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Browsing by Author "Aguilera, Ximena"

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Addressing the public health burden of respiratory viruses: the battle against respiratory viruses (BRaVe) initiative
(Future Medicine, 2013) Legrand, Anaïs; Briand, Sylvie; Shindo, Nikki; Brooks, W Abdullah; de Jong, Menno; Farrar, Jeremy; Aguilera, Ximena; Hayden, Frederick
Given the enormous estimated burden of respiratory virus infections worldwide, a substantial number of research priorities exist in order to better understand their epidemiology, pathogenesis, prevention and clinical management across different populations and resource settings. New therapeutics and specific vaccines for noninfluenza respiratory virus infections could provide enormous benefits in reducing the morbidity and mortality associated with these frequent infections and provide the foundation for responding to newly emerging threats. The BRaVe Initiative is a new WHO-led effort to catalyze multidisciplinary research on strategies to prevent and treat medically important respiratory virus infections with the goal of timely integration of scientific advances and technical innovations into public health practice.
Assistive Devices for Older Adults: A Longitudinal Study of Policy Effectiveness, Santiago, Chile, 2014–2016
(2019) Hirmas, Macarena; Olea, Andrea; Matute, Isabel; Delgado, Iris; Aguilera, Ximena; Poffald, Lucy; González, Claudia; Nájera, Manuel; Gómez, María Inés; Gallardo, Ligia; Abusleme, María Teresa; Leppe, Jaime; Mery, Hernán; Recabarren, Eladio; Massad, Cristián; Bustamante, Hernán
INTRODUCTION Population aging is a worldwide phenomenon. It is estimated that by 2050, one of five persons will be aged ≥60 years. In Chile, 15.8% of the population is now aged ≥60 years, and this figure will reach 30.7% by 2050. In 2006, a national program was implemented to provide assistive devices to older adults aged ≥65 years with limited mobility or difficulty performing activities of daily living. To date, there have been no assessments of the program's effectiveness. OBJECTIVE Assess the effectiveness of an assistive devices policy in Chile on improving functional capacity of older adults aged ≥65 years, and beneficiaries' perceptions of the services received, including changes in their quality of life. METHODS This was a before-after longitudinal study. A cohort of 309 persons was recruited, consisting of patients who received care at a public hospital in Santiago, Chile during 2014-2015. They were assessed before delivery of assistive devices, then followed for seven months, with repeated evaluations made in their homes. The following indicators were measured: functional capacity (Tinetti scale and Barthel Index); changes in perceived quality of life related to use of assistive devices; and other sociodemographic, clinical and protocol-compliance variables. A longitudinal analysis of before-after progress was carried out, as well as a description of service delivery and medical followup. RESULTS Sixty-eight percent of those surveyed were women; median age was 74 years, average schooling was 6 years, and 93% had low income (monthly income
Barreras y facilitadores para el control prenatal en adolescentes: resultados de un estudio cualitativo en Chile
(Instituto Nacional de Salud Pública de Mexico, 2013) Poffald, Lucy; Hirmas, Macarena; Aguilera, Ximena; Vega, Jeanette; González, María; Sanhueza, Gabriel
OBJECTIVE: Analyze barriers and facilitators of access to prenatal care in pregnant urban adolescents between 15-19 years of age in Santiago, Chile. MATERIALS AND METHODS: Qualitative study based on grounded theory with 17 adolescent mothers. Eleven semi-structured interviews and one focus group were conducted. RESULT: . The denial and concealment of pregnancy is the main barrier to start the prenatal care in the "delayed access group". This group does not identify facilitators. For maintenance in antenatal care, all participants identified a support figure as a facilitator. Family and social vulnerabilities explain why some adolescents start the prenatal care late. CONCLUSION: The presence of facilitators is crucial for both, the timely entry and the maintenance in antenatal care because they reduce or nullify the effect of barriers. The health system must become a facilitator to accompany adolescents and promote a bond of trust and respect.
Características clínicas y factores pronósticos de la enfermedad meningocóccica: un estudio de serie de casos en Chile durante el brote 2012-2013
(Sociedad Chilena de Infectología, 2015) Matute, Isabel; Olea, Andrea; López, Darío; Loayza, Sergio; Nájera, Manuel; González, Claudia; Poffald, Lucy; Hirmas, Macarena; Delgado, Iris; Pedroni, Elena; Alfaro, Tania; Gormaz, Ana María; Sanhueza, Gabriel; Vial, Pablo; Dabanch, Jeannette; Gallegos, Doris; Aguilera, Ximena
Introduction: Meningococcal disease (MD) is a major global problem because of its case fatality rate and sequels. Since 2012 cases of serogroup W have increased in Chile, with nonspecific clinical presentation, high case fatality rate and serious consequences. Objective: To characterize the evolution and outcome of MD cases between January 2012 and March 2013 in Chile. Material and Methods: Case series considering149 MD cases of 7 regions. A questionnaire was applied and clinical records were reviewed, including individual, agent, clinical course and healthcare process variables. The analysis allowed to obtain estimates of the OR as likelihoodof dying. Results: 51.5% was meningococcemia, the case fatality rate reached 27%, prevailing serogroup W (46.6%). Factors that increased the probability of dying: > age, belonging to indigenous people, having lived a stressful event, having diarrhea, impaired consciousness, cardiovascular symptoms, low oxygen saturation and low Glasgow coma scale score. Discussion: The case fatality rate exceeded normal levels and was higher in serogroup W. Increasing in this serogroup, associated to the increased presence of nonspecific symptoms or rapid progression to septicemia, hit a health system accustomed to more classic meningococcal disease presentation, which could partly explain the observed increased fatality rate.
Carcinoma Hepatocelular y su Epidemiología Internacional
(2023) Massé, Constanza; Saitua, Javiera; Troc, Constanza; Vaccarezza, Valeria; De la Maza, Beatriz; Descalzi, Fernando; Molina, Xaviera; Aguilera, Ximena
El cáncer hepático es una neoplasia maligna del hígado, que se desarrolla generalmente en contexto de una enfermedad hepática crónica. Objetivo: recopilar información relevante respecto a la clínica, diagnóstico y factores de riesgo del hepatocarcinoma y realizar una descripción epidemiológica internacional de la enfermedad. Metodología: diseño descriptivo observacional, basado en fuentes secundarias. Se realiza una revisión bibliográfica a partir de papers, libros y páginas internacionales de epidemiología, desde 1980 hasta 2022. Con respecto al tipo de publicación, no hay criterios de exclusión, pero se le dio preferencia a metaanálisis, revisiones sistemáticas y reviews. Las variables analizadas fueron magnitud, variación en el tiempo, lugar y persona (específicamente sexo y edad). Resultados: se describe la presentación clínica, criterios diagnósticos, factores de riesgo, patogenia, secuelas y letalidad del hepatocarcinoma, y se ve su incidencia, prevalencia y mortalidad a nivel mundial de acuerdo a tiempo, edad, sexo y lugar. Discusión: El hepatocarcinoma es un cáncer que se desarrolla en contexto de enfermedad hepática crónica. Tiene más de una etiología, siendo más frecuente el VHC en hombres y el VHB en mujeres, y es más prevalente en personas de estrato socioeconómico bajo. Si bien existe el screening con ecografía abdominal, el hepatocarcinoma se diagnostica tardíamente. A nivel epidemiológico, se ve que el hepatocarcinoma es poco prevalente, pero con altas tasas de mortalidad. Conclusión: el hepatocarcinoma es un cáncer de alta letalidad, en el cual manejar los factores de riesgo y ampliar el screening podrían disminuir su incidencia y mortalidad.
Case−Control Study of Risk Factors for Meningococcal Disease in Chile
(Centers for Disease Control and Prevention, 2017) Olea, Andrea; Matute, Isabel; Gonzalez, Claudia; Delgado, Iris; Poffald, Lucy; Pedroni, Elena; Alfaro, Tania; Hirmas, Macarena; Nájera, Manuel; Gormaz, Ana; Lopez, Dario; Sergio, Loayza; Ferreccio, Catterina; Gallegos, Doris; Fuentes, Rodrigo; Vial, Pablo; Aguilera, Ximena
An outbreak of meningococcal disease with a case-fatality rate of 30% and caused by predominantly serogroup W of Neisseria meningitidis began in Chile in 2012. This outbreak required a case−control study to assess determinants and risk factors for infection. We identified confirmed cases during January 2012−March 2013 and selected controls by random sampling of the population, matched for age and sex, resulting in 135 case-patients and 618 controls. Sociodemographic variables, habits, and previous illnesses were studied. Analyses yielded adjusted odds ratios as estimators of the probability of disease development. Results indicated that conditions of social vulnerability, such as low income and overcrowding, as well as familial history of this disease and clinical histories, especially chronic diseases and hospitalization for respiratory conditions, increased the probability of illness. Findings should contribute to direction of intersectoral public policies toward a highly vulnerable social group to enable them to improve their living conditions and health.
Compliance with the smoking ban in enclosed, semiopen and open areas of workplaces and public places in Chile
(2020) Peruga, Armando; Molina, Xaviera; Delgado, Iris; Matute, Isabel; Olea, Andrea; Hirmas, Macarena; González, Claudia; Aguilera, Ximena
Objective To assess the national level of compliance with the Chilean comprehensive smoke-free legislation by observing healthcare facilities, education centres, government offices, hospitality venues and private workplaces, by type of area within workplaces and public places: enclosed, semiopen and open. Methodology In this cross-sectional observational study, we studied a national representative sample of 3253 venues obtained through a two-stage cluster sampling design. First, 57 municipalities were randomly selected, proportionally to the total number of venues of interest. Second, within each selected municipality, a maximum of 12 venues of each sector was selected systematically from a list of existing sites. We determined the non-compliance level by estimating the percentage of the visited venues where smoking was observed or suspected in banned areas of the premises. Results Smoking or suspicion thereof was not observed in any enclosed area of any establishment. However, smoking violations were observed in semiopen areas ranging from less than 0.5% of schools and healthcare centres to around 10% of hospitality venues or 23.0% of higher education centres. Smoking violations were also observed in outdoor areas of 6.7% and 1.6% of the health centres and schools, respectively. Discussion The stark contrast in compliance with the smoking ban between the enclosed areas and the semiopen areas may be a consequence of the complex definition of semiopen areas in the regulations. The study also reflects the need to improve the overall enforcement of the smoke-free law, particularly in universities and hospitality venues.
Correlates of compliance with national comprehensive smoke-free laws
(2018) Peruga, Armando; Hayes, Luminita; Aguilera, Ximena; Prasad, Vinayak; Bettcher, Douglas
Objective To explore correlates of high compliance with smoking bans in a cross-sectional data set from the 41 countries with national comprehensive smoke-free laws in 2014 and complete data on compliance and enforcement. Methods Outcome variable: compliance with a national comprehensive smoke-free law in each country was obtained for 2014 from the WHO global report on the global tobacco epidemic. Explanatory variables: legal enforcement requirements, penalties, infrastructure and strategy were obtained through a separate survey of governments. Also, country socioeconomic and demographic characteristics including the level of corruption control were included. Analysis: an initial bivariate analysis determined the significance of each potentially relevant explanatory variable of high compliance. Differences in compliance were tested using the exact logistic regression. Results High compliance with the national comprehensive smoke-free law was associated with the involvement of the local jurisdictions in providing training and/or guidance for inspections (OR=10.3, 95% CI 1.7 to 117.7) and a perception of high corruption control efforts in the country (OR=7.2, 95% CI 1.1 to 85.8). Discussion The results show the importance of the depth of the enforcement infrastructure and effort represented by the degree to which the local government is involved in enforcement. They also show the significance of fighting corruption in the enforcement process, including the attempts of the tobacco industry to undermine the process, to achieve high levels of compliance with the law. The results point out to the need to invest minimal but essential enforcement resources given that national comprehensive smoke-free laws are self-enforcing in many but not all countries and sectors
Descripción de las estrategias de prevención de daño hepático crónico vigentes en Chile
(2023) Descalzi, Fernando; De la Maza, Beatriz; Masse, Constanza; Saitúa, Javiera; Constanza Troc; Vaccarezza, Valeria; Molina, Xaviera; Aguilera, Ximena
Introducción: El carcinoma hepatocelular es la neoplasia maligna primaria del hígado más común. Los factores de riesgo del carcinoma hepatocelular incluyen enfermedad hepática metabólica (particularmente enfermedad del hígado graso no alcohólico), consumo excesivo de alcohol, hepatitis B crónica y hepatitis C, todos siendo prevenibles. A nivel mundial se utilizan múltiples intervenciones para su prevención, sin embargo, actualmente, no existe un documento del Ministerio de Salud que aborde directamente las estrategias de prevención utilizadas en Chile. Objetivos: Revisar y describir las intervenciones usadas en Chile en prevención primaria respecto a las principales etiologías de daño hepático crónico, así como las intervenciones según nivel de prevención secundaria y terciaria. Metodología: Se realizó una revisión bibliográfica tanto de literatura gris nacional como indexada a través de búsqueda sistemática con términos medical subject headings y libres. Resultados: La revisión se desarrolla categorizando la prevención según niveles; primaria, secundaria y terciaria. En la prevención primaria se abarcaron los factores de riesgo del carcinoma hepatocelular. Con respecto a la prevención secundaria, se aborda el diagnóstico y el screening con imágenes, mientras que en la prevención terciaria se describen los tratamientos existentes. Conclusión: A nivel primario, no están descritas medidas para la prevención secundaria y terciaria del daño hepático crónico por alcohol (segunda causa a nivel nacional). A nivel secundario, no existen guías clínicas del Ministerio de Salud que aborden el seguimiento de la cirrosis hepática, además de no encontrarse actualmente dentro de las garantías explícitas de salud.
El deterioro de la tuberculosis en Chile
(2019) Fica, Alberto; Herrera, Tania; Aguilera, Ximena
Background: Recent data suggest an increase in tuberculosis (TB) incidence in Chile. Aim: To evaluate recent epidemiological trends, geographic extension and potential factors associated with TB reemergence in Chile. Material and methods: Data analysis from official sources and trend analysis. Results: TB incidence rate increased from 12.3 (2014) to 14.7 (2017) per 100,000 inhabitants. Morbidity rates also increased in nine out of 15 regions. The proportion of TB cases in specific groups has also increased in the last six years: HIV/AIDS (68%), immigrants (118%), drug users/alcoholics (267%) and homeless people (370%). Several indicators of the national TB program performance have deteriorated including TB case detection, HIV co-infection study and contact tracing activities. Overall results indicate a higher than expected case-fatality ratio (> 3%), high rates of loss from follow-up (> 5%), and low percentage of cohort healing rate (< 90%). This decline is associated with a Control Program with scarce human resources whose central budget decreased by 90% from 2008 to 2014. New molecular diagnostic tools and liquid media culture were only recently implemented. Conclusions: TB trends and overall program performance indicators have deteriorated in recent years in Chile and several factors appear to be involved. Multiple strategies will be required to rectify this situation.
Disease surveillance for the COVID-19 era: time for bold changes
(2021) Morgan, Oliver; Aguilera, Ximena; Ammon, Andrea; Amuasi, John; Fall, Ibrahima; Frieden, Tom; Heymann, David; Ihekweazu, Chikwe; Jeong, Eun-Kyeong; Leung, Gabriel M; Mahon, Barbara; Nkengasong, John; Qamar, Farah Naz; Schuchat, Anne; Wieler, Lothar; Dowell, Scott
The COVID-19 pandemic has exposed weaknesses in disease surveillance in nearly all countries. Early identification of COVID-19 cases and clusters for rapid containment was hampered by inadequate diagnostic capacity, insufficient contact tracing, fragmented data systems, incomplete data insights for public health responders, and suboptimal governance of all these elements. Once SARS-CoV-2 became widespread, interventions to control community transmission were undermined by weak surveillance of cases and insufficient national capacity to integrate data for timely adjustment of public health measures. Although some countries had little or no reliable data, others did not share data consistently with their own populations and with WHO and other multilateral agencies. The emergence of SARS-CoV-2 variants has highlighted inadequate national pathogen genomic sequencing capacities in many countries and led to calls for expanded virus sequencing. However, sequencing without epidemiological and clinical surveillance data is insufficient to show whether new SARS-CoV-2 variants are more transmissible, more lethal, or more capable of evading immunity, including vaccine-induced immunity.
Epidemic preparedness in urban settings: new challenges and opportunities
(2020) Lee, Vernon J.; Ho, Marc; Wen Kai, Chen; Aguilera, Ximena; Heymann, David; Wilder-Smith, Annelies
Estructura y funcionamiento del sistema de salud chileno. Serie de Salud Poblacional N°2
(Universidad del Desarrollo, 2019) Aguilera, Ximena; Castillo, Carla; Covarrubias, Trinidad; Delgado, Iris; Fuentes, Rodrigo; Gómez, María Inés; González, Claudia; Hirmas, Macarena; Matute, Isabel; Olea, Andrea; Quiroga, Anita; Urrejola, Oscar; Soto, Marco; Aguilera, Ximena; Castillo, Carla; Covarrubias, Trinidad; Delgado, Iris; Fuentes, Rodrigo; Gómez, María Inés; González, Claudia; Hirmas, Macarena; Matute, Isabel; Olea, Andrea; Quiroga, Anita; Urrejola, Oscar; Soto, Marco
Con este documento ponemos a su disposición la segunda publicación de la serie Salud Poblacional del Centro de Epidemiología y Políticas de Salud, dedicada en esta oportunidad a entregar una visión global sobre la estructura, organización y funcionamiento del sistema de salud chileno, como una herramienta que permita a los estudiantes comprender su estructura, funciones y complejas interrelaciones.
Evaluación de la infección por VIH en Chile: pronunciamiento del Comité VIH de la Academia Chilena de Medicina
(2020) Wolff R., Marcelo; Pinto C., María Eugenia; Santolaya, María Elena; Aguilera, Ximena; Child, Raquel
The Chilean Academy of Medicine convened a commission to evaluate the status of HIV epidemic and the national response to it, regarding its achievements, gaps and challenges, aiming to recommend actions to optimize assessment quality and national response. This publication summarizes the agreed upon opinion of its members. The epidemic is overwhelmingly sexually transmitted, predominant in homo/bisexual men. Vertical transmission is very low. An increasing number of new diagnoses is occurring, with relative over representation of foreign people lately. There is a legal guarantee of confidentiality, nondiscrimination and treatment for those affected, both in the private and public sector. All public health services have active HIV care units. Modern antiviral drugs and monitoring tests are also available. Despite these clear achievements, insufficient, occasionally inadequate public policies and certain rigid regulations thwart optimal effectivity and efficiency of the programs, contributing to the slow and incomplete compliance with international commitments. Shortcomings worth highlighting are: suboptimal educational and preventive programs directed to youngsters, vulnerable and general population; persistent underdiagnosis of infected population; cumbersome requirements to request and inform diagnostic tests, thus discouraging testing; excessive centralization and long latency of diagnosis confirmation and monitoring tests; incomplete epidemiologic analysis and public reporting of findings; non flexibility and slow updating of therapeutic guidelines; insufficient adaptation of care and drug delivery modalities to patients’ needs; excessive administrative requirements at care centers and restrictive legislation for outcome and interventional clinical research. Recommendations to deal with these issues were proposed.
Evaluation of a novel antigen-based rapid detection test for the diagnosis of SARS-CoV-2 in respiratory samples
(2020) Porte, Lorena; Legarraga, Paulette; Vollrath, Valeska; Aguilera, Ximena; Munita, José; Araos, Rafael; Pizarro, Gabriel; Vial, Pablo; Iruretagoyena, Mirentxu; Dittrich, Sabine; Weitzel, Thomas
Objectives: In the context of the coronavirus disease 2019 (COVID-19) pandemic, the development and validation of rapid and easy-to-perform diagnostic methods are of high priority. This study was performed to evaluate a novel rapid antigen detection test (RDT) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory samples. Methods: The fluorescence immunochromatographic SARS-CoV-2 antigen test (Bioeasy Biotechnology Co., Shenzhen, China) was evaluated using universal transport medium with nasopharyngeal (NP) and oropharyngeal (OP) swabs from suspected COVID-19 cases. Diagnostic accuracy was determined in comparison to SARS-CoV-2 real-time (RT)-PCR. Results: A total of 127 samples were included; 82 were RT-PCR-positive. The median patient age was 38 years, 53.5% were male, and 93.7% were from the first week after symptom onset. Overall sensitivity and specificity were 93.9% (95% confidence interval 86.5-97.4%) and 100% (95% confidence interval 92.1-100%), respectively, with a diagnostic accuracy of 96.1% and Kappa coefficient of 0.9. Sensitivity was significantly higher in samples with high viral loads. Conclusions: The RDT evaluated in this study showed a high sensitivity and specificity in samples mainly obtained during the first week of symptoms and with high viral loads, despite the use of a non-validated sample material. The assay has the potential to become an important tool for early diagnosis of SARS-CoV-2, particularly in situations with limited access to molecular methods.
Evaluation of the effectiveness and equity of the maternity protection reform in Chile from 2000 to 2015
(2019) Delgado, Iris; Cabieses, Báltica; Apablaza, Mauricio; Castillo, Carla; Aguilera, Ximena; Matute, Isabel; Najera, Manuel; Pericás, Juan M.; Benach, Joan
Introduction According to the International Labor Organization, Maternity Protection (MP) policies try to harmonize child care and women’s paid work, without affecting family health and economic security. Chile Law 20.545 (2011) increased benefits for economically active women and reduced requirements for accessing these benefits. The goals of the reform included: 1) to increase MP coverage; and 2) to reduce inequities in access to the benefits. Method This study uses two data sources. First, using individual data routinely collected from 2000 to 2015, yearly MP coverage access over time was calculated. Second, using national representative household surveys collected before and after the Law (2009 and 2013), coverage and a set of measures of inequality were estimated. To compare changes over time, we used non-experimental, before-after intervention design for independent samples. For each variable, we estimated comparative proportions at 95% confidence interval before and after the intervention. Additionally, we included multivariate and propensity score analysis. Results Between 2000 and 2015, MP coverage grew from 24.4% to 44.8%. Using comparable 2009 and 2013 survey data, we observed the same trend, with 31.6% of estimated MP coverage in 2009, escalating to 39.5% in 2013. We conclude that: 1) after the reform, there was an increase in MP coverage; and, 2) there was no significant reduction of inequities in the distribution of MP benefits. Discussion/Conclusion Few scientific evaluations of MP reforms have been conducted worldwide; even fewer including an equity analysis. This study provides an empirically-based evaluation of MP reform from both a population-level and an equity-focused perspective. We conclude that this reform needs to be complemented with other policies to ensure maternity protection in terms of access and equity in a country with deep socioeconomic stratification.
Exposure of 4- year to 24- year olds to tobacco imagery on prime- time Chilean television
(2023) Peruga, Armando; Oscar Urrejola; Delgado, Iris; Matute, María Isabel; Castillo-Laborde, Carla; Molina, Xaviera; Hirmas Adauy, Macarena; Olea, Andrea; González, Claudia; Aguilera, Ximena; Sargent, James
Introduction: The extent of the population's exposure to tobacco imagery across all genres of regular TV programming and the contribution of each of these genres is unknown, except for UK broadcast channels. The objective of this study is to estimate the exposure of young people to tobacco imagery on Chilean prime-time television and the programme source contributing to such exposure. Methods: Programmes aired during 3 weeks in 2019 from the 15 highest audience channels in Chile were content-analysed for the occurrence of tobacco categorised as actual use, implied use, tobacco paraphernalia, tobacco brand appearances and whether they violated Chilean smoke-free law for each 1 min interval (92 639). The exposure of young people to tobacco content was estimated using media viewership figures. Results: Young people received 29, 11 and 4 million tobacco impressions of any type, explicit use and smoke-free violation, respectively, at a rate of 21.8, 8.0 and 2.1 thousand impressions per hour of TV viewing. The main sources of exposure to tobacco impressions were feature films and animated productions, which were almost entirely non-Chilean. Finally, young people were exposed to tobacco brand impressions primarily through films, effectively circumventing the advertising ban in Chile. Discussion: Television programming is a source of significant youth exposure to tobacco imagery, including branding impressions. To conform to the WHO FCTC, Chile should prohibit tobacco branding in any TV programme and require strong anti-tobacco advertisements prior to any TV programme portraying tobacco.
Exposure to tobacco impressions during prime-time TV among Chilean minors by sex and socioeconomic status
(2022) Peruga, Armando; Castillo-Laborde, Carla; Matute, María Isabel; Molina, Xaviera; Urrejola, Oscar; Aguilera, Ximena
Introduction: We tested if tobacco impressions were delivered differentially to prime-time TV watching minors by sex and socioeconomic status. Methods: Programs aired during prime-time for three random weeks in 2019 from the 15 highest audience channels in Chile were content-analyzed for the occurrence of tobacco for each one-minute interval of 92639 recorded. Such occurrences were categorized as actual use and whether they violated Chilean smoke-free law or tobacco brand appearances. We estimated the number of persons per hour (p/h) exposed to tobacco impressions for the 4 to 17 years age group by sex and socioeconomic status (SES). Results: Minors spent over a billion p/h watching TV during the observation period. Minors were exposed to tobacco explicit use, branding and smoke-free violation impressions for 9.7 million, 1.2 million, and 1.0 million p/h, respectively. The odds ratios (OR) of exposure to total tobacco impressions were always greater among boys with higher SES compared to boys with low SES. However, they were greater among girls of low SES compared to those of high SES for all types of impressions. The OR of exposure to tobacco branding was higher among girls of any SES compared to boys of any SES. Conclusions: Minors need protection from tobacco imagery on television, particularly girls of low SES. To that end, new legislation should implement all measures to counter depictions of tobacco in entertainment media, as recommended in the WHO FCTC Article 13 guidelines. This should require strong anti-tobacco advertisements before any TV program portraying tobacco targeting minor audiences, particularly girls of low SES. Given that Chile has one of the highest prevalences in the world of current cigarette smoking among young females, the potential contribution of tobacco impressions on TV to smoking differentials across female socioeconomic groups should be further studied.
Factors influencing neutralizing antibody response to the original SARS-CoV-2 virus and the Omicron variant in a high vaccination coverage country, a population-based study
(2023) Hormazabal, Juan; Nuñez-Franz, Loreto; Rubilar, Paola; Apablaza, Mauricio; Vial Cox, María Cecilia; Cortes Salinas, Lina Jimena; González, Natalia; Vial, Pablo; Said, Macarena; Gonzalez Wiedmaier, Claudia; Olivares, Kathya; Aguilera, Ximena; Ramírez-Santana, Muriel
The study compared immunity to the original SARS-CoV-2 virus (Wuhan) and the Omicron variant using neutralizing antibodies (NAbs), that provide a good approximation of protective immunity. The results might help determine immunization strategies. Design and methods: Unlike previous studies, we analyzed NAbs in a random sample of 110 IgG positive sera from individuals who participated in a population-based seroprevalence transversal study, carried out in May 2022 in two Chilean cities, a country with high vaccination coverage. Results: Our findings indicate that 98.2% of individuals had NAbs against Wuhan, 65.5% against Omicron, and 32.7% tested positive for Wuhan but not Omicron. Factors influencing protective immunity included a prior natural infection and the number of vaccines received. NAbs titers against the original virus were high, demonstrating vaccine effectiveness in the population. However, the level of antibodies decreased when measuring NAbs against Omicron, particularly among older individuals, indicating a decline in vaccine protection. Previous COVID-19 episodes acted as a natural booster, increasing NAbs titers against both virus strains. Conclusions: Protective immunity against the original Wuhan SARS-CoV-2 virus is reduced when compared to Omicron variant. Updating vaccine to target emerging variants and continued monitoring of effectiveness at the population level are necessary.
First wave of SARS-CoV-2 in Santiago Chile: Seroprevalence, asymptomatic infection and infection fatality rate
(2022) Vial, Pablo; González, Claudia; Apablaza, Mauricio; Vial, Cecilia; Lavín, M. Estela; Araos, Rafael; Rubilar, Paola; Icaza, Gloria; Florea, Andrei; Pérez, Claudia; Concha, Paula; Bastías, Diego; Errázuriz, María Paz; Pérez, Ruth; Guzmán, Francisco; Olea, Andrea; Guzmán, Eugenio; Correa, Juan; Munita, José; Aguilera, Ximena
Background: The first wave of SARS-CoV-2 infection in Chile occurred during the cold season reaching a peak by the end of June 2020, with 80 % of the cases concentrated in its capital, Santiago. The main objective of this study was to estimate the attack rate during this first wave of SARS-CoV-2 in a large, densely populated city with more than seven million inhabitants. Since the number of confirmed cases provides biased information due to individuals’ potential self-selection, mostly related to asymptomatic patients and testing access, we measured antibodies against SARS-CoV-2 to assess infection prevalence during the first wave in the city, as well as estimate asymptomatic cases, and infection fatality ratio. To our knowledge this is one of the few population-based cross- sectional serosurvey during the first wave in a highly affected emerging country. The challenges of pandemic response in urban settings in a capital city like Santiago, with heterogeneous subpopulations and high mobility through public transportation, highlight the necessity of more accurate information regarding the first waves of new emerging diseases. Methods: From April 24 to June 21, 2020, 1326 individuals were sampled from a long-standing panel of household representatives of Santiago. Immunochromatographic assays were used to detect IgM and IgG anti-body isotypes. Results: Seroprevalence reached 6.79 % (95 %CI 5.58 %− 8.26 %) in the first 107 days of the pandemic, without significant differences among sex and age groups; this figure indicates an attack rate 2.8 times higher than the one calculated with registered cases. It also changes the fatality rate estimates, from a 2.33 % case fatality rate reported by MOH to an estimated crude 1.00 % (CI95 % 0.97–1.03) infection fatality rate (adjusted for test performance 1.66 % [CI95 % 1.61–1.71]). Most seropositive were symptomatic (81,1 %). Conclusions: Despite the high number of cases registered, mortality rates, and the stress produced over the health system, the vast majority of the people remained susceptible to potential new epidemic waves. We contribute to the understanding of the initial spread of emerging epidemic threats. Consequently, our results provide better information to design early strategies that counterattack new health challenges in urban contexts.

Browsing by Author "Aguilera, Ximena"

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