Browsing by Author "Gonzalez, Claudia"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Item 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, XimenaAn 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.Item From instinct to evidence: the role of data in country decision-making in Chile(Taylor & Francis Online, 2017) Aguilera, Ximena; Espinosa-Marty, Consuelo; Castillo-Laborde, Carla; Gonzalez, ClaudiaBACKGROUND: The Chilean health system has undergone profound reforms since 1990, while going through many political upheavals, and faced demographic, health, and economic transformations. The full information requirements to develop an evidence-informed process implied the best possible use of available data, as well as efforts for improving the information systems. OBJECTIVE: To examine, from a historical perspective, the use of data during the health reforms undertaken in Chile since 1990, and to identify the factors that have determined its utilization and improvement. DESIGN: A qualitative methodological approach was followed to review the case study of the Chilean experience with data on decision-making. We use as the primary source our first-hand experience as officials of the Ministry of Health (MOH) and the Ministry of Finance during the reform period considered. Second, a literature review was conducted, using documents from official sources, historical accounts, books, policy reports, and articles about the reform process, looking for the use of data. FINDINGS: The Chilean health care reform process was intensive in utilization and production of information. In this context, the MOH conducted several studies, from the burden of disease, efficacy of interventions, cost-effectiveness, out-of-pocket payments, and fiscal impact to social preferences, among others. Policy and prioritization frameworks developed by international agencies influenced the use of data and the studies' agenda. CONCLUSIONS: Health systems in Latin America have struggled to adapt to changing health needs caused by demographic transition and economic growth. Health reforms in Chile provide lessons of this sustained effort, based on data and scientific grounds, with lights and shadows. Tradition, receptiveness to foreign ideas, and benchmarking with international data determined this approach, facilitated by the political influence of physicians and other technocrats. Besides, internationally comparable statistics are shown to play a significant role in policy debate.Item Knowledge, attitudes, and practices regarding hantavirus disease and acceptance of a vaccine trial in rural communities of southern Chile(Taylor & Francis Online, 2016) Valdivieso, Francisca; Gonzalez, Claudia; Najera, Manuel; Olea, Andrea; Cuiza, Analía; Aguilera, Ximena; Mertz, GregoryAndes hantavirus cardiopulmonary syndrome, transmitted by Oligoryzomys longicaudatus, has no approved treatment, a case fatality rate of 35%, and documented person-to-person transmission. An Andes vaccine, highly needed for prevention, is in development. We aimed to evaluate knowledge, attitudes and practices (KAP) regarding hantavirus disease and willingness to participate in a future Andes vaccine trials through a cross sectional face-to-face oral survey of a randomly selected adult sample from 2 rural communes in southern Chile. Human subjects approval was obtained from our institutional IRBs, and participants signed informed consent. We enrolled 319 subjects from Corral and 321 from Curarrehue; 98% had heard about hantavirus disease and its reservoir but only half knew about transmission, symptoms and prevention. Participants fear the disease but are only partially aware of their own risk. One third of participants reported presence of rodents inside their homes. Despite moderate confidence in their health system, most subjects perceived vaccines as beneficial, and 93% would accept an approved hantavirus vaccine. Half would agree to participate in a vaccine trial and 29% would allow their children to participate. Motivations to participate were mainly altruistic, while risk perception was the main reason for declining. Knowledge about hantavirus disease and prevention practices require reinforcement, and a vaccine trial seems feasible in these populations.