Progress towards the elimination of hepatitis B in children in Colombia: A novel two-phase study approach.

The World Health Organization (WHO) has established a target to eliminate mother-to-child-transmission (EMTCT) of hepatitis B virus (HBV), defined as a prevalence of hepatitis B surface antigen (HBsAg) of ≤0.1% among children, by 2030. Using nationally representative serosurveys to verify achievement of this target requires large sample sizes and significant resources. We assessed the feasibility of a potentially more efficient two-phase method to verify EMTCT of HBV in Colombia. In the first phase, we conducted a risk assessment to identify municipalities at the highest risk of ongoing HBV transmission. We ranked the 1122 municipalities of Colombia based on the reports of HBV infection in pregnant women per 1000 population. Municipalities with ≥0.3 reports per 1000 persons (equating to the top quartile) were further assessed based on health facility birth rates, coverage with three doses of hepatitis B vaccine (HepB3) and seroprevalence data. Hepatitis B risk was considered to be further increased for municipalities with HepB3 coverage or health facility birth rate <90%. In the second phase, we conducted a multistage household serosurvey of children aged 5-10 years in 36 municipalities with the highest assessed HBV risk. HBsAg was not detected in any of 3203 children tested, yielding a 90% upper confidence bound of <0.1% prevalence. Coverage with HepB3 and hepatitis B birth dose was high at 97.5% and 95.6%, respectively. These results support the conclusion that Colombia has likely achieved EMTCT of HBV.

Percepciones de niñas, niños y adolescentes sobre violencias en los entornos familiar y escolar en ocho municipios de Colombia / Children and adolescents' perception of violence in family and school settings from eight municipalities in Colombia / Percepções de crianças e adolescentes sobre violência nos ambientes familiar e escolar em oito municípios na Colômbia

Resumen Objetivo: Esta investigación explora las percepciones, actitudes y prácticas de niñas, niños y adolescentes sobre violencias en los entornos familiar y escolar. Metodología: Durante 2018, se aplicó una encuesta sobre sexualidad, convivencia familiar y entorno escolar a 16 558 niñas, niños y adolescentes escolarizados de entre 9 y 19 años de edad, habitantes de ocho municipios de Colombia, de las zonas Caribe y Pacífico. Resultados: Se encontraron porcentajes altos de violencia en el hogar y de actitudes violentas en el entorno escolar, además de bajos índices de educación sobre temas relacionados con la violencia de género. La violencia física fue ejercida en mayor frecuencia en los niños y adolescentes varones, entre los 15 y 19 años, y en los municipios de Bahía Solano y El Carmen de Atrato. En contraste, la violencia sexual fue principalmente ejercida a las niñas, entre los 9 y 11 años, y en los municipios de Uribía y Pivijay. Conclusiones: las normas de género y las expectativas sociales atribuidas a las personas en función de su sexo exponen a niñas, niños y adolescentes a violencias diferenciadas; a ello se suman la edad y el lugar en el que se habita.

Abstract Objective: The study explores children and adolescents'perceptions, attitudes and behaviors regarding violence in family and school settings. Methodology: A survey about sexuality, family life and the school setting was conducted in 2018 to 16,558 children and adolescents aged between 9 and 19 years, who were attending school and were residents of eight municipalities of the Caribbean and Pacific regions of Colombia. Results: High percentages of family violence and violent behavior in the school setting were found along with a low degree of knowledge about subjects related to gender-based violence. Young boys and male adolescents aged between 15 and 19 years from Bahía Solano and El Carmen de Atrato municipalities were exposed most frequently to physical violence while girls aged between 9 and 11 years from Uribía and Pivijay were exposed mostly to sexual violence. Conclusions: Gender norms and social expectations expose children and adolescents to different types of violence. Other contributing factors are age and place of residence.

Resumo Objetivo: Explorar percepções, atitudes e práticas de algumas crianças e adolescentes sobre a violência nos ambientes familiar e escolar. Metodologia: Em 2018, foi aplicada uma pesquisa sobre sexualidade, vida familiar e ambiente escolar em 16.558 meninas, meninos e adolescentes entre 9 e 19 anos, habitantes de oito municípios da Colômbia. Resultados: Foram encontrados altos percentuais de violência doméstica e atitudes violentas no ambiente escolar, além de baixos níveis de educação em questões relacionadas à violência de gênero. A violência física foi maior em meninos e adolescentes, entre 15 e 19 anos, e nos municípios de Bahía Solano e El Carmen de Atrato. Por outro lado, a violência sexual foi maior em meninas, entre 9 e 11 anos, e nos municípios de Uribía e Pivijay. Conclusões: as normas de gênero e as expectativas sociais atribuídas às pessoas com base no sexo, expõem meninas e meninos e adolescentes à violência diferenciada, agregando idade e local onde moram.

Respuesta social a las medidas no farmacológicas para controlar la propagación del COVID-19 en Colombia / Social response to non-pharmacological measures to control the spread of COVID-19 in Colombia

Resumen Introducción: Los gobiernos al inicio de la pandemia, con el fin de mitigar y suprimir la propagación del virus implementaron medidas no farmacológicas ante la falta de vacunas y tratamientos farmacológicos efectivos. El gobierno colombiano emprendió acciones para controlar el contagio del COVID-19. Estas afectaron a la población y por ello el país requiere una evaluación profunda de la respuesta social ante la pandemia. Objetivo: Analizar la respuesta social a las medidas no farmacológicas para controlar la propagación del COVID-19 en Colombia. Metodología: Estudio exploratorio descriptivo transversal. El total de personas que respondieron la encuesta fue de 3549 adultos, entre el 8 y el 20 de abril de 2020. Resultados: En el país existen tres grupos de personas que han respondido a la pandemia de formas diferentes: quienes se resisten (34 %), quienes sufren (26 %) y quienes la aceptan (40 °%). En general, 90 % de las personas adoptó al menos una medida para protegerse, el 68 % adoptó más de tres medidas de higiene y autocuidado y un 60 °% implementó más de tres medidas de distanciamiento físico. Conclusiones: Al inicio de la pandemia, la ausencia de una vacuna hizo que las acciones individuales fueran tan importantes como las medidas implementadas por el gobierno. Sin embargo, pedagogía a nivel comunitario y el acceso a la información correcta, clara y concisa contribuyó con cambios de comportamientos positivos en la higiene, autocuidado y adherencia a medidas de distanciamiento, todo esto ha sido crucial para detener la propagación de COVID-19.

Abstract Introduction: At the beginning of the pandemic, governments implemented non-pharmacological measures to mitigate and suppress the spread of the virus in the absence of vaccines and effective pharmacological treatments. The Colombian government undertook actions to control the spread of COVID-19. These affected the population; therefore, the country requires a thorough evaluation of the social response to the pandemic. Objective: To analyze the social response to non-pharmacological measures to control the spread of COVID-19 in Colombia. Methodology: Cross-sectional descriptive exploratory study. The total number of people who responded to the survey was 3549 adults, between April 8 and 20, 2020. Results: There are three groups of people in the country who are responding to the pandemic in different ways: those who resist (34%), those who suffer (26%) and those who accept it (40%). Overall, 90% of people took at least one measure to protect themselves and others, 68% took more than three hygiene and self-care measures, 60% implemented more than three physical distancing measures. Conclusions: At the beginning of the pandemic, in the absence of a vaccine, individual actions are as important as measures implemented by the government. However, community-level education and access to correct, clear and concise information contributed to positive behavioral changes in hygiene, self-care and adherence to distancing measures, all of which are crucial to stop the spread of COVID-19.