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Benjumea-Bedoya D, Villegas Arbeláez E, Martínez-Peñaloza D, Beltrán-Arroyave CP, Restrepo Gouzy AV, Marín D, Cadavid Álvarez LM, Molinares B, Montes Zuluaga FN, Pulido Duarte H, Suárez Parra PM, Alzate Ángel JC, Vélez-Parra G, Realpe T, Vásquez Villa M, Ríos Buitrago SY, Puerta Zapata J, Arango García LM, Perea Torres Y, Pérez Doncel N, Arbeláez Montoya MP, Robledo J. Implementation of an integrated care strategy for child contacts of tuberculosis patients: a quasi-experimental study protocol. BMC Pediatr 2023; 23:28. [PMID: 36653768 PMCID: PMC9850583 DOI: 10.1186/s12887-022-03798-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/12/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Childhood tuberculosis continues to be a major public health problem. Although the visibility of the epidemic in this population group has increased, further research is needed. OBJECTIVE To design, implement and evaluate an integrated care strategy for children under five years old who are household contacts of bacteriologically confirmed pulmonary tuberculosis patients in Medellín and the Metropolitan Area. METHODS A quasi-experimental study in which approximately 300 children who are household contacts of bacteriologically confirmed pulmonary tuberculosis patients from Medellín and the Metropolitan Area will be evaluated and recruited over one year. A subgroup of these children, estimated at 85, who require treatment for latent tuberculosis, will receive an integrated care strategy that includes: some modifications of the current standardized scheme in Colombia, with rifampicin treatment daily for four months, follow-up under the project scheme with nursing personnel, general practitioners, specialists, professionals from other disciplines such as social work, psychology, and nutritionist. Additionally, transportation and food assistance will be provided to encourage treatment compliance. This strategy will be compared with isoniazid treatment received by a cohort of children between 2015 and 2018 following the standardized scheme in the country. The study was approved by the CIB Research Ethics Committee and UPB. CLINICALTRIALS gov identifier NCT04331262. DISCUSSION This study is expected to contribute to the development of integrated care strategies for the treatment of latent tuberculosis in children. The results will have a direct impact on the management of childhood tuberculosis contributing to achieving the goals proposed by the World Health Organization's End TB Strategy. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT04331262 . Implementation of an Integrated Care Strategy for Children Contacts of Patients with Tuberculosis. Registered 2 April 2020.
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Affiliation(s)
- Dione Benjumea-Bedoya
- Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas, Universidad Pontificia Bolivariana, Medellín, Colombia ,grid.441797.80000 0004 0418 3449Grupo de Investigación en Salud Familiar y Comunitaria, School of Health Sciences, Corporación Universitaria Remington, Medellín, Colombia ,grid.412881.60000 0000 8882 5269Grupo de Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia
| | - Esteban Villegas Arbeláez
- Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Daniela Martínez-Peñaloza
- Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Claudia Patricia Beltrán-Arroyave
- grid.412881.60000 0000 8882 5269Grupo Pediaciencias, Medicine School, Universidad de Antioquia, Medellín, Colombia ,Clínica El Rosario, Medellín, Colombia ,Clínica del Prado, Medellín, Colombia
| | | | - Diana Marín
- grid.412249.80000 0004 0487 2295Grupo de Investigación en Salud Pública, School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia
| | | | - Beatriz Molinares
- grid.413124.10000 0004 1784 5448Hospital Pablo Tobón Uribe, Medellín, Colombia
| | | | | | | | - Juan Carlos Alzate Ángel
- grid.412881.60000 0000 8882 5269Grupo de Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia
| | - Guillermo Vélez-Parra
- grid.411140.10000 0001 0812 5789Hospital General de Medellín, Professor Universidad CES, Medellín, Colombia
| | - Teresa Realpe
- Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Marisol Vásquez Villa
- Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Stefani Yamile Ríos Buitrago
- Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Jenifer Puerta Zapata
- Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Lisandra María Arango García
- Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Yesenia Perea Torres
- Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Natalia Pérez Doncel
- grid.412249.80000 0004 0487 2295School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - María Patricia Arbeláez Montoya
- grid.412881.60000 0000 8882 5269Grupo de Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia
| | - Jaime Robledo
- Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas, Universidad Pontificia Bolivariana, Medellín, Colombia
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González Quiroz DJ, Agudelo Lopez SDP, Arango CM, Acosta JEO, Bello Parias LD, Alzate LU, Hernández Castro C, Medina Lozano AP, Sepúlveda Vergara GD, Giraldo AM, Trujillo-Trujillo J, Pernett Bolaño IDC, Cuellar Segura CM, Arbeláez Montoya MP. Prevalence of soil transmitted helminths in school-aged children, Colombia, 2012-2013. PLoS Negl Trop Dis 2020; 14:e0007613. [PMID: 32678821 PMCID: PMC7390406 DOI: 10.1371/journal.pntd.0007613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 07/29/2020] [Accepted: 07/08/2019] [Indexed: 11/20/2022] Open
Abstract
Background This study aims to establish the prevalence of soil-transmitted helminth (STH) intestinal infections, nutritional status, and anemia in school children aged 7 to 10 years old in the biogeographic provinces of Colombia in 2012–2013. STH prevalence in the country has not been described within the last 30 years and it is needed in order to establish policies its control in the country. Methodology National Survey of STH in school-aged children with a multistage stratified probability sampling was conducted. The overall prevalence and intensity of STH infection, as well as for each parasite, (A. lumbricoides, T. trichiura and hookworms) were calculated for the country and for each of the nine biogeographic provinces. Principal findings Stool samples were collected from 6045 children in eight out of nine biogeographic provinces. The combined prevalence of STH in the country was 29.6%. T. trichiura was the most prevalent helminth (18.4%), followed by A. lumbricoides (11.3%), and hookworms (6.4%). For A. lumbricoides and hookworms, the highest prevalence values were found in the Amazonía province (58.0% and 35.7%, respectively). Regarding STH intensity, most cases showed moderate intensity (41.3%) for A. lumbricoides, and light intensity, for T. trichiura and hookworms. The national prevalence of anemia in school-aged children was 14.2%, lowest in the Nor-Andina province (3.5%), and highest in the Territorios Insulares oceánicos del Caribe province (45.1%). Significance Colombia has a moderate risk of STH infection in school-aged populations, with considerable variation in the prevalence values among the biogeographic provinces. Like any public health issue, this problem should be handled with a comprehensive approach that involves deworming programs and strategies for STH control according to the specific epidemiological and socioeconomic conditions and sanitation service coverage in each biogeographic province. The program should be further supported by intersectoral action to improve living conditions, particularly the excreta disposal, promoted at municipality levels. STH infection (infection by A. lumbricoides, T. trichiura, and hookworms) are endemic in Colombia; however, its prevalence in the country has not been described within the last 30 years. This study determines the prevalence and intensity of STH infections, nutritional status, and anemia in children, using multistage stratified probability sampling. The prevalence result of all STH at national level was 29.6%. T. trichiura was the most prevalent (18.4%), followed by A. lumbricoides (11.3%), and hookworms (6.4%). Comparing the biogeographic provinces (eco-epidemiological zones), Amazonía had the highest STH prevalence. A large spatial variation was found in STH prevalence by province. The study shows that STH infection remains a national public health problem, which requires intervention through nationwide strategies using a comprehensive inter-programmatic approach and prioritizing high-risk areas. These strategies should aim at improving the living conditions associated with the infection while being supported by large-scale anthelmintic chemotherapy.
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Affiliation(s)
- David José González Quiroz
- Epidemiology Group, National School of Public Health, University of Antioquia, Medellin, Colombia
- * E-mail:
| | | | - Catalina María Arango
- Epidemiology Group, National School of Public Health, University of Antioquia, Medellin, Colombia
| | | | - León Darío Bello Parias
- Epidemiology Group, National School of Public Health, University of Antioquia, Medellin, Colombia
| | - Leonardo Uribe Alzate
- Epidemiology Group, National School of Public Health, University of Antioquia, Medellin, Colombia
| | | | | | | | - Adriana Molina Giraldo
- Epidemiology Group, National School of Public Health, University of Antioquia, Medellin, Colombia
| | | | - Ivet Del Carmen Pernett Bolaño
- Knowledge Management Group, Epidemiology and Demography Department, Ministry of Health and Social Protection, Bogotá, Colombia
| | - Claudia Milena Cuellar Segura
- Knowledge Management Group, Epidemiology and Demography Department, Ministry of Health and Social Protection, Bogotá, Colombia
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Villa Vélez L, Arbeláez Montoya MP. Gender Differences in the Interpretation of Experiences of Patients with Tuberculosis in Medellín, Colombia. Invest Educ Enferm 2015; 33:217-225. [PMID: 26535843 DOI: 10.17533/udea.iee.v33n2a04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 04/15/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE This study sought to determine gender differences in the interpretation of tuberculosis (TB) in a group of patients from the city of Medellín. METHODOLOGY This was a qualitative study, with the grounded theory method. Twelve semistructured interviews were applied to patients from both genders who were cured of TB. The sample was selected through convenience and for analysis the information was categorized through the Atlas Ti tool. RESULTS Regarding the symptoms, the most reported is cough, but men manifest expectoration more frequently. Men overstated the symptoms, while women tend to minimize them. Women report mental impairment and emotional-type manifestations produced by the disease. Men and women expressed ignorance about the disease upon diagnosis. Both manifested fear of infection, work incapacity, loss of employment, rejection by others, and death. Also highlighted is the importance of family support and of the healthcare personnel. Women expressed shame in that others knew of their disease and mentioned greater intolerance with taking the medications. CONCLUSION The gender role constructed culturally constitutes the central axis that explains how men and women interpret TB and can be modified by educational and accompaniment processes. Family support plays an important role in the healing process. Although common aspects exist, delving into the gender differences against the interpretation of TB may permit a different approach of the disease and better control of it.
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Arroyave Ospina JC, Alvarez Flórez CM, Correa Arango G, Balcázar Morales N, Arbeláez Montoya MP, Navas Navas MC. Infección por el virus de la hepatitis C en individuos transfundidos antes de 1994 en Antioquia, Colombia. ACTA ACUST UNITED AC 2014. [DOI: 10.22516/25007440.435] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Introducción: la infección por el virus de la hepatitis C es un problema de salud pública. Según datos de la Organización Mundial de la Salud, se estiman 184 millones de casos de infección por VHC en el mundo. El principal factor de riesgo en países en desarrollo corresponde a la transfusión de componentes sanguíneos. En Colombia, en 1993, se reglamentó el tamizaje serológico en los bancos de sangre para diferentes agentes infecciosos, incluido el VHC; sin embargo, los datos de infección por VHC en la población transfundida antes de esta fecha es limitada.
Objetivo: describir la frecuencia de infección por el VHC en una población de individuos transfundidos antes de 1994 en Antioquia.
Materiales y Métodos: un total de 166 individuos transfundidos antes de 1994 aceptaron participar en el estudio. A partir de las muestras de suero se realizó la detección de anticuerpos totales contra el VHC (anti-VHC) mediante prueba de ELISA y en las muestras positivas se determinó la presencia del genoma viral por RT-PCR de la región no codificante 5’.
Resultados y conclusiones: en el población de estudio se encontró una frecuencia de anticuerpos anti-VHC de 6,6% (11/166) y presencia del genoma del VHC en 7/11 de las muestras; el genotipo 1 se identificó en 4 de las muestras. No se encontró asociación de otros factores de riesgo diferentes a transfusión en los individuos con marcadores de infección por el VHC. Este estudio aporta datos a la epidemiología de la infección por el VHC en Colombia.
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Valencia JG, Duarte AVV, Vila ALP, Kremeyer B, Montoya MPA, Linares AR, Acosta CAP, Duque JO, Berrío GB. [Association of Schizophrenia and its Clinical Implications with the NOS1AP Gene in the Colombian Population]. Rev Colomb Psiquiatr 2012; 41:249-272. [PMID: 26573492 DOI: 10.1016/s0034-7450(14)60003-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 05/15/2012] [Indexed: 06/05/2023]
Abstract
INTRODUCTION The nitric oxide synthase 1 adaptor protein (NOS1AP) gene is possibly implicated in schizophrenia etiopathogenesis. OBJECTIVE To determine the association of NOS1AP gene variants with schizophrenia and the relationship of variants with the clinical dimensions of the disorder in the Colombian population. METHODOLOGY It is a case-control study with 255 subjects per group. Markers within the NOS1AP gene were typified as well as other informative material of genetic origin so as to adjust by population stratification. A factorial analysis of the main components for each item in the Scales for Evaluating Negative Symptoms (SENS) together with the Scales for Evaluating Positive Symptoms (SEPS) to determine clinical dimensions. RESULTS Association between the C/C genotype of the rs945713 marker with schizophrenia (OR = 1.79, 95% CI: 1.13 - 2.84) was found. The C/C genotype of the rs945713 was related to higher scores in the "affective flattening and alogia" dimension; and the A/A genotype of the rs4657181 marker was associated to lower scores in the same dimension. CONCLUSIONS Significant associations of markers inside the NOS1AP gene with schizophrenia and the "affective flattening and alogia" clinical dimension were found. These results are consistent with previous studies and support the possibility that NOS1AP influences schizophrenia susceptibility. Furthermore, NOS1AP might be a modifier of schizophrenia clinical characteristics.
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Affiliation(s)
- Jenny García Valencia
- Médica psiquiatra, MSc Epidemiología, PhD Epidemiología, profesora del Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
| | - Ana Victoria Valencia Duarte
- Bióloga, MSc Genética, Aspirante PhD en Biología con énfasis en Genética, profesora de la Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Ana Lucía Páez Vila
- Bióloga, estudiante de MSc en Biología con énfasis en Genética, Laboratorio de Genética Molecular, Universidad de Antioquia, Medellín, Colombia
| | - Bárbara Kremeyer
- Bióloga, PhD Genética, Department of Genetics, Evolution and Environment, University College of London
| | - María Patricia Arbeláez Montoya
- Médica MSc Salud Pública, PhD Epidemiología, profesora del Departamento de Ciencias Básicas, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia
| | | | - Carlos Alberto Palacio Acosta
- Médico psiquiatra, MSc Epidemiología, profesor del Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Jorge Ospina Duque
- Médico Psiquiatra, MSc Epidemiología, profesor del Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Gabriel Bedoya Berrío
- Biólogo, MSc Bioquímica, profesor, coordinador del Laboratorio de Genética Molecular de la Universidad de Antioquia, Medellín, Colombia
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