Suchergebnisse

Undernutrition produces physical and irreversible damage in cognitive capacity, growth disorders, motor and cognitive delays and decreased immunity. In addition, undernutrition increases morbidity and mortality in children under-five. We estimated the factors associated with undernutrition in children under-five in La Guajira, Colombia. We conducted a cross-sectional multivariate analysis, using data of the Colombian National Survey of the Nutritional Situation (ENSIN, in Spanish). We estimated a logit model on the determinants of global malnutrition. The outcome variable was undernutrition, defined as weightfor-age lesser or equal than two standard deviation. We estimated Odds Ratios (OR) adjusted by the sample design in order to assess the risk of each group compared to a reference group. We studied 622 children under-five years, of which 52.7% were men and 55% lived in rural areas. Out of the total, 11.2% of the children had global undernutrition. Being of the sixth child onwards increases the risk of global undernutrition (OR=4.07, CI95%=1.50-10.99). Also, living at homes with sewerage service provides protection against global undernutrition (OR=0.16, CI95%=0.05-0.57). In short, sewerage service and large families were associated with undernutrition in La Guajira, Colombia. To affect these social health determinants would improve the policy of surveillance and control of undernutrition in children under-five years. ; La desnutrición infantil produce daños físicos e irreversibles en la capacidad cognitiva, trastornos del crecimiento, retrasos motores y cognitivos, disminución de la inmunidad y un aumento de la morbilidad y mortalidad. Este estudio estimó los factores asociados a la desnutrición en menores de cinco años en La Guajira, Colombia. Se realizó un análisis multivariado de corte transversal, a partir de la Encuesta Nacional de Salud Nutricional (ENSIN). Se estimó un modelo logit sobre los determinantes de la desnutrición global. La variable dependiente se construyó como el peso para la edad menor a dos desviaciones estándar. Se estimaron Odds Ratio (OR) ajustados por pesos muestrales para evaluar el riesgo de las variables independientes con sus valores de referencias. Entre los principales hallazgos, se estudiaron 622 niños menores de cinco años de La Guajira, de los cuales 52,7% fueron hombres y 55% vivían en zona rural. El 11,2% de los niños presenta desnutrición global. Ser el sexto hijo o posterior representa un mayor riesgo de desnutrición global (OR=4,07, IC95%=1,50–10,99), mientras que habitar viviendas con servicio de alcantarillado los protege de sufrir este tipo de desnutrición (OR=0,16, IC95%=0,05–0,57). No contar con servicio de alcantarillado y pertenecer a una familia numerosa resultan siendo características de contexto que se asocian con un mayor riesgo de desnutrición infantil en esta región. Afectar estos determinantes sociales permitirá hacer más eficiente la política de vigilancia y control de la desnutrición en este grupo etario. ; La dénutrition entraîne des dommages physiques et irréversibles de la capacité cognitive, des troubles de la croissance, des retards moteurs et cognitifs et une diminution de l'immunité. De plus, la dénutrition augmente la morbidité et la mortalité chez les enfants de moins de cinq ans. Nous avons estimé les facteurs associés à la dénutrition chez les enfants de moins de cinq ans à La Guajira, en Colombie. Nous avons effectué une analyse multivariée transversale, en utilisant les données de l'Enquête nationale colombienne sur la situation nutritionnelle (ENSIN, en espagnol). Nous avons estimé un modèle logit sur les déterminants de la malnutrition globale. La variable de résultat était la dénutrition, définie comme un rapport poids / âge inférieur ou égal à deux écarts-types. Nous avons estimé les rapports de cotes (OR) ajustés par le plan de sondage afin d'évaluer le risque de chaque groupe par rapport à un groupe de référence. Nous avons étudié 622 enfants de moins de cinq ans, dont 52,7% d'hommes et 55% vivant en milieu rural. Sur ce total, 11,2% des enfants souffraient de dénutrition mondiale. Le fait d'avoir un sixième enfant augmente le risque de dénutrition globale (OR = 4,07, IC95% = 1,50-10,99). De plus, le fait de vivre dans des maisons avec un service d'assainissement offre une protection contre la dénutrition mondiale (OR = 0,16, IC95% = 0,05-0,57). En bref, les services d'assainissement et les familles nombreuses étaient associés à la dénutrition à La Guajira, en Colombie. Affecter ces déterminants sociaux de la santé améliorerait la politique de surveillance et de contrôle de la dénutrition chez les enfants de moins de cinq ans.

Background: Colombia detected its first coronavirus disease 2019 (COVID-19) case on March 2, 2020. From March 22 to April 25, it implemented a national lockdown that, apparently, allowed the country to keep a low incidence and mortality rate up to mid-May. Forced by the economic losses, the government then opened many commercial activities, which was followed by an increase in cases and deaths. This paper presents a critical analysis of the Colombian surveillance data in order to identify strengths and pitfalls of the control measures. Methods: A descriptive analysis of PCR-confirmed cases between March and July 25 was performed. Data were described according to the level of measurement. Incidence and mortality rates of COVID-19 were estimated by age, sex, and geographical area. Sampling rates for suspected cases were estimated by geographical area, and the potential for case underestimation was assessed using sampling differences. Results: By July 25, Colombia (population 50 372 424) had reported 240 745 cases and 8269 deaths (case fatality rate of 3.4%). A total of 1 370 271 samples had been analyzed (27405 samples per million people), with a positivity rate of 17%. Sampling rates per million varied by region from 2664 to 158 681 per million, and consequently the incidence and mortality rates also varied. Due to geographical variations in surveillance capacity, Colombia may have overlooked up to 82% of the actual cases. Conclusion: Colombia has a lower case and mortality incidence compared to other South American countries. This may be an effect of the lockdown, but may also be attributed, to some extent, to geographical differences in surveillance capacity. Indigenous populations with little health infrastructure have been hit the hardest.