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Setting up regional diagnostic reference levels for pediatric computed tomography in Latin America: preliminary results, challenges and the work ahead
(2023)
Lina Cadavid
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Lina Karout
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Mannudeep K. Kalra
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Flavio Morgado
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María Antonieta Londoño
Scopus© Citations 4 2
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“Border closure only increased precariousness”: a qualitative analysis of the effects of restrictive measures during the COVID-19 pandemic on Venezuelan’s health and human rights in South America
(2023)
Teresita Rocha-Jimenez
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Carla Olivari
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Alejandra Martínez
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Michael Knipper
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CABIESES VALDES, BALTICA BEATRIZ
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>In 2010, a political and social crisis pushed thousands of Venezuelans out of their country; today, seven million Venezuelans live abroad. In addition, during the COVID-19 pandemic, border closure increased and affected specific vulnerable migration flows, such as Venezuelans trying to migrate to Chile through the Northern borders. In this context, there is little evidence of migrants’ health status and needs, their access to health services, and other basic needs (e.g., housing) from a human rights perspective. Therefore, we qualitatively explored the effects of border closure due to the COVID-19 pandemic on Venezuelan migrants’ health and human rights, focusing on access to healthcare in the Northern Chilean border that adjoins Peru and Bolivia.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Following a case-study qualitative design, we conducted an ethnography that included participatory observation of relevant sites (e.g., hospitals, main squares, migrant shelters) in Antofagasta, Iquique, and Arica and 30 in-depth interviews with actors in the health sector (<jats:italic>n</jats:italic> = 7), experts from the non-governmental sector (<jats:italic>n</jats:italic> = 16), and governmental actors (<jats:italic>n</jats:italic> = 7) in three large cities close to the Northern border.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>We found four main dimensions: (i) border and migration processes, (ii) specific groups and intersectionality, (iii) barriers to healthcare services, and (iv) regional and local responses to the crisis during the COVID-19 pandemic. Programs characterized by the presence of healthcare providers in the field were essential to attend to migrants’ health needs at borders.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Coordination between actors is crucial to implement regional protocols that respond to current migration phenomena and migrants’ health needs. Health policies using a human rights approach are urgently required to respond to migrants’ healthcare needs at borders in South America.</jats:p> </jats:sec>
Scopus© Citations 2 1
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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
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CABIESES VALDES, BALTICA BEATRIZ
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Isabel Rada
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Alice Blukacz
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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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University-Industry joint undertakings with high societal impact: A micro-processes approach
(2022)
Jason Roncancio-Marin
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Nikolay Dentchev
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GUERRERO CANO, MARIBEL
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Abel Díaz-González
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Thomas Crispeels
Scopus© Citations 20 4
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Antimicrobial stewardship programs in adult intensive care units in Latin America: Implementation, assessments, and impact on outcomes
(2021)
Rodolfo E. Quirós
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Ana C. Bardossy
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Patricia Angeleri
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Jeannete Zurita
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Washington R. Aleman Espinoza
<jats:title>Abstract</jats:title><jats:sec id="S0899823X21000805_as1"><jats:title>Objective:</jats:title><jats:p>To assess the impact of antimicrobial stewardship programs (ASPs) in adult medical–surgical intensive care units (MS-ICUs) in Latin America.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as2"><jats:title>Design:</jats:title><jats:p>Quasi-experimental prospective with continuous time series.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as3"><jats:title>Setting:</jats:title><jats:p>The study included 77 MS-ICUs in 9 Latin American countries.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as4"><jats:title>Patients:</jats:title><jats:p>Adult patients admitted to an MS-ICU for at least 24 hours were included in the study.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as5"><jats:title>Methods:</jats:title><jats:p>This multicenter study was conducted over 12 months. To evaluate the ASPs, representatives from all MS-ICUs performed a self-assessment survey (0–100 scale) at the beginning and end of the study. The impact of each ASP was evaluated monthly using the following measures: antimicrobial consumption, appropriateness of antimicrobial treatments, crude mortality, and multidrug-resistant microorganisms in healthcare-associated infections (MDRO-HAIs). Using final stewardship program quality self-assessment scores, MS-ICUs were stratified and compared among 3 groups: ≤25th percentile, >25th to <75th percentile, and ≥75th percentile.</jats:p></jats:sec><jats:sec id="S0899823X21000805_as6"><jats:title>Results:</jats:title><jats:p>In total, 77 MS-ICU from 9 Latin American countries completed the study. Twenty MS-ICUs reached at least the 75th percentile at the end of the study in comparison with the same number who remain within the 25th percentile (score, 76.1 ± 7.5 vs 28.0 ± 7.3; <jats:italic>P</jats:italic> < .0001). Several indicators performed better in the MS-ICUs in the 75th versus 25th percentiles: antimicrobial consumption (143.4 vs 159.4 DDD per 100 patient days; <jats:italic>P</jats:italic> < .0001), adherence to clinical guidelines (92.5% vs 59.3%; <jats:italic>P</jats:italic> < .0001), validation of prescription by pharmacist (72.0% vs 58.0%; <jats:italic>P</jats:italic> < .0001), crude mortality (15.9% vs 17.7%; <jats:italic>P</jats:italic> < .0001), and MDRO-HAIs (9.45 vs 10.96 cases per 1,000 patient days; <jats:italic>P</jats:italic> = .004).</jats:p></jats:sec><jats:sec id="S0899823X21000805_as7"><jats:title>Conclusion:</jats:title><jats:p>MS-ICUs with more comprehensive ASPs showed significant improvement in antimicrobial utilization.</jats:p></jats:sec>
Scopus© Citations 25 1
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Tool to monitor tobacco control policy implementation: the Tobacco Control Scale in Latin America. Adaptation process and pilot study
(2021)
Ariadna Feliu
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Cristina Martinez
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PERUGA URREA, ARMANDO
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Luk Joossens
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Eduardo Bianco
<jats:sec><jats:title>Background</jats:title><jats:p>Monitoring tobacco control policy implementation is one of the keys for tobacco consumption reduction in Latin America (LA). This study reports on the adaptation of the Tobacco Control Scale (TCS) for use in LA countries and the level of tobacco control policy implementation in this region according to the scale.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Ecological cross-sectional survey. The questionnaire to measure tobacco control policies was a translated (into Spanish and Portuguese) and adapted version of the last TCS as used in Europe. The resulting TCS-LA maintains the same structure as the original TCS, with eight policy domains and 100 points (pts) as maximum score; however, four policy domains were adapted because the exact same rationale could not be applied. At least two non-governmental tobacco control experts were contacted per country to answer the TCS-LA.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Informants from 17 out of 18 countries completed the questionnaire. Using the TCS-LA, Panama (70 pts), Uruguay (68 pts) and Ecuador (61 pts) exhibited the strongest tobacco control policies, while Guatemala (32 pts), Bolivia (30 pts) and Dominican Republic (29 pts) have implemented a lower number of tobacco control policies. Eight countries reached 50% of the TCS-LA total possible score, indicating a relatively good implementation level of tobacco control policies.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Panama, Uruguay and Ecuador are the tobacco control policy leaders in LA; however, tobacco control in the region has room for improvement since nine countries have a total score under 50 pts. The TCS is a feasible and adaptable tool to monitor tobacco control in other WHO regions beyond Europe.</jats:p></jats:sec>
Scopus© Citations 5 1 1

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