[Health impact of the community intervention programme "Health education in adolescence"]. / Impacto en la salud del programa de intervención comunitaria «Educación para la salud en la adolescencia¼.

OBJECTIVE: To measure the impact of the community health programme "Education for health in adolescence" carried out in the Parquesol neighborhood, Valladolid (Spain), during the years 2015-2019. METHOD: Community-based quasi-experimental pre- and post-test analytical intervention trial with control group. A total of 407 adolescent surveys were collected. The CHIP-AE test validated for Spain was used. Pre- and post-test results were analyzed and compared with the control group. RESULTS: Improvements were found in the female intervention group compared to the control group in the variables resilience (3.68 vs. 3.41; p <0.01), health and safety at home (4.30 vs. 4.00; p <0.01), physical activities (3.16 vs. 2.60; p <0.01) and self-esteem (3.17 vs. 2.79; p <0.05). CONCLUSIONS: The community intervention carried out improves the health profile of adolescents. The baseline perception of health presents differences by gender, with higher scores in males. Post-intervention improvement is substantial in females in resilience, physical activities and health and safety at home. In addition, the worsening due to the passage of time described in previous studies is corrected in the variables self-esteem, satisfaction and well-being.

Impacto en la salud del programa de intervención comunitaria «Educación para la salud en la adolescencia» / Health impact of the community intervention programme “Health education in adolescence”

Objetivo: Medir el impacto del programa de intervención comunitaria «Educación para la salud en la adolescencia» llevado a cabo en el barrio de Parquesol, Valladolid, durante los años 2015-2019. Método: Ensayo comunitario de intervención cuasi experimental analítico pre- y postest con grupo control. Se recogieron 407 encuestas de adolescentes. Se utilizó el test CHIP-AE validado para España. Se analizaron los resultados pre- y postest y se compararon con el grupo control. Resultados: Se encontraron mejoras en el grupo de intervención femenino frente al grupo control en las variables resistencia (3,68 vs. 3,41; p < 0,01), salud y seguridad en el hogar (4,30 vs. 4,00; p < 0,01), actividades físicas (3,16 vs. 2,60; p < 0,01) y autoestima (3,17 vs. 2,79; p < 0,05). Conclusiones: La intervención comunitaria realizada mejora el perfil de salud de los/las adolescentes. La percepción basal de la salud presenta diferencias por sexo, con mayor puntuación en los hombres. La mejoría posintervención es sustancial en las mujeres en resistencia, actividades físicas y salud y seguridad en el hogar. Además, se corrige en la variable autoestima el empeoramiento debido al paso de los años descrito en estudios previos.(AU)

Objective: To measure the impact of the community health programme “Education for health in adolescence” carried out in the Parquesol neighborhood, Valladolid (Spain), during the years 2015-2019. Method: Community-based quasi-experimental pre- and post-test analytical intervention trial with control group. A total of 407 adolescent surveys were collected. The CHIP-AE test validated for Spain was used. Pre- and post-test results were analyzed and compared with the control group. Results: Improvements were found in the female intervention group compared to the control group in the variables resilience (3.68 vs. 3.41; p < 0.01), health and safety at home (4.30 vs. 4.00; p < 0.01), physical activities (3.16 vs. 2.60; p < 0.01) and self-esteem (3.17 vs. 2.79; p < 0.05). Conclusions: The community intervention carried out improves the health profile of adolescents. The baseline perception of health presents differences by gender, with higher scores in males. Post-intervention improvement is substantial in females in resilience, physical activities and health and safety at home. In addition, the worsening due to the passage of time described in previous studies is corrected in the variables self-esteem, satisfaction and well-being.(AU)

Sensibilidad del test de diagnóstico rápido SARS-CoV-2 Panbio en Atención Primaria / Sensitivity of the Panbio COVID-19 rapid antigen detection test in primary care

Introducción y objetivos: los pediatras de Atención Primaria necesitamos técnicas de diagnóstico rápido (TDR) fiables para prevenir la propagación de la enfermedad COVID-19 mediante un cribado temprano y eficaz a la espera de una vacuna. El objetivo de este trabajo fue evaluar como novedad en Atención Primaria, tanto en adultos como niños, sintomáticos y contactos asintomáticos, la sensibilidad (S) de los test de antígeno SARS-CoV-2 Panbio del laboratorio Abbott respecto a la reacción en cadena de la polimerasa (PCR).Pacientes y métodos: se incluyeron 591 pacientes (222 menores de 14 años) (249 sintomáticos y 342 contactos). Se calculó la sensibilidad (S) y la especificidad (E) junto con sus intervalos de confianza (IC) del 95%. La independencia de los dos resultados ha sido analizada mediante el test de McNemar.Resultados: la S del test en adultos fue del 81% (IC 95%: 66,16-96,34) y en niños del 80% (IC 95%: 34,94-100) dentro de los 5 primeros días. En contactos se evaluó la S en los cinco primeros días, en adultos (68%; IC 95%: 51,13-86,37), del 5.º al 9.º día (85%) y en niños (66%; IC 95%: 30,31-100). El tipo de contacto más frecuente fue domiciliario en un 52% de los casos. La E fue 100% en todos los casos.Conclusiones: el test rápido de antígeno SARS-CoV-2 Panbio puede ser útil para diagnóstico de adultos y niños los primeros cinco días de inicio de síntomas, así como entre el 5.º y 9.º día tras el contacto con positivo COVID-19 confirmado, pendiente de interpretar en futuros estudios. (AU)

Introduction and objectives: primary care paediatricians need reliable rapid diagnostic techniques (RDTs) to prevent the spread of coronavirus disease 19 (COVID-19) through early and effective screening while awaiting a vaccine. The objective of this study was to evaluate the sensitivity (Sen) of the Abbott laboratory SARS-CoV-2 Panbio antigen test, newly introduced in primary care, in both adults and children (symptomatic and asymptomatic contacts) in comparison to the polymerase chain reaction (PCR) test.Sample and methods: the study included 591 patients (222 aged less than 14 years) from 7 primary care centres; of who 249 were symptomatic and 342 asymptomatic contacts. We calculated the Sen and specificity (Spe) with their 95% confidence intervals (CIs). We assessed the independence of the two results with the McNemar test.Results: the Sen of the test within 5 days from onset was 81% in adults (95% CI, 66.16-96.34) and 80% in children (95% CI: 34.94-100). In contacts, we assessed the Sen within 5 days, in adults (68%; 95% CI: 51.13- 86.37), in 5 to 9 days (85%) and in children (66%; 95% CI: 30.31-100). The most frequent source of exposure were household contacts (52% of the cases). The Spe was 100% in every case.Conclusions: the Panbio SARS-CoV-2 rapid antigen test can be useful for diagnosis in adults and children within 5 days of onset, and from days 5 to 9 in contacts of confirmed COVID 19 cases. Further studies are required for adequate interpretation of the latter result. (AU)

Análisis del uso ambulatorio de antibióticos en los hospitales generales de Asturias entre 2006 y 2015 / Analysis on the ambulatory usage of antibiotics at general hospitals in Asturias (2006-2015)

Introducción. La Organización para la Cooperación y el Desarrollo Económicos (OCDE) señala, en su informe sobre políticas de salud de 2017 que, España es uno de los países con mayor consumo en antibióticos, 21,6 DHD (dosis diaria definida por 1000 habitantes y día) en 2014 superior a los 20,5 DHD de media en sus países, situándose según el European Centre for Disease Prevention and Control (ECDC) en el puesto 11 de 30 países europeos en 2016. La prescripción ambulatoria de atención especializada se analiza con menor frecuencia, debido a la mayor contribución en consumo y gasto de la atención primaria. Material y métodos. Estudio descriptivo, observacional, y retrospectivo del consumo y gasto del grupo J01 derivado de la prescripción ambulatoria (consulta externa y urgencias) de los hospitales públicos generales de Asturias, en una década (2006- 2015). Se estudió el consumo a través de la base de datos de facturación de receta del Servicio de Salud del Principado de Asturias, los datos demográficos se obtuvieron del Instituto Nacional de Estadística. El consumo se expresó en DHD y el gasto: en gasto por habitante e importe por dosis diaria definida. Resultados. El consumo medio ambulatorio global del periodo fue de 23,4 DHD, correspondiendo el 11,5% (2,7 DHD) a la receta ambulatoria de atención especializada. En términos de gasto, supuso el 13,6% del gasto global ambulatorio en antibióticos. Conclusiones. Gasto y consumo tuvieron tendencias opuestas, las medidas de control del gasto no tuvieron, o tuvieron poco impacto en consumo, por tanto, se precisan en este ámbito medidas de racionalización independientes y específicas (AU)

Introduction. The Organization for Economic Co-operation and Development (OECD) emphasize, in its report on health policies from 2017 that, Spain is one of the countries with largest consumption of antibiotics, 21.6 DHD (defined daily dose per 1000 inhibitants per day) in 2014 greater than the average 20.5 DHD in their countries, ranking according to the European Center for Disease Prevention and Control (ECDC) in the 11th place out of 30 European countries in 2016. The outpatient prescription of specialized care is analyzed less frequently, due to the greater contribution in consumption and expenditure of primary care. Material and methods. A descriptive, observational, and retrospective study of the consumption and expenditure of the J01 group derived from outpatient prescription (outpatient and urgent care) of public hospitals in Asturias, in a period of ten years (2006-2015). Consumption data were obtained using the database of prescription billing of the Health Service of the Principality of Asturias, demographic data were provided by the National Institute of Statistics. Consumption was expressed in DHD and antibiotics expenditure in: expenditure per capita and expenditure in euros per defined daily dose. Results. The average global ambulatory consumption for the period was 23.4 DHD, corresponding 11.5% (2.7 DHD) to the ambulatory specialty care prescription. In terms of expenditure, it accounted for 13.6% of overall outpatient spending on antibiotics. Conclusions. Outlay and consumption had opposite tendencies, the expenditure control measures did not have or had little impact on consumption, therefore, independent and specific rationalization measures are required in this area (AU)

Socio-economic modelling of rotavirus vaccination in Castilla y Leon, Spain.

Rotavirus is one of the main causes of acute gastroenteritis in infants and young children. Furthermore, rotavirus is the leading cause of hospitalization and death from acute gastroenteritis among infants and young children worldwide. Although death due to rotavirus is rare in industrialized regions such as Spain, the rotavirus disease burden and its economic impact is severe. This study aims to assess systematic vaccination against rotavirus economically and socially in a Spanish region. Economic cost-effectiveness and cost-benefit assessment through a choice tree was designed. We estimated health provider costs, economic costs and quality-adjusted life years (QALYs) lost due to rotavirus infections. The study includes a fictitious cohort of 100,000 children from Castilla y Leon who were also administered the rotavirus vaccine together with diphtheria and tetanus toxoids and pertussis (DTP) . The study adopted a society and health care system perspective. A sensitivity analysis was developed to assess the uncertainty of some variables. According to the estimated incidence rate for children in Castilla y Leon, rotavirus immunization is projected to prevent 45% of cases with RotaTeq and 57% with Rotarix. The respective cost per QALY is about Euro 75,000 and 50,000 from the perspective of the health care system. Routine infant vaccination in Castilla y Leon using either rotavirus vaccine is not profitable from the payer's perspective and is not cost-effective under basic case assumptions unless the vaccine is available at a lower cost.

Gastroenteritis by rotavirus in Spanish children. Analysis of the disease burden.

Rotavirus is one of the most common causes of gastroenteritis worldwide. With the commercialisation of effective rotavirus vaccines in Europe in sight, it is necessary to provide studies which evaluate the disease burden. The aim of this study is two-fold, on one hand, to determine the burden of the rotavirus disease in Spanish children under the age of five, and on the other, to estimate the economic cost of these hospitalizations. The study was undertaken during a 5 year period (2000-2004). The rotavirus hospitalization rate was determined using the Minimum Basic Data Set of the national hospital discharge register. The observed data were compared with those expected by applying a model developed by the Centers for Disease Control and Prevention (CDC) adapted for European Countries. The financial expense of these hospitalizations was estimated. Of all admissions coded as gastroenteritis, 31.6% were due to rotavirus. The hospitalization rate by rotavirus was 480 cases per 100,000 children under five. These data are within the confidence range proposed by the adapted CDC model. The financial expense due to hospitalizations reaches 123,262 euros yearly in a Spanish University Hospital. In conclusion, rotavirus contributes significantly to the hospitalization of acute gastroenteritis. The rate of hospitalization by rotavirus is higher compared to other studies carried out in Spain. In view of future commercialisation of rotavirus vaccines, more in-depth analysis considering direct and indirect costs are necessary.