Browsing by Author "González, Claudia"
Now showing 1 - 17 of 17
Results Per Page
Sort Options
Item Actualización en el diagnóstico y manejo de la Infección Urinaria en pediatría.(2012) Salas, Paulina; Barrera, Patricia; González, Claudia; Zambrano, Pedro; Salgado, Ignacio; Quiroz, Lily; Lillo, Ana María; Hevia, Pilar; Cavagnaro, FelipeLa infección urinaria (ITU) es una de las patologías infecciosas más frecuentes en pediatría. Tradicionalmente se ha considerado como marcador de probables anormalidades anatómicas y funcionales de la vía urinaria, por lo cual, en las últimas décadas todos los niños que presentaban una ITU eran sometidos a estudio por imágenes en busca de cicatrices renales o anormalidades de la vía urinaria. El objetivo de este artículo es actualizar los conceptos sobre el estudio y tratamiento de pacientes pediátricos que presentan una ITU febril. El estudio por imágenes es incómodo para los pacientes, estresante para los padres y las evidencias actuales para continuar realizándolo son limitadas por lo cual debe ser selectivo en orden de focalizar en los pacientes que puedan beneficiarse con cirugías urológicas correctoras o tratamientos médicos adecuados. Estas pautas están basadas en las guías NICE de ITU e intentan demostrar que uno de los pilares más importantes para evitar secuelas renales es el diagnóstico y tratamiento oportuno de las ITU febriles.Item 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, HernánINTRODUCTION 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 incomeItem 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, XimenaIntroduction: 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.Item 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, XimenaObjective 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.Item 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, MarcoCon 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.Publication 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, JamesIntroduction: 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.Item 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, XimenaBackground: 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.Item Health insurance scheme performance and effects on health and health inequalities in Chile(Medical Education Cooperation with Cuba, 2017) Castillo, Carla; Aguilera, Ximena; Hirmas, Macarena; Matute, Isabel; Delgado, Iris; Nájera, Manuel; Olea, Andrea; González, ClaudiaINTRODUCTION Health systems are one determinant of health; their role is to facilitate timely and equitable access to quality services. The way in which a health system is organized can profoundly affect achievement of its objectives. The main feature of the Chilean health system is the coexistence of a public health insurance program (based on a social insurance model) with several market-based private health insurance companies. This hybrid structure provides an interesting framework for analyzing and evaluating the system’s effects on health inequalities. OBJECTIVE Assess Chilean public and private health insurance schemes’ performance and its effects on health inequalities. METHODS Public health insurance was compared with private insurance using indicators from 2013 (or the closest year) in the following domains: inputs, outputs (provider visits, discharges), outcomes (coverage) and impact (on health, quality of life, finances and patient satisfaction) as well as demographic and social determinant indicators. A conceptual framework for measuring health system performance was used. Data were obtained from administrative records and population-based surveys. RESULTS The publicly insured population had greater health care needs, was older (aging index 83.4 vs. 36.5) and poorer (17.2% vs. 1.5% below the poverty line) than the population covered by private insurers. The public insurer received average monthly funding of US$50.94 per beneficiary and spent US$51.43, while private insurers on average collected US$94.79 monthly per beneficiary, and spent US$69.63 on health services (excluding medical leave benefits). Private health insurance beneficiaries were more likely than their publicly insured counterparts to access specialized medical services (18.3% vs. 9.3%) and dentists (11.2% vs. 5.9%), have laboratory tests (18.1% vs. 4.8%), and undergo surgery (7.8% vs. 5.9%). Risk factor and disease prevalence was lower among private insurance beneficiaries for 16 of 18 tracer conditions, although age-adjusted differences were not significant. Finally, incidence of catastrophic spending was slightly lower among private insurance beneficiaries (3.7% vs. 4.2%), and a greater proportion of them were satisfied or very satisfied with the health system (37% vs. 17%). CONCLUSIONS The relative youth and better financial status of beneficiaries of private insurers is compatible with selection for lower risk. While private plans offer greater financial protection and receive higher user satisfaction ratings than the public plan, differences in financing between the two types of insurance affect availability and utilization of services. This constitutes a structural problem for the Chilean health system. There is an urgent need to move toward an integrated health system, in which incentives are aligned with social insurance objectives.Publication Immune response against SARS-CoV-2 of primary healthcare personnel in a commune of Santiago, Chile: follow-up at 6 months(2022) Matute, Isabel; Hirmas, Macarena; González, Claudia; Iruretagoyena, Mirentxu; Munita, José; Pedroni, Elena; Gómez, María; Córtez, L.; Hormazábal, J.; Olea, AndreaBackground The COVID-19 pandemic that emerged in Wuhan, China at the end of 2019, spread rapidly around the world with almost 600 million cases and 6.3 million deaths today. The most affected were health workers with at least three times the risk of contracting the disease than the general community. Most studies on seroprevalence in health workers focus on hospital care establishments and what happens in Primary Health Care (PHC) has not been investigated with the same intensity. Objectives to determine the prevalence and know the variation of antibody titers for SARS-CoV-2 in serial samples of primary healthcare personnel from the commune of La Pintana. Method an analytical observational study with a cross-sectional and a longitudinal component, carried out from November 2020 to June 2021. The first component consisted of an IgG antibody seroprevalence study performed at baseline (time 0) in volunteer of a universe of 900 workers. The longitudinal component considered the monitoring of IgG antibodies in those who presented a positive result at baseline and the analysis of neutralizing antibodies in a random sub-sample of 50% of them. Additionally, sociodemographic and clinical information was collected via a questionnaire. Univariate, bivariate, and longitudinal analyses were performed to evaluate differences in antibodies. The study was approved by the Universidad del Desarrollo’s Scientific Ethics Committee. Results 463 primary healthcare workers participated, mostly women and with a median of 38 years; doctors and nurses represented 9.5% each and 14.7% had a history of COVID-19. The seroprevalence at baseline was 22.3% and was associated with younger age, being a doctor and having been in close contact of a case. IgG titers increased with the vaccine, but decreased over time. At the 6-month follow-up, 76% had neutralizing antibodies. Those belonging to indigenous peoples had higher IgG levels and higher rates of neutralizing antibodies. Conclusion Healthcare workers were highly affected by COVID-19, and the medical profession and younger age were factors associated with increased risk. Antibodies decrease over time, highlighting the importance of follow-up studies, as well as the importance of vaccination boosters in healthcare workers, especially those in PHC.Publication Immunization and SARS-CoV-2 Antibody Seroprevalence in a Country with High Vaccination Coverage: Lessons from Chile(2022) Aguilera, Ximena; González, Claudia; Apablaza, Mauricio; Rubilar, Paola; Icaza, Gloria; Ramírez, Muriel; Pérez, Claudia; Cortes, Lina; Núñez, Loreto; Quezada, Rubén; Castillo, Carla; Correa, Juan; Said, Macarena; Hormazábal, Juan; Vial, Cecilia; Vial, PabloChile is among the most successful nations worldwide in terms of its COVID-19 vaccine rollout. By 31 December 2021, 84.1% of the population was fully vaccinated, and 56.1% received booster doses using different COVID-19 vaccines. In this context, we aimed to estimate the prevalence of anti-SARS-CoV-2 antibodies following the infection and vaccination campaign. Using a three-stage stratified sampling, we performed a population-based cross-sectional serosurvey based on a representative sample of three Chilean cities. Selected participants were blood-sampled on-site and answered a short COVID-19 and vaccination history questionnaire using Wantai SARS-CoV-2 Ab ELISA to determine seroprevalence. We recruited 2198 individuals aged 7-93 between 5 October and 25 November 2021; 2132 individuals received COVID-19 vaccinations (97%), 67 (3.1%) received one dose, 2065 (93.9%) received two doses, and 936 received the booster jab (42.6%). Antibody seroprevalence reached 97.3%, ranging from 40.9% among those not vaccinated to 99.8% in those with booster doses (OR = 674.6, 154.8-2938.5). SARS-CoV-2 antibodies were associated with vaccination, previous COVID-19 diagnosis, age group, and city of residence. In contrast, we found no significant differences in the type of vaccine used, education, nationality, or type of health insurance. We found a seroprevalence close to 100%, primarily due to the successful vaccination program, which strongly emphasizes universal access.Item Immunization and SARS-CoV-2 antibody seroprevalence in a country with high vaccination coverage: Lessons from Chile(2022) Aguilera, Ximena; González, Claudia; Apablaza, Mauricio; Rubilar, Paola; Icaza, Gloria; Ramírez-Santana, Muriel; Pérez, Claudia; Cortés, Lina Jimena; Núñez-Franz, Loreto; Quezada-Gaete, Rubén; Castillo-Laborde, Carla; Correa, Juan; Said, Macarena; Hormazábal, Juan; Vial, Cecilia; Vial, PabloObjective: Chile is among the most successful nations worldwide in COVID-19 vaccine rollout. By December 31st, 2021, 84.1% of the population was fully vaccinated, and 56.1% received booster doses using DIFFERENT TYPES OF COVID-19 VACCINES. In this context, we aimed to estimate the anti-SARSCoV-2 antibodies following the infection and vaccination campaign. Study design: Population-based cross-sectional serosurvey based on a representative sample of the cities of Santiago, Coquimbo/La Serena, and Talca used in a previous study. Methods: We selected the participants using a three-stage stratified sampling. They were blood-sampled on-site and answered a questionnaire regarding COVID-19-associated variables and vaccination antecedents using Wantai SARS-CoV-2 Ab ELISA to determine seroprevalence. This research followed the generic protocol of World Health Organization Unity studies. Results: We recruited 2,198 individuals aged 7-93 between October 5th and November 25th, 2021. In our sample, 2,132 individuals received COVID-19 vaccinations (97%); 67 (3.1%) received one dose; 2,065 (93.9%) received the complete scheme; and 936 received the booster jab (42.6%). Antibody seroprevalence reached 97.3%, ranging from 40.9% among those not vaccinated to 99.8% in those with booster doses (OR=674.6, 154.8-2938.5). SARS-CoV-2 antibodies were associated with vaccination, previous COVID-19 diagnosis, age group, and city of residence. In contrast, we found no significant differences in the type of vaccine used, education, nationality, or type of health insurance. Conclusion: We found a seroprevalence close to 100% in the population aged seven years and older, primarily due to the successful vaccination program, which has a strong emphasis on universal access.Publication Respuesta inmunitaria al SARS-CoV-2 y factores asociados previo a la vacunación, en personal de salud de atención primaria en una comuna de Santiago, Chile(2022) Olea, Andrea; Matute, Isabel; Hirmas, Macarena; González, Claudia; Iruretagoyena, Mirentxu; Munita, José; Pedroni, Elena; Gómez, María; Nájera, ManuelIntroducción: La pandemia de COVID-19 surgida en China a fines de 2019, se extendió rápidamente por el mundo, con casi 600 millones de casos y 6,3 millones de fallecidos en la actualidad. Los más afectados fueron los trabajadores de la salud con al menos tres veces más riesgo que la comunidad general de contraer la enfermedad. La mayoría de los estudios sobre seroprevalencia en trabajadores de la salud, se enfocan en establecimientos de atención hospitalaria y no se ha indagado con igual intensidad sobre lo que ocurre en la Atención Primaria de Salud (APS). Objetivos: Determinar prevalencia de SARS-CoV-2 mediante anticuerpos IgG en personal de atención primaria de comuna de La Pintana y explorar sus características clínicas y factores de riesgo, previo a la vacunación en Chile. Metodología: Diseño transversal realizado en noviembre 2020. Se recogieron datos sociodemográficos y clínicos mediante entrevista cara a cara, previa firma de consentimiento. Se determinó IgG específica mediante ELISA que utiliza proteína N y S. Las diferencias entre sujetos positivos y negativos se estudiaron mediante análisis bivariado y para asociaciones encontradas, se desarrollaron modelos multivariados controlando potenciales variables de confusión. El estudio contó con la aprobación del Comité Ético Científico de la Universidad del Desarrollo. Resultados: Participaron 463 funcionarios (51,4%) encontrando prevalencia de 21,8%. Los factores de riesgo fueron edad menor, ser médico y haber sido contacto estrecho de un caso. El 22% fue asintomático. Entre quienes presentan anosmia o ageusia, la probabilidad de IgG+ fue superior a 70%. Los títulos de anticuerpos aumentan significativamente con la gravedad. Conclusiones: La prevalencia en personal de atención primaria encontrada es concordante con la evidencia previa en trabajadores de salud. La menor edad y la profesión de médico se asocian a un mayor riesgo de enfermar.Item SARS-CoV-2 Neutralizing Antibodies in Chile after a Vaccination Campaign with Five Different Schemes(2022) Aguilera, Ximena; Hormazábal, Juan; Vial, Cecilia; Cortés, Lina Jimena; González, Claudia; Rubilar, Paola; Apablaza, Mauricio; Ramírez-Santana, Muriel; Icaza, Gloria; Núñez-Franz, Loreto; Castillo-Laborde, Carla; Ramírez-Riffo, Carolina; Pérez, Claudia; Quezada-Gate, Rubén; Said, Macarena; Vial, PabloUsing levels of neutralizing antibodies (nAbs), we evaluate the successful Chilean SARS-CoV-2 vaccine campaign, which combines different vaccine technologies and heterologous boosters. From a population-based study performed in November 2021, we randomly selected 120 seropositive individuals, organized into six groups of positive samples (20 subjects each) according to natural infection history and the five most frequent vaccination schemes. We conclude that the booster dose, regardless of vaccine technology or natural infection, and mRNA vaccines significantly improve nAbs response.Item Serie de salud poblacional: Las enfermedades no transmisibles en Chile. Aspectos epidemiológicos y de salud pública(Facultad de Medicina. Clínica Alemana - Universidad del Desarrollo, 2016) Aguilera, Ximena; González, Claudia; Matute, Isabel; Nájera, Manuel; Olea, Andrea; Aguilera, Ximena; González, Claudia; Matute, Isabel; Nájera, Manuel; Olea, AndreaEl texto que aquí se presenta pretende contribuir a integrar contenidos de Salud Pública dentro de la malla curricular de la Carrera de Medicina, con temáticas que permiten contextualizar la enseñanza clínica a la realidad epidemiológica chilena. Nuestro objetivo es entregar un material de apoyo para los docentes clínicos, de manera que puedan contar con información actualizada sobre la situación de los principales problemas de salud que aquejan a nuestra población y sobre las estrategias de salud pública que se están desarrollando para enfrentarlos.Item Seroprevalence of Natural and Acquired Immunity against the SARS-CoV-2 Virus in a Population Cohort from Two Chilean Cities, 2020–2022(2023) Núñez-Franz, Loreto; Ramírez-Santana, Muriel; Rubilar, Paola; Vial, Cecilia; Apablaza, Mauricio; González, Claudia; Said, Macarena; Olivares, Kathya; Cortés, Lina Jimena; Hormazábal, Juan; Canales, Luis; Vial, Pablo; Icaza, Gloria; Quezada-Gaete, Rubén; Aguilera, XimenaBackground: Chile has achieved the highest coverage for vaccines against the SARS-CoV-2 virus worldwide. Objective: To assess the progression of immunity (natural and acquired by vaccine) in a cohort from two Chilean cities. Methods: Individuals (n = 386) who participated in three phases of population-based serial prevalence studies were included (2020–2021 and 2022). Presence of SARS-CoV-2 antibodies was measured in serum. Data including time of vaccination and type of vaccine received were analysed with descriptive statistics. Results: Seroprevalence was 3.6% in the first round and increased to 96.9% in the second and 98.7% in the third. In the third round, 75% of individuals who had received the basal full scheme were seropositive at 180 days or more since their last dose; 98% of individuals who received one booster dose were seropositive at 180 days or more, and 100% participants who received two boosters were seropositive, regardless of time since their last dose. Participants receiving mRNA vaccines had higher seroprevalence rates over time. Conclusions: The high vaccination coverage in Chile enabled the population to maintain high levels of antibodies. Vaccination boosters are essential to maintain immunity over time, which also depends on the type of vaccine administered.Item Seroprevalence, spatial distribution, and social determinants of SARS-CoV-2 in three urban centers of Chile(2022) Vial, Pablo; González, Claudia; Icaza, Gloria; Ramirez‐Santana, Muriel; Quezada‐Gaete, Rubén; Núñez‐Franz, Loreto; Apablaza, Mauricio; Vial, Cecilia; Rubilar, Paola; Correa, Juan; Pérez, Claudia; Florea, Andrei; Guzmán, Eugenio; Lavín, María Estela; Concha, Paula; Nájera, Manuel; Aguilera, XimenaBackground: Seroprevalence studies provide an accurate measure of SARS-CoV-2 spread and the presence of asymptomatic cases. They also provide information on the uneven impact of the pandemic, pointing out vulnerable groups to prioritize which is particularly relevant in unequal societies. However, due to their high cost, they provide limited evidence of spatial spread of the pandemic specially in unequal societies. Our objective was to estimate the prevalence of SARS-CoV-2 antibodies in Chile and model its spatial risk distribution. Methods: During Oct–Nov 2020, we conducted a population-based serosurvey in Santiago, Talca, and Coquimbo–La Serena (2493 individuals). We explored the individual association between positive results and socio-economic and health-related variables by logistic regression for complex surveys. Then, using an Empirical Bayesian Kriging model, we estimated the infection risk spatial distribution using individual and census information, and compared these results with ofcial records. Results: Seroprevalence was 10.4% (95% CI 7.8–13.7%), ranging from 2% (Talca) to 11% (Santiago), almost three times the number ofcially reported. Approximately 36% of these were asymptomatic, reaching 82% below 15 years old. Seroprevalence was associated with the city of residence, previous COVID-19 diagnosis, contact with confrmed cases (especially at household), and foreign nationality. The spatial model accurately interpolated the distribution of disease risk within the cities fnding signifcant diferences in the predicted probabilities of SARS-CoV-2 infection by census zone (IQR 2.5–15.0%), related to population density and education. Conclusions: Our results underscore the transmission heterogeneity of SARS-CoV-2 within and across three urban centers of Chile. Socio-economic factors and the outcomes of this seroprevalence study enable us to identify priority areas for intervention. Our methodological approach and results can help guide the design of interdisciplinary strate‐ gies for urban contexts, not only for SARS-CoV-2 but also for other communicable diseases.Item ¿Sirven las ayudas técnicas a las personas mayores? Percepción desde la Atención Primaria sobre esta Garantía Explícita en Salud, Santiago, Chile(Esc. Salud Pública, Universidad de Chile, 2019) Hirmas, Macarena; Pofald, Lucy; Olea, Andrea; Ximena, Aguilera; Matute, Isabel; González, Claudia; Delgado, Iris; Nájera, Manuel; Gómez, María Inés; Gallardo, Ligia; Bustamante, Hernán; Di Silvestre, María CristinaObjetivo: Conocer la percepción de informantes clave pertenecientes a la red de Atención Primaria de Salud en Chile, respecto al proceso de gestión asistencial y el impacto del programa nacional de Garantías Explícitas en Salud (GES) sobre la entrega de ayudas técnicas a personas mayores. Materiales y métodos: Un estudio cualitativo basado en análisis de casos múltiples, en el cual se realizó entrevistas semi-estructuradas a 8 informantes clave de la red asistencial, fue desarrollado en 2015 en tres comunas de Santiago, Chile. El análisis de la información recogida se realizó mediante análisis de contenido, y se finalizó el muestreo de máxima variación al saturar la información. Se resguardaron los criterios de rigor científico y el protocolo fue aprobado por un Comité de Ética. Resultados: Hay una percepción de cobertura y detección de necesidad como adecuada en pacientes bajo control, aunque desde la perspectiva de los informantes, hay desconocimiento de esta garantía en la población. La necesidad es detectada por cualquier profesional de salud, pero la indicación es exclusivamente médica, lo que genera barreras de acceso. Hay una entrega oportuna; sin embargo, no se realiza seguimiento ni se aprecia como parte de una atención integral. Se percibe que la ayuda técnica es de calidad y la articulación de la red es adecuada, aunque no hay retroalimentación a Atención Primaria de Salud. El impacto lo consideran positivo en pacientes y familiares: mejora la ejecución de actividades diarias y genera mayor autonomía y capacidad de desplazamiento. Conclusiones: Existe una percepción positiva de este programa GES y su impacto en la mejoría en la calidad de vida de vida de los pacientes. Pero, la entrega de ayudas técnicas se encuentra desvinculada de una atención integral, por ende, este programa prioriza sólo la garantía de oportunidad.