Dengue is an arboviral disease of major public health relevance in Colombia, where recurrent endemic-epidemic transmission intersects with climatic variability, urbanization, population mobility, co-circulation of viral serotypes and lineages, seasonal healthcare pressure, and substantial direct and indirect costs. Although dengue prevention and response in Colombia include epidemiological surveillance, clinical diagnosis, management of warning signs, vector-control activities, outbreak response, and assessment of preventive interventions, these components may be implemented unevenly across territories and may remain insufficiently integrated with health system planning, operational readiness, and economic risk assessment. This technical report proposes an evidence-informed conceptual preparedness framework for dengue in Colombia. The framework was developed through a structured narrative synthesis of peer-reviewed evidence, preparedness-oriented guidance, and Colombia-specific epidemiological, clinical, operational, and health system considerations. It is intended to complement, rather than replace, existing dengue surveillance, prevention, and response strategies by organizing decision points across five interrelated domains: surveillance-to-action, risk-stratified clinical triage, adaptive vector control, contextual vaccination assessment, and healthcare response capacity. A cross-cutting economic risk-mapping component is included to identify relevant cost domains and potential pathways of preventable burden related to outpatient care, hospitalization, productivity loss, outbreak response, severe disease, and healthcare service saturation, without constituting a formal economic evaluation. The framework emphasizes territorial prioritization, timely translation of risk signals into action, early recognition of patients at risk of progression, alignment between community-based interventions and healthcare capacity, and contextual assessment of emerging tools such as tetravalent dengue vaccines and Wolbachia-based vector strategies. It also recognizes implementation constraints, including data interoperability, laboratory and genomic capacity, workforce availability, territorial inequities, financing, pharmacovigilance, governance, and feasibility of local adoption. Future evaluation should assess operational indicators such as signal-to-alert time, triage performance, severe dengue incidence, hospitalization, healthcare resource utilization, stock availability, equity, and cost-effectiveness. In heterogeneous endemic settings, this conceptual framework may support more coordinated dengue preparedness; however, its operational usefulness, economic value, scalability, and policy relevance require stakeholder validation, territorial adaptation, pilot implementation, and prospective evaluation.
The Valle del Cauca region of Colombia is the homeland of the Hartón del Valle (HV) breed, which has been adapted to lowland tropical conditions for more than 500 years. The Lucerna breed is a Colombian synthetic breed composed of 40% Holstein, 30% Shorthorn and 30% HV. Therefore, this study examined the genetic diversity, admixture, and relationships of the Lucerna breed. Information was collected from the farms where the breed originated: El Hatico Nature Reserve and Hacienda Lucerna. Additionally, the HV conservation nucleus (CN) at the National University of Colombia in Palmira was included for comparison and to assess the status of the CN. Genealogical information was collected from 9,526 Lucerna and 64 HV individuals. DNA was extracted from 94 Lucerna and 10 HV animals. The GGP-Bovine 100 K chip was used, quality control was applied (Excluding SNPs with a MAF < 0.05 and missing data > 0.05), to estimate minor allele frequencies (MAF) and LD. ROH fragments, Ne, heterozygosity and Fis were estimated, PCA analysis, population structuring by Fst. Admixture (K = 2 to 12) and Treemix between breeds and with additional information from other breeds. The average MAF was 0.31 for Lucerna and 0.28 in HV-CN. The observed and expected heterozygosity was higher in Lucerna. The average ROH coverage was 8.43% for HV-CN and 7.00% for Lucerna, with a higher proportion of recent autozygosity in both breeds. Finally, genetic diversity was lower in HV-CN than in Lucerna, which coincides with FAO reports. Analyses show that Lucerna has its own genomic profile.
Iron deficiency and hemoglobinopathies significantly impact public health, affecting morbidity, mortality, and quality of life. Their prevalence and consequences vary across populations, with Afro-descendant communities being of particular interest due to unique genetic, socioeconomic, and cultural factors. Subclinical iron deficiency, may go unnoticed in these populations, contributing to adverse health outcomes. This study aimed to determine the presence of iron deficiency, anemia, and hemoglobinopathies in Afro-descendant Populations of Colombia's Pacific coast. This descriptive, cross-sectional study included 198 Afro-descendant adults, both men and women, recruited through convenience sampling from various healthcare centers in the Pacific region. All participants provided written informed consent prior to enrollment. Blood samples were analyzed for total hemoglobin, ferritin levels, and hemoglobin variants. Only 18.1% of participants reported a previous anemia diagnosis. Low hemoglobin was found in 23.2% of participants, ferritin deficiency in 49%, and 33.8% presented subclinical iron deficiency (low ferritin with normal Hb). Hemoglobin variants were identified in 17% of participants: Hb AS 4.5%, Hb AC 3%, and HbSS 0.5%. Hemoglobin variants were significantly associated with low hemoglobin (OR = 10.6; 95% CI: 4.7-24.4; p < 0.001), as were low ferritin levels (OR = 2.32; 95% CI: 1.17 - 4.50; p = 0.01). The high frequency of subclinical iron deficiency, anemia, and hemoglobinopathies in this population highlights the urgent need for strategies focusing on prevention, early diagnosis, genetic counseling, and comprehensive health management in Afro-descendant populations.
El sistema general de seguridad social en salud (SGSSS) colombiano atraviesa una de las crisis más profundas desde la implementación de la Ley 100 de 1993. Las dificultades actuales en el acceso oportuno a los servicios de salud, la creciente desfinanciación de múltiples actores del sistema, la intervención y liquidación de aseguradoras, el deterioro de la capacidad operativa de numerosas instituciones prestadoras, y la insatisfacción de pacientes y trabajadores de la salud (1) evidencian la necesidad de un amplio acuerdo social que permita reconstruir la confianza y garantizar la sostenibilidad del sistema.
estimar la prevalencia de infección por virus de la hepatitis B (VHB), virus de la hepatitis C (VHC) y virus linfotrópico humano de células T tipo 1 (HTLV-1) mediante panel ampliado en mujeres embarazadas atendidas en dos ciudades de Colombia, 2024-2025, y describir la clasificación serológica obtenida con el triple panel para VHB. Materiales y métodos: estudio transversal descriptivo realizado en mujeres embarazadas atendidas en tres instituciones de primer nivel de Cali y Buenaventura entre el 1 de junio de 2024 y el 30 de junio de 2025. La selección se hizo mediante muestreo consecutivo. Se aplicó el panel ampliado, que incluyó antígeno de superficie del VHB, anticuerpos contra el antígeno de superficie y contra el núcleo total, anticuerpos contra VHC con confirmación mediante ARN viral, y anticuerpos contra HTLV-1 con confirmación por Western Blot. Se realizó análisis descriptivo y se estimó la prevalencia de periodo. se evaluaron 320 mujeres para criterios de elegibilidad; 305 firmaron consentimiento informado, respondieron un cuestionario estructurado, tuvieron muestras completas y fueron incluidas en el análisis final. La mediana de edad fue de 26 años y la mediana de edad gestacional de 22 semanas. La prevalencia de HTLV-1 fue de 1,6 % y la infección activa por virus de la hepatitis C del 0,7 %. Para el virus de la hepatitis B la prevalencia de infección aguda fue del 0,3 %, y para la infección crónica reagudizada fue del 0,7 %. El 70,25 % eran mujeres susceptibles de la infección, 84 con inmunidad atribuible a vacunación (27,5 %) y 4 con infección resuelta (1,3 %). la alta susceptibilidad a la infección VHB es un problema que debería ser abordado desde una política pública que tenga en cuenta la revisión del estado vacunal y la vacunación durante el control prenatal. Se requieren estudios de implementación que evalúen la factibilidad, aceptabilidad, costo-efectividad e impacto clínico y programático del panel ampliado para VHB, VHC y HTLV-1 en la atención prenatal.
A promising sustainable strategy for reducing arbovirus transmission by the mosquito vector Aedes aegypti is the deployment of individuals transinfected with Wolbachia pipientis, a bacterium that inhibits replication of viruses such as dengue and is being used in population replacement programs aimed at blocking Aedes-borne virus transmission. Between 2017 and 2022, the World Mosquito Program released Ae. aegypti infected with the wMel Wolbachia strain throughout Medellín, Colombia. Long-term Wolbachia surveillance following population replacement requires approaches that balance accuracy and cost while providing reliable information regarding infection persistence in targeted populations. Therefore, we assessed current Wolbachia prevalence in Ae. aegypti, surveying five comunas (geographic administrative units) of Medellín spanning ~32.66 km, using ovitrap collections and field sampling of adult mosquitoes and assessed Wolbachia infection using conventional PCR and quantitative PCR (qPCR) in pooled and individual samples. We found that Wolbachia infection remains widespread across the surveyed areas, with estimated infection frequencies ranging from ~60% to near fixation depending on sampling strategy and molecular detection method. Screening pooled adults emerging from ovitraps using conventional PCR provided a cost-effective method for confirming Wolbachia persistence across sites, whereas qPCR of individual field-captured adults provided more sensitive estimates of infection prevalence. Our results suggest that Wolbachia is broadly established in Ae. aegypti populations in the surveyed areas and demonstrate practical approaches for the long-term surveillance of Wolbachia-based vector control programs.
A previously healthy woman developed acute painless left-eye vision loss after travelling to Colombia, with recent febrile episodes and kitten exposure. Examination showed left neuroretinitis with papilledema and macular star. Bartonella henselae serology confirmed diagnosis. Treatment with doxycycline and rifampicin led to a gradual and complete visual recovery.
describir la práctica de automedicación en el embarazo en gestantes atendidas en la Clínica Maternidad Rafael Calvo entre junio de 2023 y febrero de 2024. Metodología: estudio de corte transversal. Se incluyeron mujeres gestantes mayores de 14 años, recibidas en atención ambulatoria u hospitalización, entre junio de 2023 y febrero de 2024, en una institución de atención maternoinfantil de referencia, ubicada Cartagena (Colombia). Se aplicó un cuestionario basado en el Medication-Related Outcome Expectancies Scale for Self-Medicating, y en la encuesta desarrollada por la Universidad de Mizan-Tepi de Etiopía. Se evaluaron las variables sociodemográficas y la práctica de automedicación durante el embarazo, donde se obtuvo información sobre el tipo de medicamentos utilizados, así como los conocimientos y las actitudes frente al uso de medicamentos y la automedicación en gestantes. Se hizo análisis descriptivo. De 356 pacientes encuestadas, 258 (72,5 %) gestantes practicaban la automedicación con medicina moderna durante el embarazo actual; el 28,7 % refirió la experiencia previa con el fármaco como motivo principal. El síntoma que con mayor frecuencia llevó a la automedicación fue la cefalea, reportada por 164 (63,3 %) de las encuestadas, y el fármaco más utilizado para su control fue el acetaminofén, en 164 (64,3 %); el 23,8 % de las participantes afirmaron haberse automedicado con medicina natural. Es necesario identificar prácticas de automedicación en el control prenatal e informar a las pacientes sobre el riesgo de estas. Es importante realizar estudios de base poblacional para hacer una mejor aproximación a la frecuencia de esta práctica en el país.
Household locations of pedestrian injuries and fatalities are disproportionately concentrated in lower socioeconomic neighborhoods, reflecting deep-rooted disparities in urban infrastructure, pedestrian exposure, and traffic safety. This study analyzes the relationship between socioeconomic levels and pedestrian incidents in Cali, Colombia, focusing on both the residential locations of injured individuals and the physical locations of fatalities. By separately examining injury residences and fatality locations, we begin to investigate how socioeconomic disparities influence both who is affected and where incidents occur. Residential injury data (2009-2010) and pedestrian fatality data (2008-2010) were analyzed using spatial mapping and Poisson regression modeling. Our preliminary findings reveal individuals injured in pedestrian incidents predominantly reside in lower socioeconomic neighborhoods, where inadequate infrastructure and increased exposure to traffic hazards are likely contributing factors. In contrast, fatal incidents tend to cluster in specific high-risk zones, particularly in middle-high socioeconomic neighborhoods characterized by dangerous road conditions and high vehicle speeds. Poisson regression identified socioeconomic levels and proximity to health centers were significant predictors of pedestrian fatalities, while road and population density showed weaker or nonsignificant associations. These findings provide an initial foundation for hypothesis generation and future research on urban safety disparities. They suggest socioeconomic context and access-related infrastructure together influence pedestrian risk, underscoring the need to integrate equity-focused and built-environment strategies into pedestrian safety planning and policy. By examining both socioeconomic context and physical risk, this study offers early, but critical insights for creating safer, more equitable urban environments.
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[This corrects the article DOI: 10.3389/fonc.2026.1831845.].
This multicenter cross-sectional study evaluated the prevalence and variables statistically associated with primary and post-treatment apical periodontitis (AP) in subjects from eight Hispanic American countries. Digital panoramic radiographs from subjects living in Argentina, Colombia, Ecuador, Guatemala, Mexico, Dominican Republic, Uruguay and Venezuela were analyzed. Teeth were evaluated for diverse factors, including the periapical status and presence of root canal treatment, caries, coronal restoration, intraradicular post, root resorption and periodontal involvement. Quality of root canal treatment and coronal restorations was also recorded. Associations between these diverse variables and AP were evaluated using chi-square tests and multivariable mixed-effects logistic regression with a random intercept for patient to account for within-patient clustering of teeth. Overall, 11 850 subjects (294 662 teeth) were included; 51.5% of the subjects and 5.5% of the examined teeth had AP. Ecuador (62%) and Argentina (61%) had the highest AP prevalence per subject, whereas Mexico had the lowest (37%). Intermediate values were observed in Venezuela (57%), Guatemala (57%), Colombia (47%), Dominican Republic (46%) and Uruguay (45%). In general, 43% of the subjects had at least one root canal-treated tooth. Primary and post-treatment AP were observed in 3% and 42% of the teeth, respectively. Of the teeth with primary AP, 51% showed coronal restorations, and 32% had caries. Post-treatment AP was significantly associated with inadequate root canal fillings, inadequate coronal restorations and inadequate intraradicular posts (p < 0.05). The prevalence of AP in the Hispanic American countries evaluated was high, affecting nearly half of the population. Post-treatment AP was highly prevalent and predominantly linked to inadequate root canal fillings, deficient or absent coronal restorations and intraradicular posts. These findings emphasize the importance of strengthening caries prevention strategies and improving the quality of endodontic and restorative care to reduce the burden of apical periodontitis in these regions.
Adolescent involvement in mental health prevention research remains limited in low-resource settings. This study examined the feasibility, acceptability, processes and perceived impacts of adolescent advisory groups (AAGs) within the ALIVE research in Colombia, Nepal and South Africa. Using a convergent mixed-methods design, we analysed data collected between October 2022 and August 2025 using surveys with adolescents (t1: n = 33; t2: n = 26), focus group discussions (n = 6 with adolescents; n = 2 with caregivers), interviews (n = 8 with adolescents; n = 5 with facilitators), process documents (n = 58) and post-session feedback (n = 7). Participation was highly valued by most adolescents, who were motivated by altruism, peer connection, skill development and project incentives. Most adolescents strongly agreed they could express their views freely (t1: 79%; t2: 81%) and felt listened to (t1:76%; t2: 81%, respectively). Participants reported experiences of trust, confidence and collective agency; challenges included stigma, unequal participation and logistical barriers. Facilitators' relational and adaptive support appeared central to sustaining engagement. Adolescent members contributed in important ways to the ALIVE research. Adolescent involvement in prevention research in low-resource settings is feasible and can be experienced by participants as valuable.
This study identifies and explores literature evidence on the effects of public-private partnerships in health systems on health inequities in Latin America. For this purpose, a scoping review was conducted following the Joanna Briggs Institute and PRISMA-ScR guidelines, employing the methodological steps of: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) data charting; and (5) collating, summarizing and reporting the results. Study analysis focused on the health systems of Argentina, Brazil, Chile, Colombia, Cuba, Ecuador, Mexico, Peru, and Uruguay, emphasizing financing, coverage, supply, and access. Initial bibliographic search identified 2,596 studies published on the topic between 2002 and 2024, of which 102 were included in this review. All analyzed studies reveal that the nature of public-private relations within Latin American health systems reinforces structural inequalities expressed in various dimensions which require context-appropriate policies, including sufficient financing, strengthening private sector regulation, and redistribution of resources and services that follow the geographical logic of social and health needs. In this context, overcoming the segmentation of coverage and access in favor of universalizing services and consolidating the right to health is essential.
Glioblastoma multiforme (GBM) is an aggressive primary brain tumor associated with poor prognosis, rapid functional decline, and psychological distress. An updated review of the literature is lacking, despite that patients with GBM appear to be among the highest risk for suicide among cancer patients. This review summarizes up-to-date evidence of suicide risk factors, screening approaches, and suicide mitigation strategies in patients with GBM. Suicide risk is the highest in the first year following GBM diagnosis. It is also associated with older age, male gender, and tumor-related factors such as supratentorial location. Other factors such as neurocognitive decline and poor functional status may also contribute. Evidence emerging from broader oncology populations suggests that demoralization and existential distress may be factors, though these have not been studied in GBM cohorts. Treatment-related psychiatric adverse effects from corticosteroids, anti-epileptic drugs, chemotherapy, and radiotherapy may also influence psychiatric illness and mediate suicide risk. Screening tools such as the Patient Health Questionnaire-9, Hospital Anxiety and Depression Scale, and Colombia-Suicide Severity Rating Scale have been effectively used to screen for suicide in conjunction with clinical interviewing in GBM patients. Evidence-based suicide reduction interventions include psychotherapy, safety planning, lethal means restriction, and caregiver support. GBM is a diagnosis that is associated with higher rates of suicide than almost all other cancers, and the extant literature identifies demographic and tumor features that are associated with suicide in this population. Effective interventions exist to identify and support these patients. Future studies should systematically measure risk factors identified in broader oncology populations to identify additional GBM-specific risk factors for suicide.
Canine transmissible venereal tumor (CTVT) is a naturally occurring transmissible cancer and an important model in comparative oncology due to its immune evasion mechanisms and tumor-host interactions. Although CTVT usually responds favorably to chemotherapy, variations in tumor behavior suggest the involvement of inflammatory and molecular pathways. CXCL8 is a key mediator of inflammation and immune modulation, whereas the biological significance of TP53 intronic polymorphic loci in CTVT remains poorly understood. CTVT samples from dogs in Colombia and Brazil were evaluated for CXCL8 and P53 expression by immunohistochemistry. Polymorphic loci were investigated by Sanger sequencing followed by MUSCLE alignment, genomic remapping, and comparative analysis against canine TP53 reference sequences and previously published canine transmissible tumor genomic datasets. Tumor-associated CD8 + T-cell infiltration was assessed by flow cytometry. Associations among polymorphic loci, inflammatory biomarkers, cytomorphological features, and histopathological parameters were analyzed. High CXCL8 immunoreactivity was observed in tumor cells and was significantly associated with increased cellular cannibalism. Three TP53 polymorphic loci were identified within an intronic/non-coding region relative to the canine reference sequence KJ511265.1. Two loci showed concordance with previously reported high-confidence (PASS) variants. Tumors harboring polymorphic loci showed increased neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, CD8 + T-cell infiltration, and cytomorphological indicators associated with malignancy. CXCL8 appears to play an important role in the inflammatory microenvironment of CTVT. TP53 intronic polymorphic loci may reflect regulatory variability associated with tumor-host interactions, reinforcing the value of CTVT as a comparative oncology model.
Cardiovascular diseases are the leading cause of death worldwide. Taxi drivers constitute a high-risk occupational group due to prolonged sedentary work, extended shifts and chronic stress, beyond traditional cardiovascular risk factors. To describe the prevalence of coronary heart disease (CHD) risk factors and their sociodemographic and occupational associations among taxi drivers in Medellín, Colombia. We conducted a cross-sectional study of 484 taxi drivers recruited citywide. We obtained data using a structured questionnaire on sociodemographic and occupational factors and self-reported diagnoses of hypertension, dyslipidaemia and diabetes. We assessed physical activity with the International Physical Activity Questionnaire, and alcohol and tobacco use with the Alcohol, Smoking and Substance Involvement Screening Test. We estimated prevalences and analysed associations with multiple risk factors using chi-squared test and Poisson regression with a robust error variance. Sedentary lifestyle prevalence was 71%; hypertension 30%; dyslipidaemia 24%; hazardous alcohol use 25%; hazardous tobacco use 14%; and diabetes 10%. Overall, 52% of participants had two or more CHD risk factors. In adjusted models, a higher prevalence of multiple risk factors was observed among drivers with primary education (adjusted prevalence ratio [aPR] = 1.71; 95% CI 1.26-2.32) and secondary education (aPR = 1.43; 95% CI 1.06-1.93), more than 10 years of driving experience (aPR = 1.39; 95% CI 1.09-1.75) and mixed day and night shifts (aPR = 1.18; 95% CI 1.01-1.40), after adjustment for sociodemographic and occupational variables. Taxi drivers in Medellín show a high burden of CHD risk factors, underscoring the need for targeted occupational health interventions addressing modifiable conditions.
Retained surgical foreign bodies are an infrequent but clinically significant complication, associated with considerable morbidity and potential medico-legal implications. Intraluminal location represents an exceptional presentation, with high diagnostic difficulty due to its nonspecific symptoms. We present the case of a male patient in his fourth decade of life with a history of open cholecystectomy who developed intestinal obstruction secondary to an intraluminal textiloma in the distal ileum. The clinical presentation included progressive abdominal pain, vomiting, and absence of bowel movements. Diagnosis was established through abdominal radiography and computed tomography. Laparoscopic management was performed with enterotomy and removal of the foreign body, followed by enterorrhaphy, which was complicated by leakage requiring terminal ileostomy. Textilomas are more frequently associated with emergency surgeries and prolonged procedures, with the pelvic cavity being the most common location (56%). Although magnetic resonance imaging may be useful in complex cases, plain radiography remains a key initial diagnostic tool. Gossypibomas should be considered a cause of mechanical obstruction, requiring prompt management once diagnosed. Intraluminal textilomas should be considered in patients with a prior surgical history and obstructive symptoms. Management should be individualized according to clinical and local conditions. Prevention, through strict counting protocols, the use of radiopaque materials, and effective teamwork, remains the most effective strategy.
The global demographic shift toward an aging population necessitates a critical transformation in healthcare, particularly within Physical and Rehabilitation Medicine (PRM). Older adults frequently present with complex geriatric syndromes, such as frailty, sarcopenia, and cognitive impairment, that demand specialized, multidisciplinary rehabilitation strategies. The present global survey conducted by the International Society of Physical and Rehabilitation Medicine (ISPRM) Special Interest Group (SIG) in Geriatric Rehabilitation identifies systemic and educational gaps in the current PRM landscape. Despite a high clinical caseload of older adults, the majority of PRM practitioners report inadequate residency training in geriatric competencies and cite workforce shortages as primary barriers to care. This article discusses the perspectives and future steps required to elevate geriatric rehabilitation, emphasizing the urgent need for structured academic programs.
Despite national and international commitments to food systems transformation and an increasing adoption of common indicators, no comprehensive targets have been established against which progress can be measured. Here, building on the Food Systems Countdown Initiative framework, we identify existing targets-based on internationally agreed commitments and normative goals-and establish benchmarks-based on empirically derived peer performance reference values at the global, regional and income group levels-for 44 Food Systems Countdown Initiative indicators. We also assess countries' historical progress and the rate of change required to achieve targets and benchmarks over two different timescales. We show that current progress is insufficient to meet 2030 targets and benchmarks at global level. Comparing countries' status to regional and income benchmarks, which are generally less ambitious, yields better performance across indicators and regions, although gaps remain. Achieving most targets and benchmarks by 2050 is possible if countries correct course and accelerate progress, but certain indicators will require considerable investment and intervention.