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La ECP 2023-2028 ha sido desarrollada en estrecha colaboración con el Ministerio de Salud (MINSAL), las instituciones claves del Sistema Nacional de Salud y otros socios internacionales de cooperación en el país. El proceso de trabajo dinámico que ha seguido esta estrategia ha permitido evaluar la ECP anterior, así como realizar un análisis integral de la situación de salud del país y el alineamiento con las prioridades sanitarias del país. Por tanto, el presente documento establece las principales prioridades estratégicas en las que la OPS/OMS brindará su cooperación técnica para apoyar al país en el desarrollo de un sistema nacional de salud resiliente por estar basado en la estrategia de la Atención Primaria de la Salud renovada La ECP 2024-2028 es un instrumento de planificación estratégica para los próximos cinco años. Este documento, que se presenta con satisfacción, ha requerido un análisis cuidadoso y una consulta amplia para asegurar que responde a las necesidades y prioridades de Chile. Dentro de las seis prioridades estratégicas identificadas y sus respectivas áreas de enfoque, se contemplan acciones orientadas a apoyar al país en su determinación de superar los desafíos de la pandemia de COVID-19 además de fortalecer la preparación y respuesta ante las múltiples amenazas a la salud pública.
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Cooperación Internacional , Cooperación Técnica , Salud Pública , Sistemas de Salud , Desarrollo Sostenible , ChileRESUMEN
Latin American cities have evolved via exclusionary historical processes, resulting in hasty and unplanned urbanization, insufficient infrastructure, and extreme levels of violence. These issues have well-documented health implications. In urban settings, gender may lead to unequal access to opportunities and services, however, its consideration into policies, interventions, and research remains insufficient, potentially exacerbating urban inequities. Drawing inspiration from feminist urbanism and urban health research, we propose a structured tool for Latin American cities to develop gender-sensitive urban policies, interventions, and urban health research. The study encompassed: (1) a narrative literature review of feminist urbanism frameworks and the Delphi method to select the most appropriate dimensions; (2) a thorough examination of data availability and indicators in three studies of urban transformation interventions in Brazil, Colombia, and Chile to evaluate data availability and local interest; and (3) an urban health dialogue with the relevant indicators. We identified three key dimensions: "proximity", "autonomy", and "representativeness". Neighborhood was considered the most meaningful level for analyses. The indicators were organized into subdimensions, considering existing literature on their implications for gender and health. The proposed tool is comprehensive and adaptable, thus, it can be used in diverse Latin American urban contexts. It is a valuable resource for incorporating a gender-sensitive perspective into urban policymaking, interventions, and health-related research.
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Salud Urbana , Humanos , Femenino , América Latina , Masculino , Brasil , Política de Salud , Colombia , Chile , Población Urbana , Factores SexualesRESUMEN
The COVID-19 pandemic revealed disparities in policy responses in Latin America. We examined the association between trust in the president and COVID-19 preventive behaviors in Brazil, Chile, Colombia, and Mexico. We used data from the Collaborative COVID-19 Response Survey by the McDonnell Academy at Washington University in St. Louis (United States), from September 2020 to March 2021. Nonprobabilistic sampling included adult citizens from the four countries. Multivariate negative binomial regression models were applied. The study included 8,125 participants, with Brazil showing the lowest adherence to preventive behaviors (65.5%). Increased adoption of preventive behaviors was linked with ages 18-26 (aIRR = 1.05; 95%CI: 1.01-1.09), 60 or more (aIRR = 1.10; 95%CI: 1.05-1.15), and high socioeconomic status (aIRR = 1.09; 95%CI: 1.05-1.13). Decreased engagement was linked to participants from Brazil (aIRR = 0.74; 95%CI: 0.71-0.78), Mexico (aIRR = 0.95; 95%CI: 0.92-0.99), basic education (aIRR = 0.75; 95%CI: 0.68-0.84), intermediate education (aIRR = 0.88; 95%CI: 0.85-0.91), low socioeconomic status (aIRR = 0.91; 95%CI: 0.87-0.94), lack of concern about contracting COVID-19 (aIRR = 0.93; 95%CI: 0.88-0.98), and poor knowledge about COVID-19 (aIRR = 0.92; 95%CI: 0.88-0.96). No significant association was found between trust in the president and preventive behaviors. Targeted communication, public education, and improved access to reliable information are crucial for fostering preventive behaviors. Public health practitioners should not overly concern themselves with political rhetoric, as our study suggests that trust in political authorities may not systematically affect compliance with directives.
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COVID-19 , Pandemias , Confianza , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , Adulto , Femenino , Masculino , Adulto Joven , Brasil/epidemiología , Adolescente , Pandemias/prevención & control , Persona de Mediana Edad , México/epidemiología , Factores Socioeconómicos , Colombia/epidemiología , Chile/epidemiología , Conductas Relacionadas con la Salud , América Latina/epidemiología , SARS-CoV-2 , Encuestas y CuestionariosRESUMEN
AIM: This study aimed determine the prevalence of shoulder pain among Chilean patients with type 2 DM and to characterize their pain intensity and associated disabilities, including an analysis of sex-based differences. METHODS: A total of 151 participants with type 2 DM, aged 18-79, from family health centers in Talca, Chile, were included. Data were collected via telephone interview, capturing demographic details and information about current shoulder pain, including its duration, intensity, using a Numerical Rating Scale (NRS), and disability using the Shoulder Pain and Disability Index (SPADI). Statistical analysis was performed using frequency measures, Chi-squared tests, binary logistic regression, and Student's t-tests with SPSS version 21.0. RESULTS: Out of 1662 eligible patients, 151 participated. The overall prevalence of shoulder pain was 53.6â¯% (95â¯% CI: 53.8-53.4), with women showing a higher prevalence (63â¯%; 95â¯% CI: 63.2-62.8) compared to men (37â¯%; 95â¯% CI: 37.2-36.8), a difference that was statistically significant (chi-square=13.5; pâ¯≤â¯0.001). The results showed that neither BMI nor sex was significantly associated with the presence of pain. No significant differences were found between sexes regarding pain intensity and disability (pâ¯≥â¯0.05). CONCLUSION: Shoulder pain is highly prevalent among patients with type 2 DM, with a higher prevalence in women. Future research should explore the impact of this condition on patients and develop targeted musculoskeletal rehabilitation programs.
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Diabetes Mellitus Tipo 2 , Evaluación de la Discapacidad , Dimensión del Dolor , Dolor de Hombro , Humanos , Femenino , Masculino , Chile/epidemiología , Dolor de Hombro/epidemiología , Dolor de Hombro/diagnóstico , Estudios Transversales , Persona de Mediana Edad , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/diagnóstico , Prevalencia , Adulto , Anciano , Factores de Riesgo , Adolescente , Adulto Joven , Factores Sexuales , Distribución de Chi-CuadradoRESUMEN
BACKGROUND: In the latter half of 2023, the northern hemisphere initiated the rollout of nirsevimab immunization strategies for infants, yielding promising early results. As Chile prepared for its 2024 strategy implementation, we retrospectively evaluated the potential cost-saving nature of various immunization strategies. METHODS: Leveraging comprehensive inpatient, outpatient, and sentinel programs data, we conduct a simulation-based retrospective analysis to evaluate the net cost savings of various immunization strategies based on nirsevimab. We first characterize RSV burden among Chilean infants between 2019 and 2023, focusing on medically attended lower respiratory tract infections (MA LRTI), hospital admissions (HA LRTI), and severe cases requiring ICU admission (ICU LRTI). Utilizing nirsevimab efficacy estimates, we simulate counterfactual scenarios to estimate reductions in outpatient visits, hospitalizations, and ICU admissions had nirsevimab been used. We evaluate diverse immunization strategies and estimate their cost-saving status. FINDINGS: With nirsevimab costing about USD$225 per dose, immunizing infants under 6 months before the RSV season, all newborns during the season, and high-risk groups would have been cost-saving in 2023 and 2019. This strategy would have significantly decreased the strain on the healthcare system during the seasonal surge, reducing 13,533 ICU (77·81/1000 live newborns) and 27,465 hospital bed requirements (157·91/1000 live newborns), alongside 46,886 emergency room visits (269·58/1000 live newborns). INTERPRETATION: In Chile, a country with a GDP per capita of USD$17,000, various immunization strategies are cost-saving for scenarios comparable to pre-pandemic 2019 and to the particularly severe 2023 when considering only those direct costs associated with patient care, albeit differing in their impact in health outcomes. The resulting decrease in healthcare strain during the Winter virus surge underscores the strategy's impact.
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Ahorro de Costo , Hospitalización , Infecciones por Virus Sincitial Respiratorio , Humanos , Infecciones por Virus Sincitial Respiratorio/prevención & control , Infecciones por Virus Sincitial Respiratorio/economía , Chile , Estudios Retrospectivos , Lactante , Hospitalización/estadística & datos numéricos , Hospitalización/economía , Recién Nacido , Femenino , Antivirales/economía , Antivirales/uso terapéutico , Antivirales/administración & dosificación , Masculino , Virus Sincitial Respiratorio Humano , Bases de Datos Factuales , Infecciones del Sistema Respiratorio/prevención & control , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/economía , Anticuerpos Monoclonales Humanizados/economía , Anticuerpos Monoclonales Humanizados/uso terapéutico , Anticuerpos Monoclonales Humanizados/administración & dosificaciónRESUMEN
INTRODUCTION: The dissemination of information to caregivers of pediatric cancer patients in Chilean hospitals is now sporadic and contingent upon available time, underscoring the need for a systematic education program. This study assesses caregivers' perceptions of the information provided by healthcare teams to support the development of a national education program tailored to their needs. METHODS: A descriptive, prospective, multicenter study was conducted from June 2021 to March 2022 across six public hospitals in Chile. The study included caregivers of children undergoing cancer treatment. Caregivers completed a survey assessing the education received and their preferred educational methods. Data were analyzed using STATA 18 and Graph Pad 6.0, with qualitative responses analyzed through an iterative coding process. RESULTS: Of 173 respondents, 94% rated the education received as very good or good. While 51% felt well-informed at hospital discharge, 28% desired more information. Caregivers preferred information from healthcare teams (88%), websites (55%), and written materials (51%). Significant differences were found in preferred educational content based on cancer type and the time elapses since diagnosis. CONCLUSION: Caregivers generally rated the education provided positively but expressed a need for more structured and targeted information. The findings inform the design of a national education program, emphasizing the need for tailored content and improved communication strategies to enhance caregiver support.
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Cuidadores , Neoplasias , Grupo de Atención al Paciente , Humanos , Cuidadores/educación , Neoplasias/terapia , Masculino , Femenino , Niño , Estudios Prospectivos , Adulto , Chile , Adolescente , Encuestas y Cuestionarios , Persona de Mediana Edad , Preescolar , Estudios de Seguimiento , LactanteRESUMEN
Nature-based solutions (NBSs) offer environmentally rational, socially acceptable, and economically viable alternatives for solving diverse water issues. Therefore, the involvement of local communities is crucial, as their participation in developing shared knowledgewithin their territories is essential for building and sustaining resilient ecosystems. This study highlights a co-created, nature-based initiative that led to the construction of a vegetated vermifilter for greywater reuse and monitoring in a small community at the Nonguén School Community, located in the Biobío region, central Chile. The project was initiated in 2019, but not completed until 2022 due to the COVID-19 pandemic. The vermifilter was based on green filters and was used to recover white greywater (dishwater and handwash water) for irrigation use. The circular biofilter, built by the community and directly connected to the kitchen, consisted of four distinct layers: rock, sand, topsoil, and sawdust. It also included populations of earthworms and wetland plants, all primarily collected by the community. Water analysis (i.e., pH, temperature, BOD5, TSS, nitrate, phosphate, turbidity, dissolved oxygen, and total and fecal coliforms) demonstrated a moderate effectiveness during a measured period in 2022. We highlight and discuss the fundamental role of the participation of the local community in the whole co-work process and key lessons and barriers to further optimize a vermifilter design.
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Ciencia Ciudadana , Chile , COVID-19 , Humedales , Monitoreo del Ambiente/métodos , HumanosRESUMEN
Frilled sharks are rarely observed and limited information is available regarding their life history. The global number of records for these sharks does not exceed 40, with most sightings reported in the Western Pacific Ocean. In 1976, one specimen was recorded for the first time in the South East Pacific Ocean; however, this study provides new evidence for the presence of Chlamydoselachus anguineus in Chilean waters, extending its distribution range 850 km south of the previous record. The morphological features of all specimens from Chile are discussed, supplementing previous observations and adding to the existing knowledge on this species in the Pacific Ocean.
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Tiburones , Animales , Océano Pacífico , Chile , Masculino , Femenino , Distribución AnimalRESUMEN
Harmful algal blooms (HABs) are highly relevant for public health, the economy, the ecosystem, and biodiversity stability in southern Chile (40° to 53°S), where they occur regularly and are frequently monitored. However, HAB events and their associated microbes in northern Chile (17° to 30°S) remain unknown and difficult to track due to a lack of monitoring, particularly in urban areas. We investigated changes in microbial communities in coastal seawater before and during an Akashiwo sanguinea bloom (B) at two sampling points in Antofagasta city (23°38'39S, 70°24'39W). Seawater samples (filtered at 1 and 0.2 µm) were collected during distinct bloom phases (control, prebloom, and in-bloom), and 16S and 18S rDNA gene libraries were constructed and analyzed via the DNA metabarcoding technique. Our findings indicate that species diversity within the 16S rDNA-based community was greater during the prebloom phase than during the control and in-bloom phases. Conversely, species diversity within the 18S rDNA-based community was lower during the in-bloom phase than during the control and prebloom phases. Independent of the sampling points and fractions, principal coordinate analysis (PCoA) revealed distinct differences in both the 16S and 18S rDNA-based communities between the analyzed bloom phases. Our analysis further revealed that the 16S rDNA-based community was dominated by the Flavobacteriaceae and Rhodobacteraceae families, whose abundance decreased and increased, respectively, during the bloom. As anticipated, the structure of the 18S rDNA-based community was predominantly governed by the Gymnodiniaceae family, specifically the Akashiwo genus, during the bloom. The differentiation in microbial communities was more pronounced in taxa with low abundances than in the dominant taxa. Additionally, co-occurrence network analysis revealed predominantly positive relationships within the microbial communities, particularly during the bloom event. Our analysis also identified several bacterial genera as keystone taxa within the microbial communities, notably members of Pseudomonadota and Bacteroidota.
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Dinoflagelados , Floraciones de Algas Nocivas , Microbiota , Agua de Mar , Chile , Agua de Mar/microbiología , Dinoflagelados/genética , Dinoflagelados/fisiología , ARN Ribosómico 16S/análisis , ARN Ribosómico 16S/genética , Bacterias/genética , Bacterias/clasificación , Bacterias/aislamiento & purificación , Biodiversidad , ARN Ribosómico 18S/análisis , ARN Ribosómico 18S/genética , CiudadesRESUMEN
INTRODUCTION: The COVID-19 pandemic drastically changed people's lives. It had consequences at the individual and social level. The behavioral immune system predicts that when faced with the risk of contagion from pathogens, people tend to reduce their sociality, especially sociosexuality. We examine this prediction by evaluating decreases in the pandemic of the different dimensions of sociosexuality of young men (i.e., short and long-term mating orientation, sexual desire, and sociosexual behavior) and considering their relationship status (single or paired). METHODS AND MATERIALS: We compared data from two cross-sectional studies carried out in the laboratory with convenience sampling methods in the pre-pandemic period (in the years 2016 and 2018 with a sample size of N = 463) and pandemic (face-to-face panstudy N = 234,data online, N = 182), considering possible differences between samples of the same period. We reached an N = 879 young men who answered a sociodemographic questioarticipants answered a sociodemographic questionnaire that inclnnaire and the Multidimensional Sociosexual Orientation Inventory. To test our predictions, we fitted general linear models. RESULTS: Results point to a significant decrease in long-term mating orientation in paired and single men, but only when compared with the pandemic face-to-face study. In addition, no differences were found for short-term mating orientation. For sociosexual desire (i.e., sexual fantasies), we found a reduction in single pre-pandemic individuals to be compared with the sample of pandemic online study. Finally, we found a decrease in sociosexual behavior (i.e., number of partners in the last year) between pre-pandemic samples and the pandemic itself, regardless of their relationship status and samples inside of each period. In addition, we carry out analyses with a reduced sample to re-test our predictions based on the perception of contagion risk (measured by a survey from OMS). CONCLUSION: We find changes are maintained at the level of sociosexual desire and sexual behavior but mainly in those individuals with a greater perception of the risk of contagion. The hypotheses derived from the behavioral immune system regarding the decrease in sociosexuality in a context of risk of contagion by pathogens, as was the case in the initial period of COVID-19, are corroborated only in terms of desire and behavior, which suggests a certain stability in attitudes i.e., the menace of contagion modifies proximal aspects of sociosexuality, such as fantasies and behavior, but has no apparent effect on the calibration of the predisposition of individuals to varying levels of commitment in sexual relationships. These findings will allow us to understand better how the dimensions of sociosexuality (i.e., fantasies, attitudes and behavior) are affected when there are contexts of high risk of contagion, such as COVID-19. These findings will allow us to understand better how sociosexuality is affected when there are contexts of high risk of contagion, such as COVID-19.
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COVID-19 , Conducta Sexual , Humanos , COVID-19/epidemiología , COVID-19/psicología , Masculino , Estudios Transversales , Conducta Sexual/psicología , Adulto Joven , Chile/epidemiología , Adulto , Pandemias , Encuestas y Cuestionarios , Adolescente , Sistema InmunológicoRESUMEN
INTRODUCTION: In Chile, the prevalence of overweight among schoolchildren over the age of 5 is approximately 50%, one of the highest in the Americas region. This is largely influenced by the presence of inadequate food environments, characterized by limited access to healthy foods and a high availability of highly processed foods (HPF). This study analyzes food consumption in Chilean schoolchildren and the association of this with the Chilean Dietary Guidelines Based on Foods (DGBF) and the HPF consumption. MATERIAL AND METHODS: The sample (1,094 schoolchildren) was obtained from the baseline of the FONDEF IT18I0016 project, in Santiago-Chile. Anthropometry and socioeconomic data were measured. Dietary intake was assessed using a validated semi-quantitative frequency survey featuring images of food groups aligned with DGBF, as well as HPF. All data were collected by trained professional nutritionists. Associations between dependent and independent variables, and potential confounding factors were calculated using logistic regression models with stepwise backward/forward. A p < 0.05 was accepted as significant, using Stata 16.0. RESULTS: Most of the students (54.1%) were with malnutrition by excess and 20.0% exhibited abdominal obesity. Twenty percent of the students met the recommended intake for DGBF (fruits, vegetables, fish, milk and dairy products, legumes, water) and less than 5% did not consume any HPF. Consuming some sub-groups of HPF in moderate quantities (either no consumption or occasional consumption) increases the likelihood of meeting DGBF: candies and sweets (OR: 0.72; p = 0.04), pies with or without filling (OR: 0.63; p = 0.01), and salted snacks (OR: 0.67; p = 0.02). CONCLUSION: Our results contribute to reaffirm the need to enhance healthy food consumption among schoolchildren and to discourage the intake of HPF, particularly focusing on specific sub-groups of HPF that may increase the risk of displacing the consumption of food groups recommended by the DGBF.
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Dieta , Política Nutricional , Humanos , Chile/epidemiología , Masculino , Femenino , Niño , Estudiantes/estadística & datos numéricos , Adolescente , Conducta AlimentariaRESUMEN
BACKGROUND: In 2020, countries implemented universal surveillance to detect and monitor severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases. Although crucial for early monitoring efforts, universal surveillance is resource intensive. To understand the implications of transitioning from universal to sentinel surveillance for monitoring SARS-CoV-2 transmissibility, morbidity and mortality, and disease seriousness, we compared measures of SARS-CoV-2 reported from both surveillance strategies in Argentina, Chile, and Mexico. METHODS: We obtained weekly case counts in Argentina, Chile, and Mexico, in periods when both universal and sentinel surveillance were ongoing. To assess the countries' surveillance strategies, we measured the proportion of total sites that were included in sentinel surveillance. We compared 8 measures of SARS-CoV-2 transmissibility, morbidity and mortality, and disease seriousness between sentinel and universal surveillance and assessed the correlation between the 2 strategies for the 8 measures. Pearson and Spearman correlation was classified as very strong (rs = 0.8-1.0), strong (rs = 0.60-0.79), moderate (rs = 0.50-0.59), or poor (r < 0.50). RESULTS: The proportion of total sites included in sentinel surveillance was 5.8% for Argentina, 1.1% for Chile, and 7.6% for Mexico. A total of 21 measures were calculated (8 for Mexico, 8 for Chile, and 5 for Argentina). Of these, 17 showed consistency between the 2 surveillance strategies, with strong or very strong correlations (r = 0.66-0.99): all 8 measures for Mexico, 6 of 8 measures for Chile, and 3 of 5 measures for Argentina. Each country had ≥1 measure reflecting transmissibility and ≥1 reflecting morbidity and mortality for which the correlation was strong or very strong. Chile and Mexico also had ≥1 measure of disease seriousness for which the correlation was strong. CONCLUSIONS: Our findings suggest that the integration of SARS-CoV-2 into national sentinel surveillance can yield information comparable to that provided by nationwide universal surveillance for measures related to SARS-CoV-2 transmissibility, morbidity and mortality, and seriousness of disease.
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COVID-19 , SARS-CoV-2 , Vigilancia de Guardia , Humanos , COVID-19/epidemiología , COVID-19/diagnóstico , México/epidemiología , Chile/epidemiología , Argentina/epidemiología , SARS-CoV-2/aislamiento & purificaciónRESUMEN
BACKGROUND: To better establish the value of vaccination against influenza viruses, we estimated vaccine-averted influenza illnesses among young children and older adults in Chile, Guyana, and Paraguay. METHODS: We gathered country- and target population-specific data on monthly influenza hospitalizations, vaccine coverage, and vaccine effectiveness from surveillance records and immunization registries during 2013-2018. We applied a static compartmental model to estimate differences in the number influenza-associated respiratory disease events (symptomatic nonhospitalized illnesses, medically attended illnesses, hospitalizations) in the presence and absence of influenza vaccination programs. RESULTS: Between 2013 and 2018, vaccinating 68% of children aged 6-23 months in Chile averted an annual mean of 14 617 nonhospitalized, 9426 medically attended, and 328 hospitalized influenza illnesses; vaccinating 28% of children aged 6-23 months in Paraguay averted 1115 nonhospitalized, 719 medically attended, and 25 hospitalized influenza illnesses. Vaccinating 59% of older adults in Chile averted an annual mean of 83 429 nonhospitalized, 37 079 medically attended, and 1390 hospitalized influenza illnesses; vaccinating 36% of older adults in Paraguay averted an annual mean of 3932 nonhospitalized, 1748 medically attended, and 66 hospitalized influenza illnesses. In Guyana, a hypothetical campaign vaccinating 30% of children aged <5 years could have prevented an annual 1496 nonhospitalized, 971 medically attended, and 10 hospitalized influenza illnesses. Vaccinating 30% of adults aged ≥65 years could have prevented 568 nonhospitalized, 257 medically attended, and 10 hospitalized influenza illnesses. CONCLUSIONS: Influenza vaccination averted tens of thousands of illnesses and thousands of hospitalizations in Chile and Paraguay; influenza vaccination could have had a proportional benefit in Guyana.
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Hospitalización , Vacunas contra la Influenza , Gripe Humana , Vacunación , Humanos , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/prevención & control , Gripe Humana/epidemiología , Chile/epidemiología , Lactante , Hospitalización/estadística & datos numéricos , Paraguay/epidemiología , Preescolar , Vacunación/estadística & datos numéricos , Adulto , Guyana/epidemiología , Adulto Joven , Persona de Mediana Edad , Adolescente , Anciano , Masculino , Niño , Femenino , Programas de Inmunización , Eficacia de las VacunasRESUMEN
BACKGROUND: Human papillomavirus (HPV) is the main pathogen responsible of cervical cancer. The characterization of HPV genotypes in preneoplastic lesions and cervical cancer could establishes the effectiveness of the vaccination plan in the Chilean population. The aim of this study was to determine the frequency of HPV in women in the Coquimbo region. METHODS: A total of 1235 cervical samples from women aged 20-64 years old who attended gynecological check-ups from April 2023 to July 2024 were analyzed to detect HPV genotypes using qPCR. RESULTS: The overall prevalence rate of HPV infection was 26.56â¯%, while the prevalence of HR-HPV in age groups G1 (20-29 years) and G2 (30-64 years) was 47.69â¯% and 24.07â¯%, respectively. The most prevalent genotypes of HPV infection among our entire population were HPV16, HPV51 and HPV 31. Single infection (74.70â¯%) was the main pattern of HPV infection observed in the entire group, followed by double infection (16.46â¯%) and multiple infection (8.84â¯%), which was similar in Group 2, with percentiles of 76.07â¯%, 15.79â¯% and 7.14â¯%, respectively. However, in Group 1 a higher frequency of multiple HPV infections was observed, with 16.13â¯%. CONCLUSION: This HPV prevalence infections among women in the Coquimbo region appears to be higher than the reported in Chile. In the rest of country, HPV prevalence is likely underestimated. Molecular detection of 14 HR-HPV genotypes is important because it will not only help women avoid cervical cancer but could also inform the introduction of new vaccines targeting a broader spectrum of HR-HPV.
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Genotipo , Papillomaviridae , Infecciones por Papillomavirus , Neoplasias del Cuello Uterino , Humanos , Femenino , Chile/epidemiología , Adulto , Persona de Mediana Edad , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/virología , Prevalencia , Adulto Joven , Papillomaviridae/genética , Papillomaviridae/aislamiento & purificación , Neoplasias del Cuello Uterino/virología , Neoplasias del Cuello Uterino/epidemiología , ADN Viral/genética , Virus del Papiloma HumanoRESUMEN
BACKGROUND AND AIMS: Evidence from high-income countries has linked duration and compliance with treatment for substance use disorders (SUDs) with reductions in substance use and improvements in mental health. Generalizing these findings to other regions like South America, where opioid and injection drug use is uncommon, is not straightforward. We examined if length of time in treatment and compliance with treatment reduced subsequent substance use and presence of psychiatric comorbidities. DESIGN: Prospective cohort analysis (3 assessments, 18 months) using inverse probability weighting to account for confounding and loss to follow-up. SETTINGS: Outpatient/inpatient programs in Región Metropolitana, Chile. PARTICIPANTS: Individuals initiating publicly funded treatment (n = 399). MEASUREMENTS: Exposures included length of time in (0-3, 4-7, 8 + months, currently in) and compliance with treatment (not completed, completed, currently in) measured in the intermediate assessment (12 months). Primary outcomes were past-month use of primary substance (most problematic) and current psychiatric comorbidities (major depressive episode, panic, anxiety or post-traumatic stress disorders) measured 6 months later (18 months). Secondary outcomes included past month use of alcohol, cannabis, cocaine powder and cocaine paste. FINDINGS: 18.3% [95% confidence interval (CI) = 14.7%-22.6%] of individuals participated for 3 or fewer months in treatment and 50.1% (95% CI = 45.2%-55.1%) did not complete their treatment plan at 12 months. Participating for 8 + months in treatment was associated with lower risk of past month use of primary substance at 18 months [vs. 0-3 months, risk ratio (RR) = 0.62, 95% CI = 0.38-1.00] and completion of treatment (vs. not completed, RR = 0.49, 95% CI = 0.30-0.80). Neither participating 8 + months (vs. 0-3 months, RR = 0.83, 95% CI = 0.57-1.22) nor treatment completion (vs. not completed, RR = 1.02, 95% CI = 0.72-1.46) were associated with lower risk of psychiatric comorbidity at 18 months. CONCLUSIONS: Longer time in treatment and compliance with treatment for substance use disorders in Chile appears to be associated with lower risk of substance use but not current comorbid psychiatric conditions 18 months after treatment initiation.
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Trastornos Mentales , Trastornos Relacionados con Sustancias , Humanos , Chile/epidemiología , Masculino , Femenino , Estudios Prospectivos , Adulto , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/terapia , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Resultado del Tratamiento , Comorbilidad , Cooperación del Paciente/estadística & datos numéricos , Estudios de Cohortes , Adulto Joven , Factores de Tiempo , Trastorno Depresivo Mayor/epidemiologíaRESUMEN
The burden of COVID-19 was heterogeneous, indicating that the effects of this disease are synergistic with both other non-communicable diseases and socioeconomic status (SES), highlighting its syndemic character. While the appearance of vaccines moderated the pandemic effects, their coverage was heterogeneous too, both when comparing different countries, and when comparing different populations within countries. Of note, once again SES appears to be a correlated factor. We analyzed publicly available data detailing the percentage of school-aged, vaccinated children in different municipalities belonging to the Metropolitan Area (MA) of Santiago, Chile. Vaccination data was compiled per school type, either public, state-subsidized, or private, at three different dates during the COVID-19 pandemic to cover the dispersion of Delta, Omicron, and its subvariants BA.4 and BA.5. We computed the median vaccination ratio for each municipality and school type and calculated their Spearman's rank correlation coefficient with each one of nine SES indices. The percentage of school-age children who received vaccinations against COVID-19 correlates with SES. This strong correlation is observed in public and state-subsidized schools, but not in private schools. Although inequity in vaccination coverage decreased over time, it remained higher among students enrolled either in public or state-subsidized schools compared to those of private schools. Although available data was insufficient to explore plausible causes behind lower vaccination coverage, it is likely that a combination of factors including the lack of proper information about the importance of vaccination, the lack of incentives for children's vaccination, low trust in the government, and limited access to vaccines for lower-income people, may all have contributed. These findings raise the need to design better strategies to overcome shortcomings in vaccination campaigns to confront future pandemics.
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Vacunas contra la COVID-19 , COVID-19 , Clase Social , Estudiantes , Cobertura de Vacunación , Humanos , Chile/epidemiología , Cobertura de Vacunación/estadística & datos numéricos , COVID-19/prevención & control , COVID-19/epidemiología , Niño , Vacunas contra la COVID-19/administración & dosificación , Estudiantes/estadística & datos numéricos , Adolescente , Instituciones Académicas , SARS-CoV-2 , Femenino , Masculino , Vacunación/estadística & datos numéricos , Pandemias/prevención & controlRESUMEN
The Pseudocleobis from Chile are revised. Pseudocleobis morsicans (Gervais, 1849) and P. chilensis Roewer, 1934 are considered species inquerenda. Pseudocleobis andinus (Pocock, 1899) is removed from the Chilean fauna, and its previous records are considered misidentifications. Pseudocleobis alticola Pocock, 1900 is recorded from Chile for the first time. Nine new species are described, Pseudocleobis elongatus n. sp., P. atacamensis n. sp., P. puna n. sp., P. krausi n. sp., P. choros n. sp., P. lalackama n. sp., P. mumai n. sp., P. cekalovici n. sp. and P. escuadra n. sp. The species can be distinguished by the male chelicera morphology. We discuss the relationship of Chilean Pseudocleobis with other species of the genus, based on morphology. This work increases the number of known Chilean solifuge species by almost 70%, revealing the high degree of diversification of this group in Chile.
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Biodiversidad , Chile , Animales , Masculino , Femenino , Especificidad de la EspecieRESUMEN
The Chilean sub-Antarctic ecoregion hosts the largest expanse of temperate forests, wetlands and peatlands, as well as the largest proportion of protected areas in the southern hemisphere. Bryophytes are highly diverse and ecologically essential in sub-Antarctic ecosystems and are considered as biodiversity loss indicators caused by the current socio-ecological crisis. However, knowledge about their biodiversity is rather limited. Integrating the available information on bryophyte diversity in regional platforms such as SIB-Aysén can be useful to acknowledge their ecological importance and remarkable biodiversity. This article integrates 345 records of 273 bryophyte taxa known in the region of Aysén and emphasizes the need to include citizen science as a tool to increase observations in lesser-known taxonomic groups.
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Biodiversidad , Briófitas , Chile , Regiones Antárticas , Ecosistema , Bases de Datos FactualesRESUMEN
Over recent decades, Northern Patagonia in Chile has seen significant growth in agriculture, livestock, forestry, and aquaculture, disrupting lake ecosystems and threatening native species. These environmental changes offer a chance to explore how anthropization impacts zooplankton communities from a molecular-ecological perspective. This study assessed the anthropogenic impact on Daphnia pulex by comparing its proteomes from two lakes: Llanquihue (anthropized) and Icalma (oligotrophic). Results showed substantial differences in protein expression, with 17 proteins upregulated and 181 downregulated in Llanquihue, linked to elevated levels of copper, manganese, dissolved solids, phosphate, and nitrogen. These stressors caused metabolic damage and environmental stress in D. pulex. Our findings highlight the importance of monitoring pollution's effects on Northern Patagonian ecosystems, especially on keystone species like D. pulex, essential for ecosystem stability. This research provides fresh molecular-ecological insights into pollution's impacts, a perspective rarely addressed in this region. Understanding these effects is critical for conserving natural resources and offers pathways to study adaptive mechanisms in keystone species facing pollution. This approach also informs strategies for ecosystem management and restoration, addressing both immediate and long-term challenges in Northern Patagonian aquatic environments.
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Daphnia , Lagos , Metales Pesados , Proteómica , Contaminantes Químicos del Agua , Animales , Daphnia/metabolismo , Daphnia/efectos de los fármacos , Daphnia/genética , Metales Pesados/toxicidad , Contaminantes Químicos del Agua/toxicidad , Proteómica/métodos , Proteoma/metabolismo , Chile , Ecosistema , Monitoreo del Ambiente/métodos , Daphnia pulexRESUMEN
Background: Cardiovascular diseases increasingly impact youth, with early development of risk factors such as obesity, hypertension, and inadequate nutrient intake. Proper nutrient intake and physical fitness are vital for reducing these risks, especially in pediatric populations. This study explores the connection between physical fitness, metabolic risk, and nutrient status among 1656 Chilean schoolchildren from diverse socio-economic backgrounds. Methods: Anthropometric measures included weight, height, skinfold thickness, waist circumference, and blood pressure. Physical fitness was assessed via handgrip strength, standing long jump, and a six-minute walk test. Nutrient intake was also evaluated, and a composite metabolic risk score was calculated based on waist circumference, skinfolds, and blood pressure. Results: Boys consistently outperformed girls in physical fitness tests, including grip strength and horizontal jump, with differences becoming more pronounced in higher grades and Tanner stages. Girls exhibited higher subcutaneous fat levels and obesity prevalence during later grades, highlighting gender-specific patterns in body composition. Better physical fitness was associated with lower waist circumference, skinfold thickness, and metabolic risk scores. A moderate correlation between aerobic fitness (distance/height) and blood pressure (r = 0.27, p = 0.01) was observed. Z-Score MR analysis revealed that students in the lowest fitness tertile exhibited significantly higher cardiovascular risk profiles compared to their fitter peers. Conclusions: Physical fitness plays a critical role in reducing cardiovascular risk in children. The findings underscore the importance of promoting gender- and age-specific interventions that include both aerobic and strength-based physical activities. Comprehensive school programs focusing on nutrition and physical activity are essential to mitigating cardiovascular risk and promoting long-term health outcomes. Future longitudinal studies are recommended to establish causal relationships and evaluate the impact of targeted interventions.