BackgroundDengue fever is a major public health concern in many parts of the tropics and subtropics. The first dengue vaccine has already been licensed in six countries. Given the growing interests in the effective use of the vaccine, it is critical to understand the economic burden of dengue fever to guide decision-makers in setting health policy priorities.Methods/Principal findingsA standardized cost-of-illness study was conducted in three dengue endemic countries: Vietnam, Thailand, and Colombia. In order to capture all costs during the entire period of illness, patients were tested with rapid diagnostic tests on the first day of their clinical visits, and multiple interviews were scheduled until the patients recovered from the current illness. Various cost items were collected such as direct medical and non-medical costs, indirect costs, and non-out-of-pocket costs. In addition, socio-economic factors affecting disease severity were also identified by adopting a logit model. We found that total cost per episode ranges from $141 to $385 for inpatient and from $40 to $158 outpatient, with Colombia having the highest and Thailand having the lowest. The percentage of the private economic burden of dengue fever was highest in the low-income group and lowest in the high-income group. The logit analyses showed that early treatment, higher education, and better knowledge of dengue disease would reduce the probability of developing more severe illness.Conclusions/SignificanceThe cost of dengue fever is substantial in the three dengue endemic countries. Our study findings can be used to consider accelerated introduction of vaccines into the public and private sector programs and prioritize alternative health interventions among competing health problems. In addition, a community would be better off by propagating the socio-economic factors identified in this study, which may prevent its members from developing severe illness in the long run.
Background Eye injury is a serious worldwide public health problem that may cause blindness. In children, blindness has functional impact and psychosocial implications. As indicated in many worldwide studies, identification of risk factors associated with the socio-cultural context may prevent eye injuries. The objetive of the study is to describe the sociodemographic and epidemiological characteristics of pediatric eye injury and its effects on ocular structures in a public hospital from Colombia. Method A retrospective cross-sectional study was carried out between January 1, 2015, and December 31, 2017, in a tertiary public hospital of a medium-sized city located in the Northeast of Colombia. Children under 15 years old with trauma to the eyeball or its adnexa were included. The Birmingham Eye Trauma Terminology System (BETTS) was used. Eye burns and Ocular adnexa were also included. Results 61 cases of eye injuries were recorded, 67.21% (41 cases) of which were males. 57.37% (35 cases) corresponded to closed-globe injuries both contusion and lamellar laceration. Visual acuity fluctuated between 20/20 and 20/40. 14.75% (9 cases) were open-globe injuries while 50% (4 cases) were penetrating trauma. 27.86% of the injuries (17 cases) did not directly compromise the eyeball, 58.82% (10 of these cases) of which corresponded to eyelid wounds, and neither of those had visual acuity information. Conclusion The study showed that the majority of eye injuries in children under 15 years old, from a public hospital in the Northeast of Colombia, are closed globe, caused by blows, and occur in males.
Highlights: Se describen fallas en la identificación y orientación de la baja visión y las posibilidades para su rehabilitación. La rehabilitación de la visión es inicipiente, pues se limita a intervenciones clínicas diagnósticas y prescripción de dispositivos. Las consecuencias de la baja visión pueden ser atenuadas al acceder a procesos de rehabilitación; sin embargo, existen falencias de recurso humano, infraestructura y estructurales del sistema de salud. Es prioritario fortalecer la formación del recurso humano en salud visual para hacer frente a las necesidades de rehabilitación visual. Introducción: Las personas con baja visión requieren de un proceso de rehabilitación de la visión que les permita optimizar su resto visual, mitigando así el impacto de la discapacidad. Objetivo: Describir las condiciones del acceso a la rehabilitación de la visión en Bucaramanga y su Área Metropolitana. Materiales y Métodos: Se realizó un estudio de caso colectivo tomando elementos de la fenomenología. Se asumió la postura teórica de Andersen y colaboradores. Se realizaron entrevistas semi-estructuradas a 11 pacientes y profesionales involucrados en la atención y rehabilitación, residentes en municipios del área metropolitana de Bucaramanga. El análisis se hizo en tres momentos: descubrimiento, codificación e interpretación de los datos. Resultados: Dos categorías emergen del estudio: 1. Rehabilitación de la visión: Un asunto incipiente. 2. Experiencia de las personas con baja visión frente a los procesos de atención para el manejo de la baja visión, con sus subcategorías: Fallas en la identificación y orientación frente al manejo de la baja visión y Dificultades para asistir a las atenciones clínicas y acceso a dispositivos. Discusión: Describir las condiciones de acceso a los servicios de rehabilitación puede contribuir a generar estrategias de intervención que permitan abordar las barreras identificadas. Conclusiones: Las consecuencias de la baja visión pueden ser atenuadas al acceder a procesos de rehabilitación; sin embargo, en los cuatro municipios participantes las personas experimentan múltiples barreras para lograr su rehabilitación, lo que evidencia la necesidad de establecer mecanismos que permitan el ejercicio del derecho a la salud de las personas con discapacidad visual. Como citar este artículo: Oviedo-Cáceres Maria del Pilar, Arias-Pineda Karen Natalia, Palencia-Flórez Diana Cristina. Rehabilitación de la baja visión: Un asunto incipiente. Revista Cuidarte. 2023;14(2):e2665. http://dx.doi.org/10.15649/cuidarte.2665
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