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Background: intrinsic capacity (IC) is a construct encompassing people's physical and mental abilities. There is an implicit link amongst IC domains: cognition, locomotion, nutrition, sensory and psychological. However, little is known about the integration of the domains., Objectives: to investigate patterns in the presentation and evolution of IC domain impairments in low-and-middle-income countries and if such patterns were associated with adverse outcomes., Methods: secondary analyses of the first two waves of the 10/66 study (population-based surveys conducted in eight urban and four rural catchment areas in Cuba, Dominican Republic, Puerto Rico, Venezuela, Peru, Mexico and China). We applied latent transition analysis on IC to find latent statuses (latent clusters) of IC domain impairments. We evaluated the longitudinal association of the latent statuses with the risk of frailty, disability and mortality, and tested concurrent and predictive validity., Results: amongst 14,923 participants included, the four latent statuses were: high IC (43%), low deterioration with impaired locomotion (17%), high deterioration without cognitive impairment (22%), and high deterioration with cognitive impairment (18%). A total of 61% of the participants worsened over time, 35% were stable, and 3% improved to a healthier status.Participants with deteriorated IC had a significantly higher risk of frailty, disability and dementia than people with high IC. There was strong concurrent and predictive validity. (Mortality Hazard Ratio = 4.60, 95%CI 4.16; 5.09; Harrel's C = 0.73 (95%CI 0.72;0.74))., Conclusions: half of the study population had high IC at baseline, and most participants followed a worsening trend. Four qualitatively different IC statuses or statuses were characterised by low and high levels of deterioration associated with their risk of disability and frailty. Locomotion and cognition impairments showed other trends than psychological and nutrition domains across the latent statuses., (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society.)

Setting: Tuberculosis elimination is a priority in most developed countries, although the AIDS epidemic and drug resistance are a handicap in some of them. Tuberculosis is an even greater problem in developing countries., Objective: To evaluate the epidemiological situation in Cuba, the trend of new cases reported for 1979-91 by clinical category and age group is described., Design: A simple regression model was fitted to the time series data on 'new case' rates taken from the national surveillance system. The annual variation percentage was estimated., Results: From 1979-91 tuberculosis decreased by 59.5% (from 11.6-4.7 per 10(5) persons per year). This decline occurred in all age groups; 60% of new cases in 1991 were aged 45 years and over, of which 30% were aged 65 and over. Drug resistance of Mycobacterium tuberculosis strains (2.49% in 1989) remains uncommon and HIV infection (0.009% in 1991) is rare in the general population., Conclusions: The continuing steady decline of the number of new cases reported, in addition to the favorable trend of drug resistance and the low rate of HIV infection in the general population so far seem to indicate the real possibility of maintaining the effectiveness of the National Programme for Tuberculosis Control in the future, making it reasonable to formulate new strategies for the elimination of the disease.

A large influenza epidemic took place in Havana during the winter of 1988. The epidemiologic surveillance unit of the Pedro Kourí Institute of Tropical Medicine detected the beginning of the epidemic wave. The Rvachev-Baroyan mathematical model of the geographic spread of an epidemic was used to forecast this epidemic under routine conditions of the public health system. The expected number of individuals who would attend outpatient services, because of influenza-like illness, was calculated and communicated to the health authorities within enough time to permit the introduction of available control measures. The approximate date of the epidemic peak, the daily expected number of individuals attending medical services, and the approximate time of the end of the epidemic wave were estimated. The prediction error was 12%. The model was sufficiently accurate to warrant its use as a practical forecasting tool in the Cuban public health system.

A forecast of nonepidemic morbidity due to acute respiratory infections were carry out by using time series analysis. The data consisted of the weekly reports of medical patient consultation from ambulatory facilities from the whole country. A version of regression model was fitted to the data. Using this approach, we were able to detect the starting data of the epidemic under routine surveillance conditions for various age groups. It will be necessary to improve the data reporting system in order to introduce these procedures at the local health center level, as well as on the provincial level.

Studied were a total of 322 samples of water, feed, and grass vegetation with soil from a region where there were records of unspecific tuberculin reactions with cattle. Investigations were also carried out on viscera and lymph nodes of 120 slaughtered cattle. It was found that the atypical acid-fast mycobacteria were widely spread in some regions of Cuba: 42.5% were found in grass samples, 37.5%--in soil samples, 35.0%--in water ones, and 9.6% in feed samples. Atypical mycobacteria were isolated in 35.0% of the cases with internal organs and lymph nodes of slaughtered healthy animals. Established were as many as ten species of such bacteria, prevailing being M. aquae B, M. aquae A, M. smegmatis, and M. phlei. Suggested is the preparation of an allergen from selected strains of atypical mycobacteria to carry out differential tuberculin tests where suspected tuberculin reactions were recorded in the practice.