The World Health Organization warned on Friday that cases of dengue fever could reach close to record highs this year, partly due to global warming and the way that climate has helped the mosquitoes that spread it, Reuters reported.

Rates of the disease are climbing worldwide, "with reported cases since 2000 up eight-fold to 4.2 million in 2022," according to the same source.

"Europe has reported a surge in cases and Peru declared a state of emergency in most regions."

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However, international travelers in the U.S. who are looking for protection against this tropical infectious disease spread by mosquitoes will have to wait a little longer. 

On July 11, the Japanese drug-maker Takeda voluntarily withdrew its application to the Food and Drug Administration (FDA) for its dengue vaccine candidate in the U.S. after the agency requested more data that the current trial could not capture, according to a press release. 

A dengue vaccine from the company is already approved in multiple endemic and non-endemic areas, such as the European Union, United Kingdom, Brazil, Argentina, Indonesia and Thailand.

There is only one dengue vaccine approved by the FDA in the U.S., but it is indicated only for children and teenagers ages six to 16 living in endemic areas — mainly Puerto Rico — who have previously had the infection.

The World Health Organization listed dengue fever as one of the top 10 threats to global health in 2019.

Roughly half the world’s population, or about 4 billion people, live in places that are at risk for dengue fever, with some 400 million people infected every year.

One country, Peru, is currently battling its worst outbreak in history.

"Dengue is occurring in urban areas where it did not exist before," Dr. Coralith García, associate professor at the school of medicine at Cayetano Heredia University in Lima, Peru, told Fox News Digital. 

Experts blame warmer temperatures and increased rainfall, but even in Lima, the second largest desert city in the world, dengue is flourishing because "it’s so crowded that anything can happen," she added.

"But Peru had the highest COVID mortality rate [in] the world and now we have several patients dying of dengue, confirming that the Peruvian health system is very weak." 

Most Americans get infected with dengue fever while traveling internationally. 

Yet it can spread locally in several states with hot, humid climates, such as Florida, Hawaii, Texas, and Arizona — although this is not common, according to the Centers for Disease Control and Prevention (CDC).

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From January to June 1 of this year, there were 129 reported cases in the U.S. and 256 reported cases in Puerto Rico, according to the CDC.

Dengue fever is caused by four viruses: dengue virus 1, 2, 3, and 4. 

It is spread primarily by the bite of the Aedes aegypti mosquito, which bites generally during the day, per the CDC.

A person can get infected as many as four times because one virus strain only confers immunity against that specific serotype; people are at higher risk for a life-threatening condition called dengue hemorrhagic fever when they are infected twice, per the CDC.

About one in four people with dengue fever become sick, which can be either a mild or severe illness; but some 40,000 die from severe disease every year, according to the CDC.

Dengue fever is the leading cause of fever among returning travelers to Europe from all continents except Africa, according to a recent study on the tropical disease.

International travelers often complain of a fever with dengue within two weeks after returning home, but symptoms generally resolve within one week.

Dengue has 3 phases of disease: 1) fever phase; 2) critical phase; and 3) recovery phase.

The fever phase, named after its most common symptom, is characterized by severe joint pain and headaches, but most patients recover without complications, Dr. David O. Freedman, professor emeritus of infectious diseases at the University of Alabama at Birmingham, told Fox News Digital.

The disease’s hallmark bone and joint pains have earned it the nickname "breakbone fever."

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"In a small proportion of patients, just as the fever is resolving, a second critical phase develops where fluid leaks out of the circulation and gets into body spaces, such as the chest and abdominal cavities," he added. 

During this phase, the blood pressure drops; severe bleeding may also occur.

Freedman recommends watching for abdominal pain or tenderness; 2) persistent vomiting; 3) fluid in body spaces; 4) bleeding from the mouth or rectum; and 5) lethargy and restlessness.

Any of these combined with a fever increase the likelihood of patients becoming very sick and needing to be hospitalized.

He also reminds people that "a total body rash often develops during the critical or early recovery phase."

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Freedman noted, "If the patient survives the critical phase usually with medical intervention, the third phase, recovery, occurs about 3-4 days after that."

A recent paper analyzed nearly 6,000 returning travelers with dengue using the GeoSentinel network surveillance platform.

The network is a collaboration between the CDC and the International Society of Travel Medicine. It monitors infectious diseases in 29 countries on six continents that affect international travelers and migrants.

The researchers looked at the patients with dengue fever, which was relatively mild illness without any complications, or "complicated dengue," which included those who had warning signs or severe illness.

They found only 2% of dengue cases were considered "complicated," but approximately 99% had warning signs, with 31% classified as severe.

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"Most of the time it is an uncomplicated course," lead author Ralph Huits, M.D., PhD, department of infectious tropical diseases and microbiology at IRCCS Sacro Cuore Don Calabria Hospital in Negrar, Verona, Italy, told Fox News Digital. 

"You can feel very sick, such as [with] a headache, anorexia, but then get better," he added.

"But some 2% of travelers can have a severe dengue," he continued.

"What you should remember is if you have any of the warning signs, then you or the doctor should monitor them very closely, preferably by hospitalization."

Preparations are underway for the construction of a modern waste water treatment plant for Georgetown and bring an end to the dumping of that type of waste into the Demerara River and Atlantic sea, Minister of Housing and Water Collin Croal said Saturday. He said the US$36 million effluent treatment plant, which would probably be ...

“Despite our patriotic pride of referring to our nation as one of the safest spots on the planet, we cannot bury our heads in the sand and ignore nor doubt the numbers”

View the full post A better place for you and for me!! on NOW Grenada.

Barbados Cancer Support Services (CSS) is continuing its close association with Ward C12 at the Queen Elizabeth Hospital. Its most recent act was the handing over of a set of equipment and supplies to be used in the care of the terminally-ill.

During the recent presentation ceremony held at the Dayrells Road, Christ Church facility Henderson Pinder, Director of Nursing at the QEH, expressed his appreciation for the much-needed equipment and supplies provided by CSS.

Under a Memorandum of Understanding signed in November last year, the group committed to continuing its support for the ward.

Included in the package were an aspirator, a commode, linens, pampers and incontinence pads. 

Pinder said the linens are all custom embroidered with the logo of the Cancer Support Services and would help with the management of linen on the ward.

“Each ward has specific markings for their sheets, and we want to give the assurance that the sheets with this logo will be used on Ward C12,” Pinder explained.

Since the signing of the MOU both the staff and patients at the QEH have been the recipients of significant benefits, according to Pinder.

Lisa Dodson, a nursing officer actively involved with the ward, expressed her gratitude for the donation. She acknowledged that the aspirator and commode would address some of the equipment shortages and challenges on C12.

“The aspirator is particularly important to us as we have been facing a shortage of these machines. It is primarily used for suction in cases where individuals may be unable to swallow or have an accumulation of fluid. It will greatly benefit us,” Dodson remarked. 

“We are thankful for the ongoing donations from Cancer Support Services and hope for your continued support in future endeavours.” 

In addition to thanking CSS for the continued support, Pinder revealed that the organisations are looking to strengthen their partnership.

“The support that they continue to give to us has been tremendous. We were looking at how we could strengthen and further programmes between the two organisations and how we could make it better for each of us as we try to achieve the goal of better patient care,” Pinder stated. 

Speaking briefly during the handing over of the equipment, Antoine Williams, the public relations officer of the CSS, emphasised the significance of the donation in strengthening the valuable relationship between his organisation and the QEH.

He said the MOU highlights the viable relationship with the hospital which allows Cancer Support Services to work with the institution in the care of patients. 

Furthermore, Williams encouraged corporate entities in Barbados to join CSS and other stakeholders in extending support to the QEH, as he stressed the importance of collective efforts in assisting the hospital. (BB)

The post Cancer Support Services provides more support for Ward C12 appeared first on Barbados Today.

Breast milk has always played a pivotal role in nurturing newborn babies, building natural immunity, and providing a unique blend of essential vitamins, minerals, and antioxidants. Speaking at the 7th Annual General Meeting of the Breastfeeding & Child Nutrition Foundation at the Sandy Lane Hotel on Saturday, July 15, Dr Sonia Browne, Minister of State in the Ministry of Health & Wellness, emphasised the potential of breastfeeding in mitigating the risk of chronic noncommunicable diseases in children throughout their lives.

Dr Browne highlighted that breastfed children experience a reduced risk of developing various conditions including but not limited to, asthma, severe respiratory diseases, obesity, ear infections, and gastrointestinal infections. She explained that breastfeeding also fosters a profound bond between mother and child while offering numerous benefits to the mother such as a lower risk of type 2 diabetes, hypertension, breast and ovarian cancer, and postpartum weight loss. 

Expressing her admiration for the Breastfeeding & Child Nutrition Foundation’s initiatives, Dr Browne acknowledged their efforts in empowering women and promoting effective breastfeeding practices. 

“I am particularly impressed by the many initiatives of the Foundation…including programmes such as the Baby and Me Breastfeeding Support Group, the Baby and Me WhatsApp Group, breastfeeding classes and consultations, advocacy for breastfeeding-friendly workshop policies, and community outreach.”

Echoing her sentiments, Dr Alison Bernard, the Executive Director of the Breastfeeding & Child Nutrition Foundation, commented, “We came up with this year’s theme, Achieving our Vision: Building Community Capacity for the Future, very quickly, because empowering our beneficiaries to optimise their children’s nutrition is a high-priority objective for the BCNF.”

Providing families with the necessary tools, education, and skills to improve their children’s nutrition lies at the core of the organisation’s mission.

 Dr. Bernard further stressed the need for employers to implement supportive measures for new mothers in the workplace, including the provision of clean and private spaces for pumping and storing breast milk. She advocated for flexible work hours and remote work options, which can lead to benefits for employers such as decreased absenteeism, improved productivity, employee satisfaction, retention, and reduced medical insurance claims.

Recognising the significance of breastfeeding on public health and well-being, the World Health Assembly has set a target of achieving a breastfeeding rate of at least 50 per cent by 2025. However, a critical aspect lacking in Barbados’ breastfeeding efforts is up-to-date breastfeeding data. The last available data is from 2012, which hinders accurate assessment and progress tracking on a national level. The Breastfeeding & Child Nutrition Foundation urges the ministry to prioritise the collection of current and comprehensive breastfeeding data, stressing the need for understanding breastfeeding practices, duration, and the transition to solid foods.

Breastfeeding plays a vital role in the development and long-term health of children, and it is essential to support and encourage breastfeeding practices at all levels. By championing breastfeeding and empowering mothers, Barbados can enhance the well-being of its population and achieve lasting positive impacts. It is estimated that for every $1 spent on breastfeeding, there is a return on investment of $35, and upscaling breastfeeding globally could potentially save $300 billion annually. Implementing a range of policies and actions will allow Barbados to reach national and international health goals for the population.

The post Breastfeeding critical for child development and long-term health appeared first on Barbados Today.

Speaking at the 7th Annual General Meeting of the Breastfeeding & Child Nutrition Foundation at the Sandy Lane Hotel on Saturday, July 15, Dr Sonia Browne, Minister of State in the Ministry of Health & Wellness, emphasised the potential of breastfeeding in mitigating the risk of chronic noncommunicable diseases in children throughout their lives.

Dr Browne highlighted that breastfed children experience a reduced risk of developing various conditions including but not limited to, asthma, severe respiratory diseases, obesity, ear infections, and gastrointestinal infections. She explained that breastfeeding also fosters a profound bond between mother and child while offering numerous benefits to the mother such as a lower risk of type 2 diabetes, hypertension, breast and ovarian cancer, and postpartum weight loss. 

Expressing her admiration for the Breastfeeding & Child Nutrition Foundation’s initiatives, Dr Browne acknowledged their efforts in empowering women and promoting effective breastfeeding practices. 

“I am particularly impressed by the many initiatives of the Foundation…including programmes such as the Baby and Me Breastfeeding Support Group, the Baby and Me WhatsApp Group, breastfeeding classes and consultations, advocacy for breastfeeding-friendly workshop policies, and community outreach.”

Echoing her sentiments, Dr Alison Bernard, the Executive Director of the Breastfeeding & Child Nutrition Foundation, commented, “We came up with this year’s theme, Achieving our Vision: Building Community Capacity for the Future, very quickly, because empowering our beneficiaries to optimise their children’s nutrition is a high-priority objective for the BCNF.”

Providing families with the necessary tools, education, and skills to improve their children’s nutrition lies at the core of the organisation’s mission.

 Dr. Bernard further stressed the need for employers to implement supportive measures for new mothers in the workplace, including the provision of clean and private spaces for pumping and storing breast milk. She advocated for flexible work hours and remote work options, which can lead to benefits for employers such as decreased absenteeism, improved productivity, employee satisfaction, retention, and reduced medical insurance claims.

Recognising the significance of breastfeeding on public health and well-being, the World Health Assembly has set a target of achieving a breastfeeding rate of at least 50 per cent by 2025. However, a critical aspect lacking in Barbados’ breastfeeding efforts is up-to-date breastfeeding data. The last available data is from 2012, which hinders accurate assessment and progress tracking on a national level. The Breastfeeding & Child Nutrition Foundation urges the ministry to prioritise the collection of current and comprehensive breastfeeding data, stressing the need for understanding breastfeeding practices, duration, and the transition to solid foods.

Breastfeeding plays a vital role in the development and long-term health of children, and it is essential to support and encourage breastfeeding practices at all levels. By championing breastfeeding and empowering mothers, Barbados can enhance the well-being of its population and achieve lasting positive impacts. It is estimated that for every $1 spent on breastfeeding, there is a return on investment of $35, and upscaling breastfeeding globally could potentially save $300 billion annually. Implementing a range of policies and actions will allow Barbados to reach national and international health goals for the population.

The post Breastfeeding critical for child development and long-term health appeared first on Barbados Today.

Santo Domingo.- Scientists and laboratory personnel in the Dominican Republic are participating in a biosafety and biosecurity course aimed at strengthening their capacities and raising awareness about preventing the proliferation of biological weapons and their delivery systems. The course, coordinated by the Organization of American States (OAS) and the Inter-American Committee Against Terrorism (CICTE), is being held with the support of the Ministry of Defense. It focuses on UN Security Council Resolution 1540 and the Biological Weapons Convention.

During the course’s opening, Ambassador Aracelia Azuara emphasized the importance of proper and safe handling of biological components to protect lives and the need for strong scientific networks with well-trained technical personnel. She also mentioned the uncertainties surrounding the origins of the COVID-19 pandemic and the concern over potential biological weapons.

Brigadier General Francisco Ovalle Pichardo, the national contact point for Resolution 1540, highlighted the evolving nature of warfare, including hybrid conflicts and media-based wars facilitated by social networks. He reaffirmed the Dominican Republic’s commitment to security, peace, and the agreements under the Biological Weapons Convention.

José Antonio Matos, Vice Minister of the Ministry of Public Health, and Enya Daniela Ramírez Castillo of CICTE stressed the importance of increasing knowledge and training high-level officials to prevent and control biological weapons, ensuring a safer country.

The course also covers crisis management exercises for biological accidents, the treatment of epidemics like H1N1, and a comprehensive review of Resolution 1540 based on the events of 2016. The aim is to strengthen capabilities and promote a safer environment in the face of biological threats.

Kelvin Regalado, for example, is facing charges related to the possession and distribution of various drugs, including carfentanil, heroin, fentanyl, and ketamine. According to the United States Department of Justice, Regalado conspired to deliver significant amounts of heroin and carfentanil to cooperating witnesses in multiple states.

Carfentanil is primarily used as a veterinary anesthetic for large animals such as elephants and bears. Its controlled and restricted use is due to its extreme potency, and any trade outside approved uses is illegal and highly dangerous. Handling the substance requires strict safety measures, including protective gloves, glasses, and masks, as even skin contact can be lethal.

Reports indicate that carfentanil poses significant risks not only to individuals who consume it but also to rescuers, medical personnel, and even drug-sniffing dogs. Inhaling its vapors can lead to immediate collapse, necessitating urgent treatment with drugs like Narcan, which contains naloxone to counteract acute opioid intoxication.

Carfentanil, first synthesized in the 1970s, is known for its minuscule lethal dose compared to fentanyl. While 2 milligrams of fentanyl can trigger an overdose, just 0.02 milligrams of carfentanil are sufficient to produce lethal effects. The potency and dangers associated with carfentanil make it a significant concern in the fight against illicit drug trafficking.

The first new Alzheimer’s treatment in 20 years was given full FDA approval earlier this month — and now two patients who participated in the clinical trials have spoken about their personal experience with the drug to Fox News Digital.

Lecanemab, sold under the brand name Leqembi, works by reducing amyloid plaques in the brain, which is one of the hallmarks of Alzheimer’s. 

In early trials, the drug was shown to slow cognitive decline by 27%.

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Two Ohio patients who participated in the trials recently spoke to Fox News Digital about how Leqembi has impacted their Alzheimer’s journeys — and changed their lives.

Joan Murtaugh, 77, lives in Lakewood, Ohio, with her husband, Larry. 

She first started noticing memory problems nearly seven years ago, just after her 70th birthday.

"Timing is everything," her husband, Larry Murtaugh, told Fox News Digital in an interview. "It was Joan who made an appointment at the brain center clinic."

In 2017, Murtaugh was diagnosed with mild cognitive impairment. 

The next year, after having a 3-D MRI and spinal tap, she learned that she had an enzyme in her spinal fluid that predicted a 65% chance of getting Alzheimer’s in her lifetime. 

In February 2020, Murtaugh received some good news: She was eligible to participate in a double-blind study trial for a new drug, Leqembi, at Cleveland Clinic in Ohio. 

"I assume it was because it was obvious there was some plaque in my brain, which they realized was causing Alzheimer’s," Murtaugh told Fox News Digital.

This was Phase 3 of the clinical trial, which included some 1,800 people worldwide. Murtaugh was one of only eight people to receive the drug at Cleveland Clinic.

A few months later, she began getting twice-monthly infusions of what was either a drug or a placebo.

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To this day, Murtaugh still doesn’t know if she was getting the real thing or a placebo — she won’t find out until the very last person has received the very last dose of the double-blind study. Yet she said she "has a hunch."

"I am fully functional — I’m still doing everything I always did," Murtaugh said. 

"I can still drive my car, shop, garden, cook, read — all those things."

Throughout the entire trial period, Murtaugh said she never got any worse. She just experienced the same mild symptoms she’d had before starting the drug — and she may have even improved a bit. 

Although Leqembi has been linked to some potential side effects, she experienced none.

"When you first hear the word ‘Alzheimer’s,’ a chill goes through you — it’s like you’re looking into a dark abyss," Murtaugh said. 

"But this new drug offers great hope."

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In September 2021, the trial portion of the study ended and Murtaugh was eligible to start receiving the actual medication, which she still takes today. 

Instead of the lengthy infusions, she now gets the medication via an EpiPen injection once a week with the help of her husband.

The drug is currently covered by Medicare, which means Murtaugh gets it for free — and she hopes that will continue for the foreseeable future.

While the Murtaughs realize that the future may bring challenges, they regard Leqembi as "a ray of sunshine in a very cloudy sky."

Paired with other approaches such as cognitive speech therapy, they’re optimistic that the drug will continue to keep Alzheimer’s symptoms at bay.

"We’re not going to declare victory, but we’re on the right path and we have the right team at Cleveland Clinic," said Larry Murtaugh. 

"It’s not a miracle, but it’s gradual progress."

A retired attorney in Aurora, Ohio, John Domeck was just 57 years old when he was diagnosed with Alzheimer’s.

The people around him — his colleagues at the law office and his family at home — started noticing his memory lapses before he did.

After 30 years of never having to take many notes at work, Domeck, now 61, had started to write things down to avoid forgetting them.

"Over time, I wasn't able to continue doing as much work as quickly as I once did," he told Fox News Digital during an interview.

His wife of 40 years, Ann Domeck, had also started noticing some red flags at home, but said the last thing they expected was Alzheimer's disease.

The Domecks made an appointment at Cleveland Clinic for some cognitive testing, which led to a spinal tap and, ultimately, an Alzheimer’s diagnosis in July 2019.

Domeck’s wife, a TV news producer in Cleveland, left her job to help care for her husband.

Given Domeck’s young age and early-stage decline, a Cleveland Clinic doctor told him he was the perfect candidate for a clinical trial for a new Alzheimer’s drug.

For 18 months, Domeck went in for twice-monthly infusions, which lasted up to six hours per session — without knowing whether he was getting the drug or the placebo.

A year ago, he was switched to the "open-label" Leqembi medication, which he takes via injection at home once a week.

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The Domecks suspect that John has been on the drug the entire time, as he has not declined much at all in the past four years.

"Everyone's like, he had to have been getting it before — he's doing so well," Ann Domeck said. "His cognitive deficits have only increased minimally. After four years of Alzheimer’s, his scores should be a lot lower."

"The fact that he’s still able to maintain his day-to-day activities and do the things that he enjoys is just so promising," she added.

"John gets up and drives and golfs and reads every day," she said. "He got to see our son get married, and we’re planning to visit our daughter in Europe."

Throughout the process, the Domecks said they have been "astounded" by the compassion and support of their care team at Cleveland Clinic.

"They're professionals, and they know their stuff about Alzheimer's, but they're also some of the nicest people we've ever met," Ann Domeck said. 

While the couple understand that Leqembi is not a cure, they’re more optimistic now than they were a few years ago. 

"Alzheimer's kind of rocked our world, and this drug kind of rocked it back a little bit the other way," said Ann Domeck. 

After initially being "shell-shocked" by the unexpected diagnosis, the Domecks feel that the drug has given them time they were told not to expect.

"I thank God every day that we got in this trial," Ann Domeck said. "It's the best thing that's happened to us."

While it's the first Alzheimer’s drug to receive full FDA approval in 20 years, Leqembi is also the first medication to target the underlying disease and not just the symptoms, explained Dylan Wint, M.D., director of the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas, Nevada.

Leqembi is approved only for the treatment of mild cognitive impairment or early-stage Alzheimer's for people who have been shown to have amyloid plaques in the brain.

"Lecanemab labels abnormal amyloid and tells the immune cells to remove those fibers from the brain," Wint told Fox News Digital. 

In testing, about two-thirds of patients went from amyloid positive to amyloid negative — and cognitive and functional decline was 27% slower for study participants compared to those on placebo, the doctor said.

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"Taking this drug is a long-term commitment," said Wint. "Doctors need to make sure the patient can tolerate this rigorous regimen — intravenous infusions every two weeks for 18 months, interspersed with MRI scans and memory testing."

More care and support are needed for people with moderate and severe Alzheimer’s disease and their families, not to mention people with other forms of dementia, he added.

As with any medication, lecanemab can have some side effects. 

Most commonly, it can cause various brain reactions, like swelling and bleeding, explained Manisha Parulekar, M.D., co-director of Hackensack University Medical Center’s Center for Memory Loss & Brain Health in New Jersey.

"Patients will have to stop the medication if these changes are noted on MRIs," Parulekar told Fox News Digital. "People who are taking multiple blood thinners will not be able to take Leqembi."

Headaches and confusion are also commonly reported. 

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Now that Leqembi is fully approved, Medicare will cover the medication, with other insurance companies likely to follow, said Parulekar.

"Without Medicare or insurance, the out-of-pocket costs are around $26,000 per year," she noted. 

Alzheimer’s disease involves many complex factors, Wint noted, and the new medication targets just one factor: amyloid. 

"While this new approach is excellent news, removing amyloid is not a cure," he said. 

"We still need to find better symptomatic and disease-modifying treatments in the future." 

Leqembi is most effective when combined with existing treatments, said Wint, including symptomatic medicines, rehabilitation and family support.

Santo Domingo.- According to the Minister of Public Health, Daniel Rivera, there is no presence of fentanyl in the population addicted to drugs in the Dominican Republic. He stated that there are no records of fentanyl in autopsy reports, and the National Directorate for Drug Control has not seized any of it.

Rivera emphasized that medical-grade fentanyl, which is not mixed with other substances, does not pose risks as seen in Mexico and other countries where it is used illicitly alongside synthetic drugs for recreational purposes.

The minister clarified that the fentanyl entering the country for medical purposes is well controlled by the Drug Directorate and is directly distributed to clinics, with no access for individuals to purchase it at pharmacies.

Rivera also highlighted the assistance program implemented by the Ministry of Public Health called “Ruta de la Salud” (Health Route). This program was developed based on a study revealing that 32% of the population suffers from high blood pressure, 12% have diabetes, and 70% are obese or overweight.

He mentioned that Monte Cristi has the highest prevalence of hypertension, with 50% of the population affected. As a result, the Health Route will focus on that region in the upcoming week.

The Health Route program provides the population with 35 different types of care, including check-ups, diagnostic tests, and treatments. Recent visits to Azua revealed a 37% prevalence of hyperglycemia in the population. However, through the treatments provided, the risks of cardiovascular events and heart attacks are being reduced.

Given the high levels of obesity in the Dominican population, the Health Route includes a one-hour walk as part of the program in different cities each week. This initiative aims to address the fact that 93% of people do not engage in regular physical exercise.