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Background: Colombia is currently the world's main recipient country for Venezuelan migrants, and women represent a high proportion of them. This article presents the first report of a cohort of Venezuelan migrant women entering Colombia through Cúcuta and its metropolitan area. The study aimed to describe the health status and access to healthcare services among Venezuelan migrant women in Colombia with irregular migration status, and to analyze changes in those conditions at a one-month follow-up. Methods: We carried out a longitudinal cohort study of Venezuelan migrant women, 18 to 45 years, who entered Colombia with an irregular migration status. Study participants were recruited in Cúcuta and its metropolitan area. At baseline, we administered a structured questionnaire including sociodemographic characteristics, migration history, health history, access to health services, sexual and reproductive health, practice of early detection of cervical cancer and breast cancer, food insecurity, and depressive symptoms. The women were again contacted by phone one month later, between March and July 2021, and a second questionnaire was applied. Results: A total of 2,298 women were included in the baseline measurement and 56.4% could be contacted again at the one-month follow-up. At the baseline, 23.0% of the participants reported a self-perceived health problem or condition in the past month and 29.5% in the past 6 months, and 14.5% evaluated their health as fair or poor. A significant increase was found in the percentage of women who reported a self-perceived health problem during the past month (from 23.1% to 31.4%; p<0.01); as well as in the share who reported moderate, severe, or extreme difficulty working or performing daily chores (from 5.5% to 11.0%; p = 0.03) and who rated their health as fair (from 13.0% to 31.2%; p<0.01). Meanwhile, the percentage of women with depressive symptoms decreased from 80.5% to 71.2% (p<0.01). Conclusion: This report presents initial information on the health status of Venezuelan migrant women in Colombia, and is a starting point for further longer longitudinal follow-ups to assess changes over time in health conditions. [ABSTRACT FROM AUTHOR]

Copyright of Revista Salud UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We evaluated the short-term effect of mixtures of ambient air pollutants on respiratory and circulatory morbidity in four Colombian cities. Daily Emergency Department (ED) visit records for respiratory and circulatory selected diagnosis and daily concentrations for six criteria air pollutant were obtained in four of the five major cities in Colombia: Bucaramanga, Bogota, Cali, and Medellin during 2011–2014. Using conditional Poisson time series analysis with fixed effects, we assessed the effect of air pollutants on health outcomes using single-pollutant, two-pollutant and specific mixtures-of-pollutant models controlling for meteorology and time trends. The percentages of change in the rate of ED visits and their 95% confidence interval were estimated for the joint effect of pollutants. In single-pollutant models increases in gases concentrations were associated with increases in ED visits for respiratory and circulatory diseases. The two-pollutant models for respiratory diseases showed that the effect of NO 2 alone (% change 2.86 95% CI 1.87–3.85) is higher than the joint effect of any of its combinations except for its combination with SO 2 (% change 3.05 95%CI 1.04–5.05). The two-pollutant models for circulatory diseases showed synergistic effects between NO 2 and PM 2.5 (% change 2.13 95%CI 0.001–4.26). Specific mixtures models showed that the mixture of "traffic-related pollutants" has the higher joint effect on circulatory morbidity and respiratory morbidity. The results show the dominant effect of NO 2 in air pollution mixtures on respiratory and circulatory morbidity, and the synergistic effect of NO 2 and SO 2 in air pollution mixtures on respiratory morbidity. Image 1 • Multipollutant analyses of air pollutant effects is limited in developing countries. • We assessed short-term joint effect of mixtures in a tropical developing country. • We found a dominant effect of NO 2 in air pollution mixtures on morbidity. • There is evidence of synergistic effect NO 2 and SO 2 on respiratory morbidity. • Some mixtures effects are well represented by single-pollutant effects. [ABSTRACT FROM AUTHOR]

Objective: Maternal mortality reduction is a Millennium Development Goal. In Colombia, there is a large disparity in the maternal mortality ratio (MMR) between and into departments (states) and also between municipalities. We examined socioeconomics variables at the municipal and departmental levels which could be associated to the municipal maternal mortality in Colombia. Methods: A multilevel ecology study was carried out using different national data sources in Colombia. The outcome variable was the MMR at municipal level in 2011 with multidimensional poverty at municipal and department level as the principal independent variables and other measures of the social and economic characteristics at municipal and departmental level were also considered explicative variables (overall fertility municipal rate, percentage of local rural population, health insurance coverage, per capita territorial participation allocated to the health sector, transparency index and Gini coefficient). The association between MMR and socioeconomic contextual conditions at municipal and departmental level was assessed using a multilevel Poisson regression model. Results: The MMR in the Colombian municipalities was associated significantly with the multidimensional poverty (relative ratio of MMR: 3.52; CI 95%: 1.09-11.38). This association was stronger in municipalities from departments with the highest poverty (relative ratio of MMR: 7.14; CI 95%: 2.01-25.35). Additionally, the MMR at municipal level was marginally associated with municipally health insurance coverage (relative ratio of MMR: 0.99; CI 95%: 0.98-1.00), and significantly with transparency index at departmental level (relative ratio of MMR: 0.98; CI 95%: 0.97-0.99). Conclusion: Poverty and transparency in a contextual level were associated with the increase of the municipal MMR in Colombia. The results of this study are useful evidence for informing the public policies discussion and formulation processes with a differential approach. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• We developed knowledge and practice surveys on the Taeniasis/Cysticercosis complex (TCC) in two prioritized municipalities in the north and south of Colombia. • We present differences in knowledge and practices present Mahates and Mercaderes inhabitants about Taenia solium transmission and symptoms as well as housing, pig farming practices and sanitation conditions. • Interventions in education, pig management, pig treatment and sanitation improvement must be considered in view of the differences in the target population knowledge and practices during the following phases of Colombia's National and Cross-sectoral Plan for TCC Elimination. The taeniasis/cysticercosis complex (TCC) belongs to the group of neglected infectious diseases with a multifactorial transmission that includes hosts such as humans and pigs of the parasitic tapeworm (Taenia solium) and environmental factors. This study represents the first phase of the National and Cross-sectoral Plan for TCC Elimination. Objectives: To obtain data about knowledge and practices in relation to the TCC from knowledge, attitudes, and practices (KAP) surveys applied in two pilot localities for building a baseline of the potential risk factors related to identification, prevention, and control of TCC in Colombia. Methods: A descriptive cross-sectional survey from October to November in 2019 was carried out using a structured questionnaire and random sampling by single-stage conglomerates in the municipalities of Mahates, Bolívar (n = 152) (Atlantic Region) and Mercaderes, Cauca (n = 152) (Andean Region). Results: Respondents in Mahates showed moderate knowledge about TCC compared to those in Mercaderes, however, risky practices were identified in both places (consumption of pork with cysts and defecation in places other than the bathroom or latrine). Deficiency in infrastructure and failure in basic services were observed as potential risk factors for TCC transmission in both municipalities. Conclusion: Based on the framework of the National and Cross-sectoral Plan for TCC Elimination, adequate knowledge on identification, prevention, and control of the disease must be reinforced; cultural and ecological differences should be considered when designing communication and knowledge transmission tools. We consider that major investment should be made in improving basic services and creating sustainable modernized pig farming in Mahates and Mercaderes. [ABSTRACT FROM AUTHOR]

The causes and conditions of displacement often increase the vulnerability of migrant and refugee populations to food insecurity, alongside other material hardships. We aimed to examine the multidimensional aspects and patterns of food insecurity and other material hardships in a cross-sectional sample of 6221 Venezuelan refugees and migrants in urban Colombia using a latent class analysis. Using multinomial and logistic regression models, we investigated the demographic and migratory experiences associated with identified classes and how class membership is associated with multiple health outcomes among Venezuelan refugees and migrants, respectively. Approximately two thirds of the sample was comprised cisgender women, and the participants had a median age of 32 years (IQR: 26-41). Four heterogeneous classes of food insecurity and material hardships emerged: Class 1-low food insecurity and material hardship; Class 2-high food insecurity and material hardship; Class 3-high income hardship with insufficient food intake; and Class 4-income hardship with food affordability challenges. Class 2 reflected the most severe food insecurity and material hardships and had the highest class membership; Venezuelans with an irregular migration status were almost 1.5 times more likely to belong to this class. Food insecurity and material hardship class membership was independently associated with self-rated health, mental health symptoms, and recent violence victimization and marginally associated with infectious disease outcomes (laboratory-confirmed HIV and/or syphilis infection). Social safety nets, social protection, and other interventions that reduce and prevent material hardships and food insecurity among refugees and migrants, alongside the host community, may improve public health, support development, and reduce healthcare costs. In the long term, regularization and social policies for migrants aimed at enhancing refugees' and migrants' social and economic inclusion may contribute to improving food security in this population.

Background: Colombia's national COVID-19 vaccination plan began in February of 2021. It gave priority to older adults, who constituted 77.7% of deaths from this illness in the year 2020. The main goal of the plan is to decrease specific mortality and the number of serious COVID-19 cases, however, the number of deaths avoided by this strategy is unknown. The objective of this study was to estimate the number of avoided deaths in Colombia by fully vaccinating older adults against COVID-19, during the first year of the implementation of the national vaccination plan. Methods: This study took on the design of an ecological, longitudinal study. Full vaccination coverage for older adults was calculated for each epidemiological week and age group from March to December 2021, based on which the number of avoided COVID-19 deaths was estimated. A sensitivity analysis was performed taking into account variations in the vaccines' effectiveness by age group. Results: In Colombia, over 5.3 million adults 60 years of age and older received full COVID-19 vaccinations between March and December 2021. During that same period, nearly 46,000 deaths of older adults from this cause were registered. We estimated that vaccination has avoided around 22,000 more older adults from dying from COVID-19 in Colombia, that is, 32.4% of expected deaths in 2021. According to the sensitivity analysis, the number of lives saved ranged from 19,597 to 36,507. Conclusions: Colombia's strategy to vaccinate older adults against COVID-19 has avoided mortality for this age group from being 48.0% higher than what was observed during the study period. Even more lives have been saved when taking into account the parameters that were defined and the omission of the contribution from partial vaccinations., Competing Interests: Competing interests: All the authors worked at the Ministry of Health and Social Protection. FRG is the Colombian Minister of Health. Authors do not have other conflicts of interest to declare., (Copyright: © 2022 Rojas-Botero ML et al.)

Objectives: To explore the experiences of irregular (undocumented) Venezuelan migrants in accessing prenatal health services in Colombia and to examine the economic, social, and cultural resources mobilized by them to gain access to care., Methods: Data was retrieved from the qualitative component of a multi-method research conducted with pregnant immigrants in Barranquilla, Colombia, between 2018 and 2019, and triangulated with a review of regulations established by the Ministry of Health and Social Protection., Results: Having limited economic capital, participants use social capital from personal networks and migrant organizations. They obtain cultural health capital in the form of information on the health system and use their cultural competencies to interact with this system., Conclusions for Practice: Migrants exert their agency through the use of capitals, although with certain constraints. Policies aimed at this social group should consider the strengths of migrants.

Objective: The present study aimed to determine the association between chronic exposure to fine particulate matter (PM 2.5 ), sociodemographic aspects, and health conditions with COVID-19 mortality in Colombia., Methods: We performed an ecological study using data at the municipality level. We used COVID-19 data obtained from government public reports up to and including July 17th, 2020. We defined PM 2.5 long-term exposure as the 2014-2018 average of the estimated concentrations at municipalities obtained from the Copernicus Atmospheric Monitoring Service Reanalysis (CAMSRA) model. We fitted a logit-negative binomial hurdle model for the mortality rate adjusting for sociodemographic and health conditions., Results: Estimated mortality rate ratios (MRR) for long-term average PM 2.5 were not statistically significant in either of the two components of the hurdle model (i.e., the likelihood of reporting at least one death or the count of fatal cases). We found that having 10% or more of the population over 65 years of age (MRR = 3.91 95%CI 2.24-6.81), the poverty index (MRR = 1.03 95%CI 1.01-1.05), and the prevalence of hypertension over 6% (MRR = 1.32 95%CI1.03-1.68) are the main factors associated with death rate at the municipality level. Having higher hospital beds capacity is inversely correlated to mortality., Conclusions: There was no evidence of an association between long-term exposure to PM 2.5 and COVID-19 mortality rate at the municipality level in Colombia. Demographics, health system capacity, and social conditions did have evidence of an ecological effect on COVID-19 mortality. The use of model-based estimations of long-term PM 2.5 exposure includes an undetermined level of uncertainty in the results, and therefore they should be interpreted as preliminary evidence., Competing Interests: Declaration of competing interest The authors have no conflicts of interest relevant to this article to declare., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Despite the positive response of Colombia's health system to the arrival of Venezuelan migrants, the new challenges that accompany the COVID-19 pandemic have triggered a closed-borders response that runs the risk of encouraging a negative view of migrants and increasing their health risks. This manuscript discusses the recommendations that could be proposed in the case of a country with limited resources such as Colombia to respond to the needs of the Venezuelan mixed migrant flows.

Women are primarily exposed to mercury through the consumption of fish contaminated by gold mining activities. The main systems affected are the central nervous and renal systems, although effects on the reproductive system have also been found. Objective : To explore the relationship between mercury levels in women and their possible sources of contamination. A cross-sectional study was conducted from 2013 to 2015 with women residing in 11 municipalities in La Mojana, Colombia, using non-random sampling. Standardized instruments were used to identify sociodemographic characteristics, mercury use, mining-related activities, water and fish consumption, and other factors. Blood, urine, and hair samples were taken to quantify mercury levels. A logistic regression model was used to identify factors associated with elevated mercury values in the participants' samples. A total of 428 women were included, with an average age of 36.7 ± 16.7 years, 3.3% of whom were pregnant at the time of the survey and 8.4% of whom were exposed occupationally. High levels of mercury were present in 62.8% of the women, in any one of the three samples processed. Those exposed occupationally and environmentally had similar values ( p = 0.821). Frequency of fish consumption and source of drinking water were associated with higher levels of mercury ( p < 0.05).

Backgrounds : The signing of the peace accords in Colombia created challenges that are inherent to post-conflict transitions. One of those is the process of reintegrating ex-combatants into society, in which ensuring their rights to health is a particularly significant challenge in rural areas affected by armed conflict. These areas, known as Territorial Spaces for Training and Reintegration (ETCR, in Spanish), are geographically dispersed throughout 24 municipalities and 13 departments in Colombia. This study aimed to describe how ex-combatants in ETCR regions perceived access to health services one year after the signing of the peace accords. Methods: A descriptive, cross-sectional study was performed between September and October 2018. It included 591 adults and their families, from 23 ETCRs. The study was designed, culturally validated, and piloted. Interviewers were trained and a structured survey was administered containing five dimensions that characterized the perception of effective access to health services. Results : The majority of interviewees were women, heads of household, young adults, ex-combatants, and residents in an ETCR. In total of 96.4% were enrolled in Colombia's subsidized health system, and 20.8% indicated that a member of their household required emergency health services. The regional health center provided the majority of the services. Most of those surveyed (96.0%) reported that they did not have to pay for the services, and that they received respectful (91.6%) and good quality (66.6%) care. There were few referrals to disease prevention and health promotion activities, and only 19.0% of households reported having been visited by extramural health care teams, whose activities were highly valued (80%). Lastly, there was little knowledge about community health activities. Conclusions : While residents of ETCR regions have a favorable perception of their access to health services, they need to be made aware of extramural and public health activities., Competing Interests: No competing interests were disclosed., (Copyright: © 2019 Fernández-Niño JA et al.)

Homicides are currently the third leading cause of death among young adults, and an increase has been reported during holidays. The aim of the present study was to explore whether an association exists between Carnival in Barranquilla, Colombia, and an increase in homicides in the city. We used mortality records to identify the number of daily homicides of men and women throughout the week of Carnival, and we compared those with records from all of standard days between 1 January 2005 and 31 December 2015. Conditional fixed-effects models were used, stratified by time and adjusted by weather variables. The average number of homicides on Carnival days was found to be higher than on a standard day, with an OR of 2.34 (CI 95%: 1.19-4.58) for the occurrence of at least one male homicide per day during Carnival, and 1.22 (CI 95%: 1.22-7.36) for female homicides, adjusted by weather variables. The occurrence of homicides during Carnival was observed and was similar to findings for other holidays. Given that violence is a multifactorial phenomenon, the identification of the factors involved serves as a basis for evaluating whether current strategies have a positive effect on controlling it.

In Colombia, the inhabitants of the Mojana region have historically been subjected to high levels of environmental and occupational exposure to mercury; however, there are few robust data on the magnitude of this exposure and associated factors. This study aimed to describe the levels of mercury in the workers and inhabitants in this region, and to identify the main sociodemographic and occupational factors that are associated with this exposure. A cross-sectional study was conducted, in which mercury levels were determined in biological samples (blood, urine, hair) from 1119 people in the Mojana region. A questionnaire was also administered, which was adapted from the Global Mercury Assessment. Linear regression models were adjusted for the natural logarithm of mercury levels in blood, urine, and hair, using the factors that were explored as independent variables. The study reports high mercury levels in 35.0% of blood samples (95% CI 31.9⁻38.1%), 28.8% (95% CI 24.9⁻32.8%) of urine samples, and 56.3% (95% CI 53.1⁻59.5%) of hair samples. The reported source of water for consumption was associated with high levels of mercury ( p -value < 0.05). We provide evidence of high levels of mercury exposure for the population in the Mojana region.

Few studies have been conducted on the effect of air pollution on morbidity in Latin America. This study analyzed the effects of air pollution on respiratory and circulatory morbidity in four major cities in Colombia. An ecological time-series analysis was conducted with pollution data from air quality monitoring networks and information on emergency department visits between 2011 and 2014. Daily 24-h averages were calculated for NO₂, PM 10 , PM 2.5 , and SO₂ as well as 8-h averages for CO and O₃. Separate time-series were constructed by disease group and pollutant. Conditional negative binomial regression models were used with average population effects. Effects were calculated for the same day and were adjusted for weather conditions, age groups, and their interactions. The results showed that effects of some of the pollutants differed among the cities. For NO₂, PM 10 , and PM 2.5 , the multi-city models showed greater and statistically significant percentage increases in emergency department visits for respiratory diseases, particularly for the 5 to 9-year-old age group. These same pollutants also significantly affected the rate of emergency department visits for circulatory diseases, especially for the group of persons over 60 years of age.

Historically, seasonal variations in suicide rates were thought to be associated with changes in weather. Most of this evidence however, is based on studies that were conducted in developed countries that are located outside the tropics. As such, it is necessary to examine this association in developing countries, such as Colombia, which do not experience marked seasons. In addition, it is important to adjust for the effect of holidays when analyzing this association as they have been reported to be a relevant confounding factor. Our objective was to estimate the association between daily suicide incidence among men and women in five major Colombian cities (Bogotá, Medellin, Cali, Barranquilla, and Bucaramanga) and daily temperature and rainfall. For this purpose, we conducted a multi-city, multi-temporal ecological study from 2005 to 2015, using data from the suicide mortality registries (provided by the National Administrative Department of Statistics). Daily measurements of the two weather variables were obtained from the official historical registry of the meteorological station at each city airport. We used these data to estimate conditional Poisson models for daily suicide counts, stratifying by sex and adjusting for holidays. Although we found that none of the weather variable estimators could reject the null hypothesis, we uncovered an association between suicide incidence and long weekends in the total suicide model (Incidence Rate Ratio (IRR): 1.19, 95% confidence interval (CI): 1.04⁻1.23). We found no evidence of association between weather variables and suicide in Colombia. Our study is based on daily observations and it provides evidence of absence of this association in a tropical country that does not experience marked seasons.

Introduction: Regression modeling is a statistical method commonly used in health research, especially by observational studies. Objective: The objectives of this paper were to 1) determine the frequency of reporting of regression modeling in original biomedical and public health articles that were published in Biomédica between 2000 and 2017; 2) describe the parameters used in the statistical models, and 3) describe the quality of the information reported by the studies to explain the statistical analyses. Materials and methods: We conducted a critical assessment review of all original articles published in Biomédica between 2000 and 2017 that used regression models for the statistical analysis of the studies main objectives. We generated a 20-item checklist based on four good practice guidelines for the presentation of statistical methods. Results: Most of the studies were observational studies related to public health sciences (65.7%). Less than half (37.2%) of them reported using a combination of conceptual frameworks and statistical criteria for the selection of variables to be included in the regression model. Less than one quarter (22.1%) reported the verification of the assumptions of the model. The most frequently used uncertainty measure was the p-value (73.5%). Conclusion: There are significant limitations in the quality of the reports of statistical regression models, which reviewers and readers need in order to correctly assess and interpret the statistical models. The results, herein, are provided as an invitation to researchers, reviewers, and editors of biomedical journals to develop, promote, and control an appropriate culture for statistical analysis and reporting in Colombia.

Background: Recent epidemiological studies have suggested that air pollution could be associated with suicide. However, other studies have criticized these results for being analytically weak and not taking into account potential confounding factors. As such, further studies examining the relationship under diverse contexts are necessary to help clarify this issue. This study explored the association between specific air pollutants (NO 2 , SO 2 , PM 10 , PM 2.5 , CO and O 3 ) and suicide incidence in four Colombian cities after adjusting for climatic variables and holidays., Methods: A time series of daily suicides among men and women living in Bogota, Medellin, Cali and Bucaramanga was generated using information from the National Administrative Department of Statistics (DANE) for the years 2011-2014. At the same time, the average daily concentration of each air pollutant for each city was obtained from monitoring stations belonging to the National Air Quality Surveillance System. Using this information together, we generated conditional Poisson models (stratified by day, month and year) for the suicide rate in men and women, with air pollutants as the principal explanatory variable. These models were adjusted for temperature, relative humidity, precipitation and holidays., Results: No association was found between any of the examined pollutants and suicide: NO 2 (IRR:0.99, 95% CI: 0.95-1.04), SO 2 (IRR:0.99, 95% CI: 0.98-1.01), PM 10 (IRR:0.99, 95% CI:0.95-1.03), PM 2.5 (IRR:1.01, 95% CI: 0.98-1.05), CO (IRR:1.00, 95% CI:1.00-1.00) and O 3 (IRR: 1.00, 95% CI: 0.96-1.04). In the same way, no association was found in stratified models by sex and age group neither in lagged and cumulative effects models., Conclusions: After adjusting for major confounding factors, we found no statistically significant association between air pollution and suicide in Colombia. These "negative" results provide further insight into the current discussion regarding the existence of such a relationship.

Social capital is considered a structural determinant of social development and wellbeing. Its cognitive component assesses the degree of confidence of the population in their systems for social organization, as well as community interactions to coordinate social responses to social problems. There are few available scales for measuring this construct. This work presents the adaptation to Spanish and psychometric validation of a scale for measuring social capital in a rural setting. The Wang Social Cognitive Scale was also adapted to Spanish. 1200 questionnaires were applied to adults in 12 villages of the municipality of Tierra Alta, (Colombia) recruited by random sampling. Factor analysis of the scale was performed based on a polychoric correlation matrix. Exploratory factor analysis suggests the existence of two principal factors distributed as follows: 7 items for factor 1, trust (eigenvalue 3.23) and 2 items, for factor 2, distrust (eigenvalue 1.40). As observed by Wang, Q9 and Q10 could be ambiguous questions which do not contribute enough to either of the factors. The first factor validation to Spanish language of the Wang Social Capital Scale is presented in the social context of rural Colombia.