Hepatitis B vaccination in the Columbian Amazon : effectiveness and factors influencing vaccine coverage

A vaccination coverage survey was carried out in the Colombian Amazon, a former high endemic area for hepatitis B, involving 3573 children less than II years old. It was carried out in Leticia, Puerto Narifio, and Araracuara, both urban and rural areas. Children were selected using a one stage cluster sampling, randomly selecting clusters in urban and rural areas where all children under 11 were surveyed. At the same time blood samples were taken from all children with known vaccination status (n=1603), and from their mother, when she was available (n=8l2). These samples were processed for hepatitis B surface antigen (HBsAg), antibodies to hepatitis B core antigen (Anti-HBc) and antibodies to HBsAg (Anti- HBs). A sample of children without vaccination data available was also bled to compare their results with those of children with vaccination data. Full vaccination coverage was found to range between 39% and 69% among different areas while hepatitis B vaccination ranged between 73% and 95%. Factors which improve the likelihood of being fully vaccinated in this study were: Age above one year, living in Leticia, being. affiliated to the social security, mother's years of schooling. Health worker's knowledge on vaccine contraindications and perceptions of logistical barriers against vaccination or importance of hepatitis B as a public health problem were also related to full vaccine coverage. Prevalence of hepatitis B infection reached 5% among those who were bled (8211603) while HBsAg positive status was 1.6% (26/1603). Since the introduction of the vaccine prevalence of hepatitis B infection has fallen from 40%, an 85% reduction, while carrier prevalence has fallen from 5%, a 68% reduction. Age above 7 years, living in a rural area, birth delivery supervised by other than a MD or nurse, and being born from an Anti-HBc+ mother were the most important general factors related to being infected with HBV. Having an incomplete schedule for hepatitis B vaccine was associated with an increase in the risk of being Anti- HBc or HBsAg+. However, some characteristics of the vaccination process were related to being HBsAg+/Anti-HBc+. Delays in receiving the first dose of hepatitis B after birth and delays to receiving the second dose after the first dose were associated with an increased risk of being HBsAg+/Anti-HBc+. None of these characteristics were related to being Anti-Hlic+ alone. In conclusion, the introduction of a recombinant Cuban manufactured hepatitis B vaccine has produced a marked decline in the high infection prevalence of children in the Colombian Amazon area. A higher coverage has been achieved from the beginning of the program though intervals from birth to first dose and between doses are too long leading to new infections that could have been avoided. There is still room to make improvements in the control program, including the implementation of a surveillance system of the HBV serological status for pregnant women, in order to ensure better vaccination schemes for those born to infected or HBsAg+ mothers

Is Colombia an example of successful containment of the 2020 COVID-19 pandemic? A critical analysis of the epidemiological data, March to July 2020

Background: Colombia detected its first coronavirus disease 2019 (COVID-19) case on March 2, 2020. From March 22 to April 25, it implemented a national lockdown that, apparently, allowed the country to keep a low incidence and mortality rate up to mid-May. Forced by the economic losses, the government then opened many commercial activities, which was followed by an increase in cases and deaths. This paper presents a critical analysis of the Colombian surveillance data in order to identify strengths and pitfalls of the control measures. Methods: A descriptive analysis of PCR-confirmed cases between March and July 25 was performed. Data were described according to the level of measurement. Incidence and mortality rates of COVID-19 were estimated by age, sex, and geographical area. Sampling rates for suspected cases were estimated by geographical area, and the potential for case underestimation was assessed using sampling differences. Results: By July 25, Colombia (population 50 372 424) had reported 240 745 cases and 8269 deaths (case fatality rate of 3.4%). A total of 1 370 271 samples had been analyzed (27405 samples per million people), with a positivity rate of 17%. Sampling rates per million varied by region from 2664 to 158 681 per million, and consequently the incidence and mortality rates also varied. Due to geographical variations in surveillance capacity, Colombia may have overlooked up to 82% of the actual cases. Conclusion: Colombia has a lower case and mortality incidence compared to other South American countries. This may be an effect of the lockdown, but may also be attributed, to some extent, to geographical differences in surveillance capacity. Indigenous populations with little health infrastructure have been hit the hardest

Texts and documents for the study of the Edict of Decio

En el presente trabajo se estudia el edicto del emperador Decio (años 249 a 251) y el conflicto que supuso para el cristianismo su promulgación. Se explicará qué son los libelos que debían firmar quienes demostraban el culto a los dioses romanos tradicionales y se traducen al castellano 41 papiros encontrados en Egipto desde el año 1948, conteniendo esa declaración de lealtad a los dioses romanos. Se explica la visión del Edicto desde los escritos de Cipriano de Cartago y Eusebio de Cesarea, recogiendo el relato de Dionisio de Alejandría y se profundiza en esa persecución que fue considerada por el lado cristiano como la primera que fue universal y sistemática contra la nueva religión. También se relata cuáles fueron las grandes consecuencias de las apostasías para la Iglesia, por la situación que se creó de determinadas personas ("lapsi") que luego pidieron ser reintegrados en el seno de la misma y las posturas distintas sobre ese “segundo bautismo” y el perdón que se les podría, o no, otorgar.In the following article we follow the Emperor Decius’ Edict (year 249 to 251) and the conflict it meant for the christians. It will explain the libels that they had to sign in order to prove they believed in the Roman gods. There are 41 of them translated to Spanish since their discovery in 1948. The Edict will be explained based on the writings of Cyprian of Carthage and Eusebius of Caesarea, including the story of Dionisio of Alexandria, which expands on the persecution the christians suffered and is considered as the first one they encountered. It also tells the biggest consequences of the apostasíes for the Church because of the different christians who later claimed to be reintegrated on it, and the different takes on the “second baptism” and whether there could be forgiveness for them.Fac. de FilologíaInstituto Universitario de Ciencias de las ReligionesTRUEunpu

Encefalitis equina Venezolana

El virus de la encefalitis equina venezolana (VEEV) pertenece al género de los alfavirus (familiaTogaviridae) con serotipos enzootico y epizootico. Dentro de este mismo grupo de virus se encuentran los de la encefalitis equina del Este y del Oeste, el de Mayaro, el de Mucambo y el de Everglades. Estos virus se caracterizan por tener entre 50 y 70 nm, tener un RNA de cadena simple y simetria icosahedrica. Poseen además una hemaglutinina activa para los eritrocitos de ganso, pollo recien nacido y paloma. El VEEV fue descubierto por primera vez por Kubes y Rios y por Beck y Wyckoff en 1937

Encefalitis equina Venezolana

El virus de la encefalitis equina venezolana (VEEV) pertenece al género de los alfavirus (familiaTogaviridae) con serotipos enzootico y epizootico. Dentro de este mismo grupo de virus se encuentran los de la encefalitis equina del Este y del Oeste, el de Mayaro, el de Mucambo y el de Everglades. Estos virus se caracterizan por tener entre 50 y 70 nm, tener un RNA de cadena simple y simetria icosahedrica. Poseen además una hemaglutinina activa para los eritrocitos de ganso, pollo recien nacido y paloma. El VEEV fue descubierto por primera vez por Kubes y Rios y por Beck y Wyckoff en 1937