Climate change represents one of the main public health challenges in Latin America and the Caribbean, a region especially vulnerable to phenomena such as heatwaves, floods, droughts, and hurricanes, despite its low contribution to global greenhouse gas emissions. These events intensify health risks and deepen existing inequalities, disproportionately affecting indigenous peoples, Afro-descendant communities, rural populations, women, older adults, and people with chronic illnesses. Facing this scenario, the study “Climate health action in Latin America and the Caribbean: Priorities identified through a multi-stakeholder engagement process”, with the participation of CISeAL principal researcher Dr. Anita Villacís, identifies and establishes priorities to strengthen the response of health systems to the effects of climate change in the region. The research employed a participatory methodology integrating qualitative and quantitative components through two phases of virtual workshops with representatives from academia, governments, civil society organizations, and communities.

Human papillomavirus (HPV) represents a major public health problem among men as well, due to its association with various types of cancer, including penile, anal, and head and neck cancers. Although many HPV infections disappear spontaneously, those that persist can favor the development of malignant diseases, the diagnosis of which is often limited by the absence of widely established early detection strategies for the male population. In this context, research conducted by our CISeAL researchers, Xavier Sánchez and Ruth Jimbo-Sotomayor, alongside other experts, analyzed the burden of hospitalizations and mortality associated with these types of cancer in men in Ecuador during the 2015–2019 period, by analyzing national databases from the National Institute of Statistics and Censuses (INEC). The results identified 3,442 hospitalizations and 575 deaths related to HPV-associated cancers during the five years studied, representing an approximate annual average of 688 hospitalizations and 115 deaths. Head and neck cancers accounted for the highest proportion of hospitalizations (66.4%) and deaths (71.1%), while penile cancer stood out for its contribution to the estimated burden of diseases directly attributable to the virus. By applying HPV attribution percentages established in previous research, the authors estimated that 1,002 hospitalizations (29.1%) and 134 deaths (23.3%) could be attributed to this virus.

Lemierre's syndrome is a rare and potentially serious infectious disease characterized by septic thrombophlebitis of the internal jugular vein and the dissemination of infectious emboli to other organs, primarily the lungs. In the article “Streptococcus constellatus–Associated Lemierre Syndrome Presenting With Cavitating Septic Pulmonary Emboli Managed by Video-Assisted Thoracoscopy,” with the participation of CISeAL researchers Jordan Llerena-Velastegui, Ruth Jimbo-Sotomayor, and Xavier Sánchez, alongside other experts from PUCE, the case is presented of a 25-year-old man, a resident of northern Ecuador with no relevant medical history, who developed a severe infection with respiratory distress, fever, productive cough, and hemoptysis. Imaging studies identified multiple cavitated pulmonary lesions compatible with septic emboli, while vascular evaluation confirmed thrombosis of the left internal jugular vein. Blood cultures identified Streptococcus constellatus, a bacterium belonging to the Streptococcus anginosus group, known for its ability to cause invasive infections and form abscesses. This finding is relevant because Lemierre's syndrome is classically associated with Fusobacterium necrophorum, meaning this case expands the understanding of the microorganisms that can be involved in this disease.

Chronic ulcers represent a healthcare challenge due to their prolonged healing process, recurrence, and frequent microbial colonization. In this context, a study involving our researchers Miryan Rivera and Mateo Salazar, both members of the Amphibian Cytogenetics and Biomolecules Research Laboratory (LICBA)—a laboratory that is part of CISeAL—explored the development of advanced antibacterial dressings for the management of this type of wounds. The article presents the creation of sodium alginate and collagen-based hydrogel dressings, reinforced with cotton and functionalized with copper oxide (CuO) nanoparticles obtained through a green synthesis process using gallic acid and orange peel extract. The proposal seeks to integrate high exudate absorption capacity, mechanical stability, and localized antibacterial activity into a single material. Among the formulations analyzed, the one composed of 2% sodium alginate, 0.5% collagen, and 2.5% glycerin exhibited an absorption capacity of 476.82 ± 3.80% and a tensile strength of 148.7 ± 5.5 N, characteristics that led to its selection as the matrix for the incorporation of the nanoparticles.

Device-detected atrial fibrillation has become a major challenge for clinical practice, because episodes identified by cardiac devices can be asymptomatic and do not necessarily equate to clinically diagnosed atrial fibrillation. In this context, the study analyzes evidence from the ARTESiA and NOAH-AFNET 6 trials to evaluate the benefits and risks of anticoagulation in patients with subclinical atrial fibrillation. The results show that direct oral anticoagulants can decrease the risk of ischemic stroke, but they also increase the probability of major bleeding; therefore, the decision to initiate treatment must consider each patient's individual risk rather than solely the duration or frequency of the detected episodes. ARTESiA demonstrated a reduction in strokes or systemic embolisms with apixaban compared to aspirin, whereas NOAH-AFNET 6 did not find a significant reduction in its composite cardiovascular endpoint with edoxaban and recorded a higher risk of death or major bleeding. Together, these results show that the risk of stroke in patients with device-detected atrial fibrillation tends to be relatively low, while the benefit of anticoagulation can vary considerably among individuals. For this reason, the authors emphasize the importance of first confirming that the detected episode truly corresponds to atrial fibrillation, analyzing its characteristics and evolution, assessing history such as stroke or transient ischemic attack, vascular disease, heart failure, and renal function, in addition to considering bleeding risk and each patient's preferences.

A study featuring the participation of Dr. Ana Lucía Moncayo, a researcher at CISeAL, analyzed racial inequalities in cervical cancer mortality and the potential role of the Bolsa Família conditional cash transfer program in reducing these gaps in Brazil. The study used individual data from the 100 Million Brazilian Cohort, a national administrative cohort linked to mortality records, which made it possible to analyze 18,291,600 women aged 18 to 100 during the period 2004–2015. The results showed significant differences in cervical cancer mortality by race, even after adjusting for age, education, place of residence, year of entry into the cohort, and participation in Bolsa Família. Indigenous women had the highest mortality rate, with a risk 78% higher than that observed in white women, followed by Asian (55%), mixed-race (pardas) (28%), and black (20%) women. One of the main findings was that participation in Bolsa Família modified the magnitude of these inequalities: among beneficiaries, black, mixed-race, and indigenous women experienced 12%, 25%, and 74% higher mortality than white women, respectively, whereas among non-beneficiaries, these disparities increased to 53%, 36%, and 98%, respectively.