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Objective: Characterize and describe reports of suspected adverse reactions to a group of drugs used in Colombia, Costa Rica, Cuba, Chile, El Salvador, Mexico, and Peru to treat or prevent coronavirus disease (COVID-19) between 1 March and 31 August 2020. Methods: A list of the 13 drugs used to treat or prevent COVID-19 was prepared, based on official and unofficial sources. Drawing on the databases of the national pharmacovigilance programs of the participating countries, reports of suspected adverse reactions to these drugs were collected for the period from 1 March and 31 August 2020. Results: A total of 3 490 reports of suspected adverse reactions were received from the pharmacovigilance programs of Peru (n = 3 037), Cuba (n = 270), Colombia (n = 108), Chile (n = 72), and El Salvador (n = 3). The drugs with the highest number of reported adverse reactions were azithromycin, ivermectin, and hydroxychloroquine. Diarrhea was the most frequent event (15.0%). Of the total suspected adverse reactions, 11.9% were reported as serious. The most frequent was QT prolongation following use of hydroxychloroquine. Of these suspected serious adverse reactions, 54.5% occurred in people over 65 years of age. Conclusions: While it is not possible to establish a causal relationship from the evaluation of spontaneous reports, the present study confirms the presence of adverse reactions-some of them serious-involving drugs used to treat or prevent COVID-19.
Objetivo: Caracterizar e descrever as notificações de suspeitas de reações adversas a um grupo de medicamentos utilizados na Colômbia, Costa Rica, Cuba, Chile, El Salvador, México e Peru, para tratar ou prevenir a doença do coronavírus (COVID-19), entre 1º de março e 31 de agosto de 2020. Métodos: Foi elaborada uma lista dos 13 medicamentos usados para tratar ou prevenir a COVID-19, segundo fontes oficiais e não oficiais. A partir das bases de dados dos programas nacionais de farmacovigilância dos países participantes, foram coletadas notificações de suspeitas de reações adversas a esses medicamentos, recebidas no período entre 1º de março e 31 de agosto de 2020. Resultados: Foram recebidas 3.490 notificações de suspeitas de reações adversas dos programas de farmacovigilância do Peru (n = 3.037), Cuba (n = 270), Colômbia (n = 108), Chile (n = 72) e El Salvador (n = 3). Os medicamentos com maior número de notificações de reações adversas foram azitromicina, ivermectina e hidroxicloroquina. A diarreia foi o evento mais frequente (15,0%). Do total de suspeitas de reações adversas, 11,9% foram notificadas como graves. A mais frequente foi o prolongamento do intervalo QT após o uso de hidroxicloroquina. Dessas suspeitas de reações adversas graves, 54,5% ocorreram em pessoas com mais de 65 anos. Conclusão: Embora não seja possível estabelecer uma relação causal com base na avaliação de relatos espontâneos, o presente estudo confirma a presença de reações adversas algumas graves a medicamentos que foram usados para tratar ou prevenir a COVID-19.
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[RESUMEN]. Objetivo. Caracterizar y describir las notificaciones de sospechas de reacciones adversas de un grupo de medicamentos que se utilizaron en Colombia, Costa Rica, Cuba, Chile, El Salvador, México y Perú para tratar o prevenir la enfermedad por el coronavirus (COVID-19, por su sigla en inglés) entre el 1 de marzo y el 31 de agosto del 2020. Métodos. Se elaboró una lista de los 13 medicamentos utilizados para tratar o prevenir la COVID-19, según fuentes oficiales y no oficiales. Desde las bases de datos de los programas nacionales de farma- covigilancia de los países participantes, se recopilaron las notificaciones de sospechas de reacciones adversas a estos medicamentos recibidas en el período comprendido entre el 1 de marzo y 31 de agosto de año 2020. Resultados. Se recibieron 3 490 notificaciones de sospechas de reacciones adversas desde los programas de farmacovigilancia de Perú (n = 3 037), Cuba (n = 270), Colombia (n = 108), Chile (n = 72) y El Salvador (n = 3). Los medicamentos con mayor número de notificaciones de reacciones adversas fueron la azitromi- cina, la ivermectina y la hidroxicloroquina. La diarrea fue el evento más frecuente (15,0%). Del total de las sospechas de reacciones adversas, 11,9% fueron notificadas como graves. La más frecuente fue la prolon- gación del intervalo QT posterior al uso de hidroxicloroquina. De estas sospechas de reacciones adversas graves, 54,5% ocurrieron en personas mayores de 65 años. Conclusión. Si bien no es posible establecer una relación causal a partir de la evaluación de informes espon- táneos, el presente estudio confirma la presencia de reacciones adversas, algunas graves, con medicamentos que se utilizaron para tratar o prevenir la COVID-19.
[ABSTRACT]. Objective. Characterize and describe reports of suspected adverse reactions to a group of drugs used in Colombia, Costa Rica, Cuba, Chile, El Salvador, Mexico, and Peru to treat or prevent coronavirus disease (COVID-19) between 1 March and 31 August 2020. Methods. A list of the 13 drugs used to treat or prevent COVID-19 was prepared, based on official and unofficial sources. Drawing on the databases of the national pharmacovigilance programs of the participating countries, reports of suspected adverse reactions to these drugs were collected for the period from 1 March and 31 August 2020. Results. A total of 3 490 reports of suspected adverse reactions were received from the pharmacovigilance programs of Peru (n = 3 037), Cuba (n = 270), Colombia (n = 108), Chile (n = 72), and El Salvador (n = 3). The drugs with the highest number of reported adverse reactions were azithromycin, ivermectin, and hydroxychlo- roquine. Diarrhea was the most frequent event (15.0%). Of the total suspected adverse reactions, 11.9% were reported as serious. The most frequent was QT prolongation following use of hydroxychloroquine. Of these suspected serious adverse reactions, 54.5% occurred in people over 65 years of age. Conclusion. While it is not possible to establish a causal relationship from the evaluation of spontaneous reports, the present study confirms the presence of adverse reactions—some of them serious—involving drugs used to treat or prevent COVID-19.
[RESUMO]. Objetivo. Caracterizar e descrever as notificações de suspeitas de reações adversas a um grupo de medica- mentos utilizados na Colômbia, Costa Rica, Cuba, Chile, El Salvador, México e Peru, para tratar ou prevenir a doença do coronavírus (COVID-19), entre 1o de março e 31 de agosto de 2020. Métodos. Foi elaborada uma lista dos 13 medicamentos usados para tratar ou prevenir a COVID-19, segundo fontes oficiais e não oficiais. A partir das bases de dados dos programas nacionais de farmacovigilância dos países participantes, foram coletadas notificações de suspeitas de reações adversas a esses medicamentos, recebidas no período entre 1o de março e 31 de agosto de 2020. Resultados. Foram recebidas 3.490 notificações de suspeitas de reações adversas dos programas de far- macovigilância do Peru (n = 3.037), Cuba (n = 270), Colômbia (n = 108), Chile (n = 72) e El Salvador (n = 3). Os medicamentos com maior número de notificações de reações adversas foram azitromicina, ivermectina e hidroxicloroquina. A diarreia foi o evento mais frequente (15,0%). Do total de suspeitas de reações adversas, 11,9% foram notificadas como graves. A mais frequente foi o prolongamento do intervalo QT após o uso de hidroxicloroquina. Dessas suspeitas de reações adversas graves, 54,5% ocorreram em pessoas com mais de 65 anos. Conclusão. Embora não seja possível estabelecer uma relação causal com base na avaliação de relatos espontâneos, o presente estudo confirma a presença de reações adversas – algumas graves – a medicamen- tos que foram usados para tratar ou prevenir a COVID-19.
Asunto(s)
Farmacovigilancia , Infecciones por Coronavirus , Evaluación de Medicamentos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Utilización de Medicamentos , Seguridad del Paciente , Antiinfecciosos , Farmacovigilancia , Infecciones por Coronavirus , Evaluación de Medicamentos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Utilización de Medicamentos , Seguridad del Paciente , Antiinfecciosos , Farmacovigilancia , Infecciones por Coronavirus , Evaluación de Medicamentos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Utilización de Medicamentos , Seguridad del Paciente , Antiinfecciosos , COVID-19RESUMEN
RESUMEN Objetivo. Caracterizar y describir las notificaciones de sospechas de reacciones adversas de un grupo de medicamentos que se utilizaron en Colombia, Costa Rica, Cuba, Chile, El Salvador, México y Perú para tratar o prevenir la enfermedad por el coronavirus (COVID-19, por su sigla en inglés) entre el 1 de marzo y el 31 de agosto del 2020. Métodos. Se elaboró una lista de los 13 medicamentos utilizados para tratar o prevenir la COVID-19, según fuentes oficiales y no oficiales. Desde las bases de datos de los programas nacionales de farmacovigilancia de los países participantes, se recopilaron las notificaciones de sospechas de reacciones adversas a estos medicamentos recibidas en el período comprendido entre el 1 de marzo y 31 de agosto de año 2020. Resultados. Se recibieron 3 490 notificaciones de sospechas de reacciones adversas desde los programas de farmacovigilancia de Perú (n = 3 037), Cuba (n = 270), Colombia (n = 108), Chile (n = 72) y El Salvador (n = 3). Los medicamentos con mayor número de notificaciones de reacciones adversas fueron la azitromicina, la ivermectina y la hidroxicloroquina. La diarrea fue el evento más frecuente (15,0%). Del total de las sospechas de reacciones adversas, 11,9% fueron notificadas como graves. La más frecuente fue la prolongación del intervalo QT posterior al uso de hidroxicloroquina. De estas sospechas de reacciones adversas graves, 54,5% ocurrieron en personas mayores de 65 años. Conclusión. Si bien no es posible establecer una relación causal a partir de la evaluación de informes espontáneos, el presente estudio confirma la presencia de reacciones adversas, algunas graves, con medicamentos que se utilizaron para tratar o prevenir la COVID-19.
ABSTRACT Objective. Characterize and describe reports of suspected adverse reactions to a group of drugs used in Colombia, Costa Rica, Cuba, Chile, El Salvador, Mexico, and Peru to treat or prevent coronavirus disease (COVID-19) between 1 March and 31 August 2020. Methods. A list of the 13 drugs used to treat or prevent COVID-19 was prepared, based on official and unofficial sources. Drawing on the databases of the national pharmacovigilance programs of the participating countries, reports of suspected adverse reactions to these drugs were collected for the period from 1 March and 31 August 2020. Results. A total of 3 490 reports of suspected adverse reactions were received from the pharmacovigilance programs of Peru (n = 3 037), Cuba (n = 270), Colombia (n = 108), Chile (n = 72), and El Salvador (n = 3). The drugs with the highest number of reported adverse reactions were azithromycin, ivermectin, and hydroxychloroquine. Diarrhea was the most frequent event (15.0%). Of the total suspected adverse reactions, 11.9% were reported as serious. The most frequent was QT prolongation following use of hydroxychloroquine. Of these suspected serious adverse reactions, 54.5% occurred in people over 65 years of age. Conclusions. While it is not possible to establish a causal relationship from the evaluation of spontaneous reports, the present study confirms the presence of adverse reactions—some of them serious—involving drugs used to treat or prevent COVID-19.
RESUMO Objetivo. Caracterizar e descrever as notificações de suspeitas de reações adversas a um grupo de medicamentos utilizados na Colômbia, Costa Rica, Cuba, Chile, El Salvador, México e Peru, para tratar ou prevenir a doença do coronavírus (COVID-19), entre 1º de março e 31 de agosto de 2020. Métodos. Foi elaborada uma lista dos 13 medicamentos usados para tratar ou prevenir a COVID-19, segundo fontes oficiais e não oficiais. A partir das bases de dados dos programas nacionais de farmacovigilância dos países participantes, foram coletadas notificações de suspeitas de reações adversas a esses medicamentos, recebidas no período entre 1º de março e 31 de agosto de 2020. Resultados. Foram recebidas 3.490 notificações de suspeitas de reações adversas dos programas de farmacovigilância do Peru (n = 3.037), Cuba (n = 270), Colômbia (n = 108), Chile (n = 72) e El Salvador (n = 3). Os medicamentos com maior número de notificações de reações adversas foram azitromicina, ivermectina e hidroxicloroquina. A diarreia foi o evento mais frequente (15,0%). Do total de suspeitas de reações adversas, 11,9% foram notificadas como graves. A mais frequente foi o prolongamento do intervalo QT após o uso de hidroxicloroquina. Dessas suspeitas de reações adversas graves, 54,5% ocorreram em pessoas com mais de 65 anos. Conclusão. Embora não seja possível estabelecer uma relação causal com base na avaliação de relatos espontâneos, o presente estudo confirma a presença de reações adversas - algumas graves - a medicamentos que foram usados para tratar ou prevenir a COVID-19.
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Nicaragua presenta altos niveles de inseguridad alimentaria y nutricional. Predomina la deficiencia proteico-energética y la carencia de nutrientes específicos y al mismo tiempo presenta la superposición epidemiológica-nutricional y la doble carga de riesgos para la salud. Faltan conocimientos para optimizar los escasos recursos para adquirir productos de mayor valor nutricional. El objetivo fue contribuir a reducir el hambre y la desnutrición y mejorar la alimentación y el estado nutricional de la población del municipio nicaragüense de Somotillo, a través de estrategias educativas difundidas por el medio radiofónico. Se ejecutó el programa "Por una mejor nutrición" en la radio (1 junio al 29 de julio, 2016) y se abordaron cuatro temas: conocimientos sobre alimentación saludable, higiene alimentaria, enfermedades asociadas a la malnutrición y alimentación del escolar y se acompañaron de tres cápsulas informativas cada uno, transmitidas 1v/s y 5v/s (8v/día), respectivamente, más una sesión 1v/s de respuesta a los oyentes (maestros y niños escolares). Además, se hizo una evaluación cualitativa (grupo de discusión con maestros y promotores de salud) y se aplicó un cuestionario de 5 preguntas pre y post intervención a 600 escolares seleccionados al azar en 20 escuelas rurales. Se encontró dominio parcial del tema de higiene pre-intervención y fallas en las acciones para prevenir las enfermedades que afectan el estado nutricional de los escolares (post intervención). El programa benefició a 2.349 estudiantes y familias. Esta experiencia puede mejorar el empoderamiento de las familias y la comunidad frente a los problemas de alimentación y prácticas higiénicas peligrosas existentes, pero requieren por parte de las comunidades garantizar la sostenibilidad y replicabilidad del mismo(AU)
Nicaragua has high levels of food and nutritional insecurity. Protein-energy deficiency and lack of specific nutrients predominate, while epidemiological-nutritional deficiencies and excess overlap and the double burden of health risks. There is a lack of knowledge in order to optimize scarce resources and to acquire products of greater nutritional value. The aim was to contribute to the reduction of hunger and malnutrition and to improve the diet and nutritional status of the population of the Nicaraguan municipality of Somotillo, through educational strategies broadcasted by radio. The program "For better nutrition" was carried out on the radio (1 June to 29 July 2016) and addressed four topics: knowledge of healthy eating, food hygiene, diseases associated with malnutrition and school feeding, and was accompanied by three information capsules, each transmitted 1/s and 5/s (8v/day), respectively, plus a 1/s response session for listeners (teachers and school children). In addition, a qualitative evaluation (discussion group with teachers and health promoters) and a questionnaire of 5 pre and post intervention questions were applied to 600 randomly selected schoolchildren in 20 rural schools. Partial mastery was found of the issue of pre-intervention hygiene and failures in actions to prevent diseases that affect the nutritional status of schoolchildren (post-intervention). The program benefited 2,349 students and families. This experience can improve the empowerment of families and the community in the face of existing food problems and dangerous hygiene practices(AU)
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Humanos , Masculino , Femenino , Preescolar , Niño , Adulto , Persona de Mediana Edad , Programas de Nutrición , Higiene Alimentaria , Estado Nutricional , Desnutrición Proteico-Calórica , Estrategias de eSalud , Medios de Comunicación de Masas , Radio , Educación Alimentaria y Nutricional , Hambre , DesnutriciónRESUMEN
OBJECTIVE: To describe the adaptation and scaling-up of an intervention to improve the visual health of children in the Apurimac region, Peru. METHODS: In a pilot screening programme in 2009-2010, 26 schoolteachers were trained to detect and refer visual acuity problems in schoolchildren in one district in Apurimac. To scale-up the intervention, lessons learnt from the pilot were used to design strategies for: (i) strengthening multisector partnerships; (ii) promoting the engagement and participation of teachers and (iii) increasing children's attendance at referral eye clinics. Implementation began in February 2015 in two out of eight provinces of Apurimac, including hard-to-reach communities. We made an observational study of the processes and outcomes of adapting and scaling-up the intervention. Qualitative and quantitative analyses were made of data collected from March 2015 to January 2016 from programme documents, routine reports and structured evaluation questionnaires completed by teachers. FINDINGS: Partnerships were expanded after sharing the results of the pilot phase. Training was completed by 355 teachers and directors in both provinces, belonging to 315 schools distributed in 24 districts. Teachers' appraisal of the training achieved high positive scores. Outreach eye clinics and subsidies for glasses were provided for poorer families. Data from six districts showed that attendance at the eye clinic increased from 66% (45/68 children referred) in the pilot phase to 92% (237/259) in the implementation phase. CONCLUSION: Adaptation to the local context allowed the scaling-up of an intervention to improve visual health in children and enhanced the equity of the programme.
Asunto(s)
Docentes , Promoción de la Salud/métodos , Selección Visual/métodos , Adolescente , Niño , Preescolar , Relaciones Comunidad-Institución , Anteojos/economía , Humanos , Perú/epidemiología , Proyectos Piloto , Derivación y Consulta , Errores de Refracción/epidemiología , Errores de Refracción/terapia , Población Rural , Instituciones AcadémicasRESUMEN
La alimentación y la nutrición adecuadas son el primer y el más importante de los derechos humanos fundamentales y de los determinantes de la salud de las personas. Con el propósito de ayudar a reducir el impacto del hambre y facilitar el control y la eliminación de las enfermedades tropicales desatendidas (ETDs), contribuyendo al alcance de la seguridad alimentaria en la población escolar del Departamento de Chinandega (Nicaragua), se desarrolló el proyecto piloto Hambre, miseria y enfermedad: el papel de la nutrición en las enfermedades tropicales desatendidas (ETDs) en Nicaragua. El presente artículo documenta esta experiencia. Para conseguir los objetivos planteados se organizó una jornada científica con expertos en nutrición y en las ETDs, un panel elaboró las conclusiones que sirvieron para la redacción del documento de consenso, en el cual se fundamentó la elaboración de los materiales a ser utilizados en la intervención educativa: Alimentación para crecer sano, manual dirigido a los promotores de salud y Manual de estrategias educativas: alimentación para crecer sano dirigido a los escolares. Se realizaron cuatro jornadas de capacitación que inicialmente involucró a 80 maestros de 20 escuelas, y que en la última jornada logró sumar 145 docentes. Seguidamente se desarrolló la fase de multiplicación en las escuelas, con la participación de 2.327 niños de entre 7 y 14 años de edad. En esta experiencia la receptividad de los docentes, la mejora en sus habilidades y conocimientos son una garantía para la replicación en los niños y niñas(AU)
Food and proper nutrition are the first and most important of fundamental human rights and the determinants of health of people. In order to help reduce the impact of hunger and facilitate the control and elimination of neglected tropical diseases (NTDs), contributing to the extent of food safety in the school population of the Department of Chinandega (Nicaragua), the pilot project Hunger, misery and disease: the role of nutrition in neglected tropical diseases (NTDs) in Nicaragua was developed. This article documents this experience. To achieve the goals a scientific conference with experts in nutrition and NTDs was organized, a panel drew conclusions that were used for drafting the consensus document in which the development of the materials was based to be used in the intervention education: A Food to grow healthy manual aimed at health promoters and a Manual of educational strategies: healthy food for growth aimed at schoolchildren. Four days of training initially involved 80 teachers from 20 schools were made, and on the last day managed to reach 145 teachers. Then the multiplication phase in schools was developed with the participation of 2,327 children between 7 and 14 years old. In this experience the receptivity of teachers, improving their skills and knowledge are a guarantee for replication in children(AU)
Asunto(s)
Humanos , Masculino , Femenino , Programas de Nutrición , Educación , Ciencias de la Nutrición , Enfermedades Desatendidas , Epidemiología , Hambre , Desnutrición , Crecimiento y DesarrolloRESUMEN
BACKGROUND: Refractive error is defined as the inability of the eye to bring parallel rays of light into focus on the retina, resulting in nearsightedness (myopia), farsightedness (Hyperopia) or astigmatism. Uncorrected refractive error in children is associated with increased morbidity and reduced educational opportunities. Vision screening (VS) is a method for identifying children with visual impairment or eye conditions likely to lead to visual impairment. OBJECTIVE: To analyze the utility of vision screening conducted by teachers and to contribute to a better estimation of the prevalence of childhood refractive errors in Apurimac, Peru. Design : A pilot vision screening program in preschool (Group I) and elementary school children (Group II) was conducted with the participation of 26 trained teachers. Children whose visual acuity was<6/9 [20/30] (Group I) and ≤ 6/9 (Group II) in one or both eyes, measured with the Snellen Tumbling E chart at 6 m, were referred for a comprehensive eye exam. Specificity and positive predictive value to detect refractive error were calculated against clinical examination. Program assessment with participants was conducted to evaluate outcomes and procedures. RESULTS: A total sample of 364 children aged 3-11 were screened; 45 children were examined at Centro Oftalmológico Monseñor Enrique Pelach (COMEP) Eye Hospital. Prevalence of refractive error was 6.2% (Group I) and 6.9% (Group II); specificity of teacher vision screening was 95.8% and 93.0%, while positive predictive value was 59.1% and 47.8% for each group, respectively. Aspects highlighted to improve the program included extending training, increasing parental involvement, and helping referred children to attend the hospital. CONCLUSION: Prevalence of refractive error in children is significant in the region. Vision screening performed by trained teachers is a valid intervention for early detection of refractive error, including screening of preschool children. Program sustainability and improvements in education and quality of life resulting from childhood vision screening require further research.
Asunto(s)
Errores de Refracción/prevención & control , Servicios de Salud Escolar , Selección Visual/métodos , Niño , Preescolar , Femenino , Humanos , Masculino , Perú/epidemiología , Proyectos Piloto , Refracción Ocular , Errores de Refracción/diagnóstico , Errores de Refracción/epidemiología , Agudeza VisualRESUMEN
BACKGROUND: Intimate partner violence (IPV) against women occurs in all countries, all cultures and at every level of society; however, some populations may be at greater risk than others. The aim of this study was to explore IPV prevalence among Ecuadorian, Moroccan and Romanian immigrant women living in Spain and its possible association with their personal, family, social support and immigration status characteristics. METHODS: Cross-sectional study of 1607 adult immigrant women residing in Barcelona, Madrid and Valencia (2011). Prevalence rates and adjusted odds ratios (AORs) were calculated, with current IPV being the outcome. Different women's personal (demographic), family, social support and immigration status characteristics were considered as explicative and control variables. All analyses were separated by women's country of origin. RESULTS: Current IPV prevalence was 15.57% in Ecuadorians, 10.91% in Moroccans and 8.58% in Romanians. Some common IPV factors were found, such as being separated and/or divorced. In Romanians, IPV was also associated with lack of social support [AOR 5.96 (1.39-25.62)] and low religious involvement [AOR 2.17 (1.06-4.43)]. The likelihood of current IPV was lower among women without children or other dependents in this subgroup [AOR 0.29 (0.093-0.92)]. CONCLUSION: The IPV prevalence rates obtained for Moroccan, Romanian and Ecuadorian women residing in Spain were similar. Whereas the likelihood of IPV appeared to be relatively evenly distributed among Moroccan and Ecuadorian women, it was higher among Romanian women in socially vulnerable situations related to family responsibilities and the lack of support networks. The importance of intervention in the process of separation and divorce was common to all women.
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Emigrantes e Inmigrantes/estadística & datos numéricos , Maltrato Conyugal/etnología , Adolescente , Adulto , Anciano , Estudios Transversales , Ecuador/etnología , Emigrantes e Inmigrantes/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Marruecos/etnología , Oportunidad Relativa , Prevalencia , Psicología , Rumanía/etnología , España/epidemiología , Maltrato Conyugal/estadística & datos numéricos , Adulto JovenRESUMEN
BACKGROUND: Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997-2011). METHODS: A systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen's conceptual framework of access and use of health services and by incorporating other emergent categories. RESULTS: We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. CONCLUSIONS: Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.
Asunto(s)
Accesibilidad a los Servicios de Salud/normas , Disparidades en Atención de Salud , Atención Primaria de Salud/economía , Migrantes/psicología , Cultura , Servicios de Salud/estadística & datos numéricos , Necesidades y Demandas de Servicios de Salud , Humanos , Atención Primaria de Salud/estadística & datos numéricos , Investigación CualitativaRESUMEN
BACKGROUND: Discrimination is an important determinant of health inequalities, and immigrants may be more vulnerable to certain types of discrimination than the native-born. This study analyses the relationship between immigrants' perceived discrimination and various self-reported health indicators. METHODS: A cross-sectional survey was conducted (2008) amongst a non-random sample of 2434 immigrants from Ecuador, Morocco, Romania and Colombia in four Spanish cities: Barcelona, Huelva, Madrid and Valencia. A factorial analysis of variables revealed three dimensions of perceived discrimination (due to immigrant status, due to physical appearance, and workplace-related). The association of these dimensions with self-rated health, mental health (GHQ-12), change in self-rated health between origin and host country, and other self-reported health outcomes was analysed. Logistic regression was used adjusting for potential confounders (aOR-95%CI). Subjects with worsening self-reported health status potentially attributable to perceived discrimination was estimated (population attributable proportion, PAP %). RESULTS: 73.3% of men and 69.3% of women immigrants reported discrimination due to immigrant status. Moroccans showed the highest prevalence of perceived discrimination. Immigrants reporting discrimination were at significantly higher risk of reporting health problems than those not reporting discrimination. Workplace-related discrimination was associated with poor mental health (aOR 2.97 95%CI 2.45-3.60), and the worsening of self-rated health (aOR 2.20 95%CI 1.73- 2.80). 40% (95% CI 24-53) PAP of those reporting worse self-rated health could be attributable to discrimination due to immigrant status. CONCLUSIONS: Discrimination may constitute a risk factor for health in immigrant workers in Spain and could explain some health inequalities among immigrant populations in Spanish society.
Asunto(s)
Emigrantes e Inmigrantes/psicología , Disparidades en el Estado de Salud , Prejuicio , Percepción Social , Adulto , Colombia/etnología , Estudios Transversales , Autoevaluación Diagnóstica , Ecuador/etnología , Emigrantes e Inmigrantes/estadística & datos numéricos , Empleo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Marruecos/etnología , Rumanía/etnología , España , Adulto JovenRESUMEN
Objetivo El objetivo de este trabajo es describir las principales características de los artículos publicados en revistas científicas entre los años 1992 y 2007 que aborden el análisis de los factores etiológicos asociados a esta patología. Material y Método Revisión sistemática de artículos científicos sobre esta asociación, utilizando las bases de datos de ciencias de la salud y sociales: Medline, Cinhal, Web of Science, Lilacs, Sociological Abstracts, Cuiden, Embase, PsycoInfo e ISI Web of Knowledge. Resultados Se ha obtenido en el período de estudio 21 artículos, distribuidos así: 7 (33,3 por ciento) revisiones teóricas, 6 (28,5 por ciento) estudios transversales, 4 (19,0 por ciento) estudios de cohortes, 2 (9,5 por ciento) estudios de casos y controles y 1 (4,7 por ciento) revisión sistemática. De éstos, 7 (33,3 por ciento) consideraban como factor de riesgo el estrés, 3 (14,3 por ciento) la hepatitis C, 4 (19,0 por ciento) antecedente traumático, 3 (14,3 por ciento) la ocupación y en 4 (19,0 por ciento) se asoció la aparición a otros factores como los implantes de silicona, el tabaco, los factores sociodemográficos y factores hormonales. El período temporal más productivo fue 2000-2004. Se observa una gran dispersión temática en las revistas de publicación. Discusión La evidencia empírica existente en torno a los factores de riesgo de la fibromialgia es todavía escasa y dispersa. Estudios futuros deberían centrarse en generar más conocimiento sobre los factores de riesgo estudiados, para así poder contribuir a mejorar la atención, diagnóstico y tratamiento de la fibromialgia.
Objective This study was aimed at describing the main features of articles published in scientific journals between 1992 and 2007 addressing the analysis of the etiological factors associated with this condition. Materials and MethodsThis consisted of a systematic review of scientific articles regarding this association using the following health and social science databases: Medline, Cinhal, Web of Science, Lilacs, Sociological Abstracts, Embase, Psycoinfo and ISI web of Knowledge. Results 21 articles were obtained during the study period, distributed as follows: 7 theoretical reviews (33.3 percent), 6 cross-sectional studies (28.5 percent), 4 cohort studies, (19.0 percent) 2 case-control studies (9.5 percent) and 1 systematic review (4.7 percent). Of these, 7 (33.3 percent) considered the following to risk factors to be associated with the emergence of other factors such as silicone implants, socio-demographic and hormonal factors: 3 on stress (14.3 percent), 4 on hepatitis C (19.0 percent), 3 on traumatic antecedents (14.3 percent) and 4 on occupation (19.0 percent). The most productive time was 2000-2004. There was broad thematic dispersion in the published journals. Discussion Available empirical evidence about risk factors related to fibromyalgia is still scarce and scattered. Future studies should focus on generating more knowledge about the risk factors studied so as to help improve fibromyalgia care, diagnosis and treatment.
Asunto(s)
Humanos , Fibromialgia/fisiopatología , Factores de RiesgoRESUMEN
Objetivo Describir y analizar el debate parlamentario español sobre inmigración y salud. Métodos Búsqueda sistemática de las iniciativas parlamentarias (IP) sobre inmigración e inmigración y salud desde el inicio del periodo democrático español en 1979 hasta 2007. Se aplicó un protocolo de recogida de información para identificar las características del debate parlamentario y los principales temas en las IP relacionadas con inmigración y salud. Se calcularon la proporción de IP de inmigración sobre el total de iniciativas y la proporción de población inmigrante sobre la población española por cada año de estudio. Resultados Se identificaron 4 022 IP sobre inmigración en el periodo estudiado. Se destaca la generación de datos estadísticos sobre aspectos que afectan a la población inmigrante (57,2 por ciento). En 116 IP sobre inmigración y salud, destaca la discusión sobre estrategias de atención sanitaria (25 por ciento) y el acceso a servicios de salud (24,1 por ciento). El 94 por ciento de estas IP fueron preguntas correspondientes a la función de control del gobierno. En 113 IP (97,4 por ciento) sobre inmigración y salud no se tomaron decisiones. Junto a la presencia cada vez mayor de población inmigrante por año, no se observan cambios notorios en las IP sobre inmigración hasta el año 1996 y en inmigración y salud hasta 1999. Conclusión El debate sobre inmigración y salud es heterogéneo. Seria conveniente fomentar la discusión sobre estrategias para el fomento de la salud basadas en las necesidades de la población inmigrante.
Objective Describing and analysing the Spanish Parliamentary debate on immigration and health. Methods A systematic search regarding parliamentary initiatives (PI) on immigration and immigration and health was conducted from the beginning of the Spanish democratic period (1979 to 2007). A protocol for collecting information was used to identify the parliamentary debates main characteristics and the main topics related to PI concerning immigration and health. The PI immigration rate was calculated regarding the total rate of PI about the immigrant population based on the Spanish population per year. Results 4,022 PI concerning immigration were identified. The main content concerned statistical information about the immigrant population (57.2 percent). 116 PI about immigration and health were analysed. The most frequently recurring topics were health-care strategies (25 percent), health-service access (24.1 percent) and epidemiological information (19.8 percent). Most PI concerned questions related to the function of government control (94 percent). No decisions were taken in 113 PI (97.4 percent). Immigrant population rates increased per year; however, notable changes in PI regarding immigration were not observed until 1996 and PI about immigration and health until 1999. Conclusion The immigration and health debate on the parliamentary agenda is heterogeneous. It would seem necessary to increase parliamentary debate about strategies and action for promoting immigrant-based needs in health.
Asunto(s)
Humanos , Emigración e Inmigración , Administración de los Servicios de Salud , Política , Administración de los Servicios de Salud/legislación & jurisprudencia , EspañaRESUMEN
OBJETIVOS: Sistematizar la información publicada sobre la situación y los avances en el logro de los Objetivos de Desarrollo del Milenio relacionados con la salud (ODMS), así como analizar su asociación con algunos factores económicos y los pronósticos de cumplimiento. MÉTODOS: Se realizó una búsqueda de los artículos científicos sobre los Objetivos de Desarrollo del Milenio en general publicados entre el 1 de enero de 2000 y el 31 de agosto de 2006 en las bases bibliográficas electrónicas EBSCO, CSA Illumina, Thomson Gale, SwetsWise y BIREME. Se seleccionaron los artículos originales en inglés o español que evaluaran la situación de los ODMS o sus avances y se refirieran a factores determinantes. Se analizó la distribución de los factores determinantes de la situación de los ODMS o sus avances, los ODMS referidos, el tipo de evaluación, la relación entre los indicadores económicos y la salud, el lugar estudiado, y la situación y los pronósticos del cumplimiento de los ODMS. Se valoró la calidad de los artículos. RESULTADOS: Se identificaron 304 artículos originales, de ellos 114 (37,5 por ciento) se ocupaban de uno o varios ODMS. Los objetivos relacionados con la mortalidad infantil y materna fueron los más frecuentemente abordados. De los 39 artículos que evaluaban los ODMS y su relación con los factores económicos, en 13 se consideraban factores económicos relacionados con la equidad, la política o la globalización. Los factores económicos y políticos fueron los más frecuentemente asociados con la situación de los ODMS o sus avances. CONCLUSIONES: Existe una tendencia a utilizar variables económicas vinculadas con las condiciones de la población para analizar la situación de los ODMS y sus avances. Falta información sobre la relación con el gasto gubernamental, el comercio exterior, la ayuda externa y las políticas económicas mundiales. Los pronósticos para lograr los ODMS en los países pobres son desfavorables.
OBJECTIVES: To systematize all the information published on the status of and progress made toward the Health-related Millennium Development Goals (HMDGs), as well as to understand associations with certain economic factors and the potential for success. METHODS: A search was conducted for all scientific articles covering the Millennium Development Goals in general, published from 1 January 2000 to 31 August 2006, in the electronic databases of the EBSCO, CSA Illumina, Thomson Gale, SwetsWise, and BIREME. All original articles in English or Spanish that evaluated HMDG status, progress, and determinants were selected. The analysis evaluated the distribution of determinants of HMDG status or progress, the HMDGs referred to, the study type, the relationship between economic indicators and health, the study location, and the status and potential for attaining the HMDGs. The quality of the articles was also rated. RESULTS: Of the 304 original articles found, 114 (37.5 percent) covered one or more HMDGs. The most frequently addressed goals were those concerning infant and maternal mortality. Of the 39 articles that evaluated HMDGs and their association with economic variables, 13 dealt with economic factors related to equity, policy, or globalization. Economic and policy factors were most frequently associated with HMDG status or progress. CONCLUSIONS: There is a definitive trend toward measuring HMDG status and progress according to economic factors that reflect the population's condition. There is an information gap regarding government spending, international commerce, international aid, and global economic policy. The potential for achieving HMDGs in poor countries is low.
Asunto(s)
Humanos , Desarrollo Económico , Objetivos , Indicadores de Salud , Factores SocioeconómicosRESUMEN
BACKGROUND: Association between immigration and low birth weight (LBW) and preterm birth (PB) is an important indicator of health inequalities. The objective of this study is to analyse the differences between LBW and PB according to the mothers nationality in newborns in Spain. METHODS: Data were provided from the National Statistical Bulletin of Birth of 1,878,718 newborns in the period 2001-2005. The nationality was considered the exposure variable (Spanish- Immigrant). The outcomes were LBW (< 2,500 gr and >or=37 gestational weeks) and PB (< 37 gestational weeks). Odds ratios were calculated and adjusted by possible confounders by logistic regression. RESULTS: PB and LBW prevalence were higher in Spanish women (7.9% and 3.2% respectively). In comparison with Spanish ones, the lowest risk of PB was observed in North Africa (ORa= 0.77 CI95% 0.74-0.80). With respect to LBW, the lowest risk was found in mothers from South America (ORa=0.62 CI95% 0.59-0.65) and Eastern Europe (ORa=0.65 CI95% 0.60-0.71). CONCLUSION: Results of LBW and PB were more favourable in the births of immigrant women. It could be associated with the healthy migrant effect and a low frequency of risk practices during gestation.
Asunto(s)
Emigración e Inmigración , Recién Nacido de Bajo Peso , Madres , Nacimiento Prematuro/epidemiología , Adulto , Peso al Nacer , Femenino , Edad Gestacional , Humanos , Recién Nacido , Prevalencia , España , Adulto JovenRESUMEN
One of the most important social phenomena in the global context is the flow of immigration from developing countries, motivated by economic and employment related issues. Discrimination can be approached as a health risk factor within the immigrant population's working environment, especially for those immigrants at greater risk from social exclusion and marginalisation. The aim of this study is to research perceptions of discrimination and the specific relationship between discrimination in the workplace and health among Spain's immigrant population. A qualitative study was performed by means of 84 interviews and 12 focus groups held with immigrant workers in five cities in Spain receiving a large influx of immigrants (Madrid, Barcelona, Valencia, Alicante and Huelva), covering representative immigrant communities in Spain (Romanians, Moroccans, Ecuadorians, Colombians and Sub-Saharan Africans). Discourse narrative content analysis was performed using pre-established categories and gradually incorporating other emerging categories from the immigrant interviewees themselves. The participants reported instances of discrimination in their community and working life, characterised by experiences of racism, mistreatment and precarious working conditions in comparison to the Spanish-born population. They also talked about limitations in terms of accessible occupations (mainly construction, the hotel and restaurant trade, domestic service and agriculture), and described major difficulties accessing other types of work (for example public administration). They also identified political and legal structural barriers related with social institutions. Experiences of discrimination can affect their mental health and are decisive factors regarding access to healthcare services. Our results suggest the need to adopt integration policies in both the countries of origin and the host country, to acknowledge labour and social rights, and to conduct further research into individual and social factors that affect the health of the immigrant populations.
Asunto(s)
Emigrantes e Inmigrantes , Empleo , Disparidades en el Estado de Salud , Prejuicio , Adolescente , Adulto , Países en Desarrollo , Femenino , Grupos Focales , Disparidades en Atención de Salud , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Factores de Riesgo , Medio Social , España , Adulto JovenRESUMEN
OBJECTIVE: Describing and analysing the Spanish Parliamentary debate on immigration and health. METHODS: A systematic search regarding parliamentary initiatives (PI) on immigration and immigration and health was conducted from the beginning of the Spanish democratic period (1979 to 2007). A protocol for collecting information was used to identify the parliamentary debate's main characteristics and the main topics related to PI concerning immigration and health. The PI immigration rate was calculated regarding the total rate of PI about the immigrant population based on the Spanish population per year. RESULTS: 4,022 PI concerning "immigration" were identified. The main content concerned statistical information about the immigrant population (57.2 %). 116 PI about "immigration and health" were analysed. The most frequently recurring topics were health-care strategies (25 %), health-service access (24.1 %) and epidemiological information (19.8 %). Most PI concerned questions related to the function of government control (94 %). No decisions were taken in 113 PI (97.4 %). Immigrant population rates increased per year; however, notable changes in PI regarding immigration were not observed until 1996 and PI about immigration and health until 1999. CONCLUSION: The immigration and health debate on the parliamentary agenda is heterogeneous. It would seem necessary to increase parliamentary debate about strategies and action for promoting immigrant-based needs in health.
Asunto(s)
Emigración e Inmigración , Administración de los Servicios de Salud , Política , Administración de los Servicios de Salud/legislación & jurisprudencia , Humanos , EspañaRESUMEN
OBJECTIVE: This study was aimed at describing the main features of articles published in scientific journals between 1992 and 2007 addressing the analysis of the etiological factors associated with this condition. MATERIALS AND METHODS: This consisted of a systematic review of scientific articles regarding this association using the following health and social science databases: Medline, Cinhal, Web of Science, Lilacs, Sociological Abstracts, Embase, Psycoinfo and ISI web of Knowledge. RESULTS: 21 articles were obtained during the study period, distributed as follows: 7 theoretical reviews (33.3 %), 6 cross-sectional studies (28.5 %), 4 cohort studies, (19.0 %) 2 case-control studies (9.5 %) and 1 systematic review (4.7 %). Of these, 7 (33.3 %) considered the following to risk factors to be associated with the emergence of other factors such as silicone implants, socio-demographic and hormonal factors: 3 on stress (14.3 %), 4 on hepatitis C (19.0 %), 3 on traumatic antecedents (14.3 %) and 4 on occupation (19.0 %). The most productive time was 2000-2004. There was broad thematic dispersion in the published journals. DISCUSSION: Available empirical evidence about risk factors related to fibromyalgia is still scarce and scattered. Future studies should focus on generating more knowledge about the risk factors studied so as to help improve fibromyalgia care, diagnosis and treatment.
Asunto(s)
Fibromialgia/fisiopatología , Humanos , Factores de RiesgoAsunto(s)
Estrategias de Salud Globales , Indicadores Económicos , Factores Socioeconómicos , Política , Desarrollo Económico , Estrategias de Salud Globales , Indicadores Económicos , Factores Socioeconómicos , Política , Desarrollo Económico , Desarrollo Económico , Indicadores de Salud , Factores SocioeconómicosRESUMEN
OBJECTIVE: Eradication of poverty is Target 1 of the first of eight Millennium Development Goals, which were adopted by world leaders at the United Nations General Assembly in the year 2000. This study aims to explore the influence of political and social context in the achievement of poverty eradication. METHODS: A retrospective ecological study was carried out to explore associations between progress towards the achievement of Target 1 in 2002 and political and social context variables. The study contained cross-sectional estimates in 1990, 1995, 2000 and 2002. The analysis and observation unit was the countries (n = 88). A descriptive analysis was made, as well as simple and multiple analyses with logistic regression. FINDINGS: Of the 88 countries studied, 71 (80.7%) are not on track to achieving the target of eradicating poverty. The factor most associated with non-attainment of this goal was reduced government consumption per capita (odds ratio, OR: 13.8; 95% confidence interval, CI: 2.92-65.26). In the multiple regression analysis, the most significant factors are: reduced government consumption per capita (OR: 9.8; 95% CI: 1.82-52.75), losses in the balance between imports and exports (OR: 5.3; 95% CI: 1.32-21.54) and more inequality in family income (OR: 4.7; 95% CI: 1.12-20.01). CONCLUSION: Progress towards achievement of Target 1 seems to be hindered, fundamentally, by the significant reduction in government consumption in certain countries and the absence of redistribution policies. To understand the political determinants of poverty, more attention must be paid to the national and international political milieu, which seem to have a relevant impact on this problem and hence on population health.
Asunto(s)
Política de Salud , Disparidades en el Estado de Salud , Pobreza/prevención & control , Conferencias de Consenso como Asunto , Comparación Transcultural , Humanos , Política , Estudios Retrospectivos , Medio Social , Naciones UnidasRESUMEN
OBJECTIVE: Exploring the self-perceptions of a group of migrants from Colombia living in Alicante , Spain , regarding their working conditions and health. MATERIAL AND METHODS: This was a qualitative and descriptive research was conducted on a group of Colombian workers (with and without legal permission to work) having lived in Alicante ( Spain ) for more than 6 months. 11 interviews were carried out, plus 2 focal groups, from November 2006 to January 2007. The interviews were recorded and transcribed. A narrative analysis of the contents was carried out, a mixture of categories being obtained from different viewpoints. RESULTS: Immigration was understood as being an action for improving an immigrant worker and family's socioeconomic conditions. Work and social recognition should lead to avoiding exclusion and discrimination. The people interviewed had associated their health problems with their living conditions. Such problems were considered to be a limitation on carrying out their daily activities. CONCLUSIONS: Working and health situations were perceived from a multi-dimensional perspective associated with biological and socio-cultural conditions. More political action should be taken for improving immigrant people's economic, work and health conditions.