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1.
Montevideo; OPS; 2021-09-02. (OPS/URI/21-0001).
No convencional en Español | PAHO-IRIS | ID: phr2-54792

RESUMEN

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS a nivel de país en el 2020, mediante la aplicación de la estrategia de cooperación con el país, la respuesta a las necesidades y prioridades nacionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Asunto(s)
Cooperación Técnica , Sistemas de Salud , Sistemas Nacionales de Salud , Política de Salud , Políticas, Planificación y Administración en Salud , Cobertura de los Servicios de Salud , Enfermedades no Transmisibles , Enfermedades Transmisibles , Factores de Riesgo , Factores Socioeconómicos , Salud Mental , Administración en Salud Pública , Administración Financiera , América del Sur , Uruguay
2.
MEDICC Rev ; 23(3-4): 65-73, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34516540

RESUMEN

INTRODUCTION: One year after WHO declared COVID-19 a pandemic, we found it useful to carry out a diagnosis of the situation in Latin America. OBJECTIVE: Examine the prevailing epidemiological panorama in mid-March 2021 in 16 countries in Latin America and the performance, over time, in the two countries with the best responses to their respective epidemics. METHODS: Using morbidity and mortality data, we compared the relative performance of each country under review and identified the two countries with the most successful responses to the pandemic. We used five indicators to analyze the course of each country's performance during the pandemic throughout 2020: prevalence of active cases per million population; cumulative incidence rate in 7 days per 100,000 population; positivity rate over a 7-day period; percentage of recovered patients and crude mortality rate per 1,000,000 population. RESULTS: According to the performance indicators, Cuba was ranked highest, followed by Uruguay. Although figures remained within acceptable margins, both nations experienced notable setbacks in the first weeks of 2021, especially sharp in Uruguay. CONCLUSIONS: Any characterization of the situation is condemned to be short-lived due to the emergence of mutational variants; however, this analysis identified favorable sociodemographic characteristics in both nations, and in their health systems, which may offer possible explanations for the results we obtained.

3.
Emerg Infect Dis ; 27(11)2021 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-34437831

RESUMEN

We developed a genomic surveillance program for real-time monitoring of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) in Uruguay. We report on a PCR method for SARS-CoV-2 VOCs, the surveillance workflow, and multiple independent introductions and community transmission of the SARS-CoV-2 P.1 VOC in Uruguay.

4.
Appetite ; 167: 105651, 2021 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-34400222

RESUMEN

In May 2020, Uruguay was one of the few Latin American countries that had managed to control the outbreak of COVID-19 without mandatory curfews or quarantines. However, several social distancing measures created a major disruption in different aspects of the daily life of Uruguayan citizens. In this context, the objectives of the present work were i) to identify changes in eating habits perceived by Uruguayan citizens as a consequence of the COVID-19 pandemic, and ii) to explore factors associated with different perceived changes on eating habits. A cross-sectional online study was conducted with 891 participants, recruited using an advertisement on Facebook and Instagram. Fifty-one percent of the participants indicated that their eating habits had changed since the detection of the first cases of COVID-19 in Uruguay. Large heterogeneity in the categorization of the changes existed: 45% of the participants regarded the changes as positive, 32% as negative and 23% as neither positive nor negative. A multinomial logistic regression analysis was used to study the influence of explanatory variables in the likelihood of belonging to groups who reported different changes in eating habits (no changes, positive, negative, or neither positive nor negative changes). Household income and reliance on instrumental and emotional support increased the likelihood of reporting positive changes in eating habits, whereas negative changes were associated with a reduction in household income due to COVID-19 and the coping strategies self-distraction and self-blaming. Insights for policy making to reinforce positive effects and minimize threats to healthy eating are discussed.


Asunto(s)
COVID-19 , Pandemias , Estudios Transversales , Dieta Saludable , Conducta Alimentaria , Humanos , SARS-CoV-2 , Encuestas y Cuestionarios , Uruguay/epidemiología
5.
Public Health Nutr ; : 1-10, 2021 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-34392866

RESUMEN

OBJECTIVE: The aim of this study was to explore and analyse the actions implemented by civil society to contribute to food security in the context of the COVID-19 outbreak in Uruguay, a high-income country in South America. DESIGN: An exploratory systematic approach was used to identify the contributions of civil society to food security through reports in news websites and Facebook posts. Data were analysed based on content analysis following a deductive-inductive approach. SETTING: Uruguay, Latin America. RESULTS: A total of 1220 civil society organisations were identified, which developed two main actions to increase access to food among the Uruguayan population: food baskets and 'community pots' (also known as 'common pots'). Most of the initiatives targeted citizens under socioeconomic vulnerability in the face of COVID-19, without specifying any specific requirement or population segment. Actions were mainly led by spontaneously organised community groups, and, to a lesser extent, by consolidated organisations. Interactions between organisations were identified. The foods provided by the organisations were mostly aligned with national dietary guidelines. Social media posts evidenced that the main challenge faced by organisations was related to the lack of funds or supplies. CONCLUSIONS: Results from this work suggest that the lack of funds or supplies poses challenges to the medium- and long-term contributions of civil society to food security and stresses the need for comprehensive governmental measures to guarantee food security amongst Uruguayan citizens.

6.
Artículo en Inglés | PAHO-IRIS | ID: phr-54606

RESUMEN

[RESUMEN]. Se presentan las principales características y logros de la Estrategia Nacional e Intersectorial para la Prevención del Embarazo en Adolescentes, implementada en Uruguay entre 2016 y 2020. Este proceso se desarrolló en un contexto en el que el embarazo no intencional en adolescentes continúa siendo un problema social relevante para Uruguay y la Región, por lo que se requieren políticas públicas integrales, sostenidas y basadas en evidencias científicas. En Uruguay, la fecundidad adolescente se ha mantenido en niveles elevados por más de una década. Además de la acción intersectorial del Gobierno y la sociedad civil, la estrategia aprobada contó con asesoramiento científico desde el ámbito académico y la cooperación técnica y financiera de organismos regionales e internacionales. Las acciones y medidas adoptadas se basan en una visión socio-ecológica, con sensibilidad cultural, enfoque transformador de género y perspectiva de derechos humanos. Entre las barreras más importantes están las normas sociales que valoran la maternidad como el principal proyecto de vida para las mujeres que viven en contextos de pobreza, los estereotipos de género —el embarazo como una responsabilidad exclusiva de las adolescentes, sin involucrar a los adolescentes varones—, el estigma del aborto, la insuficiente oferta de servicios de salud sexual y reproductiva, y la resistencia a visibilizar el embarazo en niñas menores de 15 años víctimas de la violencia estructural e intrafamiliar. Es necesario asegurar la continuidad de las políticas públicas, ajustadas a un enfoque de género y de derechos humanos, y que se tomen en cuenta los nuevos escenarios, como el que impone la pandemia por COVID-19.


[ABSTRACT]. This article presents the main characteristics and achievements of Uruguay’s National and Intersectoral Strategy for Prevention of Adolescent Pregnancy, implemented from 2016 to 2020. This strategy was implemented in a context in which unintentional adolescent pregnancy continues to be a major social problem for Uruguay and the Region, necessitating comprehensive, sustained, and evidence-based public policies. In Uruguay, adolescent fertility rates have remained high for over a decade. In addition to intersectoral action by government and civil society, the strategy received scientific assistance from the academic community, and technical and financial cooperation from regional and international organizations. Its actions and measures were adopted based on a socio-ecological vision, with cultural sensitivity, a gender-transformative approach, and a human rights perspective. Major barriers include social norms that value maternity as the main life project for women living in poverty, gender stereotypes (pregnancy as the exclusive responsibility of adolescent girls, without involving adolescent boys), the stigma of abortion, a lack of sexual and reproductive health services, and resistance to raising the visibility of pregnancy in girls under 15 years of age who are victims of structural and family violence. It is necessary to ensure the continuity of public policies––adjusted to a gender and human-rights approach––that take into account new scenarios such as the one imposed by the COVID-19 pandemic.


[RESUMO]. Este artigo apresenta os principais aspectos e os resultados da Estratégia Nacional e Intersetorial para Prevenção da Gravidez na Adolescência, implementada no Uruguai entre 2016 e 2020. A gravidez não intencional na adolescência persiste como uma questão social importante no Uruguai e na Região, exigindo políticas públicas com base em evidências científicas que sejam abrangentes e permanentes. A fecundidade na adolescência no Uruguai tem se mantido elevada há mais de uma década. Além da ação intersetorial do governo e da sociedade civil, a estratégia aprovada recebeu orientação científica de entidades acadêmicas, e cooperação técnica e financeira de organismos regionais e internacionais. As ações e as medidas da estratégia foram elaboradas a partir de uma visão socioecológica, com sensibilidade cultural e enfoque transformador de gênero e uma perspectiva de direitos humanos. Entre as barreiras mais importantes enfrentadas estão as normas sociais que valorizam a maternidade como principal projeto de vida para a mulher que vive em situação de pobreza, os estereótipos de gênero (a gravidez é vista como responsabilidade exclusiva da adolescente, sem envolver o parceiro adolescente), o estigma do aborto, a oferta insuficiente de serviços de saúde sexual e reprodutiva, e a resistência a dar visibilidade à gravidez de menores de 15 anos que são vítimas de violência estrutural e intrafamiliar. É necessário garantir a continuidade das políticas públicas que incorporem uma perspectiva de gênero e direitos humanos, e que sejam adaptadas aos novos cenários da pandemia de COVID-19.


Asunto(s)
Embarazo en Adolescencia , Política Pública , Uruguay , Embarazo en Adolescencia , Política Pública , Embarazo en Adolescencia , Uruguay
7.
Sensors (Basel) ; 21(12)2021 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-34198627

RESUMEN

In this paper, we group South American countries based on the number of infected cases and deaths due to COVID-19. The countries considered are: Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Peru, Paraguay, Uruguay, and Venezuela. The data used are collected from a database of Johns Hopkins University, an institution that is dedicated to sensing and monitoring the evolution of the COVID-19 pandemic. A statistical analysis, based on principal components with modern and recent techniques, is conducted. Initially, utilizing the correlation matrix, standard components and varimax rotations are calculated. Then, by using disjoint components and functional components, the countries are grouped. An algorithm that allows us to keep the principal component analysis updated with a sensor in the data warehouse is designed. As reported in the conclusions, this grouping changes depending on the number of components considered, the type of principal component (standard, disjoint or functional) and the variable to be considered (infected cases or deaths). The results obtained are compared to the k-means technique. The COVID-19 cases and their deaths vary in the different countries due to diverse reasons, as reported in the conclusions.


Asunto(s)
COVID-19 , Pandemias , Argentina , Brasil , Chile , Colombia , Ecuador , Humanos , Perú , Análisis de Componente Principal , SARS-CoV-2 , Uruguay , Venezuela
8.
J Matern Fetal Neonatal Med ; : 1-4, 2021 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-34219582

RESUMEN

INTRODUCTION: The mitigation measures to face the health emergency due to the COVID 19 pandemic generated a deep economic, social, and psychological crisis at the community level. This effect is greater in the people, who are the most violated in their rights. In relation to the social crisis and gender perspective, women are particularly affected by the pandemic. Given the disadvantaged situation of women socially, economically, and politically, their self-care is diminished. OBJECTIVE: To identify whether there is an association between the classic risk factors for prematurity and fetal growth restriction and the increase in these pathologies in the period March-September 2020, in a maternity hospital that assists women from low resources. MATERIALS AND METHODS: A retrospective study, with a comparative analysis of the periods between 15 March and 30 September 2019 and the same period in 2020. The data were obtained from an electronic clinical database. The prevalence of preterm birth and small-for-gestational age newborn was analyzed. Indicators available in the database that reflect maternal conditions that lead to an unfavorable maternal environment were selected and they were classified into categories. RESULTS: In the period of 2019, 3225 births were registered and in the period of 2020, 3036 births. In the 2019 period, 12.2% of prematurity was evidenced, while in the 2020 period, 14.5% (RR = 1.19, IC 95% = 1.05-1.35, p = .005). In relation to PEG 5.5% in the first period versus 6.9% in the second (RR = 1.26, CI 95% = 1.04-1.53, p = .01). No increases were found in the indicators that are traditionally related to the etiologies proposed to explain the increase in prematurity and small-for-age gestational, there was no evidence of an increase in inflammatory or vascular conditions. CONCLUSION: The economic, psychological and social crises, in the 1st semester of the health emergency, seriously affected the social determinants of the health of pregnant women who use the Public Maternity of reference in Uruguay. This situation is at the base of the poor perinatal results in the period of the maximum mediated mitigation of the pandemic.

9.
Rev. urug. enferm ; 16(2): 1-14, jul. 2021.
Artículo en Español | LILACS, BDENF - Enfermería, BNUY, BNUY-Enf | ID: biblio-1283284

RESUMEN

La experiencia que relatamos corresponde al re-diseño y dictado de una Unidad Curricular Optativa de Licenciatura de Facultad de Enfermería, y electiva para otras Facultades del área de ciencias de la salud de la Universidad de la República, Uruguay. Con el nombre Uso adecuado de redes sociales: una responsabilidad ciudadana, se plantea conformar el perfil de egreso contribuyendo a la comprensión epistemológica de la disciplina e interacción con la sociedad en la era digital a partir del intercambio y producción de contenidos en y para los espacios donde se encuentra y comunica la sociedad. Diseñada en modalidad semipresencial y a través de redes sociales, debió ser codiseñada ante el contexto de Pandemia que caracterizó el año 2020 para dictarse en línea. El Entorno Virtual de Aprendizaje, designado por la Universidad de la República, dio soporte a los intercambios y al trabajo grupal. La asignatura se dictó en línea con un sistema de asesoramiento pedagógico por parte de los docentes a cargo durante todo el proceso. La metodología de enseñanza se basó en una dinámica de participación-acción y trabajo colaborativo. Los resultados cuantitativos indican que el 73% de los estudiantes aprobaron el curso. A su vez el alcance cualitativo muestra alto interés por la mejora de las prácticas en redes sociales como ciudadanos y futuros profesionales, alcanzado a partir de la reflexión de esta práctica al ocupar el lugar de prosumidores de contenidos en redes sociales.


The experience that we relat corresponds to the re-design and delivery of an Optional Curriculum Unit of the Bachelor of the Faculty of Nursing, and elective for other Faculties of the area of health sciences of the University of the Republic, Uruguay. With the name Proper use of social networks: a civic responsibility, it is proposed to shape the graduation profile contributing to the epistemological understanding of the discipline and interaction with society in the digital age from the exchange and production of content in and for spaces where society meets and communicates. Designed in a blended mode, with face-to-face meetings outside the academic field and online through social networks, it had to be co-designed in the context of the Pandemic that characterized the year 2020 to be dictated online. The Virtual Learning Environment, designated by the University of the Republic, gave support to exchanges and group work. The subject was taught online with a pedagogical advisory system by the teachers in charge throughout the process. Regarding the teaching methodology, it was based on a dynamic of participation-action and collaborative work. The quantitative results indicate that 73% of the students passed the course. At the same time, the qualitative scope shows a high interest in improving practices in social networks as citizens and future professionals, achieved from the reflection of this practice by occupying the place of content prosumers for social networks.


A experiência que relatamos corresponde ao redesenho e entrega de uma Unidade Curricular Opcional do Bacharelado da Faculdade de Enfermagem e eletiva para outras Faculdades da área de ciências da saúde da Universidade da República, Uruguai. Com a denominação Uso adequado das redes sociais: uma responsabilidade cívica, propõe-se moldar o perfil da graduação contribuin-do para a compreensão epistemológica da disciplina e interação com a sociedade na era digital a partir da troca e produção de conteúdos nos e para os espaços onde a sociedade se encontra e se comunica. Projetado de forma mista, com encontros presenciais fora do campo acadêmico e online por meio de redes sociais, teve que ser co-projetado no contexto da Pandemia que caracterizou o ano de 2020 para ser ditado online. O Ambiente Virtual de Aprendizagem, designado pela Universidade da República, deu suporte a intercâmbios e trabalhos de grupo. A disciplina foi ministrada online com sistema de aconselhamento pedagógico pelos professores responsáveis ao longo do processo. Quanto à metodologia de ensino, esta se baseou em uma dinâmica de participação-ação e trabalho colaborativo. Os resultados quantitativos indicam que 73% dos alunos foram aprovados no curso. Ao mesmo tempo, o escopo qualitativo mostra um alto interesse em aprimorar as práticas nas redes sociais como cidadãos e futuros profissionais, conquistado a partir da reflexão dessa prática por ocupar o lugar de prossumidores de conteúdo para as redes sociais.


Asunto(s)
Humanos , Estudiantes de Enfermería , Uruguay , Tecnología Educacional , Educación en Enfermería , Pandemias , Red Social , COVID-19
11.
Soc Sci Med ; 281: 114040, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34144481

RESUMEN

RATIONALE: Stress process theory considers that actual and perceived isolation, caused by mobility restrictions from attempted containment of the COVID-19 pandemic, deteriorates mental health. OBJECTIVE: We examine the relationship between the COVID-19 lockdowns and mental health-related Google searches in 11 Latin American countries. We include the following countries: Argentina, Bolivia, Chile, Colombia, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Uruguay. We also explore how changes in search patterns relate to income support policies and to COVID-19 death rates. METHOD: Using Google Trends data and an event-study design, as well as a difference-in-differences analysis, we investigate the association between country specific stay-at-home orders and internet searches including the following words: insomnia, stress, anxiety, sadness, depression, and suicide. RESULTS: We find three main patterns. First, searches for insomnia peak but then decline. Second, searches for stress, anxiety, and sadness increase and remain high throughout the lockdown. Third, there is no substantial change in depression-related or suicide-related searches after the lockdown. In terms of potential mechanisms, our results suggest that searches declined for suicide and insomnia following the passage of each country's income support, while in countries with higher COVID-19-related death rates, searches for insomnia, stress, and anxiety increased by more. CONCLUSIONS: Our results suggest that, in Latin America, Google searches for words associated with mild mental health disorders increased during the COVID-19 stay-at-home orders. Nonetheless, these conclusions should not be construed as a general population mental health deterioration, as we cannot verify that search indicators are accurately related to the users' current feelings and behaviors, and as internet users may not be representative of the population in this region.


Asunto(s)
COVID-19 , Salud Mental , Motor de Búsqueda , Argentina , Bolivia , Chile , Colombia , Control de Enfermedades Transmisibles , Ecuador , Guatemala , Honduras , Humanos , América Latina/epidemiología , México , Pandemias , Perú , SARS-CoV-2 , Uruguay
12.
J Cancer Res Ther ; 17(2): 547-550, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34121706

RESUMEN

Purpose: Health emergency due to COVID-19 started in Uruguay on March 13, 2020; our mastology unit tried to ensure adequate oncological care, and protect patients from the virus infection and complications. Objective: To assess the health care activities in the "peak" of the pandemic during 3 months. Materials and Methods: we collected data from the electronic health record. Results: There were a total of 293 medical appointments from 131 patients (221 face-to-face), that decreased by 16.7% compared to the same period in 2019 (352 appointments). The medical appointments were scheduled to evaluate the continuity of systemic treatment or modifications (95 patients; 72.5%), follow-up (17; 12.9%), first-time consultation (12; 9.1%), and assess paraclinical studies (7; 5.3%). The patients were on hormone therapy (81 patients; 74%), chemotherapy (CT) (21; 19%), and anti-HER2 therapies (9; 8%). New twenty treatments were initiated. Of the 14 patients that were on adjuvant/neoadjuvant CT, 9 (64.3%) continued with the same regimen with the addition of prophylactic granulocyte-colony-stimulating factors (G-CSF), and 5 (35.7%), who were receiving weekly paclitaxel, continued the treatment with no changes. Of the seven patients that were on palliative CT, 2 (28.5%) continued the treatment with the addition of G-CSF, 3 (42.8%) continued with weekly capecitabine or paclitaxel with no treatment changes, and 2 (28.5%) changed their treatment regimen (a less myelosuppressive regimen was selected for one and due to progression of the disease in the other patient). The ninety patients who were receiving adjuvant, neoadjuvant, or palliative criteria hormone therapy and/or anti-HER2 therapies, continued the treatment with no changes. Conclusions: The evidence suggests that, although medical appointments decreased by approximately 17%, we could maintain healthcare activities, continued most of the treatments while the most modified was CT with G-CSF to avoid myelosuppression.


Asunto(s)
Neoplasias de la Mama/tratamiento farmacológico , COVID-19/epidemiología , Continuidad de la Atención al Paciente/estadística & datos numéricos , Atención a la Salud/estadística & datos numéricos , Oncología Médica/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Médula Ósea/efectos de los fármacos , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/inmunología , COVID-19/inmunología , COVID-19/prevención & control , COVID-19/transmisión , Control de Enfermedades Transmisibles/normas , Continuidad de la Atención al Paciente/organización & administración , Atención a la Salud/organización & administración , Atención a la Salud/normas , Registros Electrónicos de Salud/estadística & datos numéricos , Femenino , Factor Estimulante de Colonias de Granulocitos/administración & dosificación , Hematopoyesis/efectos de los fármacos , Hematopoyesis/inmunología , Humanos , Oncología Médica/organización & administración , Oncología Médica/normas , Persona de Mediana Edad , Pandemias/prevención & control , Derivación y Consulta/normas , Derivación y Consulta/estadística & datos numéricos , Estudios Retrospectivos , Telemedicina/organización & administración , Telemedicina/normas , Telemedicina/estadística & datos numéricos , Triaje/organización & administración , Triaje/normas , Uruguay/epidemiología
13.
Arch. pediatr. Urug ; 92(1): e203, jun. 2021. tab
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1248842

RESUMEN

Resumen: Introducción: el 11 de marzo la enfermedad COVID-19, causada por SARS-CoV-2, fue declarada pandemia. En Uruguay el Plan Nacional Coronavirus desde el 16 de marzo suspendió actividades presenciales educativas y espectáculos públicos; recomendó confinamiento voluntario, adoptar distanciamiento físico, uso de tapaboca y lavado de manos. Objetivo: describir hospitalizaciones por infecciones respiratorias agudas (IRA) de niños de 0 a 14 años entre el 1/1/2020 y el 31/5/2020 durante la pandemia comparadas con aquellas en igual período en 2018 y 2019 y los resultados de la investigación de SARS-CoV-2 en casos sospechosos. Metodología: se incluyeron egresos por IRA, bronquiolitis, neumonía viral y neumonía en unidades de cuidados moderados e intensivos. Se describen: egresos totales, casos, tasa por 1.000 egresos (intervalo de confianza 95% = IC95%) y la distribución por grupos etarios (< 2, 2 a 4 y 5 a 14 años). En 2020 se promovió la atención telefónica, por telemedicina o en domicilio para pacientes sin criterios de hospitalización; se describen hallazgos microbiológicos en casos de IRA y sospechosos de SARS-CoV-2. Resultados: la tasa promedio de egresos por IRA en cuidados moderados en 2018 y 2019 que fue 94 (IC95%: 72-117), en 2020 fue 15 (IC95%: 3-27), con una reducción significativa de 85%. Se investigó SARS-CoV-2 en 30 niños, los resultados fueron negativos. En 2020 no se hospitalizaron niños menores de 1 año, ni casos de infección por influenza, VRS o SARS-CoV-2. Conclusión: las medidas adoptadas contribuyeron a la reducción significativa de hospitalizaciones por IRA.


Summary: Introduction: on March 11th, COVID-19 caused by SARS CoV-2 was declared a pandemic. The Uruguayan National Coronavirus Plan was set up on March 16th and suspended in-person educational activities and public shows; set a voluntary quarantine, social distancing, face masks and hand washing as main recommendations. The British Hospital Contingency Committee approved the healthcare modifications established by Department of Pediatrics. Objective: describe hospitalizations for acute respiratory infection (ARI) in children of 0-14 years of age between 1/1/2020 and 5/31/2020 during the pandemic, compare them to those in the same period in 2018 and 2019, and describe the microbiological findings in children with IRA and suspected cases of SARS CoV-2 infection during 2020. Methodology: we included all discharges from Moderate Care Unit due to ARI, bronchiolitis, viral pneumonia and pneumonia and described total discharges, cases and rates per 1000 discharges (Confidence Interval 95%=CI95%). In 2020, we described healthcare modifications at all levels of care (telephone or telemedicine assistance and home care was promoted) and seasonal respiratory virus cases and SARS CoV-2 nucleic acid detection results. Results: the average rate of discharges due to ARI in Moderate Care Units in 2018 and 2019 was 94 (95% CI: 72-117). In 2020, the rate was 15 (95% CI: 3-27), and showed a significant reduction of 85%. SARS CoV-2 was researched in 30 children, all results were negative. There were no hospitalizations of children of under one year of age due to influenza, RSV or SARS CoV-2 Conclusion: the measures adopted contributed to the significant reduction in hospitalizations due to ARI.


Resumo: Introdução: o dia 11 de março de 2020 a COVID-19 causada pelo SARS CoV-2 foi declarada pandêmica. No Uruguai, as autoridades do Plano Nacional do Coronavírus suspenderam atividades educativas presenciais e shows públicos desde o dia 16 de março e recomendaram o confinamento voluntário, adotando distanciamento físico, uso de máscara e lavagem das mãos. Objetivo: descrever as hospitalizações por infecções respiratórias agudas (IRA) em crianças de 0 a 14 anos de idade entre 01/01/2020 e 31/05/2020 durante a pandemia em comparação com as do mesmo período em 2018 e 2019 e os resultados da Pesquisa do SARS CoV-2 em casos suspeitos. Metodologia: incluíram-se altas das Unidades de Terapia Moderada e Intensiva por IRA, bronquiolite, pneumonia viral e pneumonia. Descrevemos altas totais, casos, totais, taxa por 1000 altas (intervalo de confiança de 95% = IC 95%) e distribuição por grupos de idade (<2, 2 a 4 e 5 a 14 anos). Descrevemos as mudanças promovidas para o caso de atendimento telefónico, telemedicina e atendimento domiciliar para pacientes sem critérios de internação e os achados microbiológicos para casos de IRA e suspeitos de SARS CoV-2. Resultados: a taxa média de alta por IRA em cuidados moderados em 2018 e 2019 foi de 94 (IC 95%: 72-117), em 2020 foi de 15 (IC 95%: 3-27), mostrando uma redução significativa de 85 %. O SARS CoV-2 foi pesquisado em 30 crianças e os resultados foram negativos. Em 2020, nenhuma criança de menos de um ano foi hospitalizada, nem houve casos de infecção por influenza, RSV ou SARS CoV-2. Conclusão: As medidas adotadas contribuíram para redução significativa das internações por IRA.

14.
Microbiol Resour Announc ; 10(21): e0041021, 2021 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-34042476

RESUMEN

Two severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants associated with increased transmission and immune evasion, P.1 and P.2, emerged in Brazil and spread throughout South America. Here, we report genomes corresponding to these variants that were recently detected in Uruguay. These P.1 and P.2 genomes share all substitutions that are characteristic of these variants.

15.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33858666

RESUMEN

Multiple studies have reported a high prevalence of mental health problems among male and female physicians. Although doctors are reluctant to seek professional help when suffering from a mental disorder, specialised services developed specifically to treat their mental health problems have reported promising results. The purpose of this article is to describe the design and implementation of the Professional Wellbeing Programme (Programa de Bienestar Profesional) of the Uruguayan Medical Association (Colegio Médico del Uruguay). The context, inputs, activities and some of the outputs are described according to a case study design. The main milestones in the implementation of the programme are also outlined, as well as the enabling elements, obstacles and main achievements. Emphasis will be placed on the importance of international collaboration to share experiences and models, how to design the care process to promote doctors' access to psychiatric and psychological care, the need for them to be flexible and dynamic in adapting to new and changing circumstances, such as the COVID-19 pandemic, and to work in parallel with the medical regulatory bodies. It is hoped that the experience described in this work may be of use to other Latin American institutions interested in developing mental health programmes for doctors.

16.
Rev. méd. Urug ; 37(1): e501, mar. 2021. tab
Artículo en Español | LILACS, BNUY | ID: biblio-1180963

RESUMEN

Resumen: Introducción: la pandemia provocada por el SARS-CoV-2 genera un importante desafío para el sistema sanitario y especialmente para la Medicina Intensiva. Es necesario prepararse en múltiples aspectos. Además, considerar plausible una demanda extraordinaria de camas críticas que puede llevar a un desbalance entre las necesidades clínicas y la disponibilidad efectiva de los recursos sanitarios. Objetivos: realizar un análisis bioético para brindar una orientación en la atención a los pacientes críticos. Objetivos específicos: 1) Analizar los principios bioéticos fundamentales en este contexto. 2) Apoyar a los clínicos en la toma de decisiones difíciles. 3) Hacer explícitos los criterios de asignación de recursos. 4) Definir líneas de acción ante un posible escenario de "desastre sanitario". Método: la SUMI ha generado un ámbito de trabajo colectivo cuyo método de trabajo fue la deliberación. En la documentación se utiliza la revisión bibliográfica y los protocolos ya existentes. Resultados: el trabajo plantea un análisis teórico documentado sobre los principios bioéticos involucrados en el contexto de pandemia, sobre los escenarios de demanda asistencial y sobre la fundamentación para un cambio en los criterios éticos ante un escenario de saturación del sistema. Conclusión: se plantean recomendaciones prácticas para: 1) Toma de decisiones de ingreso y egreso en demanda controlada. 2) Criterios de acción ante el aumento de la demanda estableciendo definiciones de los diferentes escenarios. 3) Recomendaciones para aplicar en un escenario de saturación del sistema.


Summary: Introduction: the pandemic caused by SARS-CoV2 constitutes a significant challenge for the health system, and especially for Critical Care Units, so we need to prepare in many aspects. Likewise, we need to consider there could be an extraordinary demand for beds in critical care units, what would lead to an imbalance between clinical needs and the effective availability of health resources. Objectives: the study aims to perform a bioethical analysis that could provide guidelines for the assistance of patients in critical care. Specific objectives: 1) to analyse the main bioethical principles in this context, 2) to support clinicians in the making of difficult decisions, 3) to make the resource allocation criteria specific, 4) to define action lines upon a potential "health's disastrous" scenario Method: the Uruguayan Society of Intensive Care has generated a space for collective work based on discussion processes. Documents include a bibliographic review and the existing protocols. Results: the study presents a theoretical analysis that is backed up by the bioethical principles involved in the pandemic context on the scenarios of demand for assistance and, by the arguments calling for a change in the ethical criteria upon the saturation of the health system. Conclusion: practical recommendations are made: 1) for the making of decisions about admission and discharge in a controlled demand. 2) to define action criteria upon an increase in demand, clearly defining the different scenarios, 3) to apply upon the saturation of the health system.


Resumo: Introdução: a pandemia causada pelo SARS-CoV2 gera um importante desafio para o sistema de saúde e principalmente para a Medicina Intensiva. É preciso se preparar em vários aspectos. Além disso, considera plausível uma demanda extraordinária por leitos críticos, que pode levar a um desequilíbrio entre as necessidades clínicas e a disponibilidade efetiva de recursos de saúde. Objetivos: realizar uma análise bioética para orientar o cuidado ao paciente crítico. Objetivos específicos: 1) Analisar os princípios bioéticos fundamentais neste contexto, 2) Apoiar os médicos na tomada de decisões difíceis, 3) Tornar explícitos os critérios de alocação de recursos, 4) Definir linhas de ação perante um possível cenário de " desastre de saúde ". Métodos: a SUMI gerou um ambiente de trabalho coletivo cujo método de trabalho era deliberativo. A documentação usa a revisão da literatura e os protocolos existentes. Resultados: o trabalho propõe uma análise teórica documentada sobre os princípios bioéticos envolvidos no contexto da Pandemia, sobre os cenários da demanda de saúde e sobre os fundamentos para uma mudança de critérios éticos em um cenário de saturação do sistema. Conclusão: são propostas recomendações práticas para: 1) tomada de decisão para admissão e alta sob demanda controlada. 2) critérios de atuação frente ao aumento da demanda, estabelecendo definições dos diferentes cenários. 3) recomendações a serem aplicadas em um cenário de saturação do sistema.


Asunto(s)
Bioética , Cuidados Críticos/ética , Pandemias/ética , COVID-19
17.
Epidemiol Infect ; 149: e44, 2021 02 10.
Artículo en Inglés | MEDLINE | ID: mdl-33563349

RESUMEN

Much of our current understanding about novel coronavirus disease 2019 (COVID-19) comes from hospitalised patients. However, the spectrum of mild and subclinical disease has implications for population-level screening and control. Forty-nine participants were recruited from a group of 99 adults repatriated from a cruise ship with a high incidence of COVID-19. Respiratory and rectal swabs were tested by polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sera were tested for anti-SARS-CoV-2 antibodies by enzyme-linked immunosorbent assay (ELISA) and microneutralisation assay. Symptoms, viral shedding and antibody response were examined. Forty-five participants (92%) were considered cases based on either positive PCR or positive ELISA for immunoglobulin G. Forty-two percent of cases were asymptomatic. Only 15% of symptomatic cases reported fever. Serial respiratory and rectal swabs were positive for 10% and 5% of participants respectively about 3 weeks after median symptom onset. Cycle threshold values were high (range 31-45). Attempts to isolate live virus were unsuccessful. The presence of symptoms was not associated with demographics, comorbidities or antibody response. In closed settings, incidence of COVID-19 could be almost double that suggested by symptom-based screening. Serology may be useful in diagnosis of mild disease and in aiding public health investigations.


Asunto(s)
Anticuerpos Antivirales/sangre , COVID-19/epidemiología , COVID-19/virología , Navíos , Evaluación de Síntomas , Esparcimiento de Virus , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Pruebas de Neutralización , SARS-CoV-2/fisiología , Turismo , Uruguay , Victoria/epidemiología
18.
Braz J Microbiol ; 52(2): 977-988, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33575990

RESUMEN

Neonatal calf diarrhea (NCD) and mortality cause significant losses to the dairy industry. The preweaning dairy calf mortality risk in Uruguay is high (15.2%); however, causes for these losses are largely unknown. This study aimed to assess whether various pathogens were associated with NCD and death in Uruguayan dairy calves and whether these infections, diarrhea, or deaths were associated with the failure of transfer of passive immunity (FTPI). Contemporary diarrheic (n = 264,) and non-diarrheic (n = 271) 1- to 30-day-old calves from 27 farms were sampled. Feces were analyzed by antigen-capture ELISA for Cryptosporidium spp., rotavirus, bovine coronavirus, and Escherichia coli F5+, RT-PCR for bovine astrovirus (BoAstV), and bacterial cultures for Salmonella enterica. Blood/serum was analyzed by RT-PCR or antigen-capture ELISA for bovine viral diarrhea virus (BVDV). Serum of ≤ 8-day-old calves (n = 95) was assessed by refractometry to determine the concention of serum total proteins (STP) as an indicator of FTPI. Whether the sampled calves died before weaning was recorded. At least one pathogen was detected in 65.4% of the calves, and this percentage was significantly higher in diarrheic (83.7%) versus non-diarrheic (47.6%) calves. Unlike the other pathogens, Cryptosporidium spp. and rotavirus were associated with NCD. Diarrheic calves, calves infected with any of the pathogens, and calves infected with rotavirus had significantly lower concentrations of STP. Diarrheic calves had higher chances of dying before weaning than non-diarrheic calves. Diarrheic calves infected with S. enterica were at increased risk of mortality. Controlling NCD, salmonellosis, cryptosporidiosis, and rotavirus infections, and improving colostrum management practices would help to reduce calf morbi-mortality in dairy farms in Uruguay.


Asunto(s)
Enfermedades de los Bovinos/etiología , Enfermedades de los Bovinos/mortalidad , Diarrea/veterinaria , Animales , Animales Recién Nacidos , Astroviridae/aislamiento & purificación , Estudios de Casos y Controles , Bovinos , Cryptosporidium/aislamiento & purificación , Industria Lechera/métodos , Diarrea/etiología , Diarrea/mortalidad , Virus de la Diarrea Viral Bovina/aislamiento & purificación , Ensayo de Inmunoadsorción Enzimática/veterinaria , Escherichia coli/aislamiento & purificación , Heces/microbiología , Heces/parasitología , Heces/virología , Femenino , Inmunización Pasiva/veterinaria , Reacción en Cadena en Tiempo Real de la Polimerasa/veterinaria , Rotavirus/aislamiento & purificación , Salmonella enterica/aislamiento & purificación , Encuestas y Cuestionarios , Síndrome , Uruguay/epidemiología
19.
s.l; Ministerio de Salud Pública; feb. 23, 2021. 38 p. ilus..
No convencional en Español | LILACS | ID: biblio-1151280

RESUMEN

La respuesta de la OPS/OMS ha consistido en activar equipos regionales y nacionales del sistema de gestión de incidentes para transmitir orientación técnica y brindar apoyo directo a los ministerios de salud de los países en materia de vigilancia, capacidad de laboratorios, servicios de apoyo a la atención de salud, prevención y control de infecciones, manejo clínico y comunicación de riesgos, todo en consonancia con líneas de acción prioritarias. A través del Centro de Operaciones de Emergencia (COE) de la OPS se planifica, coordina y controla la respuesta. Para ello se recolecta y analiza información que permite a la OPS y a los estados miembros tomar decisiones efectivas y a tiempo. La comunicación de información clara y de calidad y la participación de la comunidad también es un área priorizada en el trabajo. Para ello se asistió a los gobiernos en las capacidades para generar la comunicación del riesgo, ampliando las capacidades locales. Además, la OPS/OMS contribuyó al fortalecimiento de las capacidades de detección y vigilancia del SARS-CoV-2 capacitando a laboratorios nacionales en los protocolos recomendados y asegurando la disponibilidad de reactivos y pruebas para las mismas. También se trabajó en el desarrollo de vacunas y generaron mecanismos de acceso, investigación de tratamientos (ejemplo ensayo Solidaridad) y fortalecimiento de sistemas de salud. El acompañamiento y la cooperación técnica han sido los postulados principales en el vínculo con la Autoridad Sanitaria Nacional en el Uruguay. Los indicadores de la respuesta a la pandemia constituyen pruebas de la preparación y capacidad de respuesta, de los que subrayamos nueve factores: 1. Según el "Informe Mundial de la Protección Social 2017-2019" de la OIT y el Reporte del Banco Mundial (2013), Uruguay cuenta con "uno de los sistemas de protección social más desarrollados de América Latina, comparable, en algunos aspectos, a los de países de la OCDE". Contar con una protección social sólida ayuda a que los países desarrollen una respuesta más efectiva. 2. La información requiere provenir de fuentes verificadas y la respuesta de la sociedad uruguaya fue responsable eligiendo cumplir el distanciamiento físico voluntario.


Asunto(s)
Humanos , Neumonía Viral/prevención & control , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Monitoreo Epidemiológico , Servicios Públicos de Salud/organización & administración , Uruguay/epidemiología
20.
s.l; Ministerio de Salud; feb. 15, 2021. 12 p. ilus..
No convencional en Español | LILACS | ID: biblio-1151282

RESUMEN

El presente informe brinda la actualización de la situación epidemiológica nacional en referencia a COVID-19, con la información disponible según las estrategias de vigilancia epidemiológica actualmente vigentes en el país. A la fecha la OMS reporta la ocurrencia de 109.729.579 casos confirmados en todo el mundo, con 2.424.897 defunciones. Se han reportado casos en 192 países. A continuación, se presenta la situación epidemiológica de COVID-19 en Uruguay actualizada a la fecha, utilizando como fuente de datos el SG-DEVISA. El día 13 de marzo, se realizó la primera confirmación de un caso de COVID-19 en Uruguay. Desde la fecha se han confirmado por laboratorio 48909 casos (incidencia acumulada de 1385,17 casos por 100.000 habitantes).


Asunto(s)
Neumonía Viral/epidemiología , Infecciones por Coronavirus/epidemiología , Pandemias/prevención & control , Monitoreo Epidemiológico , Uruguay/epidemiología
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