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    Global research priorities for COVID-19 in maternal, reproductive and child health: Results of an international survey
    (2021)
    Melanie Etti
    ;
    Jackeline Alger
    ;
    Sofía P. Salas
    ;
    Robin Saggers
    ;
    Tanusha Ramdin
    <jats:sec id="sec001"> <jats:title>Background</jats:title> <jats:p>The World Health Organization’s “<jats:italic>Coordinated Global Research Roadmap</jats:italic>: <jats:italic>2019 Novel Coronavirus</jats:italic>” outlined the need for research that focuses on the impact of COVID-19 on pregnant women and children. More than one year after the first reported case significant knowledge gaps remain, highlighting the need for a coordinated approach. To address this need, the Maternal, Newborn and Child Health Working Group (MNCH WG) of the COVID-19 Clinical Research Coalition conducted an international survey to identify global research priorities for COVID-19 in maternal, reproductive and child health.</jats:p> </jats:sec> <jats:sec id="sec002"> <jats:title>Method</jats:title> <jats:p>This project was undertaken using a modified Delphi method. An electronic questionnaire was disseminated to clinicians and researchers in three different languages (English, French and Spanish) via MNCH WG affiliated networks. Respondents were asked to select the five most urgent research priorities among a list of 17 identified by the MNCH WG. Analysis of questionnaire data was undertaken to identify key similarities and differences among respondents according to questionnaire language, location and specialty. Following elimination of the seven lowest ranking priorities, the questionnaire was recirculated to the original pool of respondents. Thematic analysis of final questionnaire data was undertaken by the MNCH WG from which four priority research themes emerged.</jats:p> </jats:sec> <jats:sec id="sec003"> <jats:title>Results</jats:title> <jats:p>Questionnaire 1 was completed by 225 respondents from 29 countries. Questionnaire 2 was returned by 49 respondents. The four priority research themes which emerged from the analysis were 1) access to healthcare during the COVID-19 pandemic, 2) the direct and 3) indirect effects of COVID-19 on pregnant and breastfeeding women and children and 4) the transmission of COVID-19 and protection from infection.</jats:p> </jats:sec> <jats:sec id="sec004"> <jats:title>Conclusion</jats:title> <jats:p>The results of these questionnaires indicated a high level of concordance among continents and specialties regarding priority research themes. This prioritized list of research uncertainties, developed to specifically highlight the most urgent clinical needs as perceived by healthcare professionals and researchers, could help funding organizations and researchers to answer the most pressing questions for clinicians and public health professionals during the pandemic. It is hoped that these identified priority research themes can help focus the discussion regarding the allocation of limited resources to enhance COVID-19 research in MNCH globally.</jats:p> </jats:sec>
      3Scopus© Citations 8
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    Lifestyle Habits and Health Indicators in Migrants and Native Schoolchildren in Chile
    (2021)
    Mónica Suárez-Reyes
    ;
    Daiana Quintiliano-Scarpelli
    ;
    PINHEIRO FERNANDES, ANNA CHRISTINA  
    ;
    Cristian Cofré-Bolados
    ;
    Tito Pizarro
    <jats:p>In Chile, the migrant population has increased in the last years. Migrants adopt behaviors of this new culture, which can have an effect on their health. Contradictory results regarding differences between migrant and native children have been reported. The aim of this study was to explore the associations between nationality with health indicator and lifestyle habits among schoolchildren in Chile. A cross-sectional and observational study with a non-probabilistic sample was conducted in 1033 children (86.4% Chilean and 13.6% migrant) from second to fourth grade of seven public schools from low-income municipalities from the Metropolitan Region, Chile. Anthropometric measurements (weight, height, waist circumference, triceps and subscapular folds), handgrip strength, and standing long jump measurements, physical activity, self-esteem and food guidelines accomplishments were determined. Migrant children presented lower body mass index (BMI), Z-BMI, body fat% and waist circumference values; and higher handgrip strength, standing long jump, and more satisfactory compliance with food guidelines than natives (p &lt; 0.05). No significant difference for physical activity and self-esteem was observed. In the adjusted models, migrants presented lower odds for overweight/obesity, risk of abdominal obesity, low handgrip strength and unsatisfactory food guidelines accomplishment in all models (p &lt; 0.05). The nutritional and muscular fitness of migrant children was better than that of the Chilean ones.</jats:p>
      1Scopus© Citations 8  1
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    Epidemiology of Parkinson’s Disease in Chile
    (2021)
    VIAL UNDURRAGA, FELIPE AGUSTIN  
    ;
    DELGADO BECERRA, OROZIMBA IRIS  
    ;
    Francisca Canal
    ;
    IDIAQUEZ RIOS, JUAN FRANCISCO  
    ;
    Pedro Chana-Cuevas
    <jats:p>&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; Parkinson’s disease (PD) is one of the most common neurodegenerative disorders. There is no epidemiological description of PD in Chile and not many descriptions in Latin America. This study aims to describe the incidence and prevalence of PD in Chile. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; The study group was the population on the public health system in Chile between 2010 and 2018 that were registered in the GES system as having PD. Crude and standardized prevalence and incidence were calculated with a 95% confidence interval. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; 33,345 patients were found in the register as confirmed cases with PD. The crude incidence in 2018 was 23.7/100,000; the crude prevalence in 2018 was 160.7/100,000. The male-to-female ratio was 1.03. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; The prevalence and incidence observed in the Chilean population are consistent with studies from other countries. </jats:p>
    Scopus© Citations 8  114
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    A Chilean Experience of Telestroke in a COVID-19 Pandemic Year
    (2022)
    Carlos Delfino
    ;
    MAZZON AGURTO, ENRICO  
    ;
    Felipe Jurado Díaz
    ;
    MUÑOZ VENTURELLI, PAULA ANDREA  
    ;
    BRUNSER, ALEJANDRO  
    <jats:p>&lt;b&gt;&lt;i&gt;Background and Purpose:&lt;/i&gt;&lt;/b&gt; Telemedicine for stroke patients’ care (telestroke [TS]) has grown notably in recent decades and may offer advantages during health crisis. Hospital admissions related to stroke have decreased globally during the COVID-19 pandemic, but scarce information is available regarding the effect of COVID-19 in TS. Using a population-based TS registry, we investigated the impact of the first year of the COVID-19 pandemic throughout our TS network in Santiago, Chile. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Stroke codes evaluated after the onset of COVID-19 restrictions in Chile (defined as March 15, 2020) were compared with those evaluated in 2019. We analyzed differences between number of stroke codes, thrombolysis rate, stroke severity, and time from the stroke onset to hospital admission. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; We observed that the number of stroke codes and the number of patients undergoing reperfusion therapy did not change significantly (&lt;i&gt;p&lt;/i&gt; = 0.669 and 0.415, respectively). No differences were found with respect to the median time from the stroke onset to admission (&lt;i&gt;p&lt;/i&gt; = 0.581) or in National Institutes of Health Stroke Scale (NIHSS) scores (&lt;i&gt;p&lt;/i&gt; = 0.055). The decision-making-to-needle time was significantly shorter in the COVID-19 period (median 5 min [IQR 3–8], &lt;i&gt;p&lt;/i&gt; &amp;#x3c; 0.016), but no significant changes were found at the other times. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; This study demonstrates the potential of adapting TS to extreme situations such as the COVID-19 pandemic, as well as the importance of establishing networks that facilitate patient access to quality treatments. </jats:p>
    Scopus© Citations 7  1
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    Trail running injury risk factors: a living systematic review
    (2022)
    Carel Viljoen
    ;
    Dina C (Christa) Janse van Rensburg
    ;
    Willem van Mechelen
    ;
    Evert Verhagen
    ;
    Bruno Silva
    <jats:sec><jats:title>Objective</jats:title><jats:p>To review and frequently update the available evidence on injury risk factors and epidemiology of injury in trail running.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Living systematic review. Updated searches will be done every 6 months for a minimum period of 5 years.</jats:p></jats:sec><jats:sec><jats:title>Data sources</jats:title><jats:p>Eight electronic databases were searched from inception to 18 March 2021.</jats:p></jats:sec><jats:sec><jats:title>Eligibility criteria</jats:title><jats:p>Studies that investigated injury risk factors and/or reported the epidemiology of injury in trail running.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Nineteen eligible studies were included, of which 10 studies investigated injury risk factors among 2 785 participants. Significant intrinsic factors associated with injury are: more running experience, level A runner and higher total propensity to sports accident questionnaire (PAD-22) score. Previous history of cramping and postrace biomarkers of muscle damage is associated with cramping. Younger age and low skin phototypes are associated with sunburn. Significant extrinsic factors associated with injury are neglecting warm-up, no specialised running plan, training on asphalt, double training sessions per day and physical labour occupations. A slower race finishing time is associated with cramping, while more than 3 hours of training per day, shade as the primary mode of sun protection and being single are associated with sunburn. An injury incidence range 0.7–61.2 injuries/1000 hours of running and prevalence range 1.3% to 90% were reported. The lower limb was the most reported region of injury, specifically involving blisters of the foot/toe.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Limited studies investigated injury risk factors in trail running. Our review found eight intrinsic and nine extrinsic injury risk factors. This review highlighted areas for future research that may aid in designing injury risk management strategies for safer trail running participation.</jats:p><jats:p>PROSPERO registration number</jats:p><jats:p>CRD42021240832.</jats:p></jats:sec>
      5Scopus© Citations 23
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    Unequal Access and Use of Health Care Services among Settled Immigrants, Recent Immigrants, and Locals: A Comparative Analysis of a Nationally Representative Survey in Chile
    (2022)
    Marcela Oyarte
    ;
    CABIESES VALDES, BALTICA BEATRIZ  
    ;
    Isabel Rada
    ;
    Alice Blukacz
    ;
    Manuel Espinoza
    <jats:p>Globally, and particularly in the Latin American region, international migration continues to grow. Access and use of health care services by migrants vary according to their country of origin and residence time. We aimed to compare the access and use of health care services between international migrants (including settled migrants from Peru, Argentina, Bolivia, Ecuador; Emerging migrants from Venezuela, Dominican Republic, Colombia, Haiti; and migrants from other countries) and the Chilean population. After performing a secondary data analysis of population-based nationally representative surveys (CASEN 2011–2017), access and use patterns (insurance, complementary insurance, non-consultation, and non-treatment coverage) were described and compared among settled immigrants, recent emerging immigrants, others, and locals. Immigrants had a significantly higher uninsured population compared to locals. Specifically, in CASEN 2017, 19.27% of emerging (95% CI: 15.3–24.1%), 11.79% of settled (95% CI: 10.1–13.7%), and 2.25% of locals (95% CI: 2.1–2.4%) were uninsured. After 2013, settled and recent emerging migrants showed higher percentages of non-consultation. Collaborative and interculturally relevant strategies from human rights and equity perspectives are needed. Initiatives with a particular focus on recent immigrants can contribute to reducing the existing disparities in health care access and use with locals due to lack of insurance and treatment coverage.</jats:p>
      9Scopus© Citations 10
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    Seroprevalence of Natural and Acquired Immunity against the SARS-CoV-2 Virus in a Population Cohort from Two Chilean Cities, 2020–2022
    (2023)
    Loreto Núñez-Franz
    ;
    Muriel Ramírez-Santana
    ;
    RUBILAR RAMIREZ, PAOLA  
    ;
    Macarena Said
    ;
    VIAL COX, MARIA CECILIA  
    <jats:p>Background: Chile has achieved the highest coverage for vaccines against the SARS-CoV-2 virus worldwide. Objective: To assess the progression of immunity (natural and acquired by vaccine) in a cohort from two Chilean cities. Methods: Individuals (n = 386) who participated in three phases of population-based serial prevalence studies were included (2020–2021 and 2022). Presence of SARS-CoV-2 antibodies was measured in serum. Data including time of vaccination and type of vaccine received were analysed with descriptive statistics. Results: Seroprevalence was 3.6% in the first round and increased to 96.9% in the second and 98.7% in the third. In the third round, 75% of individuals who had received the basal full scheme were seropositive at 180 days or more since their last dose; 98% of individuals who received one booster dose were seropositive at 180 days or more, and 100% participants who received two boosters were seropositive, regardless of time since their last dose. Participants receiving mRNA vaccines had higher seroprevalence rates over time. Conclusions: The high vaccination coverage in Chile enabled the population to maintain high levels of antibodies. Vaccination boosters are essential to maintain immunity over time, which also depends on the type of vaccine administered.</jats:p>
      1Scopus© Citations 12
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    The impacts of social determinants of health and cardiometabolic factors on cognitive and functional aging in Colombian underserved populations
    (2023)
    Hernando Santamaria-Garcia
    ;
    Sebastian Moguilner
    ;
    Odir Antonio Rodriguez-Villagra
    ;
    Felipe Botero-Rodriguez
    ;
    Stefanie Danielle Pina-Escudero
    <jats:title>Abstract</jats:title><jats:p>Global initiatives call for further understanding of the impact of inequity on aging across underserved populations. Previous research in low- and middle-income countries (LMICs) presents limitations in assessing combined sources of inequity and outcomes (i.e., cognition and functionality). In this study, we assessed how social determinants of health (SDH), cardiometabolic factors (CMFs), and other medical/social factors predict cognition and functionality in an aging Colombian population. We ran a cross-sectional study that combined theory- (structural equation models) and data-driven (machine learning) approaches in a population-based study (<jats:italic>N</jats:italic> = 23,694;<jats:italic>M</jats:italic> = 69.8 years) to assess the best predictors of cognition and functionality. We found that a combination of SDH and CMF accurately predicted cognition and functionality, although SDH was the stronger predictor. Cognition was predicted with the highest accuracy by SDH, followed by demographics, CMF, and other factors. A combination of SDH, age, CMF, and additional physical/psychological factors were the best predictors of functional status. Results highlight the role of inequity in predicting brain health and advancing solutions to reduce the cognitive and functional decline in LMICs.</jats:p>
    Scopus© Citations 10  1
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    Status and Trends of Physical Activity Surveillance, Policy, and Research in 164 Countries: Findings From the Global Observatory for Physical Activity—GoPA! 2015 and 2020 Surveys
    (2023)
    Andrea Ramírez Varela
    ;
    Pedro C. Hallal
    ;
    Juliana Mejía Grueso
    ;
    Željko Pedišić
    ;
    Deborah Salvo
    <jats:p><jats:italic><jats:bold>Background</jats:bold>:</jats:italic> Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. <jats:italic><jats:bold>Methods</jats:bold>:</jats:italic> We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. <jats:italic><jats:bold>Results</jats:bold>:</jats:italic> The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world’s population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world’s population live in countries where PA promotion capacity should be significantly improved. <jats:italic><jats:bold>Conclusion</jats:bold>:</jats:italic> Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion.</jats:p>
      1  2Scopus© Citations 46
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    Promoting the Participation of “Hard-to-Reach” Migrant Populations in Qualitative Public Health Research during the COVID-19 Pandemic in Chile
    (2023)
    Alice Blukacz
    ;
    CABIESES VALDES, BALTICA BEATRIZ  
    ;
    OBACH KING, ALEXANDRA ALICE  
    ;
    María Inés Álvarez
    ;
    Paula Madrid
    <jats:p>The COVID-19 pandemic has further deepened socioeconomic and health inequities worldwide, especially among populations experiencing social vulnerability, such as international migrants. Sustained lockdowns and social distancing have raised challenges to conducting public health research with hard-to-reach populations. This study aims at exploring strategies to recruit “hard-to-reach” international migrants for qualitative public health research during the pandemic in Chile, based on the authors’ experience. A retrospective qualitative evaluation process was carried out on the recruitment processes of three qualitative research projects focused on international migrants in Chile. All projects were implemented during the COVID-19 pandemic, demanding complementary and flexible strategies: (i) social media; (ii) snowball sampling; (iii) referrals from social workers and pro-migrant and migrant-led organizations; (iv) vaccination centers and healthcare centers; and (v) community-based recruitment. The strategies are qualitatively evaluated around seven emerging qualitative categories: (i) feasibility during lockdown periods; (ii) speed of recruitment; (iii) geographical coverage; (iv) sample diversity; (v) proportion of successful interviews; (vi) ethical considerations; and (vii) cost. Engaging hard-to-reach international migrants in public health research during the pandemic required constantly adapting recruitment strategies. Furthermore, relying on strategies that were not only Internet-based promoted the participation of populations with limited access to the Internet and low-digital literacy.</jats:p>
    Scopus© Citations 10  1