Evaluation of the quality of prenatal care in Colombia during the 2016 Zika outbreak in endemic and non-endemic areas

Objetive: To evaluate the quality of prenatal care during the outbreak of Zika virus infection in endemic and non-endemic vector-borne regions in Colombia. Materials and methods: A descriptive study of prenatal care supplemented by interviews to explore personal experiences during the epidemic. A total of 40 pregnant women in endemic areas and 44 in nonendemic areas participated. Information collected included previous pregnancies, reasons for starting prenatal care, information about Zika, prenatal care (activities of doctors, nurses, laboratories, and images), and perceptions of quality. Then, 8 interviews were conducted with pregnant women diagnosed with Zika. Questioned about knowledge of Zika and the quality of medical care services. Results: Problems with laboratories and diagnostic images were found in both regions and dehumanizing treatment in the endemic region. Women from the endemic region received news and communications about the effects of Zika during pregnancy, causing anxiety and fear among some women. The quality of health care was not what the women expected and they thought they would receive more care from doctors and nurses. Discussion: Our findings show deficiencies in education provided in health institutions. The experience during prenatal control in the endemic regions was imprecise and the information came from other sources, different from the health sector. Adittionally, support and follow-up was deficient as well. It's possible that health professionals have few knowledge about information management, which generated confusion, fear and uncertainty among the pregnant women about the adverse effects on the newborns. Conclusions: Findings suggest deficiencies in the technical quality of the prenatal care provided, particularly in the region that was endemic for vector-borne diseases. Reproductive health services and the technical quality of prenatal care need to be strengthened, especially during a sanitary crisis.

Objetivo: Evaluar la calidad de la atención prenatal durante la epidemia de Zika en regiones endémicas y no endémicas de infecciones trasmitidas por vectores en Colombia. Materiales y Métodos: Estudio descriptivo de la atención prenatal complementado con entrevistas, con el fin de explorar experiencias personales durante la epidemia. Participaron 40 gestantes en zona endémica y 44 en no endémicas. La información recolectada incluyó embarazos previos, razones para iniciar control prenatal, información sobre Zika, control prenatal (actividades de médicos, enfermeras, laboratorios e imágenes) y percepción de calidad. Luego se realizaron 8 entrevistas a gestantes con diagnóstico de Zika. Se interrogó sobre conocimiento del Zika y calidad de los servicios de atención médica. Resultados: Se encontraron problemas con laboratorios e imágenes diagnósticas en ambas regiones y trato deshumanizado en la región endémica. Las gestantes en la región endémica recibieron noticias y comunicados sobre los efectos de Zika durante el embarazo, lo que causó ansiedad y miedo en algunas mujeres. La calidad de la atención medica no era la deseada y pensaron que recibirían mejor atención de médicos y enfermeras. Discusión: Nuestros hallazgos demuestran educación deficiente en las instituciones de salud. La experiencia durante el control prenatal en las regiones endémicas fue imprecisa y venía de fuentes diferentes al sector salud. Además, el soporte y seguimiento fue deficiente. Es probable que el personal de salud tenga poco conocimiento sobre cómo manejar la información, lo cual generó confusión, miedo e incertidumbre entre las gestantes sobre los efectos adversos en los bebes. Conclusiones: Los hallazgos sugieren deficiencia en la calidad técnica de la atención prenatal, particularmente en la región endémica. Es necesario fortalecer los servicios de salud reproductiva y la calidad técnica de la atención prenatal, especialmente durante crisis sanitaria.

Factores de riesgo relacionados con el síndrome poscovid-19 en pobladores pinareños / Risk factors related to postcovid­19 syndrome in residents from Pinar del Río i: en

Introducción: Las posibilidades de padecer el síndrome poscovid-19 crecen en la medida en que se expande la pandemia. Objetivo: Identificar los factores de riesgo relacionados con el síndrome poscovid-19 en pobladores pinareños. Métodos: Se realizó un estudio de casos y controles, que incluyó a convalecientes de covid-19, atendidos en la consulta multidisciplinaria del Policlínico Luis Augusto Turcios Lima de la provincia de Pinar del Río durante el 2022, quienes fueron incluidos de forma aleatoria en 2 grupos, a razón de 1:2 (100 casos y 200 controles). El análisis estadístico se basó en una estrategia univariada, que consistió en la determinación del odds ratio para cada factor de riesgo, así como en la estimación de los intervalos de confianza al 95 % y la prueba de la Χ2, con un nivel de significación de p<0,05. Resultados: En el estudio predominaron el sexo femenino, la diabetes mellitus, el tratamiento farmacológico, el soporte ventilatorio, la presencia de secuelas establecidas y las complicaciones. Conclusiones: A pesar de identificar los factores de riesgo más frecuentes relacionados con el síndrome poscovid-19, este continúa siendo un desafío para los profesionales de la salud.

Introduction: The possibilities to suffer from the postcovid-19 syndrome grow as the pandemic expands. Objective: To identify the risk factors related to the postcovid-19 syndrome in residents from Pinar del Río. Methods: A cases and controls study that included covid-19 convalescents was carried out. They were assisted in the multidisciplinary service of Luis Augusto Turcios Lima Polyclinic of Pinar del Rio province during 2022 that were included in 2 groups at random, at a ratio of 1:2 (100 cases and 200 controls). The statistical analysis was based on an univaried strategy, for which the odds ratio was determined for each risk factor and the confidence intervals were considered at 95 %, as well as the chi-square test, with a significance level of p<0,05. Results: In the study there was a prevalence of the female sex, diabetes mellitus, pharmacological treatment, ventilation support, the presence of established sequels and complications. Conclusions: In spite of identifying the most frequent risk factors related to the postcovid-19 syndrome, it is still a challenge for health professionals.

Manifestaciones mucocutáneas de la fiebre de chikungunya / Mucocutaneous manifestations of chikungunya fever

Las manifestaciones típicas de la Chikungunya son la fiebre y las artralgias en la mayoría de los casos, pero debemos recordar que presentan manifestaciones mucocutáneas, donde la más frecuente es el exantema, además pueden presentar manifestaciones mucocutáneas atípicas con un gran polimorfismo simulando varias dermatosis como los casos expuestos anteriormente. Este reporte cuenta con 5 casos clínicos del mes de enero y febrero del año 2023 en el departamento Central de Paraguay, durante la mayor epidemia de Chikungunya registrada en el país hasta el momento. Es importante conocerlas y correlacionar con los demás signos y síntomas de la enfermedad para un diagnóstico y tratamiento adecuados.

The typical manifestations of Chikungunya are fever and arthralgia in most cases, but we must remember that they present mucocutaneous manifestations, where the most frequent is rash, they can also present atypical mucocutaneous manifestations with great polymorphism simulating various dermatoses such as cases outlined above. This report has 5 clinical cases from the month of January and February 2023 in the Central area of Paraguay, during the largest recorded Chikungunya epidemic in the country so far. It is important to know them and correlate them with the other signs and symptoms of the disease for proper diagnosis and treatment.

Learning from history in the midst of the COVID-19: epidemics/pandemics of antiquity up to the fall of the Western Roman Empire / Aprendiendo de la historia en medio del COVID-19: epidemias/pandemias de la antigüedad hasta la caída del Imperio Romano de Occidente

Abstract When humans discovered agriculture and livestock, they ceased to be nomads and began to settle in towns until they created large cities. From the first human settlements in Egypt, Mesopotamia, and the Anatolian Peninsula, populations were exposed and susceptible to new infectious agents, leading to epidemics and pandemics. Great civilizations emerged, such as Egypt, the land of Hatti, Israel, Greece, Carthage, and Rome, among others. Contact between different populations through wars or maritime trade is well documented and has been described as a source of epidemics throughout history. Epidemics described as plagues or pestilences, such as those of Egypt, the Hebrews, or the Hittites, are based on biblical texts or evidence such as tablets or hieroglyphic writings. We also reviewed classical books by authors such as Homer, Aeschylus, Herodotus of Halicarnassus, Thucydides, Diodorus Siculus, Dionysius of Halicarnassus, Titus Livius, Suetonius, and others; and described all epidemics/pandemics chronologically. This article describes the epidemics/pandemics for which there is written evidence from ancient Egypt to the fall of the Roman Empire. We should not be surprised when new epidemics/pandemics appear as causes of political and economic collapse, as this has been common throughout history, decimating, blocking, or even destroying cultures and civilizations repeatedly.

Resumen Cuando el hombre descubrió la agricultura y la ganadería, dejó de ser nómada y empezó a asentarse en pueblos hasta crear grandes ciudades. Desde los primeros asentamientos humanos en Egipto, Mesopotamia y la península de Anatolia, las poblaciones estuvieron expuestas y susceptibles a nuevos agentes infecciosos, dando lugar a epidemias y pandemias. Aparecieron grandes civilizaciones como Egipto, la Tierra de Hatti, Israel, Grecia, Cartago y Roma, entre otras. El contacto entre las distintas poblaciones a través de las guerras o el comercio marítimo está muy bien establecido y descrito como focos de epidemias a lo largo de la historia. Las epidemias descritas como plagas o pestilencias, como las que ocurrieron a los egipcios, los judíos, o los hititas, se describen con base en textos bíblicos o mediante evidencias como tablillas o escritos jeroglíficos. También revisamos libros clásicos de autores como Homero, Esquilo, Herodoto de Halicarnaso, Tucídides, Diodoro Sículo, Dionisio de Halicarnaso, Tito Livio, Suetonio, entre otros. Este artículo describe cronológicamente todas las epidemias/pandemias de las que existe evidencia a través de la escritura desde el antiguo Egipto hasta la caída del Imperio Romano. No debemos sorprendernos cuando aparecen nuevas epidemias/pandemias como causantes del colapso político y económico, ya que ha sido algo común a lo largo de la historia, diezmando, bloqueando o incluso destruyendo culturas y civilizaciones reiteradamente.

Impacto da pandemia de Covid-19 no consumo alimentare treinamento de praticantes de musculação / Impact of the Covid-19 pandemic on food consumptionand training of bodybuilders

A pandemia de Covid-19 impactou a vida de milhares de pessoas no mundo, e mesmo com a vacinação o número de infectados foi elevado. Esta pesquisa teve como objetivo verificar o impacto da pandemia de Covid-19 no consumo alimentar e no treinamento de praticantes de musculação. Foi realizada uma pesquisa transversal, com 134 praticantes de musculação, de ambos os sexos, do Sudoeste do Paraná, Brasil, com idade entre 18 e 50 anos, em setembro de 2021. A pesquisa foi realizada através do siteGoogle Forms®, enviada aos voluntários através de mensagens diretas e mídias sociais. Os dados foram tabulados e analisados no software PSPP. A maioria dos pesquisados relatou percepção de aumento no apetite (50%) e de aumento da quantidade de alimentos ingeridos durante o dia (47%) e do peso corporal (41,8%), sendo que a maioria acreditava que o ganho de peso foi de gordura corporal. Ainda, 40,3% dos pesquisados referiram que a frequência de prática de musculação diminuiu durante a pandemia. Apesar disso, observou-se que os indivíduos relataram consumir mais frutas (50,7%), verduras (49,3%) e legumes (45,5%), e menos açúcar ou adoçantes (34,3%), bebidas açucaradas (31,3%) e lanches tipo fast food (29,9%). Foi possível concluir que apesar do impacto da pandemia na prática de musculação, percepção de aumento de apetite, peso e ingestão alimentar, notou-se melhora da qualidade do consumo alimentar dessa população.

The Covid-19 pandemic has impacted the lives of thousands of people around the world and even with vaccination, the number of infected was high. This research aimed to verify the impact of the Covid-19 pandemic on food consumption and training of bodybuilders. A cross-sectional survey was carried out with 134 bodybuilders, of both sexes, from the Southwest of Paraná, Brazil, aged between 18 and 50 years, in September 2021. The survey was carried out through the Google Forms® website, sent to volunteers through direct messages and social media. Data were tabulated and analyzed using the GNU PSPP 1.4.1-g79ad47 software. Most respondents reported an increase in appetite (50%), the amount of food eaten during the day (47%) and body weight (41.8%), with the majority believing that the weight gain was due to fat body. Also, 40.3% of respondents reported that the frequency of bodybuilding practice decreased during the pandemic. Despite this, it was observed that individuals reported consuming more fruits (50.7%), green (49.3%), vegetables (45.5%) and less sugar or sweeteners (34.3%), sugary drinks (31.3%) and fast food snacks (29.9%). It was possible to conclude that despite the impact of the pandemic on bodybuilding practice, perception of increased appetite, weight and food intake, there was an improvement in the quality of food consumption in this population.

Viruela símica grave en un paciente con infección por VIH, Ecuador

En mayo de 2022 se reportó un aumento de casos de viruela símica (mpox en inglés) en el mundo, cuyo comportamiento epidemiológico y clínico, particularmente en pacientes con infección por VIH, condujo a la declaración del brote de mpox 2022 como emergencia de salud pública internacional. Se presenta el caso de un paciente con infección por VIH que cursó con mpox grave y fulminante, con placas necróticas en párpado y membrana inflamatoria sobre la superficie ocular; mucosa oral con lesiones blanquecinas y úlceras en lengua; induración de tejidos blandos y lesiones necróticas en los pies. Tras múltiples complicaciones, se convirtió en la primera víctima fatal reportada en Ecuador en 2022. En pacientes con infección por VIH, mpox puede presentarse como un agente oportunista, causando lesiones cutáneas graves, con o sin manifestaciones sistémicas.

In May 2022 several cases of mpox were reported worldwide, whose epidemiological and clinical outcome, particularly in patients seropositive for HIV, led to declaring the 2022 mpox outbreak as a public health emergency. We describe a case of a patient with HIV infection and severe and fulminant mpox, with necrotic plaques on the eyelid and an inflammatory membrane on the ocular surface; oral mucosa with whitish lesions and ulcers on the tongue; soft tissues induration, and necrotic lesions on the feet. After multiple complications, he became the first fatality reported in Ecuador in 2022. In HIV-infected patients mpox can be considered an opportunistic agent, with severe skin lesions with or without systemic manifestations.

A estratégia de resposta da Nova Zelândia à COVID-19: lições aprendidas / New Zealand's COVID-19 response strategy: lessons learnt

Resumo O objetivo deste artigo é analisar as características do sistema de saúde e de vigilância e as medidas adotadas no enfrentamento à pandemia de COVID-19 na Nova Zelândia entre março de 2020 e dezembro de 2021. Revisão integrativa de literatura em que foram incluídos 29 artigos, além da consulta aos sites da OMS, do Banco Mundial e Our World in Data sobre a situação sociodemográfica e econômica do país, bem como testes, óbitos, vacinas e casos novos. Os dados foram importados em formato CSV, e os gráficos, elaborados no software RStudio. As evidências apontam que a Nova Zelândia pode ser considerada um caso de sucesso na resposta à pandemia de COVID-19, sendo um dos países com menor número de óbitos pela doença no mundo. Esse sucesso foi resultado de uma organização do sistema de saúde com rápida ação interna, elevada capacidade de testagem, rastreamento dos contatos, sem chegar ao colapso do sistema de saúde em 2020 e 2021. Apontou também que a população aderiu às condições de confinamento e seguiu as recomendações das autoridades, ainda que com baixa participação da comunidade nas decisões de governo. Há lições importantes que podem ser recomendadas e úteis para uma potencial nova epidemia com vírus desconhecido ou pandemias semelhantes.

Abstract This study analyzed the characteristics of the health system, surveillance system, and the measures adopted to face the COVID-19 pandemic in New Zealand between March 2020 and December 2021. 29 fully read articles from an integrative literature review were included, and the websites of the WHO, the World Bank, the "Stringency Index" of "ourworldindata" were consulted to collect data on the socio-demographic situation, economic indicators of the country, as well as tests, deaths, vaccines and new cases. The data were imported in CSV format and the graphs elaborated in RStudio software. The evidence points out that New Zealand can be considered a success story regarding the nationwide response to the COVID-19 pandemic, it being one of the countries with the lowest number of deaths from the disease in the world. This success was the result of a health system organization with fast internal action, high testing capacity, and contact tracing, without causing the collapse of the health system. In turn, it also pointed out that the population adhered to the confinement conditions, and faithfully followed the authorities' instructions, even with low community participation in government decisions. Important lessons can be learnt leading to useful recommendations for a potential new epidemic with an unknown virus or similar.

O trem e a "senhorita espanhola": a epidemia de gripe em Diamantina, 1918 / The train and the "Spanish señorita": the flu epidemic in Diamantina, 1918

Resumo O artigo analisa a epidemia de gripe de 1918 em Diamantina, no interior de Minas Gerais. A partir de fontes bibliográficas e documentais, discute como o ramal ferroviário da Estrada de Ferro Vitória a Minas, inaugurado em 1914, contribuiu para a chegada da doença à cidade que, até então, era representada no discurso de suas elites como isolada e salubre. Aborda as imbricadas relações entre a expansão dos sistemas de transportes pelo interior do Brasil, o meio ambiente, o conhecimento científico e os processos saúde/doença.

Abstract The article analyzes the influenza epidemic in 1918 in Diamantina, a town in the Brazilian state of Minas Gerais. Bibliographic and documental sources are used to investigate the influence of the Vitória-Minas railroad (Estrada de Ferro Vitória a Minas), opened in 1914, on the arrival of the disease in the town, which had until then been represented in the discourse of its elites as insalubrious and isolated. The interrelations between the spread of transportation systems across Brazil, the environment, scientific knowledge, and health-disease processes are discussed.

Global epidemiology of Equine Influenza viruses: "A possible emerging zoonotic threat in future" an extensive systematic review with evidence / Epidemiologia global dos vírus da Gripe Equina: "Uma possível ameaça zoonótica emergente no futuro" uma extensa revisão sistemática com evidências

There are different opinions around the World regarding the zoonotic capability of H3N8 equine influenza viruses. In this report, we have tried to summarize the findings of different research and review articles from Chinese, English, and Mongolian Scientific Literature reporting the evidence for equine influenza virus infections in human beings. Different search engines i.e. CNKI, PubMed, ProQuest, Chongqing Database, Mongol Med, and Web of Knowledge yielded 926 articles, of which 32 articles met the inclusion criteria for this review. Analyzing the epidemiological and Phylogenetic data from these articles, we found a considerable experimental and observational evidence of H3N8 equine influenza viruses infecting human being in different parts of the World in the past. Recently published articles from Pakistan and China have highlighted the emerging threat and capability of equine influenza viruses for an epidemic in human beings in future. In this review article we have summarized the salient scientific reports published on the epidemiology of equine influenza viruses and their zoonotic aspect. Additionally, several recent developments in the start of 21st century, including the transmission and establishment of equine influenza viruses in different animal species i.e. camels and dogs, and presumed encephalopathy associated to influenza viruses in horses, have documented the unpredictable nature of equine influenza viruses. In sum up, several reports has highlighted the unpredictable nature of H3N8 EIVs highlighting the need of continuous surveillance for H3N8 in equines and humans in contact with them for novel and threatening mutations.

Existem diferentes opiniões em todo o mundo a respeito da capacidade zoonótica dos vírus da influenza equina H3N8. Neste relatório, tentamos resumir os resultados de diferentes pesquisas e artigos de revisão da literatura científica chinesa, inglesa e mongol relatando as evidências de infecções pelo vírus da influenza equina em seres humanos. Diferentes mecanismos de busca, como CNKI, PubMed, ProQuest, Chongqing Database, Mongol Med e Web of Knowledge geraram 926 artigos, dos quais 32 atenderam aos critérios de inclusão para esta revisão. Analisando os dados epidemiológicos e filogenéticos desses artigos, encontramos uma considerável evidência experimental e observacional de vírus da influenza equina H3N8 infectando seres humanos em diferentes partes do mundo no passado. Artigos publicados recentemente no Paquistão e na China destacaram a ameaça emergente e a capacidade dos vírus da influenza equina para uma epidemia em seres humanos no futuro. Neste artigo de revisão, resumimos os relatórios científicos relevantes publicados sobre a epidemiologia dos vírus da influenza equina e seu aspecto zoonótico. Além disso, vários desenvolvimentos recentes no início do século 21, incluindo a transmissão e estabelecimento de vírus da influenza equina em diferentes espécies animais, ou seja, camelos e cães, e presumida encefalopatia associada aos vírus da influenza em cavalos, documentaram a natureza imprevisível dos vírus da influenza equina. Em suma, vários relatórios destacaram a natureza imprevisível de H3N8 EIVs destacando a necessidade de vigilância contínua para H3N8 em equinos e humanos em contato com eles para novas mutações ameaçadoras.

Global epidemiology of Equine Influenza viruses; A possible emerging zoonotic threat in future an extensive systematic review with evidence

Abstract There are different opinions around the World regarding the zoonotic capability of H3N8 equine influenza viruses. In this report, we have tried to summarize the findings of different research and review articles from Chinese, English, and Mongolian Scientific Literature reporting the evidence for equine influenza virus infections in human beings. Different search engines i.e. CNKI, PubMed, ProQuest, Chongqing Database, Mongol Med, and Web of Knowledge yielded 926 articles, of which 32 articles met the inclusion criteria for this review. Analyzing the epidemiological and Phylogenetic data from these articles, we found a considerable experimental and observational evidence of H3N8 equine influenza viruses infecting human being in different parts of the World in the past. Recently published articles from Pakistan and China have highlighted the emerging threat and capability of equine influenza viruses for an epidemic in human beings in future. In this review article we have summarized the salient scientific reports published on the epidemiology of equine influenza viruses and their zoonotic aspect. Additionally, several recent developments in the start of 21st century, including the transmission and establishment of equine influenza viruses in different animal species i.e. camels and dogs, and presumed encephalopathy associated to influenza viruses in horses, have documented the unpredictable nature of equine influenza viruses. In sum up, several reports has highlighted the unpredictable nature of H3N8 EIVs highlighting the need of continuous surveillance for H3N8 in equines and humans in contact with them for novel and threatening mutations.

Resumo Existem diferentes opiniões em todo o mundo a respeito da capacidade zoonótica dos vírus da influenza equina H3N8. Neste relatório, tentamos resumir os resultados de diferentes pesquisas e artigos de revisão da literatura científica chinesa, inglesa e mongol relatando as evidências de infecções pelo vírus da influenza equina em seres humanos. Diferentes mecanismos de busca, como CNKI, PubMed, ProQuest, Chongqing Database, Mongol Med e Web of Knowledge geraram 926 artigos, dos quais 32 atenderam aos critérios de inclusão para esta revisão. Analisando os dados epidemiológicos e filogenéticos desses artigos, encontramos uma considerável evidência experimental e observacional de vírus da influenza equina H3N8 infectando seres humanos em diferentes partes do mundo no passado. Artigos publicados recentemente no Paquistão e na China destacaram a ameaça emergente e a capacidade dos vírus da influenza equina para uma epidemia em seres humanos no futuro. Neste artigo de revisão, resumimos os relatórios científicos relevantes publicados sobre a epidemiologia dos vírus da influenza equina e seu aspecto zoonótico. Além disso, vários desenvolvimentos recentes no início do século 21, incluindo a transmissão e estabelecimento de vírus da influenza equina em diferentes espécies animais, ou seja, camelos e cães, e presumida encefalopatia associada aos vírus da influenza em cavalos, documentaram a natureza imprevisível dos vírus da influenza equina. Em suma, vários relatórios destacaram a natureza imprevisível de H3N8 EIVs destacando a necessidade de vigilância contínua para H3N8 em equinos e humanos em contato com eles para novas mutações ameaçadoras.

Cobertura de vacinação e surtos de sarampo em uma região do Ceará / Vaccination coverage and measles outbreaks in a region of Ceará / Cobertura de vacunación y casos de sarampión en una región de Ceará

O objetivo desta pesquisa foi analisar a relação entre surtos de sarampo e as coberturas vacinais municipais na 11ª Região de Saúde de Sobral, noroeste do Ceará, ocorridos entre 2013 e 2015. Para isso, elaborou-se estudo misto por fonte de dados secundários, extraídos na referida região de saúde. Para análise quantitativa, foram investigadas 766 notificações de casos suspeitos de sarampo. Além disso, realizou-se pesquisa de campo pós-epidemia com profissionais envolvidos na imunização, por meio da aplicação de 31 questionários eletrônicos. A análise das informações permitiu identificar que 451 casos notificados da doença foram descartados; 65 foram considerados inconclusivos; e 217 foram confirmados. Os profissionais envolvidos sinalizaram como causa dos surtos: baixas coberturas vacinais, bolsões de suscetíveis, falta de capacitação dos profissionais e inexperiência na contenção de bloqueios. As estratégias de vacinação realizadas priorizaram a imunização da população de risco, a reorientação e sistematização das ações de bloqueio e a varredura.

This research aimed to analyze the relationship between measles outbreaks and municipal vaccination coverage in the 11th Health Region of Sobral, northwest of Ceará, which occurred between 2013 and 2015. To that end, a mixed study by source of secondary data, extracted in the health region was elaborated. For quantitative analysis, a total of 766 reports of suspected measles cases were investigated. Also, post-epidemic field research was carried out with professionals involved in immunization, by applying 31 electronic questionnaires. The analyzes of the information allowed us to identify that 451 notified cases of the disease were discarded; 65 were considered inconclusive; and 217 were confirmed. The professionals involved pointed out the following as the cause of the outbreaks: low vaccination coverage, pockets of susceptible people, lack of training of professionals and inexperience in containing blockages. The vaccination strategies prioritized the immunization of the population at risk, the reorientation and systematization of blocking and scanning actions.

El objetivo de este estudio fue analizar la relación entre los casos de sarampión y las coberturas municipales de vacunación en la 11.ª Región de Salud de Sobral, noreste de Ceará (Brasil), ocurridos en el periodo entre 2013 y 2015. Para ello, se utilizó un estudio mixto por fuente de datos secundarios, extraídos en la citada región. Para el análisis cuantitativo, se investigaron un total de 766 informes de casos sospechosos de sarampión. Se realizó investigación de campo postepidemia con los profesionales involucrados en inmunización, mediante la aplicación de 31 cuestionarios electrónicos. El análisis de la información permitió identificar que se descartaron 451 casos notificados de la enfermedad; 65 fueron no concluyentes y 217 confirmados. Los profesionales implicados señalaron las siguientes causas de los brotes: bajas coberturas de vacunación, bolsa de susceptibles, falta de formación profesional e inexperiencia en la contención de bloqueos. Las estrategias de vacunación priorizaron la inmunización de la población en riesgo, la reorientación y sistematización de las acciones de bloqueo y barrido.

Estrategia de enfrentamiento a la epidemia de COVID-19, Cuba, 2020 / Strategy to Confront the COVID-19 Epidemic, Cuba, 2020

Introducción: Desde que aparecieron los primeros casos en China de COVID-19, el Gobierno cubano, de conjunto con el Ministerio de Salud Pública y el Estado Mayor de la Defensa Civil aprobó el Plan de Prevención y Control del nuevo coronavirus (COVID-19) con las medidas para el control de la epidemia en el país. Objetivo: Describir las principales características de la estrategia para el enfrentamiento a la epidemia de la COVID-19 en Cuba en el año 2020. Métodos: Se consultaron artículos científicos y sitios web de organismos internacionales, el gobierno y la prensa cubanos. De la información obtenida se realizó el análisis sobre las acciones realizadas por el Gobierno cubano y sus instituciones para el enfrentamiento a la epidemia de COVID 19 en el 2020. Resultados: Se implementó un sistema de alerta epidemiológica, se reforzaron todos los mecanismos para la vigilancia clínico epidemiológica y las relacionadas con el control sanitario internacional, se activaron los Consejos de Defensa provinciales y municipales en apoyo a las acciones de enfrentamiento. La participación social y la intersectorialidad fueron pilares en el enfrentamiento a la epidemia. También la ciencia y la innovación estuvieron vinculadas a la gestión gubernamental. Conclusiones: Distinguen entre las características de la estrategia adoptada por la gestión del gobierno, la capacitación, vigilancia epidemiológica y pesquisa activa, bajo un protocolo de actuación y una efectiva comunicación que se aplica en todo el país e integra todos los sectores de la sociedad cubana(AU)

Introduction: Since the appearance of the first cases of COVID-19 in China, the Cuban Government, together with the Ministry of Public Health and the General Staff of Civil Defense, approved the Plan for Prevention and Control of the new coronavirus (COVID-19) with the measures for the control of the epidemic in the country. Objective: To describe the main characteristics of the strategy to confront the COVID-19 epidemic in Cuba in 2020. Methods: Scientific articles and websites of Cuban international organizations, the government and the press were consulted. From the information collected, the analysis was carried out on the actions implemented by the Cuban government and its institutions to confront the COVID 19 epidemic in 2020. Results: An epidemiological alert system was implemented, all mechanisms for clinical epidemiological surveillance and those related to International Sanitary Control were reinforced, and provincial and municipal Defense Councils were activated in support of confrontation actions. Social participation and intersectoriality have been pillars in the fight against the epidemic. Science and innovation have also been linked to government management. Conclusions: Among the characteristics of the strategy adopted by the government's management, training, epidemiological surveillance and active research, are highlighted under a protocol of action and effective communication that is applied throughout the country and integrates all sectors of Cuban society(AU)

Calidad de Vida, Ansiedad, Depresión y Consumo de Alcohol en Adultos con Diabetes Tipo Dos durante la Pandemia por COVID-19 / Quality of Life, Anxiety, Depression, and Alcohol Consumption in Adults with Type 2 Diabetes during the COVID-19 Pandemic

Resumen El objetivo de este estudio fue relacionar la calidad de vida, el consumo de alcohol, la depresión y ansiedad en pacientes con diabetes tipo 2 (DT2) durante la pandemia de COVID-19. Se aplicó una encuesta a un total de 119 pacientes con DT2 seleccionados mediante un muestreo no probabilístico intencional de la zona centro del país, con al menos un año de diagnóstico. Para evaluar la calidad de vida se utilizó la escala diabetes-39, la escala de autoevaluación de la depresión de Zung, la escala de ansiedad de Hamilton y la prueba de identificación de trastornos por uso de alcohol. Los hallazgos son: correlaciones positivas entre la preocupación por la disminución en la calidad de vida en todas las áreas con la ansiedad. Así como consumo de riesgo en hombres y calidad de vida, señalando mayor consumo de alcohol en esta población. Estos resultados indican que tener diabetes tipo 2 es un predisponente para presentar problemas de salud mental como: ansiedad, depresión y consumo de alcohol, lo que señala la importancia de trabajar con esta población en el periodo de postpandemia.

Abstract The aim of this study was to relate quality of life, alcohol consumption, depression, and anxiety in patients with type 2 diabetes (T2D) during the COVID-19 pandemic. A survey was applied to a total of 119 patients with T2D selected by non-probability purposive sampling from the central part of the country, with at least one year of diagnosis. The diabetes-39 quality of life scale, the Zung Depression Self-Assessment Scale, the Hamilton Anxiety Scale and the Alcohol Use Disorders Identification Test were used. The findings are positive correlations between concern for diminished quality of life in all areas with anxiety. As well as risk consumption in men and quality of life, indicating higher alcohol consumption in this population. These results indicate that having type 2 diabetes is a predisposing factor for presenting mental health problems such as anxiety, depression and alcohol consumption, which points to the importance of working with this population in the post-pandemic period.

As ciências sociais e humanas e a pandemia de COVID-19 / The social and human sciences and the COVID-19 pandemic

Resumo O artigo aborda os desafios enfrentados pelas ciências sociais e humanas na epidemia/pandemia de COVID-19. Esta revisão se refere somente a alguns aspectos, aproximando-se do chamado paradigma indiciário de Ginsburg ao enunciar que "a realidade é opaca, existem zonas privilegiadas - sinais, indícios - que permitem decifrá-la". De um modo geral, as pesquisas em ciências sociais e humanas voltadas para a crise sanitária são de fundamental importância - primeira afirmação: tanto no período de disseminação da doença como na pós-pandemia; segunda afirmação: a epidemia não se restringe a um evento viral.

Abstract This paper addresses the challenges the social and human sciences face in the COVID-19 epidemic/pandemic. This review refers only to a few aspects, approaching the so-called Ginzburg evidential paradigm by stating that "reality is opaque; there are privileged areas - signs, indications - that make us decipher it". In general, research in the social and human sciences focused on the health crisis is fundamental: First statement: both in the disease spread period and the post-pandemic period. Second statement: the epidemic is not restricted to a viral event.

Viruela símica y faringitis exudativa en Argentina / Monkeypox and exudative pharyngitis in Argentina

Resumen Desde mayo de 2022 se han notificado casos de viruela símica en países no endémicos con características diferentes a la descripción tradicional de la enfermedad, predominio en población de hombres que tienen sexo con hombres, posible transmisión sexual y ausencia de mortalidad a la fecha. Reporta mos el que sería el primero diagnosticado en Argentina sin nexo de viaje a países con circulación viral. Se trata de un hombre joven, bisexual, en profilaxis antirretroviral de pre-exposición al HIV, cuya forma de presentación fue faringitis exudativa sin otra etiología documentada y adenopatías que evolucionaron a la necrosis, presencia de lesiones asincrónicas características en cara, cuello, abdomen, extremidades y genitales. El diagnóstico fue por detección de ADN viral por reacción en cadena de la polimerasa en lesiones de piel, exudado de fauces y semen. El compromiso faríngeo con presencia de exudado luego del descarte de otras infecciones, podría ser una rareza para la forma epidémica de la enfermedad. El hallazgo del virus en semen ya reportado en otras publica ciones no es suficiente aún para confirmar la vía sexual como forma de trasmisión. En conclusión, nuestro caso alerta sobre otras posibles formas de presentación de la viruela símica epidémica y la necesidad de aumentar el nivel de sospecha para su detección precoz, como estrategia para evitar la diseminación y proteger a grupos vulnerables. Se requiere aún más información para determinar la transmisión sexual de esta enfermedad.

Abstract Since May 2022, monkeypox cases have been reported in non-endemic countries with different charac teristics from the traditional description of the disease, predominantly in men who have sex with men, with possible sexual transmission and with no documentation of mortality to date. We report what would be the first patient diag nosed in Argentina with no travel nexus to countries with viral circulation. Young, bisexual man, on antiretroviral HIV pre-exposure prophylaxis, whose presentation was exudative pharyngitis with no other documented aetiology and lymphadenopathy that progressed to necrosis, presence of characteristic asynchronous lesions on the face, neck, abdomen, extremities, and genitals, in a total of no more than 25. Polymerase-chain-reaction assay of samples from skin lesions, fauces exudate and semen were positive for monkeypox. Pharyngeal involvement with the presence of exudate after ruling out other infections could be a rarity for the epidemic form of the disease. The finding of the virus in semen, already reported in other publications, is still not enough to confirm the sexual route as a form of transmission. In conclusion: Our case warns about other possible forms of presentation of epidemic monkeypox and the need to increase the level of suspicion for its early detection as a strategy to prevent dissemination and protect vulnerable groups. Even more information is required to determine the sexual transmission of this disease.

Aspectos relevantes de las epidemias y pandemias en México: desde la perspectiva del derecho sanitario / Relevant Aspects of Epidemics and Pandemics in Mexico: From the Perspective of Health Law

Resumen A lo largo de su historia, México ha sido afectado por diversas epidemias, así como pandemias, y el sistema de salud de cada época ha tenido que desarrollar, adoptar y perpetuar múltiples acciones y medidas de seguridad sanitarias, entre las que destacan las siguientes: vacunación, higiene personal, sana alimentación, cloración del agua, suspensión de actividades, desinfección de lugares públicos y casas, cuarentena, confinamiento o aislamiento, uso de cubrebocas, evitar lugares concurridos, prohibición de reuniones colectivas, por mencionar las más relevantes. Todo lo anterior se ha implementado con la intención de mitigar y erradicar su propagación; así como disminuir su morbilidad y mortalidad. La pandemia por COVID-19, al igual que todas las epidemias y pandemias que se han presentado en México, ha trastocado diversos aspectos como el económico, social, político y sanitario. En cada época se ha hecho evidente la crisis por la que atraviesa el sector salud, lo cual ha implicado que las autoridades sanitarias realicen múltiples esfuerzos para hacerles frente y tratar de sobrellevarlas. En este escrito hacemos un breve recuento de las epidemias y pandemias que han afectado a México, desde el año 1450 hasta el 2020, la evolución histórica de las autoridades sanitarias y los aspectos generales del Derecho Sanitario.

Abstract Throughout history, Mexico has been affected by major epidemics and pandemics, for this reason the health system of each era has had to develop, adopt and perpetuate multiple actions and health security measures, in which the following measures stand out: vaccination, adequate personal hygiene, a balanced diet, water chlorination, suspension of some activities, adequate disinfection of public places, preventive and disinfection measures in homes, quarantine, isolation or confinement, correct use of face masks, avoid crowded places, prohibit or avoid collective meetings, this just to mention the most relevant. The aforementioned cares have been implemented with the intention of mitigating and eradicating its spread, as well as reducing its morbidity and mortality from it. The COVID-19 pandemic, like other pandemics that have arisen over time in México, have affected various aspects such as economic, social, political and especially sanitary health. As time has passed, the crisis that the health sector is going through has become evident, which has forced the corresponding health authorities to make multiple efforts to face it and try to cope with these epidemics and pandemics. In this article we make a brief account of the epidemics and pandemics that have affected Mexico from the year 1450 to 2020, as well as the historical evolution of the pertinent health authorities and the general aspects of health law.

Sentido de coherencia en universitarios: recurso para el cuidado en tiempos de pandemia / The sense of coherence among university students: A resource for care in times of pandemic / Senso de coerência nos estudantes universitários: um recurso para o cuidado em tempos de pandemias

Introducción: El constructo Sentido de Coherencia derivado del modelo salutogénico, permite afrontar factores estresantes a través de activos para mantener una buena salud. Objetivo: Describir el Sentido de Coherencia (SOC-29) en estudiantes universitarios de la ciudad de Manizales como recurso de cuidado en tiempos de pandemia. Materiales y métodos: Se realizó un estudio cuantitativo, descriptivo con una fase asociativa y comparativa, con 566 estudiantes matriculados en universidades públicas y privadas de la ciudad de Manizales, Caldas (Colombia), durante el primer período académico del 2021. La técnica de recolección fue la encuesta online. Para el análisis univariado se realizó distribución de frecuencias, medidas de tendencia central y dispersión, y para el bivariado U de Mann Whitney, H de Kruskal-Wallis y Chi-cuadrado. Resultados: El valor del Sentido de Coherencia osciló entre 58 y 185 puntos, promedio 133.6 ± 24,4 puntos, un 27% de los participantes informó la pandemia afectó negativamente su vida, se encontró asociación estadísticamente significativa p<0,05 entre el cambio en las condiciones de vida y todos los ítems de la escala. Conclusión: La consolidación del Sentido de Coherencia como parte integral de la salud mental de los universitarios los prepara para afrontar cambios en sus condiciones de vida y hace factible direccionar acciones de cuidado en el contexto social, familiar y académico.

Introduction:The construct of the sense of coherence, derived from the salutogenic model, allows people to cope with stressors through resources to maintain good health. Objective: To describe the sense of coherence (SOC-29) among university students in the city of Manizales as a care resource in times of pandemic. Materials and Methods: A quantitative and descriptive study with an associative-comparative phase was conducted with 566 students enrolled in public and private universities in Manizales, Caldas, (Colombia), during the first semester of 2021. The data collection technique was online surveys. For the univariate analysis, frequency distribution and central tendency and dispersion measures were determined. For bivariate analysis, the Mann-Whitney U test, Kruskal-Wallis H test, and Chi-square test were used. Results:The SOC-29 score ranged from 58 to 185 points (mean 133.6 ± 24.4 points), and 27% of the participants reported that the pandemic negatively affected their life, a statistically significant association (p<0.05) was found between the change in living conditions and all the items of the scale. Conclusions: Consolidating the sense of coherence as an integral part of university students' mental health prepares them to cope with changes in their living conditions and makes it feasible to direct care actions in social, family, and academic settings.

Introdução: A construção Sentido de Coerência derivada do modelo salutogênico, permite lidar com os estressores através de ativos para manter a boa saúde. Objetivo: Descrever o Sentido de Coerência (SOC-29) em estudantes universitários da cidade de Manizales, Caldas (Colômbia), como um recurso para o cuidado em tempos de pandemia. Materiais e Métodos: Foi realizado um estudo quantitativo, descritivo com uma fase associativa e comparativa com 566 estudantes matriculados em universidades públicas e privadas na cidade de Manizales, Caldas (Colômbia), durante o primeiro período acadêmico de 2021. A técnica de coleta foi a pesquisa on-line. Para a análise univariada, foram utilizadas a distribuição de frequência, medidas de tendência central e dispersão, e para a análise bivariada foram utilizadas Mann Whitney U, Kruskal-Wallis H e Chi-quadrado. Resultados: O valor de senso de coerência variou de 58 a 185 pontos, média 133,6 ± 24,4 pontos, 27% dos participantes relataram que a pandemia afetou negativamente suas vidas, associação estatisticamente significativa p<0,05 foi encontrada entre mudança nas condições de vida e todos os itens da escala. Conclusões: A consolidação do Senso de Coerência como parte integrante da saúde mental dos estudantes universitários os prepara para enfrentar mudanças em suas condições de vida e torna viável a abordagem de ações de cuidado no contexto social, familiar e acadêmico.

El pensamiento antivacuna de Alfredo Helsby Hazell: controversias y debates a fines del siglo XIX e inicios del siglo XX en Chile / Alfredo Helsby Hazell's antivaccine view: controversies and debates at the end of the XIX century and the beginning of the XX century in Chile

Resumen El objetivo central de este artículo, es reconstruir los principales argumentos contrarios a la vacunación que circularon en Chile durante fines del siglo XIX e inicios del siglo XX. Para ello, estudiaremos la figura de Alfredo Helsby Hazell, quien fue el principal opositor que tuvo la vacuna en Chile y publicó diversos escritos en los que desarrolló y difundió sus ideas. A través de éstos, observamos que Helsby argumentó su rechazo a la vacunación a partir de la defensa del higienismo y de la desconfianza respecto de las explicaciones de carácter científico que se comenzaron a difundir a partir de la teoría de los gérmenes. Ello se articuló con la defensa de la salud como un ámbito privado de acción, criticando la intervención del Estado en dichas materias.

Abstract This article reconstructs the main arguments against vaccination that circulated in Chile during the late nineteenth and early twentieth centuries. For this purpose, we will study the figure of Alfredo Helsby Hazell, who was the primary opponent of vaccination in Chile and published several writings in which he developed and disseminated his ideas. We observe that Helsby argued his rejection of vaccination from the defence of hygienism and distrust of the scientific explanations that began to spread from the germ theory. This was articulated with the defence of health as a private sphere of action, criticizing the intervention of the State in such matters.

Efectos de la COVID-19 sobre los servicios de salud en Santiago de Cuba, 2020 / Effects of COVID-19 on health services in Santiago de Cuba, 2020

Introducción: En Santiago de Cuba las acciones aplicadas para el control de la epidemia en el 2020 ocasionaron cambios y efectos negativos sobre muchos de los servicios de salud que se brindan de manera habitual en el territorio. Objetivo: Identificar el efecto de la epidemia de COVID-19 sobre los servicios de salud en la provincia Santiago de Cuba durante el año 2020. Métodos: Se realizó un estudio ecológico retrospectivo con series temporales como unidades de análisis comparadas en la provincia de Santiago de Cuba como único territorio geográfico para evaluar los efectos que tuvo la COVID-19 sobre la prestación de los servicios de salud durante el año 2020. Se seleccionaron algunos indicadores de servicios de salud de la serie de tiempo de 2015 a 2019. La fuente de datos fueron las estadísticas oficiales. Se estimó el porcentaje de cambio y se propuso una clasificación de los efectos de la COVID-19 según su magnitud y sentido. Resultados: Se produjeron cambios en la cantidad y tipos de servicios de salud en cuanto a las consultas médicas externas y de urgencia, los ingresos hospitalarios y promedio de estadía de las actividades de cardiología relacionados con ingresos, coronariografías realizadas, marcapasos implantados y operaciones ejecutadas, de las actividades quirúrgicas operaciones electivas y de urgencia, así como las ambulatorias y por mínimo acceso, los tratamientos rehabilitadores, los estudios para el diagnóstico mediante el uso de los laboratorios clínicos y de microbiología, estudios imagenológicos, en general, y los más afectados fueron los relacionados con la Estomatología, trasplantes renales y de córnea. Conclusiones: La epidemia de COVID-19 tuvo un efecto negativo en el funcionamiento de los servicios de salud al producirse cambios desfavorables en la cantidad de servicios prestados en los niveles de atención primario y secundario, lo que puede impactar en la salud de personas vulnerables si no se establecen estrategias alternativas(AU)

Introduction: In Santiago de Cuba province, the actions applied to control the epidemic in 2020 caused changes and negative effects on many of the health services that are usually provided in the territory. Objective: To identify the effect of the COVID-19 epidemic on health services in Santiago de Cuba province during 2020. Methods: A retrospective ecological study was conducted with time series as units of comparative analysis in Santiago de Cuba province as the only geographical territory to evaluate the effects of COVID-19 on the provision of health services during 2020. Some health service indicators from the time series from 2015 to 2019 were selected. The data source was official statistics. The percentage of change was estimated and a classification of the effects of COVID-19 according to its magnitude and meaning was proposed. Results: There were changes in the number and types of health services in terms of outpatient and emergency medical consultations, hospital admissions and average stay of cardiology activities related to admissions, coronary angiographies performed, pacemakers implanted and operations performed, elective surgical activities and emergency operations, as well as outpatient and minimal access ones, rehabilitative treatments, studies for diagnosis through the use of clinical and microbiology laboratories, imaging studies in general, and the most affected were those related to Stomatology, and kidney and corneal transplants. Conclusions: The COVID-19 epidemic had a negative effect on the functioning of health services as there were unfavorable changes in the number of services provided at the primary and secondary care levels, which can impact on the health of vulnerable people if alternative strategies are not established(AU)