Análisis de las demoras en salud en personas que enfermaron de gravedad o fallecieron por dengue en cinco ciudades de Colombia

Pinto, Fabián Ardila; Martínez, Sandra; Fuentes, Mauricio; Borrero, Elizabeth

doi:10.1590/s0103-73312015000200013

Cited by 9 publications

(16 citation statements)

References 5 publications

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“…According to the SES level of the neighborhood of residency, findings from the joint model suggests a non-monotonic distribution of cases across SES levels, with fewer cases at low and high SES levels. There were fewer cases among neighborhoods at the lowest SES level, which could be attributed to limited access (physical and financial) to health care, compared to people living in neighborhoods with medium- or higher SES levels and or health seeking behavior (1, 2, 51-53). Although the rate of dengue cases seems to decrease in neighborhoods at the high SES level, the lack of precision (i.e., high uncertainty of the posterior distribution) of the estimates could be attributed to the small number of cases in this stratum (n=193 cases).…”

Section: Discussionmentioning

confidence: 95%

“…In Colombia, the health coverage under the contributory system corresponds to employed individuals or people with capacity to pay for their health system coverage (affiliated to a private insurance plan or out-of-pocket) and the subsidized system corresponds to individuals for whom the state pays for health coverage. Health insurance here was modeled as a proxy for socioeconomic status at the individual level (30, 51, 52). In our study, most of the notified cases were from the contributory system and contributory insurance was associated to the overall dengue rates but not to severity (1, 2, 51-53).…”

Section: Discussionmentioning

confidence: 99%

“…Health insurance here was modeled as a proxy for socioeconomic status at the individual level (30, 51, 52). In our study, most of the notified cases were from the contributory system and contributory insurance was associated to the overall dengue rates but not to severity (1, 2, 51-53). Using the health insurance as a proxy for individual socioeconomic status could be challenging but modeling simultaneously area level-socioeconomic characteristics and individual-level socioeconomic status or their proxy addresses this issue, at least partially.…”

Section: Discussionmentioning

confidence: 99%

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A joint spatial marked point process model for dengue and severe dengue in Medellin, Colombia

Carabalí

Restrepo

et al. 2021

Preprint

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The spatial distribution of surveillance-reported dengue cases and severity are usually analyzed separately, assuming independence between the spatial distribution of non-severe and severe cases. Given the availability of data for the individual geo-location of surveillance-notified dengue cases, we conducted a cross-sectional study to model non-severe and severe dengue simultaneously, identifying the spatial patterns of dengue distribution, using individual and area level covariates within a hierarchical Bayesian model. Results showed that age and socioeconomic status were associated with dengue presence, and there was evidence of clustering for overall cases but not for severity. Our findings inform decision making to address the preparedness or implementation of dengue control strategies at the local level.HighlightsA model to jointly assess the spatial distribution of reported dengue and severity.We account for uncertainty in the surveillance-reported dengue while modelling severe cases.We assess spatial clustering using individual locations of dengue cases in Medellin.Young age was associated with higher dengue rates and older age to dengue severity.Non-monotonic distribution of reported dengue cases across socioeconomic status.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A joint spatial marked point process model for dengue and severe dengue in Medellin, Colombia

Carabalí

Restrepo

et al. 2021

Preprint

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“…In addition, mortality rates and severe outcomes are higher among people at the bottom of the socioeconomic distribution [5]. For instance, 80% of dengue and 70% of chikungunya deaths in Colombia were cases from the government‐subsidised health programme (i.e., low socioeconomic position) [6, 7]. In Brazil, there is an increased risk of dengue death, with rates between 40% and 70% larger among people with less than 4 years of schooling [8, 9].…”

Section: Introductionmentioning

confidence: 99%

“…A reduction of dengue deaths by 10% has also been observed among people with a median monthly income over US$350 (roughly US$100 above the minimum wage) [8]. In general, people in low socioeconomic position are contributing differentially to the morbidity and mortality burden of vector‐borne diseases [5, 7–10].…”

Section: Introductionmentioning

confidence: 99%

Spatiotemporal distribution and socioeconomic disparities of dengue, chikungunya and Zika in two Latin American cities from 2007 to 2017

Carabalí

Neto

Sousa

et al. 2020

Tropical Med Int Health

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Objective To assess the presence, pattern and magnitude of socioeconomic inequalities on dengue, chikungunya and Zika in Latin America, accounting for their spatiotemporal distribution. Methods Using longitudinal surveillance data (reported arboviruses) from Fortaleza, Brazil and Medellin, Colombia (2007–2017), we fit Bayesian hierarchical models with structured random effects to estimate: (i) spatiotemporally adjusted incidence rates; (ii) Relative Concentration Index and Absolute Concentration Index of inequality; (iii) temporal trends in RCIs; and (iv) socioeconomic‐specific estimates of disease distribution. The spatial analysis was conducted at the neighbourhood level (urban settings). The socioeconomic measures were the median monthly household income (MMHI) for Brazil and the Socio‐Economic Strata index (SES) in Colombia. Results There were 281 426 notified arboviral cases in Fortaleza and 40 887 in Medellin. We observed greater concentration of dengue among residents of low socioeconomic neighbourhoods in both cities: Relative Concentration Index = −0.12 (95% CI = −0.13, −0.10) in Fortaleza and Relative Concentration Index = −0.04 (95% CI = −0.05, −0.03) in Medellin. The magnitude of inequalities varied over time across sites and was larger during outbreaks. We identified a non‐monotonic association between disease rates and socioeconomic measures, especially for chikungunya, that changed over time. The Relative Concentration Index and Absolute Concentration Index showed few if any inequalities for Zika. The socioeconomic‐specific model showed increased disease rates at MMHI below US$400 in Brazil and at SES‐index below level four, in Colombia. Conclusions We provide robust quantitative estimates of socioeconomic inequalities in arboviruses for two Latin American cities. Our findings could inform policymaking by identifying spatial hotspots for arboviruses and targeting strategies to decrease disparities at the local level.

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Dengue: actualidades y estándares en el manejo clínico. Revisión de tema

Pérez-Gutiérrez

Amador-León

2021

Acta Colombiana de Cuidado Intensivo

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Análisis de las demoras en salud en personas que enfermaron de gravedad o fallecieron por dengue en cinco ciudades de Colombia

Cited by 9 publications

References 5 publications

A joint spatial marked point process model for dengue and severe dengue in Medellin, Colombia

A joint spatial marked point process model for dengue and severe dengue in Medellin, Colombia

Spatiotemporal distribution and socioeconomic disparities of dengue, chikungunya and Zika in two Latin American cities from 2007 to 2017

Dengue: actualidades y estándares en el manejo clínico. Revisión de tema

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