Browsing by Author "Santelices, Emilio"
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Item Priority setting for mental health research in Chile(BioMed Central, 2017) Zitko, Pedro; Borghero, Francesca; Zavala, Cynthia; Markkula, Niina; Santelices, Emilio; Libuy, Nicolás; Pemjean, AlfredoBackground: Scientifc knowledge is a fundamental tool for making informed health policy decisions, but the link between health research and public policy decision-making is often missing. This study aims to identify and prioritize a national set of research gaps in mental health. Methods: A multi-approach method to identify gaps in knowledge was developed, including (1) document analysis and identifcation of possible research questions, (2) interviews to Ministry of Health key informants, (3) focus groups with diferent stakeholders, and (4) a web consultation addressed to academics. The identifed gaps were translated to a standardized format of research questions. Criteria for prioritization were extracted from interviews and focus groups. Then, a team of various professionals applied them for scoring each question research. Findings: Fifty-four people participated in the knowledge gaps identifcation process through an online consultation (n = 23) and focus groups (n = 18). Prioritization criteria identifed were: extent of the knowledge gap, size of the objective population, potential beneft, vulnerability, urgency and applicability. 155 research questions were prioritized, of which 44% were related to evaluation of systems and/or health programs, and 26% to evaluation of interventions, including questions related to cost-efectiveness. 30% of the research questions came from the online consultation, and 36% from key informants. Users groups contributed with 10% of total research questions. Conclusion: A fnal priority setting for mental health research was reached, making available for authorities and research agencies a list of 155 research questions ordered by relevance. The experience documented here could serve to other countries interested in developing a similar process.Publication The added effect of non-pharmaceutical interventions and lifestyle behaviors on vaccine effectiveness against severe COVID-19 in Chile: A matched case-double control study(2023) Urquidi, Cinthya; Santelices, Emilio; Lagomarcino. Anne; Valenzuela, María; Larrañaga, Nicolás; González Silva, Emilio; Pavez, Axel; Wosiack, Amanda; Maturana, Marcela; Moller, Paulina; Torres, Juan; Muñoz, Sergio; O’Ryan, MiguelBackground: World Health Organization approved vaccines have demonstrated relatively high protection against moderate to severe COVID-19. Prospective vaccine effectiveness (VE) designs with first-hand data and population-based controls are nevertheless rare. Neighborhood compared to hospitalized controls, may differ in compliance to non-pharmacuetical interventions (NPI) compliance, which may influence VE results in real-world settings. We aimed to determine VE against COVID-19 intensive-care-unit (ICU) admission using hospital and community-matched controls in a prospective design. Methods: We conducted a multicenter, observational study of matched cases and controls (1:3) in adults ≧18 years of age from May to July 2021. For each case, a hospital control and two community controls were matched by age, gender, and hospital admission date or neighborhood of residence. Conditional logistic regression models were built, including interaction terms between NPIs, lifestyle behaviors, and vaccination status; the model's β coefficients represent the added effect these terms had on COVID-19 VE. Results: Cases and controls differed in several factors including education level, obesity prevalence, and behaviors such as compliance with routine vaccinations, use of facemasks, and routine handwashing. VE was 98·2% for full primary vaccination and 85·6% for partial vaccination when compared to community controls, and somewhat lower, albeit not significantly, compared to hospital controls. A significant added effect to vaccination in reducing COVID-19 ICU admission was regular facemask use and VE was higher among individuals non-compliant with the national vaccine program, and/or tonroutine medical visits during the prior year. Conclusion: VE against COVID-19 ICU admission in this stringent prospective case-double control study reached 98% two weeks after full primary vaccination, confirming the high effectiveness provided by earlier studies. Face mask use and hand washing were independent protective factors, the former adding additional benefit to VE. VE was significantly higher in subjects with increased risk behaviors.Publication Vaccine effectiveness in reducing COVID-19-related hospitalization after a risk-age-based mass vaccination program in a Chilean municipality: A comparison of observational study designs(2024) Urquidi, Cinthya; Sepúlveda-Peñaloza, Alejandro; Valenzuela, María T.; Ponce, Alexander; Menares, Verónica; Cortes, Claudia P.; Benítez, Rosana; Santelices, Emilio; Anfossi, Renato; Moller, Andrea; Santolaya, María E.Background: Case–control studies involving test-negative (TN) and syndrome-negative (SN) controls are reliable for evaluating influenza and rotavirus vaccine effectiveness (VE) during a random vaccination process. However, there is no empirical evidence regarding the impact in real-world mass vaccination campaigns against SARS-CoV-2 using TN and SN controls. Objective: To compare in the same population the effectiveness of SARS-CoV-2 vaccination on COVID-19-related hospitalization rates across a cohort design, TN and SN designs. Method: We conducted an unmatched population-based cohort, TN and SN case–control designs linking data from four data sources (public primary healthcare system, hospitalization registers, epidemiological surveillance systems and the national immunization program) in a Chilean municipality (Rancagua) between March 1, 2021 and August 31, 2021. The outcome was COVID-19-related hospitalization. To ensure sufficient sample size in the unexposed group, completion of follow-up in the cohort design, and sufficient time between vaccination and hospitalization in the case–control design, VE was estimated comparing 8-week periods for each individual. Results: Among the 191,505 individuals registered in the primary healthcare system of Rancagua in Chile on March 1, 2021; 116,453 met the cohort study’s inclusion criteria. Of the 9,471 hospitalizations registered during the study period in the same place, 526 were COVID-19 cases, 108 were TN controls, and 1,628 were SN controls. For any vaccine product, the age- and sex-adjusted vaccine effectiveness comparing fully and nonvaccinated individuals was 67.2 (55.7–76.3) in the cohort design, whereas it was 67.8 (44.1–81.4) and 77.9 (70.2–83.8) in the TN and SN control designs, respectively. Conclusion: The VE of a COVID-19 vaccination program based on age and risk groups tended to differ across the three observational study designs. The SN case-control design may be an efficient option for evaluating COVID- 19 VE in real-world settings.