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1.
PLoS One ; 19(5): e0283037, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38713667

RESUMEN

COVID-19 affects children less seriously than adults; however, severe cases and deaths are documented. This study objective is to determine socio-demographic, clinical and laboratory indicators associated with severe pediatric COVID-19 and mortality at hospital entrance. A multicenter, retrospective, cross-sectional study was performed in 13 tertiary hospitals in Bolivia. Clinical records were collected retrospectively from patients less than 18 years of age and positive for SARS-CoV-2 infection. All variables were measured at hospital entrance; outcomes of interest were ICU admission and death. A score for disease severity was developed using a logistic regression model. 209 patients were included in the analysis. By the end of the study, 43 (20.6%) of children were admitted to the Intensive care unit (ICU), and 17 (8.1%) died. Five indicators were independently predictive of COVID-19 severity: age below 10 years OR: 3.3 (CI95%: 1.1-10.4), days with symptoms to medical care OR: 2.8 (CI95%: 1.2-6.5), breathing difficulty OR: 3.4 (CI95%: 1.4-8.2), vomiting OR: 3.3 (CI95%: 1.4-7.4), cutaneous lesions OR: 5.6 (CI95%: 1.9-16.6). Presence of three or more of these risk factors at hospital entrance predicted severe disease in COVID-19 positive children. Age, presence of underlying illness, male sex, breathing difficulty, and dehydration were predictive of death in COVID-19 children. Our study identifies several predictors of severe pediatric COVID-19 and death. Incorporating these predictors, we developed a tool that clinicians can use to identify children at high risk of severe COVID-19 in limited-resource settings.


Asunto(s)
COVID-19 , SARS-CoV-2 , Índice de Severidad de la Enfermedad , Humanos , COVID-19/mortalidad , COVID-19/epidemiología , COVID-19/diagnóstico , Niño , Masculino , Femenino , Preescolar , Adolescente , Estudios Retrospectivos , Estudios Transversales , Lactante , SARS-CoV-2/aislamiento & purificación , Bolivia/epidemiología , Hospitalización , Unidades de Cuidados Intensivos/estadística & datos numéricos , Factores de Riesgo , Factores Sociodemográficos
2.
Public Underst Sci ; 33(4): 466-482, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38305243

RESUMEN

Research about science and publics in the COVID-19 pandemic often focuses on public trust and on identifying and correcting public attitudes. Drawing on qualitative interviews with 209 residents in six countries-Austria, Bolivia, Germany, Italy, Mexico, and Portugal-this article uses the concept of performativity to explore how participants understand, and relate to science, in the COVID-19 context. By performativity, we mean the ways by which participants understand themselves as particular sorts of publics through identification with, and differentiation from, various other actors in matters that are perceived as controversies surrounding science: COVID-19 vaccination, media communication of science, and the interactions between governments and scientists. The criteria used to construct the similarities and differences among publics were heterogeneous and fluid, showing how epistemic beliefs about the nature of, and trust in, scientific knowledge are intermingled with social and cultural memberships embedded in specific contexts and across disparate places.


Asunto(s)
COVID-19 , Opinión Pública , Ciencia , COVID-19/psicología , COVID-19/prevención & control , Portugal , Humanos , Bolivia , México , Adulto , Confianza , Italia , Masculino , Femenino , Pandemias , Persona de Mediana Edad , Austria , SARS-CoV-2 , Alemania , Investigación Cualitativa , Anciano , Comunicación
3.
Epilepsia Open ; 9(2): 513-521, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38016915

RESUMEN

OBJECTIVE: Neurocysticercosis (NCC) is considered the major cause of epilepsy in endemic regions. In the rural areas of the Bolivian Chaco prevalence of NCC among people with epilepsy (PWE) was 27.4%, according to a population-based survey carried out in 1994. The aim of the study was to estimate the prevalence of Epilepsy Associated with Tonic-Clonic Seizures (EATCS) and to evaluate the prevalence of NCC among PWE in the rural communities of the Bolivian Chaco after 30 years. METHODS: Twenty-two rural communities (total population 12 852) were involved in the study. PWE in the study area were ascertained by multiple sources and the diagnosis was confirmed by a neurologist. All PWE identified were invited to undergo brain CT scan examination and diagnosis of NCC was sought according to the revised Del Brutto criteria. RESULTS: Seventy-eight PWE (30 men, 38.4%; mean age at onset was 12.7 ± 13.2 years) with EATCS were identified giving a crude prevalence of 6.1/1000 (95% CI: 4.7-7.3). Due to the COVID-19 lockdown, the study was interrupted in 2020 and only 36 PWE (46%) of the whole sample underwent CT scan examination. Of these, 8 (22.2%) fulfilled the criteria for NCC of whom 6 (75%) presented only single or multiple calcifications. SIGNIFICANCE: This is the first study reassessing the prevalence of NCC among PWE after 30 years, in the same rural area and using a population-based design. T. solium is still endemic in the Bolivian Chaco where more than 20% of EATCS may be attributable to NCC. Our findings show a substantially unchanged prevalence of NCC over the past 30 years despite improved knowledge, underlining the need for active intervention programs to control T. solium transmission in this area. PLAIN LANGUAGE SUMMARY: Neurocysticercosis is still endemic in the Bolivian Chaco. The proportion of epilepsy attributable to neurocysticercosis is about 22%. Systematic efforts towards elimination of neurocysticercosis in these areas should be implemented.


Asunto(s)
Epilepsia , Neurocisticercosis , Masculino , Humanos , Niño , Adolescente , Adulto Joven , Adulto , Neurocisticercosis/epidemiología , Neurocisticercosis/complicaciones , Neurocisticercosis/diagnóstico , Bolivia/epidemiología , Epilepsia/epidemiología , Epilepsia/complicaciones , Convulsiones , Prevalencia
4.
IJID Reg ; 9: 95-101, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38020182

RESUMEN

Objectives: This study aimed to ascertain which factors are associated with higher risk of mortality among hospitalized COVID-19 Bolivian patients. Methods: This retrospective observational study assessed risk factors associated with mortality in patients (n = 549) hospitalized for SARS-CoV-2 infection in a Bolivian hospital between April 6, 2020, and August 18, 2022. Results: The results provide evidence of association between male sex (odds ratio [OR] = 1.6, 95% confidence interval [CI] 1.06-2.6), older age, 51-61 years-old (OR = 5.2, 95% CI 2.2-12.6), 62-70 years-old (OR = 8.7, 95% CI 3.7-20.5), >70 years-old (OR = 16.9, 95% CI 7.1-39.9), and blood group A (OR = 1.9, 95% CI: 1.1-3.4) with higher mortality risk. The strong association between mortality and relatively young age, may be due to high frequency of undiagnosed comorbidities. Vaccination was associated with a reduction in mortality only when time period of hospitalization was not adjusted for. Conclusion: Among hospitalized patients in Bolivia male sex, older age, and blood group A are associated with higher mortality risk. Mortality risk increased markedly from a relatively young age and decreased in parallel to the uptake of the vaccination program. However, the gradual reduction in mortality can also be due to improved patient management and changes in natural immunity and virulence of circulating strains as the pandemic progressed.

5.
Sci Data ; 10(1): 734, 2023 10 21.
Artículo en Inglés | MEDLINE | ID: mdl-37865630

RESUMEN

This dataset covers national and subnational non-pharmaceutical interventions (NPI) to combat the COVID-19 pandemic in the Americas. Prior to the development of a vaccine, NPI were governments' primary tools to mitigate the spread of COVID-19. Variation in subnational responses to COVID-19 is high and is salient for health outcomes. This dataset captures governments' dynamic, varied NPI to combat COVID-19 for 80% of Latin America's population from each country's first case through December 2021. These daily data encompass all national and subnational units in Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Mexico, and Peru. The dataset includes individual and aggregate indices of nine NPI: school closures, work suspensions, public event cancellations, public transport suspensions, information campaigns, local travel restrictions, international travel controls, stay-at-home orders, and restrictions on the size of gatherings. We also collected data on mask mandates as a separate indicator. Local country-teams drew from multiple data sources, resulting in high-quality, reliable data. The dataset thus allows for consistent, meaningful comparisons of NPI within and across countries during the pandemic.


Asunto(s)
COVID-19 , Humanos , Américas/epidemiología , Bolivia , Colombia , COVID-19/prevención & control , Pandemias/prevención & control
6.
Skin Health Dis ; 3(5): e253, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37799363

RESUMEN

Following a trip to Bolivia, a 32-year-old woman developed a left lower leg ulcer with a sensation of movement within the lesion. After being seen by four primary care providers, she was referred to dermatology 7 weeks after her return from Bolivia. At that time, she was found to have a 5 mm weeping ulcer, with a live larva visible at the base. We conducted a punch biopsy for botfly removal, after which the patient healed well. Herein we discuss the ways in which clinical presentation, history of travel, dermoscopy, and ultrasound can contribute to diagnosing botfly myiasis. While treatment of botfly infestation is not required, we discuss the importance of shared decision-making in considering treatment, as well as methods for extraction, including mechanical or surgical removal, which may help to reduce patient anxiety and the risk for secondary infection. As global travel resumes to levels prior to the Covid-19 pandemic, it is important for dermatologists to be aware of the presenting symptoms and treatment of tropical skin disorders.

7.
Sex Reprod Health Matters ; 31(1): 2249694, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37747711

RESUMEN

The COVID-19 pandemic impacted comprehensive abortion care provision. To maintain access to services while keeping individuals safe from infection, many organisations adapted their programmes. We conducted a programme evaluation to examine service adaptations implemented in Bolivia, Mali, Nepal, and the occupied Palestinian territory. Our programme evaluation used a case study approach to explore four programme adaptations through 14 group and individual interviews among 16 service providers, facility managers and representatives from supporting organisations. Data collection took place between October 2021 and January 2022. We identified adaptations to comprehensive abortion care services in relation to provision, health information systems and counselling, and referrals. Four overarching strategies emerged: (1) the use of digital technologies, (2) home and community outreach, (3) health worker optimisation, and (4) further consideration of groups in vulnerable situations. In Bolivia, the use of a messaging application increased access to confidential gender-based violence support and comprehensive abortion care. In Mali, the adoption of digital approaches created timely and complete data reporting and trained members of the community served as "interlocutors" between the communities and providers. In Nepal, an interim law expanded medical abortion provision to pharmacies, and home visits complemented facility-based services. In the occupied Palestinian territory, the use of a hotline and social media expanded access to quick and reliable information, counselling, referrals, and post-abortion care. Adaptations to comprehensive abortion care service delivery to mitigate disruptions to services during the COVID-19 pandemic may continue to benefit service quality of care, access to care, routine monitoring, as well as inclusivity and communication in the longer term.


Asunto(s)
Árabes , COVID-19 , Embarazo , Femenino , Humanos , Nepal , Bolivia , Malí , Pandemias , COVID-19/epidemiología
8.
BMC Public Health ; 23(1): 1846, 2023 09 21.
Artículo en Inglés | MEDLINE | ID: mdl-37735379

RESUMEN

BACKGROUND: In 2010, a political and social crisis pushed thousands of Venezuelans out of their country; today, seven million Venezuelans live abroad. In addition, during the COVID-19 pandemic, border closure increased and affected specific vulnerable migration flows, such as Venezuelans trying to migrate to Chile through the Northern borders. In this context, there is little evidence of migrants' health status and needs, their access to health services, and other basic needs (e.g., housing) from a human rights perspective. Therefore, we qualitatively explored the effects of border closure due to the COVID-19 pandemic on Venezuelan migrants' health and human rights, focusing on access to healthcare in the Northern Chilean border that adjoins Peru and Bolivia. METHODS: Following a case-study qualitative design, we conducted an ethnography that included participatory observation of relevant sites (e.g., hospitals, main squares, migrant shelters) in Antofagasta, Iquique, and Arica and 30 in-depth interviews with actors in the health sector (n = 7), experts from the non-governmental sector (n = 16), and governmental actors (n = 7) in three large cities close to the Northern border. RESULTS: We found four main dimensions: (i) border and migration processes, (ii) specific groups and intersectionality, (iii) barriers to healthcare services, and (iv) regional and local responses to the crisis during the COVID-19 pandemic. Programs characterized by the presence of healthcare providers in the field were essential to attend to migrants' health needs at borders. CONCLUSIONS: Coordination between actors is crucial to implement regional protocols that respond to current migration phenomena and migrants' health needs. Health policies using a human rights approach are urgently required to respond to migrants' healthcare needs at borders in South America.


Asunto(s)
COVID-19 , Pandemias , Humanos , COVID-19/epidemiología , Venezuela/epidemiología , Chile , Bolivia/epidemiología
9.
Lima; ORAS-CONHU; 1ra; jun. 2023. 461 p. ilus, tab, graf.
Monografía en Español | LILACS, LIPECS, MINSAPERÚ | ID: biblio-1444226

RESUMEN

El presente trabajo constituye un puntal de evidencia científica que queda disponible a los tomadores de decisiones en políticas nacionales y regionales relativas a la población de niñas, niños y adolescentes, y eso por sí solo es una muy buena contribución a la relevancia que debe tener esta población. Este estudio reconoce que vivimos un momento histórico, una ventana de oportunidad para tomar las decisiones adecuadas. Es prioridad contribuir para lograr que las políticas públicas sean eficaces en la garantía de los derechos humanos, esto requiere avanzar en consolidar Estados Sociales de Derecho y Bienestar con sistemas de salud y protección social universales. Asimismo, es fundamental fortalecer las capacidades de trabajo intersectorial y transdisciplinar, la integración regional y la cooperación internacional para hacer realidad la justicia social y ambiental, así como entender que las niñas, niños y adolescentes no son el futuro, son el presente. De lo que hagamos ahora depende el desarrollo y bienestar de nuestros pueblos. En este sentido el análisis se realiza a partir de un marco conceptual que abarca los siguientes aspectos:: Más allá de la pandemia, una sindemia; desigualdades múltiples: una manera de trascender a las desigualdades de ingreso; Derechos Humanos y su operacionalización en el contexto sindémico; Convención sobre los Derechos del Niño; sindemia COVID-19 y los derechos de niñas, niños y adolescentes; sindemia y políticas públicas, sindemia por COVID-19 y un llamado a la acción.


Asunto(s)
Perú , Venezuela , Bolivia , Chile , Colombia , Ecuador
10.
Cuad. Hosp. Clín ; 64(1): 24-31, jun. 2023.
Artículo en Español | LILACS | ID: biblio-1444461

RESUMEN

INTRODUCCIÓN: La Neumonía por Síndrome Respiratorio Agudo Severo Coronavirus 2, es un problema de Salud Pública, por su alta tasa de mortalidad en la primera ola de la pandemia. OBJETIVO: Determinar los factores de riesgo asociados a la Neumonía por Síndrome Respiratorio Agudo Severo Coronavirus 2 en pacientes fallecidos internados en el área Covid y Unidad de Terapia Intensiva del Hospital Municipal Boliviano Holandés, Municipio El Alto, en los meses de marzo a diciembre 2020. MATERIAL Y MÉTODOS: Estudio observacional analítico de casos y controles, los casos 25 fueron pacientes fallecidos de neumonía por SARS-CoV-2 durante la estadía hospitalaria y los controles 75 pacientes no fallecidos por la enfermedad. La fuente de información fue el expediente clínico, ficha de notificación epidemiológica y certificado médico único de defunción. Se clasificó las causas de fallecimiento según el Código internacional de enfermedades CIE 10. RESULTADOS: Se obtuvo información de 25 casos y 75 controles, relación 1:3. Pacientes fallecidos del sexo masculino 72% con p=0.040 (OR 2.77 IC 95% 1.042 - 7.449); La edad de 60 años con p=0.000 (OR 4.12 IC95% 1.596 - 10.664); lugar de residencia urbano 88%; el periodo infeccioso fue de 9.68 días (IC95%7.83-11.52), tiempo de internación 6.60 días p=0.010 (OR 4.03 IC95% 1.446 - 11.231); las Enfermedades Crónicas no Transmisibles 80% con p=0.040 (OR 2.98 IC95% 1.009 - 8.779); los pacientes internados en el área COVID tuvo una mortalidad de 68% con p=0.010 (OR 0.25 IC95% 0.083 - 0.774) y recibieron tratamiento farmacológico 72%. CONCLUSIÓN: El sexo masculino, mayor de 60 años y las enfermedades Crónicas no Transmisibles son un factor de riesgo para altas tasas de letalidad, resultados respaldados según Serra Valdés1.


INTRODUCTION: Pneumonia due to Severe Acute Respiratory Syndrome Coronavirus 2 is a Public Health problem, due to its high mortality rate in the first wave of the pandemic. OBJECTIVE: To determine the risk factors associated with Severe Acute Respiratory Syndrome Coronavirus 2 pneumonia in deceased patients hospitalized in the Covid area and Intensive Care Unit of the Bolivian Dutch Municipal Hospital, El Alto Municipality, from March to December 2020. MATERIAL AND METHODS: Analytical observational study of cases and controls, 25 cases were patients who died of SARS-CoV-2 pneumonia during their hospital permanence, and 75 controls were patients who did not die from the disease. The source of information was the clinical record. The method was documentary analysis, instruments were clinical histories, epidemiological notification sheet and official medical death certificate. The causes of death were classified according to the International Code of Diseases CIE 10. RESULTS: Information was obtained from 25 cases and 75 controls, ratio 1:3. 72% male patients who died with p=0.040 (OR 2.77 95% CI 1.042 - 7.449); The 60 years old with p=0.000 (OR 4.12 IC95% 1.596 - 10.664); urban area of residence 88%; the infectious period was 9.68 days (95%CI 7.83-11.52), hospitalization time 6.60 days p=0.010 (OR 4.03 95%CI 1.446 - 11.231); Chronic Noncommunicable Diseases of 80% with p=0.040 (OR 2.98 IC95% 1.009 - 8.779); The patients hospitalized in the COVID area had a mortality of 68% with p=0.010 (OR 0.25 IC95% 0.083 - 0.774) and 72% received pharmacological treatment. CONCLUSION: The male, over 60 years old and Chronic Non-Communicable Diseases are a risk factor for high-risk rates in high mortality rates, results are supported by Serra Valdés1.


Asunto(s)
Masculino , Persona de Mediana Edad
11.
Washington, D.C.; OPS; 2023-05-23. (OPS/PHE/CPI/COVID-19/23-0008).
en Español | PAHO-IRIS | ID: phr-57546

RESUMEN

Con el fin de reforzar la capacidad de preparación para la respuesta y la recuperación temprana frente a emergencias de salud y desastres, la Organización Panamericana de la Salud OPS revisó las orientaciones del Plan estratégico de preparación y respuesta frente a la COVID-19 y su grado de aplicación en el Estado Plurinacional de Bolivia, Colombia, Ecuador y Perú. En particular, se tuvieron en cuenta las orientaciones relativas a la respuesta médica a la COVID-19, la reorganización y la ampliación de la oferta de servicios de salud durante la pandemia, y la reanudación y la continuidad de los servicios esenciales. En esta publicación se sistematizan las experiencias y buenas prácticas detectadas durante la revisión. Se espera que contribuyan a fortalecer la planificación, la organización y la gestión con enfoque multiamenaza en los países de la Región y, en última instancia, a salvar vidas, con hincapié en los grupos de población en situación de vulnerabilidad.


Asunto(s)
COVID-19 , Preparación ante Desastres , Planes de Emergencia , Bolivia , Colombia , Ecuador , Perú
12.
Health Promot Int ; 38(2)2023 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-37099682

RESUMEN

Our capacity to facilitate the empowerment of children is dependent on our ability to understand their values and experiences. This study aimed to explore Bolivian children's experiences of COVID-19. This study used a participatory action research method, photovoice, which involved focus groups, individual interviews and the use of cameras by participants to capture their reality and express their ideas through photographs. Ten participants aged 12-15 years were recruited from a school in the municipality of Mecapaca in Bolivia. Thematic analysis was used to identify and report response patterns. Four themes were developed through analysis: (i) sadness and fear of getting sick, (ii) the challenges of online learning, (iii) the tension between traditional knowledge and modern medicine, and (iv) the role of nature and culture in supporting well-being-natural and cultural capital. The narratives and choice of images by the children illustrate some issues and experiences. These findings also highlighted the importance of considering and exploring how children's experiences and interactions with their habitat, nature and their physical environment impacts on their health and well-being.


Asunto(s)
COVID-19 , Humanos , Niño , Bolivia , Grupos Focales , Miedo , Ambiente
13.
Brain Sci ; 13(3)2023 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-36979253

RESUMEN

The COVID-19 pandemic has had a heavy impact on daily life, leading to physical and psychosocial consequences. Nowadays, clinicians and health researchers are particularly interested in describing and facing the long-term effects of COVID-19, also known as "long-COVID syndrome". Pandemic fatigue has been defined as a cluster of demotivation, tiredness, and psychological effects that emerge gradually over time after the infection or through the adoption of the recommended measures to combat it. In this study, we report the findings of a large survey conducted in South America involving 1448 participants (mean age: 33.9 ± 11.2 years old) from Argentina, Bolivia, Uruguay, Peru, and Paraguay. An online survey was launched through the common social media based on a specific assessment aimed to detect the prevalence of pandemic fatigue and associated factors. Socio-demographic characteristics, medical, and personal information were collected; the Pandemic Fatigue Scale (PFS) and the Coronavirus Anxiety Scale (CAS) were also administered. We found mid-levels of pandemic fatigue among respondents (21.7 ± 7.95 score at PFS) as well as significant anxiety related to the COVID-19 pandemic (1.56 ± 2.76 score at CAS). In addition, pandemic fatigue was significantly associated with the experience of the loss of a relative/friend due to COVID-19, anxiety related to the infection, and reliance on social media as a primary source of information on the pandemic. Vaccination significantly reduced the levels of fatigue among respondents. Our findings may add to the international debate regarding the long-term health consequences of the COVID-19 pandemic and strategies to manage them in the general population of South America.

14.
Washington, D.C.; OPS; 2023-02-06. (OPS/FPL/IM/COVID-19/22-0021).
No convencional en Español | PAHO-IRIS | ID: phr-57125

RESUMEN

La pandemia de COVID-19 ha obligado a poner en marcha estrategias de respuesta inmediata, entre las que destaca la introducción y despliegue de las vacunas contra la COVID-19 en un tiempo récord. Con vistas a apoyar a los países en esa labor, la OMS ha proporcionado a los países orientaciones para planificar el despliegue de las vacunas y metodologías de análisis temprano, entre las que se incluyen la minievaluación posterior a la introducción de las vacunas contra la COVID-19. En esta publicación se examinan los principales hallazgos extraídos en el ejercicio de evaluación llevado a cabo en el Estado Plurinacional de Bolivia en octubre del 2021. Se identifican los desafíos en materia de inmunización, así como las buenas prácticas, con el objetivo de contribuir a la mejora continua y el aprendizaje colectivo. La información, que se presenta desglosada por cada componente evaluado, será de gran utilidad tanto para las autoridades responsables de formular políticas públicas relativas a la vacunación como para el personal de salud encargado de su introducción, despliegue y administración.


Asunto(s)
COVID-19 , Vacunas contra la COVID-19 , Vacunas , Inmunización , Bolivia
15.
Proc Natl Acad Sci U S A ; 120(1): e2207544120, 2023 01 03.
Artículo en Inglés | MEDLINE | ID: mdl-36574663

RESUMEN

A growing body of work has addressed human adaptations to diverse environments using genomic data, but few studies have connected putatively selected alleles to phenotypes, much less among underrepresented populations such as Amerindians. Studies of natural selection and genotype-phenotype relationships in underrepresented populations hold potential to uncover previously undescribed loci underlying evolutionarily and biomedically relevant traits. Here, we worked with the Tsimane and the Moseten, two Amerindian populations inhabiting the Bolivian lowlands. We focused most intensively on the Tsimane, because long-term anthropological work with this group has shown that they have a high burden of both macro and microparasites, as well as minimal cardiometabolic disease or dementia. We therefore generated genome-wide genotype data for Tsimane individuals to study natural selection, and paired this with blood mRNA-seq as well as cardiometabolic and immune biomarker data generated from a larger sample that included both populations. In the Tsimane, we identified 21 regions that are candidates for selective sweeps, as well as 5 immune traits that show evidence for polygenic selection (e.g., C-reactive protein levels and the response to coronaviruses). Genes overlapping candidate regions were strongly enriched for known involvement in immune-related traits, such as abundance of lymphocytes and eosinophils. Importantly, we were also able to draw on extensive phenotype information for the Tsimane and Moseten and link five regions (containing PSD4, MUC21 and MUC22, TOX2, ANXA6, and ABCA1) with biomarkers of immune and metabolic function. Together, our work highlights the utility of pairing evolutionary analyses with anthropological and biomedical data to gain insight into the genetic basis of health-related traits.


Asunto(s)
Genética de Población , Estado de Salud , Humanos , Biomarcadores , Bolivia , Genómica , Genotipo , Fenotipo , Polimorfismo de Nucleótido Simple , Selección Genética , Genoma Humano
16.
J Infect Chemother ; 29(3): 333-338, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36577452

RESUMEN

INTRODUCTION: The Plurinational State of Bolivia (Bolivia) has experienced four major waves of coronavirus disease 2019 (COVID-19) so far. Although the ministry of health has been tracking morbidity and mortality through each wave, epidemiology of COVID-19 in Bolivia is not well defined, despite a need for more accurate measurement of the number of cases and deaths to allow for forecasting of the pandemic. This study examined prevalence of COVID-19 at community level, determinants of its occurrence and vaccine effectiveness. METHODS: We conducted a cross-sectional study in La Paz city on 2,775 individuals between March 2020 and February 2022. A structured questionnaire was used to collect data on COVID-19 morbidity, mortality and vaccination status. RESULTS: Of the 2,775 participants, 1,586 (57.1%) were infected with COVID-19, and 187 (6.7%) were suspected cases. The mortality rate was 2.9%. Sinopharm, Johnson & Johnson, Gamaleya, Pfizer-BioNtech, Moderna and AstraZeneka vaccines are in use, and all vaccines have demonstrated effectiveness in reducing the risk of onset. Risk for mortality was significantly lower in the vaccinated group with an odds ratio of 0.037 (95% confidential interval: 0.01-0.10, p-value: <0.001). CONCLUSIONS: Actual prevalence of COVID-19 in La Paz (the prevalence rate: 63.8%, including suspected case) was higher than that reported by the Ministry of Health and Sports in Bolivia (7.5%). In addition, vaccination has contributed significantly to the control of the COVID-19 epidemic in Bolivia. We believe that our report will be useful for COVID-19 prevention strategies in Bolivia for the future.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , Bolivia/epidemiología , Estudios Transversales
17.
Epilepsia Open ; 8(1): 125-133, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36461651

RESUMEN

OBJECTIVE: The objective of this study is to estimate the prevalence of epilepsy with Tonic-Clonic (TC) seizures in rural areas of the Bolivian Gran Chaco and to evaluate the usefulness of telemedicine in this context. METHODS: The study was carried out in the Isozo Area, southern-eastern Bolivia. Twenty-five rural communities with a population of 8258 inhabitants were included in the survey. Trained community-health workers administered a validated single screening question to the householders (stage I). A second face-to-face questionnaire was administered to each positive subject (stage II). At stage II subjects were also screened using the smartphone app "Epilepsy Diagnosis Aid". Subjects screened positive at stage II underwent a complete neurological examination to confirm the diagnosis (stage III). Due to the COVID-19 lockdown, some subjects have been evaluated through a digital platform (Zoom®). RESULTS: One-thousand two-hundred and thirteen interviews were performed at stage I, corresponding to a total screened population of 6692 inhabitants. Thirty-eight screened positive were identified at stage I and II and of these, 28 people with epilepsy were identified, giving an overall prevalence of 4.2/1000 (95% CI 2.6-5.7). Prevalence rate steeply increased with age reaching a peak of 7.9/1000 in the population aged 20-29 years without significant differences between women and men. For almost 50% of the screened positive subjects, confirmation of epilepsy by a neurologist at stage III was achieved through simple videoconsultation. After a simultaneous awareness campaign, 22 self-reported PWE requested a consultation and, among them, 11 had a diagnosis of epilepsy confirmed. SIGNIFICANCE: This study shows a prevalence estimate close to those reported for LMIC. Simple videoconsultation and specific apps may be valuable tools in epidemiological research. Awareness campaigns are important allies for a full case identification, particularly in contexts where higher rates of stigma are recorded.


Asunto(s)
COVID-19 , Epilepsia , Telemedicina , Masculino , Humanos , Femenino , Bolivia/epidemiología , Prevalencia , Control de Enfermedades Transmisibles , Epilepsia/diagnóstico , Convulsiones/diagnóstico
18.
Rev. méd. (La Paz) ; 29(2): 21-29, 2023. Tab
Artículo en Español | LILACS | ID: biblio-1530241

RESUMEN

INTRODUCCIÓN: La vacunación es la única herramienta práctica para detener la expansión y erradicar la pandemia COVID-19, la mayoría de las vacunas han demostrado capacidad de inducir respuestas inmunitarias. Es predecible que existan varias vacunas con distintos niveles de protección por lo que su uso dependerá en cada país de las autoridades sanitarias y recomendaciones de la Organización Mundial de la Salud (OMS). OBJETIVO: Determinar los Eventos Adversos (ESAVIS) de la vacuna Sinopharm administrada en personas adultas en el punto de vacunación masivo de la Red de salud N°4 ESTE de la ciudad de La Paz, meses de abril a octubre gestión 2021. MATERIAL Y MÉTODOS: Se realizó un estudio descriptivo, observacional, muestra de 60 casos, con diagnóstico de Eventos Supuestamente atribuibles a la vacunación y/o inmunización. Los métodos empleados fueron análisis documental, instrumentos usados fichas ESAVIS del Ministerio de Salud y Deportes. Se recogieron datos sociodemográficos, sexo y edad. RESULTADOS: Las personas que presentaron eventos adversos a la Vacuna Sinopharm son del sexo femenino en un 78,3% con un promedio de edad 44 años, con antecedentes patológicos de Hipertensión Arterial Sistèmica en un 5%, el medicamento administrado en un 83,3% es el oxígeno, el síntoma más frecuente son los mareos 58,3%, se presentó más ESAVIS leves en un 98,3%. CONCLUSIÓN: Las personas que recibieron la vacuna Sinopharm presentan ESAVIS Leves.


INTRODUCTION: Vaccination is the only practical tool to stop the expansion and eradicate the COVID-19 pandemic, most vaccines have demonstrated the ability to induce immune responses. It is predictable that there are several vaccines with different levels of protection, so their use will depend in each country on the health authorities and recommendations of the World Health Organization (WHO). OBJECTIVE: To determine the Adverse Events (ESAVIS) of the Sinopharm vaccine administered to adults at the mass vaccination point of the Health Network No. 4 ESTE of the city of La Paz, from April to October, 2021. MATERIAL AND METHODS: A descriptive, observational study was carried out, a sample of60 cases, with a diagnosis of Events Supposedly attributable to vaccination and/or immunization. The methods used were documentary analysis, instruments used ESAVIS files from the Ministry of Health and Sports. Sociodemographic data, sex and age were collected. RESULTS: The people who presented adverse events to the Sinopharm Vaccine are 78.3% female with an average age of 44 years, with a pathological history of Systemic Arterial Hypertension in 5%, the medication administered in 83.3% is oxygen, the most frequent symptom is dizziness 58.3%, more mild ESAVIS occurred in 98.3%. CONCLUSION: People who received the Sinopharm vaccine have Mild ESAVIS.

19.
Gac. méd. boliv ; 46(2)2023.
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1534510

RESUMEN

En mayo 2023, la OMS levanta la declaratoria de emergencia sanitaria internacional por Covid-19, pero Bolivia continúa manteniendo la declaratoria de emergencia sanitaria nacional. Objetivo: describir la situación epidemiológica por Covid-19 en Bolivia en comparación a los países sudamericanos. Metodología: Estudio observacional de tipo ecológico; con datos agregados a nivel departamental y nacional, provenientes de los reportes del Ministerio de Salud de Bolivia y la OMS. Se reportan frecuencias absolutas, porcentajes y tasas de incidencia, mortalidad, letalidad y las coberturas de vacunación, desagregadas por países, departamentos. Resultados: A nivel sudamericano, Bolivia ocupa el 6to lugar en el número de casos confirmados (n=1,198,404); 7mo en número de fallecidos (n=22,383), 5to en letalidad (1,9%), y penúltimo en cobertura de vacunación (52,08%). En Bolivia; se observa una tendencia decreciente de casos entre la primera (n=144,592) y 6ta ola (n=88,859); Santa Cruz reportó más casos (n=4037.908) y Pando el más bajo (n=15,081). La tasa de incidencia fue más alta en Tarija y más baja en Potosí. La tasa de Letalidad fue mayor en la primera ola (6,20%) y más baja en la sexta ola (0,20%). La cobertura de vacunación con al menos una dosis fue mayor en Tarija (75,10%), y la más bajas en Beni (57,10%). Conclusión: Bolivia presenta un descenso significativo en el número total de casos nuevos reportados, con disminución de la tasa de mortalidad y letalidad; sin embargo, las coberturas de vacunación en esquema completo y dosis de refuerzo siguen siendo una de las más bajas a nivel sudamericano.


In May 2023, the WHO lifts the declaration of an international health emergency due to Covid-19, but Bolivia continues to maintain the declaration of a national health emergency. Objective: describe the epidemiological situation by Covid-19 in Bolivia compared to South American countries. Methodology: Observational study of ecological type was conducted; with aggregated data at the departmental and national level, from the reports of the Bolivian Ministry of Health and the WHO. Absolute frequencies, percentages, and rates of incidence, mortality, lethality, and vaccination coverage are reported, broken down by country and department. Results: In the South American context, Bolivia ranks 6th in the number of cumulative confirmed cases (n=1,198,404); 7th in the number of deaths (n=22,383), 5th in lethality (1.9%), and 9th in vaccination coverage (52.08%) from ten countries. A decreasing trend is observed in Bolivia, between the first epidemic wave (n=144,592) to the 6th wave (n=88,859); Santa Cruz reported the most cases (n=4037,908) and Pando the lowest (n=15,081). The incidence rate was highest in Tarija and lowest in Potosí. The fatality rate was higher in the first wave (6.20%) and lower in the sixth wave (0.20%). Vaccination coverage with at least one dose was higher in Tarija (75.10%), and the lowest in Beni (57.10%). Conclusion: Bolivia presents a significant decrease in the total number of new cases reported, with a decrease in the mortality and lethality rate; however, full-schedule vaccination coverage and booster doses continue to be one of the lowest in South America.

20.
Saúde Soc ; 32(1): e210704pt, 2023. tab, graf
Artículo en Portugués | LILACS | ID: biblio-1424471

RESUMEN

Resumo Este estudo de caso tem por objetivo apresentar a importância da gestão compartilhada da saúde pública para as zonas de fronteira. Especificamente, apresentaremos como ocorreu o enfrentamento inicial da covid-19 na fronteira Brasil-Bolívia, para demonstrar as fragilidades territoriais, tanto em relação à covid-19, quanto ao enfrentamento de outras doenças infectocontagiosas. De ordem metodológica, este artigo propõe uma nova leitura teórico-analítica para os estudos da governança da saúde pública, com base na sociologia dos problemas públicos, de base pragmatista. Através de uma investigação qualitativa (teórico-reflexiva), realizada mediante levantamento bibliográfico, documental e uma consulta junto a 14 especialistas, foram identificadas as controvérsias e os conflitos que definem o problema e a ação para tentar resolvê-lo. A covid-19 reacende a importância da gestão compartilhada binacional, tanto para combate da pandemia, quanto para o controle de outras endemias locais urgentes, como a dengue e o H1N1, na fronteira.


Abstract This case study aims to present the importance of shared public health management for border areas. Specifically, we will present how the initial confrontation of covid-19 took place on the Brazil-Bolivia border, to demonstrate the territorial weaknesses, both regarding covid-19 and in the face of other infectious diseases. Of methodological order, this article proposes a new theoretical-analytical reading for the study of public health governance, based on the pragmatist sociology of public problems. By an investigation (qualitative and theoretical-reflective), carried out with a bibliographic and documental survey and a consultation with 14 specialists, the controversies and the conflicts that define the problem and the action to try to solve it were identified. covid-19 rekindles the importance of shared binational management, both to fight the pandemic and to control other urgent local endemics, such as dengue and H1N1 on the border.


Asunto(s)
Humanos , Masculino , Femenino , Áreas Fronterizas , Salud Pública , Ensayos Clínicos Pragmáticos como Asunto , Gobernanza , COVID-19 , Adaptación Psicológica , Gestión en Salud
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