Impact of the universal health insurance benefits on cervical cancer mortality in Colombia.

BACKGROUND: Cervical cancer patients in Colombia have a lower likelihood of survival compared to breast cancer patients. In 1993, Colombia enrolled citizens in one of two health insurance regimes (contributory-private insurance and subsidized- public insurance) with fewer benefits in the subsidized regime. In 2008, the Constitutional Court required the Colombian government to unify services of both regimes by 2012. This study evaluated the impact of this insurance change on cervical cancer mortality before and after 2012. METHODS: We accessed 24,491 cervical cancer mortality records for 2006-2020 from the vital statistics of Colombia's National Administrative Department of Statistics (DANE). We calculated crude mortality rates by health insurance type and departments (geopolitical division). Changes by department were analyzed by rate differences between 2006 and 2012 and 2013-2020, for each health insurance type. We analyzed trends using join-point regressions by health insurance and the two time-periods. RESULTS: The contributory regime (private insurance) exhibited a significant decline in cervical cancer mortality from 2006 to 2012, characterized by a noteworthy average annual percentage change (AAPC) of -3.27% (P = 0.02; 95% CI [-5.81, -0.65]), followed by a marginal non-significant increase from 2013 to 2020 (AAPC 0.08%; P = 0.92; 95% CI [-1.63, 1.82]). In the subsidized regime (public insurance), there is a non-significant decrease in mortality between 2006 and 2012 (AAPC - 0.29%; P = 0.76; 95% CI [-2.17, 1.62]), followed by a significant increase from 2013 to 2020 (AAPC of 2.28%; P < 0.001; 95% CI [1.21, 3.36]). Examining departments from 2013 to 2020 versus 2006 to 2012, the subsidized regime showed fewer cervical cancer-related deaths in 5 out of 32 departments, while 6 departments had higher mortality. In 21 departments, mortality rates remained similar between both regimes. CONCLUSION: Improvement of health benefits of the subsidized regime did not show a positive impact on cervical cancer mortality in women enrolled in this health insurance scheme, possibly due to unresolved administrative and socioeconomic barriers that hinder access to quality cancer screening and treatment.

Assessment of energy efficiency and performance in a two-phase anaerobic process for organic matter removal.

Energy efficiency (EE) depends mainly on the lower heating values (LHVs) of hydrogen and methane selected from the thermodynamics tables under ideal conditions. However, for practical applications, the heating value should be calculated by considering some environmental factors under real conditions. Accordingly, this study compared EE using the ideal LHV with the EE using the real LHV in a two-phase anaerobic digestion reactor treating synthetic wastewater. Additionally, the process performance and the stability were studied. The results showed that the EE value calculated using LHVideal was, on average, 35% higher than that evaluated using LHVreal; these differences are relevant to the estimation of real energy and also for practical applications. At the same time, the index buffer intermediate alkalinity/partial alkalinity was shown to be more accurate than the pH value to analyze the stability of the process. With regards to chemical oxygen demand, the removal efficiency in the methanogenic phase decreased drastically when utilizing 100% of the acidogenic phase. Future considerations for the optimization of each phase are highlighted.

Auxiliary trafficking subunit GJA1-20k protects connexin-43 from degradation and limits ventricular arrhythmias.

Connexin-43 (Cx43) gap junctions provide intercellular coupling, which ensures rapid action potential propagation and synchronized heart contraction. Alterations in Cx43 localization and reductions in gap junction coupling occur in failing hearts, contributing to ventricular arrhythmias and sudden cardiac death. Recent reports have found that an internally translated Cx43 isoform, GJA1-20k, is an auxiliary subunit for the trafficking of Cx43 in heterologous expression systems. Here, we have created a mouse model by using CRISPR technology to mutate a single internal translation initiation site in Cx43 (M213L mutation), which generates full-length Cx43, but not GJA1-20k. We found that GJA1M213L/M213L mice had severely abnormal electrocardiograms despite preserved contractile function, reduced total Cx43, and reduced gap junctions, and they died suddenly at 2 to 4 weeks of age. Heterozygous GJA1M213L/WT mice survived to adulthood with increased ventricular ectopy. Biochemical experiments indicated that cytoplasmic Cx43 had a half-life that was 50% shorter than membrane-associated Cx43. Without GJA1-20k, poorly trafficked Cx43 was degraded. The data support that GJA1-20k, an endogenous entity translated independently of Cx43, is critical for Cx43 gap junction trafficking, maintenance of Cx43 protein, and normal electrical function of the mammalian heart.

Loss of T-Cell Multifunctionality and TCR-Vß Repertoire Against Epstein-Barr Virus Is Associated With Worse Prognosis and Clinical Parameters in HIV+ Patients.

Epstein-Barr virus (EBV) is an oncogenic virus associated with the development of aggressive and poor-prognosis B-cell lymphomas in patients infected with human immunodeficiency virus (HIV+ patients). The most important risk factors for these malignancies include immune dysfunction, chronic immune activation, and loss of T-cell receptor (TCR) repertoire. The combination of all these factors can favor the reactivation of EBV, malignant cell transformation, and clinical progression toward B-cell lymphomas. The overarching aim of this study was to evaluate the frequency, phenotype, functionality, and distribution of TCR clonotypes for EBV-specific T-cell subpopulations in HIV+ patients at different clinical stages and for HIV+ patients with B-cell lymphoma, as well as to establish their association with clinical variables of prognostic value. Factors were studied in 56 HIV+ patients at different clinical stages and in six HIV+ subjects with diagnosed B-cell lymphoma. We found a significant decrease in all subpopulations of EBV-specific CD4+ T cells from HIV+ patients at stage 3 and with B-cell lymphoma. EBV-specific effector CD8+ T cells, particularly effector memory cells, were also reduced in HIV+ patients with B-cell lymphoma. Interestingly, these cells were unable to produce IFN-γ and lacked multifunctionality in HIV+ patients. The TCR-Vß repertoire, which is key for protection against EBV in healthy individuals, was less diverse in HIV+ patients due to a lower frequency of TCR-Vß2+, Vß4+, Vß7.1+, Vß9+, Vß13.6+, Vß14+, Vß17+, Vß22+ CD4+, Vß14+, and Vß17+ CD8+ T cells. HIV+ patients with positive plasma EBV loads (EBV+HIV+) had a noteworthy decrease in the levels of both TNF-α+ and multifunctional TNF-α+/IL-2+ and TNF-α+/IFN-γ+ CD8+ T cells. Altogether, our findings demonstrate that HIV+ patients have significant alterations in the immune response to EBV (poor-quality immunity) that can favor viral reactivation, escalating the risk for developing EBV-associated B-cell lymphomas.

Stress response protein GJA1-20k promotes mitochondrial biogenesis, metabolic quiescence, and cardioprotection against ischemia/reperfusion injury.

Connexin 43 (Cx43), a product of the GJA1 gene, is a gap junction protein facilitating intercellular communication between cardiomyocytes. Cx43 protects the heart from ischemic injury by mechanisms that are not well understood. GJA1 mRNA can undergo alternative translation, generating smaller isoforms in the heart, with GJA1-20k being the most abundant. Here, we report that ischemic and ischemia/reperfusion (I/R) injuries upregulate endogenous GJA1-20k protein in the heart, which targets to cardiac mitochondria and associates with the outer mitochondrial membrane. Exploring the functional consequence of increased GJA1-20k, we found that AAV9-mediated gene transfer of GJA1-20k in mouse hearts increases mitochondrial biogenesis while reducing mitochondrial membrane potential, respiration, and ROS production. By doing so, GJA1-20k promotes a protective mitochondrial phenotype, as seen with ischemic preconditioning (IPC), which also increases endogenous GJA1-20k in heart lysates and mitochondrial fractions. As a result, AAV9-GJA1-20k pretreatment reduces myocardial infarct size in mouse hearts subjected to in vivo ischemic injury or ex vivo I/R injury, similar to an IPC-induced cardioprotective effect. In conclusion, GJA1-20k is an endogenous stress response protein that induces mitochondrial biogenesis and metabolic hibernation, preconditioning the heart against I/R insults. Introduction of exogenous GJA1-20k is a putative therapeutic strategy for patients undergoing anticipated ischemic injury.

La formación de biopelículas y la calidad del agua en la consulta odontológica / Biofilm formation and water quality in the dental practice

Resumen Objetivo. Recuperar y analizar la presencia de bacterias formadoras de biopelículas en las mangueras de la jeringa triple y de la pieza de mano que distribuyen el agua a las unidades dentales de la Fundación Universitaria San Martin. Método. Se realizó un estudio descriptivo de corte transversal con muestreo probabilístico. Se estudiaron las bacterias presentes en el agua recolectada en la jeringa triple y la pieza de mano, las cuales fueron seleccionadas al ser los instrumentos por los cuales transita el agua que entrará en contacto con el paciente. Se tomaron muestras antes y después de la consulta, de la jeringa triple con solo agua, con agua-aire y la pieza de mano. Se realizaron cultivos por filtración por membrana en medios Endo, Cetrimide y Sangre Azida. Resultados. Se encontraron 84 % de muestras positivas para cocos Gram positivos, mientras que el 8 % de las muestras presentaban aislamientos de bacilos Gram negativos, representado en E coli y P aeruginosa. La flora Gram positiva estuvo representada por Staphylococcus hominis y Staphylococcus epidermidis.

Abstract Objective. To recover and to analyze the presence of biofilm forming bacteria in the triple syringe and handpiece hoses, which distribute the water to the dental units from La Fundación Universitaria San Martin. Methods. A cross-sectional descriptive study was carried out with probabilistic sampling. We studied the bacteria present in the water collected in the triple syringe and the handpiece were selected because they are the instruments through which the water that will come into contact with the patient. Samples were taken before and after the consultation, of the triple syringe with only water, with air water and the handpiece. Cultures were performed by membrane filtration in Endo, Cetrimide and Blood Azida media. Results. We found 84 % positive samples for Gram positive cocci, while there were 8 % of samples, with isolates of Gram negative bacilli, represented in E coli and P aeruginosa. The Gram positive flora was represented by Staphylococcus hominis and Staphylococcus epidermidis.

Efecto de la estructura molecular sobre el espectro electrónico vertical de la oxoglaucina / Effects of the molecular structure on the electronic vertical spectrum of oxoglaucine / Efeito da estrutura molecular no espectro eletrônico vertical da oxoglaucina

Resumen Se investigó el espectro electrónico vertical de la oxoglaucina utilizando el método de interacción de configuraciones multi-referencial (DFT/MRCI). Se analizó el efecto de los grupos metilo y metoxilo sobre la geometría y la distribución energética de los estados excitados de baja energía utilizando la base TZVP. Se encontró que, en los mínimos del estado fundamental de oxoglaucina, oxoglaucina sin grupos metilo y sin grupos metoxilo, los estados excitados singulete de más baja energía son de tipo nП* (S1) y ПП* (S2) y que los estados triplete ПП* (T1) y nП* (T2) son energéticamente accesibles desde S1 Desde el punto de vista energético, se encontró que el canal más eficiente para el entrecruzamiento de sistemas singulete-triplete es 1(nП*)3(ПП*). Aunque la presencia de los grupos metilo y metoxilo distorsionan la planaridad del sistema de anillos, su efecto en la distribución (vertical) de los estados singulete y triplete de más baja energía es mínimo.

Abstract The vertical electronic spectrum of oxoglaucine by means of a multireference configuration interaction method (DFT/ MRCI) was studied. The effect of both methyl and methoxy groups on the geometries and energetic distribution of the low-lying excited states was analyzed. The results show that, by means of the TZVP basis set, at the ground state minima of oxoglaucine, oxoglaucine without methyl and methoxy groups, the lowest excited singlet states are of nП* (S1) and ПП* (S2) type. Triplet states of ПП* (T1) and nП* (T2) type are energetically accessible from S1. From the energetic point of view, it can be proposed that the channel for an efficient intersystem crossing 1(nП*)3(ПП*) is plausible. Although the presence of the methyl and methoxyl groups distort the planarity of the rings system, the effect in the vertical distribution of the lowest lying singlet and triplet states can be considered as negligible.

Resumo O espectro eletrônico vertical da oxoglaucina foi investigado por meio do método de interação de configurações multi referência (DFT/MRCI). Foi estudado o efeito dos grupos metilo e metoxi nas geometrias e na distribuição energética dos estados excitados de baixa energia utilizando a base TZVP. Os resultados mostram que nos mínimos do estado fundamental da oxoglaucina, a oxoglaucina sem grupos metilo e metoxi os estados excitados singletos de mais baixa energia são de tipo nП* (S1) y ПП* (S2) e que os estados tripletos do tipo ПП* (T1) e nП* (T2) são energeticamente acessíveis a partir de S1 Do ponto de vista energético, pode-se propor que o canal para um cruzamento intersistema eficiente 1(nП*)3(ПП*) seja plausível. Embora a presença dos grupos metilo e metoxilo distorçam a planaridade do sistema de anéis, o efeito na distribuição vertical dos estados de singleto e de tripleto de mais baixa energía pode ser considerado negligenciável.

Estimating the burden of disease and the economic cost attributable to chikungunya, Colombia, 2014.

BACKGROUND: Chikungunya (CHIK) virus disease is expected to be a considerable cause of disability and economic burden in Latin America given its chronic sequelae, particularly its chronic inflammatory rheumatism. There have been no previous studies assessing CHIK costs and disability in Latin America. METHODS: We calculated incidence rates for CHIK during the 2014 outbreak in Colombia using epidemiological data provided by the Colombian National Institute of Health, using demographic data from the National Administrative Department of Statistics. The burden of disease was estimated through disability adjusted life years (DALYs) lost and the costs were estimated based on the national recommendations for CHIK acute and chronic phase attention. RESULTS: There were a total of 106 592 cases, with incidence rates ranging from 0 to 1837.3 cases/100 000 population in different departments. An estimate was made of total DALYs lost of 40.44 to 45.14 lost/100 000 population. The 2014 outbreak estimated costs were at least US$73.6 million. CONCLUSIONS: Our estimates raise concerns about the effects of continued CHIK spread in Colombia and other Latin-American countries. The lack of transmission control for this disease and potential for spread means that there will be significant acute and chronic disability and related costs in the short and long term for Latin American health care systems.

Panorama de las enfermedades transmisibles en Colombia desde la perspectiva del Plan Decenal de Salud Pública 2012-2021: [Editorial] / Panorama of communicable diseases in Colombia from the perspective of the Public Health 2012-2021 Ten-Year Plan: [Editorial]

Las enfermedades transmisibles en Colombia han demostrado históricamente diferentes comportamientos 1 , debido a inequidades sociales 2,3 y condiciones precarias de saneamiento básico, entre otros factores que han dado lugar a altas tasas de morbimortalidad poblacional 4-7. Colombia adoptó el Plan Decenal de Salud Pública 2012- 2021 (PDSP), mediante resolución número 1841 (2013) del Ministerio de Salud, apostando políticamente por la equidad en salud, entendida como: « ausencia de diferencias en salud entre grupos sociales consideradas innecesarias, evitables e injustas ¼ 8 . Esto implica que la equidad sanitaria se logra cuando todos alcanzan su potencial de salud independientemente de sus condiciones culturales y socioeconómicas. El PDSP es producto del Plan Nacional de Desarrollo 2010-2014, y busca reducir la inequidad en salud, planteando 3 objetivos para lograrlo, avanzar hacia la garantía del goce efectivo del derecho a la salud, mejorar las condiciones de vida que modifican la situación de salud y disminuyen la carga de enfermedad existente y no tolerar la mortalidad, la morbilidad y las discapacidades evitables 9 , para alcanzar mayor equidad en salud y desarrollo humano sostenible, construir capital humano y disminuir vulnerabilidades sociales, incorporando políticas nacionales e internacionales dirigidas a grupos poblacionales como niños, niñas, adolescentes, jóvenes y personas mayores, mujeres víctimas de maltrato y otras clases de violencia de género, víctimas del conflicto, personas con discapacidad y grupos étnicos. Cuenta con 8 dimensiones prioritarias, que incluyen la vida saludable y enfermedades transmisibles (VSET), entre otras, cada una a su vez con objetivos, estrategias, metas e indicadores

Communicable diseases in Colombia have historically shown different behaviours 1 , due to social inequities 2,3 and precarious basic sanitation conditions, among other factors that have led to high morbidity and mortality rates in the population 4-7. Colombia adopted the Ten-Year Public Health Plan 2012-2021 (PDSP), through resolution number 1841 (2013) of the Ministry of Health, making a political commitment to health equity, understood as: "the absence of differences in health between social groups considered unnecessary, avoidable and unfair "8 . This implies that health equity is achieved when everyone reaches their health potential regardless of their cultural and socio-economic conditions. The PDSP is a product of the National Development Plan 2010-2014, and seeks to reduce inequity in health, setting out 3 objectives to achieve this: to move towards guaranteeing the effective enjoyment of the right to health, to improve living conditions that modify the health situation and reduce the existing burden of disease, and not to tolerate avoidable mortality, morbidity and disability 9 , to achieve greater equity in health and sustainable human development, build human capital and reduce social vulnerabilities, incorporating national and international policies aimed at population groups such as children, adolescents, youth and the elderly, women victims of abuse and other kinds of gender-based violence, victims of conflict, people with disabilities and ethnic groups. It has 8 priority dimensions, including healthy living and communicable diseases (STDs), among others, each in turn with objectives, strategies, targets and indicators.

Asociación entre incidencia de tuberculosis e Índice de Desarrollo Humano en 165 países del mundo / Association between tuberculosis incidence and the Human Development Index in 165 countries of the world

Objetivos. Evaluar la relación entre el índice de desarrollo humano (IDH) y la incidencia de tuberculosis (TB) en 165 países del mundo en el período 2005-2011. Materiales y métodos. Se realizó un estudio ecológico para el cual el IDH se obtuvo de la base de datos del Fondo de Naciones Unidas para el Desarrollo (PNUD) y la incidencia de TB del Programa Alto a la TB de la Organización Mundial de la Salud (OMS). Se evaluó la variación anual de las variables y se realizaron modelos de regresión no lineales (exponencial). Resultados. Al analizar los datos con los modelos de regresión no lineal, se observó que los países con mayores tasas de incidencia de TB fueron aquellos con menores valores de IDH, siendo significativa su asociación (p<0,01). De igual forma se observó que en los países, la variación en el tiempo se asoció significativamente con la variación en el IDH. Conclusiones. Se ha encontrado una relación inversa y significativa entre el IDH y la morbilidad por TB en los países estudiados, incluidos tanto los países de mayor carga de enfermedad como los de la región andina en Latinoamérica. Esta información refleja la influencia significativa de indicadores socioeconómicos como el IDH sobre la tasa de incidencia de la TB, especialmente en países endémicos, siendo inversa entre ambos tipos de variables; con el incremento o mejoría del IDH la tasa de incidencia de la enfermedad disminuyó o se encontró siendo significativamente menor.

Objectives. Assess relationship between the Human Development Index (HDI) and the incidence of tuberculosis (TB) in 165 countries in the World in the period 2005-2011. Materials and methods. An ecological study was done, using HDI data that were obtained from the United Nations Development Program (UNDP), and the incidence rates from the Stop TB Program of the World Health Organization (WHO). The annual variation of the variables was assessed and non-linear regression models (Exponential), were done. Results. At the non-linear regression models, it was observed that the relationship between epidemiological and HDI was significant, those countries with higher rates presented lower values of HDI (p<0.01). Additionally the variation in time was significantly associated with HDI variation. Conclusions. This information reflect the significant influence of socioeconomical indicators such as the HDI on the TB incidence rates in the World, particularly in endemic countries, being an inverse relationship between both types of variables; with an increase or improvement in the HDI, the disease incidence rate decreased or it is found lower.

La investigación científica en tuberculosis: Evaluación bibliométrica de las contribuciones de la literatura colombiana / Scientific research in tuberculosis: bibliometric assesment of the colombian contributions to the literature

Introducción: La tuberculosis (TB) es un importante problema de salud tanto a nivel mundial como también en Colombia, por lo cual se requiere intensificar más acciones en salud y en investigación. Se realizó una evaluación bibliométrica de las contribuciones de la literatura colombiana sobre TB con el objeto de determinar el nivel de producción en la materia. Materiales y métodos: Estudio de producción colombiana en TB en las bases MEDLINE/ GOPUBMED (1809-2012), Scopus (1959-2012), SciELO Colombia (20042012) e IMBIOMED (2005-2012). Se incluyen todos los tipos de estudios, caracterizándolos por años, cooperación internacional (CI), ciudad de origen de la publicación (COP), revista de publicación (RP) y autores con mayor contribución (AMC). Resultados: En MEDLINE, se encontraron 232 artículos (0,12% del total en TB, 0,49/100.000 hab.), de los cuales 52,2% fueron 20052012, promedio 2007-2011 de 19,6±5,1. La CI se observó en 21,9%. Bogotá, Medellín y Cali publicaron 65,52% de los artículos, 16,4% en Biomédica, 5,2% en Revista de Salud Pública y 4,3% en IJTLD. En MEDLINE el AMC es Luís F. García (Universidad de antioquia). En scopus los resultados son similares a MEDLINE (n=168, 0,08%). En SciELO sólo existen 29 registros (de 30) y en IMBIOMED 35 (de 513, 6,8%). Discusión: La producción científica en TB en Colombia es baja, no solo al compararla con países desarrollos (EUA, 4,08 artículos/100.000 hab.) sino con otros en América Latina incluso de menor incidencia como chile (19 casos/100.000 hab.) pero con una productividad 2,2 veces mayor (1,09 artículos/100.000 hab.). Un mayor fomento de la investigación, desde pregrado, una mayor interacción entre organismos públicos y privados, así como mayor cooperación académica e internacional, podrían permitir disminuir dichas brechas, incrementar la publicación científica y que la aplicación de dichos conocimientos generados en el propio país contribuya a mejorar la epidemiología y los diferentes aspectos de la enfermedad.

Introduction: Tuberculosis (TB) is an important public health problem, globally as well in Colombia. For these reasons more actions in health and research should be intensified. A bibliometric assessment of the colombian contributions to the biomedical literature on TB with the objective to determinate the level of production on it was done. Methods: Bibliometric study of the colombian production on TB in the databases MEDLINE/GOPUBMED (1809-2012), SCOPUS (1959-2012), SCIELO Colombia (2004-2012) and IMBIOMED (2005-2012). Ah kind of studies, analyzing by years, international cooperation (IC), publication origin city (POC), publication journal (PJ) and authors with more contribution (AMC) were included. Results: at MEDLINE, 232 articles were found (0.12% from the total on TB, 0.49/100,000 hab.), from them 52.2% were 2005-2012, mean 2007-2011 of 19.6±5.1. IC was recorded in 21.9%. Bogotá, Medellín and Cali published 65.52% of the articles, 16.4% at Biomédica, 5.2% at Revista de Salud Pública and 4.3% at IJTLD. At MEDLINE the AMC was Luís F. García (Universidad de Antioquia). At SCOPUS results were similar to MEDLINE (n=168, 0.08%). At SciELO only 29 records were found (out of 30) and at IMBIOMED 35 (of 513, 6.8%). Discussion: scientific production on TB in Colombia is low, not just comparing it with developed countries (UsA, 4.08 articles/100,000 hab.) but also with others in Latin America with even lower TB incidence such as Chile (19 cases/100,000 hab.) but with a better productivity 2.2 times higher (1.09 articles/100,000 hab.). A higher promotion of research, beginning in undergraduate studies, better interaction between public and private organizations, as well more academic and international cooperation, would allow to decrease those gaps, increase scientific publication and let that the application of that generated knowledge in the same country contribute to improve the TB epidemiology and different aspects of disease.

[Association between tuberculosis incidence and the Human Development Index in 165 countries of the world]. / Asociación entre incidencia de tuberculosis e Índice de Desarrollo Humano en 165 países del mundo.

OBJECTIVES: Assess relationship between the Human Development Index (HDI) and the incidence of tuberculosis (TB) in 165 countries in the World in the period 2005-2011. MATERIALS AND METHODS: An ecological study was done, using HDI data that were obtained from the United Nations Development Program (UNDP), and the incidence rates from the Stop TB Program of the World Health Organization (WHO). The annual variation of the variables was assessed and non-linear regression models (Exponential), were done. RESULTS: At the non-linear regression models, it was observed that the relationship between epidemiological and HDI was significant, those countries with higher rates presented lower values of HDI (p<0.01). Additionally the variation in time was significantly associated with HDI variation. CONCLUSIONS: This information reflect the significant influence of socioeconomical indicators such as the HDI on the TB incidence rates in the World, particularly in endemic countries, being an inverse relationship between both types of variables; with an increase or improvement in the HDI, the disease incidence rate decreased or it is found lower.

Impacto de una actividad formativa en los conocimientos, actitudes y percepciones sobre tuberculosis de estudiantes de medicina de una universidad de Risaralda Colombia / Impact of one formative activity in the students`knowledge, attitudes and perceptions on tuberculosis from one university in Risaralda Colombia

La tuberculosis continúa siendo una de las principales enfermedades tropicales en términos de morbimortalidad. De allí la importancia de mejorar su prevención, a través de diferentes estrategias, incluida la educación médica continua. En el marco del Día Mundial de la lucha contra la tuberculosis se realizó un simposio eduactivo incluyendo charlas y una obra de teatro sobre diferentes aspectos de la enfermedad (duración 280 minutos). Antes de iniciar se aplicó una encuesta para evaluar conocimientos, actitudes y percepciones sobre tuberculosis, basada en guía para encuestas ACMS, de STOP Tuberculosis Partnership de la OMS. Al finalizar esta fue aplicada de nuevo. Se comparan las diferecias entre los resultados antes u después con la prueba X², confianza 95%. Se evaluó un total de 109 universitarios antes de iniciar (pre) y 103 después (pos) (total, 211 encuestas). Sobre las preguntas realizadas, la primera de ella fue "¿Cuán serio percibe usted el problema de la tuberculosis en su comunidad?". En la encuesta pre solo 50,9% lo consideró un problema muy serio. En la pos se incrementó a 94,1% (X²= 49,602; P<0,001). En la encuesta pre, 31,5% lo consideró como algo serio, 2,8% no tan serio, 8,3% no sabía y 6,5% no contestó. En la pos, el restante 5,9% correspondió solo a considerarlo como algo serio. En general se observó mejoría significativa sobre los conocimientos, actitudes y percepciones en síntomas, trasmisión, prevención, curación, que sentiría al ser diagnosticado y otros aspectos evaluados (P<0,05). Este tipo de abordajes, especialmente a nivel comunitario, debe ser replicado, con el fin de mejorar los conocimientos, actitudes y percepciones de la población no solo universitaria, sino también general, sobre la tuberculosis. Se requiere dar mayor información en las poblaciones afectadas y sus familiares sobre las formas de transmisión, para mitigar los mitos y el estigma, que es también prevalente

Tuberculosis continues to be one of the most principal tropical diseases in terms of its morbidity and mortality. Since there the importance to improve its prevention, through different strategies, included the continuing medical eduaction. In the context of the World Tuberculosis Day an educative symposium, including conferences and a theater play about different disease aspects (lasting 280 minutes), was done. Before start them, a questionnaire to assess knowledges, attitudes and perceptions about tuberculosis, based on the guide for surveys ACMS, of STOP Tuberculosis Partnership from the who, was applied. Finishing them this questionnaire was applied again. Differences between before and after results, using the X²-test, 95% confidence level, were compared. A total 109 universitary students (before) and 102 (after) were evaluated. About the applied questions, first of them was "How serious do you perceive the tuberculosis problem in your community?" In the pre-test survey only 50.9% considered it as a very serious problem. In the post-test it increased to 94.1% (X²=49.602; P<0.001). In the pre-test, 31.5% considered as something serious, 2.8% not so serious, 8.3% did not knew and 6.5% did not answered. In the post-test, resting 5.9% corresponded just no considered it as something serious. In genral a significant improvement about the knowledges, attitudes and perceptions in symptoms, transmission, prevention, cure, how feel about been diagnosed and other evaluated aspect was observed (P<0.05). This type of approach, especially at community level, should be replicated, with the goal to improve the knowledges, attitudes and perceptions of the population not just universitary, but also general, about tuberculosis. It is requerid to give more information in the affected populations and their families about the transmission, in order to mitigate the myths and stigma, which is also prevalent