Measuring Food Insecurity in Children under 5 Years of Age with Acute Undernutrition in Valle Del Cauca-Colombia.

Malnutrition is a global problem that affects all countries in one or more of its forms, representing one of the greatest challenges worldwide. One of the key contributing factors is food insecurity, which must be evaluated in children with moderate and severe acute malnutrition, as they are at imminent risk of death. OBJECTIVE: Our objective was to assess food insecurity among children under 5 years old with moderate, and severe malnutrition from Valle del Cauca, a state located in the southwestern region of Colombia. METHODS: A descriptive observational study was conducted, including children whose weight-for-height (W/H) indicator was below 2 SD, as recorded on the World Health Organization (WHO) growth charts, or who exhibited severe malnutrition phenotypes such as marasmus or Kwashiorkor. Family and child food security were evaluated using the Latin American and Caribbean Food Security Scale (ELCSA). RESULTS: 58.6% of households with acutely malnourished children experienced food insecurity. A statistically significant relationship was found between food insecurity and children of Afro-Colombian and Indigenous descent. According to caregivers' perceptions, 30.2% of child malnutrition cases were related to poor feeding and caregiving practices. CONCLUSIONS: Not all children with acute malnutrition suffer from food insecurity. Therefore, the findings of this research suggest that governmental efforts should focus not only on ensuring food availability, but also on educating caregivers about the importance of a balanced and nutritious diet tailored to the specific characteristics of each region and promoting appropriate caregiving practices.

[Antibiotic consumption surveillance in 10 health institutions between 2013 and 2020 in Colombia]. / Vigilancia del consumo de antimicrobianos en 10 instituciones de salud entre 2013 y 2020 en Colombia.

BACKGROUND: The use of antibiotics is the main factor of microbial resistance. AIM: To determine the consumption of antibiotics in health care institutions in Santiago de Cali between 2013 and 2020. METHODS: The methodology of the Defined Daily Dose per 100 beddays was employed. Institutions that had at least 9 annual reports and that the report is greater than 95% were defined as inclusion criteria. In this case, 10 institutions were included. RESULTS: Consumption in Intensive Care Units (ICU) was higher than in other units. Ceftriaxone and imipenem were more consumed in units other than ICU, whereas meropenem, piperacillin/tazobactam and vancomycin were more consumed in the ICU. In units other than ICU, two institutions increased the consumption of ceftriaxone, ciprofloxacin and piperacillin/tazobactam and one the consumption of vancomycin, whereas in the ICU, one institution increased the consumption of piperacillin/tazobactam. The endemic range identified that vancomycin located itself in the epidemic zone in one institution. CONCLUSION: The system provided tools for prospective surveillance that showed the need for intervention in institutions.

Vigilancia del consumo de antimicrobianos en 10 instituciones de salud entre 2013 y 2020 en Colombia / Antibiotic consumption surveillance in 10 health institutions between 2013 and 2020 in Colombia

INTRODUCCIÓN: El uso de antimicrobianos es el principal factor de resistencia bacteriana. OBJETIVO: Determinar el consumo de antimicrobianos en instituciones de salud de Santiago de Cali entre 2013 y 2020. MATERIAL Y MÉTODO: Se empleó la Dosis Diaria Definida por 100 camas-día. Se definieron como criterios de inclusión las instituciones que tuvieran como mínimo 9 reportes anuales y que el reporte fuese superior a 95%. En este caso quedaron incluidas 10 instituciones. RESULTADOS: El consumo en Unidades de Cuidados Intensivos (UCI) fue mayor que en servicios diferentes a UCI. Se consumió más ceftriaxona e imipenem en servicios diferentes a UCI, mientras que meropenem, piperacilina/tazobactam y vancomicina lo fueron en UCI. En servicios diferentes a UCI, dos instituciones aumentaron el consumo para ceftriaxona, ciprofloxacina y piperacilina/tazobactam y una para vancomicina, mientras que en UCI en una institución el consumo aumentó para piperacilina/tazobactam. CONCLUSIÓN: El sistema brindó herramientas de vigilancia prospectiva que mostraron necesidades de intervención en instituciones.

BACKGROUND: The use of antibiotics is the main factor of microbial resistance. Aim: To determine the consumption of antibiotics in health care institutions in Santiago de Cali between 2013 and 2020. METHODS: The methodology of the Defined Daily Dose per 100 beddays was employed. Institutions that had at least 9 annual reports and that the report is greater than 95% were defined as inclusion criteria. In this case, 10 institutions were included. RESULTS: Consumption in Intensive Care Units (ICU) was higher than in other units. Ceftriaxone and imipenem were more consumed in units other than ICU, whereas meropenem, piperacillin/tazobactam and vancomycin were more consumed in the ICU. In units other than ICU, two institutions increased the consumption of ceftriaxone, ciprofloxacin and piperacillin/tazobactam and one the consumption of vancomycin, whereas in the ICU, one institution increased the consumption of piperacillin/tazobactam. The endemic range identified that vancomycin located itself in the epidemic zone in one institution. CONCLUSION: The system provided tools for prospective surveillance that showed the need for intervention in institutions.

Ralstonia spp. in a dialysis unit: an experience in the identification and control of an outbreak / Ralstonia spp. en una unidad de diálisis: experiencia en la identificación y control de brote

Abstract Objective: to describe an experience in identification and control of an outbreak of Ralstonia spp. in a renal unit. Material and Method: an epidemiological investigation of a hospital outbreak in 2 sites and extramural service of a renal unit. The investigation included patients who presented fever or chills, during or after dialysis, and who had positive blood culture for Ralstonia spp. Results: Of 769 hemodialysis patients, 124 were identified with bacteremia by Ralstonia spp.; of these, 98.4% had catheter access and 1.6% had fistula. The overall attack rate was 16.1% and the case fatality rate was 0.8%. Environmental cultures were taken and drugs and devices were tracked. Several cultures were taken of the prefilled heparin following the methods described in the International Pharmacopoeia. However, it was the technique of microbial isolation recommended by experts that enabled the isolation of the microorganism and confirmed the source. Conclusions: The outbreak described exceeded the number of patients affected documented in literature. It was caused by a contaminated batch of heparin. Evidence is provided of a recommended by expert technique used for the isolation of Ralstonia spp. in order to achieve control of outbreaks in a timely manner, minimizing clinical, economic, and social impact.

Resumen Objetivo: describir la experiencia en la identificación y control de un brote por Ralstonia spp. en una unidad renal. Material y Método: investigación epidemiológica de brote hospitalario en 2 sedes y servicio extramural de una unidad renal. Se incluyeron pacientes que presentaron fiebre o escalofrío, durante o después de la terapia dialítica, y que tuvieran hemocultivo positivo para Ralstonia spp. Resultados: De los 709 pacientes para hemodiálisis, se identificaron 124 con bacteriemia por Ralstonia spp., 98,4% tenían acceso por catéter. La tasa de ataque global fue del 16,1% y la tasa de letalidad 0,8%. Se realizaron cultivos ambientales y trazabilidad de medicamentos y dispositivos, pero ante la presencia de casos extramurales la hipótesis fue redireccionada. La heparina prellenada había sido cultivada en varias oportunidades siguiendo la metodología de la farmacopea internacional. Sin embargo, la técnica de aislamiento microbiano recomendada por expertos fue la que permitió aislar el microorganismo y confirmar la fuente. Conclusiones: El brote que se describe excedió el número de pacientes documentados en la literatura y fue causado por un lote contaminado de heparina. Se aporta evidencia de una técnica recomendada por expertos utilizada para el aislamiento de Ralstonia spp. a fin de lograr el control de brotes de manera oportuna, minimizando el impacto clínico, económico y social.

Seroprevalencia de dengue en municipios con transmisión hiperendémica y mesoendémica, Valle del Cauca, Colombia / Seroprevalence of dengue in municipalities with hyperendemic and mesoendemic transmission in Valle del Cauca, Colombia

Introducción: El dengue se ha convertido en una de las enfermedades de mayor impacto epidemiológico, social y económico para la salud pública a nivel mundial. Objetivo: Determinar la seroprevalencia de dengue en cinco municipios del Valle del Cauca con transmisión hiperendémica y mesoendémica de la enfermedad. Métodos: Estudio de prevalencia mediante muestreo probabilístico por conglomerados multietápico. Se evaluaron 822 personas. Resultados: La seroprevalencia de dengue fue del 91,36 por ciento obtenida a partir de la aplicación de la prueba de ensayo por inmunoabsorción ligado a enzimas para dengue indirecta IgG. Al aplicar la prueba de captura para IgM para dengue, la seroprevalencia fue de un 21,41 por ciento. La seropositividad conjunta de anticuerpos IgM e IgG fue del 20,3 por ciento. Conclusiones: La alta seroprevalencia de dengue en el Valle del Cauca muestra el impacto de esta enfermedad en la historia de vida de sus residentes. Su reemergencia impacta negativamente en los que tienen como antecedentes haber padecido la enfermedad provocando un desarrollo de su variante más grave, lo que se puede evitar con la administración de una vacuna tetravalente contra el dengue(AU)

Introduction: Dengue has become one of the largest epidemiological, social, and economic impacts for global public health. Objective: To determine the seroprevalence of dengue in five municipalities of Valle del Cauca with hyperendemic and mesoendemic transmission of the disease. Methods: Prevalence study through multistage probability sampling by clusters. 822 people were assessed. Results: Seroprevalence of dengue was of 91.36 percent, it was obtained from the implementation of the enzyme-linked immunosorbent´s trial test for indirect dengue IgG. When applying the capture test IgM for dengue, seroprevalence was of 21.41 percent. The joint seropositivity of IgM and IgG antibodies was 20.3 percent. Conclusions: The high seroprevalence of dengue in Valle del Cauca shows the impact of this disease in the life history of the residents. Dengue re-emergence impacts negatively on those who have a background of having suffered from the disease which caused a development of its most severe variant that can be avoided with the administration of a quadrivalent vaccine against dengue(AU)

Abuso sexual en mujeres de 10 a 13 años en el Valle del Cauca, Colombia / Sexual abuse against women aged 10-13 in Valle del Cauca, Colombia

Objetivo: describir características del abuso sexual en mujeres de 10 a 13 años en el Valle del Cauca notificados a través del sistema de vigilancia en salud pública. Materiales y métodos: estudio observacional de corte transversal, la población objeto fueron mujeres entre 10 y 13 años víctimas de abuso sexual notificadas al sistema de vigilancia en salud pública del departamento del Valle del Cauca. A través de análisis secundario, se evaluaron características sociodemográficas de la víctima, información del agresor e información relacionada con el evento. Resultados: se utilizó el total de 431 casos de mujeres de 10 a 13 años violentadas sexualmente. 17,9% de las víctimas eran afrodescendientes, 58,2% pertenecían al régimen subsidiado, 6,3% no tenían afiliación, 75,9% eran estudiantes y 15,1% residían en la zona rural. La edad promedio de los agresores fue 24,9 años, 94,1% del sexo masculino y 94% eran personas conocidas por la víctima. En términos de atención en salud, 23,9% fueron hospitalizadas, 61,3% de los abusos fueron reportados a las autoridades, 53,6% recibieron atención en salud mental y 13,6% anticonceptivos de emergencia. Conclusiones: el abuso sexual afecta principalmente población con bajas condiciones sociales y económicas.La mayoría de victimarios son menores de edad con vínculos familiares con la víctima.Se hace imperativo fortalecer la atención integral en salud que se brinda a las víctimas y la complementariedad con los sectores de justicia y protección...(AU)

Objective: to describe characteristics of sexual abuse in women aged 10 to 13 years in the Valle del Cauca reported through the public health surveillance system. Materials and methods: a cross-sectional observational study, the target population was women between 10 and 13 years old, victims of sexual abuse notified to the public health surveillance system of the department of Valle del Cauca. Sociodemographic characteristics of the victim, information of the aggressor, and information related to the event were evaluated through secondary analysis. Results: a total of 431 cases of sexually abused women aged 10 to 13 years were used. 17.9% of the victims were Afro-descendants, 58.2% belonged to the subsidized regime, and 6.3% had no affiliation. 75.9% were students and 15.1% lived in rural areas. The average age of the perpetrators was 24.9 years, 94.1% were male and 94% were persons known to the victim. In terms of health care, 23.9% were hospitalized, 61.3% of the abuses were reported to the authorities, 53.6% received mental health care and 13.6% received emergency contraceptives. Conclusions: sexual abuse mainly affects the population with low social and economic conditions. The majority of perpetrators are minors with family ties to the victim. It is imperative to strengthen the comprehensive health care provided to victims, and the integration with the justice and protection sectors...(AU)

Actitud de los estudiantes en tres facultades de odontología en Santiago de Cali, Colombia, frente a pacientes con VIH / Atitude dos estudantes em três faculdades de odontologia em Santiago de Cali, Colômbia, frente a pacientes com HIV / Attitudes of students at three dental schools in Santiago de Cali, Colombia, toward HIV+ patients

Objetivos: Conocer la actitud de estudiantes de odontología de Cali respecto del manejo de personas con diagnóstico de VIH/SIDA. Método: Estudio observacional descriptivo mediante aplicación de una encuesta aplicada en 1.173 estudiantes de tres facultades de odontología de Cali, clasificados en tres grupos (preclínica, clínica inicial y clínica final). Resultados: participó un 63,4 por ciento; 50 por ciento tenía menos de 20 años, 68 por ciento mujeres. 92 por ciento solteros y 82 por ciento católicos. Se encontró actitud positiva entre 86 por ciento y 92 por ciento, la disposición de atender pacientes fue más favorable en preclínica (p=0.03). Aunque 88,7 por ciento mostró disposición de atender pacientes VIH+; entre los que pensaban que sería difícil hacerlo para su personal auxiliar, se encontró 33 por ciento de estudiantes con probabilidad de hacerlo, (p= 0.03). Cuando se interrogó sobre conocimientos acerca del VIH/SIDA, 66,7 por ciento (clínica final) y 82,2 por ciento (preclínica) percibían que no habían recibido entrenamiento previo (p<0,001). Conclusiones: Se evidenció que la intención de atender pacientes VIH+ era similar a lo reportado en otros países americanos e Irlanda. Los estudiantes necesitan recibir un mejor entrenamiento con el fin de disminuir sus temores y mejorar su actitud para atenderlos.

Objective: To know attitude of students at three dental schools in Santiago de Cali, Colombia, toward HIV+ patients. Methods: This is a cross-sectional study with using a questionnaire to 1173 invited to attend students from three dental schools in Cali. Students were classified in three groups (Pre-clinic: semester I-IV; initial clinic: V to VII and last clinical: VIII to X). Results: Participation rate was 63.4 percent. 50 percent under 20 years old, 68 percent female, 92 percent single, and 82 percent Catholics. Between 86 percent and 92 percent had positive attitudes; when asked about their willingness to care patients being more favorable preclinical students (p=0.03). Although, 88.7 percent of all students showed a willingness to address HIV patients. Among those who believed that it would be difficult for assistant staff to accept treating such patients there was a 33 percent chance of doing so (p=0.003). When we asked about training to manage, between 67 percent (clinical) and 82 percent (preclinical) perceive not receiving any. Conclusions: The intention to dental care was similar to that reported in the other American countries, and Ireland. Dental students need better training, because they do not perceived adequate training, to reduce their fear and increase positive attitudes to care for HIV/AIDS patients.

Objetivos: Conhecer a atitude de estudantes de odontologia de Cali a respeito do manejo de pessoas com diagnóstico de HIV/AIDS. Método: Estudo observacional descritivo mediante aplicação de um questionário aplicado em 1.173 estudantes de três faculdades de odontologia de Cali, classificados em três grupos (pré-clínica, clínica inicial e clínica final). Resultados: participaram 63,4 por cento; 50 por cento tinham menos de 20 anos, 68 por cento mulheres. 92 por cento solteiros e 82 por cento católicos. Foi encontrada atitude positiva entre 86 por cento e 92 por cento; a disposição de atender pacientes foi mais favorável na pré-clínica (p=0.03). Ainda que 88,7 por cento mostraram disposição de atender pacientes HIV+; entre os que pensavam que sería difícil fazê-lo para o seu pessoal auxiliar, foram encontrados 33 por cento de estudantes com probabilidade de fazê-lo, (p= 0.03). Quando se interrogou a cerca de conhecimentos sobre HIV/AIDS, 66,7 por cento (clínica final) e 82,2 por cento (pré-clínica) perceberam que não haviam recebido treinamento prévio (p<0,001). Conclusões: Foi evidenciado que a intenção de atender pacientes HIV+ era similar ao reportado em outros países americanos e Irlanda. Os estudantes necessitam receber um melhor treinamento com a finalidade de diminuir seus temores e melhorar sua atitude para atendê-los.