Impact of COVID-19 on foreign population resident in urban areas of Italy: selection of indicators, data sources, and definition of geographical stratification levels / Impatto del COVID-19 negli stranieri residenti nelle aree urbane in Italia: la scelta degli indicatori, delle fonti informative e la definizione dei livelli di stratificazione del territorio.

OBJECTIVES: to describe indicators, data sources, and levels of geographical stratification used within the framework of the CCM project "Epidemiological Surveillance and Control of COVID-19 in Metropolitan Urban Areas and for the containment of SARS-CoV-2 circulation in the immigrant population in Italy". DESIGN: population-based observational study based on data from the Integrated Covid-19 Surveillance System and the archive of hospital discharge records. SETTING AND PARTICIPANTS: interregional collaborative project. Resident population in 5 Italian Regions (Piedmont, Emilia-Romagna, Tuscany, Lazio, and Sicily). MAIN OUTCOMES MEASURES: crude and age-standardized rates of diagnostic test utilization and positivity, hospitalization (in any department and in intensive care unit), and mortality in COVID-19 cases. RESULTS: starting from the set of 11 indicators from the Italian National Institute for Health, Migration and Poverty (INMP) project "Epidemiology of SARS-CoV-2 Infection (COVID-19) and Use of Health Services in the Immigrant Population and Vulnerable Population Groups in Italy", the five most effective indicators for CCM purposes were identified. The INMP project highlighted higher rates of test access and positivity among Italians compared to foreigners, higher standardized hospitalization rates among foreigners, and higher standardized mortality rates among Italians, with geographical and temporal heterogeneity. The intersection between the DEGURBA (degree of urbanisation) classification and altimetric zones defined five levels of territorial stratification characterized by decreasing population density. Approximately 81% of the population involved in the CCM project resided in the first two levels; 43% of Italians lived in areas with intermediate population density in hilly or plain areas, while 48% of foreigners were concentrated in densely populated areas. CONCLUSIONS: sharing the collaborative approach and a research methodology already tested, integrated with the analysis of disaggregated indicators by morphological, functional, and administrative characteristics of the residential territory, allowed for assessing differences in the impact of the pandemic between Italians and foreigners residing in more or less densely populated areas.

Knowledge about cardiovascular diseases in a first-level healthcare center in Lima, Peru. / Conocimientos sobre enfermedades cardiovasculares en un establecimiento de primer nivel de atención en Lima, Perú.

BACKGROUND: Motivation for the study. In Peru, the knowledge level of patients about their cardiovascular health is unknown at the first level of care, which receives 85% of the population, and where primary disease prevention activities are carried out. BACKGROUND: Main findings. More than 70% of people had an inadequate level of knowledge about their own cardiovascular health. BACKGROUND: Implications. Our results highlight the need to improve the education of people on cardiovascular health issues at the first level of care, taking into account that these diseases are increasingly frequent in the population. BACKGROUND: This study aimed to determine the level of knowledge about cardiovascular diseases in people in a primary healthcare center (PHCC). A descriptive and cross-sectional study was carried out by surveying people who attended a PHCC in Lima, Peru. A score less than 6 was considered inadequate knowledge. A total of 400 people were surveyed, 66.3% were women and the mean age was 46.8 ± 16.2 years. The average score was 4.52 +/- 1.85. We found that 71% of those surveyed had an inadequate level of knowledge, regardless of age, gender or education level. Our findings show that the level of knowledge about risk factors and cardiovascular disease was inadequate in the primary care population. It is necessary to achieve proper specific education in cardiovascular risk factors in order to reduce the impact of these diseases.

Health impact of urban green spaces: a systematic review of heat-related morbidity and mortality.

OBJECTIVES: The objective of this review was to scrutinise the impact of urban green spaces on heat-related morbidity and mortality. DESIGN: This systematic review was meticulously carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines DATA SOURCES: A comprehensive search was conducted across PubMed, Scopus and Google Scholar including studies from January 2000 to December 2022. ELIGIBILITY CRITERIA: Studies that examined the influence of urban green spaces on heat-related morbidity and mortality, including randomised controlled trials, observational and modelling studies, were included. DATA EXTRACTION AND SYNTHESIS: A total of 3301 publications were initially identified, out of which 12 studies met the inclusion criteria and were selected for analysis. The selected studies were predominantly from high-income and upper-middle-income nations (95%). RESULTS: The research points towards a pattern where regions abundant in green spaces report lower rates of heat-related morbidity and mortality in contrast to those with sparse greenery. Additionally, urban vegetation appears to exert a positive influence on mental health and well-being, potentially aiding in offsetting the adverse health repercussions of high temperatures. CONCLUSION: Urban green spaces play a vital role in mitigating heat-related health risks, offering a potential strategy for urban planning to address climate change and enhance public health. Additional research is required to thoroughly comprehend the magnitude of urban greenery's impact on heat-related morbidity and mortality, as well as its interplay with other variables, including air pollution, socioeconomic status, among others.

Dental caries lesions and impact on quality of life in adolescents living in urban and rural areas. A case study.

The concept of quality of life (QoL) developed from early studies on subjective wellbeing and satisfaction with life, interpreted as resulting from living conditions, and recognized by means of objective indicators. Indicators have been developed and validated to measure the relationship between quality of life and health Aim: To determine, during an Educational Social Practice, the association between presence of dental caries lesions and its impact on quality of life of adolescents living in rural and urban areas in Argentina. Materials and Method: This was an observational cross-sectional study in (a) a rural area (Tres Isletas; Chaco Province/Schools No. 601 and 477) and (b) an urban area (Villa Soldati; Buenos Aires City/Nuestra Sra. Fátima School). The sample included 40 students from the urban area (UG) and 30 from the rural area (RG). A calibrated researcher (Kappa 0.80) collected the survey data and performed the clinical examinations. The following were recorded: (a) sociodemographic distribution in terms of age and gender; (b) presence of dental biofilm according to Silness and Löe; caries lesions according to ICDAS II /INTCy criteria, and (d) DMFT, total and per component. Quality of life was assessed using the CPQ 11-14r. Statistical processing included calculation of frequency distribution of the variables (X± DS), and chi-square and Mann-Whitney tests to calculate association and comparisons between groups. Results: The sample included 47 girls (67.1%) and 23 boys (32.9%). Distribution according to sex and age did not differ significantly between sites (UG:12.9 years ± 0.5 and RG:11.8 years ±1.1). No significant difference was found between sites for a) plaque biofilm (p=0.759); b) DMFT, total value and per component, or c) individual and grouped ICDAS scores. Percentage analysis of the CPQr 1-14 scores showed significant differences between groups for questionnaire total scores (26.9% ± 2.2 in UG and 4.1% ± 0.8 in RG) and for the different domains. Conclusion: Perceived impact on quality of life caused by dental caries lesions was significantly higher in urban than the rural group, although neither the dental caries process nor the amount of biofilm differed significantly between groups.

El concepto de calidad de vida (CV) se desarrolló a partir de estudios tempranos sobre bienestar subjetivo y satisfacción con la vida3, interpretado como resultante de las condiciones de vida empleando para su reconocimiento. Para medir su relación con la salud se han desarrollado y validado indicadores. Objetivo: Determinar la asociación entre presencia de lesiones de caries dental y el impacto que producen sobre la calidad de vida de adolescentes residentes en áreas rural y urbana República Argentina), en un caso de Practica Social Educativa. Materiales y Método: Estudio observacional de corte transversal en (a) área rural (Tres Isletas; Provincia Chaco/escuelas N° 601 y N° 477) y (b) área urbana (Villa Soldati; CABA/ escuela Nuestra Sra. Fátima). La muestra incluyó 40 escolares residentes en área urbana (GU) y 30 residentes en área rural (GR). Un investigador calibrado (Kappa 0.80) realizó el relevamiento de datos y el examen clínico Se registraron (a) distribución sociodemográfica en términos de edad y género; (b) presencia de biofilm dental segùn Silness y Löe; lesiones de caries según criterios ICDAS II /INTCy (d) cálculo de CPOD total y por componente. La calidad de vida fue evaluada mediante cuestionario CPQ 11-14r. El procesamiento estadístico incluyó cálculo de distribución de frecuencias de las variables (X± DS) y las pruebas chi cuadrado y Mann-Whitney.para calcular asociacion y comparaciones. entre grupos. Resultados: La muestra incluyó 47 mujeres (67,1%) y 23 hombres (32,9%). La distribución según sexo y edad no mostró diferencias significativas entre las sedes (GU:12,9 años ± 0,5 y GR:11,8 años ±1,1). No se encontraron diferencias significativas entre las sedes al comparar a) biofilm de placa (p=0,759); b) CPOD, valor total y por componentes y c) códigos de ICDAS individuales y agrupados. El análisis porcentual del índice CPQr 1-14 reveló diferencias significativas en el puntaje total (26,9% ± 2.2 en GU y 4,1% ± 0.8 en GR) y en los respectivos dominios del instrumento. Conclusión: La percepción del impacto sobre la calidad de vida generado por las lesiones de caries dental resultó significativamente mayor en los escolares urbanos que en los rurales, aunque ni el proceso de caries dental ni la cantidad de biofilm encontrados en cada grupo, revelaron diferencias significativas.

The impact of economic agglomeration on China's urban public health.

Introduction: This study aims to explore the impact of economic agglomeration on the urban prosperity through economies of scale and agglomeration, it may also affect the public health of the agglomeration area. Methods: This paper takes 280 cities in China as the research object, and explores the impact of economic agglomeration on public health through a two-way fixed effects model, instrumental variable method, and generalized moment estimation. Results: The results indicate that: (1) the improvement of China's economic agglomeration can significantly promote urban public health, and economic agglomeration is a prerequisite for the improvement of urban public health, but there is no reverse causal relationship. (2) The enhancement of economic agglomeration in Northeast China has the greatest promotion effect on public health, followed by the eastern, western, and central regions; The economic agglomeration enhancement of the pilot medical group in closely connected cities has a greater promoting effect on public health than the pilot medical group in non-closely connected cities. (3) Empirical results based on micro sample data show that the improvement of economic agglomeration will also promote the increase of the number of public hospitals in cities. Discussion: This study emphasizes the important role of economic accumulation in the improvement of urban public health and provides empirical support for future economic development policies and practices.

GIS-based assessment of spatial and temporal disparities of urban health index in Shenzhen, China.

Purpose: To explore the inter-regional health index at the city level to contribute to the reduction of health inequalities. Methods: Employed the health determinant model to select indicators for the urban health index of Shenzhen City. Utilized principal component analysis, the weights of these indicators are determined to construct the said health index. Subsequently, the global Moran's index and local Moran's index are utilized to investigate the geographical spatial distribution of the urban health index across various administrative districts within Shenzhen. Results: The level of urban health index in Shenzhen exhibits spatial clustering and demonstrates a positive spatial correlation (2017, Moran's I = 0.237; 2019, Moran's I = 0.226; 2021, Moran's I = 0.217). However, it is noted that this clustering displays a relatively low probability (90% confidence interval). Over the period from 2017 to 2019, this spatial clustering gradually diminishes, suggesting a narrowing of health inequality within economically developed urban areas. Conclusion: Our study reveals the urban health index in a relatively high-income (Shenzhen) in a developing country. Certain spatially correlated areas in Shenzhen present opportunities for the government to address health disparities through regional connectivity.

Clinical and Sociodemographic Features of Alopecia Areata in Five Colombian Cities: An Analysis of the RENAAC Registry. / [Artículo traducido] Características clínicas y sociodemográficas de la alopecia areata en 5 ciudades colombianas: un análisis del RENAAC.

BACKGROUND: Alopecia areata (AA) is an autoimmune disease characterized by non-scaring hair loss and preservation of hair follicles. The information available on disease course, and clinical features of AA is scarce worldwide, and almost nonexistent in Colombia. OBJECTIVE: To determine the clinical and sociodemographic characteristics of patients diagnosed with AA who presented to a dermatology consultation in five Colombian cities. MATERIAL AND METHODS: This was a retrospective and multicenter study on data from an ongoing National Registry of Alopecia Areata in Colombia (RENAAC) collected in Bogota, Cali, Cartagena, Barranquilla, and Medellin, Colombia from March 2022 through April 2023. Data was recorded in a standardized form by trained physicians. The variables were expressed as measures of central tendency and dispersion, and absolute and relative frequencies. RESULTS: A total of 562 patients were included, 59.4% of whom were women, aged between 15 and 49 years (63.9%) with a mean disease course of 1.7 years. The most common finding was multiple plaque (53.2%), the predominant AA subtype was patchy (71.4%), and 29.5% of the patients had a past dermatological history, 18.3% had a past endocrinological history, and 8.9% had a past psychiatric history. The treatments most widely used were steroid injections (76.4%), 5% topical minoxidil (46.4%), followed by high-potency corticosteroids (42.5%). STUDY LIMITATIONS AND CONCLUSIONS: AA was slightly predominant in women. As seen in other populations, this disease had an earlier onset in men vs women. Presentation in pediatric age was uncommon. The previous history of other dermatological diseases was checked in almost one third of the patients. Analysis of the co-presentation of AA with other autoimmune diseases is biased due to excluding patients with systemic erythematous lupus from the study.

[Assessment of the impact on mortality of air pollution by particles in the city of Valencia during the period 2015-2017]. / Evaluación del impacto en mortalidad de la contaminación del aire por partículas en la ciudad de València en el periodo 2015-2017.

OBJECTIVE: Air pollution is a global public health issue, with particulate matter (PM) being the pollutant with the greatest impact on health. The main objective of this article was to estimate the impact of mortality attributable to particulate pollution in the city of Valencia during the period 2015-2017. METHODS: The Health Impact Assessment (HIA) methodology from the Aphekom project was used. Scenarios of a 5 µg/m3 reduction in the annual mean concentration of PM10 and PM2.5 were employed, along with the assumption of meeting the World Health Organization (WHO) recommendations in effect during the study period, to estimate both short- and long-term impacts. RESULTS: The estimated average concentrations for 2015-2017 were 18.4 µg/m3 for PM10 and 12.3 µg/m3 for PM2.5. The short-term HIA, assuming a reduction of 5 µg/m3 in the averages, resulted in a total of 65.4 premature deaths that could be postponed during that period (21.8 annually), corresponding to a rate of 2.8 deaths per 100,000 inhabitants. In the long term, if PM2.5 concentrations had been reduced by 5 µg/m3, 124 premature deaths could have been postponed annually. CONCLUSIONS: The annual average concentrations of these pollutants meet the limits set by European regulations. However, compared to WHO recommendations, PM2.5 levels are higher by 2.3 µg/m3. An air quality scenario in line with WHO recommendations would have resulted in a reduction of 122 premature deaths annually.

OBJETIVO: La contaminación del aire es un problema de Salud Pública de importancia global, siendo las partículas en suspensión (PM) el contaminante con mayor impacto en la salud. El objetivo principal de este artículo fue estimar el impacto en mortalidad atribuible a la contaminación por partículas en la ciudad de València en el periodo 2015-2017. METODOS: Se utilizó la metodología para la Evaluación del Impacto en Salud (EIS) del proyecto Aphekom. Se realizó un estudio descriptivo y para la correlación se emplearon los escenarios de reducción de la media anual de 5 µg/m3 en la concentración de PM10 y de PM2,5 y el supuesto de cumplir las recomendaciones de la Organización Mundial de la Salud (OMS) vigentes en el periodo a estudio para estimar el impacto a corto y largo plazo. RESULTADOS: Las concentraciones estimadas del promedio 2015-2017 para PM10 y PM2,5 fueron de 18,4 µg/m3 y 12,3 µg/m3, respectivamente. La EIS a corto plazo, en el supuesto de reducir en 5 µg/m3 las medias, tuvo como resultado un total de 65,4 muertes prematuras que se podrían posponer en ese periodo (21,8 anuales), correspondiendo con una tasa de 2,8 defunciones por cada 100.000 habitantes. A largo plazo, si se hubiesen reducido las concentraciones de PM2,5 en 5 µg/m3, se hubieran podido posponer 124 muertes prematuras anuales. CONCLUSIONES: Las concentraciones medias anuales de estos contaminantes se ajustan a los límites marcados por la normativa europea. Sin embargo, respecto a las recomendaciones de la OMS, los niveles de PM2,5 son superiores en 2,3 µg/m3. Un escenario de calidad del aire conforme a las recomendaciones de la OMS se hubiera traducido en una reducción de 122 defunciones prematuras anuales.

Exploring the Relationship Between Education, Living Environment, and Anxiety/Depression Among Stable Patients: Insights from the COPD-AD China Registry Study.

Background: Education and living environment are related to mental health. But the independent and combined effects of them on mental health among patients with chronic obstructive pulmonary disease (COPD) are uncertain. Methods: The independent and combined effects of education and living environment on mental health were assessed by binary logistic regression in 1064 COPD patients. Additive interaction was assessed with the relative excess risk ratio (RERI), attribution percentage (AP), and synergy index (SI). Results: Our results shown that low education level and urban living environment were independently associated with higher risks for anxiety (odds ratio [OR]: 1.56, 95% confidence interval [CI] 1.06-2.29 and OR:2.15, 95% CI 1.51-2.05) or depression (OR:1.62, 95% CI 1.17-2.27 and OR: 2.01, 95% CI 1.46-2.75) among COPD patients. The combination effect of them was also associated with higher risks for anxiety (OR: 7.90, 95% CI 3.83-16.29, P < 0.001) or depression (OR: 11.79, 95% CI 5.77-24.10, P < 0.001) among these patients. Furthermore, we observed strong synergistic additive interactions between them for anxiety (SI: 11.57, 95% CI 1.41-95.27; RERI: 6.31, 95% CI 1.60-11.01; AP: 0.8, 95% CI 0.66-0.94) and depression (SI: 31.31, 95% CI 1.59-617.04; RERI: 10.44, 95% CI 2.66-18.23; AP: 0.89, 95% CI 0.8-0.97). Conclusion: Low education levels and living in urban areas had an independent and synergistic effects on mental health among COPD patients.

Green workspace and urban health: exploring the impacts of industrial robotics in pollution emissions and public health.

Introduction: This study addresses a critical gap in understanding how technological advancements, specifically industrial robots, influence urban pollution emissions and public health. The rapid evolution of technology and changing working conditions significantly affect these areas, yet research has not extensively explored this domain. Methods: Utilizing 2018 China Labor-force Dynamic Survey (CLDS) dataset, this study examines the impact of industrial robots on public health. An analytical framework is employed to assess the correlation between the adoption of eco-friendly industrial robots and improvements in worker health, attributed to the reduction of pollution emissions. Results: The findings reveal that the adoption of industrial robots significantly enhance both public physical and mental health. This study also identifies potential demographic heterogeneity in the effects of industrial robots. The benefits are more pronounced among non-insured manual female workers who are older, have lower education levels, and hold rural hukou. These benefits are closely linked to improvements in the quality of the production environment and reductions in pollution emissions at both macro and micro levels. Discussion: The study underscores the significant potential of industrial robots to positively impact urban health, advocating for strategies that promote the development of safer, greener environments.

Improving urban health through primary health care in south Asia.

South Asia is rapidly urbanising. The strains of rapid urbanisation have profound implications for the health and equity of urban populations. This Series paper examines primary health care (PHC) in south Asian cities. Health and its social determinants vary considerably across south Asian cities and substantial socioeconomic inequities are present. Although cities offer easy geographical access to PHC services, financial hardship associated with health care use and low quality of care are a concern, particularly for low-income residents. Providing better PHC in south Asia requires a multi-sectoral response, with effective and resourced urban local bodies; increased public financing for health care; and new service delivery models aimed at low-income urban communities that involve strengthening public sector services, strengthening government engagement with private providers where necessary, and engaging with low-income communities and the PHC providers that serve them.

Comprehensive evaluation of global health cities development levels.

Introduction: How to scientifically assess the health status of cities and effectively assist in formulating policies and planning for health city development remains a profound challenge in building a global "health community." Methods: This study employs the Building Research Establishment's International Healthy Cities Index (BRE HCI), encompassing ten environmental categories and fifty-eight indicators, to guide and support the scientific development of healthy cities. The entropy weight-TOPSIS method and the rank sum ratio (RSR) method were applied to comprehensively rank and categorize the health development levels of fifteen global cities. Furthermore, through cluster analysis, this research identifies universal and unique indicators that influence the development of healthy cities. Results: The results indicate that: (1) Within the scope of 58 evaluation indicators, the precedence in weight allocation is accorded to the kilometres of bicycle paths and lanes per 100,000 population (0.068), succeeded by m2 of public indoor recreation space per capita (0.047), and kilometres of bicycle paths and lanes per 100,000 population (0.042). (2) Among the ten environmental categories, the top three in terms of weight ranking are transport (0.239), leisure and recreation (0.172), and resilience (0.125). Significant disparities exist between different cities and environmental categories, with the issue of uneven health development within cities being particularly prominent. (3) The study categorizes the development levels of healthy cities into three tiers based on composite scores: it classifies Singapore, Shanghai, and Amsterdam at an excellent level; places Dubai and Johannesburg at a comparatively poor level; and situates the remaining ten cities at a moderate level. (4) The analysis identifies 53 international common indicators and 5 characteristic indicators from the 58 indicators based on the significance of the clustering analysis (p < 0.05). Discussion: The study proposes four strategic recommendations based on these findings: establishing a comprehensive policy assurance system, refining urban spatial planning, expanding avenues for multi-party participation, and augmenting distinctive health indicators. These measures aim to narrow the developmental disparities between cities and contribute to healthy global cities' balanced and sustainable growth. However, due to existing limitations in sample selection, research methodology application, and the control of potential confounding variables, further in-depth studies are required in the future.

Erectile dysfunction among men with chronic kidney disease undergoing hemodialysis in a Brazilian Amazon urban setting: an epidemiological study.

INTRODUCTION: Erectile dysfunction (ED) is a common sexual problem among men with chronic kidney disease (CKD). The severity of sexual dysfunction tends to worsen with kidney damage. This study aims to evaluate the erectile function and sexual quality of life of adult male CKD patients undergoing hemodialysis (HD) in a hospital located in the Brazilian Amazon. METHODS: A cross-sectional quantitative study was performed within the HD Sector of the Nephrology Unit including men with CKD aged ≥ 18 years, undergoing ≥ 3 weekly HD sessions for ≥ 3 months who had been sexually active for ≥ 6 months. We used the Male Sexual Quotient (MSQ) to measure sexual satisfaction and the International Index of Erectile Function (IIEF5) to establish erectile function. Statistical analysis was performed with SPSS 21.0 using appropriate tests, such as Mann-Whitney and Kruskal-Wallis (P < 0.05). RESULTS: Ninety-eight patients (51.68 ± 15.28 years) were evaluated. They were primarily married/or living with a partner (60.20%), with HD time between 1 to 5 years (55.10%), and an average KTV of 1.17. ED prevalence was 66.30%, and it was associated with a higher age group (p = 0.01), lower family income (p = 0.02), diabetes (p = 0.01), lower mean corpuscular hemoglobin (p = 0.04), higher total calcium (p = 0.04), and lower albumin (p = 0.03). Around 75% classified their sex life as regular to excellent. CONCLUSION: Despite the high ED prevalence, most men with CKD in HD reported experiencing regular to excellent sex life. The study underscores the importance of establishing effective screening and conducting routine evaluations regarding sexual issues in these men.

Trypanosoma spp. infection in urban and wild ecotopes of the caribbean region in Colombia. / Infección por Trypanosoma spp. en murciélagos capturados en ecótopos urbanos y silvestres de la región Caribe en Colombia.

Motivation for the study. The role of bats as hosts of Trypanosoma spp. in the Atlantic department in Colombia, as well as its taxonomic diversity has been poorly studied. Main findings. This is the first report of frequency of infection by Trypanosoma spp. in bats in the Atlántico Department in Colombia. Implications. The great adaptive capacity of bats to different ecological niches and its role as hosts of Trypanosoma spp. for wild and urban ecotopes represents a risk factor in transmission cycles of epidemiological importance. We conducted a study to evaluate the frequency of infection by Trypanosoma spp. in bats captured in wild and urban ecotopes in the Department of Atlántico in the Caribbean region of Colombia from March 2021 to May 2022. Bats were taxonomically identified, and sex, relative age, and reproductive conditions were determined. A blood sample was used for parasitological analysis and DNA extraction to amplify a region of the 18S rRNA. 125 bats were collected, with the most abundant families being Molossidae (62/125; 49.6%) and Phyllostomidae (43/125; 34.4%). Molossus molossus collected in wild habitats showed an infection frequency of 8.1% (5/61) and 4.1% (3/61) through parasitological and molecular analysis, respectively. In comparison, Noctilio albiventris collected in urban habitats showed an infection frequency of 16.6% (2/12) for both analyses. These findings represent the first records of M. molossus harboring trypanosomes for the Department of Atlántico and of N. albiventris harboring trypanosomes in Colombia.

Se evaluó la frecuencia de infección por Trypanosoma spp. en murciélagos capturados en ecótopos silvestres y urbanos del Departamento del Atlántico, en la región Caribe de Colombia, entre marzo de 2021 y mayo de 2022. Se identificaron taxonómicamente los murciélagos y se determinó sexo, edad relativa y condiciones reproductivas. Se utilizó una muestra de sangre para análisis parasitológico y extracción de ADN para la amplificar una región del ARNr 18S. Se capturaron 125 murciélagos, siendo las familias más abundantes Molossidae (62/125; 49,6%) y Phyllostomidae (43/125; 34,4%). Molossus molossus capturado en ecótopos silvestres mostró una frecuencia de infección del 8,1% (5/61) y 4,1% (3/61) mediante análisis parasitológico y molecular, respectivamente. En comparación, Noctilio albiventris capturado en ecótopos urbanos mostró una frecuencia de infección del 16,6% (2/12) para ambos análisis. Estos hallazgos representan los primeros registros de M. molossus albergando Trypanosoma spp. para el Departamento del Atlántico y de N. albiventris albergando Trypanosoma spp. en Colombia. Motivación para realizar el estudio. El rol de los murciélagos como hospederos de Trypanosoma spp. en el Departamento del Atlántico en Colombia, así como su diversidad taxonómica ha sido poco estudiada. Principales hallazgos. Este es el primer reporte de frecuencia de infección por Trypanosoma spp. en murciélagos en el Departamento del Atlántico en Colombia. Implicancias. La gran capacidad de adaptación de los murciélagos a diferentes nichos ecológicos y su rol como hospederos de Trypanosoma spp. en ecótopos silvestres y urbanos representa un factor de riesgo en ciclos de transmisión de importancia epidemiológica.

First report of an acute case of chagas disease in the municipality of Miraflores, Guaviare, Colombia. / Primer caso agudo de enfermedad de Chagas en el municipio de Miraflores, Guaviare, Colombia.

We present a case of acute phase Chagas disease in a 40-year-old male patient from Vereda Buenos Aires, Municipality of Miraflores, Department of Guaviare. The patient attended the emergency department with fever, headache, asthenia, adynamia and dysuria. The blood smear and urinalysis were positive for symptomatic urinary tract infection, but negative for malaria. Five days later the diagnosis of acute phase Chagas disease was confirmed after a positive result for Trypanosoma cruzi. The patient was treated with nifurtimox and benznidazole, his contacts and risk areas were investigated, an active entomological community and institutional search was carried out, as well as in the reservoirs, finally, laboratory surveillance for possible cases of infection in the community was conducted. Five cases with similar symptoms were identified, but parasitological tests were negative. Health education measures were implemented to prevent the spread of the disease.

Se presenta un caso de enfermedad de Chagas en fase aguda en un paciente masculino de 40 años, procedente de la Vereda Buenos Aires, Municipio de Miraflores, Departamento del Guaviare. El paciente acudió a urgencias con fiebre, cefalea, astenia, adinamia y disuria. Se realizó un frotis de sangre y un análisis de orina, con resultados positivos para infección urinaria sintomática, pero negativos para malaria. Cinco días más tarde se confirmó el diagnóstico de enfermedad de Chagas en fase aguda tras recibir un resultado positivo para Trypanosoma cruzi. El paciente recibió tratamiento con nifurtimox y benznidazol, y se llevó a cabo una investigación de contactos y zonas de riesgo, búsqueda activa comunitaria e institucional, entomológica y de reservorios, y una vigilancia de laboratorio para detectar posibles casos de infección en la comunidad. Se identificaron cinco casos con síntomas similares, pero las pruebas parasitológicas fueron negativas. Se aplicaron medidas de educación sanitaria para prevenir la propagación de la enfermedad.

Evaluation of the management of a first crisis of atrial fibrillation in a group of Cameroon's urban setting subjects.

BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. When atrial fibrillation is first diagnosed, it tends to be permanent and associated with significant morbidity and mortality. We aimed to study the management of a first episode of atrial fibrillation in a group of patients in Yaounde, Cameroon. METHODS: We conducted a retrospective study with data collected from the Cardiology department of Yaounde Central Hospital and the internal medicine department of Yaounde General Hospital over five years (January 2017 to December 2021), for a duration of 4 months, from February 2022 to May 2022. All patients older than 15 years with a first episode of atrial fibrillation were included, and all patients with incomplete medical records were excluded. The association between different variables was assessed using a χ² test and logistic regression method with a significance threshold of p < 0.05. RESULTS: Of the 141 patients recruited, the mean age was 68.5 ± 10.6 years. The sex ratio (M/F) was 0.7. The main associated factors and co-morbidities were hypertension in 70.2% (99) patients, heart failure in 36.9% (52) patients and a sedentary lifestyle in 33.3% (47) patients. The most common anticoagulant treatment was AntiVitamin K, used in 64.5% (91) of patients. Heart rate control was the most commonly used symptom control strategy in 85.1% (120) patients, mainly with beta-blockers in 52.5% (74). We found 1.4% (2) participants who were not treated with antithrombotics as recommended. Treatment of arrhythmia due to co-morbidities was not always recommended. The complication rate was 94.3% (133) patients. Control of the bleeding risk due to antithrombotic therapy and monitoring of anticoagulant therapy were not optimal. The heart rate control strategy had a higher success rate, and the sinus rhythm maintenance rate at one year was 61.7% (37) participants. CONCLUSION: The management of a first episode of atrial fibrillation at Yaoundé's Central and General Hospitals is not always performed according to current recommendations and is far from optimal. However, nearly two out of three patients maintained sinus rhythm for one year.

Healthy city evaluation based on factor analysis-Taking cities in the Guangxi Zhuang Autonomous Region as an example.

As urbanization speeds up, the concept of healthy cities is receiving more focus. This article compares Chongzuo and Nanning in Guangxi with Beijing to assess the development gaps in cities in Guangxi. An indicator system for healthy cities was designed from six dimensions-healthy economy, healthy population, healthy healthcare, healthy environment, healthy facilities, and healthy transportation-and 26 secondary indicators, which were selected from 2005 to 2022, and an improved factor analysis was used to synthesize a healthy city index (HCI). The number of factors was determined by combining characteristic roots and the variance contribution rate, and the HCI was weighted using the entropy-weighted Topsis method. A comprehensive evaluation of the urban health status of these cities was conducted. The results showed that extracting six common factors had the greatest effect, with a cumulative variance contribution rate of 93.83%. Chongzuo city scored higher in the field of healthcare. The healthy environment score of Nanning was relatively high, which may be related to continuous increases in green measures. In terms of the healthy economy dimension, Beijing was far ahead. However, in recent years, the healthy economy level in Chongzuo has increased, and the GDP growth rate has ranked among the highest in Guangxi. In addition, the growth rate of healthy facilities in Nanning was relatively fast and has been greater than that in Chongzuo in recent years, which indicates that the Nanning Municipal Government believes urban construction and municipal supporting facilities are highly important. In terms of healthy transportation, Chongzuo and Nanning scored higher than Beijing. This may be because the transportation in these two cities is convenient and the traffic density is more balanced than that in Beijing, thereby reducing traffic congestion. Chongzuo had the highest score for a healthy population, and a steadily growing population provides the city with stable human resources, which helps promote urban economic and social development. Finally, relevant policy recommendations were put forwards to enhance the health level of the cities.

Heat exposure impacts on urban health: A meta-analysis.

The escalating health risks posed by warm weather in urban areas have become a pressing global public health issue. This study undertakes a meta-analysis to evaluate the impact of warm weather on health in urban settings. We comprehensively searched PubMed, Embase, Scopus, and Web of Science for literature published before September 6, 2023, evaluating evidence quality using the Navigation Guide Criteria. We included original studies utilizing high temperatures or heatwaves as exposure metrics and employing observational designs. A meta-analysis was carried out to assess the relative risk (RR) of the association between high temperatures (or heatwaves) and disease outcomes. Out of 12,893 studies identified, 188 met the inclusion criteria for meta-analysis. Results demonstrate a statistically significant association between a 1 °C temperature increase and a 2.1 % elevation in disease-related mortality (RR 1.021 [95 % CI 1.018-1.023]), alongside a 1.1 % increase in morbidity (RR 1.011 [95 % CI 1.007-1.016]). Heatwaves also showed associations with increased total mortality (RR 1.224 [95 % CI 1.186-1.264]) and morbidity (RR 1.038 [95 % CI 1.010-1.066]). Subgroup analyses for diseases, sex, age, climatic zones, countries, and time periods consistently indicated heightened disease-related mortality and morbidity linked to high temperatures. Notably, China's urban population faced an elevated mortality risk (RR 1.027 [95 % CI 1.018-1.036]) compared to other countries (RR 1.021 [95 % CI 1.019-1.024]). Mortality associated with high temperatures after 2007 (RR 1.022 [95 % CI 1.015-1.029]) was higher than before 2007 (RR 1.017 [95 % CI 1.013-1.021]), reflecting increased health risks as the global warming accelerates. Our findings underscore the positive association between rising temperatures and/or heatwaves and adverse health outcomes in urban populations. The widespread exposure to high temperatures amplifies health risks across various diseases, demographics, climates, and countries, with potential exacerbation under ongoing global warming. Further research is imperative to delineate factors influencing altered heat exposure impacts.