Supplemental Digital Content is available in the text
The designed survey is valid, relevant and representative of access to health services in Colombia. Empirically, the pilot showed institutional weaknesses in a municipality of the country, indicating that health coverage does not in practice mean real and effective access to health services.
Introduction: Bordetella pertussis causes whooping cough or convulsive cough, a contagious and immune-preventable disease. It is one of the 10 leading causes of death among children younger than one year of age, when not completely immunized. It is considered reemerging in several countries, with high rates of complications and hospitalizations. Objective: to learn of the proportion of infection by B. pertussis among suspected cases of whooping cough and their household contacts among children from the southeast zone of Cali, a geographic area with great consultation demand due to this infection. Methodology: This is a cross-sectional descriptive study. Epidemiological data and nasopharyngeal samples were taken from 24 suspected cases and from their 109 household contacts. The samples were analyzed via real-time polymerase chain reaction (Q-PCR) and through culture. Results: The proportion of positivity among the cases via the Q-PCR technique was at 50% (12/24) and at 40% via the culture technique (8/20), with good agreement between both techniques (Kappa 0.61). Regarding the household contacts, 30.3% (33/109) (CI 95%: 21.8%-39.8%) tested positive. The sibling contacts (7/15) and the mothers (7/22) presented the greatest proportion of positivity. Regarding age, 60% were 4 years of age (3/5) and 50% were in the group comprised of individuals 45 to 64 years of age. No significant differences were found among the presence or absence of symptoms and the presence of B. pertussis infection, except for the presence of nasal secretions (runny nose) (27%) and coughing (36%) during the last month. Conclusions: The study confirms the high prevalence of asymptomatic infection by B. pertussis among household contacts of children with whooping cough symptomatology and its household transmission. In Cali, health authorities need to review the effectiveness of implemented control strategies and the use of a vaccination scheme that does not cover adolescent and adult populations as a focus of infection control.
Introducción. El acceso a servicios de salud es una de las principales preocupaciones de las políticas sanitarias. En el Valle del Cauca es escasa la información local sobre acceso efectivo desde la perspectiva de la población. Objetivo. Analizar el comportamiento del acceso a los servicios de salud de la población urbana del municipio de Palmira, Valle del Cauca en el año 2017. Método. Estudio cuantitativo transversal, a través de encuesta aplicada a una muestra de 242 hogares; el muestreo fue probabilístico, estratificado, multietápico por conglomerados. Resultado. Urgencias y consulta médica evidencian alta resolución de la necesidad demandada y satisfacción, pero baja oportunidad; la continuidad de la atención se ve afectada por excesiva tramitología, no autorización de servicios y no entrega de medicamentos; en consulta especializada la oportunidad es baja; hospitalización reportó mejor en la oportunidad, alta satisfacción y alta resolución de la necesidad; en servicios preventivos la escasa promoción de la oferta determina el poco uso de los servicios, y en varios casos, es mayor el uso que la promoción. Discusión. Se corroboran resultados de estudios anteriores; se destaca la importancia de las barreras administrativas y estructurales del sistema para comprender la problemática del acceso en Colombia. Conclusiones. Pese al aumento en el aseguramiento de la población persisten problemas que impiden el acceso real de la población a los servicios de salud, relacionados con oportunidad, continuidad, complementariedad y gasto de bolsillo; la escasa promoción de los servicios preventivos evidencia el enfoque curativo del modelo de atención en salud en Colombia.
BackgroundSince more common patterns of antinuclear antibodies (ANAs) such as homogeneous or nucleolar patterns are well recognized, the prevalence of uncommon or atypical pattern is not well describedObjectivesOur aim was to describe the prevalence of atypical ANAs patterns in a big cohort of ANA measurements in general Colombian population.MethodsWe included all ANAS determinations done during 2 consecutive years (2013 and 2014) from Dinamica IPS in 8 different cities in Colombia. We defined such as uncommon patters the following: anti MSA-2 (mitotic spindle apparatus), cytoplasmatic fibers, lysosomal, Golgi, multiple dots, NuMA1 (MSA-1), anti MSA-3, PCNA, centrosome and nuclear envelope. All patient sera submitted for ANAs testing were tested by conventional indirect immunofluorescence using Hep-2 cells (AESKU.DIAGNOSTICS, Wendelsheim, Germany). We use 3 images for sample and in some cases several dilutions were needed. Parametric test were used for comparison among groups.ResultsThe overall sample included 113,491 consecutive samples for ANAs, being positive in 62,501 (55%) cases. 912 (1.45%) samples in 838 patients were classified as atypical pattern. Mean age for atypical positive pattern patients was 47±16.8 years and 80% of patients were female. The most common atypical patterns are summarized in Table. We did not find any difference among sex according atypical patterns. In subgroup analysis, centrosome pattern was more common in younger patients (<18 years) than in older than 18 years (27.84% vs 11.5%; Chi2, p=0.001), anti MSA-2 pattern was significantly more common in patients >18 years than in ≤18 years (23.6% vs 11.3%; Chi2, p=0.038), and cytoplasmic fibers was more prevalent in patients older than 55 years (14.7 vs 9%, p=0.013).Table 1.More common atypical ANA patterns in Colombian populationN=843%NuMA29435.0Midbody (MSA-2)19022.5Centriosome10612.5Cytoplasmatic fibers9311.0Multiple dots829.7Lysosomal283.3Golgi212.5PCNA192.3MSA-381.0Nuclear envelope20.2ConclusionsIn this large cohort of almost 130.000 samples of ANAs from a Colombian general population, the prevalence of atypical ANAs was around 1.5%. That prevalence is in concordance with some other series (1). Anti NuMa and MSA-2 patterns were the most common atypical ANAS. Anti centrosome were more common in young people, anti MSA in middle age patients and anti cytoplasmic fibers in elderly population.ReferencesVermeersch P et al. Autoimmunity Rev 2013;12:998–1003Disclosure of InterestNone declared
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.