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BackgroundAccess to audiology services for older adults residing in sparsely populated regions is often limited compared to those in central urban areas. The geographic accessibility to follow-up care, particularly the influence of distance, may contribute to an increased risk of hearing aid abandonment.ObjectiveTo assess the association between the home-to-healthcare-calibration-center distance and hearing aid abandonment among older adults fitted in the Chilean public health system.Methods455 patients who received hearing aids from two public hospitals in two regions were considered. Univariate and multivariate Poisson regression models with robust variance estimation were used to analyze the association between the geographical distance and hearing aid abandonment, accounting for confounding effects.ResultsApproximately 18% of the sample abandoned the hearing aid, and around 50% reported using the hearing aid every day. A twofold increase in distance between home and the hearing center yielded a 35% (RR = 1.35; 95% CI: 1.04–1.74; p = 0.022) increased risk of hearing aid abandonment. Also, those in the second quintile had a 2.17 times the risk of abandoning the hearing aid compared to the first quintile (up to 2.3 km). Under the assumption that patients reside within the first quintile of distance, a potential reduction of 45% in the incidence of hearing aid abandonment would be observed. The observed risk remained consistent across different statistical models to assess sensitivity.ConclusionA higher distance between the residence and the healthcare center increases hearing aid abandonment risk. The association may be explained by barriers in purchasing supplies required to maintain the device (batteries, cleaning elements, potential repairs, or maintenance).

This study aimed to analyse how socio-environmental conditions affected the early evolution of COVID-19 in 14 urban sites in South America based on a spatio-temporal multidisciplinary approach. The daily incidence rate of new COVID-19 cases with symptoms as the dependent variable and meteorological-climatic data (mean, maximum, and minimum temperature, precipitation, and relative humidity) as the independent variables were analysed. The study period was from March to November of 2020. We inquired associations of these variables with COVID-19 data using Spearman's non-parametric correlation test, and a principal component analysis considering socio economic and demographic variables, new cases, and rates of COVID-19 new cases. Finally, an analysis using non-metric multidimensional scale ordering by the Bray-Curtis similarity matrix of meteorological data, socio economic and demographic variables, and COVID-19 was performed. Our findings revealed that the average, maximum, and minimum temperatures and relative humidity were significantly associated with rates of COVID-19 new cases in most of the sites, while precipitation was significantly associated only in four sites. Additionally, demographic variables such as the number of inhabitants, the percentage of the population aged 60 years and above, the masculinity index, and the GINI index showed a significant correlation with COVID-19 cases. Due to the rapid evolution of the COVID-19 pandemic, these findings provide strong evidence that biomedical, social, and physical sciences should join forces in truly multidisciplinary research that is critically needed in the current state of our region.

Abstract Trichinellosis is a foodborne disease caused by several Trichinella species around the world. In Chile, the domestic cycle was fairly well-studied in previous decades, but has been neglected in recent years. The aims of this study were to analyze, geographically, the incidence of trichinellosis in Chile to assess the relative risk and to analyze the incidence rate fluctuation in the last decades. Using temporal data spanning 1964–2019, as well as geographical data from 2010 to 2019, the time series of cases was analyzed with ARIMA models to explore trends and periodicity. The Dickey-Fuller test was used to study trends, and the Portmanteau test was used to study white noise in the model residuals. The Besag-York-Mollie (BYM) model was used to create Bayesian maps of the level of risk relative to that expected by the overall population. The association of the relative risk with the number of farmed swine was assessed with Spearman’s correlation. The number of annual cases varied between 5 and 220 (mean: 65.13); the annual rate of reported cases varied between 0.03 and 1.9 cases per 105 inhabitants (mean: 0.53). The cases of trichinellosis in Chile showed a downward trend that has become more evident since the 1980s. No periodicities were detected via the autocorrelation function. Communes (the smallest geographical administrative subdivision) with high incidence rates and high relative risk were mostly observed in the Araucanía region. The relative risk of the commune was significantly associated with the number of farmed pigs and boar (Sus scrofa Linnaeus, 1758). The results allowed us to state that trichinellosis is not a (re)emerging disease in Chile, but the severe economic poverty rate of the Mapuche Indigenous peoples and the high number of backyard and free-ranging pigs seem to be associated with the high risk of trichinellosis in the Araucanía region.

Abstract: Automatic geocoding methods have become popular in recent years, facilitating the study of the association between health outcomes and the place of living. However, rather few studies have evaluated geocoding quality, with most of them being performed in the US and Europe. This article aims to compare the quality of three automatic online geocoding tools against a reference method. A subsample of 300 handwritten addresses from hospital records was geocoded using Bing, Google Earth, and Google Maps. Match rates were higher (> 80%) for Google Maps and Google Earth compared with Bing. However, the accuracy of the addresses was better for Bing with a larger proportion (> 70%) of addresses with positional errors below 20m. Generally, performance did not vary for each method for different socioeconomic status. Overall, the methods showed an acceptable, but heterogeneous performance, which may be a warning against the use of automatic methods without assessing quality in other municipalities, particularly in Chile and Latin America.

The extreme north of Chile presents a subtropical climate permissive of the establishment of potential disease vectors. Anopheles (Ano.) pseudopunctipennis is distributed from the south of the United States to the north of Argentina and Chile, and is one of the main vectors of malaria in Latin America. Malaria was eradicated from Chile in 1945. Nevertheless, the vector persists in river ravines of the Arica and Tarapacá regions. The principal effect of climate change in the north of Chile is temperature increase. Precipitation prediction is not accurate for this region because records were erratic during the last century. The objective of this study was to estimate the current and the projected distribution pattern of this species in Chile, given the potential impact due to climate change. We compiled distributional data for An. (Ano.) pseudopunctipennis and constructed species distribution models to predict the spatial distribution of this species using the MaxEnt algorithm with current and RCP 4.5 and 8.5 scenarios, using environmental and topographic layers. Our models estimated that the current expected range of An. (Ano.) pseudopunctipennis extends continuously from Arica to the north of Antofagasta region. Furthermore, the RCP 4.5 and 8.5 projected scenarios suggested that the range of distribution of An. (Ano.) pseudopunctipennis may increase in longitude, latitude, and altitude limits, enhancing the local extension area by 38 and 101%, respectively, and local presence probability (>0.7), from the northern limit in Arica y Parinacota region (18°S) to the northern Antofagasta region (23°S). This study contributes to geographic and ecologic knowledge about this species in Chile, as it represents the first local study of An. (Ano.) pseudopunctipennis. The information generated in this study can be used to inform decision making regarding vector control and surveillance programs of Latin America. These kinds of studies are very relevant to generate human, animal, and environmental health knowledge contributing to the “One Health” concept.

Summary: In 2011, Chile experienced an increase in the number of cases of IMD caused by Neisseria meningitidis group W. This epidemiological scenario prompted authorities to implement prevention strategies. As part of these strategies, the Institute of Public Heath of Chile conducted a cross-sectional study to determine the prevalence of pharyngeal carriage of N. meningitidis in a representative sample of healthy children and adolescents aged 10–19 years.The identification of presumptive N. meningitidis strains was performed by testing carbohydrate utilization in the National Reference Laboratory at the ISP. Association of meningococcal carriage with risk factors was analyzed by calculating the Odds Ratio. Selected variables were included in a logistic model for risk analyses.The prevalence of carriage of N. meningitidis was 6.5% (CI: 5.7–7.3%). Older age (carriers: 14.2 ± 0.29 vs. non-carriers: 13.8 ± 0.08 years old; p = 0.009), cohabitation with children (carriers: 0.9 ± 0.13 vs. non-carriers: 0.7 ± 0.03; p = 0.028), number of smoking cohabitants (carriers: 0.55 ± 0.13 vs. non-carriers: 0.44 ± 0.03) and frequent attendance to crowded social venues (carriers: 49% vs. non-carriers: 37%; p = 0.008) were determined to favor carriage. Statistical modeling showed that meningococcal carriage was associated with older age (OR: 1.077, p-value: 0.002) and cohabitation with children (OR: 1.182, p-value: 0.02). Keywords: Neisseria meningitidis, Prevalence, Multivariate logistic regression, IMD, Meningococcal carriage, Risk factors

SUMMARY The frequency of anti-Toxocara spp. antibodies in individuals attended by the Centro de Salud Familiar in the coastal Niebla town, Chile, was related to the host and to environmental factors. IgG anti- Toxocara antibodies were detected with a commercial ELISA kit (SCIMEDX Corporation, USA). Samples with undetermined absorbance values were subjected to an additional ELISA standardized by the Instituto de Salud Pública, Chilean Health Ministry, a commercial ELISA (NOVATEC, Germany), and a commercial Western blot kit (LDBio Diagnostics, France). Hematological exams were performed using an automated blood counter and blood smears. Dog feces were collected from the ground along the main road in Niebla, including rural and urban locations. Ninety (25.4%) of the 355 examined individuals were positive by the ELISA test. The frequency of anti-Toxocara antibodies and the infection risk were significantly higher (p < 0.05) among those individuals ≥ 40 years old with respect to the 20-39 years old group, in individuals from rural locations, those who did not have a safe drinking water supply in the house or who presented blood eosinophilia. The proportion of positive samples of dog feces and the mean number of Toxocara canis eggs/g of feces in urban and rural areas were similar (p > 0.05).