Calidad de vida relacionada con la salud y los estados de ánimo en estudiantes de instituciones educativas de Antioquia, Colombia / Quality of life related to the health and mood states of students in educational institutions from Antioquia, Colombia / Qualidade de vida relacionada à saúde e ao humor em estudantes de instituições de ensino em Antioquia, Colômbia

Introducción: La calidad de vida relacionada con la salud (CVRS) y los estados de ánimo son indicadores cruciales del bienestar en adolescentes, pero su relación con estudiantes de Antioquia, Colombia, no ha sido ampliamente estudiada. Objetivo: Determinar la CVRS y los estados de ánimo en escolares de Antioquia-Colombia. Materiales y métodos: Estudio transversal con 1957 escolares de 9 a 20 años. Se aplicaron mediciones de CVRS, ansiedad, depresión, hostilidad y alegría, actividad física, comportamiento sedentario, apoyo social de padres y nivel socioeconómico. Resultados: La calidad de vida alta (CVA) es más elevada en hombres, personas con alegría, estudiantes con apoyo de padres, activos físicamente y personas de nivel socioeconómico alto y medio. AL aumentar un año de edad, disminuye en un 15 % la CVA, y al aumentar la depresión, la ansiedad y el comportamiento sedentario disminuye la CVA. Además, los niveles de depresión y ansiedad son mayores en mujeres, estudiantes mayores, sin apoyo de los padres y personas sedentarias. Conclusiones: La CVRS se asocia con estados de ánimo, actividad física, comportamiento sedentario y apoyo de los padres; mientras que los estados de ánimo se asocian con el sexo, el apoyo de los padres, la CVS y el sedentarismo.

Introduction: Even though health-related quality of life (HRQL) and mood states are key indicators of the well-being of adolescents, their relationship has not been analyzed in students from Antioquia, Colombia. Objective: To determine HRQL and mood states in schoolchildren from Antioquia. Materials and methods: A cross-sectional study was conducted on 1,957 schoolchildren and adolescents aged between 9 and 20 years. Measurements of HRQL, anxiety, depression, hostility and happiness, physical activity, sedentary behavior, parental social support, and socioeconomic status were applied. Results: A high quality of life (HQL) was observed more frequently in male participants, students with parental support, physically active, and those belonging to medium and high socioeconomic status. HQL decreased 15% as their age increased by one year. Also, HQL was reduced when depression, anxiety, and sedentary behavior increased. Furthermore, depression and anxiety levels were higher in women, older students, as well as in those without parental control and with sedentary behavior. Conclusions: HRQL is associated with mood states, physical activity, sedentary behavior, and parental support. In contrast, mood states are related to gender, parental support, HQL, and sedentary lifestyle.

Introdução: A qualidade de vida relacionada à saúde (CVRS) e os estados de humor são indicadores cruciais de bem-estar em adolescentes, mas sua relação com estudantes de Antioquia, Colômbia, não foi amplamente estudada. Objetivo: Determinar a CVRS e os estados de humor em escolares de Antioquia-Colômbia. Materiais e métodos: Estudo transversal com 1.957 escolares de 9 a 20 anos. Foram aplicadas medidas de QVRS, ansiedade, depressão, hostilidade e felicidade, atividade física, comportamento sedentário, apoio social dos pais e nível socioeconômico. Resultados: A alta qualidade de vida (CVA) é maior em homens, pessoas com alegria, estudantes com apoio parental, fisicamente ativos e pessoas de nível socioeconômico alto e médio. À medida que a idade aumenta em um ano, diminui em 15% o CVA, e ao aumentar a depressão, a ansiedade e o comportamento sedentário aumentam, o CVA diminui. Além disso, os níveis de depressão e ansiedade são mais elevados nas mulheres, nos estudantes mais velhos, sem apoio dos pais e nas pessoas sedentárias. Conclusões: A QVRS está associada a estados de humor, atividade física, comportamento sedentário e apoio parental; enquanto os estados de humor estão associados ao sexo, apoio parental, CVS e estilo de vida sedentário.

Efectos de la COVID-19 en la calidad de la atención de los servicios de salud en Colombia: Revisión de literatura / Effects of COVID-19 on the quality of health care services in Colombia: a literature review / Efeitos da covid-19 na qualidade dos serviços de saúde na colômbia: revisão da literatura

Introducción: La pandemia por COVID-19 ha afectado significativamente la calidad de los servicios de cuidado de la salud. Objetivo: Analizar los efectos en los atributos de la calidad en salud de los servicios de atención de enfermedades diferentes a la COVID-19 en Colombia, durante el periodo 2020-2022. Materiales y métodos: Se analizaron 24 artículos de alcance nacional y otros específicos de departamentos como Antioquia, Córdoba, Santander y Cundinamarca. Resultados: La pandemia por COVID-19 impactó la calidad de los servicios en la atención de enfermedades como cáncer, accidentes cerebrovasculares y de eventos como la interrupción voluntaria del embarazo. Conclusión: La calidad de la salud se vio afectada en todas sus dimensiones durante las fases de la pandemia, especialmente en la población con enfermedades crónicas y relacionadas con la salud infantil y materna. Además, se destacaron respuestas como el uso de la telemedicina y de la atención domiciliaria para contribuir a la calidad de la salud en Colombia.

Introduction: The COVID-19 pandemic has significantly affected the quality of health care services. Objective: To analyze the effects of COVID-19 on the quality of health care services focused on treating diseases other than COVID-19 in Colombia during the 2020-2022 period. Materials and methods: 24 articles were analyzed, which included some studies focused on national issues and others specific to the departments of Antioquia, Cordoba, Santander, and Cundinamarca. Results: The COVID-19 pandemic affected the quality of health services caring for diseases such as cancer, strokes, and critical circumstances like voluntary termination of pregnancy. Conclusion: All dimensions of health care were affected during the pandemic, especially impacting populations with chronic diseases and diseases related to child and maternal health. It is important to highlight that telemedicine and home care contributed to improving the quality of health in Colombia.

Introdução: A pandemia de COVID-19 afetou significativamente a qualidade dos serviços de saúde. Objetivo: Analisar os efeitos da COVID-19 nos atributos de qualidade em saúde dos serviços de atenção a outras doenças além da COVID-19 na Colômbia, durante o período 2020-2022. Materiais e métodos: foram analisados 24 artigos de âmbito nacional e outros específicos de departamentos como Antioquia, Córdoba, Santander e Cundinamarca. Resultados: A pandemia da COVID-19 impactou a qualidade dos serviços no cuidado de doenças como câncer, acidente vascular cerebral e eventos como a interrupção voluntária da gravidez. Conclusão: A qualidade da saúde foi afetada em todas as suas dimensões durante as fases da pandemia, especialmente na população com doenças crônicas e doenças relacionadas à saúde infantil e materna. Além disso, foram destacadas respostas como o uso da telemedicina e do atendimento domiciliar para contribuir para a qualidade da saúde na Colômbia.

Mayaro Virus as the cause of Acute Febrile Illness in the Colombian Amazon Basin.

Introduction: Mayaro Fever (MF) is a tropical disease caused by the Mayaro virus (MAYV), with outbreaks documented in Latin America. Methods: A hospital-based fever surveillance in Leticia, Colombian Amazon, collected sera from 1,460 patients aged 5-89 between December 2020 and April 2023. Results: Dengue and malaria were the main diagnoses (19.4 and 5.8%, respectively), leaving 71.4% of cases unidentified after testing. Metagenomic sequencing and real-time RT-qPCR testing identified MAYV in two patients (25-year-old male and an 80-year-old female) exhibiting typical symptoms, of MF including rash, joint pain, and fever. Phylogenetics analysis of these two viruses revealed a close relationship to Peruvian strains within the MAYV D genotype. Discussion: The study of AFI in Leticia, Colombia, identified dengue as prevalent, with malaria, COVID-19, Influenza, and Zika viruses also detected. Despite extensive testing, most cases remained unexplained until metagenomic sequencing revealed MAYV, previously unseen in Colombia but known in neighboring countries. Conclusion: This study presents the first near full-length genomes of MAYV in Colombia, highlighting the need for further seroprevalence studies and enhanced surveillance to understand and control the spread of the virus in the region.

Economic burden due to COVID-19 in a Colombian Caribbean state, 2020 and 2021.

OBJECTIVE: To estimate the economic burden associated with COVID-19 in Córdoba, Colombia, 2020 and 2021. METHODS: Economic burden study. Direct costs were analyzed from the third-party payer perspective using healthcare administrative databases and interviews from a cohort of confirmed COVID-19 cases from Córdoba. Costing aggregation was performed by the bottom-up method. Indirect costs were estimated using the productivity loss approach. Contrast tests and statistical models were estimated at 5% significance. RESULTS: We studied 1,800 COVID-19 cases. The average economic cost of COVID-19 per episode was estimated at US$ 2,519 (95%CI 1,980;3,047). The direct medical cost component accounted for 92.9% of the total; out-of-pocket and indirect costs accounted for 2% and 5.1%, respectively. CONCLUSION: COVID-19 economic cost was mainly due to direct medical costs. This study provided evidence of the economic burden faced by households due to COVID-19, with the most vulnerable households bearing much of the burden on their income.

Telerehabilitation in Colombia: A Country Report and Qualitative Analysis During the Covid-19 Pandemic - Perceptions of Healthcare Providers and Patients.

Given Colombia's status as a middle-income country with healthcare challenges, leveraging telemedicine could significantly benefit hard-to-reach regions, under-resourced and underserved communities. This study provides a comprehensive overview of the country's telerehabilitation landscape, exploring the clinicians' and patients' perspectives during the COVID-19 pandemic through systematic review and qualitative analysis. Sixteen therapists and three patients were identified via snowball sampling. The literature review was scarce and scattered across various topics in the country; some studies delved into specific aspects like legislative frameworks and patient outcomes from different medical specialties. The qualitative analysis demonstrates that despite the learning curve, telerehabilitation strengthens therapeutic support, enhances patient autonomy, fosters a positive patient-provider relationship, achieves treatment goals, promotes family involvement, reduces time and costs, and ensures continuity of therapy services. This study identified research gaps, challenges, and opportunities in telerehabilitation in a Latin American country. Adopting telemedicine technologies in low- and middle-income countries could significantly enhance their healthcare systems.

Key Determinants of COVID-19 Vaccination Take-Up in Remote Rural Areas: Evidence From Colombia.

Objetives: The adoption of vaccines was a crucial factor in overcoming the COVID-19 pandemic. However, vaccination rates between rural and urban areas varied greatly. In this paper, our objective is to understand the individual and institutional factors associated with the uptake of vaccines in remote rural areas in Colombia. Methods: We interviewed a random sample of 800 households (1,592 individuals) in remote rural areas of Antioquia (Colombia) during February 2022 when vaccinations were available. Then, we use a linear probability model to explain the uptake of the COVID-19 vaccine. Results: The results indicate that the probability of having at least the first dose of the COVID-19 vaccine is positively associated with access to information, trust in police and army, and the perceived risk of contracting COVID-19. Trust in the church is negatively related to vaccination. Conclusion: Institutions can play a critical role in the management of pandemics. Timely information on the risks associated with the disease and perceived riskiness are key factors that mobilize the population to take the COVID-19 vaccine.

Corrigendum: Implementing a provisional overarching intervention for COVID-19 monitoring and control in the Brazil-Colombia-Peru frontier.

[This corrects the article DOI: 10.3389/fpubh.2023.1330347.].

Spatiotemporal hierarchical Bayesian analysis to identify factors associated with COVID-19 in suburban areas in Colombia.

Introduction: The pandemic had a profound impact on the provision of health services in Cúcuta, Colombia where the neighbourhood-level risk of Covid-19 has not been investigated. Identifying the sociodemographic and environmental risk factors of Covid-19 in large cities is key to better estimate its morbidity risk and support health strategies targeting specific suburban areas. This study aims to identify the risk factors associated with the risk of Covid-19 in Cúcuta considering inter -spatial and temporal variations of the disease in the city's neighbourhoods between 2020 and 2022. Methods: Age-adjusted rate of Covid-19 were calculated in each Cúcuta neighbourhood and each quarter between 2020 and 2022. A hierarchical spatial Bayesian model was used to estimate the risk of Covid-19 adjusting for socioenvironmental factors per neighbourhood across the study period. Two spatiotemporal specifications were compared (a nonparametric temporal trend; with and without space-time interaction). The posterior mean of the spatial and spatiotemporal effects was used to map the Covid-19 risk. Results: There were 65,949 Covid-19 cases in the study period with a varying standardized Covid-19 rate that peaked in October-December 2020 and April-June 2021. Both models identified an association of the poverty and stringency indexes, education level and PM10 with Covid-19 although the best fit model with a space-time interaction estimated a strong association with the number of high-traffic roads only. The highest risk of Covid-19 was found in neighbourhoods in west, central, and east Cúcuta. Conclusions: The number of high-traffic roads is the most important risk factor of Covid-19 infection in Cucuta. This indicator of mobility and connectivity overrules other socioenvironmental factors when Bayesian models include a space-time interaction. Bayesian spatial models are important tools to identify significant determinants of Covid-19 and identifying at-risk neighbourhoods in large cities. Further research is needed to establish causal links between these factors and Covid-19.

External validation of two clinical prediction models for mortality in COVID-19 patients (4C and NEWS2), in three centers in Medellín, Colombia: Assessing the impact of vaccination over time.

OBJECTIVES: External validation of the 4C and NEWS2 scores for the prediction of in-hospital mortality in COVID-19 patients, and evaluation of its operational performance in two time periods: before and after the start of the vaccination program in Colombia. METHODS: Retrospective cohort in three high complexity hospitals in the city of Medellín, Colombia, between June 2020 and April 2022. RESULTS: The areas under the ROC curve (AUC) for the 4C mortality risk score and the NEWS2 were 0.75 (95% CI 0.73-0.78) and 0.68 (95% CI 0.66-0.71), respectively. For the 4C score, the AUC for the first and second periods was 0.77 (95% CI 0.74-0.80) and 0.75 (95% CI 0.71-0.78); whilst for the NEWS2 score, it was 0.68 (95% CI 0.65-0.71) and 0.69 (95% CI 0.64-0.73). The calibration for both scores was adequate, albeit with reduced performance during the second period. CONCLUSIONS: The 4C mortality risk score proved to be the more adequate predictor of in-hospital mortality in COVID-19 patients in this Latin American population. The operational performance during both time periods remained similar, which shows its utility notwithstanding major changes, including vaccination, as the pandemic evolved.

Feasibility, acceptability and preliminary effectiveness of a community-based group psychosocial support model for conflict survivors in Colombia: An assessment of in-person and remote intervention modalities during the COVID-19 pandemic.

Background: Community-based psychosocial support (CB-PSS) interventions utilizing task sharing and varied (in-person, remote) modalities are essential strategies to meet mental health needs, including during the COVID-19 pandemic. However, knowledge gaps remain regarding feasibility and effectiveness. Methods: This study assesses feasibility, acceptability and preliminary effectiveness of a CB-PSS intervention for conflict-affected adults in Colombia through parallel randomized controlled trials, one delivered in-person (n = 165) and the other remotely (n = 103), implemented during the COVID-19 pandemic and national protests. Interventions were facilitated by nonspecialist community members and consisted of eight problem-solving and expressive group sessions. Findings: Attendance was moderate and fidelity was high in both modalities. Participants in both modalities reported high levels of satisfaction, with in-person participants reporting increased comfort expressing emotions and more positive experiences with research protocols. Symptoms of depression, anxiety and posttraumatic stress disorder improved among in-person participants, but there were no significant changes for remote participants in comparison to waitlist controls. Implications: This CB-PSS intervention appears feasible and acceptable in both in-person and remote modalities and associated with reduction in some forms of distress when conducted in-person but not when conducted remotely. Methodological limitations and potential explanations and areas for future research are discussed, drawing from related studies.

[Social media as platforms for the visibility of gender-based violence during the COVID-19 pandemic in Colombia]. / Redes sociales como escenarios para la visibilización de las violencias basadas en género durante la pandemia de covid-19 en Colombia.

The purpose of this research is to identify predominant problematizations in Colombian feminist Instagram accounts regarding gender-based violence during the first year of the COVID-19 pandemic. Employing a qualitative approach, a digital ethnography based on the principles of netnography was conducted as an alternative to detail the social worlds constructed from online groups. Fifty pieces of content from @lainsumisa and twenty pieces of content from @feministasenconstrucción, published between March 2020 and March 2021, were selected based on observations made within the online fieldwork framework. These were analyzed using discourse analysis techniques. The findings discuss the following emerging categories: unpaid household work, romanticized harassment, fatphobia, and the violation of Black and racialized women's rights. In this context, cyberactivism is presented as an opportunity for the emergence of collectives and support networks for women advocating for gender equality and their rights, towards questioning patriarchal ideas that jeopardize their well-being.

El propósito de esta investigación es identificar las problematizaciones predominantes en cuentas feministas colombianas de Instagram, sobre las violencias basadas en género durante el primer año de la pandemia de covid-19. Desde un enfoque cualitativo, se realizó una etnografía digital basada en los preceptos de la netnografía, como alternativa para detallar los mundos sociales construidos a partir de los grupos en línea. A partir de las observaciones realizadas en el marco del trabajo de campo en línea se seleccionaron 50 contenidos de @lainsumisa y 20 contenidos de @feministasenconstrucción, publicados entre marzo de 2020 y marzo de 2021, los cuales se analizaron mediante técnicas de análisis del discurso. Entre los hallazgos se discuten las siguientes categorías emergentes: el trabajo no remunerado en el hogar, el acoso romantizado, la gordofobia y la vulneración a las mujeres negras y racializadas. Al respecto, se plantea el ciberactivismo como una oportunidad para el surgimiento de colectivos y redes de apoyo para las mujeres que luchan por la equidad de género y por sus derechos, hacia el cuestionamiento de ideas patriarcales que atentan contra su bienestar.

Análisis del desempeño presupuestario del sector salud en el período 2019-2021. Resultados para Chile, Colombia, Guatemala, Honduras, Panamá, Perú, República Dominicana y Uruguay

Esta publicación analiza el grado de alineamiento entre la necesidad de priorizar el primer nivel de atención con el desempeño presupuestario en salud y la capacidad de absorción del sector salud del incremento de los recursos financieros en el periodo 2019 a 2021. La Estrategia de OPS/OMS para el Establecimiento de Sistemas de Salud Resilientes enfatiza la necesidad de priorizar las inversiones en el primer nivel de atención por su incidencia en los niveles de acceso y cobertura. En este ámbito, los presupuestos públicos sirven como el mecanismo por excelencia de revisión de políticas públicas donde se plasman las prioridades de los gobiernos y los diferentes actores del sistema de salud, se articula el modelo de atención y se reasignan recursos ante eventos de emergencia sanitaria. La relevancia del presupuesto público se manifiesta también en la propuesta de incrementar la inversión en salud proveniente de recursos públicos, principalmente ingresos generales (o impuestos) acercándose al 6% del PIB incluido en la estrategia de Salud Universal de la OPS/OMS. El periodo de análisis de esta publicación se caracterizó por un incremento sin precedentes en el flujo de recursos financieros hacia el sector salud para asegurar la capacidad de respuesta del sistema de salud frente a la emergencia sanitaria originada por la pandemia de la Covid-19. La mayor priorización de recursos públicos para salud se viabilizó a través de la implementación de diferentes mecanismos de expansión fiscal, y la utilización de recursos de emergencia; así como a través de las innovaciones en las reglas de gestión financiera pública. Del análisis en este documento elaborado para ocho países de la región utilizando información presupuestaria de acceso público se obtienen varias lecciones que relevan la importancia de fortalecer capacidades de gestión para una asignación más rápida, eficaz y equitativa que se traduzca a la vez en una ejecución presupuestaria más eficiente y equitativa de acuerdo con los objetivos sanitarios. Queda asimismo como tarea pendiente, el relacionar la asignación y uso de estos recursos con las barreras de acceso no-financieras y la interrupción de los servicios esenciales durante el mismo periodo.

Unveiling the dynamics of sexual crimes in Colombia based on complaints over a decade / Desvelando la dinámica de los delitos sexuales en Colombia a partir de las denuncias de más de una década / Revelando a dinâmica de crimes sexuais na Colômbia, com sede em reclamações ao longo de uma década

The aim of this article was to analyse the dynamics of sexual offense reports in Colombia over the period between 2010 and 2022. For this, a mixed methodology was applied in the following phases: first, the Colombian National Police registry ­which included 286 604 sexual crimes reported in the aforementioned period­ was analysed. Then, a causal loop diagram of System Dynamics was designed to highlight the role of reporting sexual crimes in the Colombian Penal System. The main findings of this article include that 85.73 % of the complaints are mostly associated with women and 68 % of the victims are minors or adolescents of both sexes. It must be noted that Colombian legislation divides these crimes into those that are aggravated by violence and those that are not. It was also found that when the victim was a woman, the crimes occurred in a higher proportion with the aggravating factor of violence. It can also be concluded that during the COVID-19 pandemic confinement, there was a decrease in the number of sexual offense reports due to its negative effect on the possibility of adult women reporting crimes. In addition, it was found that it is imperative to direct the criminal policies towards the general positive prevention of sexual crimes, without instrumentalising individuals, and aimed at completing a detailed follow-up of complaints.

El objetivo de este artículo fue analizar la dinámica de las denuncias por delitos sexuales en Colombia en el periodo comprendido entre 2010 y 2022. Para ello, se aplicó una metodología mixta en las siguientes fases: primero, se analizó el registro de la Policía Nacional de Colombia -que incluyó 286 604 delitos sexuales denunciados en el periodo mencionado-. Luego, se diseñó un diagrama de bucle causal de Dinámica de Sistemas para resaltar el papel de la denuncia de delitos sexuales en el Sistema Penal Colombiano. Entre los principales hallazgos de este artículo se destaca que el 85.73 % de las denuncias están asociadas mayoritariamente a mujeres y el 68 % de las víctimas son menores de edad o adolescentes de ambos sexos. Es de anotar que la legislación colombiana divide estos delitos en agravados por violencia y no agravados por violencia. También se encontró que cuando la víctima es mujer, los delitos se presentan en mayor proporción con el agravante de violencia. También se puede concluir que durante el encierro pandémico COVID-19, hubo una disminución en el número de denuncias de delitos sexuales debido a su efecto negativo en la posibilidad de que las mujeres adultas denuncien delitos. Además, se constató que es imperativo orientar las políticas criminales hacia la prevención general positiva de los delitos sexuales, sin instrumentalizar a los individuos, y dirigidas a completar un seguimiento detallado de las denuncias.

O objetivo deste artigo foi analisar a dinâmica das denúncias de crimes sexuais na Colômbia no período entre 2010 e 2022. Para isso, foi aplicada uma metodologia mista nas seguintes fases: primeiro, foi analisado o registro da Polícia Nacional da Colômbia, que incluía 286 604 crimes sexuais denunciados no período mencionado. Em seguida, foi elaborado um diagrama de loop causal do System Dynamics para destacar o papel da denúncia de crimes sexuais no sistema penal colombiano. As principais conclusões desse artigo incluem que 85.73 % das denúncias estão associadas principalmente a mulheres e 68 % das vítimas são menores ou adolescentes de ambos os sexos. Deve-se observar que a legislação colombiana divide esses crimes entre aqueles que são agravados pela violência e aqueles que não são. Também foi constatado que, quando a vítima era mulher, os crimes ocorreram em uma proporção maior com o agravante de violência. Também se pode concluir que, durante o confinamento da pandemia da COVID-19, houve uma diminuição no número de denúncias de crimes sexuais devido ao seu efeito negativo sobre a possibilidade de mulheres adultas denunciarem crimes. Além disso, constatou-se que é imprescindível direcionar as políticas criminais para a prevenção geral positiva dos crimes sexuais, sem instrumentalizar os indivíduos, e visando à conclusão de um acompanhamento detalhado das denúncias.

Los servicios de odontología en los tiempos del COVID- 19 en Colombia: análisis de país

Se desconoce el impacto que produjo la pandemia por el COVID-19 en la prestación y en la consulta de los servicios odontológicos y analizados según el sistema integrado de protección social o SISPRO en Colombia. El objetivo fue Determinar los cambios en la cobertura y los patrones de atención odontológica, entre los años pre pandemia (2017-2019) y los años de pandemia (2020-2021). Se analizaron los registros de las atenciones odontológicas reportadas en el sistema SISPRO del Ministerio de Salud de Colombia en periodos prepandemia y postpandemia por el COVID-19. En el año 2019 la tasa de cobertura por cada 100 habitantes en el estudio era de 31,14; sin embargo, la cobertura de atención odontológica se redujo al 17% en el 2020 y al 9% en el 2021 y las atenciones de urgencias disminuyeron drásticamente en los años 2020 y en el 2021. Se requiere que los tomadores de decisión promuevan los servicios de odontología para recuperar los niveles de cobertura previos a la pandemia. Se identificó una disminución en la cobertura odontológica asociada a la pandemia de la COVID-19 en los años 2020 y 2021 y desconocen cuales son los posibles efectos en la morbilidad bucal de los Colombianos.

Introduction. The COVID-19 pandemic affected Colombian dental services from March 2019 to now, but its magnitude is unknown. Objective. To determine dental care coverage in Colombia during the pandemic period and compare these data with the pre-pandemic period 2017-2019. Methods. Dental coverage and consultation services registered in the "Sistema Integrado de Protección Social" or SISPRO from 2017 to 2021 were analyzed. Results. The whole dental service coverage rate was nearly 20% before Covid-19 pandemic and even registered a slight increase from 2017 to 2018 at national and at department levels. This dental national coverage was 31,14% for every 100 habitants in 2019. However, there was a sharp reduction to 17% in 2020 and to 9% in 2021, revealing a clear and negative impact of the pandemic in dental coverage services and in dental emergency services. Conclusion. A decrease in dental coverage during to the COVID-19 pandemic is revealed, with a concomitant reduction in dental emergency consultations during 2020 and 2021 at country level. The consequences of this disruption on the oral and dental epidemiological profile of Colombians is still unknown and might require urgent preventive, promotional and curative care actions to recover the pre-pandemic dental coverage levels.

Genomic epidemiology of SARS-CoV-2 δ sublineages of the second wave of 2021 in Antioquia, Colombia / Epidemiología genómica de los sublinajes δ del virus SARS-CoV-2 de la segunda ola de COVID en Antioquia en el 2021.

Introduction. During the development of the SARS-CoV-2 pandemic in Antioquia, we experienced epidemiological peaks related to the α, É£, ß, ƛ, and δ variants. δ had the highest incidence and prevalence. This lineage is of concern due to its clinical manifestations and epidemiological characteristics. A total of 253 δ sublineages have been reported in the PANGOLIN database. The sublineage identification through genomic analysis has made it possible to trace their evolution and propagation. Objective. To characterize the genetic diversity of the different SARS-CoV-2 δ sublineages in Antioquia and to describe its prevalence. Materials and methods. We collected sociodemographic information from 2,675 samples, and obtained 1,115 genomes from the GISAID database between July 12th, 2021, and January 18th, 2022. From the analyzed genomes, 515 were selected because of their high coverage values (>90%) to perform phylogenetic analysis and to infer allele frequencies of mutations of interest. Results. We characterized 24 sublineages. The most prevalent was AY.25. Mutations of interest as L452R, P681R, and P681H were identified in this sublineage, comprising a frequency close to 0.99. Conclusions. This study identified that the AY.25 sublineage has a transmission advantage compared to the other δ sublineages. This attribute may be related to the presence of the L452R and P681R mutations associated in other studies with higher evasion of the immune system and less efficacy of drugs against SARS-CoV-2.

Introducción. Durante el desarrollo de la pandemia por SARS-CoV-2 en Antioquia se presentaron picos epidemiológicos relacionados con las variantes α, É£, ß, ƛ y δ, donde δ tuvo la mayor incidencia y prevalencia. Este linaje se considera una variante de preocupación dadas las manifestaciones clínicas que desencadena y sus características epidemiológicas. Se han informado 253 sublinajes δ en la base de datos PANGOLIN. La identificación de estos sublinajes mediante análisis genómico ha permitido rastrear su evolución y propagación. Objetivo. Caracterizar la diversidad genética de los diferentes sublinajes δ de SARSCoV-2 en Antioquia y determinar su prevalencia. Materiales y métodos. Se recopiló información sociodemográfica de 2.675 muestras y de 1.115 genomas del repositorio GISAID entre el 12 de julio de 2021 y el 18 de enero de 2022. Se seleccionaron 501 por su alto porcentaje de cobertura (>90 %) para realizar análisis filogenéticos e inferencia de frecuencias alélicas de mutaciones de interés. Resultados. Se caracterizaron 24 sublinajes donde el más prevalente fue AY.25. En este sublinaje se identificaron mutaciones de interés como L452R, P681R y P681H, que comprendían una frecuencia cercana a 0,99. Conclusiones. Este estudio permitió identificar que el sublinaje AY.25 tiene una ventaja de transmisión en comparación con los otros sublinajes δ. Esto puede estar relacionado con la presencia de las mutaciones L452R y P681R que en otros estudios se han visto asociadas con una mayor transmisibilidad, evasión del sistema inmunitario y menor eficacia de los medicamentos contra SARS-CoV-2.

Psychosocial risk profiles to address future health emergencies: a country study during the COVID-19 lockdown period in Colombia.

Introduction: The different strategies used worldwide to curb the COVID-19 pandemic between 2020 and 2021 had a negative psychosocial impact, which was disproportionately higher for socially and economically vulnerable groups. This article seeks to identify the psychosocial impact of the confinement period during the COVID-19 pandemic for the Colombian population by identifying profiles that predict the levels of different mental health indicators (feelings of fear, positive emotions or feelings during free time, and work impact) and based on them, characterize the risk factors and protection that allows us to propose guidelines for prevention or recovery from future health emergencies. Methods: This is an observational, cross-sectional, retrospective ex post facto study. Multistage cluster probabilistic sampling and binary logistic regression analysis were used to predict extreme levels of various mental health indicators based on psychosocial indicators of the COVID-19 confinement period and to identify risk and protection factors. Results: A relationship was established between the combination of some of the different psychosocial factors evaluated (this combination being the predictive profile identified) with each of the three main variables: feeling of fear (n = 8,247; R = 0.32; p = 0.00; Poverall = 62.4%; 𝜔overall = 0.25; 1-𝛽overall = 1.00), positive emotions or feelings during free time (n = 6,853; R = 0.25; p = 0.00; Poverall = 59.1%; 𝜔overall = 0.18; 1-𝛽overall = 1.00) and labour impact (n = 4,573; R = 0.47; p = 0.63; Poverall = 70.4%; 𝜔overall = 0.41; 1-𝛽overall = 1.00), with social vulnerability determined by sociodemographic factors that were common in all profiles (sex, age, ethnicity and socioeconomic level) and conditions associated with job insecurity (unemployed, loss of health insurance and significant changes to job's requirements) and place of residence (city). Conclusion: For future health emergencies, it is necessary to (i) mitigate the socio-employment impact from emergency containment measures in a scaled and differentiated manner at the local level, (ii) propose prevention and recovery actions through psychosocial and mental health care accessible to the entire population, especially vulnerable groups, (iii) Design and implement work, educational and recreational adaptation programs that can be integrated into confinement processes.

Cytokine expression and mortality risk among COVID-19 hospitalized patients over 60 years of age in a referral hospital in Cartagena, Colombia.

Background: Cytokine dysregulation in COVID-19 patients aged over 60 has been associated to adverse outcomes. While serum levels have been studied, cellular expression, particularly in Afro-Colombians, remains understudied. This research aims to describe cytokine expression in peripheral blood leukocytes and its association with adverse outcomes in COVID-19 patients aged over 60 at Cartagena's referral hospital. Methods: A cohort study was conducted, encompassing severe and critical cases of COVID-19 between November 2021 and February 2022. At baseline, the cellular expression level of cytokines IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ was assessed using flow cytometry. Additionally, various biochemical, hematological, and coagulation markers were evaluated. The main outcome was time to death. Results: Among the 50 enrolled participants, the median age was 76.5 years, 60% were male, 60% were admitted to the ICU, and 42% died. Lactate dehydrogenase and hemoglobin were the only markers that differed between fatal and surviving cases. Regarding cytokines, the level of IL-6 expression was associated with an increased risk of death. Specifically, a one percent increase in the expression was associated with a 7.3% increase in the risk of death. Stratifying the analysis by death and ICU admission, the median expression level remained high in fatal cases who were admitted to the ICU. Conclusions: Our findings revealed a significant association between high cellular expression levels of IL-6 and an increased risk of mortality. These results provide valuable scientific insights that could inform the prioritization of case management, providing especially advantageous for the vulnerable Afro-Colombian group.

Telemedicine for Screening and Follow-Up of Glaucoma: A Descriptive Study.

Introduction: Glaucoma is a leading cause of irreversible blindness. It is a prevalent disease worldwide, affecting ∼70 million people and expected to reach up to 112 million by 2040. Purpose: The aim of this study is to describe the implementation and initial experience of a telemedicine program to monitor glaucoma and glaucoma suspect patients in a large, integrated health care system during the COVID-19 pandemic. Methods: A retrospective chart review of established glaucoma or glaucoma suspect patients who participated in a telemedicine evaluation at the ophthalmic center of a large, Colombian health care system between June 2020 and April 2023 was conducted. Clinical and sociodemographic variables were analyzed. Generated clinical orders for additional testing, surgical procedures, follow-ups, and referrals, as well as changes in medical treatment, were evaluated. Results: A total of 11,034 telemedicine consults were included. The mean ± standard deviation age of this group was 63 ± 17.2 years and 67% were female. Of the patients who attended teleconsults, 49% were glaucoma suspects and 38.5% were followed with a diagnosis of open-angle glaucoma. After the consult, 25% of patients were referred to a glaucoma specialist, 40% had additional testing ordered, and 8% had a surgical procedure ordered, mainly laser iridotomy (409 cases). Almost a third of patients returned for subsequent telemedicine visits after the initial encounter. Despite some technical difficulties, 99.8% of patients attended and completed their scheduled telemedicine appointments. Conclusions: A telemedicine program aimed to monitor established glaucoma patients can be successfully implemented. Established patients within an integrated health care system have high adherence to the virtual model. Further research by health care institutions and government agencies will be key to expand coverage to additional populations. Clinical Trial Registration Number: CEIFUS 1026-24.

SARS-CoV-2 Mu variant in dogs visiting veterinary clinics during the third pandemic peak in Eastern Colombia.

The global presence of SARS-CoV-2 in household pets is acknowledged, yet documentation remains scarce, leaving many regions unexplored. Thus, our study sought to fill this gap by investigating SARS-CoV-2 presence in dogs visiting veterinary clinics during the third pandemic peak in eastern Colombia. We collected and analyzed 43 oropharyngeal and rectal swabs using real-time PCR assays targeting the Envelope Gene of SARS-CoV-2. Out of these, two dogs tested positive, indicating an infection rate of 4.7%. Further examination through complete sequencing and phylogenetic analysis revealed the lineage B.1.621 for the SARS-CoV-2 genome. Consequently, our study unveils the first documented cases of Canis lupus familiaris infected with the Mu variant of SARS-CoV-2, the variant with the most death burden during the whole pandemic in Colombia. Remarkably, these cases presented mild and reversible respiratory and gastrointestinal symptoms, or no clinical manifestations at all. This sheds light on the virus's interaction with our four-legged companions, offering valuable insights into its transmission dynamics and potential effects on animal health.

Estimating the incidence of Venezuelan migration and other socioeconomic factors on urban growth in Colombia.

This study investigates the intricate relationship between Venezuelan migration and urban growth in Colombia from 2018 to 2021. The study employs remote sensing data and social network metrics to uncover migration patterns and their impact on urban expansion. The methodology consists of three stages. Firstly, nighttime satellite imagery is used to analyze year-over-year urban growth in Colombia. Secondly, social network data estimates Venezuelan migration, overcoming challenges of underreporting and informal border crossings. Lastly, an econometric analysis explores the quantitative link between Venezuelan migration and urban growth, integrating socioeconomic variables to address endogeneity. The findings reveal the complex interplay of Venezuelan migration, socioeconomic factors, and urban growth. The study outlines remote sensing analysis, introducing the Anthropogenic Footprint Expansion Index (AFEI) to quantify urban growth. Facebook API data estimates migration trends and explores socioeconomic impacts on urban expansion. The analysis uncovers migration, poverty, aging, and urban population proportion as key factors affecting Colombia's urban landscape. Furthermore, the research underscores how Venezuelan migration affected short-term urban expansion pre- and post-COVID-19. Migration had a notable effect before the pandemic, but this influence waned afterward. The study highlights migration's short-term nature and emphasizes age demographics' role in medium-term dynamics.