (95·3 to 403·7) facility readmissions averted, 866·8 (537·8 to 1193·2) unplanned clinic visits averted, and 1816·2 (1324·5 to 2299·7) antibiotic regimens averted. Using mean health-care costs across the A-PLUS sites, intrapartum azithromycin
resulted in net savings of US$32 661 (–52 218 to 118 210) per 100 000 pregnancies and 13·2 (8·3 to 17·9) disabilityadjusted life-years averted. The cost of facility readmission, cost of azithromycin, and probability of infection had the greatest impact on the incremental cost.
Interpretation In most cases, intrapartum azithromycin is a cost-saving intervention for the prevention of maternal infection, sepsis, or death in LMICs. This evidence supports global consideration of intrapartum azithromycin as an economically efficient preventive therapy to reduce infection, sepsis, or death among women planning a vaginal birth in LMICs.
Funding Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Foundation for the National Institutes of Health through the Maternal, Newborn, and Child Health Discovery and Tools Initiative of the Bill & Melinda Gates Foundation]]></description>
   <guid isPermaLink="false">1607329</guid>
   <pubDate>Wed, 25 Jun 2025 00:00:00 UTC</pubDate>
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   <title><![CDATA[Protocolo de recomendaciones nutricionales para deportistas de la Región SICA en el marco del CODICADER]]></title>
   <author><![CDATA[Instituto de Nutrición de Centro América y Panamá (INCAP), Secretaría de la Integración Social Centroamericana (SISCA/SICA)]]></author>
   <link>https://bvssan.incap.int/biblio/resource/?id=biblioref.referencesource.1610846</link>
   <description><![CDATA[Este protocolo es una herramienta técnica y práctica dirigida a profesionales en nutrición, con el objetivo de orientar la atención nutricional de adolescentes deportistas. Se ha tomado en cuenta las condiciones reales del entorno escolar, familiar y deportivo centroamericano, priorizando recomendaciones viables y culturalmente pertinentes para los países de la región.  El mismo ofrece recomendaciones concretas, adaptables a distintos niveles de práctica deportiva, priorizando el uso de alimentos locales como principal fuente de nutrientes. Además , se han incorporado herramientas prácticas de decisión, menús, y recomendaciones para eventos deportivos según nivel de actividad. El contenido se basa en evidencia científica actualizada y en lineamientos emitidos por organismos internacionales como el Comité Olímpico Internacional (IOC), la Autoridad Mundial Antidopaje (WADA), la Academia Americana de Pediatría (AAP), la Autoridad Europea de Seguridad Alimentaria (EFSA), la Sociedad de Dietistas Deportivos de Australia (SDA) y la United States Anti-Doping Agency (USADA), así como guías técnicas de referencia como el Compendio de Actividades Físicas (Ainworth et al., 2024), documentos de la OMS y artículos científicos de autoridades en la temática]]></description>
   <guid isPermaLink="false">1610846</guid>
   <pubDate>Tue, 14 Oct 2025 00:00:00 UTC</pubDate>
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   <title><![CDATA[La doble carga de la malnutrición en Guatemala:  Una llamada a la acción (DCE-265)]]></title>
   <author><![CDATA[Sagastume, Diana, Mazariegos, Mónica, Kroker Lobos, María F, Ramírez Zea, Manuel]]></author>
   <link>https://bvssan.incap.int/biblio/resource/?id=biblioref.referencesource.1626791</link>
   <guid isPermaLink="false">1626791</guid>
   <pubDate>Fri, 17 Oct 2025 00:00:00 UTC</pubDate>
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   <title><![CDATA[El huevo de gallina, un alimento de alto valor nutritivo, funcional y versátil (PP-NT-130)]]></title>
   <author><![CDATA[López, Mario]]></author>
   <link>https://bvssan.incap.int/biblio/resource/?id=biblioref.referencesource.1638201</link>
   <guid isPermaLink="false">1638201</guid>
   <pubDate>Fri, 05 Dec 2025 00:00:00 UTC</pubDate>
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   <title><![CDATA[Consumo de huevos y riesgo para la salud (PP-NT-131)]]></title>
   <author><![CDATA[González, María Antonieta]]></author>
   <link>https://bvssan.incap.int/biblio/resource/?id=biblioref.referencesource.1638235</link>
   <guid isPermaLink="false">1638235</guid>
   <pubDate>Fri, 05 Dec 2025 00:00:00 UTC</pubDate>
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   <title><![CDATA[Evaluación del aporte nutricional del Programa de Alimentación Escolar del Ministerio de Educación de Guatemala, mediante metodología NutrINCAP (DOE-IP-126)]]></title>
   <author><![CDATA[López Santisteban, Pilar, Mazariegos, Manolo, Pérez, Wilton, Orozco, Idania]]></author>
   <link>https://bvssan.incap.int/biblio/resource/?id=biblioref.referencesource.1647458</link>
   <description><![CDATA[Este informe pretende brindar las bases técnicas y las recomendaciones para el fortalecimiento de los Programas de Alimentación Escolar para que optimicen su objetivo, tal cual es contribuir al desarrollo integral y bienestar físico, mental y social de la niñez de Guatemala]]></description>
   <guid isPermaLink="false">1647458</guid>
   <pubDate>Thu, 26 Feb 2026 00:00:00 UTC</pubDate>
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