Metodología de educación para la salud / Health education methodology

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[Acute otitis media in a pediatric primary care unit]. / Otitis media aguda en un centro de salud.

BACKGROUND: Acute otitis media (AOM) is a serious public health problem and is considered one of the most common diagnoses in pediatric outpatient units. The aim of this study was to asses the incidence and distribution of AOM by age, sex, number of visits per episode, and the most frequent symptoms and signs in four pediatric primary care units. PATIENTS AND METHODS: A 12-month (1 September 2000 to 31 August 2001), prospective study was carried out in a primary care center on the outskirts of Madrid. RESULTS: During the study period there were 1,098 consultations for AOM in 521 patients. The overall incidence per 100,000 children aged less than 14 years was 12,080 cases (95 % CI: 11,120-13,090). The highest incidence per 100,000 children was in children aged 12-23 months with 38,780 cases (95 % CI: 33,340-44,430). A total of 34.5 % of the children diagnosed with AOM were aged less than 2 years. Ninety-six percent of the children received antibiotics. Most (81.4 %) of the children were completely cured while symptoms persisted in 15.4 %. A minority of the children (3.5 %) were referred to the otolaryngology department.

Otitis media aguda en un centro de salud / Acute otitis media in a pediatric primary care unit

Antecedentes: La otitis media aguda (OMA) supone un importante problema de salud pública debido a su alta frecuencia, y se considera un diagnóstico muy frecuente en las consultas de Pediatría. Nuestro objetivo fue conocer la incidencia de OMA atendidas en cuatro consultas de Pediatría, así como conocer su distribución por edad y sexo, número de visitas realizadas por episodio, y síntomas y signos otoscópicos más frecuentes. Pacientes y métodos: Se trata de un estudio de casos clínicos prospectivos realizado en un Centro de Salud periurbano de Madrid durante un período de 12 meses (septiembre 2000-agosto 2001). Resultados: Durante el período de estudio se atendieron 1.098 visitas motivadas por OMA en 521 pacientes. La incidencia total fue de 12.080 casos por cada 100.000 menores de 14 años (intervalo de confianza del 95 por ciento [IC 95 por ciento], 11.120-13.090). Con una incidencia máxima entre los 12 y los 23 meses de edad con 38.780 casos por cada 100.000 niños (IC 95 por ciento, 33.340-44.430). Un 34,5 por ciento de los niños diagnosticados de OMA eran menores de 2 años de edad. El 96 por ciento de los pacientes recibieron tratamiento antibiótico. El 81,4 por ciento de los niños presentaron una curación completa, mientras que en el 15,4 por ciento de los casos se observó persistencia de la sintomatología. El 3,5 por ciento de los niños fueron derivados al otorrinolaringólogo (AU)

[Acute otitis media in a pediatrics consulting office]. / Otitis media aguda en una consulta de pediatría.

OBJECTIVE: To know the incidence and natural development of acute otitis media (AOM) in a pediatric outpatient office. PATIENTS AND METHODS: A descriptive study was performed on a population of 867 children, between the ages of 3 months and 7 years, diagnosed with AOM in a pediatric consultation room. The following data were recorded: age, gender, month, type of episode, number of visits to the consulting room and number of referrals to the ear, nose and throat specialist, as well as the symptoms and otoscopic signs that they showed. Observations were made after 15, 30 and 60 days. RESULTS: Of this population, 146 children were diagnosed as having AOM. The incidence was 12.1% and 71.92% were new cases. The age with the larger number of AOM cases was 5 years (20.55%). February was the month with the most cases. The most frequent symptom was nasal congestion. Among the otoscopic signs, the most frequent were hyperaemia and convincing of the tympanic membrane. CONCLUSIONS: Because the study was conducted on a select population, that attended by this outpatient service, the found incidence could be lower than if the study had been conducted on the general population.

[Study of vaccination of children at a health center]. / Estudio de cobertura vacunal en niños de un centro de salud.

OBJECTIVE: To find the vaccination coverage of children seen at a Health Centre. To complete the vaccination, assess the validity of the clinical notes as a record and to verify the tendency for the number of those properly vaccinated to decrease with age. DESIGN: Crossover and descriptive. SETTING: Chopera I Primary Care team. PARTICIPANTS: The 877 children between 4 months and 7 years old at a Paediatrics clinic and between 12 and 16 years at a general medical clinic. MEASUREMENTS AND RESULTS: The percentage of those properly vaccinated were, for the first five appointments of the official vaccination calendar, 85.29%, 89.24%, 83.98%, 81.90% and 81.95%, respectively; at 6 years, 65.51%; for German Measles, 44.30%; and in the last one, 40.80%. The percentage of the 2 to 5-year old cohort fully vaccinated was 91.10%; and of the 15 to 16-year old cohort, 37%. CONCLUSIONS: The importance of vaccination surveys as against other measures. Limitations of surveys at the Health Centre. First vaccination percentages close to W.H.O. objectives. Decrease with age of those properly vaccinated. Need for universal recording systems and that the Primary Care teams assume the prime responsibility in vaccination monitoring.

[Familial outbreak of Mycoplasma pneumoniae pneumonia]. / Brote familiar de neumonía por Mycoplasma pneumoniae.

Mycoplasma pneumoniae is a pathogen of the human species which causes primarily acute respiratory diseases including pneumonia. It is transmitted from person through the respiration, and results in small epidemics. Most infected persons only develop pharyngitis or tracheobronchitis, whereas pneumonia develops in 3-30% depending on the age and characteristics of the evaluated group. Mycoplasma pneumoniae is the causative organism of 20% of community acquired pneumonias in the general population; this proportion rises to 60% in closed groups and in individuals below age 20 years. Two cases of Mycoplasma pneumoniae pneumonia identified in a single family are reported, together with a case of tracheobronchitis most likely caused by the same organism. The clinical, diagnostic, therapeutic and preventive approaches to the mycoplasma infections are discussed, and also the therapeutic approach to be recommended, in primary care, to young patients with pneumonia.