RESUMEN
Background: French Polynesia is a French overseas collectivity in the Southeast Pacific, comprising 75 inhabited islands across five archipelagoes. The human settlement of the region corresponds to the last massive migration of humans to empty territories, but its timeline is still debated. Despite their recent population history and geographical isolation, inhabitants of French Polynesia experience health issues similar to those of continental countries. Modern lifestyles and increased longevity have led to a rise in non-communicable diseases (NCDs) such as obesity, diabetes, hypertension, and cardiovascular diseases. Likewise, international trade and people mobility have caused the emergence of communicable diseases (CDs) including mosquito-borne and respiratory diseases. Additionally, chronic pathologies including acute rheumatic fever, liver diseases, and ciguatera, are highly prevalent in French Polynesia. However, data on such diseases are scarce and not representative of the geographic fragmentation of the population. Objectives: The present project aims to estimate the prevalence of several NCDs and CDs in the population of the five archipelagoes, and identify associated risk factors. Moreover, genetic analyses will contribute to determine the sequence and timings of the peopling history of French Polynesia, and identify causal links between past genetic adaptation to island environments, and present-day susceptibility to certain diseases. Methods: This cross-sectional survey is based on the random selection of 2,100 adults aged 18-69 years and residing on 18 islands from the five archipelagoes. Each participant answered a questionnaire on a wide range of topics (including demographic characteristics, lifestyle habits and medical history), underwent physical measurements (height, weight, waist circumference, arterial pressure, and skin pigmentation), and provided biological samples (blood, saliva, and stool) for biological, genetic and microbiological analyses. Conclusion: For the first time in French Polynesia, the present project allows to collect a wide range of data to explore the existence of indicators and/or risk factors for multiple pathologies of public health concern. The results will help health authorities to adapt actions and preventive measures aimed at reducing the incidence of NCDs and CDs. Moreover, the new genomic data generated in this study, combined with anthropological data, will increase our understanding of the peopling history of French Polynesia. Clinical trial registration: https://clinicaltrials.gov/, identifier: NCT06133400.
RESUMEN
Objetivo: Determinar la Dosis Diaria Definida (DDD) de antibióticos utilizados en los Servicios de Medicina Interna de cuatro hospitales públicos en Panamá. Métodos: Se escogió una muestra a conveniencia de 4 hospitales públicos de segundo nivel de atención de la seguridad social y Ministerio de Salud, atendiendo características en cuanto a ubicación en provincias, población atendida, servicios médicos ofrecidos y con Dosis Unitaria en funcionamiento. Se obtuvieron datos de los pacientes hospitalizados entre los meses de enero a marzo del 2017 y la información era registrada en una base de datos anotándose generales del paciente, diagnósticos, antibióticos, dosis, frecuencia, tiempo de tratamiento. Igualmente se anotaron los consumos y costos unitarios de todos los antibióticos usados en los hospitales durante el año 2016, para calcular la DDD y Dosis Diaria Prescrita. Resultados: La oxacilina fue el antibiótico con mayor DDD días cama con 60.5, luego le siguen ceftriaxona (45.2), cefalotina (35.5), clindamicina (35.5). Por grupo farmacológico, las cefalosporinas tienen consumos más altos con 87.6 DDD días cama, la penicilina MRSA 60.5, la lincosamidas con 35.5 DDD días cama, seguido de las quinolonas con 29.3. Conclusiones: Los resultados pueden ser utilizados para implementar programas para mejorar el uso racional y gasto de antibióticos a nivel hospitalario y que la DDD se use para medir el consumo y a la vez propiciar el control de antibióticos a través de comunicaciones escritas con los médicos tratantes. Se deben realizar estudios de DDD días cama relacionando con los aspectos microbiológicos para relacionar mejor el uso de los antibióticos. (provisto por Infomedic International)
Objective. Determine the Defined Daily Dose of antibiotics used in the Internal Medicine Services of 4 public hospitals in Panama. Methods. A convenience sample of 4 public hospitals of the second level of social security care and the Ministry of Health was chosen, considering characteristics in terms of location in the provinces, population served, medical services offered and with Unit Dose in operation. Data were obtained from hospitalized patients between the months of January to March 2017 and the information was recorded in a database, noting general patient reports, diagnoses, antibiotics, dose, frequency, treatment time. Likewise, the consumptions and unit costs of all antibiotics used in hospitals during 2016 were recorded to calculate the DDD and Prescribed Daily Dose. Results. Oxacillin was the antibiotic with the highest DDD bed days with 60.5, followed by ceftriaxone (45.2), cephalothin (35.5), and clindamycin (35.5). By pharmacological group, cephalosporins have higher intakes with 87.6 DDD bed days, penicillin MRSA 60.5, and lincosamides with 35.5 DDD bed days, followed by quinolones with 29.3. Conclusions. The results can be used to implement programs to improve the rational use and expense of antibiotics at the hospital level and that the DDD is used to measure the consumption and at the same time promote the control of antibiotics through written communications with the treating physicians. Bed-day DDD studies should be carried out relating to microbiological aspects to better relate the use of antibiotics. (provided by Infomedic International)