Background: Exposure to 2.5-micron diameter air pollutants (PM2.5) has been associated with an increased risk of illness and death worldwide; however, in Latin American health impacts assessment of this risk factor is scarce. Medellín is one of the most polluted cities in the region, with a population growth rate that is twice as high as that of other Colombian cities, which implies a growing population at risk. Methods: A descriptive study of the disease burden was carried out using the city as the unit of observation. Health events were selected based on epidemiologic evidence and the availability of the population attributable fraction associated with PM2.5. The mortality records were taken from the module of deceased of the Single Registry of Affiliates of the Health System; the morbidity records were taken from the Individual Health Services Registries. For the estimation of the burden of disease, the current Global Burden of Disease guidelines were followed. Results: Attributable disability-adjusted life years to exposure to ambient PM2.5 pollution (DALYsPM2.5) constituted 13.8% of total burden of the city. Males showed the greatest loss of DALYsPM2.5 due to acute events, while in women the greatest loss was due to chronic events. Ischemic heart disease, chronic diseases of the lower respiratory tract, and influenza and pneumonia were the events that contributed the most to DALYsPM2.5. 71.4% of the DALYsPM2.5 corresponded to mortality, mainly in the population over 65 years of age. Regarding attributable morbidity, acute events were more prevalent in both sexes, especially due to respiratory diseases Conclusion: Premature death among the elderly population has the greatest weight on burden of disease attributable to ambient PM2.5 pollution, mainly due to respiratory and cardiovascular diseases, without significant differences according to gender.
Background: Exposure to 2.5-micron diameter air pollutants (PM2.5) has been associated with an increased risk of illness and death worldwide; however, in Latin American health impacts assessment of this risk factor is scarce. Medellín is one of the most polluted cities in the region, with a population growth rate that is twice as high as that of other Colombian cities, which implies a growing population at risk. Methods: A descriptive study of the disease burden was carried out using the city as the unit of observation. Health events were selected based on epidemiologic evidence and the availability of the population attributable fraction associated with PM2.5. The mortality records were taken from the module of deceased of the Single Registry of Affiliates of the Health System; the morbidity records were taken from the Individual Health Services Registries. For the estimation of the burden of disease, the current Global Burden of Disease guidelines were followed. Results: Attributable disability-adjusted life years to exposure to ambient PM2.5 pollution (DALYsPM2.5) constituted 13.8% of total burden of the city. Males showed the greatest loss of DALYsPM2.5 due to acute events, while in women the greatest loss was due to chronic events. Ischemic heart disease, chronic diseases of the lower respiratory tract, and influenza and pneumonia were the events that contributed the most to DALYsPM2.5. 71.4% of the DALYsPM2.5 corresponded to mortality, mainly in the population over 65 years of age. Regarding attributable morbidity, acute events were more prevalent in both sexes, especially due to respiratory diseases Conclusion: Premature death among the elderly population has the greatest weight on burden of disease attributable to ambient PM2.5 pollution, mainly due to respiratory and cardiovascular diseases, without significant differences according to gender.
Purpose: The first 2 rounds (2012-2013) of the Colombian school-based HPV vaccination program attained 80% coverage of nine-year-old girls. After a psychogenic event in 2014 in a town of the Caribbean region, vaccination fell nationwide to 20% in 2016. We identified factors associated to decreasing coverage of the HPV vaccination program in Manizales, Colombia. Methods: Structured questionnaires based on the HPV health belief model (HBM) were used in a population-based survey (September 2017-February 2019) to privately interview girls from birth cohorts of 2003, 2004 and 2005 and their parents. Vaccination coverage (at least one dose) was defined by the Expanded Program of Immunization Registry, HPV 6/11/16/18 serology and parents and girls self-report. Multivariable adjusted Prevalence Ratios (aPR) and 95% confidence intervals were estimated using complementary log-log regression to identify sociodemographic factors associated to coverage and changes in HBM constructs scores associated to acceptability of the HPV vaccine. Results: 1.287 of 1.299 eligible girls and their parents completed the survey, 99% were school-registered and 97% urban area residents. The vaccine coverage was 93.4% (394/422), 84% (356/424), and 63% (279/441) for the 2003, 2004, and 2005 birth cohorts, respectively. High educational level in parents was associated with decreased HPV vaccine coverage (aPR 0.80, 95%CI 0.66-0.95). The perceived benefits increased (aPR 1.22, 95%CI 1.18-1.27 for parents; aPR 1.25, 95%CI 1.21-1.29 for girls) meanwhile, the perceived barriers (negative recommendation by family/friends, news about vaccine adverse events and health system and school barriers) decreased (aPR 0.73 95%CI 0.69-0.77 for parents; aPR 0.84 95%CI 0.79-0.88 for girls) the acceptability of HPV vaccine. Birth year (2005) and high socioeconomic status were also associated with decrease acceptability. Conclusion: Perceived barriers were associated to decreased acceptability and coverage of vaccination in the first 3 rounds of the national HPV vaccination program in Manizales, Colombia. Citation Format: Karen Cárdenas-Garzón, Maria Cecilia Agudelo, Olga Lucia Tovar-Aguirre, Sandra Franco, Kelly Paola Valverde, Nelson Arias, Difariney Gonzalez, Nilton E. Montoya, Maria Patricia Arbelaez, Isabel Cristina Garces-Palacio, Karly Louie, Simon Beddows, Gloria Sanchez. Factors Related to Human Papillomavirus Vaccine Uptake and Acceptability in Manizales, Colombia, 2017-2019: A Population-Based Study of the 2003, 2004 and 2005 Birth Cohorts. [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 61.
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