ABSTRACT
Many people from poverty-stricken countries are migrating across South and Central America to reach the México-United States border, a movement exacerbated by the COVID-19 pandemic. Migrant people who begin their northbound journey in South America must transit across a significant geographic bottleneck, the Darién Gap, a mountainous rainforest region between Colombia and Panama. Most migrant people crossing this region originate from Cuba, Haiti, and Venezuela. Other people reach the shores of South American countries from west and central Africa or central and southeastern Asia and continue to the Darién Gap. Poverty and violence drive families with children to flee their homes and endure incalculable risks in their path. Children traveling with their families or as unaccompanied minors across the Darién Gap are exposed to life-threatening situations and human rights violations, including abuse, exploitation, malnourishment, and limited access to medical care. In addition to experiencing untreated medical illnesses, children experience mental health disorders during migration and after they reach their destination as a result of victimization and adverse traumatic experiences. Therefore, providing migrants, especially children, with rapid medical screenings and mental health support when they arrive at their destination is critical to reduce health inequities. Furthermore, making these interventions available during their transit and ensuring their safety may prevent further human rights abuses in children and families. Latin American governments must address the ongoing humanitarian crisis endured by migrants throughout their migratory path by offering access to essential healthcare services and safeguarding the rights and security of children and vulnerable groups.
Subject(s)
COVID-19 , Transients and Migrants , Humans , Child , United States , Pandemics/prevention & control , COVID-19/epidemiology , Central America , Human RightsABSTRACT
Introducción: Las infecciones intrahospitalarias se denominan Infecciones Asociadas a Cuidados de la Salud (IACS). Los pacientes quemados tienen un alto riesgo de infección como resultado del inmunocompromiso, estancias intrahospitalarias prolongadas y los procedimientos diagnósticos/terapéuticos requeridos para su manejo. La Unidad de Quemados en 2012 fue el segundo área con mayor tasa de IACS del Hospital del Niño (incidencia 21.2%). Objetivo: Determinar los factores de riesgo para el desarrollo de IACS en pacientes de la Unidad de Quemados del Hospital del Niño de Panamá atendidos desde el año 2009 al 2013. Material y método: Estudio observacional analítico retrospectivo con muestreo probabilístico. Se determinó la frecuencia y fuerza de asociación entre las variables a estudiar y el desarrollo de IACS mediante la prueba de desigualdad relativa (OR) con su intervalo de confianza correspondiente, un nivel de significancia del 95% y precisión de 0.05, previa verificación de la significancia estadística a través de la prueba X2. Resultados: los lactantes, quemaduras de III grado, extensión >10% de SCTQ, número de segmentos corporales quemados, días de estancia hospitalaria, uso de dispositivos invasivos y la realización de procedimientos quirúrgicos son factores de riesgo para el desarrollo de IACS en pacientes quemados. Por otra parte, el uso de coberturas biosintéticas confiere un factor protector. Conclusión: los quemados poseen características endógenas y exógenas para el desarrollo de IACS. Conocer su comportamiento representa una herramienta útil para su control y prevención.
Introduction: Healthcare-associated infections (HAIs) are infections that developed during a hospitalization. Burned patients are at high risk of infection as a result of the immune suppression, long hospital stays and diagnostic / therapeutic procedures required for its management. The Burn Unit on 2012 was the second area with the highest rate of HAIs of the institution (incidence 21.2%). Objective: Determine the risk factors for the development of HAIs in patients in the Burn Unit of Panama Children Hospital since 2009 to 2013. Material and method: A retrospective analytical and observational study with a probabilistic sampling. We determined the frequency and correlations between the variables and the development of HAIs by Odds Ratio (OR) with its corresponding confidence interval, a level of significance of 95% and a precision of 0.05, upon verification of statistical significance through X2. Results: infants, III degree burns, extension above 10% of Burned Body Surface Area, number of compromised body segments, length of hospital stay, use of invasive devices and surgical procedures are risk factors for the development of HAIs in burned patients. On the other hand, the use of burn wound dressings confers a protective factor for them. Conclusion: burned patients have endogenous and exogenous features that allow the development of HAIs. Knowing their behavior represents a useful tool in the control and prevention of them.
