Educación sexual en las carreras de la salud del Campus Eloísa Díaz de la Universidad de Chile / Evaluation of a general education course on sexuality for university students

Background: Education on human sexuality was instituted in Eloisa Díaz Campus in 1946. From 2018 an online self-learning general education course on sexuality was started. Aim: To know the degree of knowledge about sexuality and the perception about the course of 586 students (42% women) who approved the course. Material and Methods: The Myths and False beliefs and Self-perception on sexuality tests were applied to students at the onset and the end of the course. They also anonymously evaluated the course. Results: In the first assessment, the proportion of correct answers about sexuality and reproduction were 47 and 40% respectively. In the second assessment, 70% of respondents had open criteria about sexuality and 90% rejected traditional criteria. In the anonymous assessment, 95% estimated that the objectives of the course were accomplished. Its quality was considered good or excellent by 95% of respondents. Conclusions: This course was well accepted by students and corrects their knowledge gaps in sexuality. Despite the social unrest during 2019 and the pandemic during 2020, the course was successfully completed by most students.

Diferencias de género en la calidad de vida relacionada con la salud en adolescentes escolarizados chilenos / Gender differences in health-related quality of life of Chilean adolescent students

Background: Health-related quality of life (HRQOL) refers to individuals' perception of their subjective well-being, considering various aspects of their life and the impact on their health. Aim: To analyze gender differences in the HRQOL of adolescent students in Chile, by age, type of school attended, and area of residence. Material and Methods: Analytical cross-sectional study conducted in a population of 5th and 12th grade students attending municipal, subsidized and private schools in 11 regions of the country. HRQOL was assessed with the KIDSCREEN-52, an instrument that has been previously adapted and validated in Chile. The database obtained from that adaption and validation process was analyzed. Results: In total, 7,910 students (median age 14 years, 53% female) completed the questionnaire. Compared to males, females had lower HRQOL scores in most of the KIDSCREEN-52 dimensions. However, males were more likely to have lower scores in the “Peers and Social Support” and “School Environment” dimensions. These differences remained valid when the sample was stratified by age, type of school, and area of residence were analyzed. Conclusions: This study supports the existence of inequalities in the self-perceived HRQOL of Chilean adolescent students. The existing differences are not only related to gender but are also evident when stratifying by type of school attended.

Propiedades psicométricas del cuestionario de calidad de vida relacionada con la salud KIDSCREEN-27 en adolescentes chilenos / Psychometric properties of the quality of life questionnaire health related KIDSCREEN-27 in Chilean adolescents

Background: KIDSCREEN-52, which assesses health related quality of life in adolescents, has been adapted and validated in Chile showing excellent psychometric properties. There is a shorter version of the instrument, whose psychometric properties must be assessed. Aim: To evaluate the psychometric properties of the instrument KIDSCREEN-27 in Chilean adolescents. Material and Methods: A secondary analysis of the database obtained for the adaptation and validation of KIDSCREEN-52. Results: The reliability, calculated through Cronbach’s alpha, for the entire instrument (five dimensions) was 0.89. For physical well-being, psychological well-being, autonomy and relationship with parents and peer social support dimensions, scores were higher than 0.75 while for school environment, the score was 0.69. The confirmatory factor analysis showed that the indices obtained to assess the goodness of fit in this study were a χ2 (314) = 10521.4, a Root Mean Square Error of Approximation = 0.064 and a Comparative Fit index = 0.96. KIDSCREEN-27 scores were higher among men in the physical well-being, psychological well-being, autonomy and relationship with parents dimensions and among women in social support and peers and school environment dimensions. Scores were higher in younger age groups. Conclusions: The Chilean version of KIDSCREEN-27 instrument has adequate reliability and validity.

Adaptación transcultural y validación de un instrumento de calidad de vida relacionada con la salud en adolescentes chilenos / Validation of an instrument to measure health-related quality of life in Chilean children and adolescents

Background: KIDSCREEN-52 is an instrument to assess health related quality of life in children and adolescents. Aim: To culturally adapt and validate the KIDSCREEN-52 questionnaire in Chileans. Material and Methods: Two independent translations from the English Spanish language were conciliated and retranslated to English. The conciliated version was tested during a cognitive interview to adolescents of different socioeconomic levels. The final version was validated in 7,910 school attending adolescents. Results: In the cross-cultural adaptation, 50 of the 52 items presented low or medium levels of difficulty and a high semantic equivalence. Distribution according to gender, grades and types of schools was similar to the sample. Single ages were not affected by sex distribution. The Confirmatory Factor Analyses were: X² (1229) = 20996.7, Root Mean Square Error of Approximation = .045 and Comparative Fit Index = .96. The instrument had a Cronbach’s alpha of .93. The domains had scores over 0.70 points, with the exception of the "Selfperception" domain, with a score of 0.62. Conclusions: The Chilean version of KIDSCREEN-52 is culturally appropriate and semantically equivalent in its English and Spanish versions (from Spain). Its reliability and validity were adequate.

Prevalencia de infección cervical por Chlamydia trachomatis en mujeres de la Región Metropolitana / Prevalence of cervical infection by Chlamydia trachomatis among Chilean women living in the Metropolitan Región

Background: Chlamydia trachomatis is the most common bacterial sexually transmitted infection (STI) worídwide. In women, chlamydia infections are 75 percent asymptomatic and can lead to pelvic inflammatory disease, infertility, and ectopic pregnancy. Infants exposed to the microorganism at birth also have a high risk to develop conjunctivitis and pneumonía. Aim: To determine the prevalence of C trachomatis in women in the Metropolitan área of Santiago (Chile). Patients and methods: Cervical specimens were collected from 403 women attending three gynecological outpatient settings from Apríl 2003 to June 2005. These included one public hospital (n =100), a prívate medical center (n =268), and a clinic for adolescents (n =35). Mean ages ofeach group of patients were 35.6±8,2, 33.4±8.1 and 16.9±4.2 years, respectively. The diagnosis of C trachomatis was performed by the amplification byPCRofa 517-base pair segment of the cryptic plasmid on specimens extracted by a commercial procedure. Positive specimens were conñrmed by nested PCRs targeting the ompl gene. The presence of vaginal infections and its association with C trachomatis was investigated in a subset of 223 women ofthe prívate center. Residís: C trachomatis was detected in the cervix of 19 out of 403 women, resulting in a prevalence of 4.7 percent. The distribution of positive cases among different age groups was not significantly different. Women presenting with bacterial vaginosis had a significantly higher prevalence of C trachomatis infection (p <0.01). Conclusions: This study found a high prevalence of C trachomatis among gynecologic patients that should prompt preventive strategies.

Madres niñas-adolescentes de 14 años y menos: Un grave problema de salud pública no resuelto en Chile / Teenage fecundity rates in Chile: A serious public health problem

Background: Teenage fecundity rates are an indicator of epidemiological discrimination in developing countries. Aim: To study fertility rates of girls under 14 years of age in Chile from 1993 to 2003. Material and methods: Information of children born alive from mothers aged 10 to 15 years, was obtained from the Chilean National Institute of Statistics. Age segmented population data was obtained from the Ministry of Health. Trends were analyzed by regions and single ages. The rates in communities of the Metropolitan Region were compared. Results: Between 1993 and 2003, there was an increasing trend in fecundity rates, ratios and crude numbers. These rates duplicate from 14 to 15 years of age. In the Metropolitan Region, the fecundity ratios of communities with lower economical incomes is seven times greater than those with higher incomes. During 2003, the fecundity rates in Chile were 100 and 10 higher than those of Holland and Sweden in 1981. Conclusions: In developing countries with very low infant mortality rates such as Chile, the high fecundity rates of young girls is an indicator of a deficient human and social development. Sexual Education and Health Services for adolescents are essential to prevent this public health problem.

Prevención del embarazo en mujeres con alto riesgo de aborto. Resultados de un proyecto de intervención en la comunidad / Pregnancy in women prevention with broad risk of abortion. Results of a project of intervention in the community

Objetivo: Es un estudio controlado, de cohorte e intervención en comunidad de bajo nivel socioeconómico, para determinar el efecto preventivo de la planificación familiar en el aborto provocado. Método: Se comparó tres comunidades muy similares. Una de ellas fue intervenida con alta calidad de servicios clínicos y seguimiento de las mujeres de alto riesgo de aborto. Otra comunidad sólo tuvo servicios de alta calidad sin seguimiento de las potenciales usuarias y la tercera comunidad fue de control, con los servicios habituales de atención. Las mujeres de las tres comunidades fueron entrevistadas antes de la intervención y 2 años después de iniciada la intervención. Se comparó ambas encuestas hechas a las mismas mujeres, en las tasas de aborto y fecundidad, de acuerdo al uso y no uso de anticonceptivos y al nivel riesgo de provocarse aborto. Resultados: La prevalencia de aborto desciende en forma significativa en la comunidad con alto riesgo de aborto y con intervención directa y total. Las tasas de fecundidad descienden en las tres comunidades, pero más en la comunidad no intervenida. Se concluye que los servicios de alta calidad en planificación familiar, en mujeres con riesgo de aborto y en un medio donde el aborto es totalmente penalizado, tienen un impacto significativo en su prevención, sin afectar la natalidad. Se recomienda aplicar esta metodología en programas de atención primaria para prevenir el aborto provocado clandestino.

Vida sexual activa en nuestra juventud y SIDA / Chilean teenager sexual behaviour and AIDS

Se estima que 20 a 60% de la juventud chilena es sexualmente activa antes de cumplir los 20 años dependiendo del sexo y nivel socio económico. Dadas las características epidemiológicas de la conducta sexual de este grupo poblacional y de la falta de información y educación en relación a E.T.S. y la falta de métodos protectores para estas transmisibles, se convierten en un grupo de alto riesgo potencial de adquirir SIDA