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OBJECTIVES: To analyze the temporal trends of premature mortality from diabetes in Costa Rica in the period 2000-2020, at a national level and by province, and the effect of the COVID-19 pandemic on diabetes mortality during the year 2020. METHODS: We studied the temporal trends of mortality from diabetes in Costa Rica in the period between 2000 and 2020. Age-standardized mortality rates and corresponding 95% confidence intervals were calculated for each year, sex and province. RESULTS: We analyzed the data of 17,968 deceased persons. The mean age was 72.5 years (range 1 to 109 years), and 51.5% of the population (n = 9253) was younger than 75 years. In both men and women, we observed a significant decrease in mortality from 2000 to 2014, followed by the opposite trend from 2014 to 2020, with average yearly increases of 13.9% in men and 11.6% in women. CONCLUSIONS: Premature mortality from diabetes has been growing from 2014. The COVID-19 pandemic changed the mortality pattern, increasing premature diabetes deaths in Costa Rica in 2020.

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AIM: To assess the association between periodontitis and preterm birth in women of childbearing age. MATERIALS AND METHODS: This review included analytical case-control studies and prospective cohort studies evaluating the association between maternal periodontitis and preterm birth. Of the 3104 screened articles, 31 met the inclusion criteria for the review, and 20 met the quality criteria. The selected studies included a total of 10 215 women. RESULTS: Twenty articles contributed to the meta-analysis; 16 used a case-control design, and 4 were prospective cohort studies. The study heterogeneity was low (Q = 24.2464; P = 0.1869; I2  = 21.63%). A positive association between maternal periodontitis and preterm birth was found in 60% of the studies. Under the random-effects model, meta-analysis gave an odds ratio (OR) of 2.01 (95% CI 1.71, 2.36), representing a significant positive association between the explanatory and outcome variables. CONCLUSION: Pregnant mothers with periodontitis double the risk of preterm birth. There is a lack of international consensus for diagnosing maternal periodontitis.

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Resumen El diálogo de saberes es un método cualitativo que busca comprender, sintetizar, teorizar y contextualizar el conocimiento; permite entender los problemas y necesidades que tiene la población, mediante la reflexión y discusión de los actores, basándose en las palabras de la misma población. Este artículo reflexiona sobre el diálogo de saberes para explicar cómo este permite identificar de manera más cercana la situación, problemas y necesidades de salud que tiene la población. También presenta una revisión de experiencias similares, evidenciando la utilidad que tiene el uso de este método. Asimismo, se sugiere que el diálogo de saberes sea un punto de partida para el estudio e intervención de las principales problemáticas de la población, y a su vez integrar el conocimiento médico con los saberes tradicionales que se enmarcan dentro de la Atención Primaria en Salud (APS).

Abstract Knowledge dialogues is a method of qualitative methodologies that seeks to understand, synthesize, theorize and contextualize knowledge. Knowledge dialogues is a suitable method to understand and identify health problems and needs of the population. Through knowledge dialogues and the reflection and discussion, they promote, community actors and health professionals can understand deeper concerns of each other. This article refers to the review of the subject of knowledge dialogues to explain how using this type of approach one can identify more closely the situation, problems and needs that people have. The article also presents a review of similar experiences, demonstrating the utility of this method. In conclusion it is suggested that knowledge dialogues remains a key factor to focus in the study and intervention of population groups, acknowledging its existence, together with integrating medical knowledge with traditional knowledge are part of primary health care (PHC).

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PURPOSE: The Pan American Health Organization (PAHO) and the Colombian Ministry of Health and Social Protection have determined a need for an approach to include Equity Focus (EF) and Social Determinants of Health (SDH) in health training programmes in Colombia. We studied the incorporation of EF and SDH in the curricula of several universities in Colombia to identify opportunities to strengthen their inclusion. METHODS: Qualitative methodology was performed in two stages: (i) initial exploration (self-administered questionnaires and review of curricula) and (ii) validation of the information (semi-structured interviews). RESULTS: The inclusion of the EF and SDH in university curricula is regarded as an opportunity to address social problems. This approach addresses a broad cross-section of the curriculum, especially in the subjects of public health and Primary Health Care (PHC), where community outreach generates greater internalization by students. The dominance of the biomedical model of study plans and practice scenarios focusing on disease and little emphasis on community outreach are factors that limit the inclusion of the approach. CONCLUSIONS: The inclusion of EF and SDH in university curricula in Colombia has primarily focused on increasing the knowledge of various subjects oriented towards understanding the social dynamics or comprehensiveness of health and disease and, in some programmes, through practical courses in community health and PHC. Increased integration of EF and SDH in subjects or modules with clinical orientation is recommended.

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