Prevalence of intestinal parasitism in preschool and school children in Colombia: Systematic review and meta-analysis.

OBJECTIVE: Intestinal parasitic infections (IPIs) are a public health challenge in developing countries such as Colombia, causing anaemia and delayed growth and development in children. We aimed to estimate the geographical and prevalence trend of IPIs in the last 30 years in school and preschool children in Colombia. METHODS: We conducted a systematic review and meta-analysis. We identified potential manuscripts through PubMed, EMBASE, Web of Science, LILACS, Scielo and Google Scholar on the IPIs prevalence in school and preschool children in Colombia. Articles included in the qualitative analysis were published between 1990 and 2020 in English or Spanish and met the inclusion criteria. Subsequently, a random-effects meta-analysis, a meta-regression and a trend analysis were performed. RESULTS: We identified 2292 articles; 109 were included in the qualitative review, and 79 articles were included in the meta-analysis. The estimated IPI prevalence was 55% (95% CI: 48-63). By age group, the prevalence in preschool children was 37% (95% CI: 26-49) and 66% (95% CI: 52-78) in schoolchildren. The prevalence by region was heterogeneous, with the Amazon being the highest (69%) and the Santanderes the lowest (28%). In the last 20 years, the prevalence of helminthiasis has decreased (from 64.66% in 1990-1995 to 22.09% in 2016-2020). CONCLUSION: The prevalence of IPIs is high (>30%) in three of the seven regions in Colombia. Biannual administration of mass deworming in schoolchildren is recommended in the Amazon region. Public policies aiming to control IPIs should be reinforced. Further prevalence studies should include Cesar, Guaviare, Vichada and Vaupés, where the epidemiology of IPIs is unknown. SUSTAINABLE DEVELOPMENT GOALS: Good health and wellbeing, clean water and sanitation, sustainable cities and communities.

SARS-CoV-2 Infection among School Population of One Developing Country. Do School Closures Protect Students and Teachers against SARS-CoV-2 Infection?

Evidence about the effectiveness of school closures as a measure to control the spread of COVID-19 is controversial. We posit that schools are not an important source of transmission; thus, we analyzed two surveillance methods: a web-based questionnaire and a telephone survey that monitored the impact of the pandemic due to COVID-19 cases in Bogotá, Colombia. We estimated the cumulative incidences for Acute Respiratory Infection (ARI) and COVID-19 for each population group. Then, we assessed the differences using the cumulative incidence ratio (CIR) and 95% confidence intervals (CI95%). The ARI incidence among students was 20.1 times higher when estimated from the telephone survey than from the online questionnaire (CIR: 20.1; CI95% 17.11-23.53). Likewise, the ARI incidence among schoolteachers was 10 times higher in the telephone survey (CIR: 9.8; CI95% 8.3-11.5). the incidence of COVID-19 among schoolteachers was 4.3 times higher than among students in the online questionnarie (CIR: 4.3, CI95%: 3.8-5.0) and 2.1 times higher in the telephone survey (CIR = 2.1, CI95%: 1.8-2.6), and this behavior was also observed in the general population data. Both methods showed a capacity to detect COVID-19 transmission among students and schoolteachers, but the telephone survey estimates were probably closer to the real incidence rate.

Burden of disease due to microcephaly associated with the Zika virus in Colombia.

In 2015, the Zika virus was introduced in Colombia. The emergence of this arbovirus is a public health challenge for the country, considering the association between the infection and congenital disorders such as microcephaly. Thus, we estimated the burden of disease due to microcephaly associated with Zika in Colombia and its administrative subdivisions for the period 2015-2016. We conducted an exploratory ecological study, using as unit of measurement disability-adjusted life years (DALYs). The cases of microcephaly were obtained from the Zika national and departmental databases built by the National Public Health Surveillance System (SIVIGILA). Deaths attributed to microcephaly were estimated from previous studies. Finally, we calculated mortality rates and incidences, then we performed a sensitivity analysis under three scenarios (conservative, medium, and extreme) to estimate the DALYs. In the 2015-2016 period, 10,609.4 DALYs were caused by microcephaly associated with Zika in Colombia. 71% of the total DALYs were years of life lost and 29% were years lived with disability. Five out of 32 departments (Meta, Córdoba, Tolima, Valle del Cauca, and Norte de Santander) contributed 71% of total DALYs. The burden of microcephaly associated with Zika outweighed the burden of other congenital anomalies such as neural tube defects and Down syndrome in children aged between 0 and 4 years in Colombia. Public health efforts must be made to prevent and monitor these cases.

Estimating the burden of arboviral diseases in Colombia between 2013 and 2016.

OBJECTIVE: During the 2013-2016 period, Dengue, Chikungunya, and Zika affected more than 1 million people in Colombia. These arboviruses and their chronic manifestations pose a public health challenge. Therefore, we estimated the burden of disease by Dengue, Chikungunya, and Zika in Colombia between 2013 and 2016. METHODS: An exploratory ecological study was carried out using the disability-adjusted life years (DALYs) as a unit of measure. The mortality databases of the National Administrative Department of Statistics (DANE) and the morbidity databases of the National Public Health Surveillance System (SIVIGILA) were used. Deaths and cases for each arbovirus were grouped and then adjusted to control biases. Subsequently, we performed a sensitivity analysis. RESULTS: In the 2013-2016 period, 491,629.2 DALYs were lost due to arboviruses in Colombia. By disease, 26.6% of the total DALYs were caused by Dengue, 71.3% by Chikungunya, and the remaining 2.2%, by Zika. The majority of DALYs (68.2%) were caused by chronic complications. Five out of 32 departments (Valle del Cauca, Tolima, Norte de Santander, Huila, and Bolívar) contributed 50.5% of total DALYs. CONCLUSION: The burden of disease by arboviruses in the 2013-2016 period exceeded the burden of other infectious diseases such as HIV/AIDS and tuberculosis in Colombia. Public health efforts must be made to mitigate new epidemics of these arboviruses.