La pandemia de gripe de 1918–1919 en Bogotá y Boyacá, 91 años después

ResumenIntroducciónLa pandemia de gripa de 1918–1919 causó la mayor mortalidad en la historia en corto tiempo. Se estima que entre 20 millones y 50 millones de personas fallecieron en menos de un año. Los historiadores de Europa y Estados Unidos registran tres oleadas, con mayor impacto en octubre y noviembre (80% de la mortalidad), que afectaron la población económicamente activa. La gripa nos ha acompañado en América desde el segundo viaje de Colón, probablemente asociada a la importación de cerdos y caballos infectados.Materiales y métodosSe describen las condiciones sociales y de salud en Bogotá y Boyacá, a partir de fuentes documentales de la época. Las tasas de mortalidad se calcularon a partir de los registros de la Iglesia.ResultadosLas condiciones de pobreza y hacinamiento acentuaron la letalidad. La iniciativa privada asumió el control y la atención de las víctimas, dada la ineficiencia de las auautoridades. Se recolectaron 106.484 registros de defunción del periodo 1912–1927, 9,5% (10.123 muertes) por gripa. Entre octubre y noviembre de 1918, hubo 2.019 muertes en Boyacá, con una tasa de 4,8 por 1.000 habitantes, y predominio en menores de 5 años y en ancianos; no se observaron oleadas. La mayor altura sobre el nivel del mar resultó ser un factor de riesgo para la muerte por gripa.DiscusiónLas condiciones actuales favorecen una nueva pandemia. Los nuevos medios de transporte podrían aumentar la velocidad de transmisión de la infección. Se hace necesario conocer el pasado y las implicaciones en la mortalidad para evitar repetir los errores en el futuro.AbstractIntroductionThe pandemic Flu of 1918–19 was the cause of the greatest mortality in history, in a very short period of time. An estimated mortality between 20 and 50 million deaths/year was calculated. The European and American researchers registered three different epidemic peaks, with a special impact between October and November (80% mortality), affecting a large proportion of the economically active population. Since Colombo's second travel, the Flu has been within us, probably associated with the presence infected pigs and horses, brought by the Spaniards.Materials and methodsWe describe the social and health conditions in Bogotá and Boyacá, from documentary sources of the time. Mortality rates were estimated from Church records.ResultsPoverty and overcrowding conditions increased the epidemic lethality. As a result of the inefficiency of the authorities of that time, the control and care of victims were assumed by private organizations. We collected 106,484 records from death certificates, since 1912 until 1927; 9.5% (10,123 deaths) were caused by flu. The mortality rate attributed to the Flu was 4.8 per 1,000 people (2,019 deaths) between October and November of 1918. Children under 5 years and the elder people were mainly affected by Flu. The highest altitude above sea level was a risk factor for Flu mortality and non epidemic waves were observed.DiscussionDue to current general conditions, a new epidemic is possible. New means of transportation may increase its transmission rate. Lessons from the past can lead us to avoid repeating same mistakes in the future

Sighting of tingua moteada, (gallinula melanops bogotensis chapman 1914) order : gruiformes family, rallidae, in weatlands of Paipa and Duitama, Boyacá, Colombia.

Se presenta un avistamiento de Gallinula melanops bogotensis Chapman 1914, en algunos humedales del municipio de Paipa e inmediaciones del municipio de Duitama, Boyacá, durante los meses de diciembre de 2016 a marzo de 2017, el cual reporta un total de cinco (5) individuos adultos y cuatro (4) polluelos en estado juvenil. Se realizan observaciones directas de su comportamiento, alimentación, reproducción, cambios en su morfología, tamaños, colores de plumas y picos, se identificó la especie y se contrastó con la lista de especies amenazadas para Colombia, obteniendo la categoría de estado crítico de acuerdo con los criterios de la Unión Internacional para la Conservación de la Naturaleza.A sighting of Gallinula melanops bogotensis Chapman 1914, in some wetlands of the municipality of Paipa and near the municipality of Duitama, Boyacá, from December 2016 to March 2017, reporting a total of five (5) adult individuals and four (4) young birds, is presented. Direct observation of their behavior, feeding, reproduction, changes in their morphology, sizes, colors of feathers and beaks were carried out. The species was identified and it was contrasted with the list of threatened species for Colombia obtaining the critical status category in accordance with the criteria of the International Union for Conservation of Nature (IUCN)

Consumo de alcohol y tabaco en escolares y adolescentes de tunja, colombia, 2009

Objetivo Caracterizar, el consumo de tabaco y alcohol y los factores psicosociales de riesgo y de protección para el consumo en estudiantes de Secundaria/Media Académica o Técnica de Tunja durante el año 2009. Métodos Estudio de prevalencia. Se evaluaron la prevalencia y factores determinantes del consumo en una muestra de 1 515 escolares de entre 13 y 18 años de edad matriculados en los grados 8° a 11°. Resultados Media de edad 15,2 años (SD=1,42); 50,2 % mujeres; prevalencia de vida: bebidas alcohólicas 73,47%, embriaguez 51,68 %, cigarrillos 50,56 %. Principales determinantes del consumo: familia disfuncional, presión e influencia de pares y grupo, dificultades académicas, conflictos con padres o tutores. Edad media de inicio: período transicional entre los 12 y los 13 años. Se reporta casi absoluta libertad para acceder a las bebidas alcohólicas y a los cigarrillos. Conclusiones Se encuentra que la frecuencia de consumo de alcohol y tabaco es bastante alta en este grupo de edad, además que los determinantes asociados son factores susceptibles de intervenciones educativas que deben considerarse prioritarias, en particular las que tienen que ver con el ambiente familiar y el grupo de pares, dada la enorme influencia que los compañeros y miembros de colectivos deportivos o recreacionales pueden tener sobre los adolescentes de este grupo de edad

Cuestionario de calidad del cuidado de enfermería (CUCACE): Validez y fiabilidad en Colombia

Objetive To determine the validity and reliability of the CUCACE (Quality of Nursing Care Questionnaire) in Colombia. Every day there is a growing interest in measuring the quality of care received from nursing personnel as a tangible element of care; however, not having reliable and valid instruments is an obstacle, especially in Colombia. Method A psychometric and evaluative instrumental study was conducted. Data of interest from CUCACE filled out in Spanish were extracted together with demographic information of the participants. Results Confirmed the validity of the content and construct validity of the scales of care, attention to nursing care and the perception of care in a Colombian hospital. Cronbach’s alpha was higher than 0.7, and its reliability is accepted in the context. Conclusion The CUCACE is adequate to measure the satisfaction and experience of patients with nursing care in the Colombian context. The questionnaire with its two scales is useful, clear, precise, valid and reliable to evaluate the quality of nursing care.Objetivo Determinar la validez y confiabilidad del CUCACE (Cuestionario de Calidad de la Atención de Enfermería) en Colombia. Cada día hay un interés creciente en medir la calidad de la atención recibida por parte del personal de enfermería como elemento tangible de la atención; sin embargo, un obstáculo para medir la satisfacción del paciente es la no tenencia de instrumentos confiables y válidos, especialmente en Colombia. Método Se realizó un estudio instrumental psicométrico y evaluativo. Se extrajeron datos de interés del CUCACE cumplimentados en español, junto con la información demográfica de los participantes. Resultados Se confirmó la validez del contenido y construcción de las escalas de atención, atención al cuidado de enfermería y percepción del cuidado en un hospital colombiano. El alfa de Cronbach fue superior a 0,7; por lo tanto su fiabilidad se acepta en el contexto. Conclusión El CUCACE es adecuado para medir la satisfacción y experiencia de los pacientes con los cuidados de enfermería en el contexto colombiano. El cuestionario con sus dos escalas es útil, claro, preciso, válido y confiable para evaluar la calidad de la atención de enfermería

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Objetivo: determinar propiedades psicométricas de los instrumentos desarrollados por la OPS para evaluar  la calidad y la efectividad potencial de material educativo. Materiales y métodos: se utilizaron instrumentos  diseñados por la OPS para evaluar la calidad de material educativo en salud, diseñado durante el primer  semestre del 2010. La evaluación fue realizada por grupos de usuarios del material, así: para material  audiovisual, n=74; material impreso, n=116; material sonoro, n=37; material visual: n=71. Para cada  instrumento se evaluó la factoriabilidad mediante las pruebas de Kaiser-Meyer-Olkin y de esfericidad de  Bartlett. Posteriormente, se determinó la consistencia interna y estructura factorial del instrumento  mediante la estimación del alfa de Cronbach, y el análisis factorial por el método de extracción de  componentes principales. Resultados: todos los instrumentos fueron factorizables. El alfa de Cronbach para  material audiovisual fue 0,687; la extracción de ejes principales reportó cuatro factores. Para material  impreso: alfa de Cronbach de 0,83; la extracción de componentes principales arrojó un solo factor  Cronbach  = 0,73 y se extrajeron tres componentes principales. Para el material visual se encuentra alfa de Cronbach =  0,66 con tres componentes principales. Conclusiones: los instrumentos diseñados por la OPS para evaluar  material educativo constituyen una herramienta confiable para evaluar los criterios de atracción,  entendimiento, identificación y aceptación; se hace necesario profundizar en el análisis estructural de estos;  no evalúan el criterio de inducción a la acción que otros autores referencian.Objective: to determine psychometric properties of the instruments developed by PAHO to assess quality  and potential effectiveness of educational material. Materials and methods: instruments designed by PAHO  to assess the quality of health educational materials designed during the first semester 2010 were used. The  evaluation was carried out through materials user groups as follows: audiovisual material, n = 74; printed  material, n = 116; audio recordings, n = 37; visual material, n = 71. Factorability was evaluated for each one of  the instruments by using Kaiser -Meyer-Olkin`s test and sphericity was evaluated with Bartlett’s test. Internal  consistency and factorial structure of the instrument were determined later using Cronbach’s alpha estimate  and the factorial analysis was carried out using the main components extraction method. Results: all  instruments were factorable. Cronbach’s alpha for audiovisual material was 0.687; extraction of principal  axes reported 4 factors. For printed material: 0.83Cronbach’s alpha; the extraction of principal components  showed a single factor which explains 45.1% of the variance. In the audio material it was found 0.73  Cronbach`s alpha and three major components were extracted. For visual material Cronbach’s alpha is = 0.66  with three main components. Conclusions: the instruments designed by PAHO to assess educational  materials are a reliable tool for assessing the attraction, understanding, identifying and accepting criteria;  however, it is necessary to go deeper in their structural analysis. The do not assess the induction to action  criterion referenced by other authors

Prevalencia de factores de riesgo para enfermedades cardiovasculares en Tunja, Colombia. 2007

Las altas frecuencias de hospitalización y mortalidad por enfermedad cardiovascular en las IPS’s de segundo y tercer nivel de Tunja, ameritan un análisis de factores de riesgo. El Objetivo del presente trabajo es evaluar la prevalencia de obesidad, diabetes e hipertensión arterial en una muestra representativa de la población de Tunja (Colombia) y su posible asociación con factores sociodemográficos en función del área geográfica de residencia

Validity and reliability of the Font-Roja job satisfaction questionnaire in Colombia

Objetivo: determinar la validez y confiabilidad del Font Roja para medir la satisfacción laboral en profesionales de la salud en Colombia, diseñado por Aranaz y Mira en el año de 1988. Metodología: estudio instrumental psicométrico que determinó la validez facial de contenido y de constructo con métodos estadísticos y confiabilidad del cuestionario. La muestra n=120 para la validez de constructo fue recolectada en diversas ciudades de Colombia por profesionales de enfermería en ejercicio vinculados a instituciones prestadoras de servicios de salud. Resultados: el Font Roja reporta validez superior a 0,71 en contenido y facial, se extrajeron 8 factores que explican el 67,5% de la varianza mediante análisis factorial. El instrumento es fiable con un Alfa de Cronbach de 0,80. Es necesario mantener la escala íntegramente sin suprimir ítems. Conclusión: la versión en español del Font Roja como instrumento de medición de la satisfacción laboral resulta válido y fiable en el contexto colombiano.Objective: to determine the validity and reliability of Font-Roja job satisfaction questionnaire designed by Aranaz and Mira, 1988, to measure job satisfaction in health professionals in Colombia. Methodology: psychometric instrumental study that determined the facial validity of content and construct with statistical methods and reliability of the questionnaire. The sample (n = 120) for construct validity was collected by intern nurses linked with institutions providing health services in various cities of Colombia. Results: Font-Roja job satisfaction questionnaire reported validity higher than 0.71 in content and facial; 8 factors were extracted that explain 67.5% of the variance by factor analysis. The instrument is reliable with a Cronbach’s alpha of 0.80. It is necessary to maintain the scale in its entirety without deleting items. Conclusion: the Spanish version of Font-Roja job satisfaction questionnaire as an instrument to measure job satisfaction is valid and reliable in the Colombian context

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Health, environment and work in vulnerable populations: potato farmers in center county of Boyacá

Objective: to describe the environmental, social, health, and labor conditions in a sample of potato farmers in a central county of Boyacá, Colombia. Materials and methods: cross sectional and descriptive study. A sample of 1.410 potato farmers from seven municipalities who were invited to answer a previously designed survey. Housing conditions, labor and socioeconomic environment, perceived illness and health attention and selfcare practices were evaluated. Results: the mean age was 44.5 years; 7.8% of illiterateness; 51,3% has not finished primary education; only 7.1% finished high school; the self-declared monthly average income was approximately US$115.34; only 1.8% perceives economic benefits; 73.4% resides in own housing; 82% is exposed to pesticides and herbicides; 31.5% are obese; 76.9% consumes alcoholic drinks; (81.9% male and 66,7% female); the mean frequency of consumption is 3.75 per week (s d = 2.35); the favorite drinks are beer and guarapo. The coverage of health promotion and prevention programs are less than 30%. Conclusions: the main risk factors identified were the low educational level, high percentage of exposure to pesticides and herbicides, overweight due to unbalanced diet, reduced incomes, high levels of alcohol consumption and limited conditions in geographical and cultural accessibility to health attention and promotion services