Regional solar radiation is inversely correlated with incidence and severity of tuberculosis in Chile.

Vitamin D (VD) deficiency has been linked to increased incidence and morbidity of tuberculosis (TB). Chile has large variations in solar radiation (SR; a proxy of VD status) and high prevalence of VD deficiency in its southernmost regions with low SR. We investigated the correlation between regional SR and rates of TB incidence, admissions and deaths in Chile by reviewing national records on prospectively collected mandatory disease notifications, admissions and mortality between 2001 and 2011. Over the study period, 26 691 new TB notifications were registered. The TB incidence rate was 14·77 (95% confidence intervals (CIs) 14·60-14·95), admission rate was 12·12 (95% CI 11·96-12·28) and mortality rate was 1·61 (95% CI 1·55-1·67) per 100 000 population per year. Multivariable linear regressions adjusting for significant demographic TB risk factors in Chile (regional prevalence of HIV infection, rates of migration from TB-endemic countries and rates of imprisonment) revealed an independent and highly statistically significant inverse association between SR and TB incidence rate (ß -1·05, 95% CI -1·73 to -0·36, P = 0·007), admission rate (ß -1·58, 95% CI -2·23 to -0·93, P < 0·001), and mortality rate (ß -0·15, 95% CI -0·23 to -0·07, P = 0·002). These findings support a potential pathogenic role of VD deficiency in TB incidence and severity.

Primary immunodeficiencies in Chile evaluated through ICD-10 coded hospital admissions

BACKGROUND: The epidemiology and hospitalisation trends of primary immunodeficiency (PID) in Chile are unknown. We aimed to evaluate hospitalisation trends and demographic characteristics of PID admissions in Chile. METHODS: PID admissions between 2001 and 2010 (ICD-10 codes D70.0, D70.4, D71, 72.0, D76.1, D80-D84, E70.3, G11.3) were reviewed using national hospital discharge databases. RESULTS: During the study period, 5486 admissions due to PID were registered (0.03% of total). 58.5% of patients were male and 66.3% were under 18 years. Median length of stay was one day (range 1-403 days). The most frequent diagnoses were hypogammaglobulinaemia (27.6%), unspecified immunodeficiency (21.9%), haemophagocytic lymphohystiocytosis (18.3%) and common variable immunodeficiency (11.2%). There was a significant increase in PID admission rate and in one-day hospitalisations during this period (β = 0.2; P = 0.001 and β = 33; P ≤ 0.001, respectively), however no significant variation was found for longer admissions (β = 4.8; P = 0.175). The increasing trend in PID admission rate was significant in patients with private, but not public insurance (β = 0.53; P ≤ 0.001 vs. β = 0.08; P = 0.079, respectively). CONCLUSIONS: We report an increasing trend in admissions due to PID in Chile over a 10-year period. Increase is mainly due to short hospitalisations, possibly accounting for improvements in IVIG access. Higher admission rates in patients with private vs. public insurance suggest socioeconomic disparities in access to PID treatment. ICD-10 coded hospitalisation databases may be useful to determine hospitalisation trends and demographic characteristics of PID admissions worldwide

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Primary immunodeficiencies in Chile evaluated through ICD-10 coded hospital admissions.

BACKGROUND: The epidemiology and hospitalisation trends of primary immunodeficiency (PID) in Chile are unknown. We aimed to evaluate hospitalisation trends and demographic characteristics of PID admissions in Chile. METHODS: PID admissions between 2001 and 2010 (ICD-10 codes D70.0, D70.4, D71, 72.0, D76.1, D80-D84, E70.3, G11.3) were reviewed using national hospital discharge databases. RESULTS: During the study period, 5486 admissions due to PID were registered (0.03% of total). 58.5% of patients were male and 66.3% were under 18 years. Median length of stay was one day (range 1-403 days). The most frequent diagnoses were hypogammaglobulinaemia (27.6%), unspecified immunodeficiency (21.9%), haemophagocytic lymphohystiocytosis (18.3%) and common variable immunodeficiency (11.2%). There was a significant increase in PID admission rate and in one-day hospitalisations during this period (ß=0.2; P=0.001 and ß=33; P≤0.001, respectively), however no significant variation was found for longer admissions (ß=4.8; P=0.175). The increasing trend in PID admission rate was significant in patients with private, but not public insurance (ß=0.53; P≤0.001 vs. ß=0.08; P=0.079, respectively). CONCLUSIONS: We report an increasing trend in admissions due to PID in Chile over a 10-year period. Increase is mainly due to short hospitalisations, possibly accounting for improvements in IVIG access. Higher admission rates in patients with private vs. public insurance suggest socioeconomic disparities in access to PID treatment. ICD-10 coded hospitalisation databases may be useful to determine hospitalisation trends and demographic characteristics of PID admissions worldwide.

Prevalence of parent-reported immediate hypersensitivity food allergy in Chilean school-aged children

BACKGROUND: Food allergies (FAs) affect 2-4% of school-aged children in developed countries and strongly impact their quality of life. The prevalence of FA in Chile remains unknown. METHODS: Cross-sectional survey study of 488 parents of school-aged children from Santiago who were asked to complete a FA screening questionnaire. Parents who reported symptoms suggestive of FA were contacted to answer a second in-depth questionnaire to determine immediate hypersensitivity FA prevalence and clinical characteristics of school-aged Chilean children.RESULTS: A total of 455 parents answered the screening questionnaire: 13% reported recurrent symptoms to a particular food and 6% reported FA. Forty-three screening questionnaires (9%) were found to be suggestive of FA. Parents of 40 children answered the second questionnaire; 25 were considered by authors to have FA. FA rate was 5.5% (95% CI: 3.6-7.9). Foods reported to frequently cause FA included walnut, peanut, egg, chocolate, avocado, and banana. Children with FA had more asthma (20% vs. 7%, P < 0.02) and atopic dermatitis (32% vs. 13%, P < 0.01) by report. The parents of children with FA did not report anaphylaxis, but 48% had history compatible with anaphylaxis. Of 13 children who sought medical attention, 70% were diagnosed with FA; none were advised to acquire an epinephrine autoinjector. CONCLUSION: Up to 5.5% of school-aged Chilean children may suffer from FA, most frequently to walnut and peanut. It is critical to raise awareness in Chile regarding FA and recognition of anaphylaxis, and promote epinephrine autoinjectors in affected children

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Prevalence of parent-reported immediate hypersensitivity food allergy in Chilean school-aged children.

BACKGROUND: Food allergies (FAs) affect 2-4% of school-aged children in developed countries and strongly impact their quality of life. The prevalence of FA in Chile remains unknown. METHODS: Cross-sectional survey study of 488 parents of school-aged children from Santiago who were asked to complete a FA screening questionnaire. Parents who reported symptoms suggestive of FA were contacted to answer a second in-depth questionnaire to determine immediate hypersensitivity FA prevalence and clinical characteristics of school-aged Chilean children. RESULTS: A total of 455 parents answered the screening questionnaire: 13% reported recurrent symptoms to a particular food and 6% reported FA. Forty-three screening questionnaires (9%) were found to be suggestive of FA. Parents of 40 children answered the second questionnaire; 25 were considered by authors to have FA. FA rate was 5.5% (95% CI: 3.6-7.9). Foods reported to frequently cause FA included walnut, peanut, egg, chocolate, avocado, and banana. Children with FA had more asthma (20% vs. 7%, P<0.02) and atopic dermatitis (32% vs. 13%, P<0.01) by report. The parents of children with FA did not report anaphylaxis, but 48% had history compatible with anaphylaxis. Of 13 children who sought medical attention, 70% were diagnosed with FA; none were advised to acquire an epinephrine autoinjector. CONCLUSION: Up to 5.5% of school-aged Chilean children may suffer from FA, most frequently to walnut and peanut. It is critical to raise awareness in Chile regarding FA and recognition of anaphylaxis, and promote epinephrine autoinjectors in affected children.