Steven Cuadra

Persistent organochlorine pollutants in children working at a waste-disposal site and in young females with high fish consumption in Managua, Nicaragua

Abstract The aim of this study was to assess persistent organochlorine pollutant (POP) levels in serum collected from children (11–15 years old) working and sometimes also living at the municipal waste-disposal site in Managua, located at the shore of Lake Managua, and in nonworking children living both nearby and also far away from the waste-disposal site. The influence of fish consumption was further evaluated by assessing POPs levels in serum from young women (15–24 years old) with markedly different patterns of fish consumption from Lake Managua. 2,2-bis(4-chlorophenyl)-1,1,1-trichloro-ethane (4,4′-DDT) and 2,2-bis(4-chlorophenyl)-1,1-dichloro-ethene (4,4′-DDE), γ-hexachlorocyclohexane (γ-HCH), polychlorinated biphenyls, pentachlorophenol, and polychlorobiphenylols were quantified in all samples. In general, the levels observed were higher than those reported in children from developed countries, such as Germany and United States. Toxaphene, aldrin, dieldrin, and ß-HCH could not be identified in any sample. The children working at the waste-disposal site had higher levels of POPs compared with the nonworking reference groups. In children not working, there were also gradients for several POPs, according to vicinity to the waste-disposal site. Moreover, in children, as well as in young women, there were gradients according to fish consumption. The most abundant component was 4,4′-DDE, but at levels still lower than those reported in children from malarious areas with a history of recent or current application of 4,4′-DDT for vector control.

Mapping snakebite epidemiology in Nicaragua : pitfalls and possible solutions

Background Snakebites are a public health problem in Nicaragua: it is a tropical developing country, venomous snakes are present and there are reports of snakebites treated both in the formal and informal health care system. We aimed to produce an incidence map using data reported by the health care system that would be used to allocate resources. However, this map may suffer from case detection bias and decisions based on this map will neglect snakebite victims who do not receive healthcare. To avoid this error, we try to identify where underreporting is likely based on available information. Method and Findings The Nicaraguan municipalities are categorized by precipitation, altitude and geographical location into regions of assumed homogenous snake prevalence. Socio-economic and healthcare variables hypothesized to be related to underreporting of snakebites are aggregated into an index. The environmental region variable, the underreporting index and three demographic variables (rurality, sex and age distribution) are entered in a Poisson regression model of municipality-level snakebite incidence. In this model, the underreporting index is non-linearly associated with snakebite incidence, a finding we attribute to underreporting in the most deprived municipalities. The municipalities with the worst scoring on the underreporting index and those with combined low reported incidence and large rural population are identified as likely underreporting. 3,286 snakebite cases were reported in 2005–2009, corresponding to a 5-year incidence of 56 bites per 100,000 inhabitants (municipality range: 0–600 cases per 100,000 inhabitants). Conclusions Using publicly available data, we identified areas likely to be underreporting snakebites and highlighted these areas instead of leaving them “white” on the incidence map. The effects of the case detection bias on the distribution of resources against snakebites could decrease. Although not yet verified empirically, our study provides an example of how snake bite epidemiology may be investigated in similar settings worldwide at a low cost.

Ecological, Groundwater, and Human Health Risk Assessment in a Mining Region of Nicaragua

The objective of the present study was to integrate the relative risk from mercury exposure to stream biota, groundwater, and humans in the Río Artiguas (Sucio) river basin, Nicaragua, where local gold mining occurs. A hazard quotient was used as a common exchange rate in probabilistic estimations of exposure and effects by means of Monte Carlo simulations. The endpoint for stream organisms was the lethal no-observed-effect concentration (NOECs), for groundwater the WHO guideline and the inhibitory Hg concentrations in bacteria (IC), and for humans the tolerable daily intake (TDI) and the benchmark dose level with an uncertainty factor of 10 (BMDLs(0.1)). Macroinvertebrates and fish in the contaminated river are faced with a higher risk to suffer from exposure to Hg than humans eating contaminated fish and bacteria living in the groundwater. The river sediment is the most hazardous source for the macroinvertebrates, and macroinvertebrates make up the highest risk for fish. The distribution of body concentrations of Hg in fish in the mining areas of the basin may exceed the distribution of endpoint values with close to 100% probability. Similarly, the Hg concentration in cord blood of humans feeding on fish from the river was predicted to exceed the BMDLs(0.1) with about 10% probability. Most of the risk to the groundwater quality is confined to the vicinity of the gold refining plants and along the river, with a probability of about 20% to exceed the guideline value.