Caracterización del entorno alimentario de una universidad en Medellín, Colombia: retos para la promoción de una alimentación saludable

La obesidad se ha convertido en una de las mayores problemáticas de salud pública a nivel mundial, y Colombia no es ajena a esta situación. El entorno universitario constituye un escenario clave para el abordaje de esta problemática. Objetivo: Caracterizar el entorno alimentario de una universidad en Medellín, Colombia. Materiales y métodos: Se realizó un estudio descriptivo transversal mediante la observación directa y registro en formularios estructurados de todos los establecimientos de venta de alimentos. Se consideraron las siguientes variables: oferta de alimentos, precio, publicidad, facilitadores y barreras. Resultados: Ningún establecimiento se clasificó como saludable. En el 76% de los establecimientos, los paquetes o promociones eran más económicos. En el 62% de los establecimientos se observó que los platos saludables eran más costosos. Solo en dos establecimientos se observó publicidad directa para fomentar una alimentación saludable. Se ofrecían principalmente productos ultraprocesados (53%). Conclusión: los resultados del estudio muestran en general un panorama de un entorno alimentario poco saludable. Este diagnóstico se configura como un insumo importante para la toma de decisiones al interior de la institución para mejorar y promover una alimentación más saludable que permita disminuir el riesgo de desarrollar enfermedades crónicas en la comunidad universitaria.

Nowadays, obesity has become one of the biggest public health challenges worldwide. This scenario includes Colombia as well. Against this background, the university environment constitutes a key scenario for addressing this situation. Research Objective: To characterize the food environment of a university in Medellín, Colombia. Materials and methods: A cross-sectional descriptive study was carried out through direct observation. Additionally, it was used structured forms for recording the data of the food establishments. The research considers the following variables: food supply, prices, advertising, facilitators and barriers. Results: No establishment was classified as healthy. In 76% of the establishments, the food-sets or promotions were cheaper. In 62% of the places under inspection, the healthy dishes were more expensive. Only in two establishments there was direct advertising that promoted healthy eating. In general, mainly ultra-processed edible products (53%) were offered. Conclusion: The results of the study generally paint a picture of an unhealthy food environment. This diagnosis is configured as an important input for decision-making within the institution to improve and promote a healthier diet that reduces the risk of developing chronic diseases in the university community.

Eventos de precipitación extrema aumentan la circulación de patógenos infecciosos: detección de rotavirus, norovirus, astrovirus, adenovirus entérico y micobacterias no tuberculosas en agua de las inundaciones en Asunción, Paraguay, año 2014

Las precipitaciones extremas representan uno de los eventos naturales climáticos más importantes y pueden originar inundaciones devastadoras. De junio a agosto del 2014 se registró una de las más graves inundaciones en la historia de la ciudad de Asunción. Ocasionó un incremento considerable del nivel del río Paraguay y el desplazamiento de 300.000 personas a campamentos provisionales. Debido a que el contacto directo con el agua de inundación, el consumo de agua contaminada y la congregación de los afectados en refugios provisorios son factores de riesgo para enfermedades infecciosas, el objetivo de este estudio fue la implementación de una metodología estandarizada para la concentración y detección de virus entéricos y micobacterias no tuberculosas, por PCR en tiempo real y PCR-asociada al análisis de restricción enzimática (PRA), en muestras de agua de inundaciones y el reporte de los patógenos detectados en las zonas afectadas de Asunción y en la Bahía del Río Paraguay. La metodología propuesta demostró poseer buena sensibilidad y se registró la presencia de rotavirus, norovirus (genogrupos I y II), astrovirus, adenovirus entéricos y micobacterias no tuberculosas en 50% (N=4/8) de las muestras de los barrios Sajonia, San Jerónimo y Ricardo Brugada, Chacarita. Además, reportamos datos secundarios de casos de enfermedades infecciosas, registrados en los servicios de salud de los barrios afectados durante el periodo de inundación.

Extreme rainfall represents one of the most important natural climatic events and can cause devastating floods. From June to August 2014, one of the most serious floods in the history of the city of Asunción was recorded. It caused a considerable increase in the level of the Paraguay River and the displacement of 300,000 people to temporary camps. Since direct contact with flood water, consumption of contaminated water and the congregation of those affected in temporary shelters are risk factors for infectious diseases, the objective of this study was the implementation of a standardized methodology for the concentration and detection of enteric viruses and non-tuberculous mycobacteria, by real-time PCR and PCR-associated enzyme restriction analysis (PRA), in samples of flood water and the report of the pathogens detected in the affected areas of Asunción and in the Bay of the Paraguay River. The proposed methodology proved to have good sensitivity and the presence of rotavirus, norovirus (genogroups I and II), astrovirus, enteric adenovirus and non-tuberculous mycobacteria was recorded in 50% (N=4/8) of the samples from the Sajonia, San Jeronimo and Ricardo Brugada, Chacarita neighborhoods. In addition, we report secondary data on cases of infectious diseases, registered in the health services of the affected neighborhoods during the flood period.

SARS-CoV-2 Variants in Paraguay: Detection and Surveillance with an Economical and Scalable Molecular Protocol.

SARS-CoV-2 variant detection relies on resource-intensive whole-genome sequencing methods. We sought to develop a scalable protocol for variant detection and surveillance in Paraguay, pairing rRT-PCR for spike mutations with Nanopore sequencing. A total of 201 acute-phase nasopharyngeal samples were included. Samples were positive for the SARS-CoV-2 N2 target and tested with the Spike SNP assay to detect mutations associated with the following variants: alpha (501Y), beta/gamma (417variant/484K/501Y), delta (452R/478K), and lambda (452Q/490S). Spike SNP calls were confirmed using amplicon (Sanger) sequencing and whole-genome (Nanopore) sequencing on a subset of samples with confirmed variant lineages. Samples had a mean N2 Ct of 20.8 (SD 5.6); 198/201 samples (98.5%) tested positive in the Spike SNP assay. The most common genotype was 417variant/484K/501Y, detected in 102/198 samples (51.5%), which was consistent with the P.1 lineage (gamma variant) in Paraguay. No mutations (K417 only) were found in 64/198 (32.3%), and K417/484K was identified in 22/198 (11.1%), consistent with P.2 (zeta). Seven samples (3.5%) tested positive for 452R without 478K, and one sample with genotype K417/501Y was confirmed as B.1.1.7 (alpha). The results were confirmed using Sanger sequencing in 181/181 samples, and variant calls were consistent with Nanopore sequencing in 29/29 samples. The Spike SNP assay could improve population-level surveillance for mutations associated with SARS-CoV-2 variants and inform the judicious use of sequencing resources.

Genomic characterization of a rotavirus G8P[1] detected in a child with diarrhea reveal direct animal-to-human transmission.

Group A rotavirus is a major cause of severe gastroenteritis in children and young animals. During a retrospective analysis of samples collected from Paraguayan children under 5 years old with diarrhea, and previously negative for rotavirus and norovirus, we detected the presence of bovine rotavirus sequences by viral metagenomics. Nucleic acid was extracted direct from stool sample and determined to be G8P[1]. The genomic analyzes revealed that the strain presents an Artiodactyl-like genome (G8-P[1]-I2-R2-C2-M1-Ax-N2-T6-E12-H3) suggesting a direct animal-to-human transmission.

Molecular epidemiology of norovirus strains in Paraguayan children during 2004-2005: description of a possible new GII.4 cluster.

BACKGROUND: Noroviruses (NoV) have been shown to be an important cause of morbidity and mortality in children worldwide, only second after Group A rotaviruses (RVA). In Paraguay, acute gastroenteritis (AGE) is the third cause of mortality in children ≤5 years old. OBJECTIVES: To analyze the presence and diversity of NoV in Paraguayan children ≤5 years old presenting AGE. STUDY DESIGN: Three hundred seventy eight fecal samples, negative for pathogenic bacteria and RVA, were collected from children admitted as ambulatory and hospitalized patients in a large private hospital from Asuncion, Paraguay from 2004 to 2005. The presence and diversity of NoV was determined by two different RT-PCR strategies and nucleotide sequencing. RESULTS: One hundred and sixty one samples were positive for NoV by partial amplification of the viral polymerase gene (RdRp). No seasonality or differences in the viral prevalence for the different age-groups were detected. GII and GI NoVs were associated to 58% and 42% of the infections, respectively. The genotype was determined in 18% (29/161) NoV-positive samples. The genotypes detected were: GII.4 (18%), GII.17 (18%), GII.6 (14%), GII.7 (14%), GII.3 (10%), GII.5 (3%), GII.8 (3%), GII.16 (3%), GI.3 (14%) and GI.8 (3%). Amplification of the ORF2 from the GII.4 strains showed the presence of a new GII.4 variant. CONCLUSIONS: The results showed a continuous circulation of NoV in children throughout the two years of study and an extensive diversity of genotypes co-circulating, highlighting the need for better surveillance of NoV in Paraguayan children.

¿Contribuyen los programas de prevención y tratamiento de la hipertensión arterial al control de la enfermedad? / Are the hypertension treatment and prevention programs helping to control the disease?

Introducción: la hipertensión arterial (HTA) es una enfermedad silenciosa y progresiva que puede desencadenar daños significativos en un órgano blanco , lo que requiere de acciones de educación para la salud. Objetivo: analizar la opinión que tienen los usuarios de diferentes Empresas Prestadoras de Servicios de Salud (EPS) de Medellín, sobre la contribución de los programas de control de HTA al manejo de la enfermedad y a la modificación de factores de riesgo que permitan su control. Materiales y métodos: estudio descriptivo transversal, se seleccionó una muestra por conveniencia en las EPS participantes. Resultados: el 52% de los usuarios percibe que dejó o disminuyó el consumo de licor por las recomendaciones del programa. De los usuarios que no fumaban al momento de la encuesta, el 42% fueron fumadores y de estos, 26% dejaron de fumar por dichas recomendaciones. El 74% realizaban actividad física y de estos, el 65% afirmaron haberla iniciado por su participación en el programa. En cuanto a la alimentación las recomendaciones que más practicaban los asistentes fueron la disminución en el consumo de grasas (92%), disminución del consumo de sal (91%) y la no adición de sal a las preparaciones (86%). Conclusiones: las actividades de educación para la salud, en opinión de los usuarios, fomentan prácticas cotidianas que contribuyen al manejo y control de la de la HTA.

Background: hypertension is a progressive disease that remains as an asymptomatic disease for a long period of time, causing damage on specific organs like heart, kidney, and blood vessels; for that reason prevention and educational health programs should be implemented. Objective: to analyze, the view that patients have about health service’s hypertension programs that help patients to control and prevent the disease risk factors. Materials and methods: it is a descriptive cross sectional study; the sample was selected in a not probabilistic approach from the participating health services. Results: 52% of the patients perceived that drinking alcohol decreased due to the recommendations given in the program, and also 42 % that were active smokers at the moment of the interview, 26 % quit smoking with those recommendations. 74 % of participants do exercises then 65% told to start work out when they were involved in the program. About food intake 92% of the Participants reported reduction in fat intake, 91% in salt consumption and 86 % decrease salt addition to food. Conclusions: health education activities given to patients help them to take part in their control and prevention of hypertension disease.