Cambios en la práctica de actividad física durante la pandemia por COVID-19 / Changes in Physical Activity Practice during the COVID-19 Pandemic

RESUMEN Objetivo Determinar los cambios en la práctica de actividad física durante la pandemia por COVID-19 en sujetos adultos. Métodos Estudio de corte transversal en 812 adultos de la región caribe colombiana. Se aplicó una encuesta vía telefónica, la cual registró: edad, sexo, nivel educativo y estrato socioeconómico; a su vez, se aplicó el Cuestionario de Intención hacia la actividad física de Prochaska y Marcus para medir las etapas de cambio hacia la actividad física. Se indagó sobre el tiempo sentado al día frente a pantallas como televisión, computador y celular. Las mediciones se realizaron entre los meses mayo y julio de 2020. Se realizó una regresión logística binaria para determinar la relación entre los factores individuales y la práctica de actividad física durante la pandemia. Resultados La proporción de personas que se categorizan en las tres primeras etapas de cambio aumentó de 65% en la medición antes de pandemia a 74,4% después de 4 meses de aislamiento social (p=0,0001). El promedio de horas al día en la población general frente al TV es de 2,7±2 horas; ante celulares, es de 3,8±2,8 horas, y 2,4±2,7 horas frente al computador. Las mujeres tuvieron mayor riesgo de no práctica de actividad física [OR 1,9 (IC 95% 1,4-2,7)], junto con las personas de nivel educativo bajo [OR 1,7 (IC 95% 1,2-2,4)] y las de edad mayor [OR 1,7 (IC 95% 1,3-2,4)]. Conclusión La pandemia por COVID-19 ha incrementado la inactividad física y los comportamientos sedentarios, los cuales varían según las características individuales.

ABSTRACT Objective To determine the changes in the practice of physical activity during the COVID-19 pandemic in adult subjects. Methods Cross-sectional study in 812 adults from the Colombian Caribbean region. A survey was applied by telephone that measured age, sex, educational level and socioeconomic status; likewise, the Prochaska and Marcus Physical Activity Intention Questionnaire to measure stages of change towards physical activity was applied. The time spent sitting each day in front of screens such as television, computer, and cellphone was investigated. Measurements were made throughout the months of May to July 2020. A binary logistic regression was performed to determine the relationship between individual factors and the practice of physical activity during the pandemic. Results The proportion of people who are categorized in the first three stages of change increased from 65% in the measurement before the pandemic to 74,4% after 4 months of social isolation (p=0,0001). The average hours a day in front of the TV for the general population is 2,7±2 hours; 3,8±2,8 hours in front of cellphones, and 2,4±2,7 hours in front of the computer. Women had a higher risk of not practicing physical activity [OR 1,9 (95% CI 1,4-2,7)], alongside people with a low educational level [OR 1,7 (95% CI 1,2-2,4)], and elderly people [OR 1,7 (95% CI 1,3-2,4)]. Conclusion The COVID-19 pandemic has increased physical inactivity and sedentary behaviors, which vary according to individual characteristics.

Determinantes de la hospitalización en pacientes con diagnóstico de bronquiolitis en Barranquilla, Colombia / Determinants of hospitalization in patients diagnosed with bronchiolitis in Barranquilla, Colombia

RESUMEN Objetivo Describir la frecuencia de los factores de riesgo que inciden en la hospitalización de pacientes con diagnóstico de bronquiolitis atendidos en una empresa social del estado (ESE) ubicada en la ciudad de Barranquilla, Colombia. Materiales y Métodos Estudio descriptivo de corte transversal retrospectivo. La fuente de información fueron las historias clínicas de ingresos al servicio de urgencias de los niños que fueron valorados por el servicio de pediatría entre los años 2016 y 2018. En total se evaluaron 865 historias, de las cuales se descartaron 103 por no cumplir con los criterios de inclusión descritos para el estudio. Resultados Los factores de riesgo modificables fueron los que más se presentaron en el grupo estudiado. El que pudo tener mayor importancia fue la aparición de la enfermedad. La lactancia materna exclusiva inadecuada fue de gran relevancia para la aparición, así como la gravedad de la enfermedad. Discusión Las enfermedades crónicas no modificables tienen relevancia por su relación con la aparición y la gravedad de enfermedades como la bronquiolitis. Factores variables como el bajo peso al nacer, la prematurez y la enfermedad cardiaca fueron considerados como los de mayor valor e importancia frente a la enfermedad en la población estudiada. Conclusiones La mayoría de los factores de riesgo que inciden en los pacientes se podrían evitar o aminorar con educación y con estrategias de mejora en la comunidad.

ABSTRACT Objective To describe the frequency of risk factors that have an impact on hospitali-zation of patients diagnosed with bronchiolitis and served in a state hospital located in Barranquilla, Colombia. Materials and Methods A retrospective, cross-sectional, descriptive study was perfor-med. The source of information was the medical records of children who were admitted to emergency service and valued by the pediatrics service between 2016 and 2018. 865 medical records were studied. 103 of them were discarded, because they did not meet the inclusion criteria described by the study. Results The modifiable risk factors were the ones that presented the most in the group studied. The onset of the disease could be the most important. Inadequate exclusive breastfeeding was of great importance for the onset, as well as the severity of the disease. Discussion Chronic non-modifiable diseases are relevant because of their relationship to the onset and severity of diseases such as bronchiolitis. Low birth weight, prematurity, and heart disease have the highest valuation and were considered the most important factors in relation to the disease in the studied population. Conclusions Most risk factors presented by patients could be avoided or reduced with education and strategies of improvement to the community, being able to decrease the appearance of the disease.

[Determinants of hospitalization in patients diagnosed with bronchiolitis in Barranquilla, Colombia]. / Determinantes de la hospitalización en pacientes con diagnóstico de bronquiolitis en Barranquilla, Colombia.

OBJECTIVE: To describe the frequency of risk factors that have an impact on hospitali-zation of patients diagnosed with bronchiolitis and served in a state hospital located in Barranquilla, Colombia. MATERIALS AND METHODS: A retrospective, cross-sectional, descriptive study was perfor-med. The source of information was the medical records of children who were admitted to emergency service and valued by the pediatrics service between 2016 and 2018. 865 medical records were studied. 103 of them were discarded, because they did not meet the inclusion criteria described by the study. RESULTS: The modifiable risk factors were the ones that presented the most in the group studied. The onset of the disease could be the most important. Inadequate exclusive breastfeeding was of great importance for the onset, as well as the severity of the disease. DISCUSSION: Chronic non-modifiable diseases are relevant because of their relationship to the onset and severity of diseases such as bronchiolitis. Low birth weight, prematurity, and heart disease have the highest valuation and were considered the most important factors in relation to the disease in the studied population. CONCLUSIONS: Most risk factors presented by patients could be avoided or reduced with education and strategies of improvement to the community, being able to decrease the appearance of the disease.

OBJETIVO: Describir la frecuencia de los factores de riesgo que inciden en la hospitalización de pacientes con diagnóstico de bronquiolitis atendidos en una empresa social del estado (ESE) ubicada en la ciudad de Barranquilla, Colombia. MATERIALES Y MÉTODOS: Estudio descriptivo de corte transversal retrospectivo. La fuente de información fueron las historias clínicas de ingresos al servicio de urgencias de los niños que fueron valorados por el servicio de pediatría entre los años 2016 y 2018. En total se evaluaron 865 historias, de las cuales se descartaron 103 por no cumplir con los criterios de inclusión descritos para el estudio. RESULTADOS: Los factores de riesgo modificables fueron los que más se presentaron en el grupo estudiado. El que pudo tener mayor importancia fue la aparición de la enfermedad. La lactancia materna exclusiva inadecuada fue de gran relevancia para la aparición, así como la gravedad de la enfermedad. DISCUSIÓN: Las enfermedades crónicas no modificables tienen relevancia por su relación con la aparición y la gravedad de enfermedades como la bronquiolitis. Factores variables como el bajo peso al nacer, la prematurez y la enfermedad cardiaca fueron considerados como los de mayor valor e importancia frente a la enfermedad en la población estudiada. CONCLUSIONES: La mayoría de los factores de riesgo que inciden en los pacientes se podrían evitar o aminorar con educación y con estrategias de mejora en la comunidad.

Comportamiento epidemiológico de la hepatitis A en Barranquilla-Colombia, durante los años 2013 a 2017 / Epidemiological behavior of hepatitis A in Barranquilla, Colombia, in the period 2013-2017 / Comportamento epidemiológico da hepatite A em Barranquilla-Colômbia, durante os anos de 2013 a 2017

RESUMEN Objetivo Analizar el comportamiento epidemiológico de la hepatitis A en el Distrito de Barranquilla (Colombia), durante los años 2013 a 2017. Metodología Estudio descriptivo, en el que se revisó de forma retrospectiva la base de datos de todos los casos de hepatitis A notificados en el Distrito de Barranquilla durante el periodo de observación. Resultados Se notificaron 293 casos nuevos de hepatitis A en el Distrito de Barran-quilla, de los cuales el 62,4% eran hombres y el 37,6% restantes mujeres. Los grupos etarios más afectados fueron los adultos con el 39,6% de los casos, seguido de jóvenes y niños en etapa escolar con el 15% respectivamente. En cuanto a la incidencia de hepatitis A en el Distrito de Barranquilla se observó un descenso entre los años 2013 a 2016 al pasar de 10,9 a 1,5 casos por 100 000 habitantes; sin embargo, en el 2017 se observó un leve aumento en la incidencia a 2,5 por 100 000 habitantes. Conclusiones La Hepatitis A es un evento de interés en salud pública para el Distrito de Barranquilla, que ha mantenido un comportamiento a la baja de su incidencia en los últimos años.(AU)

ABSTRACT Objective To analyze the epidemiological behavior of hepatitis A in the district of Barranquilla (Colombia), in the period 2013-2017. Materials and Methods Descriptive study, in which the database of all hepatitis A cases reported in the district of Barranquilla during the observation period were retrospectively reviewed. Results There were 293 new cases of hepatitis A reported in the district of Barranquilla, of which 62.4% occurred in men and 37.6% in women. The age groups most affected by the disease were adults (39.6%), followed by young people and schoolchildren (15%, respectively). The incidence of hepatitis A in the district of Barranquilla decreased between 2013 and 2016 from 10.9 to 1.5 cases per 100 000 inhabitants; however, in 2017 there was a slight increase to 2.5 cases per 100 000 inhabitants. Conclusions Hepatitis A is an event of interest for public health in the district of Barranquilla, and the behavior of its incidence has had a downward trend in recent years.(AU)

RESUMO: Objetivo Analisar o comportamento epidemiológico da hepatite A no distrito de Barranquilla (Colômbia), durante os anos de 2013 a 2017. Metodologia Estudo descritivo, que revisou retrospectivamente o banco de dados de todos os casos de hepatite A notificados no distrito de Barranquilla durante o período de observação. Resultados Foram notificados 293 novos casos de hepatite A no distrito de Barran-quilla, dos quais 62,4% eram homens e os restantes 37,6% mulheres. As faixas etárias mais afetadas foram adultos com 39,6% dos casos, seguidos por jovens e crianças em idade escolar com 15%, respectivamente. Em relação à incidência de hepatite A no distrito de Barranquilla, observou-se uma diminuição entre 2013 e 2016, passando de 10,9 para 1,5 casos por 100.000 habitantes; No entanto, em 2017, foi observado um ligeiro aumento na incidência, para 2,5 por 100.000 habitantes. Conclusões A hepatite A é um evento de interesse em saúde pública no distrito de Barranquilla, que manteve uma tendência de queda em sua incidência nos últimos anos.(AU)

[Epidemiological behavior of hepatitis A in Barranquilla, Colombia, in the period 2013-2017]. / Comportamiento epidemiológico de la hepatitis A en Barranquilla-Colombia, durante los años 2013 a 2017.

OBJECTIVE: To analyze the epidemiological behavior of hepatitis A in the district of Barranquilla (Colombia), in the period 2013-2017. MATERIALS AND METHODS: Descriptive study, in which the database of all hepatitis A cases reported in the district of Barranquilla during the observation period were retrospectively reviewed. RESULTS: There were 293 new cases of hepatitis A reported in the district of Barranquilla, of which 62.4% occurred in men and 37.6% in women. The age groups most affected by the disease were adults (39.6%), followed by young people and schoolchildren (15%, respectively). The incidence of hepatitis A in the district of Barranquilla decreased between 2013 and 2016 from 10.9 to 1.5 cases per 100 000 inhabitants; however, in 2017 there was a slight increase to 2.5 cases per 100 000 inhabitants. CONCLUSIONS: Hepatitis A is an event of interest for public health in the district of Barranquilla, and the behavior of its incidence has had a downward trend in recent years.

OBJETIVO: Analizar el comportamiento epidemiológico de la hepatitis A en el Distrito de Barranquilla (Colombia), durante los años 2013 a 2017. METODOLOGÍA: Estudio descriptivo, en el que se revisó de forma retrospectiva la base de datos de todos los casos de hepatitis A notificados en el Distrito de Barranquilla durante el periodo de observación. RESULTADOS: Se notificaron 293 casos nuevos de hepatitis A en el Distrito de Barran-quilla, de los cuales el 62,4% eran hombres y el 37,6% restantes mujeres. Los grupos etarios más afectados fueron los adultos con el 39,6% de los casos, seguido de jóvenes y niños en etapa escolar con el 15% respectivamente. En cuanto a la incidencia de hepatitis A en el Distrito de Barranquilla se observó un descenso entre los años 2013 a 2016 al pasar de 10,9 a 1,5 casos por 100 000 habitantes; sin embargo, en el 2017 se observó un leve aumento en la incidencia a 2,5 por 100 000 habitantes. CONCLUSIONES: La Hepatitis A es un evento de interés en salud pública para el Distrito de Barranquilla, que ha mantenido un comportamiento a la baja de su incidencia en los últimos años.

Assessment of hematological parameters in workers exposed to organophosphorus pesticides, carbamates and pyrethroids in Cundinamarca 2016-2017 / Evaluación de parámetros hematológicos en trabajadores expuestos a pesticidas organofosforados, carbamatos y piretroides, Cundinamarca 2016-2017

ABSTRACT Objective To establish hematotoxic alterations through clinical and paraclinical exploration in workers who are exposed to organophosphorus pesticides, carbamates and pyrethroids (OPCP) due to their work in production, packaging, distribution and fumigation processes in Cundinamarca-Colombia between 2016 and 2017. Materials and Methods A cross-sectional descriptive epidemiological study was carried out on a sample of 92 workers from six companies, mostly aged between 18 and 30 years, of which 61 % were males and 39 % females, and 71 % were workers in the operational area and 29 % in the administrative area. Univariate, bivariate and multivariate analyses were performed. Results Clinical exploration reported findings in 17 % of the sample group, of which only 2 % presented with erythrocyte cholinesterase outside the reference range. The values of hematological parameters such as peripheral blood smear (PBS) and complete blood count (CBC) were outside the range in 15 % and 47 % of the sample, respectively. Discussion The results suggest that there are hematological alterations in this group that could possibly be associated with chronic exposure to OPCP.

RESUMEN Objetivo Determinar las alteraciones hematotóxicas a través de una exploración clínica y paraclínica, en trabajadores que por su oficio se exponen a pesticidas organofosforados, carbamatos y piretroides (POCP), en procesos de producción, envase, distribución y fumigación, en el departamento de Cundinamarca Colombia. Metodología Se realizó un estudio epidemiológico descriptivo de corte transversal. Se realizó un análisis univariado, bivariado y multivariado. La muestra se conforma por 92 trabajadores de seis empresas, la mayoría entre los 18 y 30 años, de los cuales el 61 % son hombres y el 39 % mujeres, 71 % se desempeñan en el área operativa y 29 % en el área administrativa. Resultados Es de resaltar que se tienen hallazgos en la exploración clínica en el 17 % del grupo participante, solo el 2 % presenta la colinesterasa eritrocitaria por fuera del rango de referencia. Los parámetros hematológicos como el frotis de sangre periférica (FSP) presentan valores por fuera de los rangos en el 15 % y el cuadro hemático (CH) tiene valores por fuera de los rangos en el 47 % de las personas. Discusión Los resultados sugieren que existen alteraciones hematológicas en este grupo y que posiblemente podrían estar asociadas con la exposición crónica a POCP.

Determinantes del desempeño psicomotor en escolares de Barranquilla, Colombia / Determinants of psychomotor performance in schoolchildren from Barranquilla, Colombia

RESUMEN Objetivo Establecer la prevalência del perfil psicomotriz en niños de cuatro a ocho años de edad de los colegios de la localidad Norte Centro Histórico de la ciudad de Barranquilla. Método Estudio descriptivo de corte transversal realizado en 755 estudiantes de cuatro a ocho años de edad de colegios oficiales y privados. El perfil motriz se midió mediante la Batería Psicomotora (BPM) de Da Fonseca. Resultados Existe mayor riesgo para un desempeño apráxico-dispráxico del subfactor praxia global para los escolares de cuatro a cinco años [OR 4,8; IC 95 %; 3,3-7,1] que estudian en colegios oficiales [OR 4,4; IC 95 %; 2,7-7,3]; los que viven en estrato 1, 2 y 3 [OR 2,4; IC 95 %; 1,5-3,9] y quienes tienen un peso aumentado [OR 2; IC 95 %; 1,2-3,3]. El mayor riesgo para un desempeño apráxico-dispráxico en praxia fina fue los participantes de cuatro a cinco años de edad [OR 3,7; IC 95 %; 2,7-5,3], para los estudiantes de colegios oficiales [OR 1,9; IC 95 %; 1,3-2,]. Un desempeño apráxico-dispráxico en el subfactor estructuración espacio temporal es mayor en las niñas [OR 1,6; IC 95 %; 1,12,2], para los escolares de cuatro a cinco [OR 4,8; IC 95 %; 3,3-7,1]; en los que estudian en el sector oficial [OR 1,9; IC 95 %; 2,7-5,3]; para los que residen en estratos socioeconómicos 1, 2 y 3 [OR 1,6; IC 95 %; 1,1-2,7]. Conclusiones Los determinantes como estudiar en colegios del sector oficial, estado nutricional, género y estrato socioeconómico están relacionados con el desempeño motor de los estudiantes.(AU)

ABSTRACT Objective To establish the prevalence of the psychomotor profile in children aged four to eight years attending the schools of the North Historical Center of Barranquilla, Colombia. Method A cross-sectional descriptive study was conducted in 755 students from public and private schools aged between 4 and 8 years. The motor profile was measured by Da Fonseca Psychomotor Battery. Results An increased risk for apraxic-dyspraxic performance of the global praxis subfactor was observed in schoolchildren aged four to five years [OR 4.8; 95 % CI; 3.3-7.1] who study in public schools [OR 4.4; 95 % CI; 2.7-7.3], in those classified in the socioeconomic in strata 1, 2 and 3 [OR 2.4; 95 % CI; 1.5-3.9], and in those with an increased weight [OR 2; 95 % CI; 1.2-3.3]. The highest risk for apraxic-dyspraxic performance correlated to public school students [OR 1.9; 95% CI; 1.3-2.8] aged between four and five [OR 3.7; 95 % CI; 2.7-5.3]. The apraxic-dyspraxic performance in the structuring of the temporal space subfactor was higher in girls [OR 1.6; 95 % CI; 1.1- 2.2], in schoolchildren aged four to five [OR 4.8; 95 % CI; 3.3-7.1], in students of public schools [OR 1.9; 95 % CI; 2.7- 5.3], and in children classified in the socioeconomic strata 1, 2 and 3 [OR 1.6; 95 % CI; 1.1-2.7]. Conclusions Determinants such as studying in public schools, nutritional status, gender and socioeconomic stratum are related to motor performance in students.(AU)

Assessment of hematological parameters in workers exposed to organophosphorus pesticides, carbamates and pyrethroids in Cundinamarca 2016-2017.

OBJECTIVE: To establish hematotoxic alterations through clinical and paraclinical exploration in workers who are exposed to organophosphorus pesticides, carbamates and pyrethroids (OPCP) due to their work in production, packaging, distribution and fumigation processes in Cundinamarca-Colombia between 2016 and 2017. MATERIALS AND METHODS: A cross-sectional descriptive epidemiological study was carried out on a sample of 92 workers from six companies, mostly aged between 18 and 30 years, of which 61 % were males and 39 % females, and 71 % were workers in the operational area and 29 % in the administrative area. Univariate, bivariate and multivariate analyses were performed. RESULTS: Clinical exploration reported findings in 17 % of the sample group, of which only 2 % presented with erythrocyte cholinesterase outside the reference range. The values of hematological parameters such as peripheral blood smear (PBS) and complete blood count (CBC) were outside the range in 15 % and 47 % of the sample, respectively. DISCUSSION: The results suggest that there are hematological alterations in this group that could possibly be associated with chronic exposure to OPCP.

[Determinants of psychomotor performance in schoolchildren from Barranquilla, Colombia]. / Determinantes del desempeño psicomotor en escolares de Barranquilla, Colombia.

OBJECTIVE: To establish the prevalence of the psychomotor profile in children aged four to eight years attending the schools of the North Historical Center of Barranquilla, Colombia. METHOD: A cross-sectional descriptive study was conducted in 755 students from public and private schools aged between 4 and 8 years. The motor profile was measured by Da Fonseca Psychomotor Battery. RESULTS: An increased risk for apraxic-dyspraxic performance of the global praxis subfactor was observed in schoolchildren aged four to five years [OR 4.8; 95 % CI; 3.3-7.1] who study in public schools [OR 4.4; 95 % CI; 2.7-7.3], in those classified in the socioeconomic in strata 1, 2 and 3 [OR 2.4; 95 % CI; 1.5-3.9], and in those with an increased weight [OR 2; 95 % CI; 1.2-3.3]. The highest risk for apraxic-dyspraxic performance correlated to public school students [OR 1.9; 95% CI; 1.3-2.8] aged between four and five [OR 3.7; 95 % CI; 2.7-5.3]. The apraxic-dyspraxic performance in the structuring of the temporal space subfactor was higher in girls [OR 1.6; 95 % CI; 1.1- 2.2], in schoolchildren aged four to five [OR 4.8; 95 % CI; 3.3-7.1], in students of public schools [OR 1.9; 95 % CI; 2.7- 5.3], and in children classified in the socioeconomic strata 1, 2 and 3 [OR 1.6; 95 % CI; 1.1-2.7]. CONCLUSIONS: Determinants such as studying in public schools, nutritional status, gender and socioeconomic stratum are related to motor performance in students.

OBJETIVO: Establecer la prevalência del perfil psicomotriz en niños de cuatro a ocho años de edad de los colegios de la localidad Norte Centro Histórico de la ciudad de Barranquilla. MÉTODO: Estudio descriptivo de corte transversal realizado en 755 estudiantes de cuatro a ocho años de edad de colegios oficiales y privados. El perfil motriz se midió mediante la Batería Psicomotora (BPM) de Da Fonseca. RESULTADOS: Existe mayor riesgo para un desempeño apráxico-dispráxico del subfactor praxia global para los escolares de cuatro a cinco años [OR 4,8; IC 95 %; 3,3-7,1] que estudian en colegios oficiales [OR 4,4; IC 95 %; 2,7-7,3]; los que viven en estrato 1, 2 y 3 [OR 2,4; IC 95 %; 1,5-3,9] y quienes tienen un peso aumentado [OR 2; IC 95 %; 1,2-3,3]. El mayor riesgo para un desempeño apráxico-dispráxico en praxia fina fue los participantes de cuatro a cinco años de edad [OR 3,7; IC 95 %; 2,7-5,3], para los estudiantes de colegios oficiales [OR 1,9; IC 95 %; 1,3-2,]. Un desempeño apráxico-dispráxico en el subfactor estructuración espacio temporal es mayor en las niñas [OR 1,6; IC 95 %; 1,12,2], para los escolares de cuatro a cinco [OR 4,8; IC 95 %; 3,3-7,1]; en los que estudian en el sector oficial [OR 1,9; IC 95 %; 2,7-5,3]; para los que residen en estratos socioeconómicos 1, 2 y 3 [OR 1,6; IC 95 %; 1,1-2,7]. CONCLUSIONES: Los determinantes como estudiar en colegios del sector oficial, estado nutricional, género y estrato socioeconómico están relacionados con el desempeño motor de los estudiantes.

Caracterización del proceso de preparación y respuesta de entidades territoriales de salud ante la introducción del virus Chikungunya, Colombia, 2014 / Description of the process of preparation and response of local health authorities facing the introduction of the Chikungunya virus in Colombia, 2014

Objetivo Caracterizar el proceso de preparación y respuesta de las entidades territoriales en aspectos clave de salud pública ante la fase de introducción de virus inusitados: Chikungunya en Colombia 2014. Metodología Se realizó un estudio transversal por medio de una encuesta, dirigida a los coordinadores de salud pública o referente de enfermedades transmitidas por vectores de las entidades territoriales de salud del país. Resultados Un total de 23, de las 35 entidades territoriales en riesgo de transmisión de Chikungunya, accedieron a responder la encuesta. Al revisar los puntajes de la encuesta para cada eje evaluado de una forma global, se evidenciaron mejores desempeños en los ejes de gestión del conocimiento, atención integral de casos, Inteligencia epidemiológica y promoción de la salud. El sistema de vigilancia epidemiológica durante la epidemia de Chikungunya, de acuerdo a los resultados de este estudio, tuvo baja aceptabilidad y flexibilidad, contribuyendo posiblemente a un subregistro de casos. Conclusiones Se evidencia a nivel general conocimiento y ejecución por parte de las entidades territoriales de salud de la estrategia de gestión integrada EGI para las enfermedades transmitidas por vectores en los ejes evaluados en esta investigación, no obstante es necesario fortalecer los ejes de comunicación del riesgo, laboratorio y el manejo de brotes y contingencias presentadas ante la introducción de nuevos virus.(AU)

Objective To describe the process of preparation and response of local health authorities in key public health issues while facing the introduction stage of an unusual virus: Chikungunya in Colombia in 2014. Methods A cross-sectional study was conducted using a survey that was developed for this study and sent to Public Health coordinators and to the person in charge of vector borne-diseases in the country's territorial entities. Results 23 out of the 35 territories at risk from the transmission of Chikungunya agreed to answer the survey. A global review of the survey scores for each evaluated section shows better performances in the areas of knowledge management, comprehensive patient care, epidemiological intelligence, and health promotion. According to the results of this study, the epidemiological surveillance system during the Chikungunya epidemic had a low acceptability and flexibility, possibly contributing to the underreporting of cases. Conclusions In general, knowledge and implementation by local authorities of the Integrated Health Strategy- EGI (Estrategia de Gestión Integral, by its Spanish acronym)- for vector-borne diseases was evident from the themes evaluated in this study. However, it is necessary to reinforce the communication of risks, laboratory, and outbreak and contingencies management areas faced during the introduction of new viruses.(AU)

[Description of the process of preparation and response of local health authorities facing the introduction of the Chikungunya virus in Colombia, 2014]. / Caracterización del proceso de preparación y respuesta de entidades territoriales de salud ante la introducción del virus Chikungunya, Colombia, 2014.

Objective To describe the process of preparation and response of local health authorities in key public health issues while facing the introduction stage of an unusual virus: Chikungunya in Colombia in 2014. Methods A cross-sectional study was conducted using a survey that was developed for this study and sent to Public Health coordinators and to the person in charge of vector borne-diseases in the country's territorial entities. Results 23 out of the 35 territories at risk from the transmission of Chikungunya agreed to answer the survey. A global review of the survey scores for each evaluated section shows better performances in the areas of knowledge management, comprehensive patient care, epidemiological intelligence, and health promotion. According to the results of this study, the epidemiological surveillance system during the Chikungunya epidemic had a low acceptability and flexibility, possibly contributing to the underreporting of cases. Conclusions In general, knowledge and implementation by local authorities of the Integrated Health Strategy- EGI (Estrategia de Gestión Integral, by its Spanish acronym)- for vector-borne diseases was evident from the themes evaluated in this study. However, it is necessary to reinforce the communication of risks, laboratory, and outbreak and contingencies management areas faced during the introduction of new viruses.

Determinantes estructurales de países con decrecimiento en la prevalencia por la infección VIH/SIDA en el periodo 2001-2011 / Structural determinants in countries with decreased prevalence of HIV/AIDS infection between 2001 and 2011

Objetivo Analizar y comparar los elementos y características estructurales que permiten establecer un modelo sobre la disminución (superior o igual al 25%) de la infección por VIH/SIDA, en 22 países durante el periodo 2001-2011. MétodoCohorte retrospectiva enfocada desde la perspectiva de los determinantes sociales de la salud. La metodología fue desarrollada en 2 etapas: revisión documental (comportamiento de la epidemia) y cuantitativa (modelo de regresión lineal simple para variables económicas y de salud). Resultados Los indicadores que podrían influir sobre el comportamiento del decrecimiento de la prevalencia del VIH son: el PIB Per cápita, el gasto de salud Per cápita y el índice de Gini. Conclusiones Los Determinantes estructurales, así como la inequidades pueden condicionar o no el decrecimiento de la prevalencia del VIH, hipótesis que podría aplicarse a otros problemas de salud pública.(AU)

Objective The present study aims analyze and compare structural features in order to establish a model about the decline in HIV/AIDS infection (greater than or equal to 25 %) in twenty-two countries between 2001 and 2011. Methods Retrospective cohort focused on social determinants of health perspective. The methodology was mainly documentary (epidemic behavior) and quantitative (simple linear regression model for economic and health variables). Results The major indicators that influence the decrease in the prevalence of HIV are: GDP per capita, health expenditure per capita and the Gini index Conclusions Structural determinants, as well as inequities, may or not influence the decrease in prevalence of HIV. This hypothesis could be applied to other public health issues.(AU)

Proporción de leptospirosis y factores relacionados en pacientes con diagnóstico presuntivo de dengue, 2010-2012 / Leptospirosis percentage and related factors in patients having a presumptive diagnosis of dengue, 2010 -2012

Objetivo Identificar la presencia de leptospirosis y las variables sociodemográficas relacionadas, en pacientes con diagnóstico confirmado y descartado de dengue en el periodo 2010-2012, por medio de la técnica de microaglutinación (MAT). Materiales y Métodos Se realizó un estudio descriptivo retrospectivo de 238 sueros: 106 de pacientes fallecidos: 64 dengue negativo y 42 dengue positivo y 132 muestras de pacientes vivos dengue positivo: 29 confirmados por PCR y/o aislamiento viral y 103 con IgM positiva, a todos los sueros se les realizó la técnica de MAT para Leptospira, se revisaron las fichas epidemiológicas y se analizaron los datos. Resultados De los 42 pacientes fallecidos dengue positivo, 3 (7%) se encontraron positivos para Leptospira interrogans serogrupo Australis y Autumnalis; 2 mujeres, de 5 y 17 años y un hombre de 14 años.De los 64 pacientes fallecidos negativos para dengue, 7(11%) se encontraron positivos para L. interrogans de los serogrupos Pomona, Autumnalis, Canicola y Ballum; 5 hombres; edades entre 8 y 58 años; y 2 mujeres edades de 35 y 56 años. De los 103 pacientes vivos con IgM positiva para dengue, 3(2,9%) se encontraron positivos para Leptospira de los serogrupos Icterohaemorrhagiae, Cynopteri, Javanica, Proechimys y Autumnalis; 1 hombre y 2 mujeres. En los 29 pacientes vivos confirmados para dengue, no se encontraron positivos para Leptospira. Conclusiones Se debe sospechar de leptospirosis, no solo como único agente causal del síndrome febril, sino también de la coinfección que podría comprometer al paciente y estar relacionada con la mortalidad.(AU)

Objective Using the microscopic agglutination test (MAT) from 2010-2012 for identify ingleptospirosis-related and sociodemographic variables in patients havinga confirmed diagnosis of dengue and those for whom it had been discarded. Materials and Methods This was aretrospective study of 238 sera samples. 106 patients died, 64 of their samples were negative for dengue and 42 proved positive. 132 samples from live patients proved positive for dengue; 29 were confirmed by PCR and/orvirus isolation and 103 had positive IgM readings. MAT was used for all seraand diagnosing Leptospira, epidemiological records were reviewed and the data was analysed. Results 42 dengue positive patients died; 3 (7%) were positive for Leptospira interrogans sero group Australisautumnalis (two girls aged 5 and 17 years-old anda 14 year-old boy). Of the 64 deceased patients who proved negative for dengue, 7 (11%) were found positive for L.interrogans from sero groups Pomona, Autumnalis, Canicola and Ballum (5 malesaged 8to 58 years-old and 2 womenaged 35 and 56 years-old). Of the 103 living patients who proved positive for dengue IgM, 3 (2.9%) were positive for Leptospira icterohaemorrhagiae from the Cynopteri, Javanica Proechimys and Autumnalissero groups(1 maleand 2 females). None of the 29 living patients confirmedas having dengue were positive for Leptospira. Conclusions Leptospirosis should be suspected not onlyas the solecausative agent of febrile syndromebut also of co-infection which could compromisea patient and be related tomortality.(AU)

[Structural determinants in countries with decreased prevalence of HIV/AIDS infection between 2001 and 2011]. / Determinantes estructurales de países con decrecimiento en la prevalencia por la infección VIH/SIDA en el periodo 2001-2011.

OBJECTIVE: The present study aims analyze and compare structural features in order to establish a model about the decline in HIV/AIDS infection (greater than or equal to 25 %) in twenty-two countries between 2001 and 2011. METHODS: Retrospective cohort focused on social determinants of health perspective. The methodology was mainly documentary (epidemic behavior) and quantitative (simple linear regression model for economic and health variables). RESULTS: The major indicators that influence the decrease in the prevalence of HIV are: GDP per capita, health expenditure per capita and the Gini index CONCLUSIONS: Structural determinants, as well as inequities, may or not influence the decrease in prevalence of HIV. This hypothesis could be applied to other public health issues.

[Leptospirosis percentage and related factors in patients having a presumptive diagnosis of dengue, 2010 -2012]. / Proporción de leptospirosis y factores relacionados en pacientes con diagnóstico presuntivo de dengue, 2010-2012.

OBJECTIVE: Using the microscopic agglutination test (MAT) from 2010-2012 for identifying leptospirosis-related and sociodemographic variables in patients having a confirmed diagnosis of dengue and those for whom it had been discarded. MATERIALS AND METHODS: This was a retrospective study of 238 sera samples. 106 patients died, 64 of their samples were negative for dengue and 42 proved positive. 132 samples from live patients proved positive for dengue; 29 were confirmed by PCR and/or virus isolation and 103 had positive IgM readings. MAT was used for all sera and diagnosing Leptospira, epidemiological records were reviewed and the data was analysed. RESULTS: 42 dengue positive patients died; 3 (7%) were positive for Leptospira interrogans sero group Australis autumnalis (two girls aged 5 and 17 years-old and a 14 year-old boy). Of the 64 deceased patients who proved negative for dengue, 7 (11%) were found positive for L.interrogans from sero groups Pomona, Autumnalis, Canicola and Ballum (5 males aged 8 to 58 years-old and 2 women aged 35 and 56 years-old). Of the 103 living patients who proved positive for dengue IgM, 3 (2.9%) were positive for Leptospira icterohaemorrhagiae from the Cynopteri, Javanica Proechimys and Autumnalis sero groups(1 male and 2 females). None of the 29 living patients confirmed as having dengue were positive for Leptospira. CONCLUSIONS: Leptospirosis should be suspected not only as the sole causative agent of febrile syndrome but also of co-infection which could compromise a patient and be related to mortality.

Nivel de participación en actividades sociales y recreativas de personas mayores en Barranquilla, Colombia / Elderly people's level of participation in social and recreational activities in Barranquilla, Colombia

Objetivo Determinar el nivel de participación de las personas mayores en las actividades sociales y recreativas en Barranquilla, Colombia. Métodos Estudio descriptivo transversal en 469 personas mayores, a las cuales se les evaluó el nivel de participación en actividades sociales y recreativas mediante la Escala de Actividades Básicas Cotidianas, adaptada a las actividades que se realizan en los escenarios en los que se desarrollan. Mediante el análisis bivariado se estimó la relación del nivel de participación con el rango de edad y la convivencia utilizando OR y pruebas de χ². Resultados El 40,9 % de los sujetos fueron categorizados con baja participación y sólo el 20,2 % participan activa y voluntariamente en las actividades. Existe un mayor riesgo de no participación en actividades sociales y recreativas en los adultos mayores de 80 años [OR 3,3 IC95 % (2,2-4,9)] y los que viven solos [(OR 1,75 IC 95 % (1,09-2,82)]. Conclusión Se muestra claramente una tendencia a una menor participación en la medida que la edad se incrementa; razón por la cual el aislamiento social se convierte en un factor de riesgo para la calidad de vida de este grupo de personas, para quienes se recomienda el fortalecimiento de redes sociales significativas que promuevan la salud y la calidad de vida en esta etapa del ciclo vital humano.

Objective Determining elderly people's level of participation in social and recreational activities in Barranquilla, Colombia. Methods This was a descriptive cross-sectional study involving 469 elderly people; a basic activities of daily living scale, which had been adapted to the ongoing activities being carried out in the pertinent scenarios, was used for evaluating their level of participation in social and recreational activities. Bivariate analysis was used for estimating the relationship between level of participation and age-range and coexistence, using OR and χ² tests. Results The scale categorized 40.9 % of the subjects as having low participation and only 20.2 % as actively and voluntarily participating in the activities being offered. There was an increased risk of non-participation in social and recreational activities regarding adults being over 80 years of age (OR 3.3: (2.2-4.9) 95 % CI) and those living alone (OR 1.75: (1.09-2.82) 95 % CI). Conclusion A clear trend towards less participation was shown as aged increased; this is why social isolation becomes a risk factor for this group of people's quality of life. It is recommended that social networks promoting the elderly's health and quality of life should thus be strengthened.

Seasonal variation and natural infection of Lutzomyia antunesi (Diptera: Psychodidae: Phlebotominae), an endemic species in the Orinoquia region of Colombia.

Lutzomyia antunesi has been commonly reported in outbreaks of cutaneous leishmaniasis (CL) in the Orinoquia region of Colombia. The bionomics of this species were studied in the municipality of Villavicencio (Meta, Colombia). Sandflies were captured over the course of one week per month for one year in intradomiciliary, peridomiciliary and extradomiciliary housing areas. The captures were performed from 06:00 pm-06:00 am using CDC light traps and the females were processed for polymerase chain reaction (PCR) to detect Leishmania spp. A total of 22,097 specimens and 19 species were captured of which Lu. antunesi (89%) and Lutzomyia walkeri (5%) were the most abundant. Other species recognised as anthropophilic (Lutzomyia panamensis, Lutzomyia gomezi, Lutzomyia flaviscutellata and Lutzomyia fairtigi) were present in very low abundance (< 2%). Natural infection with Leishmania spp was detected using PCR in Lu. antunesi, Lu. panamensis and Lu. flavicutellata, showing infection rates of 1%, 4.8% and 7.5%, respectively. The present paper provides information on various ecological aspects of Lu. antunesi. An analysis of seasonality shows that this species increases in abundance in the hottest months (December, January and February), directly correlating with the maximum temperature and inversely correlating with precipitation. The natural infection rate is associated with the peaks of highest abundance.

Cuantificación de hidrocarburos policíclicos aromáticos urinarios en policías de tránsito del área metropolitana de Bogotá / Quantifying polycyclic aromatichydrocarbons in urine samples taken from traffic police working in Bogota's metropolitan area

Objetivos Cuantificar niveles urinarios de 1-hidroxipireno (1-OHP) y 3-hidroxibenzo [a] pireno (3-BAP) metabolitos de hidrocarburos policíclicos aromáticos (HAP) de interés toxicológico y relacionar su detección con el grado de exposición a material particulado de tamaño menor a 10 micras (PM10) u otros factores, en una población de Policías de Tránsito ocupacionalmente expuestos en el área metropolitana de Bogotá D.C. Métodos Se realizó un estudio de corte transversal en 524 Policías de Tránsito de los cuales 413 desarrollaban funciones operativas y 111 administrativas. Se tomaron muestras de orina de todos los individuos incluidos, para la determinación de metabolitos de HAP mediante cromatografía de gases con detección de masas. Se analizó la presencia de factores asociados con la detección de los metabolitos como tabaquismo, consumo de alimentos asados, lugar de residencia y exposición a PM10. Como medida de asociación se calcularon Odds Ratio (OR). Resultados Se encontraron niveles de 1-OHP y 3-BAP superiores en los individuos expuestos con OR significativos para detección de los metabolitos de 6,3 (IC 95% (3,6-11,1)) y 15,6 (IC 95% (6,2-39)), respectivamente. Se hallaron OR significativos para detección de metabolitos de HAP y exposición a PM10, tabaquismo y consumo de alimentos asados. Discusión Existe una asociación importante y significativa entre la exposición laboral a contaminación ambiental y la detección de metabolitos de HAP de importancia toxicológica en muestras de orina. Factores tales como tabaquismo, consumo de alimentos asados recientemente y exposición a PM10 también se encontraron asociados positivamente con la detección de dichos metabolitos pero en menor proporción.(AU)

Objective Quantifying polycyclic aromatic hydrocarbon levels in urine samples taken from a population of traffic police working in the metropolitan area of Bogotá who were occupationally exposed to 1-hydroxypyrene (1-OHP) and 3-hydroxy-benzo [a] pyrene (3-BaP) metabolites from polycyclic aromatic hydrocarbons (PAH) having toxicological interest, related to their detection, and a degree of exposure to particulate material having a size less than 10 micrometres (PM10) and/or other factors. Methods A cross-sectional study was made of 524 traffic police, 413 of whom were engaged in operational and 111 in administrative functions. Urine samples were taken from all the individuals included in the study for determining PAH metabolites by gas chromatography/mass spectrometry (GC/MS). The presence of factors associated with the detection of metabolites was analysed, such as smoking, consuming roasted/grilled food, place of residence and exposure to PM10. The odds ratio (OR) was calculated as a measure of association. Results Higher 1-OHP and 3-BaP levels were found in exposed individuals, having a significant OR for detecting 6.3 ((3.6-11.1) 95 % CI) and 15.6 ((6.2-39) 95 % CI) metabolites, respectively. Significant OR were found for detecting PAH metabolites and exposure to PM10, smoking and consuming roasted/grilled food. Discussion There was an important and significant association between work-related exposure to environmental contamination and detecting toxicologically important PAH metabolites in urine samples. Factors such as smoking, consuming freshly grilled/roasted food and exposure to PM10 were also found to be positively associated with detecting such metabolites, but to a lesser extent.(AU)

Validación para Colombia de la escala CRAFFT para tamización de consumo de sustancias psicoactivas en adolescentes / Validation for Colombia of the CRAFFT substance abuse screening test in adolescents

Objetivos Evaluar las propiedades de la escala CRAFFT para el cribado de consumo de sustancias psicoactivas en adolescentes entre los 14 y 18 años y validar el criterio estándar de la escala. Métodos La validez de criterio se realizó comparando la escala CRAFFT contra el gold standard para la identificación del consumo: la entrevista clínica. Mediante el modelo de pruebas diagnósticas se calculó la sensibilidad, la especificidad y los valores predictivos. Resultados Se encontró una sensibilidad de 0,95, una especificidad de 0,83, un VPP de 0,85 y un VPN de 0,94 (χ²=187,87 y p<0,0005) para identificación de consumo disfuncional (uso frecuente, abuso y dependencia) con un puntaje >2. Conclusiones La escala presenta una alta utilidad para el cribado de consumo de sustancias psicoactivas. Con un puntaje igual o mayor a 2 se puede diferenciar el consumo funcional del consumo disfuncional.

Objectives Evaluate the properties of CRAFFT scale for substance abuse screening in adolescent population aged 14 to18. Methods The criteria was validated by comparing the CRAFFT scale to the gold standard for substance use identification (i.e. the clinical interview). The diagnostic test model was used for calculating the sensitivity, specificity and predictive values of the scale. Results The test revealed 0.95 sensitivity, 0.83 specificity, 0.85 PPV and 0.94 NPV (χ²=187.87 and p<0.0005) for identifying dysfunctional use (frequent use, abuse and dependence) with a score >2. Conclusions The scale was seen to have great usefulness for psychoactive substance use screening. A cut-off point of 2 differentiated functional from dysfunctional use.

[Validation for Colombia of the CRAFFT substance abuse screening test in adolescents]. / Validación para Colombia de la escala CRAFFT para tamización de consumo de sustancias psicoactivas en adolescentes.

OBJECTIVES: Evaluate the properties of CRAFFT scale for substance abuse screening in adolescent population aged 14 to 18. METHODS: The criteria was validated by comparing the CRAFFT scale to the gold standard for substance use identification (i.e. the clinical interview). The diagnostic test model was used for calculating the sensitivity, specificity and predictive values of the scale. RESULTS: The test revealed 0.95 sensitivity, 0.83 specificity, 0.85 PPV and 0.94 NPV (χ(2)=187.87 and p<0.0005) for identifying dysfunctional use (frequent use, abuse and dependence) with a score >2. CONCLUSIONS: The scale was seen to have great usefulness for psychoactive substance use screening. A cut-off point of 2 differentiated functional from dysfunctional use.