DSpace Repository :: Browsing by Author "Pedroni, Elena"

Browsing by Author "Pedroni, Elena"

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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.
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.
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, Andrea
Background 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.
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, Manuel
Introducción: 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.

Browsing by Author "Pedroni, Elena"

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