Psychometric characteristics of a questionnaire to assess perceived disability in people with epilepsy.

It has been determined that quality of life in epilepsy is closely related to the perceived disability experienced by individuals with the diagnosis. However, this measure is seldom considered in healthcare processes. The objective of the present study is to establish the psychometric properties of the Perceived Disability Questionnaire in individuals diagnosed with epilepsy within a Latin American context. A cross-sectional, analytical study was conducted involving 325 participants, aged 12 years and older (M 40.42 years), individuals diagnosed with epilepsy in Colombia. The main psychometric properties of the instrument were explored to account for its factorial validity and reliability. The Perceived Disability Questionnaire exhibits high reliability (α = 0.878) and the three subscales comprising the final version of the questionnaire (Dissatisfaction, Pessimism, and Self-Disdain) explain 45.393 % of the total variance in relation to beliefs of disability associated with the diagnosis of epilepsy; the questionnaire significantly correlates with the Quality of Life in Epilepsy Inventory (QOLIE-10). Adequate psychometric properties of the instrument are found, which allows for its proposal as a tool in epilepsy care processes within the Colombian context.

[Mental Health Gap Action Programme: a theoretical model of barriers to implementation by health personnel in Chocó, ColombiaPrograma de Ação para Reduzir as Lacunas em Saúde Mental: modelo teórico das barreiras de implementação por profissionais de saúde de Chocó, Colômbia]. / Programa de acción para superar las brechas en salud mental: un modelo teórico de las barreras de implementación desde el personal de salud en Chocó, Colombia.

Objectives: Mental, neurological, and substance use (MNS) disorders have a high prevalence in Colombia and there is a treatment gap. The World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) has various components. The mhGAP 2.0 Intervention Guide, aimed at improving primary health care, is a guide for the assessment and management of MNS disorders based on clinical decision-making protocols. The objective of this study was to determine the barriers that may hinder the program implementation process. Methods: A qualitative study with content analysis was conducted in three phases: i) study preparation, organization, and presentation; ii) open coding, categorization, and abstraction of contents; and iii) information analysis. The study included semi-structured interviews with 21 people involved in the provision of mental health services in Chocó (Colombia): five medical doctors, seven nurses, and three psychologists, as well as six professionals working in the administrative area of the department's health secretariats. The perceptions of these stakeholders were explored. Open-ended questions were asked to explore experiences with the process, as well as the barriers identified in practice. Results: Four different thematic categories were identified: intersectoral action, long-standing challenges, opportunities, and suitability of tools. Conclusions: A theoretical model of barriers to implementation of the mhGAP program was constructed, based on stakeholder perceptions. Controlling barriers is perceived as a possible way to contribute significantly to population health.

Objetivo: Os transtornos mentais, neurológicos e por uso de substâncias psicoativas são muito prevalentes, e há uma lacuna na atenção a esses transtornos na Colômbia. O Programa de Ação para Reduzir as Lacunas em Saúde Mental (mhGAP, na sigla em inglês) da Organização Mundial da Saúde (OMS) consta de vários componentes. Um deles é o Manual de Intervenções mhGAP 2.0, elaborado para aprimorar a atenção primária à saúde. O documento contém orientações para avaliação e manejo de transtornos mentais, neurológicos e por uso de substâncias psicoativas e foi elaborado com base em protocolos para a tomada de decisões clínicas. O objetivo do estudo foi determinar as barreiras que podem surgir no processo de implementação do programa. Métodos: Estudo qualitativo com enfoque de análise de conteúdo desenvolvido em três fases: i) preparação, organização e apresentação do estudo; ii) codificação aberta, categorização e abstração do conteúdo; e iii) análise das informações. O estudo incluiu entrevistas semiestruturadas com 21 pessoas envolvidas na prestação de serviços de saúde mental em Chocó (Colômbia): cinco profissionais da medicina, sete de enfermagem e três de psicologia, bem como seis profissionais que trabalham na área administrativa das secretarias de saúde do departamento. As percepções das partes interessadas, ou seja, do pessoal assistencial e administrativo do setor de saúde no departamento de Chocó, foram exploradas. Foram feitas perguntas abertas a fim de investigar suas experiências com o processo de atenção e as barreiras identificadas na prática. Resultados: Foram identificadas quatro categorias temáticas: intersetorialidade, desafios de longa data, possibilidades e adequação das ferramentas. Conclusões: Elaborou-se um modelo teórico sobre as barreiras de implementação do Programa mhGAP com base nas percepções das partes interessadas. O controle das barreiras é visto como uma possível forma de contribuir significativamente para a saúde da população.

Programa de acción para superar las brechas en salud mental: un modelo teórico de las barreras de implementación desde el personal de salud en Chocó, Colombia / Mental Health Gap Action Programme: a theoretical model of barriers to implementation by health personnel in Chocó, Colombia / Programa de Ação para Reduzir as Lacunas em Saúde Mental: modelo teórico das barreiras de implementação por profissionais de saúde de Chocó, Colômbia

[RESUMEN]. Objetivo. Los trastornos mentales, neurológicos y por consumo de sustancias psicoactivas (MNS) tienen una prevalencia alta y existe una brecha para su atención en Colombia. El Programa de acción para superar las brechas en salud mental (mhGAP, por su sigla en inglés) de la Organización Mundial de la Salud (OMS) tiene varios componentes. Uno de ellos es la Guía de intervención mhGAP 2.0, orientada a la mejora de la atención primaria en salud; se trata de una guía para la evaluación y el manejo de trastornos MNS a partir de protocolos de toma de decisiones clínicas. Se planteó como objetivo determinar las barreras que se pueden presentar en el proceso de implementación del programa. Métodos. Se realizó un estudio cualitativo con enfoque de análisis de contenido que se desarrolló en tres fases: i) preparación, organización y presentación del estudio; ii) codificación abierta, categorización y abs- tracción de los contenidos; y iii) análisis de información. El estudio incluyó la entrevista semiestructurada a 21 personas involucradas en la prestación de servicios en salud mental en Chocó (Colombia): cinco profesionales de medicina, siete de enfermería y tres de psicología, además seis profesionales que trabajaban en el área administrativa de las secretarías de salud del departamento. Se exploraron las percepciones de las partes interesadas, que eran el personal asistencial y el personal administrativo del sector salud en el departamento del Chocó. Se realizaron preguntas abiertas para explorar las experiencias con el proceso y las barreras identificadas en la práctica. Resultados. Se identificaron cuatro categorías temáticas diferentes: intersectorialidad, viejos desafíos, posibilidades e idoneidad de herramientas. Conclusiones. Se construyó un modelo teórico sobre las barreras de implementación para el Programa de mhGAP desde las percepciones de las partes interesadas. El control de las barreras se percibe como un camino posible para generar un aporte significativo para la salud poblacional.

[ABSTRACT]. Objectives. Mental, neurological, and substance use (MNS) disorders have a high prevalence in Colombia and there is a treatment gap. The World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) has various components. The mhGAP 2.0 Intervention Guide, aimed at improving primary health care, is a guide for the assessment and management of MNS disorders based on clinical decision-making protocols. The objective of this study was to determine the barriers that may hinder the program implementation process. Methods. A qualitative study with content analysis was conducted in three phases: i) study preparation, organization, and presentation; ii) open coding, categorization, and abstraction of contents; and iii) information analysis. The study included semi-structured interviews with 21 people involved in the provision of mental health services in Chocó (Colombia): five medical doctors, seven nurses, and three psychologists, as well as six professionals working in the administrative area of the department's health secretariats. The perceptions of these stakeholders were explored. Open-ended questions were asked to explore experiences with the process, as well as the barriers identified in practice. Results. Four different thematic categories were identified: intersectoral action, long-standing challenges, opportunities, and suitability of tools. Conclusions. A theoretical model of barriers to implementation of the mhGAP program was constructed, based on stakeholder perceptions. Controlling barriers is perceived as a possible way to contribute significantly to population health.

[RESUMO]. Objetivo. Os transtornos mentais, neurológicos e por uso de substâncias psicoativas são muito prevalentes, e há uma lacuna na atenção a esses transtornos na Colômbia. O Programa de Ação para Reduzir as Lacunas em Saúde Mental (mhGAP, na sigla em inglês) da Organização Mundial da Saúde (OMS) consta de vários componentes. Um deles é o Manual de Intervenções mhGAP 2.0, elaborado para aprimorar a atenção primária à saúde. O documento contém orientações para avaliação e manejo de transtornos mentais, neurológicos e por uso de substâncias psicoativas e foi elaborado com base em protocolos para a tomada de decisões clínicas. O objetivo do estudo foi determinar as barreiras que podem surgir no processo de imple- mentação do programa. Métodos. Estudo qualitativo com enfoque de análise de conteúdo desenvolvido em três fases: i) preparação, organização e apresentação do estudo; ii) codificação aberta, categorização e abstração do conteúdo; e iii) análise das informações. O estudo incluiu entrevistas semiestruturadas com 21 pessoas envolvidas na prestação de serviços de saúde mental em Chocó (Colômbia): cinco profissionais da medicina, sete de enfermagem e três de psicologia, bem como seis profissionais que trabalham na área administrativa das secretarias de saúde do departamento. As percepções das partes interessadas, ou seja, do pessoal assisten- cial e administrativo do setor de saúde no departamento de Chocó, foram exploradas. Foram feitas perguntas abertas a fim de investigar suas experiências com o processo de atenção e as barreiras identificadas na prática. Resultados. Foram identificadas quatro categorias temáticas: intersetorialidade, desafios de longa data, possibilidades e adequação das ferramentas. Conclusões. Elaborou-se um modelo teórico sobre as barreiras de implementação do Programa mhGAP com base nas percepções das partes interessadas. O controle das barreiras é visto como uma possível forma de contribuir significativamente para a saúde da população.

Programa de acción para superar las brechas en salud mental: un modelo teórico de las barreras de implementación desde el personal de salud en Chocó, Colombia / Mental Health Gap Action Programme: a theoretical model of barriers to implementation by health personnel in Chocó, Colombia / Programa de Ação para Reduzir as Lacunas em Saúde Mental: modelo teórico das barreiras de implementação por profissionais de saúde de Chocó, Colômbia

RESUMEN Objetivo. Los trastornos mentales, neurológicos y por consumo de sustancias psicoactivas (MNS) tienen una prevalencia alta y existe una brecha para su atención en Colombia. El Programa de acción para superar las brechas en salud mental (mhGAP, por su sigla en inglés) de la Organización Mundial de la Salud (OMS) tiene varios componentes. Uno de ellos es la Guía de intervención mhGAP 2.0, orientada a la mejora de la atención primaria en salud; se trata de una guía para la evaluación y el manejo de trastornos MNS a partir de protocolos de toma de decisiones clínicas. Se planteó como objetivo determinar las barreras que se pueden presentar en el proceso de implementación del programa. Métodos. Se realizó un estudio cualitativo con enfoque de análisis de contenido que se desarrolló en tres fases: i) preparación, organización y presentación del estudio; ii) codificación abierta, categorización y abstracción de los contenidos; y iii) análisis de información. El estudio incluyó la entrevista semiestructurada a 21 personas involucradas en la prestación de servicios en salud mental en Chocó (Colombia): cinco profesionales de medicina, siete de enfermería y tres de psicología, además seis profesionales que trabajaban en el área administrativa de las secretarías de salud del departamento. Se exploraron las percepciones de las partes interesadas, que eran el personal asistencial y el personal administrativo del sector salud en el departamento del Chocó. Se realizaron preguntas abiertas para explorar las experiencias con el proceso y las barreras identificadas en la práctica. Resultados. Se identificaron cuatro categorías temáticas diferentes: intersectorialidad, viejos desafíos, posibilidades e idoneidad de herramientas. Conclusiones. Se construyó un modelo teórico sobre las barreras de implementación para el Programa de mhGAP desde las percepciones de las partes interesadas. El control de las barreras se percibe como un camino posible para generar un aporte significativo para la salud poblacional.

ABSTRACT Objectives. Mental, neurological, and substance use (MNS) disorders have a high prevalence in Colombia and there is a treatment gap. The World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) has various components. The mhGAP 2.0 Intervention Guide, aimed at improving primary health care, is a guide for the assessment and management of MNS disorders based on clinical decision-making protocols. The objective of this study was to determine the barriers that may hinder the program implementation process. Methods. A qualitative study with content analysis was conducted in three phases: i) study preparation, organization, and presentation; ii) open coding, categorization, and abstraction of contents; and iii) information analysis. The study included semi-structured interviews with 21 people involved in the provision of mental health services in Chocó (Colombia): five medical doctors, seven nurses, and three psychologists, as well as six professionals working in the administrative area of the department's health secretariats. The perceptions of these stakeholders were explored. Open-ended questions were asked to explore experiences with the process, as well as the barriers identified in practice. Results. Four different thematic categories were identified: intersectoral action, long-standing challenges, opportunities, and suitability of tools. Conclusions. A theoretical model of barriers to implementation of the mhGAP program was constructed, based on stakeholder perceptions. Controlling barriers is perceived as a possible way to contribute significantly to population health.

RESUMO Objetivo. Os transtornos mentais, neurológicos e por uso de substâncias psicoativas são muito prevalentes, e há uma lacuna na atenção a esses transtornos na Colômbia. O Programa de Ação para Reduzir as Lacunas em Saúde Mental (mhGAP, na sigla em inglês) da Organização Mundial da Saúde (OMS) consta de vários componentes. Um deles é o Manual de Intervenções mhGAP 2.0, elaborado para aprimorar a atenção primária à saúde. O documento contém orientações para avaliação e manejo de transtornos mentais, neurológicos e por uso de substâncias psicoativas e foi elaborado com base em protocolos para a tomada de decisões clínicas. O objetivo do estudo foi determinar as barreiras que podem surgir no processo de implementação do programa. Métodos. Estudo qualitativo com enfoque de análise de conteúdo desenvolvido em três fases: i) preparação, organização e apresentação do estudo; ii) codificação aberta, categorização e abstração do conteúdo; e iii) análise das informações. O estudo incluiu entrevistas semiestruturadas com 21 pessoas envolvidas na prestação de serviços de saúde mental em Chocó (Colômbia): cinco profissionais da medicina, sete de enfermagem e três de psicologia, bem como seis profissionais que trabalham na área administrativa das secretarias de saúde do departamento. As percepções das partes interessadas, ou seja, do pessoal assistencial e administrativo do setor de saúde no departamento de Chocó, foram exploradas. Foram feitas perguntas abertas a fim de investigar suas experiências com o processo de atenção e as barreiras identificadas na prática. Resultados. Foram identificadas quatro categorias temáticas: intersetorialidade, desafios de longa data, possibilidades e adequação das ferramentas. Conclusões. Elaborou-se um modelo teórico sobre as barreiras de implementação do Programa mhGAP com base nas percepções das partes interessadas. O controle das barreiras é visto como uma possível forma de contribuir significativamente para a saúde da população.

Tuberculosis Disability Adjusted Life Years, Colombia 2010-2018.

Estimating the burden of tuberculosis disease is relevant for assessing and identifying population health status and progress in policies and programs aimed at epidemic control. The objective of this study was to estimate disability-adjusted life years attributable to Tuberculosis in Colombia 2010-2018. A longitudinal descriptive study was conducted. The variables, sex, age groups and origin were studied. This study included 110,475 cases of morbidity and 8514 cases of mortality. Indicators of years of life lost, years of life with disability and disability-adjusted life years at the subnational level were determined using the methodology of the World Health Organization. With the results of this last indicator, an epidemiological risk stratification was carried out. The DALY rate of the study period was 684 (95% CI 581.2-809.1) per 100,000 inhabitants. According to sex, 68.4% occurred in men; for every DALY in women, 2.21 occur in men. People of productive age (15 to 69 years) account for 56% of DALYs. Amazonas (1857.1 CI 95% 1177.1-2389.6) was the territorial entity with the highest rate. A total of 51.5% of the territorial entities of departmental order of the country are of high burden for Tuberculosis. For the first time in Colombia, a comprehensive assessment of the status of the disease burden at a subnational (departmental) territorial level attributable to Tuberculosis is being carried out using the updated World Health Organization methodology. The results obtained allow us to specify that there is a knowledge gap in terms of the realization and clear understanding of the burden of the disease in Colombia. There are territorial gaps that are necessary to know in order to plan, develop, implement and redirect policies to improve health and eliminate disparities according to the territorial context.

Tuberculosis Mortality in Children under Fifteen Years of Age: Epidemiological Situation in Colombia, 2010-2018.

Pediatric tuberculosis is a serious infectious disease and a hidden global epidemic. The objective of this study was to describe the epidemiological situation of tuberculosis mortality in children under 15 years of age in Colombia in the period 2010-2018. A longitudinal descriptive study was conducted. The variables sex, age groups, and origin were studied. This study had 260 cases for analysis and was carried out in three phases. The first phase was the determination of the sociodemographic and clinical characteristics. The second phase was the construction of indicators by territorial entities. The third phase was stratification into four epidemiological situations according to the mortality rate and years of life lost. The median age was 7 years (range 0-14), 66.5% of cases were pulmonary tuberculosis (97.7% without bacteriological confirmation), 14.3781 years of life lost were recorded (95% CI: 142.811-168.333), and in children under 10-14 years, the loss was 110,057. Amazonas had the highest adjusted YLL rate (3979.7). In total, 36.4% of the territories had a high mortality, and 30.3% adjusted to the situation designated as 1. This is the first study that has used composite indicators to address the problem of premature mortality from childhood tuberculosis in Colombia. Our results allow us to specify that this disease remains a challenge for public health. It requires models of care and differential strategies by region. It also requires ensuring opportunities in diagnosis with sensitive methods, as well as intersectoral work for the optimal approach.

New record of Arcella gandalfi (Amoebozoa: Arcellinida) from Colombia.

The reports of testate amoebae species in Colombia are limited to a few studies in lentic and peat bog systems; however, the diversity in lotic systems has been poorly investigated. Zooplankton sampling was performed in lotic environments of the Piedemonte Llanero in Colombia. Ten individuals of the species Arcella gandalfi were identified to document the first record of A. gandalfi from the Piedemonte Llanero in Colombia, expanding its distribution from Brazil to Colombia. This finding corroborates the status of A. gandalfi as a flagship species from the South America continent.

Analytical Solution of Mixed Electroosmotic/ Pressure Driven Flow of Viscoelastic Fluids between a Parallel Flat Plates Micro-Channel: The Maxwell Model Using the Oldroyd and Jaumann Time Derivatives.

In the present work, an analytical approximate solution of mixed electroosmotic/pressure driven flow of viscoelastic fluids between a parallel plates microchannel is reported. Inserting the Oldroyd, Jaumann, or both time derivatives into the Maxwell model, important differences in the velocity profiles were found. The presence of the shear and normal stresses is only close to the wall. This model can be used as a tool to understand the flow behavior of low viscosity fluids, as most of them experiment on translation, deformation and rotation of the flow. For practical applications, the volumetric flow rate can be controlled with two parameters, namely the gradient pressure and the electrokinetic parameter, once the fluid has been rheologically characterized.

Birds vs bricks: Patterns of species diversity in response to urbanization in a Neotropical Andean city.

Urbanization is currently one the most important causes of biodiversity loss. The Colombian Andes is a well-known hotspot for biodiversity, however, it also exhibit high levels of urbanization, making it a useful site to document how species assemblages respond to habitat transformation. To do this, we compared the structure and composition of bird assemblages between rural and urban habitats in Armenia, a medium sized city located in the Central Andes of Colombia. In addition, we examined the influence of urban characteristics on bird species diversity within the city of Armenia. From September 2016 to February 2017 we performed avian surveys in 76 cells (250 x 250 m each) embedded within Armenia city limits; and in 23 cells (250 x 250 m each) in rural areas around Armenia. We found that bird diversity was significantly lower in urban habitats than in rural habitats, and differed in species composition by 29%. In urban cells, with higher abiotic noise intensity and higher impervious surface area, we found lower bird diversity than that in urban cells with higher guadual (Guadua angustifolia patches), and forested surface areas. We did not find segregation of urban cells according to the species composition, although additional bird surveys inside urban forests remnant are needed to be more conclusive about this aspect. Altogether, our results highlight the importance of green areas embedded within cities to conserve bird diversity through reducing the ecological impact of urbanization on avian biodiversity.

Mortalidad por accidentes laborales en del Departamento del Meta, años 2010-2015 / Occupational mortality in the Meta Department, 2010-2015 / Mortalidade por acidentes de trabalho no Departamento de Meta, anos 2010-2015Laura inés Plata-Casas*

Introducción:La mortalidad es considerada un factor de medición del estado de salud poblacional, por tanto, resulta indispensable reconocer su comportamiento epi-demiológico. Objetivo: Determinar la epidemiología de los casos de mortalidad por accidente laboral ocurridos en el Meta, durante el periodo comprendido entre 2010-2015. Materiales yMétodos: Estudio descriptivo y análisis de información del re-gistro único de afiliaciones, procesada en SPSS. Se utilizarán: estadística descriptiva, tasas de mortalidad y análisis de tendencias. Resultados: La tendencia en los casos de mortalidad por accidentes laborales ha disminuido, el 81% de la variabilidad de los casos de mortalidad, es explicada por su relación con los años. Conclusión: Los proyectos, programas y políticas de salud deben reflejar un seguimiento y monitoreo a los programas de promoción de la salud laboral. Igualmente, se debe evaluar su impacto, así como la realización de ajustes y su priorización.

Introduction: Mortality is considered a measuring factor of the population health; therefore, it is indispensable to recognize its epidemiological behavior. Objective:Determine the epidemiology of the occupational mortality cases in the Meta De-partment during the 2010-2015 period. Materials and Methods: Descriptive stu-dy and analysis of information from single affiliation records, processed in SPSS. Descriptive statistics, mortality rates and trend analysis will be used. Results: The tendency in occupational mortality has decreased, 81% of the variability in the oc-cupational mortality cases has been explained by its relation with age. Conclusion:The health projects, programs, and policies should reflect follow-up and monitoring of promotion programs in the occupational health area. Also, its impact must be eva-luated, as well as conducting adjustments and prioritization

Introdução: A mortalidade é considerada um indicador do estado da saúde da população, porém, é fundamental reconhecer o seu comportamento epidemiológico. Objetivo: Determinar o compor-tamento epidemiológico da mortalidade por acidentes de trabalho que aconteceram no estado do Meta, durante o período entre 2010 e 2015. Materiais e métodos: Estudo descritivo com análise do registro único de afiliações processada no SPSS. Foi empregada a estatística descritiva, taxas de mortalidade e a análise de tendências. Resultados: A tendência dos casos de mortalidade por acidentes de trabalho tem diminuído, o 81% da variabilidade dos casos de mortalidade explica-se pela sua relação com os anos. Conclusão: Os projetos, programas e politicas de saúde devem mos-trar um acompanhamento e monitoramento aos programas de promoção da saúde do trabalhador. Entretanto, deve-se avaliar o impacto dessas ações assim como ser priorizados e realizados ajustes.

Tuberculosis and human immunodeficiency virus coinfection: Epidemiological situation in the department of Meta, 2010- 2015

Introduction. One third of the increase in tuberculosis cases is attributed to the spread of HIV. Objective. To describe the Tb/HIV coinfection in the department of Meta from 2010 to 2015. Materials and methods. We conducted an observational, descriptive and retrospective study. After selecting 219 cases for analysis, two new databases were constructed and analyzed in three phases: Identification of sociodemographic and clinical characteristics, indicators by municipality (prevalence and therapeutic success) and stratification in epidemiological scenarios according to the prevalence (burden) of the illness. Results. Sixty percent of the municipalities corresponded to scenario 2. People with Tb/HIV coinfection who had not been treated previously, had 2.39 times more probability of having therapeutic success compared to those previously treated, this association being statistically significant (RP=2,39; 95% CI 1,3-9,6; p=0,01). Conclusion. Stratification by epidemiological scenarios is useful for planning prevention and control activities.

Infección concomitante por tuberculosis y el virus de la inmunodeficiencia humana: situación epidemiológica en el departamento del Meta, 2010-2015 / Tuberculosis and human immunodeficiency virus coinfection: Epidemiological situation in the department of Meta, 2010- 2015

Introducción. Una tercera parte del incremento de los casos de tuberculosis se atribuye a la propagación del HIV. Objetivo. Describir la infección concomitante de tuberculosis y HIV en el departamento del Meta durante el periodo de 2010 a 2015. Materiales y métodos. Se hizo un estudio observacional, descriptivo y retrospectivo. Se seleccionaron los 219 casos de análisis y se elaboraron dos nuevas bases de datos que fueron analizadas en tres fases: determinación de las características sociodemográficas y clínicas, construcción de indicadores por municipio (prevalencia y éxito terapéutico) y estratificación en situaciones epidemiológicas según la prevalencia (carga) de la enfermedad. Resultados. El 60 % de los municipios se ajustó a la situación designada como 2. El tratamiento de las personas con infección concomitante de tuberculosis y HIV cuya condición de ingreso era nueva, tuvo 2,39 veces más probabilidades de ser exitoso que el de los previamente tratados, siendo esta asociación estadísticamente significativa (razón de posibilidades, RP=2,39; IC95% 1,3-9,6; p=0,01). Conclusión. La estratificación por situaciones epidemiológicas es útil para planificar actividades de prevención y control.

Introduction. One third of the increase in tuberculosis cases is attributed to the spread of HIV. Objective. To describe the Tb/HIV coinfection in the department of Meta from 2010 to 2015. Materials and methods. We conducted an observational, descriptive and retrospective study. After selecting 219 cases for analysis, two new databases were constructed and analyzed in three phases: Identification of sociodemographic and clinical characteristics, indicators by municipality (prevalence and therapeutic success) and stratification in epidemiological scenarios according to the prevalence (burden) of the illness. Results. Sixty percent of the municipalities corresponded to scenario 2. People with Tb/HIV coinfection who had not been treated previously, had 2.39 times more probability of having therapeutic success compared to those previously treated, this association being statistically significant (RP=2,39; 95% CI 1,3-9,6; p=0,01). Conclusion. Stratification by epidemiological scenarios is useful for planning prevention and control activities.

Situación epidemiológica de la intoxicación por sustancias químicas en el departamento del meta-colombia, periodo 2009-2014 / Epidemiological situation of poissoning with chemical substances in the department of meta-colombia, period 2009-2014

Introducción: La intoxicación por sustancias químicas es un problema de salud pública, que afecta a la población de los municipios del departamento del Meta. Objetivo: Describir la situación epidemiológica de la intoxicación por sustancias químicas en el Meta. Metodología: Se realizó un estudio descriptivo de corte transversal, utilizando base de datos estatales de salud pública (2009-2014) constituida por 5.208 casos de intoxicación reportadas en este periodo, se calcularon la incidencia de periodo y la tasa de mortalidad; se analizaron variables epidemiológicas de morbilidad, mortalidad, tipo de sustancia, ubicación geográfica, tipo y vía de exposición, edad y sexo. Resultados: Los plaguicidas ocasionan el mayor número de intoxicaciones del Meta, causando el 68% de la incidencia y el 66% de la mortalidad, otro tipo de sustancias causan el 27,7% de los casos de morbilidad y 34% de la mortalidad. El 52,1% de las intoxicaciones ocurren de manera accidental, seguidas por la intención suicida y ocupacional con el 21,2% y 18,1% respectivamente; las vías de exposición fueron la oral, la respiratoria y la dérmica. Discusión: Meta es un departamento caracterizado por alta producción agrícola y una frontera agrícola en expansión, lo cual explicaría la elevada incidencia de los plaguicidas, la utilización de sustancias químicas en suicidios ocurren debido al fácil acceso que se tiene de las sustancias, la exposición ocupacional está ligada a la actividad agrícola y pecuaria, la exposición accidental ocurre por manejo inadecuado de sustancias químicas en las viviendas y la contaminación ambiental. Conclusiones: la actividad agropecuaria del Meta, junto con actividades cotidianas como la limpieza y el control de plagas en las viviendas, traen consigo la utilización de sustancias químicas, esta proximidad permite la exposición a estas sustancias y la posterior intoxicación que generan morbilidad y mortalidad humana.

Introduction: Chemical poisoning is a public health problem, affecting the population of the municipalities of Meta. Objective: To describe the epidemiological situation of chemical poisoning in the department of Meta. Methodology: A descriptive cross-sectional study was conducted, using statal public health data bases (2009-2014) consisting of 5,208 cases of poisoning reported in this period. The incidence, morbidity, mortality, substance type, geographic location, type and route of exposure, age and sex were analyzed. Results: Pesticides cause the highest number of poisonings of the Meta, causing 68% of incidence and 66% of mortality, and other types of substances cause 27.7% of cases of morbidity and 34% of mortality. 52.1% of the poisonings occur accidentally, followed by suicidal and occupational intent with 21.2% and 18.1% respectively; the routes of exposure were oral, respiratory and dermal. Discussion: Meta is a department characterized by high agricultural production and agricultural frontier expansion, which would explain the high incidence of pesticides, the use of chemicals in suicides occur due to the easy access of substances; occupational exposure is linked to agricultural and livestock activities, accidental exposure occurs through improper handling of chemicals in homes and environmental pollution. Conclusions: Agricultural activity in the department of Meta, along with everyday activities such as cleaning and pest control in homes bring the use of chemicals, this proximity allows exposure to these substances and the subsequent intoxication which generates morbidity and human mortality.

Mortalidad en pacientes menores de edad con diagnóstico de dengue y su relación con el uso de Dipirona / Mortality in minor patients with diagnosis of dengue and its relationship with the use of Dipirone

Introducción: El dengue es una de las diez causas de hospitalización más frecuentes en los servicios de urgencias de pediatría, en la atención sintomática se utiliza la Dipirona como antipirético, la guía clínica de manejo del dengue de la Organización Panamericana de la Salud (OPS) evidencia restricciones para su uso en pacientes con dengue y según la Guía de Atención Clínica Integral del paciente con dengue, no se debe administrar en pacientes pediátricos. Objetivo: Determinar la relación de la Dipirona con casos de mortalidad en menores de 16 años con dengue en el Meta. Materiales y métodos: Se realizó un estudio de casos y controles basado en la mortalidad por dengue en menores de edad reportados al Sistema de Vigilancia en Salud Pública del departamento del Meta, años 2008 a 2011. Resultados: La razón de las ventajas (OR) evidencia que la mortalidad por dengue es 17,6 veces mayor en menores de edad que recibieron Dipirona con un intervalo de confianza de 95% entre 3,7-84,5 y un valor de P de 0,0002. Conclusión: El grupo de casos que recibió Dipirona en su tratamiento presentó una mayor mortalidad, la revisión de literatura no evidencia resultados sobre la relación de la Dipirona y mortalidad en niños con dengue, se debe seguir estudiando el fenómeno para contar con mayor evidencia científica.

Introduction: Dengue is one of the ten most frequent causes of hospitalization in the emergency department of pediatrics where Dipyrone is used as an antipyretic in the symptomatic care. The clinical management guide for dengue of the Panamerican Health Organization (PHO) evidences restrictions for its use in patients with dengue, and according to the Integral Clinical Care Guide for patients with dengue, it should not be administered in pediatric patients. Objective: To determine the relationship between the uses of Dipyrone with the cases of mortality in children under 16 who suffered from dengue in Meta. Materials and methods: A case-control study was conducted based on mortality from dengue in minors reported to the Surveillance System in Public Health in the department of Meta, from 2008 to 2011. Results: The odds ratio (OR) shows that dengue mortality is 17.6 times greater in children Dipyrone treated with a confidence interval of 95% between 3.7 to 84.5 and a P value of 0.0002. Conclusion: The case group who received Dipyrone in their treatment had a higher mortality. There is no evidence or results in the literature review about the relationship of Dipyrone and mortality in children with dengue. This phenomenon should continue to be studied to have greater scientific evidence.

Factores asociados a la no adherencia al tratamiento anti tuberculosis / Factors associated with non-adherence to anti-tuberculosis treatment / Fatores associados à não-adesão ao tratamento anti-tuberculose

Objetivo: describir los factores de riesgo asociados a la no adherencia al tratamiento en los pacientes adscritos al programa de tuberculosis en el Municipio de Villavicencio, cohorte 2012. Materiales y Métodos: se ha realizado un estudio descriptivo de corte transversal con enfoque cuantitativo. Se obtuvieron datos de caracterización sociodemográfica sobre factores de riesgo de personas que abandonaron el tratamiento para la enfermedad- cohorte 2012- mediante la aplicación de un instrumento diseñado por el investigador y revisado por expertos. Los datos fueron tabulados y analizados mediante la herramienta Microsoft Excel® 2007 y Epi-info 7.0. Resultados: el 75% de los pacientes pertenecen al género masculino; el promedio de edad es de 30 años, el 63% pertenecen al régimen subsidiado de salud. Las principales causas de abandono fueron: efectos adversos a los medicamentos (58%), inadecuada atención del personal de salud (43%), dificultad de acceso al servicio (32%). Los factores sociales encontrados fueron hacinamiento 67% y desempleo 62%. Conclusiones: algunos factores no modificables como la edad y el género, así como factores modificables como estilos de vida inadecuados y efectos adversos; cuyo control mejoraría el cumplimiento; contribuyen al abandono del tratamiento. Las variables psicológicas y sociales deben ser evaluadas para que se conviertan en predictores de probables abandonos o irregularidades en el tratamiento antituberculoso.

Goal: to describe the risk factors associated with non-adherence to the treatment in patients enrolled in the tuberculosis program in Villavicencio city, cohort 2012. Materials and Methods: a descriptive cross-sectional study with quantitative approach. Socio-demographic data and characterization of risk factors for people who discontinued treatment for the disease. Datawere obtained by applying 2012 cohort instrument designed by the researcher and reviewed by experts. Data were tabulated and analyzed using Microsoft Excel 2007 and Epi-info 7.0 tool. Results: 75% of patients are male; the average age is 30 years, 63% of them belong to the subsidized health system. The main causes of abandonment were: adverse effects to medicines (58%),an inadequate health staff care (43%),some difficulties to access to the service (32%). The social factors were overcrowding found 67% and 62% unemployment. Conclusions: non-modifiable factors such as age and gender, as well as modifiable factors such as inadequate lifestyle and adverse effects; People in charge of the control would improve compliance; contribute to cessation of therapy. The psychological and social variables should be evaluated to become predictors of probable dropouts or irregularities in TB treatment.

Objetivo: descrever os fatores de risco associados à não-adesão ao tratamento em participar do programa de tuberculose na cidade de Villavicencio paciente coorte de 2012. Materiais e Métodos: um estudo descritivo transversal, com abordagem quantitativa. dados sócio-demográficos e caracterização dos fatores de risco para as pessoas que interromperam o tratamento para a doença foram obtidos através da aplicação de coorte 2012 instrumento concebido pelo investigador e revisados por especialistas. Os dados foram tabulados e analisados usando o Microsoft Excel 2007 e Epi-info 7.0 ferramenta. Resultados: 75% dos pacientes são masculinos; a média de idade é de 30 anos, 63% pertencem ao sistema de saúde subsidiado. As principais causas de abandono foram: efeitos adversos a medicamentos (58%), profissionais de saúde inadequada (43%), dificuldade de acesso ao serviço (32%). Os fatores sociais foram encontrados superlotação 67% e% de desemprego 62. Conclusões: os fatores não modificáveis, como idade e sexo, bem como fatores modificáveis, tais como estilos de vida inadequados e efeitos adversos; cujo controle seria melhorar o cumprimento; contribuir para a interrupção da terapia. variáveis psicológicas e sociais devem ser avaliados para se tornar preditores de abandono prováveis ou irregularidades no tratamento da TB.