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Background: Chagas disease (CD) is transmitted by vectors but can also be transmitted orally through contaminated food, drinks, or meat. The One Health perspective aims to understand the complex interaction between human, animal, and environmental health in controlling disease. This study analyzed risk factors and drew lessons from past outbreaks of orally transmitted CD to develop effective preventive strategies. Methods: A simultaneous mixed methods study was conducted. The study consisted of two phases: an ecological epidemiological analysis at the municipal level using secondary data spanning from 1992 to 2023, and semistructured interviews with health providers and policymakers at the national level in Colombia. The results from both phases were triangulated to gain a comprehensive understanding of the topic. Results: A total of 64 outbreaks, infecting 302 individuals, were reported. Most of these outbreaks (89.2%) were classified as family-related, and they occurred most frequently during the months of April to June (46.6%). It is worth noting that a significant number of these outbreaks took place in municipalities that lacked vector control plans. Risk factors for oral transmission included the location of food preparation, poor housing quality, food preparation water source, the presence of vectors/marsupials, forest type, and climatic variables. Interviews conducted emphasized the importance of implementing outbreak plans and providing staff training to effectively address the issue. Conclusion: A One Health approach strengthening prevention, surveillance, case management and cross-sectoral collaboration is needed to control outbreaks and reduce transmission in Colombia. Preparedness plans and education of health professionals are also important. This study identified modifiable risk factors to guide public health interventions.
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Background: Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, is considered a public health problem in Latin America. In Colombia, it affects more than 437,000 inhabitants, mainly in Casanare, an endemic region with eco-epidemiological characteristics that favor its transmission. The objective of this study was to describe the clinical and epidemiological characteristics of the cases of acute CD in Casanare, eastern Colombia, in the period 2012-2020. Methods: In the present study, 103 medical records of confirmed cases of acute CD were reviewed. The departmental/national incidence and fatality were compared by year; the climatological data of mean temperature, relative humidity, and precipitation per year were reviewed and plotted at IDEAM (Colombian Meteorology Institute) concerning the number of cases of acute CD per month, and it was compared with the frequency of triatomines collected in infested houses by community surveillance. Univariate, bivariate, and multivariate analyses were performed, comparing symptoms and signs according to transmission routes, complications, and age groups. Results: The incidence was 3.16 cases per 100,000 inhabitants, and the fatality rate was 20% in the study period. The most frequent symptoms included: fever 98.1%, myalgia 62.1%, arthralgia 60.2%, and headache 49.5%. There were significant differences in the frequency of myalgia, abdominal pain, and periorbital edema in oral transmission. The main complications were pericardial effusion, myocarditis, and heart failure in the group over 18 years of age. In Casanare, TcI Discrete Typing Unit (DTU) has mainly been identified in humans, triatomines, and reservoirs such as opossums and dogs and TcBat in bats. An increase in the number of acute CD cases was evidenced in March, a period when precipitation increases due to the beginning of the rainy season. Conclusions: The results corroborate the symptomatic heterogeneity of the acute phase of CD, which delays treatment, triggering possible clinical complications. In endemic regions, clinical suspicion, diagnostic capacity, detection, and surveillance programs should be strengthened, including intersectoral public health policies for their prevention and control.
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Según la Organización Mundial de la Salud, las lesiones fatalesson una de las principales causas de muerte y discapacidad en menores de18 años. El objetivo del estudio fue describir su comportamiento en losadolescentes del departamento de Casanare, durante el período 2011-2013.Materiales y métodos. Estudio descriptivo, a partir de las bases de datos de estadísticas vitales, defunciones no fetales y defunciones por causa externa del Departamento Administrativo Nacional de Estadística (DANE). El análisis de los datos se realizó en la hoja de cálculo de Excel 2010 de Microsoft Office®. Seanalizaron las tasas de mortalidad específica y ajustada por 100.000 habitantes por año, sexo, grupo etario y municipio; y los años de vida potencial perdidos (AVPP) por cada causa según la lista OPS-6/67 CIE-10.Resultados. En el período hubo un total de 99 defunciones, en 2011 (23;23,2%), 2012 (36; 36,4%) y 2013 (40; 40,4%). Tasa de mortalidad específica fue de 138,2 y ajustada de 236,4 por 100.000 habitantes, en el grupo de 10-14 años (52,8; 45,4) y de 15-19 (224,3; 189,9), en hombres (220,0; 187,7) y mujeres (54,1; 46,2). Total de AVPP 5.940, por accidentes de transporte 2.160, agresiones/homicidios 1.440, suicidios 840, intención no determinada 780,ahogamiento 420, intervención legal/operaciones de guerra y otros accidentes 120 respectivamente, armas de fuego 60; índice de AVPP 83,1 por 1.000 habitantes.Conclusiones. La primera causa de mortalidad por lesiones fatales fuepor accidentes de transporte, situación diferente a la del país en la que loshomicidios ocupan el primer lugar. Es necesario congregar esfuerzos desdetodos los sectores para reducir la mortalidad de todos los niños...