Global, Regional, And National Cancer Incidence, Mortality, Years Of Life Lost, Years Lived With Disability, And Disability-Adjusted Life-Years For 29 Cancer Groups, 1990 To 2016: A Systematic Analysis For The Global Burden Of Disease Study

Importance: The increasing burden due to cancer and other noncommunicable diseases poses a threat to human development, which has resulted in global political commitments reflected in the Sustainable Development Goals as well as the World Health Organization (WHO) Global Action Plan on Non-Communicable Diseases. To determine if these commitments have resulted in improved cancer control, quantitative assessments of the cancer burden are required. Objective: To assess the burden for 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus. Evidence Review: Cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) were evaluated for 195 countries and territories by age and sex using the Global Burden of Disease study estimation methods. Levels and trends were analyzed over time, as well as by the Sociodemographic Index (SDI). Changes in incident cases were categorized by changes due to epidemiological vs demographic transition. Findings: In 2016, there were 17.2 million cancer cases worldwide and 8.9 million deaths. Cancer cases increased by 28% between 2006 and 2016. The smallest increase was seen in high SDI countries. Globally, population aging contributed 17%; population growth, 12%; and changes in age-specific rates, -1% to this change. The most common incident cancer globally for men was prostate cancer (1.4 million cases). The leading cause of cancer deaths and DALYs was tracheal, bronchus, and lung cancer (1.2 million deaths and 25.4 million DALYs). For women, the most common incident cancer and the leading cause of cancer deaths and DALYs was breast cancer (1.7 million incident cases, 535 000 deaths, and 14.9 million DALYs). In 2016, cancer caused 213.2 million DALYs globally for both sexes combined

Estado del arte del proyecto

El objetivo de este proyecto de investigación es realizar evaluaciones económicas de intervenciones sanitarias y estudios de resultados en salud que permitan aumentar la evidencia científica que informa las decisiones en salud, tanto a nivel micro como macro en las áreas de economía de la salud, epidemiología, salud pública y la gestión sanitaria y de servicios de salud. Este proyecto de investigación se sustenta en la medida que valora la intención de materializar en artículos científicos diversas investigaciones que se vienen adelantando al interior de nuestros grupos de investigación de la Universidad de la Costa-CUC. Existen diferentes aproximaciones metodológicas desde donde se pueden diseñar y ejecutar las investigaciones que planteamos. Como grupos de análisis intentaremos abordar el mayor espectro posible de las enfermedades crónicas no transmisibles y las enfermedades infecciosas. Este proyecto será de gran utilidad para aumentar la cantidad y calidad de la evidencia en el área de las evaluaciones económicas de intervenciones sanitarias y los estudios de resultados en salud. El número de publicaciones que se esperan obtener con este proyecto impactarán positivamente en los estándares investigativos del programa al que pertenecemos, la facultad y la Universidad, así como en la clasificación de nosotros como investigadores y de los grupos de investigación en donde se articularán estos trabajos. Las publicaciones serán mayormente sometidas a revistas Q1, así también como a Q2 y Q3. Se espera que las investigaciones llevadas a cabo generen un número importante de artículos científicos, artículos cortos y presentaciones en congresos científicos

Characteristics and monetary compensation of caregivers for patients with rheumatic conditions

Musculoskeletal disorders (MD) are highly prevalent conditions that affect quality of life. MD cause physical and psychological dependence. Usually, the care of a patient with MD is assumed by a caregiver. The aim of this study was to describe the sociodemographic characteristics and the monetary remuneration associated to the care of a patient with MD. A cross sectional study was carried out in order to estimate the monetary remuneration related to the health care of patients with MD. A survey was applied to caregivers of patients with MD. Demographic data was collected. We asked about the relationship with the patient, the time as a caregiver and all data related to the monetary compensation. Descriptive epidemiology was done. We reported monetary data in American Dollars (USD) using the average exchange rate for 2018. We surveyed 132 caregivers. Mean age was 52 years [standard deviation 19], 72% were women, 78% were taking care of a patient with rheumatoid arthritis, 12% osteoarthrosis 2% lupus, and 2% osteoporosis. The remaining 6% were caregivers of patients with ankylosing spondylitis, fibromyalgia and Sjogren syndrome. Regarding the time as a caregiver, 48% had less than a year, 16% between two and three years, 18% more than three years, 13% more than four years, and 5% were temporarily caregivers. In our study, 85% of caregivers were a family member, while 15% a nurse or a non-related person. Regarding the compensation, 97% did not receive any salary or payment for being caregiver, the remaining 3% received between 265 and 530 USD per month. Our study demonstrated that the care for patients with MD is mainly assumed by family members. Our results agree with other studies in chronic conditions where only a small proportion of caregivers is paid. Caregivers should be considered for the health system

Global compliance with hepatitis b vaccine birth dose and factors related to timely schedule. A literature review

Objectives: Identify global barriers for delivery of hepatitis B vaccine birth dose. Methods: A search for cross sectional studies published between January 2001 and December 2017 was conducted using the following Mesh terms: "Vaccination"[Mesh], "Mass Vaccination"[Mesh], "Hepatitis B"[Mesh], "Hepatitis B virus"[Mesh], "Hepatitis B Surface Antigens"[Mesh]. Databases consulted included: PUBMED, SCIELO, EMBASE and BIREME. To evaluate the quality of studies, we used an adapted version of the Newcastle-Ottawa Quality Assessment Scale for cross sectional studies. Results: An initial list of 6,789 articles were generated by the combination of search terms. After reviewing titles and abstracts, they were reduced to 134 for full reading, and 22 studies were included in the barriers analysis. The region with more references was Western Pacific while eastern Mediterranean had the lowest. Being born outside of a health facility and weakness of outreach vaccination service seems to be the most important an cited factors related to underperformance of birth dose delivery. In developed countries, hospital policies on birth dose vaccination was the main factor associated to no vaccintion with the birth dose. Conclusions: New ways to deliver hepatitis B vaccines to neonates being born at home or outside health facilities should be envisaged and applied, if the goal of eliminating perinatal transmission of hepatitis B is to be achieved

Prevalence of parasite intestinal infections in a rural community of the Caribbean north of Colombia

Objectives: To estimate the prevalence of protozoan and helminth infections in a rural town of the Caribbean coast of Colombia and to identify potential risk factors. Methods: The study was conducted in Santa Catalina, a town and municipality located in the Bolívar during 2014. Parasitological analyses were done using 0.85% saline solution and lugol staining. A questionnaire was applied to participants in order to identify possible risk factors for parasite infections. Results: Mean age of sample population (N = 685) was 29.8 SD 622.46 and 68% were females. There is no sewage access in this town. Most of them were infected by any protozoan species (80%) or soil-transmitted helminthes (71%). The most common protozoan found was Entamoeba coli (53%) followed by Giardia duodenalis (13%), Blastocistys hominis (4%) and E. histolytica 82%). Ascaris lumbricoides was the most prevalent helminth (63%) followed by Trichuris trichuria (36%), hookworms (2%), Taenia sp (2%) and Hymenolepys nana (2%). Frequency rates of protozoan and helminthic infections were significantly lower in those living in a house build made of bricks (versus wood or "bahereque") or with a floor material distinct from soil/earth. Drinking boiled water was associated only with lower rates of trichuriasis (aOR: 0.59 95%CI: 0.41-0.78), but not ascariasis. Almost half of of subjects (56%) reported to have received deworming treatment in the last year, but this was not associated with having any parasite infection. In a sub-group of 109 with available data, Ascaris infection was associated with lower hemoglobin levels (B=0.75, SE: 0.25, p = 0.003, adjusted by age and gender). Conclusions: The prevalence of protozoan and helminth infections in this town, representative of the rural area of the Caribbean coast of Colombia, is high. Indicators of poverty and lower hygienic conditions are positively associated with parasite infections

A comprehensive care program achieves high remission rates in rheumatoid arthritis in a middle-income setting. Experience of a center of excellence in Colombia

Management of rheumatoid arthritis (RA) in many Latin-American countries is impaired by fragmentation and scarce healthcare provision, resulting in obstacles to access, diagnosis, and treatment, and consequently in poor health outcomes. The aim of this study is to propose a comprehensive care program as a model to provide healthcare to RA patients receiving synthetic DMARDs in a Colombian setting by describing the model and its results. Health outcomes were prospectively collected in all patients entering the program. By protocol, patients are followed up during 24 months using a treat-to-target strategy with a patient-centered care (PCC) model, meaning that a patient should be seen by rheumatologist, physical and occupational therapist, physiatrist, nutritionist and psychologist, at least three times a year according to disease activity by DAS28. Otherwise, patients receive standard therapy. The incidence of remission and low disease activity (LDA) was calculated by periods of follow-up. A total of 968 patients entered the program from January 2015 to December 2016; 80.2% were women. At baseline, 41% of patients were in remission, 17% in LDA and 42% in MDS/SDA. At 24 months of follow-up, 66% were in remission, 18% in LDA and only 16% in MDS/SDA. Regarding DAS28, the mean at the beginning of the time analysis was 3.1 (SD 1.0) and after 24 months it was 2.4 (SD 0.7), showing a statistically significant improvement (p < 0.001). In all patients, the reduction of disease activity was 65% (95% CI, 58–71). Patients entering the PCC program benefited from a global improvement in disease activity in terms of DAS28

Severity factors of Acquired Pneumonia Community in a children's hospital in the Colombian Caribbean

Objective: Identify predisposing factors to develop severe pneumonia in hospitalized children diagnosed with community-acquired pneumonia hospitalized in Cartagena´s Napoleón Franco Pareja children´s Hospital.Methods: Analytical observational cross-sectional study performed in patients under 18 years. Data from surveys and records were analyzed. Univariate and bivariate analysis was performed. The variables are grouped according to the presence or absence of complications and analyzed by ji-square test. We were calculating OR of each of the dummy variables to evaluate their association with complications was performed. A P &amp;lt; 0.05 was considered statistically significant for all analyzes.Results: 301 patients with severe pneumonia were included. Risk factors related to severity: age less than 3 months (OR: 4.86; CI 95%: 1,5 - 14.3; p = 0.004); exclusive breastfeeding for less than 6 months (CI:95% 7,7- 1,4; p = 0.0019); heart disease (OR: 5.37; CI 95%: 1,28- 19,88, p = 0.010); prematurity (OR: 1.62, CI 95%: 0.93- 6.69, p = 0.034); Incomplete vaccination (OR: 2.32; CI: 95% 1.07 - 5.10; p = 0.015).Conclusions: It was found increased severity risk, statistical significantly, in patients less than 6 months breastfeeding, prematurity, heart disease, incomplete vaccination scheme, and positive blood culture with Sp. pneumoni

Knowledeges and experiences of pregnant women on prenatal care programs of a subsidized health care company from the Caribbean region of Colombia: a qualitative analysis

Objectives: Prenatal care programs have been conceived to reduce maternal and perinatal mortality risk. However, some pregnant women arrive late or do not attend the program, thus, health risks associated with pregnancy increases considerably. The objective of this study was to know pregnant women perceptions about a prenatal care program that include two components: health services and educational advice. Methods: A randomized sample of 33 women was chosen. Inclusion criteria considered women between 30 and 32 gestation weeks of pregnancy and living in the urban area. Data was collected using the focus group technique. For the analysis, we used the following protocol: Literal transcription of oral speech, information coding and integration, and data triangulation. Qualitative analysis with textual data was conducted with Quanteda package in R statistical software. Results: Important differences were found by geographic zones. In the city, pregnant women associate the program mainly with health services, while women living in town area associate the program with the educational component. Also, in the city the first contact with the program was by the prenatal care appointment, while in town was through the educational agents from the health care company. The program is valued in special form by women with high risk pregnancy and first-time mothers like a mechanism to guarantee their wellbeing and the baby’s. On the other hand, women that planned their pregnancy, began early prenatal check-ups than those who did not planned it. Conclusions: In the design of prenatal care programs sociocultural differences of communities to which they target as well as the perceptions, realities, and motivations of pregnant women must be considered. This would allow having better results in maternal and perinatal health and public health as a result of a more comprehensive intervention