Association of nutritional support programs with zinc deficiency in Colombian children: a cross-sectional study

Background: Zinc is an essential trace element that plays a key role in the immune, gastrointestinal, respiratory and nervous systems. In Colombia, a vast percentage of children live in low-income households with food insecurity and nutritional deficiencies, including zinc. In an effort to improve children's well-being, public health measures such as nutritional support programs that provide meals have targeted the poorest populations. The aim of the present study was to assess the role of nutritional support programs on zinc deficiency in Colombian children, while considering their wealth and food security.Methods: Cross-sectional study using data from the 2010 Colombian National Nutrition Survey, a population-based study representative of Colombia. A total of 4275 children between 12 and 59months of age were included in the study. Stepwise logistic regressions were modelled with SPSS, first for zinc deficiency on wealth and food security, then adding enrolment in a nutritional support program, and finally, adjusting for socio-demographic variables.Results: A zinc deficiency prevalence of 49% was found. The adjusted models showed an association of wealth quintiles: very poor (OR=1.48) and poor (OR=1.39), food security (OR=0.75) and enrolment in a nutritional support program (OR=0.76) with zinc deficiency. Enrolment in nutritional programs did not modify the relationship of wealth and food security to zinc deficiency.Conclusion: Zinc deficiency is associated with wealth, food security and enrolment in nutritional support programs. Nutritional programs may be a good alternative against zinc deficiency, if they focus appropriately on the needs of children according to their wealth and food security

Work-related injuries among child street-laborers in Latin America: Prevalence and predictors

Objectives. To determine the prevalence and nature of occupational injuries among children working in the streets of four major cities in Latin America, as well as to identify factors that predict these work-related injuries. Methods. This cross-sectional study interviewed 584 children from 5-17 years of age working on the streets of Bogota, Colombia; Lima, Peru; Quito, Ecuador; and São Paulo, Brazil. Descriptive analyses and multivariate logistic regressions were conducted, with incidence and serious injuries regressed on occupational and sociodemographic variables. Results. Approximately 39.6% of the child street-laborers surveyed reported an injury sustained while working in the streets: scratches (19.5%), cuts/lacerations (16.4%), bums (8.6%), car accidents (8.9%), sprains (4.6%), and amputations (0.3%). Working a high number of daytime hours and performing on the street predicted the greatest risk of injury, even after controlling for sociodemographic factors; specifically, each additional hour of daytime work increased the risk of injury by 1.4%. Child performers had three times the injury rate of children primarily selling products. Boys, older children, and children in Quito were more likely to experience moderate-to-severe injuries, than girls, younger children, and street children in the other study cities. Conclusions. Interventions are needed to address the substantial risk of injury experienced by children working on the city streets of Latin America

Reduction of malnutrition prevalences through health promotion in groups of school-aged children in a locality of Bogota

La desnutrición es una condición prevalente en la etapa escolar, que conlleva consecuencias en la salud y en el rendimiento escolar de los niños, a corto y a largo plazo. El objetivo del trabajo fue identificar los cambios en las prevalencias de desnutrición en grupos de niños, quienes fueron intervenidos con una estrategia que combinó actividades educativas, evaluación y acciones de intervención directa a casos problemáticos, por parte de estudiantes de medicina, en el periodo 2001-2005. Este estudio corresponde a la evaluación del programa de salud pública “Salud Escolar Integral”, instituido por la Facultad de Medicina y Ciencias de la Salud de la Universidad del Rosario. Para dicha evaluación, se realizó un estudio ecológico con mediciones antes y después a una intervención en grupos seleccionados de estudiantes, entre 5 y 8 años de edad. Cada año, se determinó la prevalencia de desnutrición aguda, crónica y global. En los cinco años de seguimiento, se evidenció una disminución estadísticamente significativa de las prevalencias de desnutrición aguda, de 4,5 a 0,6%; de desnutrición global, de 11,8 a 5,8% y de desnutrición crónica, de 16,4 a 8,3%. Este estudio presenta evidencia sobre la efectividad que puede tener un programa de intervención integral, desarrollado por estudiantes de medicina, sobre el estado nutricional de los niños.Malnutrition is prevalent in school aged children. It impairs the health and school performance of those affected in the short and in the long run. The objective of this study was to identify the changes in the prevalence of malnutrition in groups of school-aged children that were intervened by medical students with a strategy that combined educational activities, health evaluation, and actions directed to children with particular problems. This article presents the evaluation of the program “Salud Escolar Integral” [Comprehensive School Health]. This program was conducted by medical students from Universidad del Rosario School of Medicine and Health Sciences. An ecological study was done with measures before and after intervention. Population: Elementary school students from 5 to 8 years of age. Acute, chronic, and global undernourishment were calculated. During the five years of monitoring an statistically significant decrease was found in the prevalence of acute malnutrition from 4.5 to 0.6%, global malnutrition from 11.8 to 5.8%, and chronic malnutrition from 16.4 to 8.3%. This study presents evidence on the effectiveness of a comprehensive interventional program developed by medical students to decrease undernourishment on school age children.Incluye referencias bibliográfica

Low birth weight and prenatal care in Colombia: A cross-sectional study

Background: Low birth weight (LBW) is one of the most important factors affecting child morbidity and mortality worldwide; approximately one third of neonatal deaths are attributable to it. Most research and public health policy on LBW arise from developed nations, despite that most cases (96.5%) take place in developing countries. The specific features of prenatal care that prevent LBW in developing countries are unclear. This study aims to identify the characteristics of prenatal care associated with LBW in a developing country as Colombia. Methods: Observational cross-sectional study using data from the Colombian Demographic and Health Survey 2010. A total of 10,692 children were included. Descriptive statistics were calculated, followed by bivariate regressions of LBW with all other study variables. Finally, stepwise logistic binomial regression analyses were done. Results: A LBW prevalence of 8.7% was found. Quality of prenatal care (95%CI: 0.33, 0.92; OR=0.55), number of prenatal visits (95%CI: 0.92, 0.93; OR=0.92), and first prenatal visits during pregnancy (95%CI: 1.02, 1.07; OR=1.08) were associated with LBW even after controlling for all the studied variables. The health care provider conducting prenatal checkup, and insurance coverage, were not associated with LBW. Conclusion: This research provides information on the characteristics of prenatal care (quality, number of visits, and gestational age at first prenatal visit) which may strengthen LBW prevention in Colombia and possibly in countries with similar socioeconomic characteristics. © 2015 Pinzón-Rondón et al

Care coordination in two of Bogota’s public healthcare networks: A cross-sectional study among doctors

Introduction: Care coordination is a priority concern for healthcare systems. In Colombia, there is a lack of information on the topic. This study analysed how doctors of two Bogotá’s public healthcare networks perceived coordination between healthcare levels and what factors are associated with their perception. Methods: A cross-sectional study using the COORDENA-CO questionnaire to a sample of 363 doctors (network-1 = 181; network-2 = 182) in 2015. The questionnaire asks about types and dimensions of care coordination: information and clinical management, with items in a Likert scale, as well as conditions regarding health system, organisational and doctors’ conditions. Descriptive statistics and logistic regression analysis were performed. Results: The doctors’ perception of a high level of coordination did not exceed 25.4%. On coordination of information, limited transfer of clinical information was found. Concerning clinical management, there were limited care coherence, deficits in patient follow-up and lengthy waiting times for specialised care. A high perception of coordination were associated with being female, being over 50 years old, being a specialist, having less than one year’s working experience, working less than 20 h per week at the centre, forming part of network-1, having time available for performing coordination tasks, having job satisfaction and not identifying limitations imposed by healthcare insurers. Discussion: There was limited perception of coordination, in its different dimensions and types with some differences between networks. The results support the importance of guaranteeing job satisfaction, ensuring sufficient time to coordination-related activities and intervening in the restrictions imposed by healthcare insurers to improve care coordination. © The Author(s) 2019

Sexually-transmitted disease prevalence and the factors associated with it in sexually-exploited children in Bogota, Colombia.

Objective Presenting the characteristics of a group of children who have been sexually exploited in Bogota, determining the prevalence of sexually-transmitted disease (STD) in this group of children and establishing the factors associated with STD in this population. Methodology This was a descriptive, cross-sectional study. The medical charts of children aged 10 to 17 years who sought medical attention at Fundación Renacer between January 2002 and June 2004 were reviewed. The analysis included descriptive statistics, correlations and binomial logistic regression. Results 255 children's charts were included, producing the following characteristics: being female (58.8%), average age was 15.4, 5.9% were affiliated to social security, 89.8% engaged in substance abuse, 41.2% used family planning, 3.9% used a condom during every intercourse and there were 0.86 average pregnancies per female adolescent. Sexually-transmitted disease prevalence was 30.9%. The most common diseases were condilomatosis and Neisseria gonorrhoeae infection. Substance abuse and infrequent condom use were associated with a diagnosis of STD. Conclusion Child sexual exploitation is a reality in Colombia. In spite of the limitations of this study, it can be concluded that STDs are an important problem in the sexually-abused child population in Bogota. Preventing child sexual exploitation and integral attention for these children (including health service provision) must become a priority

Hospitalización domiciliaria pediátrica en el Instituto de Ortopedia Infantil Roosevelt en Bogotá, Colombia: enero a julio, 2013

Introducción: La hospitalización domiciliaria ha surgido como una alternativa a la hospitalización tradicional, ya que brinda un mejorambiente durante la recuperación del paciente. El objetivo del estudio fue medir la tasa de reingreso de la hospitalización domiciliariadentro del Instituto de Ortopedia Infantil Roosevelt en Bogotá, Colombia. Materiales y método: Estudio de corte transversal. Se incluyeron661 niños afiliados al programa de hospitalización domiciliaria entre enero y julio del 2013. Resultados: La tasa de reingreso en las primeras72 horas fue del 2% (13 pacientes), siendo mayor en los recién nacidos (OR 4,2 - p=0,039) y patologías cráneo faciales (OR 12,1 - p=0,046).Esta tasa de reingreso fue menor que aquella evaluada en otro estudio en los que consideraron, a diferencia del presente estudio, a niñossin criterios de hospitalización; además de representar menores costos para el sistema de salud. Conclusión: Se observó una tasa dereingreso hospitalario del 2% en las primeras 72 horas lo cual permite considerar la hospitalización domiciliaria como una alternativa válidapara el paciente pediátrico. MÉD.UIS. 2016;29(3):43-8.Palabras clave: Servicios de Atención de Salud a Domicilio. Pediatría. Efectividad. Readmisión del Paciente

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

La Quinta Mutis, 50 años atrás

Mi recuerdo de la Quinta de Mutis se remonta a los años 50. Era un colegio de bachillerato con internado, en una especie de finca con sabor a hogar. Vimos desfilar grupos de muchachos costeños, vallunos, santandereanos, huilenses, etc., atendidos todos por profesores competentes dedicados por completo a ello