Población y Salud en Mesoamérica

Anthropometric and biochemical profile of adults who attended the “Programa de Educación y Atención Nutricional Universitario” of the University of Costa Rica, 2018-2019

Natalia Valverde Vindas — 2024-09-10

Introduction: obesity represents one of the main risk factors for the development of other metabolic and cardiovascular conditions. Knowing the anthropometric and biochemical profile of an individual allows the nutrition professional to optimize their care and focus their work not only on treatment but on the prevention of other possible associated comorbidities. Methodology: a cross-sectional and descriptive study was conducted with a quantitative methodological approach, with a data base of 196 nutritional files of adults, sociodemographic information, data on biochemical variables and anthropometric measures were analyzed. Results: 83.1 % of patients presented some degree of excess weight, 75 % high percentage of body fat, 52.6 % showed high risk of developing metabolic and cardiovascular diseases according to waist circumference. In addition, 83.67 % presented at least one of the lipid parameters outside normal limits and 25.51 % of patients had fasting hyperglycemia. Conclusion: the results obtained in the study agree with the national reality of the Costa Rican adult population, this may be associated with poor eating habits and lifestyle. Adult patients treated have nutritional problems such as overweight, obesity and alterations in the lipid and glycemic profile, which increases their cardiovascular and metabolic risk.

Wood extraction in the Brazilian caatinga region and the risks to rural workers

Cristina da Silva Fernandes — 2024-10-30

Objective: To describe the work process of rural workers during logging and the occupational risks involved. Method: A qualitative, descriptive-exploratory study carried out in the municipality of Cariré, Ceará, with 10 rural workers. Data was collected through semi-structured interviews and direct observation. The analysis was based on Minayo's theoretical framework. Results: The work of the extractivists involves selecting sites for camping, after leasing land; building roads to transport timber, extracting, transporting and burning waste. These workers, who have no formal employment relationship, face substandard working conditions and are exposed to various risks, such as excessive solar radiation, handling sharp tools, exposure to smoke, bites from venomous animals, and intense physical effort, without the proper use of Personal Protective Equipment. Conclusion: The study highlights the urgent need for public health policies that guarantee comprehensive and universal protection for rural workers, with a view to reducing occupational risks and improving working conditions.

Effect of the conditional cash transfer program on the incidence of pulmonary tuberculosis in Dominican Republic (2012-2018)

Francisco Martín Duarte Duarte — 2024-09-18

Introduction: Pulmonary tuberculosis is a public health problem in several countries in Latin America and the world, due to its high incidence and social impact. The objective of this study was to evaluate the impact of the CCT program on the incidence of pulmonary tuberculosis (PTB) in Health Region III of the Dominican Republic during 2012-2018. Method: An observational study with a mixed ecological design was carried out. New cases of TBP and social programs were analyzed. The coverage of social programs was the main variable, and the TBP incidence rate was the dependent variable. Other covariates were considered. Results: The results showed that the TBP incidence rate did not decrease in Health Region III despite an increase in the coverage of CCT social programs and a decrease in the poverty level. The CCT "Eating First" program had a significant impact on reducing poverty and other social determinants in Health Region III. Conclusions: Our findings support previous research suggesting that CCT programs are effective in reducing poverty and addressing some social determinants of health. However, they do not support the use of CCTs as an isolated measure to reduce new cases of TBP, since poverty must be addressed in a comprehensive, holistic and inclusive manner to achieve a more significant impact on diseases with high prevalence and endemicity.

The fertility behavior in the regions of Argentina between 2010 and 2021: Changes in the reproductive calendar of populations

Víctor Francisco Loyola — 2024-09-10

Introduction: Between 2001 and 2014, fertility in Argentina showed little variation. Subsequently, from 2015 to 2021, there was a sharp decline, placing its total fertility rate (TFR) below 2.1 children per woman from 2018 onwards. This study analyzes the regional dynamics of these changes, considering modifications in the reproductive calendar. Methodology: A quantitative analysis is presented where TFR, specific fertility rates (SFR), non-conditioned TFR by birth order (TFRi), general mean ages at maternity (MAM) and mean ages at first maternity (MAM1), and TFR adjusted for tempo effects (TFR*) are calculated. Births by maternal age and birth order were provided by the Directorate of Statistics and Health Information (DEIS) of the Ministry of Health, and population estimates were obtained from projections calculated by INDEC. Results: Between 2010 and 2014, regions experienced slight declines in fertility, with relatively stable MAM and TFR* trends. From 2015 to 2021, all regions positioned their TFR below 2.1 children per woman, concentrated most births in the 25-29 age group of women, and showed increases in tempo effects. Conclusions: The significant recent reduction in fertility in Argentina's regions is estimated to be associated with delayed reproductive timing.

The importance of approach the birth plan during prenatal care in basic health units Amazon

Mara Cristiany Rodrigues Spinola — 2024-11-13

Introduction: The Birth Plan (BP) is a document prepared by the pregnant Woman tongether with the professional who is accompanying her in her pregnancy process, Where you can list your choices regarding childbirth and first care for the newborn, providing her with the leading role and effective participation in all decisions regarding her pregnancy Objective:Report the importance of approaching the Birth Plan in basic units during prenatal care. Material and Methods: This is a field research with a qualitative approach, developed in 3 basic health units in the municipality of Santarem, inthe state of Pará. Results and discussions: During the interviews with the professionals, it was evident that although the nurses recognized the importance of the PP, the low adherence to the document is due to the professionals' lack of knowledge about it, as well as the lack of support from the municipal management and maternity hospitals in the continuity of care for this pregnant woman.Conclusion: The birth plan is an extremely important tool, but little used or commented on by the professionals who work directly in the program. Thus, there is an undeniable need for greater encouragement from professionals to adhere to this tool and for there to be effective support from maternity hospitals and from the municipal management itself, so that it is effective and continuity is given to the assistance to these pregnant women and, in this way, that they have their rights guaranteed and live a positive experience in relation to childbirth.

“Between arepas and cazuelas”: daily eating habits of the sons and daughters of Venezuelan migrant mothers in Chile

Lucia Odette Castillo — 2024-10-31

Introduction: The increase in Venezuelan migration, its tendency towards feminization, as well as the number of children and adolescents belonging to Venezuelan migrant families in Chile, invite an intercultural reflection on parenting practices, which involves feeding practices, given their health and social connotation. Methodology: Qualitative supported by the assumptions of symbolic interactionism. Semi-structured interviews were conducted, after signing informed consent, with 19 Venezuelan migrant mothers who met the defined inclusion criteria, between October 2021 and January 2022. The stories were subjected to thematic content analysis. Results: It was theorized around three categories of analysis, namely: identity heritage and integration of Chilean culinary culture, maternal deficiencies and assessment of food availability in Chile and the ambivalent relationship with the Chilean health system. Conclusions: Venezuelan mothers build a personal way of feeding their sons and daughters in Chile, based on the preservation of beliefs and traditions, and also from their experiences linked to the lack experienced in Venezuela, which draw a special appreciation of availability and access to food in the country. On the other hand, the integration of the knowledge learned in its interaction with Chilean society through health establishments is highlighted, which, for some of the participants, harbors tensions linked to the assimilationist practices exercised by the Chilean health system, through the imposition of hegemonic infant feeding practices far from an intercultural approach.

First use of contraceptive in two cohorts of women in Mexico, 2018

Elsa Ortiz-Ávila — 2024-09-03

Introduction: In Mexico, one of the most important explanations given for the rapid reduction in fertility has been the widespread use of contraceptive methods since the 1970s. However, the differences in the use of contraceptive methods respond to very different socio-cultural contexts that have been weakening over time. Therefore, the objective of this study is to analyze and describe the change in the use of contraceptive methods in two cohorts of women in Mexico.

Methodology: The analysis of the timing and intensity of the first use of contraceptive methods and of sexual intercourse was carried out using the Kaplan-Meier method. In addition, indicators linked to these events were calculated, such as: the type of contraceptive used, the number of previous children and the reasons for not using contraceptive methods. The source of information with which the objective is carried out is the National Survey of Demographic Dynamics of 2018. . Results: It is observed in the results that one of the most frequent reasons for not using contraceptive methods in the first sexual intercourse is due to the fact that they did not plan to have sexual intercourse or did not have the necessary information. Similarly, the median age at first use of contraceptive methods among women in the two birth cohorts analyzed in this work has decreased from 30 to 26 years of age. Conclusions: The main results reveal that young women are increasingly using contraceptive methods for the first sexual intercourse; however, it cannot be said that this use is constant and of their own conviction.

Multimorbidity and the combination of chronic non-communicable diseases and their relationship to all-cause mortality among Costa Rican older adults

Beatriz Novak — 2024-10-02

Objective: To estimate the prevalence of multimorbidity due to chronic non-communicable diseases, the prevalence of pairs and triads of these diseases and the respective associated mortality risks in older adults in Costa Rica. Methods: The data used belong to the study Costa Rica: Longevity and Healthy Aging Study. Gompertz models (adjusted for sociodemographic factors, health-related behaviors, and functional status) were estimated to assess the association of multimorbidity with all-cause mortality between 2005 and 2009. The study population comprised 2,565 individuals who provided data on all covariates at baseline. Results: The prevalence of multimorbidity was 42.6%. The five most frequent disease pairs combine hypertension with diabetes, coronary heart disease, respiratory conditions, arthritis, and osteoporosis (around 14%, 10%, 9%, 7%, and 6%, respectively). The most frequent disease triads were diabetes-hypertension-respiratory conditions and diabetes-hypertension-coronary heart disease (about 3% in both cases). Multimorbidity was associated with 64% increased mortality risk, not adjusting for functional limitations, and 37% when adjusting for functional limitations. The following disease pairs at baseline increased the mortality risk, compared to persons without these combinations at baseline: diabetes-hypertension (49%); cancer-respiratory disease, diabetes-coronary heart disease, and diabetes-stroke (around two times); and cancer-hypertension and cancer-diabetes (around three times). The mortality risk among those with diabetes-hypertension-coronary heart disease and diabetes-hypertension-osteoporosis was twice that of persons without these diseases at baseline. Conclusion: There is a need to develop strategies to address the burdens that multimorbidity, particularly cardiometabolic multimorbidity, impose on individuals as well as on the healthcare system.

Life expectancy loss by education level and sex: the impact of COVID-19 in the US (2020) and their forecasts

Carlos Oviedo — 2024-11-13

Objective: Stratified life expectancy loss by education levels and sex helps measure particular mortality impacts during a catastrophic event. We propose a statistical approach to estimate them using the US case during the COVID-19 pandemic in 2020. Method: First, we estimate life expectancies according to available data, including those years when catastrophic events occur. Second, we use them to calculate a valid multivariate time series VAR(p) model, omitting the respective catastrophic(s) year(s). Through the model, we generate forecasts, which are compared with estimated data, and afterward, the life expectancy losses are quantified as their differences. Results: Less than four times the life expectancy losses with low education compared to the high education group. Our projections also indicate that life expectancies with almost all education falls outside the forecast intervals. Conclusion: The more educated the population is, the less life expectancy is lost. Women always outlive men within each education stratum. Long-term estimates continue to underscore gender disparities in life expectancy.

Situation of health, disability and substance abuse among women experiencing homelessness in Nicaragua

Alberto Berrios- Ballesteros — 2024-07-01

Nicaragua is one of the lowest-income countries in Latin America. In Nicaragua there is no information available regarding women living homeless, and they are a particularly vulnerable group in situations of extreme poverty and social exclusion. This paper analyses health, disability and substance use in a sample of women living homeless (n=30) in the cities of León and Chinandega (Nicaragua). The women were asked to respond to a structured interview. The results show that women living homeless in Nicaragua presented a poor perception of their own health, high incidence of serious or chronic illness and high rates of disability. Alcohol and drug use (mainly inhaled glue) appeared mainly to affect younger women, largely during the period of slipping into homelessness. Major similarities were observed between women living homeless in low-income and high-income countries, despite being culturally very different. The lifestyle resulting from the adaptation to living on the street life subjects women living homeless to a rapid process of deterioration. Poor diet, lack of hygiene and barriers to accessing healthcare lead to a poor state of health, which appears to have had a significant impact on the length of time they remain homeless.

Detection and measurement of violence against women in Primary Health Care: A narrative review

Lucia Florencia Sánchez — 2024-07-01

Introduction: Violence against women is a social and public health problem that affects women around the world. Despite the diversity of prevalence studies carried out in health services in Latin America, to date no reviews have been carried out in this region. This work aims to review the literature to understand how this violence is detected and how its prevalence is measured in Primary Health Care services in Latin American countries. Methodology: a narrative bibliographic review was carried out of academic articles published between 2001-2021 aimed at detecting and measuring the prevalence of violence against women in the health sector. 42 original articles were selected and an integrative synthesis of the results was carried out. Results: the detection and/or measurement of violence against women in health centers is carried out by a variety of instruments, most of which are diagnostic. Three theoretical perspectives are identified; each one builds an image of the problem of violence. Conclusion: it is necessary to build valid and reliable data on this problem, with the possibility of being compared between regions and over time. It is important to clarify research designs in social theories, to achieve a contextualized and multidimensional understanding of the problem. Information should be provided on the most appropriate way to detect and care for violence against women in the health field.

Global trends to reduce carbon footprint: challenges and opportunities for the Costa Rican health sector

Ericka Murillo-Rodríguez — 2024-07-01

Introduction: The reduction of carbon footprints across all sectors is a crucial aspect of climate action. The implementation of specific strategies to achieve this goal includes the actions of healthcare services. Costa Rica has been noted for a robust health system with a primary care approach. However, there is a paucity of scientific evidence regarding the roles and impacts of the health sector in reducing the national carbon footprint. Objective: To analyze the scientific production on carbon footprint in health services at a global level and contrast it with the Costa Rican reality. Method: A mapping of the literature in Spanish and English was carried out in the Scopus database, based on online thesaurus terms. Inclusion and exclusion criteria were applied, and the Bibliometrix tool in R software was used for the analysis. Subsequently, an integrative review of the selected documents was conducted with the support of the Covidence platform. A total of 46 publications were analyzed in the bibliographic analysis and 25 documents in the scoping review, identifying currently researched topics for carbon footprint reduction in healthcare. These topics include hospital input analysis, solid waste management, environmental impact assessment techniques, sustainability strategy design, environmental education, healthcare infrastructure, sustainable purchasing, and energy consumption. Conclusions: The studies, regardless of region or country, present options for improving healthcare practice in relation to the carbon footprint, also impacting the health of the populations. However, the majority of these studies, according to the GRADE methodology, present low evidence due to the particularities of the methodological design employed. International collaborations can be a useful tool to advance the implementation of technologies and political strategies that are adaptable to the Costa Rican reality, thereby making the health sector and, consequently, healthcare sustainable.

Epidemiological evolution of dengue in the pre-pandemic to post-pandemic periods in the Americas and Brazil

Viviane Karolina Vivi-Oliveira — 2024-07-01

Introduction: Dengue is an asymptomatic infection or present symptoms like low fever to disabling high fever, severe headache, retroocular, muscle and joint pain, in addition to skin rashes, and if associated with COVID-19, it can worsen the illness condition. Objective: investigate the epidemiological evolution of dengue in the pre-pandemic, pandemic and post-pandemic periods from an American and Brazilian perspective. Methodology: descriptive study, based on the search for information in epidemiological bulletins, data from DATASUS and the Pan American Health Organization/World Health Organization, in addition to articles available in databases provided by SciELO, ScienceDirect and Pubmed. Results: In the period before the pandemic, the high number of notifications was due to the DENV2 serotype, causing a large epidemic. In the years 2020-2021 there was a drop in the number of notifications due to the introduction of social and public health measures, misdiagnosis between the signs/symptoms of dengue and COVID-19, inaccurate serological tests and underreporting. In 2022 and 2023, the epidemiological scenario again points to increasing notification of dengue cases, mainly due to changes in routine vector control during the pandemic, combined with favorable environmental factors, such as increased rainfall. Conclusion: the neglect of both dengue fever and other diseases has negatively impacted the population today, since in order to mitigate the damage caused by the pandemic, actions to promote and prevent the health of endemic diseases in our territory, when placed in the background, have caused the underreporting of cases, influenced by changes in the political, economic and health spheres of society.

Quality of Sleep in Urban and Aeronautical Firefighters of Ciudad Bolívar, Venezuela

Mishel Yohana Rincon Ortiz — 2024-07-01

Introduction: Night work increases the state of fatigue and the deterioration of biological functions, affects mental and physical health, causing poor work performance, the objective of the study was to determine the quality of sleep and the sociodemographic data related to the body staff. of urban firefighters and the aeronautical fire department of Ciudad Bolívar Venezuela. Methodology: An observational, cross-sectional study with a quantitative approach was carried out. The population was made up of 60 urban firefighters and 20 aeronautical firefighters, the sample was by convenience, through a self-administered survey, sociodemographic data, working conditions and the Pittsburgh Sleep Quality Index (ICSP) were collected. Descriptive statistics and Fisher's exact test were applied. Results: It was found in urban firefighters that 61.82% presented pathological sleep quality, the most affected gender was male, and the highest frequency of pathological sleep were those who had service time between 1-11 years. Of the aeronautical firefighters, 83.33% presented pathological sleep, with the highest frequency being pathological sleep; It was the masculine gender. It was also observed that the subjective quality of sleep is “quite good” in both. Conclusions: Both firefighters present alterations in sleep quality, with urban firefighters being the most affected. It was found that there are differences in relation to age, gender, and length of service. The importance of adapting to the pace of work was also evident. coping tools.

Insurance in public health, social and private security, and its impact on income poverty in Ecatepec de Morelos, Mexico

Hugo Nathanael Lara Figueroa — 2024-07-01

Objective: Determine the incidence of health insurance on income poverty in the municipality of Ecatepec de Morelos. Method: Quantitative study carried out with sociodemographic and economic information collected during the period 2021-2022; An ordinal logistic model was applied taking income poverty as the dependent variable and insurance and some sociodemographic variables of interest as predictors. Results: significant differences and greater impact were observed in poverty due to moderate and extreme income depending on the type of affiliation, as well as the presence of out-of-pocket health expenses. Conclusions: Insurance by itself does not guarantee financial protection, which can lead to impoverishment; Out-of-pocket spending is the variable with the highest incidence in income poverty.

Remote work and eating habits in participants of the Longitudinal Study of Adult Health (ELSA-Brasi) during COVID-19

Haysla Xavier Martins — 2024-07-26

Introduction: In a scenario of social restrictions to contain the spread of the SARS CoV-2 virus there were changes in the lifestyle and eating habits of populations around the world. Objective: To evaluate eating habits associated with remote work on COVID-19 pandemic. Methods: Cross-sectional study with active workers at ELSA-Brasil during the wave-COVID-19 (July/2020 and February/2021). Data were collected online through self-completed questionnaires. Eating habits represented the dependent variables (“increase in the acquisition of ultra processed foods”, “increase in the acquisition of fresh foods”, “food quality score”, “weekly use of fast-food delivery” and “change in the preparation of meals"). The exposure variable was the work modality (remote or face-to-face). For statistical analysis SPSS 21.0 was used, with significance of p < 0.05. Results: 2463 individuals were evaluated (44 to 83 years old), which, 78 % were working remotely. After adjustment, changes in meal preparation remained associated with remote work, indicating greater chances of cooking more, both for men (OR = 2.45 95 % CI 1.75-3.42) and for women (OR = 2.93 95 % CI 2.19-3.92). No difference was observed between the quality of food score and type of work. However, when evaluating the score using fast-food delivery, those who used it weekly had worse food quality. Conclusion: Individuals in remote work had changes in food preparation, being more likely to cook during the COVID-19. The other eating habits evaluated did not remain associated with the work modality.

Risk perception and knowledge of Human Papillomavirus infection among a group of Mexican males

Diego Sosa-Hernandez — 2024-07-01

Introduction. Human papillomavirus infection is the most common sexually transmitted viral infection that might be prevented with knowledge and attitudes that promote safe sex. Males play a role in transmission as they are asymptomatic carriers of the virus, a situation that they ignore. The aim of the study is to determine association between knowledge and risk perception with subclinical infection.

Methodology. A prospective, cross-sectional and analytical study was conducted, including 164 males between 18 and 45 years, self-selected to be included. A self-administered instrument was used to measure perception of risk and knowledge about human papillomavirus infection with ten items using the Likert scale, five for measure risk perception and five to knowledge. Molecular biology, to identify the virus in the genitals, was used. Results. The male's average age was 29 years, with an infection prevalence of 24 %, 68 % of the population studied had a high perception of risk for acquiring the infection; 30 % medium risk, and only 2 % had a low perception. Regarding knowledge, 88 % had a high level and 12 % medium level. No association between knowledge level (p=0.53299) and perception of infection risk (p=0.53299) was found. Conclusion. No association between knowledge and risk perception with asymptomatic papillomavirus infection was found.

Level of knowledge about type 2 Diabetes and treatment adherence in honduran population

Norma Isabel Galeas Calleja — 2024-07-01

Introduction: In Honduras, 495,011 people were diagnosed with type 2 Diabetes Mellitus (DMT2) during the year 2015, this being the last existing record, affecting between 7.0% and 10.0% of the population. Diabetes education is essential for adequate control of DM, therefore the purpose of the study was to describe the level of knowledge about Type 2 Diabetes Mellitus and adherence to treatment in the population that attends the National Diabetic Institute in the months of January and February of the year 2023 in Tegucigalpa, Honduras. Methodology: It is a correlational cross-sectional study with a non-experimental approach, with a population of 20,500 patients, a sample of 378 individuals was obtained for analysis. The participants were selected by a non-randomized method, where they answered the Diabetes Knowledge Questionnaire (DKQ 24) to assess the level of knowledge and for adherence to treatment, the Morisky-Green test was used. Results: 266 (70.4%) people had an intermediate level of knowledge and 193 (51.1%) participants, being the majority, reported inadequate adherence to treatment for their disease. When analyzing the relationship between both variables, they have a statistical significance of p 0.007. Conclusions: it is concluded that knowledge about DMT2 should be strengthened among Hondurans, taking into account the areas with deficiency and delve into the factors involved in poor adherence to treatment.

Impact of COVID-19 on mortality in the elderly population of Cordoba, Argentina. Preliminary analysis of the first two years of the pandemic

Enrique Pelaez — 2024-07-01

Introduction: This paper aims to analyse the impact of the COVID-19 pandemic during 2020-2021 in Córdoba (Argentina) on older people, measured by excess deaths (ED) and change in life expectancy (LE). Methodology: Data sources used were deaths for the period 2017-2020, from the national Ministry of Health. Life tables were calculated for the three-year periods 2017-2019, 2020 and 2021. Finally, the decomposition of EV differences in 2020 and 2021 was calculated. Results: There were 10.3% excess deaths in 2020 and 25.5% in 2021, higher in males. ED was concentrated in the over-60s, although in 2021 mortality in young adults was significant. In 2020 the ED rate in males over 80 is three times higher than in the 60-79 years group. There is a marked bias between males and females. In 2021 there are fewer differences between ages and sexes, although the higher rate for males over 80 remains. In 2020 COVID deaths accounted for 74.2 per cent of ED for males and 102.4 per cent for females; in 2021 they accounted for 60.2 per cent and 57.7 per cent respectively. The EV loss in 2020 was 0.83 years in males and 0.26 in females; in 2021, 2.73 and 2.25 years respectively. Older males concentrate the decline in EV in infectious diseases and COVID-19. Conclusions: Knowledge of the impact of the pandemic on older people provides valuable evidence for health policy planning.