RESUMEN
Rickettsioses and leptospirosis are infectious diseases that are often underdiagnosed due to a lack of knowledge about their epidemiology, pathophysiology, diagnosis, management, among others. Objetive: to characterize the seroprevalence and seroincidence of both Rickettsia and Leptospira agents and determine the risk factors for these outcomes in rural areas of Urabá, Antioquia. Methods: a secondary data analysis using information on Rickettsia and Leptospira exposure from a prior prospective study that explored sociocultural and ecological aspects of Rickettsia infection in rural Urabá, Colombia. A multinomial mixed logistic regression model was employed to analyze factors linked to seroprevalent cases of Rickettsia, Leptospira and both, along with descriptive analyses of seroincident cases. Results: the concomitant seroprevalence against Rickettsiaand Leptospira was 9.38% [95%CI 6.08%-13.37%] (56/597). The factors associated with this seroprevalence were age (ORa= 1.02 [95%CI 1.007-1.03]), male gender (ORa= 3.06 [95%CI 1.75-5.37]), fever history (ORa= 1.71 [95%CI 1.06-2.77]) the presence of breeding pigs (ORa= 2.29 [95%CI 1.36-3.88]), peridomicile yucca crops(ORa= 2.5 [95%CI 1.1-5.62]), and deforestation practices(ORa= 1.74 [95%CI 1.06-2.87]). The concomitant seroincidence against Rickettsia and Leptospira was 1.09% (3/274) [95%CI 0.29%-4.05%], three cases were female, with a median age of 31.83 years-old (IQR 8.69-56.99). At the household level, all the seroincident cases had households built partially or totally with soil floors, wooden walls, and zinc roofs. Two seroincident cases described the presence of equines, canines, and domestic chickens in intra or peri-domicile. Finally, two cases were exposed to synanthropic rodents, and one case to tick infestation. Conclusion: there is evidence of seroprevalent and seroincident cases of seropositivity against both Rickettsia and Leptospira in rural areas of Urabá, Colombia. These findings can help improve public health surveillance systems in preventing, detecting, and attending to the different clinical cases caused by these pathogens.
RESUMEN
Los padres son el grupo primario de referencia para la mayoría de las adolescentes y en especial son significativos para las adolescentes que sospechan o descubren que están embarazadas. La forma como responden o reaccionan los padres a esta situación es un tema que puede generarles mucho estrés. Por una parte las adolescentes están particularmente sensibles a la posibilidad de sanciones y por otra, están en una etapa del desarrollo en que ellas pueden anticipar estas sanciones. Además, la mayoría de las adolescentes que se embarazan viven con sus padres o madres y estos padres tienen poder económico, emocional y físico que pueden afectar el curso del embarazo de sus hijas. Objetivo: Analizar los factores asociados a las reacciones de madres de adolescentes embarazadas y el impacto que ellas perciben que tendrá esta maternidad en la vida de sus hijas. Material y Métodos: Se estudió 255 mujeres y sus hijas adolescentes embarazadas. A ambas se les aplicó un cuestionario previamente diseñado. Variables de las madres y de las hijas fueron seleccionadas para este estudio. Se realizó análisis uni y divariado. Se utilizo el software STATA. Resultados: Una de cada cuatro mujeres supo del embarazo porque vigilaba las reglas de sus hijas; dos tercios hubieran preferido que su hija no se embarazara hasta tener entre 20 a 22 años; previo al embarazo la mitad de las madres aspiraba a que su hija terminara la enseñanza media pero una de cada cuatro aspiraba a que ingresara a la universidad; llamó la atención el porcentaje de madres que no tenía aspiraciones académicas para la hija. Más de la mitad de las madres opinaron que el embarazo arruinó el futuro de su hija; dos tercios de ellas piensan que su hija no está preparada para ser madre a esta edad por lo que debe prepararse para asumir su maternidad. Más de la mitad de las madres reaccionaron con dolor y tristeza mientras que casi un tercio lo hizo con mucha rabia, ira y violencia...
Parents are the main group of reference for the majority of female adolescents that suspect or discover they are pregnant. The way in which the parents reply or react to this situation is an issue that can produce them a lot of stress. On the one hand, the female adolescents are particularly sensitive to the possibility of get sanctions, and, on the other hand, they are in a period of development in which they can expect these sanctions. In addition, most of the female adolescents who get pregnant live with their parents or mothers and these parents have spending power, emotional and physical power that can affect their daughters process of pregnancy. Objective: To analyze the factors associated to the reactions of pregnant adolescents mothers and the impact, they notice, this motherhood will have in their daughters lives. Material and Methods: There were studied 255 women and their adolescent pregnant daughters. It was applied a previously designed questionnaire to both of them. Variables of the mothers and daughters were chosen for this study. It was carried out an unit and bivariate analysis. It was used a STATA software. Results: one in four women knew about the pregnancy because they watched their daughters periods; two thirds would have preferred their daughters wouldnt have got pregnant until they got from 20 to 22 years old; before the pregnancy, the half of mothers expected their daughter would have finished high school but one in four expected their daughter would have entered university; it called the attention the mothers percentage who didnt have academic ambitions for their daughter. More than half of mothers expressed that pregnancy ruined their daughters future; two thirds of them think that their daughter is not prepared to be a mother at this age; therefore she must be prepared to accept her mother hood. More than half of the mothers reacted with pain and sadness...