Growth and development is considered the best positive indicator of children’s quality of life and well-being. Studies have been carried out in Cuba since the early 20th century and large scale, periodic anthropometric surveys have been regularly conducted by its National Health System to chart modifications in growth patterns of children and adolescents. These surveys have produced national references for the anthropometric indicators most commonly applied in individual assessment of the health and nutritional status of children and adolescents in health care settings. These have also provided data for estimating the magnitude and characteristics of secular growth trends, and for comparing growth of Cuban children with that of children in other countries and with WHO’s proposed growth standards. The data have also served as evidence of persisting social gradients. The most important results include, as positive data, the positive secular trend in school-aged children’s growth of 9.7 cm between 1919 and 2005, with an average increase of 1.1 cm per decade, and, in preschool children, 1.9 and 1.8 cm in boys and girls, respectively, between 1972 and 2015. More recent studies have detected unfavorable changes associated with a marked increase in adiposity and, therefore, in the prevalence of excess weight and obesity. Another interesting result is the gradual movement toward WHO height-for-age standards in preschool children in Havana, verified in surveys conducted in 2005 and 2015.

KEYWORDS Growth and development, growth, child development, children, adolescents, nutrition, obesity, pediatrics, Cuba

INTRODUCTION Women are being diagnosed with HIV infection in increasing numbers, and now account for 50% of cases worldwide. In Cuba, HIV is more frequent in men, but in recent years, a growing number of women have been diagnosed.

OBJECTIVE Describe patterns of HIV among women in Havana, Cuba, 1986–2011.

METHODS Descriptive study of women with HIV aged >14 years, residents of Havana, Cuba, who were diagnosed with HIV from 1 January 1986 through 31 December 2011. Information was obtained from the limited-access HIV/AIDS database of Cuba’s Ministry of Public Health. Data were studied from all reported cases, a total of 1274 women. Variables selected were age at diagnosis, education, municipality of residence, screening group, year of HIV diagnosis, late presentation, AIDS-defining condition, year of diagnosis as AIDS case, vital status at the end of 2011, and year of death (if applicable). Incidence of HIV and AIDS, cumulative incidence by municipality of residence, and case fatality rates were calculated.

RESULTS Those aged 20–29 years were most affected by HIV. Almost half (46.7%) the women had completed middle school, and a further 35.4% had completed high school or middle-level technical studies. HIV incidence began to increase more steeply starting in 1998, as did AIDS incidence by year of diagnosis, though to a lesser extent. Central Havana and Old Havana municipalities had the highest cumulative incidence. Late presentation was seen in 7.4% of cases; mean age of those diagnosed late was 38.9 years. Wasting syndrome and Pneumocystis jirovecii pneumonia were the most frequent AIDS-defining conditions. Case fatality rates started to decline in 1998.

CONCLUSIONS HIV infection in women is occurring in a predominantly young, relatively well-educated population. Increasing rates of HIV and AIDS in the past decade are a warning sign of the possible expansion of HIV infection in women, even though mortality is declining.

KEYWORDS Human immunodeficiency virus, acquired immunodeficiency syndrome, AIDS, HIV infections, women, delayed diagnosis, Cuba

INTRODUCTION: Rising prevalence of excess weight in children and adolescents is a serious public health problem in both developed and developing countries, associated with a growing burden of chronic non-communicable diseases in youth and adults. In Cuba, population-based growth and development surveys have been conducted since the 1970s, the latest in 2005.

OBJECTIVE: Estimate prevalence of overweight, obesity and high adiposity in children and adolescents aged ≤19 years in Havana, Cuba, in 1972, 1993 and 2005, and describe secular trends in these conditions in the periods observed.

METHODS: A retrospective, descriptive study examined data from growth and development surveys conducted in Havana in 1972, 1993 and 2005, which obtained Body Mass Index (BMI) and left mid-arm fat area (MAFA) in the population aged ≤19 years using probabilistic sampling and comparable methods of anthropometric measurement and data verification, processing and analysis. Age- and sex-specific percentiles were used as cutoff points for diagnosing overweight, obesity and high adiposity in 3 age groups (early childhood: <5 years; childhood: 5–9 years; and adolescence: 10–19 years). Descriptive statistics were used to calculate prevalence, expressed as a percentage of the population surveyed in each nutritional status category, by sex, age group and survey year. Trends were established by comparing prevalence in 3 periods: 1972–1993, 1993–2005 and 1972–2005. Statistical significance of the percentage differences between survey years in each period was calculated using 95% confidence intervals (CI).

RESULTS: Prevalence of excess weight (overweight + obesity) in the study population was 15.3% in 1972, 9.6% in 1993, and 16.4% in 2005, and was more frequent in males but varied by age group and survey year. Prevalence of high adiposity decreased from 13.3% in 1972 to 12.7% in 1993, increasing significantly to 28.8% in 2005. High adiposity was more frequent in males and decreased as age increased, except in children aged <5 years, who had lowest adiposity in 1972. While excess weight predominated over high adiposity in 1972 (15.3% and 13.3%, respectively), this relationship was reversed in 1993 (9.6% excess weight vs 12.7% high adiposity) and continued as a growing trend in 2005 (16.4% excess weight vs 28.8% high adiposity).

CONCLUSIONS: Prevalence of excess weight and high adiposity generally declined during economic crisis and scarcity, and rose as the economy improved. Continued monitoring is required to detect sustained or rising prevalence of these conditions and to develop interventions to reduce health risks.

Keywords Overweight, obesity, adiposity, child, adolescent