The impact of maternal morbidity on cesarean section rates: exploring a Latin American network of sentinel facilities using the Robson's Ten Group Classification System

Background: Latin America has the highest Cesarean Section Rates (CSR) in the world. Robson's Ten Group Classification System (RTGCS) was developed to enable understanding the CSR in different groups of women, classified according to obstetric characteristics into one of ten groups. The size of each CS group may provide helpful data on quality of care in a determined region or setting. Data can potentially be used to compare the impact of conditions such as maternal morbidity on CSR. The objective of this study is to understand the impact of Severe Maternal Morbidity (SMM) on CSR in ten different groups of RTGCS. Methods: Secondary analysis of childbirth information from 2018 to 2021, including 8 health facilities from 5 Latin American and Caribbean countries (Bolivia, Guatemala, Honduras, Nicaragua, and the Dominican Republic), using a surveillance database (SIP-Perinatal Information System, in Spanish) implemented in different settings across Latin America. Women were classified into one of RTGCS. The frequency of each group and its respective CSR were described. Furthermore, the sample was divided into two groups, according to maternal outcomes: women without SMM and those who experienced SMM, considering Potentially Life-threatening Conditions, Maternal Near Miss and Maternal Death as the continuum of morbidity. Results: Available data were obtained from 92,688 deliveries using the Robson Classification. Overall CSR was around 38%. Group 5 was responsible for almost one-third of cesarean sections. SMM occurred in 6.7% of cases. Among these cases, the overall CSR was almost 70% in this group. Group 10 had a major role (preterm deliveries). Group 5 (previous Cesarean section) had a very high CSR within the group, regardless of the occurrence of maternal morbidity (over 80%). Conclusion: Cesarean section rate was higher in women experiencing SMM than in those without SMM in Latin America. SMM was associated with higher Cesarean section rates, especially in groups 1 and 3. Nevertheless, group 5 was the major contributor to the overall CSR. (AU)

Recall en la industria alimentaria: una estrategia sanitaria por implementar en Colombia / Recall in the food industry: a health strategy to implement in Colombia

Resumen Las medidas sanitarias y fitosanitarias en los mercados internacionales han llevado a que la industria alimentaria cuente con alarmas técnicas durante sus procesos de comercialización; una de las estrategias utilizadas por algunos estados para regular las alarmas es el Recall. Este proceso, que consiste en el retiro de productos del mercado, previene impactos negativos en la salud de la población y en la reputación de la industria del sector alimentario ya que garantiza la inocuidad y calidad de los alimentos que llegan al consumidor. El Recall obliga a un plan de retiro en anaquel en los sitios de venta o en alguna de las fases de producción, para lo cual se debe implementar un sistema de trazabilidad que permita rastrear un producto durante toda la cadena productiva a través de una adecuada codificación. Del mismo modo, esta estrategia demanda un marco jurídico y regulatorio en cada país que requiere colaboración de la industria, el consumidor y las ligas y asociaciones de consumidores. Colombia tiene acciones de gestión de alerta sanitaria para tomar decisiones a fin de proteger la salud pública del país, pero están limitadas a dos sistemas de alerta que trabajan en coordinación con las alertas sanitarias emitidas por organismos reguladores internacionales que cuentan con un sistema propio.

Abstract Sanitary and phytosanitary measures taken by international markets have led the food industry to develop technical warnings during marketing processes. Recall is one of the strategies used by some states to regulate such warnings. This process, which involves withdrawal of products from the market, prevents negative impacts on the health of the population and the reputation of the food industry, since safety and quality of food that reaches the consumer is ensured. Recall requires a withdrawal plan from shelves at retail sites or at any of the stages of production; therefore, a tracking system must be implemented to track products throughout the entire production chain by using proper coding. Similarly, this strategy requires a legal and regulatory framework in each country and collaboration from the industry, consumers and consumer associations and leagues. Colombia has developed a management system for health warnings to make decisions in order to protect public health in the country, but they are limited to two warning systems working in coordination with the health warnings issued by international regulatory bodies with their own systems.

Actividad antimicrobiana In vitro de angiospermas colombianas / In vitro antimicrobial activity of Colombian angiosperms

Se determinó la actividad de 29 especies de angiospermas frente a Bacillus subtilis, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Salmonella typhi, Staphylococcus aureus, Candida albicans, Aspergillus niger, Fusarium oxisporum y Mucor sp. Las especies Cavendishia bracterata, Piper aduncum, Aragoa abietina y Piper bogotensis presentaron la mayor actividad antibacteriana y Chromolaena odorata mostró actividad antifúngica y antibacterina