Cultivos de Coca: Economía y Violencia en Municipios de Colombia 2012 – 2019.

Coca cultivation in Colombia is related to multiple problems that primarily affect the rural areas of the country. This article aims to expose the determining factors that explain the presence of coca plantations in the municipalities of Colombia for the period 2012 - 2019. To do so, a panel data model is developed to obtain results that, although not homogeneous across the territory, indicate that overall, increases in the municipal violence index are positively associated with the growth of coca cultivation hectares in Colombia's municipalities in the short term. The findings suggest that only a quarter of coca cultivation is reduced for every hectare sprayed and increases by 0.22 for every hectare eradicated manually, highlighting the ineffectiveness of anti-drug policy. It is necessary to look for alternatives to try to reduce the supply of the crop, differentiating the needs of each region of the country. In terms of the economy, the only sector that influences the reduction of cultivation is the secondary sector and the fiscal performance index.Los cultivos de coca en Colombia se relacionan con múltiples problemas que afectan primeramente al área rural del país. Este artículo tiene como objetivo exponer factores determinantes que explican la presencia de los cultivos de coca en los municipios de Colombia para el periodo 2012 – 2019. Para ello, se desarrolla un modelo de panel de datos que permite obtener unos resultados que, aunque no son homogéneos en todo el territorio, indican que globalmente los incrementos en el índice de violencia municipal están asociados de manera positiva con el crecimiento de las hectáreas de cultivos de coca en los municipios de Colombia en el corto plazo. Los hallazgos sugieren que se reduce únicamente una cuarta parte del cultivo por cada hectárea asperjada y se incrementa en 0,22 por cada hectárea erradicada manualmente, poniendo en evidencia la ineficacia de la política antidrogas. Es necesario buscar alternativas para tratar de reducir la oferta del cultivo, diferenciando las necesidades por cada región del país. En cuanto a la economía, el único sector que influye en la reducción del cultivo es el sector secundario y el índice de desempeño fiscal

Subcutaneous anti-COVID-19 hyperimmune immunoglobulin for prevention of disease in asymptomatic individuals with SARS-CoV-2 infection: a double-blind, placebo-controlled, randomised clinical trialResearch in context

Summary: Background: Anti-COVID-19 hyperimmune immunoglobulin (hIG) can provide standardized and controlled antibody content. Data from controlled clinical trials using hIG for the prevention or treatment of COVID-19 outpatients have not been reported. We assessed the safety and efficacy of subcutaneous anti-COVID-19 hyperimmune immunoglobulin 20% (C19-IG20%) compared to placebo in preventing development of symptomatic COVID-19 in asymptomatic individuals with SARS-CoV-2 infection. Methods: We did a multicentre, randomized, double-blind, placebo-controlled trial, in asymptomatic unvaccinated adults (≥18 years of age) with confirmed SARS-CoV-2 infection within 5 days between April 28 and December 27, 2021. Participants were randomly assigned (1:1:1) to receive a blinded subcutaneous infusion of 10 mL with 1 g or 2 g of C19-IG20%, or an equivalent volume of saline as placebo. The primary endpoint was the proportion of participants who remained asymptomatic through day 14 after infusion. Secondary endpoints included the proportion of individuals who required oxygen supplementation, any medically attended visit, hospitalisation, or ICU, and viral load reduction and viral clearance in nasopharyngeal swabs. Safety was assessed as the proportion of patients with adverse events. The trial was terminated early due to a lack of potential benefit in the target population in a planned interim analysis conducted in December 2021. ClinicalTrials.gov registry: NCT04847141. Findings: 461 individuals (mean age 39.6 years [SD 12.8]) were randomized and received the intervention within a mean of 3.1 (SD 1.27) days from a positive SARS-CoV-2 test. In the prespecified modified intention-to-treat analysis that included only participants who received a subcutaneous infusion, the primary outcome occurred in 59.9% (91/152) of participants receiving 1 g C19-IG20%, 64.7% (99/153) receiving 2 g, and 63.5% (99/156) receiving placebo (difference in proportions 1 g C19-IG20% vs. placebo, −3.6%; 95% CI -14.6% to 7.3%, p = 0.53; 2 g C19-IG20% vs placebo, 1.1%; −9.6% to 11.9%, p = 0.85). None of the secondary clinical efficacy endpoints or virological endpoints were significantly different between study groups. Adverse event rate was similar between groups, and no severe or life-threatening adverse events related to investigational product infusion were reported. Interpretation: Our findings suggested that administration of subcutaneous human hyperimmune immunoglobulin C19-IG20% to asymptomatic individuals with SARS-CoV-2 infection was safe but did not prevent development of symptomatic COVID-19. Funding: Grifols