1
|
Jaime Trujillo C, Herrera Olano N, Rico Gutiérrez K, Medellín D, Sánchez P, Mesa-Rubio ML, Naranjo MS, Moreno SM, Bonilla C, Barrera P, Restrepo-Gualteros SM, Mejia LM, Baquero OL, Piñeros JG, Ramírez Varela A. COVID-19 in children and the influence on the employment activity of their female caregivers: A cross sectional gender perspective study. Front Glob Womens Health 2023; 3:1021922. [PMID: 36817870 PMCID: PMC9928962 DOI: 10.3389/fgwh.2022.1021922] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/20/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction During the COVID-19 pandemic, women disproportionately assume more unpaid activities, affecting their employment. Objective Describe the influence of COVID-19 on the employment of caregivers of children and adolescents from a gender perspective. Methods Cross-sectional study in three high-complexity hospitals in Bogotá, Colombia from April 2020 to June 2021. A subsample of the FARA cohort was taken, including those patients with a positive test for SARS-COV2. We took as our analysis category children older than 8 years and younger than 18 years who had a positive SARS-COV2 test, as well as, caregivers of all children with a positive SARS-COV2 test. This subsample was drawn from the FARA cohort. A survey was applied to them. We carried out a descriptive and stratified analysis by age group, educational, and socioeconomic level. Results We included 60 surveys of caregivers and 10 surveys of children. The main caregiver in 94.8% of the cases was a female. At the beginning of the pandemic, 63.3% of the caregivers were employed, and 78.9% of those lost their employment. The vast majority of these caregiver were women (96.6%, n = 29). A predominance of loss of work activity was documented in caregivers of children in early childhood 66.6% (n = 20), with lower education 66.6% (n = 20), and from lower strata 56.6% (n = 17). Conclusion Caregivers of children with COVID-19 with low educational levels and lower socioeconomic conditions, as well as those with children under 5 years showed greater likelihood of employment loss between the interviewed subsample.
Collapse
Affiliation(s)
- Catalina Jaime Trujillo
- Pediatrics Residency Program, Universidad de los Andes and Department of Pediatrics, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Natalia Herrera Olano
- Pediatrics Residency Program, Universidad de los Andes and Department of Pediatrics, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Kevin Rico Gutiérrez
- Pediatrics Residency Program, Universidad de los Andes and Department of Pediatrics, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Daniela Medellín
- Pediatrics Residency Program, Universidad de los Andes and Department of Pediatrics, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Paola Sánchez
- Pediatrics Residency Program, Universidad de los Andes and Department of Pediatrics, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | - Melisa Sofía Naranjo
- Department of Epidemiology, School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Sergio Mauricio Moreno
- Department of Epidemiology, School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Carolina Bonilla
- Pediatrics Residency Program, Universidad de los Andes and Department of Pediatrics, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Pedro Barrera
- Pediatrics Residency Program, Universidad de los Andes and Department of Pediatrics, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Sonia M. Restrepo-Gualteros
- Pediatrics Residency Program, Universidad de los Andes and Department of Pediatrics, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | | | - Juan Gabriel Piñeros
- Pediatrics Residency Program, Universidad de los Andes and Department of Pediatrics, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Andrea Ramírez Varela
- Department of Epidemiology, School of Medicine, Universidad de Los Andes, Bogotá, Colombia,Correspondence: Andrea Ramirez Varela
| |
Collapse
|
2
|
Vargas Muñoz SM, De Vivero Haddad S, Beltran AM, Bonilla Gonzalez C, Naranjo Vanegas M, Moreno-Lopez S, Rueda-Guevara P, Barrera P, Piñeros JG, Mejía LM, Mesa ML, Restrepo-Gualteros S, Baquero Castañeda OL, Ramírez Varela A. Incidence, etiology, sociodemographic and clinical characterization of acute respiratory failure in pediatric patients at a high-altitude city: A multicenter cohort study. Front Pediatr 2022; 10:1009375. [PMID: 36619524 PMCID: PMC9815757 DOI: 10.3389/fped.2022.1009375] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/11/2022] [Indexed: 12/23/2022] Open
Abstract
Background Acute respiratory failure is a life-threatening medical condition, associated with a variety of conditions and risk factors, including acute respiratory diseases which are a frequent cause of pediatric morbidity and mortality worldwide. In Colombia, the literature related to ARF is scarce. Objective To determine the incidence, causes, and sociodemographic and clinical characteristics of ARF in three hospitals in Bogota, a high-altitude city located in Colombia, during the COVID-19 pandemic. Methods A multicenter prospective cohort study called the FARA cohort was developed between April 2020 - December 2021. Patients older than one month and younger than 18 years with respiratory distress who developed ARF were included. Results 685 patients with respiratory distress were recruited in 21 months. The incidence density of ARF was found to be 41.7 cases per 100 person-year CI 95%, (37.3-47.7). The median age was 4.5 years.. Most of the patients consulted during the first 72 h after the onset of symptoms. Upon admission, 67.2% were potentially unstable. The most frequent pathologies were asthma, bronchiolitis, pneumonia, and sepsis. At admission, 75.6% of the patients required different oxygen delivery systems, 29,5% a low-flow oxygen system, 36,8% a high-flow oxygen system, and 9,28% invasive mechanical ventilation. SARS-COV-2, respiratory syncytial virus, rhinovirus/enterovirus, and adenovirus were the most frequently isolated viral agents. The coinfection cases were scarce. Conclusions This multicenter study, the FARA cohort, developed at 2,600 meters above sea level, shows the first data on incidence, etiology, sociodemographic and clinical characterization in a pediatric population with ARF that also concurs with the COVID-19 pandemic. These results, not only have implications for public health but also contribute to the scientific and epidemiological literature on a disease developed at a high altitude.
Collapse
Affiliation(s)
- Sarha M. Vargas Muñoz
- Department of Pediatrics, Universidad de los Andes, Medical School, Bogotá, Colombia
| | - Sara De Vivero Haddad
- Department of Pediatrics, Universidad de los Andes, Medical School, Bogotá, Colombia
| | - Aldo M. Beltran
- Department of Pediatrics, Universidad de los Andes, Medical School, Bogotá, Colombia
| | | | - Melisa Naranjo Vanegas
- Department of Public Health, Faculty of Science, Universidad de los Andes, Bogotá, Colombia
| | - Sergio Moreno-Lopez
- Department of Public Health, Faculty of Science, Universidad de los Andes, Bogotá, Colombia
| | - Paola Rueda-Guevara
- Department of Public Health, Faculty of Science, Universidad de los Andes, Bogotá, Colombia
| | - Pedro Barrera
- Pediatric Intensive Care Unit, Medical Epidemiologist, Fundación Santa Fe de Bogotá University, Bogotá, United States, Colombia
| | | | | | | | | | | | | |
Collapse
|
3
|
Grisales-Romero HDJ, Montealegre N, Piñeros JG, Ospina D, Nieto E. Relación de PM2,5 y Enfermedad Respiratoria Aguda en un territorio de Colombia: Modelos Aditivos Generalizados. Univ Salud 2021. [DOI: 10.22267/rus.222401.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introducción: El efecto deletéreo de material particulado fino exterior sobre la salud respiratoria de la población de niños y de adultos mayores, es de interés en salud pública. Objetivo: Establecer el efecto de la contaminación por Material Particulado de menos de 2,5 μm de diámetro (PM2,5), sobre la Enfermedad Respiratoria Aguda (ERA) en los menores de 5 y personas de mínimo 65 años, ajustado por variables meteorológicas y climáticas, en los municipios del Área Metropolitana del Valle de Aburrá (Colombia), 2008 a 2015. Materiales y métodos: Estudio ecológico con información de la red de vigilancia de calidad del aire y de registros de prestación de servicios de salud. Se construyeron Modelos Aditivos Generalizados con función de enlace Poisson y suavización spline. Para cada rezago distribuido se calculó la medida de la asociación e intervalo de confianza. Resultados: Los casos de ERA aumentaron significativamente en los menores de 5 años en Envigado y Caldas (43,3% vs 29,6%) y en los de 65 y más años, en Medellín (13,2%) por cada incremento de 10 µg/m3 en PM2.5 al día quince a partir de la exposición. Conclusiones: Los eventos diarios respiratorios tuvieron especial frecuencia en Medellín y en municipios de la zona sur.
Collapse
|
4
|
Piñeros JG, De la Hoz-Valle J, Galvis C, Celis A, Ovalle O, Sandoval CC, Orrego J, Vides S, Rojas I, Bustamante H, Gallón C, Mesa JA. Effectiveness of palivizumab immunoprophylaxis in infants with respiratory syncytial virus disease in Colombia. J Infect Dev Ctries 2021; 15:1708-1713. [PMID: 34898500 DOI: 10.3855/jidc.12561] [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] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 02/13/2021] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Respiratory syncytial virus (RSV) is one of the most important childhood infections. OBJECTIVE To evaluate the effectiveness and safety of palivizumab immunoprophylaxis in preterm infants at a high risk of severe respiratory syncytial virus infection during the RSV season in Colombia. METHODOLOGY A prospective observational non-comparative multicenter study in six Colombian cities. At the beginning of the RSV infection season, palivizumab prophylaxis, up to five doses, was administered to infants born at ≤32 weeks of gestation, infants younger than six months, infants under one year of age with bronchopulmonary dysplasia (BPD), infants one year or less of age with hemodynamically significant acyanotic and non-acyanotic congenital heart disease (CHD), and with follow-up during the immunoprophylaxis until one month after the last dose. RESULTS The study enrolled 600 patients, 91.8% of which were born at ≤ 32 weeks of gestation. BPD was observed in 54.9% of infants. 49% were born at < 32 weeks gestation and presented BPD. 6.9% had hemodynamically significant acyanotic and non-acyanotic CHD 53.3% received three or more doses of palivizumab. The mean interval between doses was 39.6 days. 1.8% of patients were hospitalized due to a confirmed RSV infection. Overall mortality was 1.2%, whereas the mortality by RSV in infants undergoing prophylaxis was 0.2%. CONCLUSIONS Palivizumab was a clinically effective, well-tolerated treatment in the Colombian population. The safety profile of palivizumab reflects the findings from previous studies in developed countries.
Collapse
Affiliation(s)
| | | | | | | | - Oscar Ovalle
- Maternal and Child Clinic, SaludCoop. Bogota Colombia
| | | | | | - Saby Vides
- Coomeva Kangaroo Plan, Bucaramanga, Colombia
| | | | | | | | - Jaime Alberto Mesa
- Comfamiliar Risaralda Clinic, Technological University of Pereira, Colombia
| |
Collapse
|
5
|
Abstract
Talipes equinovarus, atrial septal defect, Robin sequence and persistent left superior vena cava (TARP) syndrome is a congenital disease caused by mutations in the RBBM10 gene. It has a low prevalence and a high rate of mortality in the neonatal stage. In this case report, we present a case of a 32-week gestational age preterm newborn with a prenatal diagnosis of intrauterine growth restriction, with a persistent left superior vena cava, interatrial communication and a horseshoe kidney. Additionally, postnatal optic nerve atrophy was diagnosed. By using exome sequencing, the pathogenic variant c.1877del; p.his626Lefus*78 was identified in the RMB10 gene. Due to a lack of reports in the medical literature, the phenotype has not fully been described. Here, we report on a patient with TARP syndrome and a previously unreported mutation, c.1877del; p.his627Leufs*78, which is predicted to generate a truncated and/or protein decay of the RBM10 transcript.
Collapse
Affiliation(s)
- Hernan Manotas
- Department of Pediatrics at Fundación Santa Fé de Bogotá, Hospital Universitario de la Fundacion Santa Fe de Bogota, Bogota, Colombia
| | - César Payán-Gómez
- Faculty of Natural Sciences, Universidad del Rosario, Bogota, Colombia
| | - Maria Fernanda Roa
- Department of Pediatrics at Fundación Santa Fé de Bogotá, University Hospital of the Fundacion Santa Fe de Bogota, Bogota, Colombia
| | - Juan Gabriel Piñeros
- Department of Pediatrics at Fundación Santa Fé de Bogotá, Hospital Universitario de la Fundacion Santa Fe de Bogota, Bogota, Colombia
| |
Collapse
|
6
|
Olivella A, Manotas H, Payán-Gómez C, Piñeros JG. Ebstein anomaly associated with cri du chat (cat's cry) syndrome and 20q duplication. BMJ Case Rep 2020; 13:13/6/e233766. [PMID: 32487530 DOI: 10.1136/bcr-2019-233766] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Ebstein anomaly is a congenital heart defect with a low prevalence and high mortality in the early stages of life. In medical literature, there is no reported association between Ebstein anomaly and cri du chat syndrome. Here, we report the case of a full-term newborn with a low weight for his age and who had a prenatal diagnosis of Ebstein anomaly and a postnatal diagnosis of cri du chat syndrome and 20q duplication detected on array CGH. The patient required medical treatment with inotropic support, high-frequency ventilation and nitric oxide, with an adequate response. Surgical intervention was not needed.
Collapse
Affiliation(s)
| | - Hernan Manotas
- Department of Pediatrics, Neonatology, Fundacion Santa Fe de Bogota Hospital Universitario, Bogota, Colombia
| | - César Payán-Gómez
- Department of Biology, Faculty of Natural Sciences and Mathematics, Universidad del Rosario, Bogota, Colombia
| | - Juan Gabriel Piñeros
- Department of Pediatrics, Neonatology, Fundacion Santa Fe de Bogota Hospital Universitario, Bogota, Colombia
| |
Collapse
|
7
|
Piñeros JG, Baquero H, Bastidas J, García J, Ovalle O, Patiño CM, Restrepo JC. Respiratory syncytial virus infection as a cause of hospitalization in population under 1 year in Colombia. J Pediatr (Rio J) 2013; 89:544-8. [PMID: 24029550 DOI: 10.1016/j.jped.2013.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [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: 12/10/2012] [Accepted: 04/10/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE to determine the frequency, complications and seasonality at which respiratory syncytial virus (RSV) infection of the lower respiratory tract causes hospitalization in infants of age 1 year or less in 6 cities of Colombia. METHODS one-year prospective multicentric observational study that included 717 patients presenting to the emergency department with respiratory symptoms in 6 cities of Colombia. Hospitalized children were tested for RSV with an immunofluorescence rapid test in nasopharyngeal secretions. Descriptive and statistical analyses of the population were conducted. RESULTS the study population included 717 patients with a mean age of 3.6 months (SD 3.25), 4:3 male: female ratio and a positive RSV LRTI prevalence of 30.0% (216 infants/City, range 26.0 - 49.0%). Risk factors for RSV LRTI were found in 8.2% of the population, of which 28.8% were RSV positive. RSV positive and negative groups were compared using a two-tailed t test with 95.0%CI, p < 0.05. No statistically significant differences were found. All cities presented specific year trimesters in the occurrence of RSV LRTI. CONCLUSIONS the RSV caused 1 in 3 LRTI hospitalizations in the population, with an incidence of 30.0%. This confirms a continuous circulation of RSV in Colombia varying by geographic location.
Collapse
|
8
|
Piñeros JG, Tobon-Castaño A, Alvarez G, Portilla C, Blair S. Maternal clinical findings in malaria in pregnancy in a region of northwestern Colombia. Am J Trop Med Hyg 2013; 89:520-6. [PMID: 23897991 DOI: 10.4269/ajtmh.12-0205] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In malaria-endemic regions of Latin America, little is known about malaria in pregnancy. To characterize the clinical and laboratory findings of maternal infection, we evaluated 166 cases of pregnant women infected with Plasmodium spp. in a prospective study conducted in northwestern Colombia during 2005-2006. A total of 89.8% (149 of 166) had fever or a history of fever in the past 48 hours, 9.0% (15 of 166) had severe malaria, of which 66.7% was caused by Plasmodium vivax and 33.3% by P. falciparum. Hepatic dysfunction was the main complication (9 of 15) observed. The proportion of severe cases was similar for both species (P = 0.41). In malaria-endemic areas of Colombia, malaria in pregnancy has a broad clinical spectrum. In pregnant women, P. vivax infection frequently leads to organ-specific complications.
Collapse
|
9
|
Piñeros JG. [Malaria and social health determinants: a new heuristic framework from the perspective of Latin American social medicine]. Biomedica 2010; 30:178-187. [PMID: 20890565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Accepted: 12/09/2009] [Indexed: 05/29/2023]
Abstract
Traditionally, malaria research and study have followed the positivist scientific paradigm and its biomedical conception of disease. From this perspective, diverse control actions and strategies have been designed. However, despite a century of scientific experience and the depth and thoroughness achieved in the knowledge of malaria, this has not been translated into a constant and progressive decrease of its epidemiological burden. This essay argues for the need for a change in malaria conception, reconfiguring it as a process of biological and social character, where the geno-phenotypical possibilities of the host-parasite relationship and of the diseases clinical expression are articulated with the historic and social dynamics of the spaces in which they occur. In addition, it proposes rethinking the epidemiological research of this entity on the basis of the visualization of the dynamic, heterogeneous, dialectic and complex character of biosocial organizations that constitute the reality of malaria (from the social structure to the genetic and phenotypic level of parasite individuals, vectors and humans). To achieve this, it is suggested that: 1) the Latin American perspective on the social determinants of health be adopted; 2) new analytical categories (for instance, malaria social territory) and new investigation tools (matrices of critical processes of social determination) be incorporated, and 3) the conventional epidemiological categories of infectious diseases such as the transmission and infectiousness be reinterpreted.
Collapse
|
10
|
Blair S, López ML, Piñeros JG, Alvarez T, Tobón A, Carmona J. [Therapeutic efficacy of 3 treatment protocols for non-complicated Plasmodium falciparum malaria, Antioquia, Colombia, 2002]. Biomedica 2003; 23:318-27. [PMID: 14582335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
High resistance of Plasmodium falciparum malaria to chloroquine poses malaria as a major public health problem in Colombia. In this context, the therapeutic response of uncomplicated P. falciparum malaria patients to chloroquine (CQ), sulfadoxine/pirymethamine (SDXP) and combined therapy (SDXP/CQ) was evaluated according to the WHO/PAHO protocols of 1998. The comparisons were based on a sample of 160 patients with uncomplicated P. falciparum malaria in Turbo and Zaragoza (Antioquia, Colombia). Patients were randomly assigned each of the treatment categories. The results were statistically similar in each municipality. In Turbo percentage of treatment failure was 87.5%, 22.2% and 22.6% for CQ, SDXP and SDXP/CQ, respectively, whereas in Zaragoza, the corresponding treatment failure was 77.7%, 26.5% and 12.1%. During follow up, 50% of subjects with late treatment failure were asymptomatic in Turbo, while 33.3% were asymptomatic in Zaragoza. A high level of treatment failure occurred with CQ monotherapy, while SDXP and SDXP/CQ had acceptable levels of failure, i.e., below 25%. The high percentage of late treatment failure in asymptomatic patients may contribute to increased risk of persistent transmission.
Collapse
Affiliation(s)
- Silvia Blair
- Grupo de Malaria, Universidad de Antioquia, Medellín, Colombia.
| | | | | | | | | | | |
Collapse
|