Población y Salud en Mesoamérica is an academic electronic journal, published biannually and of continued publication by the Centro Centroamericano de Población in collaboration with the Instituto de Investigaciones en Salud (INISA) and whose publisher is the University of Costa Rica. The main objective of this publication is the dissemination of research on population from demographic perspective, and public health. This journal is registered and indexed in important international indexes. E-mail contact: revista.ccp@ucr.ac.cr URL OAI-PMH: https://revistas.ucr.ac.cr/index.php/psm/oai
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In memory of Carlos we published the document "Regionalization of Costa Rica" based on studies coordinated by him. The document defines five regions and 22 sub-regions proposed by OFIPLAN in 1978. The five regions are very similar to the division into six regions that eventually prevailed. The difference is only that the "Central Pacific" region is included within the Central region.
OFICINA DE PLANIFICACIÓN NACIONAL Y POLITICA ECONOMICA
Copyright (c) 2021 OFICINA DE PLANIFICACIÓN NACIONAL Y POLITICA ECONOMICA (Autor/a) https://creativecommons.org/licenses/by-nc-sa/4.0
¿Eating as the medical-nutritional discourse orders? Discourses and practices on healthy eating habits among middle-class sectors in the City of Buenos Aires, Argentina.
Objectives: To describe and analyze the discourses on healthy eating habits and their relationship with declared practices that hold middle-class parents who live in the Autonomous City of Buenos Aires, Argentina. Methods: A qualitative research was conducted, a type of exploratory-descriptive study and data was gathered with semi-structured interviews. Twelve households were intentionally selected, consisting of couples who had children of different age. A thematic analysis strategy was carried out to systematize and analyze the transcriptions. Results: A homogeneous discourse on healthy eating was observed, which is aligned with expert recommendations regardless of the interviewee´s age, whether or not they live with their children, and also their varied food purchasing, preparation, and consumption practices. The diversity observed in these practices can be explained by other criteria which compete with their quest for healthy eating. Even if the benefits of healthy eating to prevent food-related illnesses are recognized, overweight and obesity seem to prevail as the main reasons to choose what to eat, and individual responsibility is articulated. Two are the consequences of the diffusion and incorporation of the medical and nutritional discourse: first, to consider eating practices and body care as issues related to the personal realm; and, second, to leave out the weight that the social context and collective responsibility exert in the explanation of health problems associated with current eating habits.
Copyright (c) 2020 Flavia Carolina Demonte https://creativecommons.org/licenses/by-nc-sa/4.0
Participation of young men and women in decision-making on sexual and reproductive health in Argentina: gender and socioeconomic asymmetries
Introduction: We analyse the participation of young women and men between 14 and 19 years old, in decision-making on two dimensions of sexual and reproductive health: the first sexual relationship and the use of contraceptive methods. Methodology: we use data from the first National Survey on Sexual and Reproductive Health (ESSyR) and we analyse differences by sex. We examined bivariate association measures by socio-economic status indices (High SES and Low SES). We construct the socioeconomic index using polychoric principal component analysis (ACPP). Finally, the differences by sex in decision making are visualized using Multiple Correspondence Analysis (MCA) for the different level of INSE. Results: The results suggest a differentiation by sex of the following dimensions: a) greater participation of men in decision-making regarding the first sexual relationship with respect to women, b) greater autonomy in men for decision-making about the contraceptive method to be used regularly and c) stability in the patterns of participation in decision-making between both SES, with some differences in the case of women. Conclusions: we suggest less satisfaction and autonomy of young women regarding the facts related to their sexual health than men.
Copyright (c) 2021 Pablo Sebastian Gómez, Virginia Beatriz Bolatti https://creativecommons.org/licenses/by-nc-sa/4.0
Fertility in Rosario City, Argentina: Projections and retro-projections of the global fertility rate and specific fertility rates
The study that gives rise to this article arises from the results obtained in the framework of a collaboration agreement signed by the Statistical Office of Rosario City and the School of Statistics of the Faculty of Economic Sciences and Statistics (National University of Rosario). Among its objectives is to obtain probabilistic fertility forecasts for Rosario City. For this, based on vital statistics, estimates and population projections, probable scenarios, past and future, are constructed, both for the global fertility rate and the specific fertility rates. The results of this study, based on the application of probabilistic prognostic models, allow to know structures and trends, past and future, of fertility, so that diagnoses can be generated that are useful for the evaluation and management of the health system or good for the development of new public policies. The results indicate that Rosario had, has and will continue to have a change in fertility patterns faster and more marked than the national average. Although this fact is to be expected in a context marked by advances in public health (which allow access to more and better reproductive health care), the methodology used here is based solely on the extrapolation of trends, therefore, the backprojection must be carefully analyzed.
Copyright (c) 2020 Lucia Andreozzi, Nora Ventroni https://creativecommons.org/licenses/by-nc-sa/4.0
Seroepidemiological surveillance of SARS-CoV-2 circulation in 41 municipalities in Honduras with no report of active cases, COVID-19, June 16-23, 2020
Introduction: In Honduras on March 12, 2020, the first case of COVID-19 caused by the SARS-CoV-2 was reported. From that moment on, a series of measures were adopted to slow down contact throughout the country. By June 2020, cases are reported across the whole country. With the objective of identifying the presence and circulation of SARS-CoV-2, characterizing and identifying suggestive symptoms of COVID-19 in the population, the present study was carried out. Methodology: A descriptive cross-sectional study was carried out, using a quantitative and qualitative approach, using the LQAS sampling method. The study population was the inhabitants of the identified municipalities, with no current circulation data for SARS-CoV-2 or the municipalities whose last confirmed case was 21 days ago. The data was collected through an electronic survey, it was possible to apply rapid antibody detection tests (IgG and IgM). Results: 792 people from 41 municipalities of the country were surveyed and tested. Positivity of contact was found in 6.2% (49/792). Of these, 55.1% (27/49) are men. 61.2% (30/49) are between 20 and 49 years old. The clinical symptoms found were fever, decreased appetite, respiratory distress, and loss of taste and smell, the 49.2% (32/49) without symptoms. Conclusions: virus circulation was demonstrated in the population of municipalities in which no cases were officially reported and after 96 days of the first confirmed case in the country. Detection of virus-specific antibodies could be important in surveys for asymptomatic infection in areas where contact is expected.
Copyright (c) 2021 Mario Rene Mejía Núñez, José Ángel Lara, Sandra Jeanneth Araujo Pleitez, Gilberto Ariel Ramírez https://creativecommons.org/licenses/by-nc-sa/4.0
Health literacy and drug labeling needs identified in indigenous population of Alto Telire, Talamanca Health Area, Costa Rica
Introduction: The understanding of sociodemographic characteristics, health literacy, and drug labeling needs allows to create the bases for professionals to target actions for the improvement of healthcare among vulnerable populations. Methodology: From this, a quantitative, observational research was carried out, with an exploratory scope; that addressed the indigenous population residing in the Alto Telire sector, located in the province of Limón, Costa Rica, which is characterized by its isolation and low schooling. This article presents the characterization of sociodemographic aspects, health literacy, as well as the identification of needs related to the labeling of medicines for a group of patients of the Cabécar ethnic group, attended in May 2018 by representatives of the Costa Rican Social Security Fund (CCSS). The results were obtained through direct interviews with patients. Results: The results obtained from the study highlight that 57% of the participating population is female, with ages between 18 and 45 years. Furthermore, the lack of access to education that the population had until 2009 explains why 70 42% of the participants do not have any type of education, which is related to the fact that a 100% have low health literacy level. On the other hand, participants recognize their medications principally by the name, use and physical characteristics, being the use given to the medication the main way to recognize it. Conclusions: The population included in this study has low education and an inadequate level of health literacy. Drug labeling needs are primarily related to indications and the person intended to use it. Furthermore, drug labels are the only source of information available to this population in order to rationally use their treatments.
Copyright (c) 2021 Rocio Mora Vicarioli, Angie Leon-Salas, Alejandra Castro Granados, Catalina Lizano-Barrantes (Autor/a) https://creativecommons.org/licenses/by-nc-sa/4.0
Evaluation of metabolic control of patients with type 2 diabetes mellitus participating in a group educational intervention; results of a cluster analysis
Objective: Evaluate the results of a group educational intervention in type 2 diabetes mellitus (DM2) to determine the capacity of the participants in the metabolic control of the disease. Methodology: Different statistical analyzes were performed: correlation and cluster analysis using three procedures (K means with standardized values of the variables involved, hierarchical analysis with standardized variables) and a combination of factor analysis with K means. In addition, a normalization analysis was carried out to determine the effectiveness of the Nutritional Intervention Program in Chronic Diseases. Results: 702 people with diabetes completed the educational intervention, of which the majority are women, ages between 40 and 64 years old. The variables that were statistically significant (p <0.001) for the cluster analysis were postprandial glycemia, fasting glycemia, glycated hemoglobin, total cholesterol and triglycerides, where the average values decreased in all the clinical tests after the educational intervention. Three groups were generated by combining factorial analysis and cluster analysis: low control DM2, medium control DM2 and high control DM2. In the normalization analysis, it was determined that the educational intervention of the Nutritional Intervention Program in Chronic Diseases was effective.Conclusion: The results of this study will allow us to focus on the therapeutic objectives of the educational intervention through our own actions and by monitoring the treatment in a more accurate way.
Copyright (c) 2021 Marlene Roselló-Araya, Sonia Guzmán-Padilla, Fernando Ramírez-Hernández (Autor/a) https://creativecommons.org/licenses/by-nc-sa/4.0
Tuberculosis space-temporal distribution from 2011 to 2016 in the municipality of Maputo, Mozambique
Objective: Carry out a spatial-temporal characterization of the incidence of tuberculosis (TB) in Maputo, Mozambique. Method: a descriptive ecological study of tuberculosis cases reported in an information system. The annual mean incidence rate and the number of TB notification cases in the municipality of Maputo from 2011 to 2016 were analyzed. Descriptive statistics were used with calculations of measures of central tendency (mean) and an application of the Poisson linear regression model. Trimester notifications were stratified by district, clinical form, and age group. The quarterly average temperature of the evaluated area was added as a covariate in the model seasonal. Results: 34,623 TB cases were notified from 2011 to 2016, with a trimester average of 1,443 cases. The average annual incidence was higher in the Kampfumo district, with 909.8 per 100 thousand inhabitants (95% CI 854.1 - 968.2); almost twice as much as the incidence of the municipality of Maputo, 527.8 (95% CI 514, 3-541.6), and the country of Mozambique, 551 (95% CI 356 - 787). The clinical diagnosis of the tested cases was higher concerning the bacteriological diagnosis; 44%, and 35%, respectively. Conclusion: Maputo had similar incidence rates to the country of Mozambique, however, there was a heterogeneity rate by district and a reduction in the number of TB cases in both the general population (not co-infected with HIV) and those over 15 years old, being higher in the first trimester.
Copyright (c) 2021 Antonio C. Titosse, Marcus Vinícius Pimenta Rodrigues, Ana Paula Marques Ramos, Lucas Prado Osco, Rogério Giuffrida, Elivelton da Silva Fonseca, Alba Regina Azevedo Arana https://creativecommons.org/licenses/by-nc-sa/4.0
Regional trends and differences in male homicides by firearms in a state in the Legal Amazon, Brazil
Objectives: To analyze the trend from 1996 to 2017 and to project until 2022 the rate of homicides by firearms in young men, according to the health macro-region, in the state of Mato Grosso, Brazil. Methodology: Ecological study that used data from the Mortality Information System. Mortality rates standardized by the world population were calculated. To model the series and predict the firearm homicide rate for the period from 2018 to 2022, the order one autoregressive model - AR (1) was used. Results: The standardized homicide rates indicated marked differences between the macroregions studied, revealing that the Centro Norte macroregion leads firearm mortality in most years and the lowest rate in the period occurred in 2013, in the Eastern macroregion. There was an increasing and significant trend in the rate of homicide by firearms for half of the macro-regions - North, West, South - and for the state of Mato Grosso, while for the East, Central North and Central Northwest macroregions the rates remained stable. Conclusion: The mortality of young males by firearms was high especially in the most urbanized macro-regions, with agrarian conflicts and the border region. If the strategies are not changed, homicide rates of young men by firearms in Mato Grosso will continue to be high and / or increasing.
Copyright (c) 2020 Franciele Silvia de Carlo, Ligia Regina de Oliveira, Amanda Cristina de Souza Andrade https://creativecommons.org/licenses/by-nc-sa/4.0
Analysis of food waste in food services at the University of Costa Rica: did anything change post-pandemic?
Introduction: Food waste in food services (FS) has environmental, economic, and social implications. Since 2018, the University of Costa Rica (UCR) has implemented actions to measure and reduce waste in its FS, although the COVID-19 pandemic interrupted these efforts. This study analyzed food waste in the FS of the Rodrigo Facio campus after the pandemic and compared it with previous measurements (2018-2019) to establish mitigation strategies. Methodology: A quantitative, cross-sectional, and descriptive study was conducted in four FS of UCR. Three measurements were carried out in the FS, evaluating the areas of storage, production, service, and plate waste. The data were analyzed using ANOVA and Tukey's test to determine statistical significance (p ≤ 0.05). Results: Significant differences in waste were observed, but not in the production of FS in 2023. FS N2 had over 10% of food waste. The highest food waste was observed on served plates in all cases. A 52% decrease in daily food production was identified in 2023 compared to 2019, suggesting a lower influx of users post-pandemic. It was determined that most FS have significantly reduced waste over time. Conclusions: Waste on served plates remains the greatest challenge. The data obtained contributes to the construction of the national food waste indicator and pave the way for the implementation of reduction strategies in these FS.
Copyright (c) 2026 Hidalgo-Víquez et al. https://creativecommons.org/licenses/by-nc-sa/4.0
Sociodemographic determinants that influence quality of life in three municipalities in Colombia
Introduction: Quality of life is a multidimensional construct that encompasses different aspects of human life. It is related to individuals’ sense of well-being and their degree of life satisfaction. The aim of this study was to analyze sociodemographic determinants and their influence on quality of life in three municipalities in Colombia. Methodology: A cross-sectional study was conducted using a convenience sample of 1,147 participants from three cities. A sociodemographic questionnaire and the WHOQOL-BREF instrument were administered to assess quality of life. Descriptive statistics, a normality test, and Spearman’s correlation coefficient were used for data analysis. Results: A greater proportion of participants perceived their quality of life as good in the physical (60.5%) and psychological (52.7%) domains. Lower scores were observed in the social relationships and environmental domains. Significant associations were found across all four quality of life domains, primarily with age, educational level, and socioeconomic status. Conclusions: These findings indicate that certain sociodemographic variables are key determinants of individuals’ perceptions of their quality of life.
Copyright (c) 2026 Canchala Obando et al. https://creativecommons.org/licenses/by-nc-sa/4.0
Health as a social representation: The phenomenon of health within the daily life of nicaraguan migrants in Costa Rica
Introduction: Health is loaded with symbolisms and practical manifestations that differ according to social groups and sociocultural contexts. In order to make everyday life and needs visible, the Theoretical Paradigm of Social Representations provides the theoretical-methodological bases necessary to understand the common sense knowledge associated with health among the Nicaraguan migrant population in Costa Rica. Methodology: Qualitative study with ethnographic approach that aimed to identify the social representation of health, through the process of objectification, present among Nicaraguan migrants living in Costa Rica. Data collected through semi-structured interviews, participant observation, and field diaries. Processing according to Content Analysis. Results: The social representation of health found behaves analogously to a formula; where, the search for peaceful environments is added to the achievement of financial stability to result in two interdependent representations: 1) Health as physical-mental strength; and 2) Health as a future and abstract sensation of well-being, happiness and transcendence. The socio-political antecedents in Nicaragua, the migratory process, and the adaptation to Costa Rica play a preponderant role in shaping the representation on health. Conclusion: Social representations about health have direct practical implications on the ways of life and needs of migrant groups. Understanding their common sense knowledge allows to move towards more contextualized public policies. More integration of the thoughts, opinions and feelings of migrants in decision-making platforms is recommended.
Copyright (c) 2021 Wendel Mora-Rivera https://creativecommons.org/licenses/by-nc-sa/4.0
Capacity of the foods included in the Basic Tax Basket of Costa Rica to satisfy the nutritional requirements of the quintile with less incomes
On a national level, several regulations have been developed with the aim of protecting the economically most vulnerable sectors of the population. One of these regulations is the Costa Rica’s Basic Tax Basket Regulations (CBT by the Spanish acronym for Canasta Básica Tributaria), which establishes a decrease in the tax burden on food consumed by the most vulnerable population of the 2013 National Household Income and Expense Survey (ENIGH by the Spanish acronym for Encuesta Nacional de Ingresos y Gastos de los Hogares). The objective of this research is to compare the nutritional value of the foods included in the CBT and the nutritional requirements of the first quintile members of the 2013 ENIGH. The research is quantitative and co-relational in type. The sample is the first income quantile of the ENIGH of 2013 and is composed of healthy adults with ages between 19 and 60. The analysis was made during the first four months of 2020, using an instrument formulated in Excel, in which meal plans are formulated only with the foods that are part of the CBT, to calculate the content of energy, macronutrients, saturated fatty acids, fiber, calcium, zinc, magnesium, vitamin E and vitamin D. The results determined that 46% of CBT foods are classified as source or good source of some of the studied nutrients. As well as 6 of the 11 studied nutrients are satisfactorily adapted to the requirements of the population. The results allow to conclude that with the foods included in the CBT, an adequately balanced meal plan can be formulated, because excess or deficiency of nutrients found in the meal plan are not considered harmful to the health.
Copyright (c) 2022 Katalina Peraza Garita https://creativecommons.org/licenses/by-nc-sa/4.0
Social Return on the investment of the elimination of the vertical transmission of Chagas, HIV / AIDS, HB and Syphilis: Case of a Municipality of the Province of Buenos Aires
Introduction: we seek to quantify the returns on investment associated with an intervention in the public health system of a Municipality of the Province of Buenos Aires, Argentina. This intervention consists of strengthening the strategy for the Elimination of Mother-to-Child Transmission of HIV Infection, Syphilis, Congenital Chagas Disease and Perinatal Hepatitis B Infection, a strategy called ETMI-PLUS. Methodology: the study (quantitative) is based on the Social Return on Investment (RSI) methodology. Ad-hoc definitions are established for the measurement of returns based on the information available from various sources: primary information from the Ministry of Health of the MAB; rates of congenital transmission of each disease reported to the National Health Surveillance System; detailed budgets of the resources assigned to the project by Fundación Mundo Sano and costs of treatments and supplies from official nomenclators. Results: for each argentinean peso invested in strengthening the ETMI-PLUS in the MAB, a return of almost 4 pesos would have been obtained thanks to the improvements in the vertical elimination of the 4 diseases and the reduction of cardiac complications in pregnant women. Conclusions: these results suggest the existence of a return / investment relationship favorable to the intervention, analyzed under a conservative analysis since savings for the health system are exclusively included and other dimensions of returns associated with improvements in results are excluded.
Vertical Transmission of Infectious Disease
Copyright (c) 2022 Malena Monteverde, Constanza Silvestrini, Ana Cristina Pereiro, Tamara Wolovich, Mariana Ceriotto, Juan Manuel Castelli https://creativecommons.org/licenses/by-nc-sa/4.0
Impact in the integral health of the workers the area technology of the information who make home office during Covid -19
Introduction: With the social isolation imposed by the Covid 19 pandemic, teleworking in the home office modality has been an alternative used by some companies. Objective: To determine the impact of this remote work on the integral health of workers. Methodology: A cross-sectional study was carried out, through the "Google Forms" platform, a semi-structured questionnaire was elaborated that was sent to 150 information technology workers from a medium-sized municipality in the state of São Paulo, to obtain information on the variables: age, sex, working conditions, oral and systemic health, oral hygiene habits, musculoskeletal pain, physical exercises and emotional state. Results: Of the total of 116 responses received, 87.07% belonged to the male sex, 100% reported concern with their oral and general health, 56.03% reported changes in their eating habits, 44.83% increased food consumption and 77.58% reported feeling concerned and anxious. The prevalence of painful musculoskeletal symptomatology manifested in 100% of workers predominantly found in the cervical region (53.44%). In general, low frequency of physical activity and inadequate conditions for home work performance were corroborated. Conclusions: The change from the usual work routine to the home office modality (teleworking) significantly impacted the health of information technology workers. Given the possibility of maintaining this modality of remote work to reduce the exposure and spread of the virus, it is necessary to adopt strategies to preserve the integral health of these professionals.
Copyright (c) 2022 Maria Elizabeth Pena Téllez, Suzely Adas Saliba Moimaz, Artênio José Isper Garbin, Tânia Adas Saliba https://creativecommons.org/licenses/by-nc-sa/4.0
(Ine)quality in Healthcare: a perspective from the accreditation of clinical laboratories in Costa Rica
Introduction: Given the relevance of quality-assured laboratory services for health system strengthening and improvement, this study had the objective of exploring the distribution of ISO 15189-accredited and non-accredited laboratories in Costa Rica, in order to identify possible gaps in the fulfillment of its commitment to provide ‘quality healthcare for all’. Methods: Our research was conducted with a descriptive scope and following a quantitative approach. Costa Rica’s Accreditation Body and College of Microbiologists databases were searched to collect data regarding clinical laboratory registration and ISO 15189 accreditation status. Laboratory availability indicators by geographical division were computed with this data. Results: Out of 480 clinical laboratories allowed to operate in Costa Rica as of January 2021, only 5 (about 1%) have been accredited in compliance with ISO 15189, all of which are private and located in the province of San José. Also, laboratory density (in terms of facilities per 100 km2 and per 100 000 population) is heterogeneous among provinces. Clinical laboratory services are more easily available in ‘central’ provinces of the country (e.g. San José and Heredia), where ratios for laboratory density are higher. On the contrary, coastal provinces such as Limón and Puntarenas exhibit low laboratory density ratios, reflecting geographical disparities in access to healthcare. Conclusions: Geographic disparities in the access to clinical laboratory services were observed. This should raise awareness among public health authorities and private healthcare providers regarding the country’s progress in attaining its ‘quality healthcare for all’ commitment.
Copyright (c) 2021 Daniel Quesada-Yamasaki https://creativecommons.org/licenses/by-nc-sa/4.0
Energy expenditure and time spent on physical activity in Costa Rican schoolchildren with overweight or obesity by means of the Actiheart accelerometer
Objective: To determine the energy expenditure and time spent on physical activities in Costa Rican overweight or obese schoolchildren in free-living conditions. Methodology: Participants were 31 boys and 13 girls aged 6 to 9 years old (7.6 ± 1.03 years) with overweight or obesity; nutritional status was established by BMI. The variables of the study were: anthropometric, body fat percentage (%BF), total energy expenditure product of physical activity performed during the day (EEPA daily total), plus the energy expenditure by physical activity (EEPA), and time spent on physical activity (TPA), both variables in sedentary condition, light, moderate and vigorous intensity estimated by the Actiheart accelerometer. Results: Size and %BF were significantly higher in girls (126.8 ± 5.9 cm, 34.0 ± 6.4% BF) than in boys (123.0 ± 5.4 cm, 25.2 ± 6.9% BF). Boys recorded a daily total EEPA of 824 ± 228.1 kcal / day, moderate + vigorous EEPA 285.6 ± 131.7 kcal / day and a moderate + vigorous TPA 147.0 ± 66.6 min; significantly higher (P <0.05) than girls 395 ± 144.4 kcal / day, 139.6 ± 90.1 kcal / day and 75.6 ± 43.2 min respectively . Conclusions: Schoolchildren perform over 60 min/day moderate to vigorous intensity PA recommended, however; the EEPA moderate to vigorous intensity does not meet the minimum recommendation of 300 kcal / day for weight reduction. This could be one of the causes for overweight schoolchildren.
Special Section: INISA, 45 years caring for the health of Costa Rica
Copyright (c) 2021 Juan Diego Zamora Salas https://creativecommons.org/licenses/by-nc-sa/4.0
Major depression disorder in Costa Rica: epidemiological and neurobiological aspects
Introduction: Major depression is one of the most common mental illnesses and one of the principal causes of disability worldwide, with an increasing prevalence in recent decades. The aim of this essay is to present epidemiological data, as well as to briefly review the psychobiological mechanisms of depression related to the exposure to chronic stress. Finally, we will also discuss some strategies for the prevention and/or treatment of the disease. Proposal: Alternative treatments complementing medication and psychotherapy could be much more effective in preventing and mitigating the effects of chronic stress and the risk of depression than these treatments alone. Arguments for discussion: Chronic stress can precipitate a depressive episode due to hyperactivity of the amygdala and hypothalamic-pituitary-adrenal (HPA) axis, failure of the HPA negative feedback, monoamine depletion, decreased levels of neurotrophins, increased glutamatergic excitotoxicity, reduced hippocampal neurogenesis, prefrontal cortex dysfunction, and excessive inflammatory response. Conclusions: The chronic accumulation of uncontrollable psychosocial stressors plus a sedentary lifestyle, a poor diet, and limited time or places for recreational activities underlie the high depresogenic potential of our current lifestyles. In contrast, activities that include exercise, meaningful social interactions, recreational activities, exposure to natural environments, a balanced diet, and healthy routines would represent a highly effective strategy for managing depression and improving overall health.
Copyright (c) 2021 Andrey Sequeira Cordero https://creativecommons.org/licenses/by-nc-sa/4.0
Circulation of diarrheagenic Escherichia coli associated virulence genes in Costa Rican Great Metropolitan Area wastewaters
Introduction: Diarrheic disease is one of the most important disease’s causes in children under five years. One of the most recognized etiological agents is Escherichia coli. This bacterium has the capacity of causing infections by multiple mechanisms associated with the acquisition of different virulence genes. Methodology: water samples were collected from the affluents and effluents of five wastewater treatment plants located in the Costa Rican Great Metropolitan Area, during three sequential days, in March, May, October, and December from 2013. The aim was to quantify E. coli's concentration by multiple tubes fermentation method and to evaluate the presence of aatA, bfpA, eaeA, ipaH, lt, st, stx1, and stx2 virulence genes, related with diarrheagenic E. coli, by PCR end-point method. Results: The study revealed that the levels of E. coli into the affluents are similar to those reported in other world regions. The effluent's concentration presented higher than 4 Log10 NMP/100 mL level of E. coli. A year-round circulation of virulence genes was demonstrated, and it was associated with enterotoxigenic, Shiga-toxin producers/ enterohemorrhagic, enteroaggregative, and enteropathogenic pathotypes. Genes related to enteroinvasive variety did not were detected. Not all wastewater treatment plants removed E. coli efficiently. Conclusions: Diarrheagenic E. coli circulation is common in our county with the possibility of dissemination to the environment by effluent's wastewater discharge in surface water bodies.
Copyright (c) 2021 Luz María Chacón Jiménez, Karolina Hall Loría, Lic, Pablo César Rivera Navarro, Lic., Liliana Reyes Lizano, Dra., Rosario Achí Araya, Dra., Kenia Barrantes Jiménez, M.Sc. https://creativecommons.org/licenses/by-nc-sa/4.0
Substance dependence in Costa Rica: epidemiological and neurobiological aspects of a misunderstood disease
Introduction: It has been estimated that 80% to 90% of the population worldwide has ever consumed psychoactive substances (PAS), but only 15% will develop addiction. The goal of the current essay is to describe concisely the epidemiological background, the clinical foundations, and neurobiological mechanisms of addiction. Finally, it will briefly examine some environmental strategies aimed to prevent and/or treat addiction. Addiction is not a simple vice consequence of laziness or lack of character, but a neuropsychiatric disorder that must be recognized as such. Proposal: To attain this ultimate goal, the etiological factors and the neurobiological mechanisms of addiction must be revealed and disseminated. Arguments for discussion: All PAS directly or indirectly activate the mesolimbic dopaminergic system, which –after repeated intake– sensitizes and desensitizes the motivational and the hedonic system, respectively. This phenomenon causes PAS to be consumed more frequently and at higher doses despite their effects being progressively less rewarding. Consequently, the physical and emotional distress derived from the withdrawal syndrome exacerbates the compulsive PAS intake, while the completely loss of control results from impairments in the executive functions and the prefrontal cortex. Conclusions: Addiction is a brain disease induced by the chronic consumption of PAS combined with neurobiological and psychosocial risk factors. Exposure social contact, physical exercise, and sensory-cognitive stimulation may constitute a highly effective strategy for preventing and treating addiction and improving mental health as well.
Micronucleus assay as biomarker of DNA damage in population exposed to ionizing radiation
Introduction: Ionizing radiation (IR) is capable of causing DNA damage. For the evaluation of this phenomenon it is possible to use chromosomal aberrations as biomarkers. The “Cytokinesis-Block Micronucleus assay” (CBMN) is a cytogenetic technique that allows to demonstrate the effect of genotoxic agents. Proposition: in the present review, we will describe the molecular mechanisms involved in micronucleus radioinduction, the micronucleus technique and criteria for analysis, its applications within biological research and its extension in clinical research, with emphasis on its application as a biomarker of radioinduced genetic damage. Arguments for discussion: the CBMN is considered a reliable, simple and fast technique and there is evidence of its applicability in the evaluation of biological effects in occupationally exposed personnel and in isolated or large-scale radiological accidents. Conclusions: the CBMN a valuable tool in estimating radiological risk in populations exposed to low doses of IR, allowing to guide decision-making regarding prevention or mitigation of exposure to IR in populations involved. Similarly, the CBMN can be used in research in the field of radiobiology, as a means to describe the effects of ionizing radiation on DNA.
Copyright (c) 2021 Fabio Andrés Chaves-Campos https://creativecommons.org/licenses/by-nc-sa/4.0
Identification of chromosomal aberrations in a Costa Rican children population with idiopathicintellectual disability
The prevalence of intellectual disability (ID) in the global population is 3%. One of the most frequent cause of ID are chromosome aberrations, which are easily detected by a karyotype. However, many of these maygoundetected during a conventional cytogenetic analysis because of their length.These small alterations can be localized in the subtelomeres and it has been observed that when localized there, they are an important cause of ID in patients without a causality diagnostic. In this observational study, we use the MLPA technique for the purpose of identifying the frequency of submicroscopicsubtelomere chromosomal aberrations in a population of people with ID of unknown origin. 70 samples were successfully analyzed with MLPA and we found one case with a microduplication in the 17p subtelomere for a frequency of 1,4%. Also,the karyotype was performed in 33cases, and we foundone case with a chromosome aberration that can be detect by microscope for a frequency of 3%. The subtelomeric chromosome aberration frequency was lower than expected as we compare our results with similar studies. Finally, with this work we conclude that the karyotype and the MLPA technique complement each other for approaching people with ID of unknown origin.
Copyright (c) 2021 Melissa Abarca Ramírez, Fernando Morales Montero, Rebeca Vindas Smith, Fernando Ortiz Morales https://creativecommons.org/licenses/by-nc-sa/4.0
Joint responsibility in health as the basis for an inter-institutional action plan: Addressing overweight and obesity in a Costa Rican population
The objective of this study is to describe the process of creating an inter-institutional action plan to address overweight and obesity in the population of mothers from the urban counties of Alajuelita and Escazu in Costa Rica. This research has a qualitative approach, is a descriptive transversal study, and uses a research-action methodology, which takes as participants the institutional actors of both counties, during a six-month time frame. The main results is the creation of an action plan for in each of the two counties. Process, product and result indicators are also proposed for each of the 4 work areas that were part of the action plan, It is concluded that joint responsibility in health is of vital importance for the creation of actions that seek to improve the health of the population, especially in communities in which there is significant political will from institutional actor, but there are few resources.
Copyright (c) 2022 Melina Montero-López https://creativecommons.org/licenses/by-nc-sa/4.0
Ultra-processed and highly palatable foods on the development of obesity
Introduction: Obesity is a multifactorial trait provoked by the interaction of biological, environmental, psychosocial, and socioeconomic factors. Proposal: The goal of the present review is to discuss the role of ultra-processed and highly palatable foods (UPHP) in the development of the obesity epidemic through an exploratory-descriptive review and to present some suggestions for controlling its consumption. Arguments for discussion: UPHP are energy dense foods with high contents of fat and sugar. UPHP are formulated with many industrial additives used for enhancing flavor, shelf life, and the stability of their components. UPHP used to contain diverse chemicals known as endocrine disruptors (EDC), which are transferred from packaging to foods, with bisphenol A and phthalates as the most common EDC. The EDC disrupt different hormonal signaling pathways affecting the metabolism of the adipose tissue and other endocrine systems. The overconsumption of UPHP induces neuroplastic changes in the brain reward system that increases their consumption, leading to body fat accumulation. In addition, the overconsumption of UPHP alters the composition of the intestinal microbiome (dysbiosis), which is associated with the development of obesity. Conclusions: The overconsumption of UPHP increases the risk of obesity and its related chronic, non-communicable diseases, especially when consumption initiates during early life. To counteract this problem, we proposed the following actions: changing the structure of the market-food basket, incorporating regulations to reduce the UPHP supply in and around educational centers, creating new taxes upon UPHP, and strengthening the research regarding obesity, and the effects of UPHP and EDC.
Copyright (c) 2026 Rebeca Vindas-Smith, Dayana Vargas-Sanabria, Juan C. Brenes (Autor/a) https://creativecommons.org/licenses/by-nc-sa/4.0
Inequalities in the early detection of cervical cancer: a reality in the Costa Rica
Introduction: Cervical cancer is one of the most common cancer types that affects the health of women worldwide. Objective: To determine if there are differences in the use of Pap smears at the regional level in Costa Rica, in order to visualize the inequalities related to the early detection of cervical-uterine cancer. Methodology. This study was conducted based on information from the 2014 National Household Survey. This survey is representative at the national level. R-Studio was used to estimate two multinomial regression models. The first one was used to explain the time that has elapsed since the last time women had a Pap smear. The second one was used to explain the reasons why women had never had a Pap smear. Data on the incidence of cervical cancer, from the National Tumor Registry of the Ministry of Health, were used in order to estimate the in-situ/invasive ratio. Results: Women who participate less regularly in screening are those residing in the Chorotega, Central Pacific and Huetar Caribbean regions. Compared to women in the Central region, women in these three regions are 80% (OR=1.80; p<0.01), 52% (OR=1.52; p=0.031) and 58% (OR=1.58; p<0.01) respectively more likely to have had a Pap screening 5 or more years ago, as compared to 1 to 2 years ago. Discussion: According to the results of this research, the Chorotega Region presents the most disadvantageous conditions in terms of the use of PAP, which represents a higher risk for women to develop lesions and cervical cancer. Conclusions: In order to reduce gaps and improve conditions of access to prevention, it is necessary to coordinate institutional efforts, both governmental and non-governmental, as well as the participation and protagonism of women.
Copyright (c) 2022 Carolina Santamaría-Ulloa, Melina Montero-López, Hazel Quesada-Leitón, Ileana Quirós-Rojas https://creativecommons.org/licenses/by-nc-sa/4.0
Beginning of Biological Dosimetry in Costa Rica and its importance in the care of populations overexposed to ionizing radiation
Introduction: The cytogenetics laboratory of the Health Research Institute (INISA) of the University of Costa Rica established a Biological Dosimetry Service in January 2020 using cytogenetic biomarkers of exposure to ionizing radiation. It is the first of its kind in the Central American region. Objective: establish a biological dosimetry service for Costa Rica, developing a dose-effect calibration curve for gamma rays. Methodology: to carry out the calibration curve, peripheral blood samples from two volunteers, one female and the other male, were irradiated in vitro with gamma rays, at 11 dose points in the range of 0 to 5 Gy. Blood was cultured according to international protocols for 48 hours and induced aberrations were recorded. The Dose Estimate V5.2 and R version 4.03 programs were used to calculate the coefficients of the calibration curve that correlates the frequency of dicentric chromosomes with the dose. Results: the coefficients of the curve are α: 0.02737 ± 0.00658, ß: 0.05938 ± 0.00450 and C: 0.00129 ± 0.00084. These coefficients have values similar to those reported internationally. The curve was validated by calculating two unknown doses, in the first unknown case the delivered dose was 1.5 Gy and the estimated dose was 1.47 Gy and in the second case the delivered dose was 4 Gy and the estimated dose was 3.616 Gy. for both cases there are no statistically significant differences between the delivered and estimated doses. Conclusions: the Biological Dosimetry Service of the INISA can estimate absorbed dose in persons suspected of overexposure to gamma rays in occupationally exposed personnel or persons involved in a radiological accident.
Copyright (c) 2022 Luisa Valle Bourrouet, Fernando Ortiz Morales, Omar García Lima, Jorge Ernesto González Mesa, Andrés Chaves Campos, Marvin Rodríguez González, Melissa Abarca Ramírez (Autor/a) https://creativecommons.org/licenses/by-nc-sa/4.0
Epidemiological and conjunctural characterization of violence in Brazil from 2011 to 2020
Introduction: Violence is a complex phenomenon that affects individuals of different genders, ages, ethnicities and social classes, being considered an important public health problem in Brazil and in the world. Methodology: Study with a quantitative, epidemiological and analytical approach, whose objective was to characterize the main indicators and the way they are associated with violence in Brazil according to their forms, means and circumstances of occurrence, from 2011 to 2020. A dendrogram was produced through the combined application of Multiple Correspondence Analysis and Hierarchical Clustering techniques, characterizing the main profiles associated with violence in Brazil. Results: Violence is established as a complex and multicausal phenomenon, which results not only in high public expenditures, but mainly in the reduction of social cohesion due to the immeasurable damage caused to the population involved. In the present study, the violence is mostly of the physical type, affecting adult females, with low schooling and white or brown. Recurrence occurs mainly when the violence is psychological and sexual. As for the aggressor, they are usually adults, male, and the use of alcohol is common. An important participation of the Southeast region was observed in the notifications of all forms of violence. Conclusions: The magnitude and severity of the problem is brought into question, which must be investigated regionally and in a segmented manner, according to the type of violence. Thus, it infers that spending on violence prevention can mitigate economic, social and psychological problems in Brazil.
Copyright (c) 2023 Marcos Vinicius Teixeira Martins, Veronica Perius de Brito, Alice Mirane Malta Carrijo, Stefan Vilges de Oliveira https://creativecommons.org/licenses/by-nc-sa/4.0
Violences Engaged In Community, Family And Institutional Networks Experienced By Women Who Consume Drugs And Alcohol During Their Treatments. In Four Regions Of Chile
This article presents part of a research study conducted in four regions of Chile on the strategies implemented by technical-professional health teams who work with women participating in Outpatient Alcohol and/or Drug Programs (PAI-M). These women carry a social stigma that generates multiple forms of violence throughout their life trajectories. The aim of this article is to describe the forms of violence interwoven within network, community, family, and institutional practices through the voices of women users of the programs, technical-professional teams, and key actors, in order to propose intervention recommendations. Methodology: This qualitative research, guided by a phenomenological approach, included four group interviews with technical-professional teams, 18 individual interviews with women participating in PAI-M programs across the four regions, and 12 interviews with key institutional stakeholders at national and regional levels. Thematic content analysis was applied using NVivo software. Results: The findings show that a significant number of women experience violence within institutional, community, and family networks—an issue that also affects the technical-professional teams accompanying them. The study concludes that these networks reproduce patterns of structural, cultural, and direct violence, normalized through gender stereotypes associated with women’s problematic substance use. These dynamics affect both the women’s treatment processes and the work of the PAI-M teams. The article recommends developing technical guidelines that ensure respectful, safe, and violence-free experiences, incorporating all network actors to improve coordination and support management.
Copyright (c) 2026 Mónica Palacios Tolvett, Mónica Diaz, Gloria Silva Espinosa, Carolina Frias Torrejon, Tamara Palomino Araneda, Maira Arriagada Solís, María de los Ángeles Guajardo Latorre (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Determination of the Impact Index of Covid19 in El Salvador through demographic, environmental and epidemiological relationship
This study was carried out during the Covid19 pandemic that originated in the Republic of China at the end of 2019 and has spread throughout the world since then, taking official records of demographic, environmental and epidemiological information in El Salvador , with the aim of developing a quantitative and qualitative process that demonstrates the variations in cases of Covid19 contagion as a consequence of the pandemic, based on three factors, including the environmental variable; since this can be an agent that regulates the mobility of the pandemic vectors. In addition, the importance of the use of Geographic and Satellite Information Systems is demonstrated, which allow a more complete analysis of health problems at the national, regional and / or global level; above all in decision-making on public health policies, since the lack of knowledge for decision-making in the face of this new pandemic has been evidenced. The most substantial product of this research is a thematic map of the impact of the pandemic at the country level divided by municipalities, where it shows that the cities with the highest population density and the lowest environmental quality are those that have been most affected. Therefore, in the future it is necessary not to centralize all economic activity in a few places, in addition to the importance of the environments that exist in each municipality for the well-being of people. Finally, a statistical analysis is carried out through the decision tree that supports the aforementioned.
Copyright (c) 2021 César Armando Alvarado Batres, Leonel Ernesto Méndez Gutiérrez, Mr. https://creativecommons.org/licenses/by-nc-sa/4.0
Sociodemographic and sanitary profile of chikungunya virus infection in medium-sized municipality in Mato Grosso, from January to March 2018, Brasil.
Introduction: The chikungunya virus has already been identified in more than 60 countries in Asia, Africa, Europe and the Americas, and chronicity after the disease impacts the lives of those affected by the virus, as well as society, the economy and public health. The objective was to characterize, through epidemiological survey, the profile of chikungunya infection in a mid-sized municipality in Mato Grosso according to sociodemographic and sanitary factors. Methods: The serum-epidemiological survey was conducted with 596 adults aged ≥ 18 years selected by cluster sampling process, with application of questionnaires and biological material collection. Positive cases of chikungunya fever were those with positive results in the anti-chikungunya virus enzyme immunoassay (ELISA). The statistical analyses used descriptive and inferential techniques with confidence intervals of 95% and a significance level of 5%. Results: The overall prevalence of chikungunya fever found in the community was 8.4%. The profile of infection by chikungunya fever is composed of women (p<0.204), aged between 18 and 39 years (p<0.780), more than 08 years of study (p<0.079), non-white reported race/color p<0.871) and employed in the past 12 months (p<0.927). Not residing with affective companion was statistically significant for infection by chikungunya virus (CHIKV) (p<0.028). Conclusion: The study found that women are the most affected by the infection, as well as being single represented a risk factor, and risk behaviors, such as presence of larvae and breeding of mosquitos at home, reflect a low level of awareness of the disease.
Copyright (c) 2020 Dandára Thaís Oliveira Ferreira, M.sc, Marina Atanaka, Ph.D., Mariano Martinez Espinosa, Ph.D., Lavínia Schuler-Faccini, Ph.D., Juliana Herrero da Silva, M.sc, Viviane Karolina Vivi, M.sc, Rayana de Castro da Paz, B.Sc., Vagner Ferreira do Nascimento, Ph.D., Ana Claudia Pereira Terças-Trettel, Ph.D. https://creativecommons.org/licenses/by-nc-sa/4.0