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

Cigarette smoking and the risk of high-school students becoming dependent on nicotine

Objective Establishing cigarette smoking prevalence, the factors associated with it and the risk of nicotine dependence in adolescents attending school in Cartagena, Colombia. Method This was a cross-sectional study of a probability sample of 1,152 adolescent students from public and private schools in Cartagena. Students anonymously and individually completed a questionnaire containing sociodemographic and psychosocial characteristics. A descriptive analysis was then made of the variables investigated. All qualitative and quantitative variables  were then dichotomised and odds ratios (OR) were estimated with 95 % confidence intervals. Results 1,014 students  successfully completed the survey. Mean age was 15.1 years. 355 (35.0 %) students had experimented with cigarettes, 70 (6.9 %) reported smoking regularly and 18/70 (257 %) presented a high risk of nicotine dependence. The following variables were associated with smoking: being an elementary school student (4.08 OR; 2.27 to 7.35 95 %CI), being over 15 (3.71 OR; 2.85-7.44 95 %CI), having parents who smoked (2.47 OR; 1.42 to 4.31 95 %CI), being male (2.37 OR; 1.40 to 4.00 95 %CI) and having a brother or sister who smoked (2.21 OR; 1.16 to 4.21 95 %CI). Conclusions The prevalence of smoking was low in high-school students from Cartagena. The frequency of smokers was higher amongst basic secondary education students, males older than fifteen and in whom the parents or brothers or sisters were smokers.Objetivo Establecer la prevalencia y los factores asociados con el consumo de cigarrillo y  riesgo de dependencia a la nicotina en adolescentes escolarizados de   Cartagena, Colombia. Método Se realizó un estudio analítico transversal con una muestra probabilística de 1 152 estudiantes adolescentes de colegios públicos y privados. Los estudiantes diligenciaron en forma individual y anónima un cuestionario que incluía las características sociodemográficas y psicosociales. Se realizó un análisis descriptivo de las variables investigadas, posteriormente, todas las variables, cualitativas y cuantitativas, se dicotomizaron y se estimaron razones de disparidad (OR) con intervalos de confianza del 95% (IC95%). Resultados 1 014 estudiantes completaron satisfactoriamente la encuesta. La edad media fue 15,1 años. 355 (35,0 %) estudiantes habían experimentado con cigarrillo, 70 (6,9 %) informaron fumar habitualmente y 18/70 (25,7 %) mostraron un alto riesgo de dependencia de la nicotina. Las variables que se asociaron con el consumo de cigarrillo fueron: ser estudiante de básica secundaria (OR 4,08; IC95 % 2,27-7,35), mayor de 15 años (OR 3,71; IC95 % 2,85-7,44), tener padre fumador (OR 2,47; IC95 % 1,42-4,31), ser varón (OR 2,37; IC95 % 1,40-4,00) y tener hermano fumador (OR 2,21; IC95 % 1,16-4,21). Conclusiones La prevalencia de consumo de cigarrillo es baja en estudiantes de bachillerato de Cartagena. La frecuencia de fumadores es mayor en estudiantes de básica secundaria, varones, mayores de quince años y en quienes el padre o el hermano es fumador

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

Relaciones entre los comportamientos de riesgo psicosociales y la familia en adolescentes de suba, bogotá

Objetivo Estimar las relaciones entre los comportamientos de riesgo de la población adolescente y la familia en torno a la estructura y la percepción de funcionalidad. Metodología Estudio observacional de corte transversal entre 12 302 adolescentes (10 a 19 años de edad), estudiantes de 12 colegios públicos de la localidad de Suba en el año 2006. Se aplicó una encuesta autodiligenciada donde se interrogó por comportamientos sexuales, adictivos, depresivos, violentos y de trastornos de conducta alimentaria. Resultados Se encontró una prevalencia de buena función familiar de 63 % y de disfunción familiar severa del 7 %. La disfunción severa aumentó la prevalencia de comportamientos violentos (OR de 4,1 con IC de 95 % 3,4 - 4,7), trastornos de conducta alimentaria (OR 2,3 con IC de 95 % de 1,9 – 2,8) y relaciones sexuales (OR de 2 con IC de 95 % de 1,7 - 2,4). Por el contrario, la composición de la familia (presencia o no de ambos padres) no mostró relación con comportamientos violentos. Conclusiones La disfunción familiar se asocia a una mayor frecuencia de conductas de riesgo en los adolescentes de bajo estrato socioeconómico en Bogotá. La relación más fuerte se observa entre violencia y familia

Policies and processes for human papillomavirus vaccination in Latin America and the Caribbean

e124Objectives. Three highly effective vaccines are available to prevent human papillomavirus (HPV) infection, and they have been introduced in many countries around the world. This article describes advances and challenges in introducing HPV vaccines in the Expanded Program of Immunization (EPI) of countries in Latin America and the Caribbean (LAC). Methods. We reviewed national and regional sources of information to identify LAC countries with and without universal HPV vaccination, along with the year of introduction, type of HPV vaccine, vaccination scheme, age groups targeted, and coverage level reached. Incidence rates of cervical cancer were compared across countries with and without an HPV vaccination program, in order to identify inequities in access to HPV vaccines. Results. So far, 10 LAC countries have supplied data on their vaccination policies and vaccination coverage rates to the Pan America Health Organization. The majority of those 10 started their vaccination programs using quadrivalent vaccine. Only Chile, Ecuador, and Mexico started their programs using a two-dose scheme. However, by the end of 2016, most of the other countries had switched from a three-dose to a two-dose scheme. Different age groups are targeted in the various programs. Some countries vaccinate one-year birth cohorts, while others vaccinate multiple-year birth cohorts. By the end of 2014, coverage with at least two doses ranged from a low of 2% to a high of 86%. With the exception of Venezuela, the LAC countries with the largest populations introduced universal HPV vaccination between 2010 and 2014. Despite the progress that has occurred in some LAC countries, there are still 10 LAC nations with cervical cancer rates above the LAC average (21.2 cases per 100 000) that have not introduced an HPV vaccine in their EPI. Conclusions. With several key adjustments, HPV vaccination programs across Latin America and the Caribbean could be substantially strengthened. Ongoing monitoring of HPV infection outcomes is needed in order to assess the impact of different vaccination policies

Evaluation of dengue fever reports during an epidemic, Colombia

OBJETIVO Evaluar la validez de la notificación de casos de dengue y su correspondencia con las definiciones de caso y de gravedad. MÉTODOS Evaluación de prueba diagnóstica con muestreo transversal a partir de un universo de 13.873 pacientes atendidos durante quinto periodo epidemiológico en instituciones de salud de 11 departamentos de Colombia, en 2013. La prueba en evaluación fue la notificación al Sistema Nacional de Vigilancia en Salud Pública y el estándar de referencia fue la revisión de historias identificadas mediante búsqueda activa institucional. Se revisó todas las historias de pacientes con diagnóstico de dengue y una muestra aleatoria de pacientes con síndromes febriles. Se estimó especificidad y sensibilidad de notificación ponderando por el inverso de la probabilidad de ser seleccionado. Se calculó la concordancia entre notificación y los hallazgos de la búsqueda activa institucional usando el estadístico Kappa. RESULTADOS Se incluyeron 4.359 pacientes febriles, 31,7% fueron clasificados compatibles con dengue (17 con dengue grave; 461 con dengue y signos de alarma; 904 con dengue sin signos de alarma). La sensibilidad global de la notificación fue 13,2% (IC95% 10,9;15,4) y la especificidad 98,4% (IC95% 97,9;98,9). La sensibilidad varió de acuerdo con la gravedad: 12,1% (IC95% 9,3;14,8) en pacientes con dengue sin signos de alarma; 14,5% (IC95% 10,6;18,4) en aquellos con dengue y signos de alarma y 40,0% (IC95% 9,6;70,4) en aquellos con dengue grave. La concordancia entre la notificación y los hallazgos de la búsqueda activa institucional mostró Kappa de 10,1%. CONCLUSIONES Se observó baja concordancia entre la notificación y la revisión de historias clínicas, que estuvo asociada a baja notificación de los casos compatibles con dengue, especialmente aquellos menos graves.OBJECTIVE: To assess the validity of dengue fever reports and how they relate to the definition of case and severity. METHODS: Diagnostic test assessment was conducted using crosssectional sampling from a universe of 13,873 patients treated during the fifth epidemiological period in health institutions from 11 Colombian departments in 2013. The test under analyses was the reporting to the National Public Health Surveillance System, and the reference standard was the review of histories identified by active institutional search. We reviewed all histories of patients diagnosed with dengue fever, as well as a random sample of patients with febrile syndromes. The specificity and sensitivity of reports were estimated for this purpose, considering the inverse of the probability of being selected for weighting. The concordance between reporting and the findings of the active institutional search was calculated using Kappa statistics. RESULTS: We included 4,359 febrile patients, and 31.7% were classified as compatible with dengue fever (17 with severe dengue fever; 461 with dengue fever and warning signs; 904 with dengue fever and no warning signs). The global sensitivity of reports was 13.2% (95%CI 10.9;15.4) and specificity was 98.4% (95%CI 97.9;98.9). Sensitivity varied according to severity: 12.1% (95%CI 9.3;14.8) for patients presenting dengue fever with no warning signs; 14.5% (95%CI 10.6;18.4) for those presenting dengue fever with warning signs, and 40.0% (95%CI 9.6;70.4) for those with severe dengue fever. Concordance between reporting and the findings of the active institutional search resulted in a Kappa of 10.1%. CONCLUSIONS: Low concordance was observed between reporting and the review of clinical histories, which was associated with the low reporting of dengue fever compatible cases, especially milder cases.OBJECTIVE To assess the validity of dengue fever reports and how they relate to the definition of case and severity. METHODS Diagnostic test assessment was conducted using cross-sectional sampling from a universe of 13,873 patients treated during the fifth epidemiological period in health institutions from 11 Colombian departments in 2013. The test under analyses was the reporting to the National Public Health Surveillance System, and the reference standard was the review of histories identified by active institutional search. We reviewed all histories of patients diagnosed with dengue fever, as well as a random sample of patients with febrile syndromes. The specificity and sensitivity of reports were estimated for this purpose, considering the inverse of the probability of being selected for weighting. The concordance between reporting and the findings of the active institutional search was calculated using Kappa statistics. RESULTS We included 4,359 febrile patients, and 31.7% were classified as compatible with dengue fever (17 with severe dengue fever; 461 with dengue fever and warning signs; 904 with dengue fever and no warning signs). The global sensitivity of reports was 13.2% (95%CI 10.9;15.4) and specificity was 98.4% (95%CI 97.9;98.9). Sensitivity varied according to severity: 12.1% (95%CI 9.3;14.8) for patients presenting dengue fever with no warning signs; 14.5% (95%CI 10.6;18.4) for those presenting dengue fever with warning signs, and 40.0% (95%CI 9.6;70.4) for those with severe dengue fever. Concordance between reporting and the findings of the active institutional search resulted in a Kappa of 10.1%. CONCLUSIONS Low concordance was observed between reporting and the review of clinical histories, which was associated with the low reporting of dengue fever compatible cases, especially milder cases

Paracoccidioidomicocis: definición de las áreas endémicas de Colombia

An endemic disease is one that is constantly present within a geographical area or population group; the definition of endemia also encompasses the usual prevalence of a disease within a defined area or a determined group. The aim of this work was to establish the endemicity of paracoccidioidomycosis in the 32 Colombian departments (political divisions) and to associate it with certain geographical characteristics such as altitude. A retrospective study was carried out from 1949 to 1999. The data collected referred to the year of diagnosis and patients' residence locality, while the information was derived from four different mycology laboratories, two pathology services and the Colombian publications on the disease. The incidence rate for department was obtained from three individual censuses. 1973, 1985 and 1993. as well as from projections for 1990 and 1995. Definition of endemic areas was based on the distribution of case frequencies by place and time. Statistical rneasurements used were the median and the quartiles. In the 50-year period 1,191 cases had been recorded and were analyzed here. Based on the total number of cases diagnosed for department, 9 were classified as endemic, having reported more than 32 cases per year; 8 of them belonged to the Andean region and 1 to the Sierra Nevada of Santa Marta. Eighteen departments were catalogued as low endemic regions, as they had reported only 2-27 cases, while the remaining 5 reported 1 or no cases and were considered non-endemic. In the period from 1980 to 1998, 8 departments diagnosed the disease regularly for 13-19 years, and they were classified as endernic. Fifteen departments were considered of low endemicity as they informed the rnycosisfor only 2-12 years. while 10 were regarded as non-endemic because they informed cases for less than 1 year Both analyses agreed in cataloguing 8 departments as endemic. The higher national incidence was obtained in 1980 with 2.4 patients/1'000.000 inhabitants. The incidence rate of the disease was found to be an inadequate pararneter to define endemicity. The findings corroborate that the distribution of paracoccidioidomycosis in Colombia is heterogeneous, and, additionally, offer an alternative way to study the habitat of the etiological agent.Una enfermedad endémica es aquélla que se presenta constantemente en un área geográfica o en un grupo de población; la definición de endemia abarca, también, la prevalencia usual de una enfermedad en un área o grupo determinado. El objetivo de este estudio fue el establecer la endemicidad de la paracoccidioidomicosis en los 32 departamentos colombianos y asociarla con algunas de las caracteristicas geográficas correspondientes a estas áreas. Se realizó un estudio retrospectivo de 1949 a 1999, para el cual sirvieron como fuentes de información cuatro laboratorios de micología, dos servicios de patologia y, además, la literatura colombiana. Las principales variables consignadas fueron el año de diagnóstico y la procedencia de los pacientes. Se calcularon las tasas de incidencia por departamento con base en los censos de 1973, 1985, 1993 y en sus proyecciones para 1990 y 1995. La definición de áreas endémicas estuvo basada en la distribución de los casos por lugar y tiempo, usando como medidas estadísticas la media y los cuartiles. Estas medidas se aplicaron al total de casos diagnosticados por departamento y a su diagnóstico anual. Se analizaron 1.191 casos en un periodo de 50 años. Con base en el número total de casos diagnosticados por departamento, 9 de ellos se clasificaron como endémicos ya que informaron más de 32 casos por año; 8 correspondieron a la región andina y 1 a la Sierra Nevada de Santa Marta. Dieciocho departamentos se catalogaron como regiones de baja endemicidad (2-27 casos) y los 5 restantes, como no endémicos (1 caso). Entre 1980-1998 y con base en el diagnóstico anual de casos, se encontraron 8 departamentos que habían diagnosticado la enfermedad por periodos de 13 a 19 años, lo que permitió clasificarlos como endémicos; adicionalmente. 15 fueron considerados de baja endemicidad, con base en un período de diagnóstico de 2 a 12 años: los restantes 10 fueron clasificados como no endémicos por haber informado la entidad solamente en un 1 año. Ambos análisis coincidieron en catalogar 8 de los departamentos como endémicos. La incidencia nacional más alta se obtuvo en 1980 con 2,4 pacientes/1'000.000 habitantes. La tasa de incidencia de la enfermedad no constituyó un parámetro adecuado para la definición de endemicidad. Estos hallazgos corroboran que la distribución de la paracoccidioidomicosis en Colombia es heterogénea y, además. ofrecen una alternativa para determinar el hábitat del agente etiológico por medio de estudios de campo