THE ASSOCIATION OF VIOLENCE WITH YOUNG CHILDREN'S PHYSICAL HEALTH IN COLOMBIA

The association of violence with the physical health of children under five years of age in Colombia is studied through the lens of three major theories: biological stress theory, family stress theory, and ecological theory. The analysis explores the association of harsh parental discipline and intimate partner violence with child health, as well as the association of community violence with child health, parental discipline, intimate partner violence, and the relations among them. Secondary data from the Colombian Demographic and Health Survey 2005 and the Colombian National Census 2005 were analyzed. A total of 10,681 children under five years of age from 230 municipalities were included in the analyses. Analyses were conducted at the family and community levels. In the family level models, parental harsh discipline and intimate partner violence were associated with poor child health. Families who used harsh discipline had children with approximately 8% more symptoms of poor health than those who didn't use such punitive practices and families who experienced intimate partner violence had children with approximately 20% more symptoms than those who did not experience such violence. In the multilevel models, community violence and intimate partner violence predicted poor child health while parental harsh discipline failed to predict it. Children living in violent communities had 16% more symptoms of poor health than those living in nonviolent communities, and children from families that experienced intimate partner violence had on average 18% more symptoms of poor health than those living in families without intimate partner violence. Despite the study limitations, mainly its cross-sectional nature and restraints imposed by secondary data, the results indicate that violence is related to young Colombian children's poor physical health. These findings suggest the need to continue studying the effects of violence on health outcomes in different populations, as well as to provide support for efforts to promote violence prevention programs in Colombia

Editorial

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La Quinta Mutis, 50 años atrás

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Prevalencia y factores asociados al embarazo y su reincidencia en adolescentes colombianas

Introducción: El embarazo en adolescentes es uno de los problemas de salud pública más relevantes a nivel mundial. En Colombia, las políticas no han sido efectivas para disminuir la tasa de embarazo en edades tempranas, ni para impedir la reincidencia de la gestación. Este estudio caracteriza esta problemática determinando la prevalencia y los factores asociados tanto del embarazo en adolescentes como de su reincidencia. Métodos: Estudio de corte transversal comparativo a partir de 13,313 adolescentes colombianas respondientes de la Encuesta Nacional de Demografía y Salud, 2010. Se realizaron regresiones multinomiales para comparar el grupo de adolescentes no embarazadas con las que tuvieron uno o varios embarazos y regresión logística para comparar el grupo de embarazo único y el reincidente. Resultados: El 13.3% tuvieron un embarazo y el 3.5% más de uno. Al comparar con las adolescentes que no se embarazaron: a) las adolescentes que tuvieron un embarazo fueron mayores, convivían con su pareja, vivían con más personas, fuera de la familia de origen y habían sido víctimas de abuso sexual y maltrato físico. La probabilidad de embarazo disminuyo en aquellas adolescentes que tenían más recursos económicos, deseaban un menor número de hijos, asistían al colegio, habían usado planificación familiar y recibido educación sexual. b) En las adolescentes que tuvieron más de un embarazo se asociaron los mismos factores sin embargo no hubo diferencias regionales ni asociación con el número deseado de hijos, se encontraron otros factores como el menor nivel educativo y las mujeres de raza negra. La reincidencia también se asocio con la edad mayor del primer compañero sexual, la ausencia de control prenatal y haber tenido un recién nacido prematuro. Conclusiones: Este estudio utilizó una muestra representativa de las adolescentes colombianas. Demuestra tanto las dimensiones del problema como los factores que se encuentran asociados al mismo con lo cual se podrán direccionar programas de prevención adecuadosIntroduction: Teen pregnancy is one of the issues most relevant to public health around the world. In Colombia, the policies have not been effective in reducing the rate of teen pregnancy, or to prevent the recurrence of pregnancy. This study pretends to define the prevalence and factors associated with teen pregnancy and its recurrence. Methods: Cross-sectional study from 13. 313 adolescents who answered the Colombian National Demographic and Health Survey, 2010. Multinomial regressions were performed to compare the group of adolescents who were pregnant with one or more pregnancies and logistic regression to compare the group with one or more pregnancies. Results: 13. 3% had a pregnancy and 3. 5% more than one. When we compared with teens who have never been pregnant: a) the adolescents who had a pregnancy were older, lived with her partner, they were living outside the family home and had been victims of sexual abuse and physical abuse. The likelihood of pregnancy decreased in those adolescents who had more monetary resources, wanted fewer children, attended school, had used family planning and received sexual education b) In the adolescents who had more than one pregnancy were associated the same factors but were not regional differences. Were found other factors such as lower education and black women. Recurrent pregnancy was also associated with older age of first sexual partner, lack of prenatal care and having a premature infant. Conclusions: This study used a representative sample of Colombian adolescents. It shows both the dimensions of the problem and the factors that are associated with it , thus may address appropriate prevention programs

Prevalence and risk factors for intestinal parasitic infections in pregnant women residing in three districts of Bogotá, Colombia

Background: Intestinal parasitic infections (IPI) lead to significant morbidity and mortality in pediatric and adult populations worldwide. Intestinal parasitism during pregnancy is of interest as it may affect the health of pregnant women and their offspring. This study determined the prevalence of IPI in pregnant women living in substandard conditions in three urban districts of Bogota, Colombia. Associations between prevalence and sociodemographic factors, housing, and living conditions were also evaluated. Methods: In a cross-sectional and community-based study, pregnant women were recruited from three districts of Bogota. A total of 550 participants answered a questionnaire;331 of these also provided stool samples, with 233 providing one and 98 providing two stool samples. Questionnaire responses were associated with the presence of intestinal parasites, which was determined using a standard combined microscopy technique including direct wet mount and formol-ether concentration. Results were verified by supplementary examination of 48 stool samples by quantitative polymerase chain reaction (qPCR). Results: Among pregnant women who lived in selected poor residential areas in Bogota, the overall prevalence of intestinal parasitism was 41% with 9% polyparasitism. Pathogenic parasites were present in 1.2% of the 331 participants including Giardia lamblia and Ascaris lumbricoides. Higher prevalence was found for parasites with debated pathogenicity, including Blastocystis hominis (25%), Endolimax nana (15%), Entamoeba coli (8%), and Iodamoeba butschlii (2%). Entamoeba histolytica/dispar complex was also detected (1.5%). When comparing a subset of stool samples using the combined microscopy technique and qPCR, the latter detected a higher 58.3% overall IPI prevalence. Higher prevalence of infections by any intestinal parasite was found in participants who had never been dewormed (p = 0.01). Higher but not statistically significant associations were found between any parasite and women living with a partner, and intestinal polyparasitism and being from a minority group and not having a water sink. Conclusions: This first study of the prevalence of intestinal parasitism in Bogota focused on pregnant women living in poverty, found a high prevalence of intestinal parasites of debated pathogenicity, and confirmed a low prevalence of pathogenic intestinal parasites. These results highlight the need for educational interventions to disrupt transmission routes for prevalent parasites

Factores perinatales para riesgo de sobrepeso y obesidad en niños de 4 a 5 años en Colombia 2010.

Introducción: La OMS revela que en 2010 alrededor de 43 millones de niños menores de 5 años presentan sobrepeso. En Colombia según la Encuesta Nacional de Situación Nutricional en Colombia en su versión 2005, mostraba una prevalencia general de sobrepeso de 3.1% niños de 0 a 4 años. Es una condición de salud de origen multifactorial en la que interviene factores genéticos, ambientales, maternos y perinatales. Objetivo: Establecer la asociación de riesgo entre el bajo peso al nacer y el desarrollo de sobrepeso y obesidad en niños de 4 a 5 años. Metodología: Se realizó un estudio observacional descriptivo retrospectivo de corte transversal con los datos nutricionales, maternos y perinatales de la Encuesta Nacional de Demografía en Salud del año 2010 en Colombia. Se analizó la asociación entre la variable independiente bajo peso al nacer con el desenlace sobrepeso y obesidad en menores de 4 a 5 años, usando como medida el IMC según la edad. Se realizaron análisis univariados, bivariados y de regresión logística con un modelo de riesgo según las variables que inciden en el desenlace y la variable independiente. Resultados: La muestra obtenida para el estudio fue de 2166 niños de 4 a 5 años de edad quienes cumplían los criterios de inclusión. La prevalencia de sobrepeso u obesidad en la primera infancia fue de 21.8% (472) y el bajo peso al nacer. Los resultados sugieren la asociación de bajo peso y sobrepeso u obesidad es de ORajustado= 0.560 (0.356 – 0.881). Conclusiones: Los resultados sugieren que existe una asociación como factor protector entre el bajo peso y el sobrepeso u obesidad en la primera infancia. Sin embargo, debido al comportamiento de las variables consideradas en la muestra no hay suficiente información para rechazar completamente la hipótesis nula.Introduction: WHO reveals that in 2010 around 43 million children under 5 are overweight. In Colombia according to the National Nutrition Survey Situation in Colombia in its 2005 version, he showed an overall prevalence of 3. 1% overweight children 0-4 years. It is a health condition in multifactorial involving genetic, environmental, maternal and perinatal factors. Objective: To establish the association of risk between low birth weight and the development of overweight and obesity in children between 4 to 5 years. Methodology: A descriptive retrospective cross-sectional study with nutritional, maternal and perinatal data from the National Demographic Health Survey 2010 was conducted in Colombia. The association between the independent variable low birth weight (LBW) with the outcome overweight and obesity in children between 4 to 5 years, as measured using BMI for age was analyzed. Univariate analyzes were performed, bivariate and logistic regression model risk according to the variables that affect the outcome and the independent variable. Results: The sample was obtained for the study of 2166 children between 4 to 5 years of age who met the inclusion criteria. The prevalence of overweight and obesity in early childhood was 21. 8% (472) and low birth weight. The results suggest the association of underweight and overweight or obese is ORajust = 0. 560 [IC95% 0356-0881]. Conclusions: The results suggest a protective factor association between low weight and overweight or obese in early childhood. However, due to the behavior of the variables considered in the sample there is not enough information to fully reject the null hypothesis

Trabajo infantil en las calles de Bogotá

Muchos niños trabajan en las calles de Bogotá. La cantidad exacta se desconoce y es muy poca la información disponible acerca de este grupo. El presente estudio identificó el comportamiento de las variables edad, género, desplazamiento por violencia, escolaridad, tipo de actividad desarrollada, tiempo de permanencia en la calle y cobertura de seguridad social, dentro de un grupo de 162 niños bogotanos con actividades económicas en la calle. Metodología: se realizó un estudio descriptivo en el que se entrevistaron los niños que se encontraban trabajando en ciertas calles de la ciudad de Bogotá, un día sábado. Resultados: de los 162 menores entrevistados, 52,5% eran niños y 47,5%, niñas. De todos ellos 38,5% resultaron ser menores de cinco años y 64,2%, mayores; 61,1% estaban solos y el resto, acompañados por algún adulto; 49,4% son hijos de familias desplazadas y el resto, hijos de habitantes de Bogotá. Se encontró una tasa de deserción escolar de 33,3% y una falta de afiliación a seguridad social de 38,9%, la cual es mayor en familias desplazadas y disminuye con el tiempo de estancia en Bogotá. Discusión: los datos sugieren una importante relación del trabajo infantil en la calle con el fenómeno de desplazamiento por violencia y un impacto serio del problema en la escolaridad de estos menores, así como largas jornadas de permanencia, en las que están expuestos a factores de riesgo tanto de seguridad como físicos, químicos, ergonómicos y psicosociales. Se evidenciaron tres grupos poblacionales diferentes de niños que trabajan en la calle, los hijos de familias desplazadas, los que trabajan en la calle y los que viven en la calle. Conclusión: el problema de trabajo infantil en la calle, en Bogotá, es un problema serio que requiere atención basada en el conocimiento de sus causas y la búsqueda de medidas más efectivas para su erradicación

Risk perception and sexual behavior in HPV-vaccinated and unvaccinated young Colombian women

"Objective To compare sexual behaviors and risk perception between young women vaccinated for HPV and unvaccinated Colombian women. Methods In a cross-sectional design study, 1436 women (231 adolescents, less than 18 years; 1205 young women, 18-26 years) completed a self-administered questionnaire between May 2011 and March 2012 in Bogotá, Colombia. Data from vaccinated and unvaccinated women were compared by descriptive statistics and multivariate models. Results Sexual risk behaviors were not associated with vaccination after adjustment for risk perception, age, educational level, and HPV knowledge. By contrast, vaccination was associated with higher routine Pap smear screening (odds ratio [OR], 2.35; 95% confidence interval [CI], 1.69-3.28), use of modern contraceptives (OR, 2.02; 95% CI, 1.26-3.22), and consistent use of condoms (OR, 1.49; 95% CI, 1.11-2.01). Vaccinated young women were more likely to have had sex (OR, 2.08; 95% CI, 1.56-2.78), but sexual debut among adolescents was not associated with vaccination. In bivariate and multivariate analyses, vaccination status was negatively associated with perceived risk of HPV infection, warts, and cervical cancer. There was no association between vaccination and perceived risk of sexually transmitted infections in any model. Conclusion No association was found between changes in risk perception after HPV vaccination and sexual risk behaviors. © 2014 International Federation of Gynecology and Obstetrics.

Effects of child labor on the health of the minor worker

Revisamos el tema del trabajo infantil, en tres aspectos: 1. Las características de los niños que los hacen vulnerables ante el trabajo; 2. Las enfermedades y accidentes relacionados con el trabajo infantil, y 3. Las lesiones asociadas con diversas ocupaciones de menores, como agricultura, construcción, manufactura, textiles, industria del cuero, ventas en calle y trabajo en plazas de mercadoThis article presents a review of the evidence on child labor, in three aspects: 1. The characteristics of children which make them vulnerable to labor; 2. The diseases and accidents related with child labor, and 3. The injuries associated with the childs' occupations, such as agriculture, construction, manufacture, textiles, leather industry, street sales and sales in marketplaces. METHODS: The Medline, EBSCO, PROQUEST and HINARI databases were searched, and material from the International Labor Organization, the American Academy of Pediatrics and the American Association of Psychology was reviewed. RESULTS: Information regarding occupational risk in children is poor as compared with information in adults. Children have characteristics which make them particularly vulnerable to occupational risks and there are no clear standards to protect them

Child Labor in a marketplace in Bogota

OBJETIVOS: El trabajo infantil en plazas de mercado es un fenómeno poco estudiado que se presenta incluso en países desarrollados y se asocia con trastornos en el desarrollo físico, psíquico, emocional y social de los niños. El presente trabajo pretende determinar el número de niños que se encuentran trabajando en la plaza de mercados más grande del país y los factores de riesgo a los que están expuestos. MÉTODOS: Se realizó un conteo de los niños que trabajan en la plaza y se determinó su genero y ocupación. Posteriormente se realizó un análisis de puesto de trabajo utilizando el panorama de riesgos profesionales de Fine. RESULTADOS: Se encontraron 376 menores, 318 niños y 58 niñas. El 30 % cargando bultos, el 42 % vendiendo y el 28 % acompañando o realizando tareas menores. Los factores de riesgo relacionados con seguridad son los que presentan un grado de peligrosidad más alto. Los siguen los ergonómicos, los psicosociales y los biológicos. CONCLUSIÓN: Los factores de riesgo que a corto plazo afectan más la salud de los niños en la plaza son los relacionados con la seguridad por el tránsito de vehículos, el apilamiento inapropiado de materiales potencialmente peligrosos y la carga física a que están sometidos. De acuerdo con el panorama de riesgos profesionales presentado, este es un trabajo peligroso para los niños. El trabajo de los niños en plazas de mercado debe ser regulado y el transporte de mercancías por parte de los mismos debe ser abolido.OBJECTIVE: Child labor in marketplaces has not been sufficiently studied. It is present even in developed countries and it has been associated with problems in the physical, psychological, emotional and social development of children. This paper aims at determining the number of children working in the largest marketplace in the country and the risk factors to which they are exposed. METHODOLOGY: Children working in the marketplace were counted and classified by gender and occupation. Working places were analyzed under Fine’s professional risk plan. RESULTS: 376 children were found, 318 boys and 58 girls. 30 % were carrying loads, 42 % were selling merchandise, and 28 % were doing minor jobs or accompanying relatives. The risk factors related with their personal security have the greatest danger level. They are followed by the ergonomic, psychosocial and biological factors. CONCLUSIONS:The risk factors affecting children’s health the most in the short term are those related to personal security. They include vehicle traffic, inadequate materials storage that can be dangerous, and the physical burden that they have to suffer. According to the professional risk factors plan, this is a dangerous job for children. Child labor in marketplaces shall be regulated and the carrying of heavy loads prohibited