Epidemiology in Latin America and the Caribbean: current situation and challenges

Sandhi M Barreto, Jaime J Miranda, J Peter Figueroa, Maria Inês Schmidt, Sergio Munoz, P Pablo Kuri-Morales, Jarbas B Silva Jr, Sandhi M Barreto, Jaime J Miranda, J Peter Figueroa, Maria Inês Schmidt, Sergio Munoz, P Pablo Kuri-Morales, Jarbas B Silva Jr

Abstract

Background: This article analyses the epidemiological research developments in Latin America and the Caribbean (LAC). It integrates the series commissioned by the International Epidemiological Association to all WHO Regions to identify global opportunities to promote the development of epidemiology.

Methods: Health situations of the regions were analysed based on published data on selected mortality, morbidity and risk factors. Epidemiological publication output by country was estimated by Medline bibliometrics. Internet and literature searches and data provided by key informants were used to describe perspectives on epidemiological training, research and funding.

Findings: Despite important advances in recent decades, LAC remains the world's most unequal region. In 2010, 10% of the LAC's people still lived in conditions of multidimensional poverty, with huge variation among countries. The region has experienced fast and complex epidemiological changes in past decades, combining increasing rates of non-communicable diseases and injuries, and keeping uncontrolled many existing endemic and emerging diseases. Overall, epidemiological publications per year increased from 160 articles between 1961 and 1970 to 2492 between 2001 and 2010. The increase in papers per million inhabitants in the past three decades varied from 57% in Panama to 1339% in Paraguay. Universities are the main epidemiological training providers. There are at least 34 universities and other institutions in the region that offer postgraduate programmes at the master's and doctoral levels in epidemiology or public health. Most LAC countries rely largely on external funding and donors to initiate and sustain long-term research efforts. Despite the limited resources, the critical mass of LAC researchers has produced significant scientific contributions. FUTURE NEEDS: The health research panorama of the region shows enormous regional discrepancies, but great prospects. Improving research and human resources capacity in the region will require establishing research partnerships within and outside the region, between rich and poor countries, promoting collaborations between LAC research institutions and universities to boost postgraduate programmes and aligning research investments and outputs with the current burden of disease.

Figures

Figure 1
Figure 1
Poorest 20% share of total income by region, 2008. Source: World Bank, World Development Indicators, 2008
Figure 2
Figure 2
Fifty-year trend in number of published epidemiological articles among the 10 LAC countries with highest publication in 2010–2011
Figure 3
Figure 3
Distribution of published articles in LAC countries in three decades according to subject area as grouped by the Burden of Disease Study
Figure 4
Figure 4
Global percentage of LAC scientific publications in Medline and SCI from 1990 to 2008.Source: Network for Science and Technology Indicators (RICYT). Based on data for the following countries: Argentina, Barbados, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominican, Ecuador, Guatemala, Guyana, Honduras, Haiti, Jamaica, México, Nicaragua, Panamá, Peru, Paraguay, El Salvador, Trinidad and Tobago, Uruguay, Venezuela
Figure 5
Figure 5
Number of master’s (a) and doctorate graduates (b) per year according to research area in Latin America in the period 1990–2008 according to the Network for Science and Technology Indicators (RICYT). Source:www.ricyt.org

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