[Vascular disruption birth defects are not associated to chromosomal alterations]. / Defectos por disrupción vascular no asociados con alteraciones cromosómicas.

BACKGROUND: It is estimated that 2 to 35 of newborns present a congenital malformation. Some publications suggest that vascular disruption birth defects are not associated with chromosomal alterations detected by conventional karyotype. OBJECTIVE: to determine the frequency of chromosomal alterations detected by high resolution G banded karyotype in patients with vascular disruption birth defects in a Colombian population (South America). MATERIAL AND METHOD: transversal study. Population: a sample of patients identified by an epidemiological surveillance system of congenital malformations in a reference hospital in Cali, Colombia. RESULTS: 41 cases of vascular disruption birth defects were identified during a 36 month period; in a descending order those were: transverse reduction defects, hydranencephaly and gastroschisis. Two expert cytogenetists performed independent evaluation of the genetic material of the patients, and no chromosomal alterations detectable by G banded karyotype were identified. CONCLUSIONS: It is recommended that genetic counseling in cases of defects by vascular disruption is carried out taking into account the empirical recurrence risks reported for each one the types of defects by vascular disruption and the use of karyotype should be limited to cases with other malformations or chromosomal abnormality suspected by phenotype.

Nutrients intake as determinants of blood lead and cadmium levels in Colombian pregnant women.

OBJECTIVE: To evaluate the relationship between nutrients intake in the first trimester of pregnancy and blood levels of lead and cadmium during the first and third trimesters of gestation. METHODS: A total of 381 pregnant women were enrolled. Blood lead and cadmium were measured using electrothermal atomic absorption spectrometry, and dietary intake was assessed using 24-h recall questionnaire. RESULTS: Lead levels in the first trimester were negatively correlated with cadmium levels in the two trimesters, and levels of both metals correlated positively in the third trimester. Zinc and calcium intakes were negatively associated with blood lead during third trimester. Thiamine and folic acid intakes were negatively and positively associated (respectively) with blood lead at third trimester with marginal significance. Fat, niacin, and vitamin B12 intakes were significantly and positively associated with blood cadmium at first trimester. Folic acid and zinc intakes showed positive and marginally significant associations with blood cadmium without adjustments. At third trimester, blood cadmium was negatively associated to ascorbic acid intake, and positively associated with iron intake with a marginal significance. CONCLUSIONS: Possible acute and late effects of nutrients intake in blood lead and cadmium levels could be related with associations exclusively observed in the first and third trimester. This study represents the first exploration of relationships among a wide range of nutrients intake in the first trimester of pregnancy with blood lead and cadmium in first and third trimester of gestation. Further studies are required to confirm the findings mentioned herein.

Association of self-reported familial history of cardiometabolic disease with metabolic syndrome in apparently healthy urban Colombian men.

OBJECTIVES: Evidence about the relationship between familial history (FH) of cardiometabolic disease (CMD) and metabolic syndrome (MetS) in Latin American populations is scarce. The aim of this study was to evaluate the relationship of FH of CMD and of dyslipidemia and obesity with MetS in healthy men. METHODS: One-hundred-twenty one individuals were recruited. Waist circumference and blood pressure were measured by a trained researcher using standard techniques. Glycemia and lipid profile were determined by colorimetric assays. A survey to record personal data and family antecedents in siblings, aunts/uncles, parents, and grandparents was conducted by trained interviewers. RESULTS: Individuals having three or more familial antecedents were associated with high triglycerides level even after adjusting by age, sedentarism, fat and carbohydrates intake, and alcohol consumption. After adjusting for the same variables, FH of dyslipidemia and hypertension was also associated with high triglycerides levels and elevated waist circumference, respectively. The FH of stroke was associated with high blood pressure after adjusting for the rest of familial antecedents, and with MetS in all adjustment models. DISCUSSION: the findings of association of this study together with the previous reports are evidence of the importance of hereditary component as independent predictor of cardiovascular risk factors and its clustering, as well as of possible specific association patterns between FH of CMD and MetS depending on evaluated population in terms of ethnic groups and geographic region. Further studies are required in other populations, as well as exploration of genetic markers of CMD regarding to MetS.

Sedentary Behavior and School Bullying in Adolescents: An Analysis Based on a National Survey in Colombia.

BACKGROUND: Sedentarism has been associated with poorer mental health, greater likelihood of bullying and suicide risk; however, studies with national coverage are needed to characterize contexts and allow comparisons between nations. The aim of this study was to examine the association between sedentary lifestyles with bullying in the social context of Colombian adolescents. METHODS: Cross-sectional study with 78,772 adolescents aged 13-17 years participating in the 2017 National School Health Survey. Sedentary behavior was defined as sitting for 3+ hours/day of leisure time, while bullying was identified by self-report of being victimized 1+ times/month. Relative frequencies were estimated and, using a log-binomial regression model, prevalence ratios (PR) were calculated. RESULTS: A total of 15.31% of students reported being victims of bullying. A higher probability to be bullied was estimated in sedentary adolescents (PR: 1.18; 95% CI: 1.09-1.29), as well as in females, ethnic minorities, those who went hungry in the last month due to lack of food, students with health problems, and private schools. CONCLUSIONS: Bullying was related with sedentary leisure time, gender, ethnicity, type of educational institution, and presence of health problems. Being a multicausal phenomenon, bullying demands policies and programs with a greater focus on the most vulnerable groups.

Armed conflict, pollution, and health risks: A risk evaluation of three sources of environmental exposure associated with the conflict in Colombia / [Conflicto armado, contaminación y riesgos en salud: una evaluación de riesgo de tres fuentes de exposición ambiental asociadas con el conflicto en Colombia].

Introduction: Armed conflicts affect territories rich in resources and biodiversity. As a result of the environmental damage caused by violent actions, the health of populations can be affected. Objectives: To assess the risks to human health due to environmental degradation associated with three violent actions in the context of the Colombian armed conflict: Pipeline bombing, informal mining with mercury, and spraying of illicit crops with glyphosate. Materials and methods: We conducted a quantitative evaluation of the risks to individual health associated with armed conflict activities using methodologies focused on the routes of pollutants dispersion, their concentrations in the environment, the exposure of the individuals, and the risks of carcinogenic and non-carcinogenic effects. Results: The risk assessment of the armed conflict-related actions under study evidenced intolerable carcinogenic risk and unacceptable non-carcinogenic risk due to the consumption of water and fish contaminated by polycyclic aromatic hydrocarbons (PAH), mercury, and glyphosate. Conclusions: The study reiterates the inextricable connections existing among the environment, society, and health, as well as the implications of environmental violence for the public health of vulnerable population groups and, in general, for the well-being of all living beings affected by the armed conflict.

Introducción. Los conflictos armados afectan los territorios ricos en recursos y biodiversidad; el daño ambiental causado por las acciones violentas puede afectar la salud de las poblaciones. Objetivos. Evaluar los riesgos para la salud humana debidos a la degradación ambiental asociada con tres acciones violentas en el marco del conflicto armado colombiano: la voladura de oleoductos, la minería informal con mercurio y la aspersión de cultivos ilícitos con glifosato. Materiales y métodos. Se hizo una evaluación cuantitativa de los riesgos para la salud individual asociados con actividades del conflicto armado, usando metodologías que tienen en cuenta la ruta de dispersión de los contaminantes, su concentración en el ambiente, la exposición de los individuos y los riesgos de efectos cancerígenos y no cancerígenos. Resultados. La evaluación de los riesgos asociados con las acciones en el marco del conflicto armado analizadas, evidenció un riesgo cancerígeno intolerable y uno no cancerígeno inaceptable debidos al consumo de agua y peces contaminados por hidrocarburos aromáticos policíclicos, mercurio y glifosato. Conclusiones. El estudio reafirmó las conexiones inextricables que existen entre ambiente, sociedad y salud, y las implicaciones de la violencia ambiental para la salud pública de los grupos poblacionales vulnerables y, en general, para el bienestar de todos los seres vivos afectados por el conflicto armado.

Continuity of Care and the Control of High Blood Pressure at Colombian Primary Care Services.

Continuity of care (COC) has been associated with lower mortality and hospitalizations and higher high blood pressure (HBP) control rates. This evidence mainly came from high income countries. We aimed to identify conditions associated with controlled HBP, particularly COC, in primary care services (PCSs) affiliated to two health insurances in Colombia, a low-median income country. A longitudinal observational study was carried out using clinical records of hypertensive adults >18 years with ≥4 clinic visits attending a contributive and a subsidized PCS in Cali (Colombia) between 2013 and 2014. Subsidized PCSs were for unemployment people and those at low socio-economic position and contributive for formal workers. COC was measured using the Bice and Boxerman index. Logistic regression models were performed to quantify the relation between COC and controlled HBP (blood pressure <140/90 mmHg). Between 2013 and 2014, among 8797 hypertensive people identified, 1358 were included: 935 (68.8%) and 423 (31.1%) from the contributive and subsidized PCSs, respectively. 856 (62.3%) were women and had a mean age of 67.7 years (SD 11.7). All people were on antihypertensive treatment. Over the study period, 522 (38.4%) people had controlled HBP, 410 (43.9%) in the contributive and 112 (26.5%) in subsidized PCSs. An increase in 1 unit of the COC index is associated with a 161% higher probability of having HBP controlled (OR, 2.61; 95% CI, 1.25-5.44). The odds of having controlled HBP increased as the number of visits rose; for example, people at the fourth visit had a 34% (OR, 1.34; 95% CI, 1.08-1.66) higher probability of reaching the target. Continuity of care was positively associated with controlled HBP. The strengthening of COC can improve the observed low HBP control rates and reduce health inequalities.

Skin color, social inequalities and health in older adults: an analysis based on the SABE survey in Colombia.

Our study is based on the Colombia SABE survey (Health, Well-Being, and Aging Study), which included 23,694 individuals aged 60+ in urban and rural areas of the country. The analysis addresses adult self-perception of health status as a dependent variable and its relationships to ethnic/racial self-recognition and to interviewer-ascribed skin color as a phenotypic trait using a validated technique with a color palette. Social inequalities were determined based on the characterization of socioeconomic status, urban or rural residence, literacy, and the average years of education attained. Our study brought together socioeconomic factors, ethnic-racial self-recognition and skin color as factors of discrimination. Descriptive statistical tests and four adjusted logistic models were developed, controlling by the sex and the age of the individuals. The findings show that adults in households with better socioeconomic conditions have a better self-perception of health. Regarding ethnic-racial self-recognition, Afro-descendant, black, and mulatto adults have less good health perception than white-mestizo adults and face the worst socioeconomic conditions. In summary, skin color and ethnic and racial self-recognition categories, together with classic socioeconomic variables, are relevant to understand the health status self-perception of older adults as part of the processes of exclusion and discrimination that have consequences for health inequalities.

No land for food: prevalence of food insecurity in ethnic communities enclosed by sugarcane monocrop in Colombia.

OBJECTIVES: To evaluate how the food systems in areas close to sugarcane monocrops influence the prevalence of food insecurity (FI) among three ethnic communities in the upper Cauca River basin of Colombia. METHODS: We developed a mixed methodology study at three rural zones located in the departments of Cauca and Valle del Cauca, Colombia, using a household survey to establish the level of FI, and semi-structured interviews with key community actors. RESULTS: These three ethnic communities have a high prevalence of FI (> 70%) that was found to be associated with economic income, social security, gender, the presence of minors in the home, refrigerator in operation and ownership of the land. Loss of food sovereignty was associated with the sale and rental of land. CONCLUSIONS: The sugarcane monocrop has contributed to environmental crises, spatial confinement and sociocultural disruption in ethnic territories; by renting, selling or leasing their land to the industrial production of sugarcane, traditional practices of food production and self-consumption have been profoundly transformed. Ethnic cultures are endangered, while food security and sovereignty of indigenous and black communities have been negatively affected.

[Predictions of a SEIR model for COVID-19 cases in Cali-Colombia]. / Predicciones de un modelo SEIR para casos de COVID-19 en Cali, Colombia.

OBJECTIVE: To predict the number of cases of COVID-19 in the city of Cali-Colombia through the development of a SEIR model. METHODS: A SEIR compartmental deterministic model was used considering the states: susceptible (S), exposed (E), infected (I) and recovered (R). The model parameters were selected according to the literature review, in the case of the case fatality rate data from the Municipal Secretary of Health were used. Several scenarios were considered taking into account variations in the basic number of reproduction (R0), and the prediction until april 9 was compared with the observed data. RESULTS: Through the SEIR model it was found that with the highest basic number of reproduction [2,6] and using the case fatality rate for the city of 2,0%, the maximum number of cases would be reached on June 1 with 195 666 (prevalence). However, when comparing the observed with the expected cases, at the beginning the observed occurrence was above the projected, but then the trend changes decreasing the slope. CONCLUSIONS: SEIR epidemiological models are widely used methods for projecting cases in infectious diseases, however it must be taken into account that they are deterministic models that can use assumed parameters and could generate imprecise results.

[SARS-coV-2 spatio - temporal analysis in Cali, Colombia]. / Análisis espacio-temporal del SARS-COV-2 en Cali, Colombia.

OBJECTIVE: To describe the spatio-temporal distribution of the COVID-19 in the city of Cali during the first month of the epidemic. METHODS: An exploratory analysis of spatial data was carried out, consisting of a kernel density analysis and the presence of spatial patterns was verified by the K-Ripley function. RESULTS: The spatial distribution of the cases tends to initially concentrate in the north and south of the city, with a changing dynamic towards the east and west. CONCLUSIONS: The identified spatial pattern may be influenced by the isolation measures taken at the local and national level, but the effect of the low access of the general population to diagnostic tests, delays and restraints to know the results cannot be ruled out and even possible biases due to difficulties in the technique of taking the sample or its conservation.

Survey on health, well-being and aging. SABE Colombia 2015: Technical Report.

INTRODUCTION: Colombian population is getting old in an accelerated manner, causing economic, social and health services effects. The Ministry of Health and Social Protection in the National System of Population Studies and Surveys for Health implemented the first health, well-being and aging survey- SABE-2015 Colombia- to know the living conditions of people 60 years of age or older. OBJECTIVE: Describe the design of the method, statistical sampling and quality control of information from the SABE-2015 survey. METHODS: A cross-sectional study, with quantitative and qualitative approaches, representative for the population in urban and rural areas aged 60 or over. Information was collected on socioeconomic variables, physical and social environment, behavior, cognition and affection, functionality, mental well-being, health conditions, and the use and access to health services. RESULTS: 23,694 surveys were conducted, 17,189 in urban population (72.5%) and 6,505 in rural population. The percentage of effective national response was 66% in 244 municipalities. Supervision was made in 40% of the surveys and telephone re-contact in 25%. The consistency of 100% surveys was reviewed and double entry was developed in 5% of them. National estimates have a 5% margin error. CONCLUSION: The SABE Colombia 2015 survey is representative of the main indicators of health, well-being and aging in Colombia. The design allows regional comparisons, between large cities and urban and rural population.

INTRODUCCIÓN: La población colombiana está envejeciendo de forma acelerada lo cual está generando efectos económicos, sociales y en los servicios de salud que exigen de información confiable para la planeación y evaluación de políticas en esta población. El Ministerio de Salud y Protección Social implementó la primera encuesta de salud, bienestar y envejecimiento- SABE Colombia 2015- para conocer las condiciones de vida de las personas de 60 años o más. OBJETIVO: Describir el diseño del método, del muestreo estadístico y del control de calidad de la información de la encuesta SABE-2015. MÉTODOS: Encuesta con enfoque cuantitativo y cualitativo, representativo de la población urbana y rural colombiana de 60 años o más. Se registró información socioeconómica, del entorno físico y social, de la conducta, la cognición y el afecto, la funcionalidad, el bienestar mental, las condiciones de salud, y el uso y acceso a servicios de salud. RESULTADOS: Se realizaron 23,694 encuestas, 17,189 en población urbanas (72.5%) y 6,505 en población rurales. El porcentaje de respuesta efectiva nacional fue del 66% en 244 municipios. Se realizó supervisión en 40% de las encuestas y re-contacto telefónico en 25%. Se revisó la consistencia del 100% de encuestas y doble digitación en el 5%. A nivel nacional las estimaciones tienen un error del 5%. CONCLUSIÓN: La encuesta SABE Colombia 2015 es representativa de los principales indicadores de salud, bienestar y envejecimiento en Colombia. El diseño permite hacer comparaciones regionales, entre grandes ciudades y de población urbana y rural.

Prevalence, awareness, treatment and control of high blood pressure in the elderly according to the ethnic group. Colombian survey.

INTRODUCTION: High blood pressure (HBP) is the main cardiovascular risk factor, it is more prevalent in the older adult population, and the prevalence can vary between ethnic groups. OBJECTIVE: To estimate the prevalence of HBP, knowledge, treatment and control in population aged ≥60 years, resident in Colombia, according to their ethnic condition. METHODS: Population sample selected by multistage sampling. Ethnicity was defined based on skin color. HBP was defined as systolic blood pressure ≥140, and/or diastolic blood pressure ≥90 mm Hg, and/or the participants' self-report. Controlled HBP at a blood pressure value <140/90, knowledge and treatment were identified by self-report. RESULTS: 23,694 adults aged ≥ 60 years were included, of which 54.5%, 34.5% and 10.9% were respectively identified as having light, medium or dark skin color; 54.5% were women, and 78.1% resided in urban areas. The standardized prevalence of HBP, by age, was 57.7% (95% CI: 55.2 - 60.2); 51.4% (95% CI: 47.3-55. 5), in men; and 62.9% (60.9-64.9), in women. The standardized prevalence for light, medium and dark skin in men was 53.2% (95% CI: 48.7-57.7), 49.6% (44.5-54.7), and 49.4% (95% CI: 41.0-57.8) respectively; and in women was 62.5% (95% CI: 60.5-64 , 5), 61.7% (95% CI: 57.8-65.6), and 69.9% (95% CI: 63.6-76.2) respectively. 98% of the population received treatment, and 93.9% were aware of HBP diagnosis. 42.5% of men and 55.5% of women with HBP were under control. Only 21.8% performed regular physical activity. CONCLUSION: Half of the adult population aged over 60 years suffers from HBP; the prevalence is higher in women particularly in dark-skinned women. It is necessary to develop policies to increase physical activity in the elderly.

INTRODUCCIÓN: La presión arterial elevada (PAE) es el principal de factor de riesgo cardiovascular, es más prevalente en población adulta mayor y la prevalencia puede variar entre etnias. OBJETIVO: Estimar la prevalencia de PAE, conocimiento, tratamiento y control en población ≥60 años residente en Colombia de acuerdo con su condición étnica. MÉTODOS: Muestra poblacional seleccionada mediante un muestreo multietápico. La etnia se definió con base en el color de piel. La PAE se definió como presión arterial sistólica ≥140 y/o presión arterial diastólica ≥90 mm Hg y/o el autoreporte del participante. La PAE controlada a un valor de presión arterial <140/90, el conocimiento y el tratamiento se identificaron por autoreporte. RESULTADOS: Fueron incluidos 23,694 adultos con edad ≥ 60 años, de los cuales, 54.5%, 34.5% y 10.9% se identificaron con color de piel claro, medio u oscuro respectivamente, El 54.5%, eran mujeres y el 78.1% residía en zona urbana, La prevalencia estandarizada por edad de PAE fue 57,7% (IC 95%: 55.2-60.2), 51.4% (IC 95%: 4.3-55.5) en hombres y 62.9% (60.9-64.9) en mujeres, La prevalencia estandarizada en hombres claros, medios y oscuros fue 53.2%(IC 95%: 48.7-57.7), 49.6% (44.5-54.7) y 49.4% (IC 95%: 41.0-57.8) respectivamente y en mujeres 62.5% (IC 95%: 60.5-64.5), 61.7% (IC 95%: 57.8-65.6) y 69.9% (IC 95%: 63.6-76.2) respectivamente, El 98% de la población recibía tratamiento y el 93.9% conocía el diagnóstico de PAE, El 42.5% de los hombres y el 55.5% de las mujeres se encontraban con PAE controlada, El 21.8% realizaba actividad física regularmente. CONCLUSIÓN: La mitad de la población adulta mayor a 60 años sufre PAE, mayor prevalencia en mujeres y particularmente mujeres oscuras. Se requiere desarrollar políticas para incrementar la actividad física en el adulto mayor.

Effect of vaccination against oral HPV-16 infection in high school students in the city of Cali, Colombia.

INTRODUCTION: In recent years, an association between HPV-16 and oropharyngeal cancers has been reported. Therefore, it is necessary to evaluate whether vaccination decreases the exposure of HPV-16 in the oral cavity. OBJECTIVE: To evaluate the effect of vaccination on oral HPV-16 infection in high school students in the city of Cali, Colombia. METHODS: In this cross-sectional study, HPV-16 DNA was detected in samples from the oral cavity and throat of 1,784 high school students of both genders, aged 14-17 years old, in 21 schools in the city of Cali, Colombia. The number in vaccinated girls were 944 vs., 95 unvaccinated girls and 745 unvaccinated boys. RESULTS: The HPV exposure percentages were: 0.7% in vaccinated girls, 3.2% in unvaccinated girls and 2.3% in unvaccinated boys. The odds ratio (OR) of detection of HPV-16 in vaccinated versus unvaccinated students was 0.28 (95% CI: 0.07-0.88), representing a 72% reduction in HPV-16 detection in students immunized with two doses. The odds of detection of HPV-16 in unvaccinated male students were 3.6 times those of vaccinated girls (OR = 3.6, 95% CI: 1.21-12.81) and increased to almost eight-fold in boys who had initiated sexual activity (OR = 7.74, 95% CI: 1.53-75.09). CONCLUSIONS: HPV vaccination was associated with the reduction of HPV-16 exposure percentages in the oral and oropharyngeal cavity.

Blood pressure, ocular perfusion pressure and open-angle glaucoma in patients with systemic hypertension.

BACKGROUND: The aim of the study was to evaluate the relationship between blood pressure (BP), ocular perfusion pressure (OPP) and occurrence of primary open-angle glaucoma (POAG) among patients with systemic hypertension. PARTICIPANTS AND METHODS: A cross-sectional study of hypertensive patients was conducted in six cities in Colombia. The participants underwent a complete ophthalmological examination. The intraocular pressure measurement was obtained by Goldmann tonometry. The diagnosis of glaucoma was confirmed by visual field and optic nerve photos. Interviews and questionnaires were used to evaluate participants' lifestyle and other health conditions. A multinomial logistic regression was used to assess the relationship between BP, OPP and presence of suspected or confirmed POAG. RESULTS: A total of 1,272 individuals were included in this study; 131 (10.3%) were diagnosed with suspected glaucoma and 65 (5.1%) with confirmed glaucoma. High values of diastolic BP (>90 mmHg) and low values of OPP (<40 mmHg) were associated to an increased risk of confirmed POAG. The type of antihypertensive treatment did not modify these relationships. CONCLUSION: This study suggests that there is a close relationship between OPP and confirmed glaucoma in hypertensive patients, providing further evidence of the vascular mechanism in glaucoma pathogenesis.

Selection of antifolate-resistant Plasmodium falciparum by sulfadoxine-pyrimethamine treatment and infectivity to Anopheles mosquitoes.

Resistance-conferring mutations in dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS) in Plasmodium falciparum are selected by treatment with sulfadoxine pyrimethamine (SP). We assessed the association between these mutations and transmission capacity of parasites to Anopheles mosquitoes on the Pacific coast of Colombia. Patients with uncomplicated P. falciparum malaria received SP treatment and were followed-up to compare the prevalence of DHFR and DHPS mutations before and after SP treatment. Membrane feeding assays were used to measure infectivity to mosquitoes of post-treatment gametocytes with and without these mutations. Per-protocol treatment efficacy was 95.0% (132 of 139). Gametocytes carrying resistance-conferring mutations were selected after SP treatment and were infective to mosquitoes. Seven days after treatment, infections with two DHFR mutations had a 10-fold higher probability of infecting mosquitoes than infections with no DHFR mutations (odds ratio = 10.23, P < 0.05). Low-level drug resistance mutations have the potential to enhance transmission of P. falciparum and spread resistant parasites.

[Socioeconomic status, eating patterns, and heavy metals exposure in women of childbearing age in Cali, Colombia].

INTRODUCTION: Global increase in food and water pollution is associated with health risk, which depends on the concentration, the dose, and the exposure time. This has raised concerns about the possible long-term effects of chronic exposure to low concentrations of heavy metals, such as lead, cadmium and mercury. OBJECTIVE: To explore the relationship among socioeconomic status, eating patterns, and exposure to heavy metals among a population of women in Cali, Colombia. MATERIALS AND METHODS: A total of 233 non-pregnant women of childbearing age living in the Aguablanca district of Cali, Colombia, were enrolled in the study. We gathered sociodemographic data, as well as information on housing conditions, exposure to heavy metals, frequency of food intake, and anthropometric measurements. Samples of lettuce, cabbage and fish (tilapia and butterfish) were collected to determine lead, cadmium, and mercury concentrations. Descriptive and multiple correspondence analyses were performed to establish eating patterns. RESULTS: Fish was served in each of the three main meals of the day, with a bigger serving at lunch time. Cadmium was found in three samples of butterfish at levels below the acceptable. Of those who ate fish more than once a week, 11.1% bought the product at a cadmium-positive store. The multiple correspondence analysis showed a positive relationship between being black and consuming butterfish and tilapia more than once per week. CONCLUSIONS: The findings showed that the studied population had access to heavy metal-contaminated food, which combined with the women's cultural eating patterns, socioeconomic status, and metabolic characteristics led to a greater vulnerability to the effects of heavy metals exposure.

[Spatial distribution of potential and positive Aedes aegypti breeding sites].

INTRODUCTION: The spatial distribution of Aedes aegypti is heterogeneous, and the interaction between positive and potential breeding sites located both inside and outside homes is one of the most difficult aspects to characterize in vector control programs. OBJECTIVE: To describe the spatial relationship between potential and positive breeding sites of A. aegypti inside and outside homes in Cali, Colombia. MATERIALS AND METHODS: We conducted an entomological survey to collect data from both indoor and outdoor breeding sites. The exploratory analysis of spatial data included location, spatial trends, local spatial autocorrelation, spatial continuity and spatial correlation of positive and potential breeding sites according to habitat. RESULTS: Spatial trends were identified, as well as clusters of potential and positive breeding sites outdoors using local spatial autocorrelation analysis. A positive correlation was found between potential and positive breeding sites, and a negative correlation existed between indoor and outdoor sites. CONCLUSIONS: The spatial relationship between positive and potential A. aegypti breeding sites both indoors and outdoors is dynamic and highly sensitive to the characteristics of each territory. Knowing how positive and potential breeding sites are distributed contributes to the prioritization of resources and actions in vector control programs.

Use of area under the curve to characterize transmission potential after antimalarial treatment.

To evaluate transmission potential of Plasmodium falciparum, we use the area under the curve (AUC) of gametocyte levels after treatment as an approach to combine their duration and magnitude. Analysis of determinants of AUC was based on two main exposures: parasite clearance time (PCT) and presence of dihydrofolate reductase and dihydropteroate synthase mutations associated with sulfadoxine-pyrimethamine (SP) resistance in vitro. Exposures were determined based on the first three days after treatment with SP of 96 individuals who had malaria, cleared parasitemia by days 1-3, and were followed-up for 21 days. Using regression methods, we characterized both the heterogeneity of the presence of gametocytes (AUC > 0) and the magnitude of the AUC among those with an AUC > 0. A PCT of two or three days was associated with a substantial and highly significant odds ratio for presence of gametocytes. Among those who developed gametocytes, if their clearance time was 3 days or if they had any mutations (1 or 2) the magnitude of gametocytemia was > or = 3-fold. Methods presented are applicable to both observational studies and clinical trials assessing the effect of therapies on transmission potential.

Human and mosquito infections by dengue viruses during and after epidemics in a dengue-endemic region of Colombia.

We conducted a study in a dengue-endemic area of Colombia to evaluate the dynamics of transmission of dengue viruses during and after epidemics. Information was simultaneously gathered about occurrence of infection in humans and mosquitoes every three months in four cities with endemic transmission. Viral isolation was confirmed in 6.7% of the persons and most were asymptomatic. Adult mosquito and larvae house indexes were not found associated with increased burden of disease. The only entomologic indicator related to dengue infection in humans was the pooled infection rate of mosquitoes. Aedes aegypti infection rates showed significant differences between the epidemic (10.68, 95% confidence interval [CI] = 7.04-15.62) and after epidemic periods of the study (6.15, 95% CI = 3.46-10.19). In addition, Ae. albopictus were also infected with dengue viruses. Increases in mosquito infection rates were associated with increases in human infection rates in the following trimester.