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Rodríguez JCP, Olivera MJ, Cantillo LA, Chaparro-Narváez P. Changes in the endemic-epidemic pattern of malaria in Colombia, 1978-2021. Rev Soc Bras Med Trop 2024; 57:e00405. [PMID: 38655991 PMCID: PMC11037921 DOI: 10.1590/0037-8682-0364-2023] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 03/08/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Malaria is a major global public health issue with varying epidemiologies across countries. In Colombia, it is a priority endemic-epidemic event included in the national public health policy. However, evidence demonstrating nationwide variations in the disease behavior is limited. This study aimed to analyze changes in the levels and distribution of endemic-epidemic malaria transmission in the eco-epidemiological regions of Colombia from 1978 to 1999 and 2000 to 2021. METHODS We conducted a comprehensive time-series study using official secondary data on malaria-associated morbidity and mortality in Colombia from 1978 to 2021. Temporal-spatial and population variables were analyzed, and the absolute and relative frequency measures of general and regional morbidity and mortality were estimated. RESULTS We observed an 18% reduction in malaria endemic cases between the two study periods. The frequency and severity of the epidemic transmission of malaria varied less and were comparable across both periods. A shift was observed in the frequency of parasitic infections, with a tendency to match and increase infections by Plasmodium falciparum. The risk of malaria transmission varied significantly among the eco-epidemiological regions during both study periods. This study demonstrated a sustained decrease of 78% in malarial mortality. CONCLUSIONS Although the endemic components of malaria decreased slightly between the two study periods, the epidemic pattern persisted. There were significant variations in the risk of transmission across the different eco-epidemiological regions. These findings underscore the importance of targeted public health interventions in reducing malarial morbidity and mortality rates in Colombia.
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Affiliation(s)
| | - Mario Javier Olivera
- Red de Gestión de Conocimiento, Investigación e Innovación en Malaria, Bogotá D.C., Colombia
- Instituto Nacional de Salud, Grupo de Parasitología, Bogotá D.C., Colombia
| | - Luis Acuña Cantillo
- Red de Gestión de Conocimiento, Investigación e Innovación en Malaria, Bogotá D.C., Colombia
- Instituto Nacional de Salud, Grupo de Entomología, Bogotá D.C., Colombia
| | - Pablo Chaparro-Narváez
- Red de Gestión de Conocimiento, Investigación e Innovación en Malaria, Bogotá D.C., Colombia
- Instituto Nacional de Salud, Observatorio Nacional de Salud, Bogotá D.C., Colombia
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Alvis-Zakzuk NJ, Díaz-Jiménez D, Chaparro-Narváez P, Gutiérrez-Clavijo JC, Castillo-Rodríguez L, Edna-Estrada F, Castañeda-Orjuela C, De La Hoz-Restrepo F. Substantial Out-of-Pocket Health Expenditure on Prenatal Check-Ups: Estimates from a Sample of Pregnant Women in Cartagena, Colombia. Clinicoecon Outcomes Res 2022; 14:51-60. [PMID: 35140484 PMCID: PMC8818551 DOI: 10.2147/ceor.s274379] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 04/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE We aimed to estimate out-of-pocket (OOP) health expenditures and the indirect costs related to prenatal check-ups in pregnant women seen in a maternity hospital in the Colombian Caribbean region. METHODS We described the economic costs of pregnant women, with no age limits, who attended prenatal check-ups in a maternity hospital. To estimate OOP and indirect costs owing to prenatal check-ups in pregnant women, a survey was constructed, where the woman was asked about some sociodemographic variables, to characterize those attending the prenatal check-ups. Absolute and relative frequencies, averages and confidence intervals were used to characterize the population and estimate OOP and indirect costs in pregnant women. The latter were estimated from the percentile method. A bootstrapping was performed to reduce the bias within the analysis. RESULTS In total, 56 pregnant women were surveyed, with an average age of 25.9 years (±6.2). All women surveyed had OOP associated to the prenatal check-up in at least one cost-item, and the OOP ranged between $0.3 and $108.7. Transportation was the item with the highest frequency of expenses, followed by food, other expenses, and drugs. The mean of OOP expenditures was $24.3 (CI 95% $18.1-31.4) for women who attended their prenatal check-up. DISCUSSION Considering the estimated OOP health expenditures caused by prenatal check-ups by household income, women living with <1 minimum wage spend 7% of their income in a prenatal check-up. In women with 1-2 and >2-3 minimum wages, these proportions were 5%, 3%, respectively. Unfortunately, this makes prenatal care a significant source of economic burden, impacting poor households in Cartagena.
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Affiliation(s)
- Nelson J Alvis-Zakzuk
- Observatorio Nacional de Salud, Instituto Nacional de Salud, Bogotá, D.C., Colombia
- Departamento de Ciencias de la Salud, Universidad de la Costa-CUC, Barranquilla, Colombia
| | - Diana Díaz-Jiménez
- Observatorio Nacional de Salud, Instituto Nacional de Salud, Bogotá, D.C., Colombia
| | | | | | | | | | | | - Fernando De La Hoz-Restrepo
- Grupo de Evaluación en Epidemiología y Salud Pública, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
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Chaparro-Narváez P, Alvis-Zakzuk NJ, Díaz-Jiménez D, Castañeda-Orjuela C. Trends in diabetes mortality identified from death certificates in Colombia, 1979-2017. Rev Panam Salud Publica 2021; 45:e13. [PMID: 33488685 PMCID: PMC7815170 DOI: 10.26633/rpsp.2021.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 09/21/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe the mortality trends of diabetes mellitus (DM) in Colombia, by sex and age group, from 1979 to 2017. METHODS We carried out an ecological study using mortality data from the Colombian National Administrative Department of Statistics. Crude and age-standardized annual mortality rates per 100 000 people were estimated. Trends of standardized rates were described by sex and age groups. Joinpoint regression models were performed to study mortality trends. RESULTS Throughout the whole period, the total number of DM recorded deaths in Colombia was 200 650, 58% (116 316) in women (p<0.05). The age-standardized mortality rates (ASMR) by sex increased from 13.2 to 26.6 deaths per 100 000 in women and from 10.1 to 22.7 in men from 1979 to 1999. We observed a decrease from 26.6 to 15.4 per 100 000 in women, and from 22.7 to 15.9 in men for the period 1999-2017. The joinpoint regression analysis showed that the average annual percentage change of the period did not vary in both sexes (men: -0.2%, 95% CI -1.0 to 1.4%; women: 0.7%, 95% CI -0.1 to 1.6%). CONCLUSIONS The DM mortality showed a decreasing trend after 2000 in women and 2004 in men. Primary and secondary prevention programs must continue to be strengthened for an earlier diagnosis of diabetes.
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Affiliation(s)
| | | | - Diana Díaz-Jiménez
- Instituto Nacional de SaludBogotáColombiaInstituto Nacional de Salud, Bogotá, Colombia
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Cárdenas-Cárdenas LM, Castañeda-Orjuela CA, Chaparro-Narváez P, Hoz-Restrepo FDL. Individual and climate factors associated with acute respiratory infection in Colombian children. CAD SAUDE PUBLICA 2017; 33:e00028216. [PMID: 29091168 DOI: 10.1590/0102-311x00028216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 01/06/2017] [Indexed: 11/21/2022] Open
Abstract
The objective of this study was to examine the association between acute respiratory infection recall (ARI-recall) and individual and environmental factors such as climate, precipitation, and altitude above sea level in Colombian children. A secondary analysis of 11,483 Colombian children, whose mothers were interviewed in the 2010 National Demographic and Health Survey, was carried out. The outcome variable was the mother's or caregiver's ARI-recall. The independent variables were expressed at individual, cluster, and municipal levels. At the individual level, we considered health and individual characteristics of the children; at cluster level, we incorporated the altitude above sea level; and at the municipal level, we included precipitation and annual average climate. The association between ARI-recall and independent variables was assessed using a multilevel logistic regression model. ARI-recall was significantly associated with age (OR = 0.61; 95%CI: 0.48-0.79), belonging to an indigenous group (OR = 1.51; 95%CI: 1.16-1.96), and a medium or very poor wealth index (OR = 2.03; 95%CI: 1.25-3.30 and OR = 1.75; 95%CI: 1.08-2.84, respectively). We found interaction between acute child malnutrition and average annual precipitation. Children with acute malnutrition and from municipalities with high annual precipitation had significantly 3.6-fold increased risk of ARI-recall (OR = 3.6; 95%CI: 1.3-10.1). Individual conditions and precipitation are risk factors for ARI-recall in Colombian children. These results could be useful to understand ARI occurrence in children living in tropical countries with similar characteristics.
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Chaparro-Narváez P, Cotes-Cantillo K, Castañeda-Orjuela C, De la Hoz-Restrepo F. Response to Letter to the Editor: 'Ocular burns due to fireworks in Colombia: A neglected public health issue'. Burns 2016; 43:452-454. [PMID: 27919510 DOI: 10.1016/j.burns.2016.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 11/15/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Pablo Chaparro-Narváez
- Colombian National Health Observatory, Instituto Nacional de Salud, Avenida calle 26 No. 51-20 - Zona 6 CAN, Bogotá, D.C., Colombia
| | - Karol Cotes-Cantillo
- Colombian National Health Observatory, Instituto Nacional de Salud, Avenida calle 26 No. 51-20 - Zona 6 CAN, Bogotá, D.C., Colombia.
| | - Carlos Castañeda-Orjuela
- Colombian National Health Observatory, Instituto Nacional de Salud, Avenida calle 26 No. 51-20 - Zona 6 CAN, Bogotá, D.C., Colombia
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Chaparro-Narváez P, Cotes-Cantillo K, Castañeda-Orjuela C, De la Hoz-Restrepo F. Injuries due to fireworks use: A surveillance data analysis in Colombia, 2008-2013. Burns 2016; 43:149-156. [PMID: 27576924 DOI: 10.1016/j.burns.2016.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 09/24/2015] [Revised: 05/02/2016] [Accepted: 07/17/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE To describe the injuries due to fireworks use in Colombia during the period 2008-2013 and to identify factors associated with hospitalization and death due to this cause. METHODS A descriptive study from surveillance data was carried out. Incidence rates and relative risks were calculated. The incidence rate trend was modeled with a joint point regression model. Multivariate logistical models were implemented to identify the associated factors with hospitalization and mortality due to firework injuries. RESULTS A total of 6585 people were reported to be injured by fireworks during the 2008-2013 period. An upward trend in the incidence rate during this period was observed, with an annual percentage of change of 28% (95% CI 27.7-28.3) during 2008-2011 and 3.5% (95% CI 3.0-3.9) during 2011-2013. The factors associated with hospitalization were injury occurrence at the workplace (odds ratio (OR) 2.62, 95% CI 1.97-3.47), storage (OR 2.40, 95% CI 1.54-3.73), transport (OR 1.63, 95% CI 1.20-2.21), multiple trauma (OR 1.49, 95% CI 1.31-1.70), and injury occurrence at home (OR 1.26, 95% CI 1.07-1.50). The factors associated with mortality were storage (OR 19.52, 95% CI 4.62-82.44), transport (OR 13.37, 95% CI 3.29-54.3), injury occurrence at the workplace (OR 4.88, 95% CI 1.69-14.13), and ethnicity (OR 3.37, 95% CI 1.12-10.12). CONCLUSION These results provided information for revising the public policies and intersectorial interventions to reduce the avoidable burden due to firework injuries at all times and not just during the high injury occurrence season.
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Affiliation(s)
- Pablo Chaparro-Narváez
- Colombian National Health Observatory, Instituto Nacional de Salud, Avenida calle 26 No. 51-20 - Zona 6 CAN, Bogotá, D.C., Colombia
| | - Karol Cotes-Cantillo
- Colombian National Health Observatory, Instituto Nacional de Salud, Avenida calle 26 No. 51-20 - Zona 6 CAN, Bogotá, D.C., Colombia.
| | - Carlos Castañeda-Orjuela
- Colombian National Health Observatory, Instituto Nacional de Salud, Avenida calle 26 No. 51-20 - Zona 6 CAN, Bogotá, D.C., Colombia
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Castellanos A, Chaparro-Narváez P, Morales-Plaza CD, Alzate A, Padilla J, Arévalo M, Herrera S. Malaria in gold-mining areas in Colombia. Mem Inst Oswaldo Cruz 2016; 111:59-66. [PMID: 26814645 PMCID: PMC4727437 DOI: 10.1590/0074-02760150382] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 11/19/2015] [Indexed: 11/22/2022] Open
Abstract
Gold-mining may play an important role in the maintenance of malaria worldwide.
Gold-mining, mostly illegal, has significantly expanded in Colombia during the last
decade in areas with limited health care and disease prevention. We report a
descriptive study that was carried out to determine the malaria prevalence in
gold-mining areas of Colombia, using data from the public health surveillance system
(National Health Institute) during the period 2010-2013. Gold-mining was more
prevalent in the departments of Antioquia, Córdoba, Bolívar, Chocó, Nariño, Cauca,
and Valle, which contributed 89.3% (270,753 cases) of the national malaria incidence
from 2010-2013 and 31.6% of malaria cases were from mining areas. Mining regions,
such as El Bagre, Zaragoza, and Segovia, in Antioquia, Puerto Libertador and
Montelíbano, in Córdoba, and Buenaventura, in Valle del Cauca, were the most endemic
areas. The annual parasite index (API) correlated with gold production (R2
0.82, p < 0.0001); for every 100 kg of gold produced, the API increased by 0.54
cases per 1,000 inhabitants. Lack of malaria control activities, together with high
migration and proliferation of mosquito breeding sites, contribute to malaria in
gold-mining regions. Specific control activities must be introduced to control this
significant source of malaria in Colombia.
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Affiliation(s)
| | | | | | - Alberto Alzate
- Malaria Vaccine and Drug Development Centre, Cali, Colombia
| | - Julio Padilla
- Ministry of Health and Social Protection, Bogotá, Colombia
| | - Myriam Arévalo
- Malaria Vaccine and Drug Development Centre, Cali, Colombia
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Chaparro-Narváez P, Castañeda-Orjuela C. [Mortality due to pesticide poisoning in Colombia, 1998-2011]. Biomedica 2015; 35 Spec:90-102. [PMID: 26535745 DOI: 10.1590/s0120-41572015000500010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 03/25/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Poisoning due to pesticides is an important public health problem worldwide due its morbidity and mortality. In Colombia, there are no exact data on mortality due to pesticide poisoning. OBJECTIVE To estimate the trend of mortality rate due to pesticide poisoning in Colombia between 1998 and 2011. MATERIALS AND METHODS We carried out a descriptive analysis with the database reports of death as unintentional poisoning, self-inflicted intentional poisoning, aggression with pesticides, and poisoning with non-identified intentionality, population projections between 1998 and 2011, and rurality indexes. Crude and age-adjusted mortality rates were estimated and trends and Spearman coefficients were evaluated. RESULTS A total of 4,835 deaths were registered (age-adjusted mortality rate of 2.38 deaths per 100,000 people). Mortality rates were higher in rural areas, for self-inflicted intentional poisoning, in men and in age groups between 15 and 39 years old. The trend has been decreasing since 2002. Municipality mortality rates due to unintentional poisoning and aggression correlated significantly with the rurality index in less rural municipalities. CONCLUSIONS Mortality rates due to pesticide poisoning presented a mild decrease between 1998 and 2011. It is necessary to adjust and reinforce the measures conducive to reducing pesticide exposure in order to avoid poisoning and reduce mortality.
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