Malaria remains endemic in 21 countries of the American continent with an estimated 427,000 cases per year. Approximately 10% of these occur in the Mesoamerican and Caribbean regions. During the last decade, malaria transmission in Mesoamerica showed a decrease of ~85%; whereas, in the Caribbean region, Hispaniola (comprising the Dominican Republic [DR] and Haiti) presented an overall rise in malaria transmission, primarily due to a steady increase in Haiti, while DR experienced a significant transmission decrease in this period.The significant malaria reduction observed recently in the region prompted the launch of an initiative for Malaria Elimination in Mesoamerica and Hispaniola (EMMIE) with the active involvement of the National Malaria Control Programs (NMCPs) of nine countries, the Regional Coordination Mechanism (RCM) for Mesoamerica, and the Council of Health Ministries of Central America and Dominican Republic (COMISCA). The EMMIE initiative is supported by the Global Fund for Aids, Tuberculosis and Malaria (GFATM) with active participation of multiple partners including Ministries of Health, bilateral and multilateral agencies, as well as research centers. EMMIE’s main goal is to achieve elimination of malaria transmission in the region by 2020. Here we discuss the prospects, challenges, and research needs associated with this initiative that, if successful, could represent a paradigm for other malaria-affected regions.

Introduction: Self-medication is an increasingly frequent phenomenon worldwide; some studies suggest that there is a relationship with socio-economic and cultural factors. Objective: To determine the prevalence of self-medication and its related factors in a Colombian city. Materials and methods: Cross-sectional descriptive study, in Pereira, Colombia. We selected 414 adults using simple randomization sampling with houses used as the observational unit. The IRIS-AM instrument was used to collect the information required. Results: Four hundred and fourteen (414) people were interviewed, 62.6% were females, and mean age was 44 years; 77.5% of the sample had self-medicated at least once in their life and 31.9% during the last month. The most commonly used medications were: analgesics and antipyretics (44.3%), non-steroidal anti-inflammatory drugs and anti-rheumatic medication (36.4%), and anti-histamine medication (8.5%). The most commonly self-medicated symptoms were: headache (55.7%), cold (16.2%) and muscular pain (13.2%). Multivariate analysis revealed an association between self-medication throughout life and storing medications at home, and between a high level of education and having a favorable opinion of self-medication. Storing medications at home and recommending them to others were associated with self-medication during the previous 30 days. Conclusion: Self-medication rates were found to be similar to those reported globally, but there is not an established pattern for this practice. Associations were found between social and demographic variables and self-medication, which require further characterization. Intention to self-medicate has not been well-described in other studies, and may be an important indicator which will contribute to future understanding of this phenomenon.

Introduction:The prescription and costs of antiulcer medications for in-hospital use have increased during recent years with reported inadequate use and underused.Aim: To determine the patterns of prescription-indication and also perform an economic analysis of the overcost caused by the non-justified use of antiulcer medications in a third level hospital in Colombia.Materials and methods: Cross-sectional study of prescription-indication of antiulcer medications for patients hospitalized in "Hospital Universitario San Jorge" of Pereira during July of 2012. Adequate or inadequate prescription of the first antiulcer medication prescribed was determined as well as for others prescribed during the hospital stay, supported by clinical practice guidelines from the Zaragoza I sector workgroup, clinical guidelines from the Australian Health Department, and finally the American College of Gastroenterology Criteria for stress ulcer prophylaxis. Daily defined dose per bed/day was used, as well as the cost for 100 beds/day and the cost of each bed/drug. A multivariate analysis was carried out using SPSS 21.0.Results: 778 patients were analyzed, 435 men (55.9 %) and 343 women, mean age 56.6 ± 20.1 years. The number of patients without justification for the prescription of the first antiulcer medication was 377 (48.5 %), and during the whole in-hospital time it was 336 (43.2 %). Ranitidine was the most used medication, in 438 patients (56.3 %). The cost/month for poorly justified antiulcer medications was € 3,335.6. The annual estimated cost for inadequate prescriptions of antiulcer medications was € 16,770.0 per 100 beds.Conclusion: A lower inadequate prescription rate of antiulcer medications was identified compared with other studies; however it was still high and is troubling because of the major costs that these inadequate prescriptions generates for the institution.

ResumenIntroducción: Los trastornos de la conducta alimentaria (TCA) son la tercera enfermedad crónica más prevalente en adolescentes, por lo que se consideran un problema de salud pública. Objetivo: Determinar la prevalencia de trastornos de la conducta alimentaria en estudiantes de media académica de colegios públicos de la zona urbana de la ciudad de Pereira Métodos: Se realizó un estudio descriptivo con muestreo aleatorio mediante distribución proporcional entre los colegios públicos de la zona urbana de Pereira agrupados por sectores según su ubicación. Se aplicó la Encuesta de Comportamiento Alimentario (ECA). Resultados: Se encuestaron 382 estudiantes, 58,9% hombres. La ECA fue positiva en el 24,3% de los encuestados. Según el Índice de Masa Corporal el 9,7% de la población se encontraba en rangos de delgadez, 5,8% sobrepeso y 1,6% obesidad. Se encontró relación (p<0,05) entre el género femenino y la ECA positiva (RM=3,83), realización de dietas (RM=1,55), alteración de la auto imagen (RM=1,79), uso de laxantes (RM=2,58) e inducción del vómito (RM=4,41). El 33,4% reportó tener con alguna frecuencia episodios de consumo de grandes cantidades de alimentos acompañados de sensación de culpa. Discusión: Existen alteraciones comportamentales relacionadas con trastornos de la conducta alimentaria en esta población, por lo que es necesario generar programas de prevención y promoción de los TCA enfocados para adolescentes. Palabras clave: Trastornos de la conducta alimentaria, Psiquiatría del adolescente, Tamizaje masivo Eating disordder among adolescents in public schools from Pereira Abstract Introduction: Eating disorders (ED) are the third most prevalent chronic disease among adolescents and they are considered a public health issue. Objective: To determine the prevalence of eating disorders in students from 10 th and 11 th grade in public high schools at the urban area of Pereira city. Methods: A descriptive study was conducted. Participants were randomly sampled using proportional allocation among public schools at the urban area of Pereira and the "Encuesta de Comportamiento Alimentario (ECA)" was applied.Results: 382 students were interviewed, of which 58.9% were male. ECA test scores were positive for eating disorders in 24.3% of the study sample. According to the Body Mass Index, 9.7% of the population was classified as underweight, 5.8% were overweighed and 1.6% were obese. The presence of episodes of eating large amounts of food followed by guilt was reported in 33.4% of the cases. A statistically significant relationship was found (p<0.005) among female gender and positive ECA results (OR=3.83), dieting (OR=1.55), altered self-image (OR=1.79), laxatives use (OR=2.58) and induced vomiting (OR=4.41). Discussion: Clearly, eating behaviors related to ED are already established in this population; therefore, prevention and promotion programs focused on teenager populations should be designed. Key words: Eating disorders, Adolescent Psychiatry, Mass screening IntroducciónLos trastornos de la conducta alimen...

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