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1.
Cureus ; 14(7): e27449, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36051711

RESUMO

Introduction Vaccination is one of the pillars for the prevention of COVID-19 in healthcare workers (HCWs). The present study aims to determine the effectiveness of vaccination for COVID-19 as well as hybrid immunity in previously infected HCWs in a hospital in a developing country. Methods An observational study was carried out on health personnel with a complete COVID-19 vaccination schedule according to their previous infection status, with a follow-up period of 15 months. Results In this study, 335 subjects were enrolled, of which 32.8% had a previous infection with COVID-19. The safety of vaccines was determined by estimating the presence of adverse effects of vaccination and immunization (AEVI), with the first and second doses showing an incidence of 8.2% and 9.5% respectively, during the second and third waves. Around 5.7% of immunized personnel were sick and 8.4% in the fourth wave; the serum value of neutralizing antibodies was normal at 60.2% with no differences between vaccines (p=0.164). However, in personnel with hybrid immunity, there were normal levels of antibodies in 81.8% of cases (p= 0.023), fewer days of medical leave (6.4 days (standard deviation=1.4) (p=0.067)), higher immunoglobin values ​​(p=0.011) and an insignificantly (p=0.248) lower rate of COVID-19 presentation. Conclusion Vaccination, when applied to people who previously acquired natural immunity, generates a hybrid immunity that is robust, and could have a longer duration, as well as greater efficacy for new COVID-19 variants of concern.

2.
Rev Panam Salud Publica ; 46: e114, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-36177303

RESUMO

Objective: To identify the prevalence of self-reporting of symptoms and access to testing and diagnosis of coronavirus-19 disease (COVID-19), as well as its association with social determinants of health (SDH). Methods: Cross-sectional study with a sample of 11 728 men and 12 612 women over the age of 17, based on the National Household Survey 2020. The dependent variables were the self-reporting of symptoms, access to testing, and a positive COVID-19 test. The independent variables were age, educational level, area of residence and geographic area, ethnicity, type of household, income per capita, occupation, and health insurance. Prevalences, bivariate associations, and binomial logistical regression models (odds ratio (OR), and 95% confidence interval (CI95%) were calculated. Results: Of the total individuals included, 16% reported symptoms, 10% a test, and 4.2% a positive COVID-19 test. Inequalities were observed in the reporting of COVID-19 symptoms, with a higher probability in women whose income had fallen (OR: 1.7; CI95%: 1.2-2.4) and unemployed persons (OR: 1.2; CI95%: 1.1-1.4 for men and OR: 1.3; CI95%: 1.5-1.5 for women). In contrast, with respect to access to diagnostic tests, the highest probability was observed in people with higher education (OR: 2.4; CI95%: 1.9-2.9 for men and OR: 2.7; CI95%: 2.2-3.4 for women), whose income was maintained (OR: 1.5; CI95%: 1.3-1.9 for men and OR: 1.7; CI95%: 1.4-2.0 for women) and those in the highest quartile of per capita household income (OR: 2.0; CI95%: 1.6-2.5 for men and OR: 1.6; CI95%: 1.3-2.0 for women). The probability of reporting symptoms and getting tested, and being diagnosed with COVID-19 increased with age for people with health insurance and those living in the llanos region; however, it decreased for residents of rural areas. Conclusions: There are inequalities in access to testing and the reporting of COVID-19 symptoms.


Objetivo: Identificar a prevalência de sintomas autorreferidos, acesso a testagem e acesso ao diagnóstico da doença do coronavírus de 2019 (COVID-19), bem como sua associação com os determinantes sociais da saúde (DSS). Métodos: Estudo transversal com amostra de 11 728 homens e 12 612 mulheres com mais de 17 anos, com base na Pesquisa Nacional de Domicílios de 2020. As variáveis dependentes foram sintomas autorreferidos, acesso ao teste e teste positivo para COVID-19. As variáveis independentes foram idade, escolaridade, tipo e local de residência, etnia, tipo de domicílio, renda per capita, atividade e plano de saúde. Foram calculados prevalência, associações bivariadas e modelos de regressão logística binomial (odds ratio [OR] e intervalo de confiança de 95% [IC95%]). Resultados: Do total de pessoas incluídas, 16% relataram sintomas; 10%, realização de teste; e 4,2%, um teste positivo para COVID-19. Houve desigualdades no relato de sintomas de COVID-19, com maior probabilidade em mulheres cuja renda havia diminuído (OR: 1,7; IC95%: 1,2-2,4) e que estavam desempregadas (OR: 1,2; IC95%: 1,1 -1,4 para homens e OR: 1,3; IC95%: 1,5-1,5 para mulheres). Em contrapartida, quanto ao acesso a exames diagnósticos, a maior probabilidade foi observada em pessoas com nível superior (OR: 2,4; IC95%: 1,9-2,9 para homens e OR: 2,7; IC95%: 2,2-3,4 para mulheres) cuja renda foi mantida (OR: 1,5; IC95%: 1,3-1,9 para homens e OR: 1,7; IC95%: 1,4- 2,0 para mulheres) e pertencentes ao maior quartil de renda domiciliar per capita (OR: 2,0; IC95%: 1,6-2,5 para homens e OR: 1,6; IC95%: 1,3-2,0 para mulheres). A probabilidade de relatar sintomas, fazer o teste e ser diagnosticado com COVID-19 aumentou com a idade e foi maior nos casos de pessoas que têm plano de saúde e nos de moradores da região dos llanos. Por outro lado, foi menor nos casos de moradores de áreas rurais. Conclusões: Existem desigualdades no acesso a testes e na notificação de sintomas de COVID-19.

3.
Rev Panam Salud Publica ; 46, sept. 2022
Artigo em Espanhol | PAHO-IRIS | ID: phr-56434

RESUMO

[RESUMEN]. Objetivo. Identificar la prevalencia del autoinforme de síntomas, del acceso al testeo y del diagnóstico de la enfermedad por el coronavirus del 2019 (COVID-19, por su sigla en inglés), así como su asociación con determinantes sociales de la salud (DSS). Métodos. Estudio transversal con una muestra de 11 728 hombres y 12 612 mujeres mayores de 17 años, con base en la Encuesta Nacional de Hogares 2020. Las variables dependientes fueron el autoinforme de síntomas, de acceso al testeo y de una prueba positiva para COVID-19. Las variables independientes fueron la edad, el nivel de educación, la zona de residencia y geográfica, la etnia, el tipo de hogar, el ingreso per cápita, la actividad y el seguro de salud. Se calcularon prevalencias, asociaciones bivariadas y modelos de regresión logística binomial (razón de momios [OR] e intervalo de confianza del 95% [IC95%]). Resultados. Del total de personas incluidas, 16% notificó síntomas, 10% un testeo y 4,2% una prueba posi- tiva para COVID-19. Existieron desigualdades en la notificación de síntomas de COVID-19, con una mayor probabilidad en las mujeres cuyos ingresos habían disminuido (OR: 1,7; IC95%: 1,2-2,4) y las personas des- empleadas (OR: 1,2; IC95%: 1,1-1,4 para los hombres y OR:1,3; IC: 1,5-1,5 para las mujeres). En cambio, con respecto al acceso a las pruebas diagnósticas, la mayor probabilidad se observó en personas con educación superior (OR: 2.4; IC95%: 1,9-2,9 para los hombres y OR: 2,7; IC95%: 2,2-3,4 para las mujeres), cuyos ingre- sos se mantuvieron (OR: 1,5; IC95%: 1,3-1,9 para los hombres y OR: 1,7; IC95%: 1,4-2,0 para las mujeres) y del cuartil de ingreso per cápita en el hogar más alto (OR: 2,0; IC95%:1,6-2,5 para los hombres y OR: 1,6; IC95%: 1,3-2,0 para las mujeres). La probabilidad de notificar síntomas, realizarse una prueba y el diagnós- tico para COVID-19 aumentó con la edad, para las personas que contaban con seguro de salud y residentes en los llanos; por otra parte, disminuyó para residentes de zonas rurales. Conclusiones. Existen desigualdades en el acceso al testeo y en la notificación de síntomas de la COVID-19.


[ABSTRACT]. Objective. To identify the prevalence of self-reporting of symptoms and access to testing and diagnosis of coronavirus-19 disease (COVID-19), as well as its association with social determinants of health (SDH). Methods. Cross-sectional study with a sample of 11 728 men and 12 612 women over the age of 17, based on the National Household Survey 2020. The dependent variables were the self-reporting of symptoms, access to testing, and a positive COVID-19 test. The independent variables were age, educational level, area of residence and geographic area, ethnicity, type of household, income per capita, occupation, and health insu- rance. Prevalences, bivariate associations, and binomial logistical regression models (odds ratio (OR), and 95% confidence interval (CI95%) were calculated. Results. Of the total individuals included, 16% reported symptoms, 10% a test, and 4.2% a positive COVID-19 test. Inequalities were observed in the reporting of COVID—19 symptoms, with a higher probability in women whose income had fallen (OR: 1.7; CI95%: 1.2–2.4) and unemployed persons (OR: 1.2; CI95%: 1.1–1.4 for men and OR: 1.3; CI95%: 1.5–1.5 for women). In contrast, with respect to access to diagnostic tests, the highest probability was observed in people with higher education (OR: 2.4; CI95%: 1.9–2.9 for men and OR: 2.7; CI95%: 2.2–3.4 for women), whose income was maintained (OR: 1.5; CI95%: 1.3–1.9 for men and OR: 1.7; CI95%: 1.4–2.0 for women) and those in the highest quartile of per capita household income (OR: 2.0; CI95%: 1.6–2.5 for men and OR: 1.6; CI95%: 1.3–2.0 for women). The probability of reporting symptoms and getting tested, and being diagnosed with COVID-19 increased with age for people with health insurance and those living in the llanos region; however, it decreased for residents of rural areas. Conclusions. There are inequalities in access to testing and the reporting of COVID-19 symptoms.


[RESUMO]. Objetivo. Identificar a prevalência de sintomas autorreferidos, acesso a testagem e acesso ao diagnóstico da doença do coronavírus de 2019 (COVID-19), bem como sua associação com os determinantes sociais da saúde (DSS). Métodos. Estudo transversal com amostra de 11 728 homens e 12 612 mulheres com mais de 17 anos, com base na Pesquisa Nacional de Domicílios de 2020. As variáveis dependentes foram sintomas autorreferidos, acesso ao teste e teste positivo para COVID-19. As variáveis independentes foram idade, escolaridade, tipo e local de residência, etnia, tipo de domicílio, renda per capita, atividade e plano de saúde. Foram calculados prevalência, associações bivariadas e modelos de regressão logística binomial (odds ratio [OR] e intervalo de confiança de 95% [IC95%]). Resultados. Do total de pessoas incluídas, 16% relataram sintomas; 10%, realização de teste; e 4,2%, um teste positivo para COVID-19. Houve desigualdades no relato de sintomas de COVID-19, com maior proba- bilidade em mulheres cuja renda havia diminuído (OR: 1,7; IC95%: 1,2-2,4) e que estavam desempregadas (OR: 1,2; IC95%: 1,1 -1,4 para homens e OR: 1,3; IC95%: 1,5-1,5 para mulheres). Em contrapartida, quanto ao acesso a exames diagnósticos, a maior probabilidade foi observada em pessoas com nível superior (OR: 2,4; IC95%: 1,9-2,9 para homens e OR: 2,7; IC95%: 2,2-3,4 para mulheres) cuja renda foi mantida (OR: 1,5; IC95%: 1,3-1,9 para homens e OR: 1,7; IC95%: 1,4- 2,0 para mulheres) e pertencentes ao maior quartil de renda domiciliar per capita (OR: 2,0; IC95%: 1,6-2,5 para homens e OR: 1,6; IC95%: 1,3-2,0 para mulheres). A probabilidade de relatar sintomas, fazer o teste e ser diagnosticado com COVID-19 aumentou com a idade e foi maior nos casos de pessoas que têm plano de saúde e nos de moradores da região dos llanos. Por outro lado, foi menor nos casos de moradores de áreas rurais. Conclusões. Existem desigualdades no acesso a testes e na notificação de sintomas de COVID-19.


Assuntos
Determinantes Sociais da Saúde , COVID-19 , Autorrelato , Diagnóstico , Mensuração das Desigualdades em Saúde , Determinantes Sociais da Saúde , Autorrelato , Diagnóstico , Mensuração das Desigualdades em Saúde , Determinantes Sociais da Saúde , Autorrelato , Mensuração das Desigualdades em Saúde , Bolívia
4.
J Popul Ageing ; : 1-31, 2022 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-35965641

RESUMO

The effects of COVID-19 revealed the fragility of health systems in the LAC region, with greater risk of death in older people than in younger people, as well as greater vulnerability to infection due to living with people aged 30-59 years, who have a higher prevalence of COVID-19. On the other hand, there is not much information on inequalities in the incidence of COVID-19 in indigenous people, a population with lower immunological resistance. The objectives are: 1) To determine the association between sociodemographic variables with self-reported COVID-19 symptoms. 2) To investigate whether this relationship shows inequalities by ethnicity and age. For that purpose I conducted a cross-sectional analysis using the 2020 Household Survey and investigated the association between sociodemographic variables and self -reported COVID-19 symptoms and explore the contribution of factors such as employment type, household living arrangements, years of education, age, ethnicity, gender, current status of working and residence area. I performed bivariate analysis to establish trends. Subsequently using logistic regressions to establish the risks to self-reported COVID-19 symptoms. A fully interacted model is analysed by ethnicity. I found those who were living alone were less likely than those living in a Couple with/without relatives' household arrangement to self-reported COVID-19 symptoms (OR = 0.79, 95% CI: 0.66-0.94, p < .01). Odds of the older persons aged 45-59 (OR = 1.44, 95% CI: 1.27-1.62, p < .05) were relatively more likely than younger people (OR = 1.19, 95% CI: 1.05-1.35, p < .01). Indigenous living in a couple with/without children household arrangement were less likely than non-Indigenous (OR = 0.75, 95% CI: 0.62-0.90, p < .01). Odds of Indigenous people of age 30-44 (OR = 1.26, 95% CI: 1.04-1.53, p < .01) were more likely than non-Indigenous. Odds of Indigenous persons of age 45-59 (OR = 1.59, 95% CI: 1.32-1.91, p < .05) were more likely than non-Indigenous (OR = 1.32, 95% CI: 1.12-1.55, p < .01). As conclusions, 45-59 age group shows higher risk factors and those aged 60 + show lower risks. These are increased in people working in managerial, administrative and professional, and technical positions, those living in a household with/without relatives, men, those living in urban areas, and/or non-indigenous people.

5.
BMC Public Health ; 22(1): 1077, 2022 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641948

RESUMO

BACKGROUND: Governments have attempted to combat the COVID-19 pandemic by issuing guidelines for disease prevention behavior (e.g., wearing masks, social distancing, etc.) and by enforcing these guidelines. However, while some citizens have complied with these guidelines, others have ignored them or have even participated in large-scale protests. This research aims both to understand the causes of such variation in citizens' adherence to government guidelines on disease prevention behavior and to extend the scientific literature on disease prevention to account for the collective resilience of a society to diseases. Thus, this research draws on the health belief model and collective resilience theory to develop hypotheses about the determinants of a citizen's disease prevention behavior. These hypotheses deal with how citizens' vulnerability, attitudes toward disease prevention, and social orientation are associated with COVID-19 prevention behaviors. METHODS: From March 24 to April 4, 2020, a cross-sectional online survey was conducted in Bolivia. It included questions on demographic characteristics, chronic health problems, emotional burden, attitudes towards preventive behaviors, trust in public institutions, and culture. Among 5265 participants who clicked on the survey, 1857 at least partially filled it out. After removing data with missing responses to any variable, the final sample consists of 1231 respondents. The collected data were analyzed using hierarchical linear modeling. RESULTS: Regarding a citizen's vulnerability, chronic health problems have a U-shaped association with disease prevention behavior. Moreover, age, female gender, and worries have positive associations with disease prevention behavior, whereas depression showed a negative association. Regarding attitudes toward disease prevention, trust in public institutions, and attitudes toward social distancing, a government-imposed lockdown and the enforcement of this lockdown showed positive associations with disease prevention behavior. Regarding social orientation, individualism and collectivism both have positive relationships with disease prevention behavior. CONCLUSIONS: In the COVID-19 pandemic, a citizen's low vulnerability, weak social orientation, and beliefs about low benefits of disease prevention behavior are associated with poor compliance with guidelines on disease prevention behavior. More research on these associations would help generalize these findings to other populations and other public health crises.


Assuntos
COVID-19 , Bolívia/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Estudos Transversais , Feminino , Modelo de Crenças de Saúde , Humanos , Pandemias/prevenção & controle
6.
Surg Endosc ; 2022 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-35419639

RESUMO

BACKGROUND: An international surgical team implemented a virtual basic laparoscopic surgery course for Bolivian general and pediatric surgeons and residents during the COVID-19 pandemic. This simulation course aimed to enhance training in a lower-resource environment despite the challenges of decreased operative volume and lack of in-person instruction. METHODS: The course was developed by surgeons from Bolivian and U.S.-based institutions and offered twice between July-December 2020. Didactic content and skill techniques were taught via weekly live videoconferences. Additional mentorship was provided through small group sessions. Participants were evaluated by pre- and post-course tests of didactic content as well as by video task review. RESULTS: Of the 24 enrolled participants, 13 were practicing surgeons and 10 were surgery residents (one unspecified). Fifty percent (n = 12) indicated "almost never" performing laparoscopic surgeries pre-course. Confidence significantly increased for five laparoscopic tasks. Test scores also increased significantly (68.2% ± 12.5%, n = 21; vs 76.6% ± 12.6%, n = 19; p = 0.040). While challenges impeded objective evaluation for the first course iteration, adjustments permitted video scoring in the second iteration. This group demonstrated significant improvements in precision cutting (11.6% ± 16.7%, n = 9; vs 62.5% ± 18.6%, n = 6; p < 0.001), intracorporeal knot tying (36.4% ± 38.1%, n = 9; vs 79.2% ± 17.2%, n = 7; p = 0.012), and combined skill (40.3% ± 17.7%; n = 8 vs 77.2% ± 13.6%, n = 4; p = 0.042). Collectively, combined skill scores improved by 66.3% ± 10.4%. CONCLUSION: Virtual international collaboration can improve confidence, knowledge, and basic laparoscopic skills, even in resource-limited settings during a global pandemic. Future efforts should focus on standardizing resources for participants and enhancing access to live feedback resources between classes.

7.
BMC Infect Dis ; 22(1): 298, 2022 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-35346096

RESUMO

BACKGROUND: As a Neglected Tropical Disease associated with Latin America, Chagas Disease (CD) is little known in non-endemic territories of the Americas, Europe and Western Pacific, making its control challenging, with limited detection rates, healthcare access and consequent epidemiological silence. This is reinforced by its biomedical characteristics-it is usually asymptomatic-and the fact that it mostly affects people with low social and financial resources. Because CD is mainly a chronic infection, which principally causes a cardiomyopathy and can also cause a prothrombotic status, it increases the risk of contracting severe COVID-19. METHODS: In order to get an accurate picture of CD and COVID-19 overlapping and co-infection, this operational research draws on community-based experience and participative-action-research components. It was conducted during the Bolivian elections in Barcelona on a representative sample of that community. RESULTS: The results show that 55% of the people interviewed had already undergone a previous T. cruzi infection screening-among which 81% were diagnosed in Catalonia and 19% in Bolivia. The prevalence of T. cruzi infection was 18.3% (with 3.3% of discordant results), the SARS-CoV-2 22.3% and the coinfection rate, 6%. The benefits of an integrated approach for COVID-19 and CD were shown, since it only took an average of 25% of additional time per patient and undoubtedly empowered the patients about the co-infection, its detection and care. Finally, the rapid diagnostic test used for COVID-19 showed a sensitivity of 89.5%. CONCLUSIONS: This research addresses CD and its co-infection, through an innovative way, an opportunity of systematic integration, during the COVID-19 pandemic.


Assuntos
COVID-19 , Doença de Chagas , Bolívia/epidemiologia , COVID-19/epidemiologia , Doença de Chagas/diagnóstico , Doença de Chagas/epidemiologia , Humanos , Pandemias , SARS-CoV-2
8.
La Paz; Médicos Consultores MEDICON; Febrero, 2022. 233 p. Tab..
Monografia em Espanhol | LIBOCS | ID: biblio-1367057

RESUMO

La pandemia Covid-19 es uno de los eventos más catastróficos que ha experimentado la humanidad en toda su historia, si consideramos el adelanto tecnológico conseguido hasta el presente. Un minúsculo engendro, de origen desconocidos, sigue poniendo en vilo a organismos internacionales, estados, sistemas de salud y habitantes. Su capacidad de permanecer está basada principalmente en la actitud suicida de gran parte de la humanidad, que le está permitiendo replicarse y modificarse hasta el punto de poner en duda los esquemas terapéuticos vigentes y la efectividad de las vacunas. Dos años de pandemia no han sido suficientes para que la ciencia actual pueda encontrar drogas verdaderamente efectivas y vacunas de amplio espectro, es decir que sirvan para todas las variantes del virus. Ese tiempo tampoco ha servido para que la humanidad pueda unirse y encontrar formas de trabajar en coordinación y con lealtad. Las medidas de bioseguridad, que hasta hoy son el mejor arsenal contra el virus, no han conseguido ser suficientemente efectivas porque: a) la gente no tiene la capacidad de decir "no" a los deseos e invitaciones para festejar y, b) porque no queremos darnos cuenta de que la actualidad , como consecuencia de lo anterior, alrededor del 90 % de los contagios se dan en los círculos familiares, de amigos y de conocidos. Cientos de investigación de todo tipo están en curso, muchos permitirán dar respuesta a interrogantes fundamentales, aunque muchas otras seguirán sin respuesta.


Assuntos
Contenção de Riscos Biológicos , Consultores
9.
Respir Physiol Neurobiol ; 299: 103868, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35150939

RESUMO

Patients admitted to the Intensive Care Unit (ICU) with acute hypoxemic respiratory failure automatically receive oxygen therapy to improve inspiratory oxygen fraction (FiO2). Supplemental oxygen is the most prescribed drug for critically ill patients regardless of altitude of residence. In high altitude dwellers (i.e. in La Paz [≈3,400 m] and El Alto [≈4,150 m] in Bolivia), a peripheral oxygen saturation (SatpO2) of 89-95% and an arterial partial pressure of oxygen (PaO2) of 50-67 mmHg (lower as altitude rises), are considered normal values ​​for arterial blood. Consequently, it has been suggested that limiting oxygen therapy to maintain SatpO2 around normoxia may help avoid episodes of hypoxemia, hyperoxemia, intermittent hypoxemia, and ultimately, mortality. In this study, we evaluated the impact of oxygen therapy on the mortality of critically ill COVID-19 patients who permanently live at high altitudes. A multicenter cross-sectional descriptive observational study was performed on 100 patients admitted to the ICU at the "Clinica Los Andes" (in La Paz city) and "Agramont" and "Del Norte" Hospitals (in El Alto city). Our results show that: 1) as expected, fatal cases were detected only in patients who required intubation and connection to invasive mechanical ventilation as a last resort to overcome their life-threatening desaturation; 2) among intubated patients, prolonged periods in normoxia are associated with survival, prolonged periods in hypoxemia are associated with death, and time spent in hyperoxemia shows no association with survival or mortality; 3) the oxygenation limits required to effectively support the intubated patients' survival in the ICU are between 89% and 93%; 4) among intubated patients with similar periods of normoxemic oxygenation, those with better SOFA scores survive; and 5) a lower frequency of observable reoxygenation events is not associated with survival. In conclusion, our findings indicate that high-altitude patients entering an ICU at altitudes of 3,400 - 4,150 m should undergo oxygen therapy to maintain oxygenation levels between 89 and 93 %.


Assuntos
COVID-19/fisiopatologia , COVID-19/terapia , Cuidados Críticos/normas , Oxigenoterapia/normas , /fisiologia , Adulto , Idoso , Altitude , Bolívia , Cuidados Críticos/métodos , Estado Terminal , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oxigenoterapia/métodos
10.
Viruses ; 14(2)2022 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-35215826

RESUMO

Healthcare workers (HCWs) are at increased risk of SARS-CoV-2 infection. The aim of the study was to estimate the SARS-CoV-2 seroprevalence among HCWs in Cochabamba, Bolivia and to determine the potential risk factors. In January 2021, a cross-sectional SARS-CoV-2 seroprevalence study was conducted in 783 volunteer clinical and non-clinical HCWs in tertiary care facilities. It was based on IgG detection using ELISA, chemiluminiscence, and seroneutralisation tests from dried blood spots. Analysis revealed a high seroprevalence (43.4%) of SARS-CoV-2 IgG antibodies. The combination of anosmia and ageusia (OR: 68.11; 95%-CI 24.83-186.80) was predictive of seropositivity. Belonging to the cleaning staff (OR: 1.94; 95%-CI 1.09-3.45), having more than two children in the same house (OR: 1.74; 95%-CI 1.12-2.71), and having been in contact with a close relative with COVID-19 (OR: 3.53; 95%-CI 2.24-5.58) were identified as risk factors for seropositivity in a multivariate analysis. A total of 47.5% of participants had received medication for COVID-19 treatment or prevention, and only ~50% of symptomatic subjects accessed PCR or antigenic testing. This study confirms a massive SARS-CoV-2 attack rate among HCWs in Cochabamba by the end of January 2021. The main risk factors identified are having a low-skilled job, living with children, and having been in contact with an infected relative in the household.


Assuntos
Anticorpos Antivirais/sangue , COVID-19/epidemiologia , COVID-19/imunologia , Pessoal de Saúde/estatística & dados numéricos , Adolescente , Adulto , Anticorpos Antivirais/imunologia , Bolívia/epidemiologia , Estudos Transversais , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , SARS-CoV-2/imunologia , SARS-CoV-2/patogenicidade , Estudos Soroepidemiológicos , Atenção Terciária à Saúde/estatística & dados numéricos , Adulto Jovem
11.
Lima; Organismo Andino de Salud Convenio Hipólito Unanue; 102; 25 ene, 2022. 3 p.
Não convencional em Espanhol | LILACS, LIVECS | ID: biblio-1381225

RESUMO

Webinar N° 102 del ORAS-CONHU, realizado el 25 de enero de 2022, se realizó un webinar sobre el impacto de la Telesalud en las atenciones de salud en el contexto de la pandemia por COVID-19 en Bolivia, Colombia y Perú. Como reto en nuestra región se resalta: Expandir los avances de la telesalud al campo de la Salud Digital, que permita materializar los ocho principios rectores de la transformación digital del sector de la salud. Conferencistas del webinar: Ernesto Lima, Responsable del Programa de Telesalud, Ministerio de Salud y Deportes de Bolivia, Sandra Gallegos, equipo de la Dirección de Prestación de Servicios y Atención Primaria Ministerio de Salud y Protección Social de Colombia; Bernardette Cotrina, Directora General de Telesalud, Referencia y Urgencias, Ministerio de Salud de Perú.


Assuntos
Telemedicina , COVID-19 , Peru , Venezuela , Bolívia , Chile , Colômbia , Infecções por Coronavirus , Equador
12.
Telemed J E Health ; 28(5): 654-665, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-34382821

RESUMO

Background: There is currently little scientific evidence on the usefulness of implementing strategies against COVID-19 remotely with the help of telemedicine. Objective: Evaluate whether teleconsultation is helpful as an instrument of mediated care in the monitoring and follow-up of individuals with high suspicion of COVID-19 through early detection by the Call Center COVID-19 of the Ministry of Health and Sports, Bolivia. Methodology: Descriptive and cross-sectional observational study of patients captured by the Call Center-COVID-19, who were monitored and followed up in their homes through teleconsultations carried out by the National TeleHealth Program, remotely through information and communication technologies throughout the Bolivian territory during the first 100 days of its implementation. Results: A total of 3,278 patients were studied, recruited between March 16 and June 23, 2020; 49.4% were women, with an overall mean age of 37.5 years (standard deviation [SD] 15.2). The mean detection time was 7.6 days (SD 6.92); 93.8% required home isolation, and only 6.2% were transferred for hospitalization. The mean follow-up time for all patients was 6.7 days (SD 4.87; range 2-38). A total of 75.6% were discharged as recovered patients, and 1.9% died. Conclusions: Early detection of individuals with suspected COVID-19 was achieved, knowing their clinical evolution until their recovery or death. Teleconsultations showed good outcomes at discharge and low fatal outcomes. From these results, it can be inferred that teleconsultation is a valuable tool in the monitoring, evaluation, and follow-up of patients. The Ministry of Health and Sports through Call Center-COVID-19 reinforced the Epidemiological Surveillance System as a passive search tool for possible suspected cases at the national level and decongesting other services in charge of this task.


Assuntos
COVID-19 , Call Centers , Consulta Remota , Telemedicina , Adulto , Bolívia/epidemiologia , COVID-19/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino
13.
J Community Psychol ; 50(6): 2682-2702, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34845739

RESUMO

This study examined whether certain demographic characteristics, caregiver strain, and coping behaviors were associated with the mental health outcomes of family caregivers of children with disabilities in Bolivia during the COVID-19 pandemic. A mixed-methods convergent study design was used with virtual interviews to quantitatively assess caregivers' demographic characteristics, caregiver strain, coping behaviors, and mental health outcomes, as well as qualitatively assess how the pandemic affected their family. Approximately 32%-71% of caregivers experienced poor mental health outcomes (stress, anxiety, and depression), especially among those experiencing poor health, high caregiver strain, and those using maladaptive coping strategies. Qualitative responses revealed that they experienced several unique stressors during the pandemic that affected them and their children. These findings highlight the need for culturally tailored prevention and treatment interventions to help offset the adverse effects of the COVID-19 pandemic on the mental health outcomes of this at-risk population.


Assuntos
COVID-19 , Crianças com Deficiência , Bolívia , Cuidadores/psicologia , Criança , Humanos , Avaliação de Resultados em Cuidados de Saúde , Pandemias , Estresse Psicológico/psicologia
14.
Gac. méd. boliv ; 45(1)2022.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1384997

RESUMO

Resumen Objetivos: analizar las características sociales, educativas, síntomas, de los servicios de salud relacionados a la Covid-19 durante la pandemia en la población boliviana, 2020. Métodos: el tipo de estudio es ecológico, el universo es toda la población boliviana; Una población total de 11 633.371 habitantes, datos recabados por el Instituto Nacional de Estadística (INE) en el 2020, de los nueve departamentos del país, tanto del área urbana como rural, el cálculo de la muestra fue previamente determinada en la encuesta de hogares 2019 por parte del INE. Resultados: el estudio identificó que la tasa de contagio afectó más al área urbana (76,6%) que al área rural (23.4%); En relación al control y manejo de la covid-19 de la población de estudio, su resultado de prueba de laboratorio ha sido positivo (n=1092), que si necesito medicamentos para el tratamiento de la covid-19 (n=1220), en la mitad de la población encuestada, que si se siguió un protocolo para la covid-19 (n=1147). Conclusiones: se evidencia relación entre las características sociales, educativas y de atención y manejo en salud con la covid-19 de la población evaluada durante la pandemia del 2020, sin embargo, se requiere más investigación focalizada de las características ya mencionadas.


Abstract Objectives: To analyze the symptoms and the social and educational characteristics of health services related to Covid-19 during the pandemic in the Bolivian population in the 2020 management. Methods: The study type is ecological, the universe is the entire Bolivian population; an overall estimated of 11 633.371 people, data was collected from the National Institute of Statistics (INE) in 2020, from all nine departments of the country, both urban and rural, the sample calculation was previously determined in the 2019 household survey by the INE. Results: The study found that the infection rate affected the urban area (76.6%) more than the rural area (23.4%); regarding control and management of covid-19 in the study population, it was found that n=1092 people tested positive in the laboratory test, and n=1220 needed medication for covid-19 and half of the surveyed population followed a therapeutic protocol for the management of covid-19 (n=1147). Conclusions: There is evidence of a relationship between social, educational and health care and management characteristics and covid-19 in the population assessed during the 2020 pandemic; however, more focused research is needed on the aforementioned characteristics.

15.
Gac. méd. boliv ; 45(1)2022.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1384999

RESUMO

Resumen Los anticuerpos neutralizantes (NAbs) contra el SARS-CoV-2 están siendo evaluados en humanos. Las respuestas adaptativas específicas de los sujetos asintomáticos o sintomáticos contra el antígeno de SARS-CoV-2, presentan una correlación positiva con la respuesta inmunitaria humoral. Objetivo: evaluar la presencia de anticuerpos contra la proteína específica de la espiga (RBD, dominio de unión al receptor de la proteína de espícula) y NP (nucleoproteína) del virus SARS-CoV-2 en personas que recibieron vacunas anti COVID-19 empleadas en Bolivia. Métodos: durante el año 2021 entre los meses de julio y agosto, se realizó un estudio observacional de tipo transversal, en 150 personas de ambos sexos que fueron reclutadas en los Hospitales: Caja de Seguro Social Militar y Caja Nacional de Salud, para detectar anticuerpos específicos contra las proteínas NP y RBD del virus SARS-CoV-2 responsable de la COVID-19, mediante una prueba inmunocromatográfica cualitativa. Resultados: la presencia de anticuerpos neutralizantes posterior a la aplicación de vacunas contra SARS-CoV-2, como esquema completo, primera dosis, y/o el antecedente de infección, se encontró en el 61 % de las personas agrupadas en la categoría "bajo riesgo laboral" de forma heterogénea en lo referente a anticuerpos RBD, NP o ambas juntas. Conclusiones: la producción de anticuerpos contra la proteína específica de la espiga RBD y NP del virus SARS-CoV-2 muestra una respuesta heterogénea por varios factores como ser, tipo de vacuna, numero de dosis, infección por el COVID-19, disminución de anticuerpo a largo del tiempo, sensibilidad del test y las propiedades intrínsecas de la persona evaluada.


Abstract Neutralizing antibodies (NAbs) against SARS-CoV-2 are being evaluated in humans. The specific adaptive responses of asymptomatic or symptomatic subjects against SARS-CoV-2 antigen show a positive correlation with the humoral immune response. Objective: To evaluate the presence of antibodies against spike specific protein (RBD, receptor binding domain of spike protein) and NP (nucleoprotein) of SARS-CoV-2 virus in people who received anti-COVID-19 vaccines used in Bolivia. Methods: During 2021 between July and August, a cross-sectional observational study was carried out in 150 persons of both sexes who were recruited in the Hospitals: Caja de Seguro Social Militar and Caja Nacional de Salud, to detect specific antibodies against the NP and RBD proteins of the SARS-CoV-2 virus responsible for COVID-19, by means of a qualitative immunochromatographic test. Results: The presence of neutralizing antibodies after the administration of vaccines against SARS-CoV-2, as complete scheme, first dose, and/or history of infection, was found in 61 % of the persons grouped in the category "low occupational risk" in a heterogeneous way regarding RBD antibodies, NP or both together. Conclusions: The production of antibodies against the specific protein of the RBD and NP spike of the SARS-CoV-2 virus shows a heterogeneous response due to several factors such as, type of vaccine, number of doses, infection by COVID-19, antibody decline over time, sensitivity of the test and intrinsic properties of the person evaluated.

17.
La Paz; OPS; 2021-09-02. (OPS/BOL/21-0001).
Não convencional em Espanhol | PAHO-IRIS | ID: phr2-54783

RESUMO

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.


Assuntos
Cooperação Técnica , Sistemas de Saúde , Programas Nacionais de Saúde , Políticas, Planejamento e Administração em Saúde , Cobertura de Serviços de Saúde , Doenças não Transmissíveis , Doenças Transmissíveis , Fatores de Risco , Fatores Socioeconômicos , Saúde Mental , Administração Financeira , Administração em Saúde Pública , COVID-19 , América do Sul , Bolívia
18.
Respir Physiol Neurobiol ; 292: 103709, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34087493

RESUMO

Previous studies suggested that erythropoietin (EPO) may protect against severe COVID-19-induced injuries, ultimately preventing mortality. This hypothesis is based on the fact that, in addition to promoting the increase in red blood cells, EPO is an anti-inflammatory, anti-apoptotic and protective factor in several non-erythropoietic tissues. Furthermore, EPO promotes nitric oxide production in the hypoxic lung and stimulates ventilation by interacting with the respiratory centers of the brainstem. Given that EPO in the blood is increased at high-altitude, we evaluated the serum levels of EPO in critical patients with COVID-19 at "Hospital Agramont" in the city of El Alto (4150 masl) in Bolivia. A total of 16 patients, 15 men, one woman, with a mean age of 55.8 ± 8.49 years, admitted to the Intensive Care Unit were studied. All patients were permanent residents of El Alto, with no travel history below 3000 masl for at least one year. Blood samples were collected upon admission to the ICU. Serum EPO concentration was assessed using an ELISA kit, and a standard technique determined hemoglobin concentration. Only half of the observed patients survived the disease. Remarkably, fatal cases showed 2.5 times lower serum EPO than survivors (2.78 ± 0.8643 mU/mL vs 7.06 ± 2.713 mU/mL; p = 0.0096), and 1.24 times lower hemoglobin levels (13.96 ± 2.56 g/dL vs 17.41 ± 1.61 g/dL; p = 0.0159). While the number of cases evaluated in this work is low, our findings strongly warrant further investigation of EPO levels in COVID-19 patients at high and low altitudes. Our results also support the hypothesis that exogenous EPO administration could help critically ill COVID-19 patients overcome the disease.


Assuntos
Altitude , COVID-19/sangue , Eritropoetina/sangue , Pulmão/diagnóstico por imagem , Idoso , Bolívia , COVID-19/diagnóstico por imagem , COVID-19/mortalidade , Feminino , Hemoglobinas/metabolismo , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , SARS-CoV-2 , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X
19.
Soc Sci Med ; 281: 114040, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34144481

RESUMO

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.


Assuntos
COVID-19 , Saúde Mental , Ferramenta de Busca , Argentina , Bolívia , Chile , Colômbia , Controle de Doenças Transmissíveis , Equador , Guatemala , Honduras , Humanos , América Latina/epidemiologia , México , Pandemias , Peru , SARS-CoV-2 , Uruguai
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