Nutritional status of children from Cochabamba, Bolivia: a cross-sectional study / Estado nutricional de los niños de Cochabamba, Bolivia: un estudio transversal

Objective. To assess the adequacy of energy and nutritional intakes compared to recommended daily intakes (RDIs) in schoolchildren from the Cochabamba region (Bolivia) and to determine micronutrient intake distributions across different ages and genders. Methods. This nutritional study (n = 315) was part of a larger population-based cross-sectional study (the “Bolkid” survey) that collected data on schoolchildren 5–16 years old in 2010 in the Cochabamba region. Information about food intake was gathered with a semiquantitative, food-frequency, parent-administered questionnaire about 12 months before the study. Descriptive and bivariate analyses of energy and nutrient intakes were assessed. Results. For all ages studied and both genders, the average energy and micronutrient intakes were acceptable but below the requirements. The diet included high amounts of fiber, some minerals (iron, magnesium, phosphorus, potassium, sodium), and vitamins (pantothenic acid, niacin, vitamins B2, B12, C, and E), but was low in calcium and vitamin D. However, more than half the children had insufficient energy intake, and low calcium, vitamin A, and vitamin D intakes, according to RDIs adjusted for age and gender; one-third of the children had insufficient folate and magnesium intakes; and adolescent girls had low iron intakes. Conclusions. Regardless of recommendations or demographic characteristics, the vast majority of children in Cochabamba consumed insufficient energy and too little calcium, folate, magnesium, and vitamin A and D. In addition, adolescent girls consumed insufficient iron. Higher energy intake for schoolchildren through increased food availability, frequency, and size portions in daily meals should be a priority for Bolivian public health institutions.

Objetivo. Evaluar la idoneidad del consumo energético y de nutrientes en escolares de la región de Cochabamba, Bolivia, por comparación con las cantidades diarias recomendadas (CDR), y determinar la distribución de la ingesta de micronutrientes en distintas edades y ambos sexos. Métodos. Este estudio nutricional (n = 315) formó parte de un estudio transversal poblacional más amplio (la llamada encuesta Bolkid) en que se obtuvieron datos de escolares de 5 a 16 años de edad en la región de Cochabamba en el 2010. Se usó un cuestionario semicuantitativo, administrado por los padres, para obtener información acerca de la frecuencia del consumo de alimentos alrededor de 12 meses antes del estudio. Se evaluaron los resultados de análisis descriptivos y bivariados de la ingesta energética y de nutrientes. Resultados. En todas las edades estudiadas y ambos sexos, las ingestas energética y de micronutrientes fueron aceptables pero inferiores a las cantidades necesarias. La alimentación tenía un alto contenido de fibra, de algunos minerales (hierro, magnesio, fósforo, potasio, sodio) y de vitaminas (ácido pantoténico, niacina, vitaminas B2, B12, C y E), pero poco contenido de calcio y vitamina D. No obstante, más de la mitad de los niños tenían una ingesta energética insuficiente e ingestas demasiado bajas de calcio, vitamina A y vitamina D, según las CDR ajustadas por edad y sexo; una tercera parte consumían cantidades insuficientes de folato y magnesio; y las adolescentes tenían ingestas de hierro demasiado bajas. Conclusiones. Independientemente de las cantidades recomendadas o de las características demográficas, la gran mayoría de los niños en Cochabamba tenían un consume energético insuficiente e ingestas demasiado bajas de calcio, folato, magnesio y vitaminas A y D. Además, las adolescentes consumían cantidades insuficientes de hierro. Las instituciones de salud pública bolivianas deberían dar prioridad a aumentar el consumo energético de los escolares propiciando una mayor disponibilidad de alimentos, un consumo más frecuente y porciones más grandes en las comidas diarias.

Nutritional status of children from Cochabamba, Bolivia: a cross-sectional study / Estado nutricional de los niños de Cochabamba, Bolivia: un estudio transversal

OBJECTIVE:To assess the adequacy of energy and nutritional intakes compared to recommended daily intakes (RDIs) in schoolchildren from the Cochabamba region (Bolivia) and to determine micronutrient intake distributions across different ages and genders. METHODS: This nutritional study (n = 315) was part of a larger population-based crosssectional study (the "Bolkid" survey) that collected data on schoolchildren 5-16 years old in 2010 in the Cochabamba region. Information about food intake was gathered with a semiquan-titative, food-frequency, parent-administered questionnaire about l2 months before the study. Descriptive and bivariate analyses of energy and nutrient intakes were assessed. RESULTS: For all ages studied and both genders, the average energy and micronutrient intakes were acceptable but below the requirements. The diet included high amounts of fiber, some minerals (iron, magnesium, phosphorus, potassium, sodium), and vitamins (pantothenic acid, niacin, vitamins B2, B12, C, and E), but was low in calcium and vitamin D. However, more than half the children had insufficient energy intake, and low calcium, vitamin A, and vitamin D intakes, according to RDIs adjusted for age and gender; one-third of the children had insufficient folate and magnesium intakes; and adolescent girls had low iron intakes. CONCLUSIONS: Regardless of recommendations or demographic characteristics, the vast majority of children in Cochabamba consumed insufficient energy and too little calcium, folate, magnesium, and vitamin A and D. In addition, adolescent girls consumed insufficient iron. Higher energy intake for schoolchildren through increased food availability, frequency, and size portions in daily meals should be a priority for Bolivian public health institutions.

OBJETIVO:Evaluar la idoneidad del consumo energético y de nutrientes en escolares de la región de Cochabamba, Bolivia, por comparación con las cantidades diarias recomendadas (CDR), y determinar la distribución de la ingesta de micronutrientes en distintas edades y ambos sexos. MÉTODOS: Este estudio nutricional (n = 315) formó parte de un estudio transversal poblacional más amplio (la llamada encuesta Bolkid) en que se obtuvieron datos de escolares de 5 a 16 años de edad en la región de Cochabamba en el 2010. Se usó un cuestionario semicuantitativo, administrado por los padres, para obtener información acerca de la frecuencia del consumo de alimentos alrededor de 12 meses antes del estudio. Se evaluaron los resultados de análisis descriptivos y bivariados de la ingesta energética y de nutrientes. RESULTADOS: En todas las edades estudiadas y ambos sexos, las ingestas energética y de micronutrientes fueron aceptables pero inferiores a las cantidades necesarias. La alimentación tenía un alto contenido de fibra, de algunos minerales (hierro, magnesio, fósforo, potasio, sodio) y de vitaminas (ácido pantoténico, niacina, vitaminas B2, B12, C y E), pero poco contenido de calcio y vitamina D. No obstante, más de la mitad de los niños tenían una ingesta energética insuficiente e ingestas demasiado bajas de calcio, vitamina A y vitamina D, según las CDR ajustadas por edad y sexo; una tercera parte consumían cantidades insuficientes de folato y magnesio; y las adolescentes tenían ingestas de hierro demasiado bajas. CONCLUSIONES: Independientemente de las cantidades recomendadas o de las características demográficas, la gran mayoría de los niños en Cochabamba tenían un consumo energético insuficiente e ingestas demasiado bajas de calcio, folato, magnesio y vitaminas A y D. Además, las adolescentes consumían cantidades insuficientes de hierro. Las instituciones de salud pública bolivianas deberían dar prioridad a aumentar el consumo energético de los escolares propiciando una mayor disponibilidad de alimentos, un consumo más frecuente y porciones más grandes en las comidas diarias.

Nutritional status of children from Cochabamba, Bolivia: a cross-sectional study.

OBJECTIVE: To assess the adequacy of energy and nutritional intakes compared to recommended daily intakes (RDIs) in schoolchildren from the Cochabamba region (Bolivia) and to determine micronutrient intake distributions across different ages and genders. METHODS: This nutritional study (n = 315) was part of a larger population-based crosssectional study (the "Bolkid" survey) that collected data on schoolchildren 5-16 years old in 2010 in the Cochabamba region. Information about food intake was gathered with a semiquan-titative, food-frequency, parent-administered questionnaire about l2 months before the study. Descriptive and bivariate analyses of energy and nutrient intakes were assessed. RESULTS: For all ages studied and both genders, the average energy and micronutrient intakes were acceptable but below the requirements. The diet included high amounts of fiber, some minerals (iron, magnesium, phosphorus, potassium, sodium), and vitamins (pantothenic acid, niacin, vitamins B2, B12, C, and E), but was low in calcium and vitamin D. However, more than half the children had insufficient energy intake, and low calcium, vitamin A, and vitamin D intakes, according to RDIs adjusted for age and gender; one-third of the children had insufficient folate and magnesium intakes; and adolescent girls had low iron intakes. CONCLUSIONS: Regardless of recommendations or demographic characteristics, the vast majority of children in Cochabamba consumed insufficient energy and too little calcium, folate, magnesium, and vitamin A and D. In addition, adolescent girls consumed insufficient iron. Higher energy intake for schoolchildren through increased food availability, frequency, and size portions in daily meals should be a priority for Bolivian public health institutions.

Prevalencia de sobrepeso y obesidad en niños y adolescentes de Cochabamba (Bolivia); estudio transversal / Prevalence of overweight and obesity in children and adolescents from cochabamba (bolivia); a cross-sectional study

INTRODUCCIÓN: La antropometría en escolares y jóvenes adolescentes de países andinos es poco conocida. OBJETIVOS: El objetivo de dicho estudio fue determinar la prevalencia de sobrepeso y obesidad en niños y adolescentes de la región de Cochabamba (Bolivia), y su asociación con diferentes variables así como determinar la concordancia entre una clasificación nacional (BAP) e internacional (IOTF) de obesidad y sobrepeso. MÉTODOS: Estudio transversal realizado en el año 2010 en escolares (n=441) entre 5 y 16 años de edad de la región de Cochabamba (Bolivia). Los padres de los participantes fueron encuestados y a los escolares se les realizó un examen físico antropométrico. Se realizó un análisis descriptivo, bivariado y de concordancia entre clasificaciones. RESULTADOS: La prevalencia global de sobrepeso fue del 20,9% (IC95% 17,1-24,7) y de obesidad del 3,2% (IC95% 1,6-4,8), con mayores tasas en cohortes más jóvenes de áreas rurales. No se detectaron diferencias estadísticamente significativas según género, nivel educativo de los padres, ingesta alimentaria ni actividad física. Hubo un grado de acuerdo moderado tanto a nivel global como en el sobrepeso, y excelente en la obesidad. CONCLUSIONES: Este estudio determinó que la prevalencia de sobrepeso y obesidad en escolares está aumentando, principalmente en cohortes más jóvenes de áreas rurales, independientemente de actividad física e ingesta alimentaria (AU)

BACKGROUND: The anthropometric status of school age children and young adolescents in Andean countries is not well known. OBJECTIVES: The aim of the study was to assess the prevalence of overweight and obese children and adolescents in the Cochabamba region (Bolivia), and their association with different variables, as well as to determine the agreement between two classifications (BAP, IOTF) of obesity and overweight. METHODS: A school-based cross-sectional survey (n=441) was carried out in 2010 in pupils, aged 5 to 16 years old, living in the Cochabamba region (Bolivia). Evaluations were based on parent-administered questionnaires and a physical examination based on anthropometric measures. Descriptive, bivariate, and concordance analyses were performed. RESULTS: The overall prevalence of overweight and obesity were 20.9% (CI95% 17.1-24.7) and 3.2% (CI 95% 1.6-4.8) respectively, with higher incidences in younger birth cohorts from rural areas. No differences were observed according to gender, parent's educational level, nutritional patterns, or physical activity. There was a moderate agreement globally and on overweight, and excellent on obesity. CONCLUSIONS: This study determined that the prevalence of overweight and obese Bolivian school children is increasing, mainly in younger birth cohorts from rural areas, independently from physical activity and energy intake (AU)

Seroprevalence of hepatitis B in two period birth cohorts of Bolivian children: effect of universal vaccination.

BACKGROUND: Since 2000 universal routine immunization against the hepatitis B virus (HBV) was implemented in Bolivia. This study aimed to assess the seroprevalence of markers against HBV in two different birth cohorts (pre-universal vaccine cohort and post-universal vaccine cohort) from Cochabamba, Bolivia. METHODS: We performed a school-based seroepidemiological survey (n = 424) of HBV in 2010 in the Cochabamba region. An ELISA test was used to measure antibodies to the hepatitis B surface antigen (anti-HBs IgG) and to the hepatitis B core antigen (anti-HBc IgG). RESULTS: The prevalence of anti-HBs IgG in the pre-universal vaccine cohort was 5.8% (95% CI: 3.3-8.3%); it was higher in boys (9.1%), and those living in suburbs (9.7%). The anti-HBs IgG prevalence among post-universal vaccine cohort was 37.9% (95% CI: 28.5-48.1%), and was higher in children who spoke Quechua at home (51.0%), those living in suburbs (53.9%), and those born in 2005 (72.7%). Neither cohort showed differences relating to parental education. The prevalence of anti-HBc IgG was 1.1% among post-universal vaccine cohort and 1.2% among pre-universal vaccine cohort (p > 0.05). CONCLUSIONS: This study identified a persistent low seroprevalence of hepatitis B infection in spite of a decade of universal immunization, and low long-term humoral immunity against HBV infection in vaccinated children in Cochabamba. 

Seroprevalence of varicella-zoster virus infection in children from Cochabamba: tropical or temperate pattern?

OBJECTIVES: To determine the seroprevalence of varicella-zoster viral (VZV) infections in schoolchildren from the Cochabamba region (Bolivia), and its association with socio-demographic variables, socio-economic status and geographical location. METHODS: Seroepidemiological survey (n = 436) on VZV of schoolchildren living in the Cochabamba region of Bolivia in 2010. An ELISA test was used to measure varicella antibodies. Parents or guardians completed a questionnaire regarding socio-demographic information (age, gender, living area, parental educational level, presence of siblings and number of family members in the household), and a blood sample was collected from each child to check for VZV antibodies. A descriptive and bivariate analysis was performed. RESULTS: The global prevalence of VZV was 78.2% (95% CI 74.3-82.1). It was higher in females (82.1%), pre-adolescents (aged 10.1-13 years: 81.4%) and adolescents (aged >13 years: 80.2%), in children with less well-educated parents (81.3% to 81.6%), in warmer municipalities (81.4% to 82.2%), in rural areas (80.0%), in children with siblings (80.1%), those who although the latter association was not statistically significant. CONCLUSIONS: The prevalence of VZV infection in childhood was relatively high for a tropical country, and much closer to that of temperate countries prior to the introduction of varicella vaccine into vaccination programmes.

Measles in Bolivia: A 'honeymoon period'.

BACKGROUND: Although measles is a highly infectious disease, the live measles vaccine provides protection for over 20 years, and immunity may be lifelong. This study assessed measles seroprevalence in schoolchildren in the Cochabamba region of Bolivia. METHODS: A seroepidemiological survey of measles immunity in 5-16-year-old schoolchildren (n=441) living in the Cochabamba region of Bolivia was performed in March and April of 2010. Representative regional samples of school children from 14 schools were obtained. A parent-administered questionnaire collected sociodemographic and socio-economic status, and serum samples were tested for measles antibodies using an enzyme-linked fluorescent antibody test. The measles prevalence and corresponding 95% confidence intervals (CI) were calculated. A descriptive and bivariate analysis was performed using the ANOVA or the Kruskal-Wallis test according to whether the data were distributed normally (Kolmogorov-Smirnov test p-value<0.05) plus the chi-square test or Fisher's exact test as needed. RESULTS: The global seroprevalence of measles was 69.61% (95% CI 65.32-73.90) and was higher in adolescents (84.16%, 95% CI 77.04-91.28) and Spanish speakers (74.74%, 95% CI 68.56-80.92). The seroprevalence did not differ according to socio-economic status, living area, or number of family members in the household. CONCLUSIONS: This study found a high prevalence of measles susceptibility in Bolivian children. Thus, herd immunity may not have been established, and some outbreak could occur. Authorities should redress this situation before endemic measles transmission occurs nationally and regionally, and there is an urgent need to conduct more seroprevalence studies in the region.

[Prevalence of overweight and obesity in children and adolescents from Cochabamba (Bolivia); a cross-sectional study]. / Prevalencia de sobrepeso y obesidad en niños y adolescentes de Cochabamba (Bolivia); estudio transversal.

BACKGROUND: The anthropometric status of school age children and young adolescents in Andean countries is not well known. OBJECTIVES: The aim of the study was to assess the prevalence of overweight and obese children and adolescents in the Cochabamba region (Bolivia), and their association with different variables, as well as to determine the agreement between two classifications (BAP, IOTF) of obesity and overweight. METHODS: A school-based cross-sectional survey (n=441) was carried out in 2010 in pupils, aged 5 to 16 years old, living in the Cochabamba region (Bolivia). Evaluations were based on parent-administered questionnaires and a physical examination based on anthropometric measures. Descriptive, bivariate, and concordance analyses were performed. RESULTS: The overall prevalence of overweight and obesity were 20.9% (CI95% 17.1-24.7) and 3.2% (CI 95% 1.6-4.8) respectively, with higher incidences in younger birth cohorts from rural areas. No differences were observed according to gender, parent's educational level, nutritional patterns, or physical activity. There was a moderate agreement globally and on overweight, and excellent on obesity. CONCLUSIONS: This study determined that the prevalence of overweight and obese Bolivian school children is increasing, mainly in younger birth cohorts from rural areas, independently from physical activity and energy intake.

INTRODUCCIÓN: La antropometría en escolares y jóvenes adolescentes de países andinos es poco conocida. OBJETIVOS: El objetivo de dicho estudio fue determinar la prevalencia de sobrepeso y obesidad en niños y adolescentes de la región de Cochabamba (Bolivia), y su asociación con diferentes variables así como determinar la concordancia entre una clasificación nacional (BAP) e internacional (IOTF) de obesidad y sobrepeso. MÉTODOS: Estudio transversal realizado en el año 2010 en escolares (n=441) entre 5 y 16 años de edad de la región de Cochabamba (Bolivia). Los padres de los participantes fueron encuestados y a los escolares se les realizó un examen físico antropométrico. Se realizó un análisis descriptivo, bivariado y de concordancia entre clasificaciones. RESULTADOS: La prevalencia global de sobrepeso fue del 20,9% (IC95% 17,1-24,7) y de obesidad del 3,2% (IC95% 1,6-4,8), con mayores tasas en cohortes más jóvenes de áreas rurales. No se detectaron diferencias estadísticamente significativas según género, nivel educativo de los padres, ingesta alimentaria ni actividad física. Hubo un grado de acuerdo moderado tanto a nivel global como en el sobrepeso, y excelente en la obesidad. CONCLUSIONES: Este estudio determinó que la prevalencia de sobrepeso y obesidad en escolares está aumentando, principalmente en cohortes más jóvenes de áreas rurales, independientemente de actividad física e ingesta alimentaria.

Estudio de minimización de costes hospitalarios en el tratamiento de la coledocolitiasis / Minimising hospital costs in the treatment of bile duct calculi: A comparison study

Introducción El tratamiento de la coledocolitiasis asociada a colelitiasis es controvertido. Los costes hospitalarios podrían ser un factor decisivo para elegir entre las distintas opciones terapéuticas. Objetivos Comparar la eficacia y los costes de 2 alternativas en el tratamiento de la coledocolitiasis: 1) Un-tiempo: colecistectomía y exploración de la vía biliar por laparoscopia y 2) Dos-tiempos: colangiopancreatografía retrógrada endoscópica y colecistectomía laparoscópica secuencial. Material y métodos Estudio observacional, retrospectivo de 49 pacientes con coledocolitiasis y vesícula in situ, tratados de forma consecutiva y simultánea durante 2 años, mediante una de las 2 estrategias. Se compararon las complicaciones postoperatorias, estancia, número de procedimientos por paciente, conversión a laparotomía, eficacia en la extracción de cálculos y costes hospitalarios. Resultados No hubo diferencias en cuanto a características clínicas y morbilidad de los pacientes. La estancia postoperatoria media para el grupo Un-tiempo fue menor que para el grupo Dos-tiempos. Tres pacientes del grupo Dos-tiempos requirieron conversión a laparotomía. La mediana de costes por paciente fue menor para la estrategia en Un-tiempo, representando un ahorro global de 37.173€ durante el período estudiado. Conclusiones Entre las 2 opciones terapéuticas, no se han encontrado diferencias significativas en cuanto a la eficacia, ni la morbimortalidad postoperatorias, pero sí desde el punto de vista de la estancia y los costes hospitalarios. El manejo de los pacientes con coledocolitiasis en un solo tiempo representó un ahorro de 3 días de estancia y 1.008€ por paciente (AU)

Introduction The treatment of bile duct calculi associated with cholelithiasis is controversial. The hospital costs could be a decisive factor in choosing between the different therapeutic options. Objectives To compare the effectiveness and costs of two options in the treatment of common bile duct calculi: 1) One-stage: Laparoscopic cholecystectomy and bile duct exploration, and 2) Two-stage: sequential endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy. Material and methods A retrospective, observational study was performed on 49 consecutive patients with bile duct calculi and gallbladder in situ, treated consecutively and simultaneously over a two year period. The post-operate complication, hospital stay, number of procedures per patient, conversion to laparotomy, efficacy of removing the calculi, and hospital costs. Results There were no differences as regards the patient clinical features or morbidity. The mean post-surgical hospital stay for the One-stage group was less than that in the Two-stage group. Three patients of the Two-stage group required conversion to laparotomy. The median costs per patient were less for the One-stage strategy, representing an overall saving of 37,173€ during the period studied. Conclusions No significant differences were found between the two treatment options as regards efficacy or post-surgical morbidity and mortality, but there were differences in hospital stay and costs. The management of patients with gallstones in one-stage surgery represents a saving of 3 days hospital stay and 1,008€ per patient (AU)

[Minimising hospital costs in the treatment of bile duct calculi: a comparison study]. / Estudio de minimización de costes hospitalarios en el tratamiento de la coledocolitiasis.

INTRODUCTION: The treatment of bile duct calculi associated with cholelithiasis is controversial. The hospital costs could be a decisive factor in choosing between the different therapeutic options. OBJECTIVES: To compare the effectiveness and costs of two options in the treatment of common bile duct calculi: 1) One-stage: Laparoscopic cholecystectomy and bile duct exploration, and 2) Two-stage: sequential endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy. MATERIAL AND METHODS: A retrospective, observational study was performed on 49 consecutive patients with bile duct calculi and gallbladder in situ, treated consecutively and simultaneously over a two year period. The post-operate complication, hospital stay, number of procedures per patient, conversion to laparotomy, efficacy of removing the calculi, and hospital costs. RESULTS: There were no differences as regards the patient clinical features or morbidity. The mean post-surgical hospital stay for the One-stage group was less than that in the Two-stage group. Three patients of the Two-stage group required conversion to laparotomy. The median costs per patient were less for the One-stage strategy, representing an overall saving of 37,173€ during the period studied. CONCLUSIONS: No significant differences were found between the two treatment options as regards efficacy or post-surgical morbidity and mortality, but there were differences in hospital stay and costs. The management of patients with gallstones in one-stage surgery represents a saving of 3 days hospital stay and 1,008€ per patient.