ABSTRACT
OBJECTIVE: Suicide attempt (SA) is the strongest predictive variable for completed suicide. The Department of Cauca in Colombia has an SA rate higher than the national average, but the factors are unknown. The objective was to identify the profiles of SA in children and adolescents of Cauca. METHODS: Cross-sectional study, which included all SA (Event-356) records from the SIVIGILA platform in children under 18 years of age between 2016 and 2019. The authors described the variables and multiple correspondence analysis (MCA) with the Burt method, according to the completeness of the data to establish the possible SA profiles using STATA 15.1, and R. The Ethics Committee at Universidad del Cauca approved it. RESULTS: The study found 977 SA during this period, 72.4% female, 97.1% adolescent, 74.4% mestizo, 19.3% indigenous, 45.3% resided in municipalities exposed to the armed conflict, 32.3% expressed ideation and previous attempts, and 15.5% prior attempts. The MCA included 810 SA and identified three profiles: "Classic", which had mestizo adolescents with a history of prior SA, mental illness, or psychoactive substance use problems; "Related to the armed conflict", which included female adolescents with a first SA and residents in municipalities exposed to the armed conflict; "Ethnic" represented by male indigenous, with housing in a rural area. CONCLUSION: The SA profiles found in Cauca were "Classic", "Related to the armed conflict", and "Ethnic"; these can be considered to implement prevention strategies from a cross-cultural, mental health, and gender perspective, with the presence of the state in the territories.
Subject(s)
Suicide, Attempted , Humans , Adolescent , Cross-Sectional Studies , Suicide, Attempted/statistics & numerical data , Suicide, Attempted/psychology , Female , Male , Colombia/epidemiology , Child , Risk Factors , Mental Disorders/epidemiologyABSTRACT
Tungiasis is an endemic ectoparasitosis in Latin America associated with risk factors such as rurality, poverty, and living with animals. In Popayán, a city in southwest Colombia, the disease was highly prevalent in the past, to such degree that its inhabitants were given the nickname of patojo, a word that describes the way of walking of people infested by the flea. However, it was believed eradicated at present. We present the case of a 12-year-old boy living in the urban area of Popayán, who presented with a one-month history of papular lesions with circular edges, blackish center, and hyperkeratotic halo on both feet. Tungiasis was suspected based on the clinical findings and ivermectin was administered. The lesions were surgically removed and sent for parasitological analysis, which confirmed the presence of Tunga penetrans. The patient evolved satisfactorily. The Secretaría de Salud Municipal de Popayán carried out an inspection of the patient's home where migrant dogs from the Colombian Pacific were found in the surroundings, some with suspicious lesions of tungiasis. We document here the resurgence of this pathology in urban areas, probably secondary to the migration of animals from rural areas. It is important to recognize the existence of the flea in rural and urban areas, make a medical diagnosis, and report cases to the surveillance entities to enable appropriate management and sanitary control of this neglected ectoparasitosis in humans and animals.
La tungiasis es una ectoparasitosis endémica en Latinoamérica y está asociada a factores de riesgo como la ruralidad, la pobreza y la convivencia con animales. Popayán, una ciudad al suroccidente de Colombia, fue históricamente afectada por la tungiasis, tanto así que a sus habitantes los apodan "patojos" debido a la forma de caminar de sus habitantes infestados por la pulga. Hoy la enfermedad se creía eliminada. Se presenta el caso de un niño de 12 años procedente del área urbana de Popayán, que consultó por lesiones papulares de bordes circulares, centro negruzco y halo hiperqueratósico en ambos pies, de un mes de evolución. Por los hallazgos clínicos se sospechó tungiasis y se le administró ivermectina. Las lesiones se removieron quirúrgicamente y se enviaron para análisis parasitológico, el cual confirmó la presencia de Tunga penetrans. La evolución del paciente fue satisfactoria. La Secretaría de Salud Municipal de Popayán inspeccionó el domicilio del paciente y encontró perros migrantes del Pacífico colombiano en sus alrededores, algunos con lesiones sospechosas de tungiasis. Se documenta, así, el resurgimiento de esta enfermedad en el área urbana, probablemente debido a la migración de animales desde las zonas rurales. Es importante reconocer la existencia de la pulga en zonas rurales y urbanas, hacer el diagnóstico médico y reportar los casos a los entes de vigilancia. Estas acciones permitirán ofrecer un apropiado manejo y control sanitario de esta ectoparasitosis desatendida en humanos y animales.
Subject(s)
Tungiasis , Animals , Colombia/epidemiology , Dogs , Humans , Poverty , Rural Population , Tunga , Tungiasis/diagnosis , Tungiasis/epidemiologyABSTRACT
Resumen | La tungiasis es una ectoparasitosis endémica en Latinoamérica y está asociada a factores de riesgo como la ruralidad, la pobreza y la convivencia con animales. Popayán, una ciudad al suroccidente de Colombia, fue históricamente afectada por la tungiasis, tanto así que a sus habitantes los apodan "patojos" debido a la forma de caminar de sus habitantes infestados por la pulga. Hoy la enfermedad se creía eliminada. Se presenta el caso de un niño de 12 años procedente del área urbana de Popayán, que consultó por lesiones papulares de bordes circulares, centro negruzco y halo hiperqueratósico en ambos pies, de un mes de evolución. Por los hallazgos clínicos se sospechó tungiasis y se le administró ivermectina. Las lesiones se removieron quirúrgicamente y se enviaron para análisis parasitológico, el cual confirmó la presencia de Tunga penetrans. La evolución del paciente fue satisfactoria. La Secretaría de Salud Municipal de Popayán inspeccionó el domicilio del paciente y encontró perros migrantes del Pacífico colombiano en sus alrededores, algunos con lesiones sospechosas de tungiasis. Se documenta, así, el resurgimiento de esta enfermedad en el área urbana, probablemente debido a la migración de animales desde las zonas rurales. Es importante reconocer la existencia de la pulga en zonas rurales y urbanas, hacer el diagnóstico médico y reportar los casos a los entes de vigilancia. Estas acciones permitirán ofrecer un apropiado manejo y control sanitario de esta ectoparasitosis desatendida en humanos y animales.
Abstract | Tungiasis is an endemic ectoparasitosis in Latin America associated with risk factors such as rurality, poverty, and living with animals. In Popayán, a city in southwest Colombia, the disease was highly prevalent in the past, to such degree that its inhabitants were given the nickname of patojo, a word that describes the way of walking of people infested by the flea. However, it was believed eradicated at present. We present the case of a 12-year-old boy living in the urban area of Popayán, who presented with a one-month history of papular lesions with circular edges, blackish center, and hyperkeratotic halo on both feet. Tungiasis was suspected based on the clinical findings and ivermectin was administered. The lesions were surgically removed and sent for parasitological analysis, which confirmed the presence of Tunga penetrans. The patient evolved satisfactorily. The Secretaría de Salud Municipal de Popayán carried out an inspection of the patient's home where migrant dogs from the Colombian Pacific were found in the surroundings, some with suspicious lesions of tungiasis. We document here the resurgence of this pathology in urban areas, probably secondary to the migration of animals from rural areas. It is important to recognize the existence of the flea in rural and urban areas, make a medical diagnosis, and report cases to the surveillance entities to enable appropriate management and sanitary control of this neglected ectoparasitosis in humans and animals.
