Herramientas de Accesibilidad
Medwave
Since its identification in 1978, Canine parvovirus type 2 (CPV-2) has been considered a pathogen of great importance in the canine population because it causes severe enteritis with high mortality rates in pups. CPV-2 is a virus belonging to the family Parvoviridae. Currently, there are three described antigenic variants (CPV-2a, CPV-2b, and CPV-2c). CPV-2c is an emerging virus that is seen as a global health hazard. The objective of this work was to confirm the presence of CPV-2 in dogs with acute gastroenteritis compatible with parvovirus and to molecularly characterize the antigenic variants circulating in two regions of Colombia. An analytical cross-sectional study was conducted with fecal samples collected from 71 dogs showing signs of acute diarrhea. The samples were processed and polymerase chain reaction (PCR), restriction fragment length polymorphism analysis (RFLP), sequencing and phylogenetic analysis was performed to detect and characterize CPV. A total of 70.42% of the individuals were confirmed positive for CPV-2. Statistically differences were found in the presentation of CPV-2 between the evaluated regions. Phylogenetic analyses confirmed the presence of the antigenic variants CPV-2a/2b. Moreover, we found the presence of two conserved substitutions Asn428Asp and Ala514Ser in the VP2 protein suggesting the presence of a possible new CPV-2a variant circulating in Colombia. This study demonstrates the importance of the CPV 2a/2b in the region and highlights the importance of performing molecular studies for the early detection of new antigenic variants of CPV-2.
Veterinary Microbiology
An immunocytochemical technique has been used to study for the first time the distribution of fibers and cell bodies containing leucine–enkephalin (leu-enk), methionine–enkephalin (met-enk) or adrenocorticotropic hormone (ACTH) in the whole brainstem of the squirrel monkey Saimiri sciureus. Cell bodies containing leu-enk or met-enk were found in the superior colliculus and the formatio reticularis tegmenti mesencephali, respectively. No immunoreactive cell bodies containing ACTH were observed. Leu-enk-immunoreactive fibers were observed in 40 brainstem nuclei/tracts/regions, fibers containing met-enk were found in 38 brainstem nuclei/tracts/regions and fibers containing ACTH were found in 26 nuclei/tracts/regions. In the latter case, the density of immunoreactive fibers was always low. A high/moderate density of leu-enk- or met-enk-immunoreactive fibers were found in 18 and 16 brainstem nuclei/tracts/regions, respectively. The distribution of immunoreactive fibers containing leu-enk or met-enk was quite similar, with both leu-enk and met-enk observed in 82.5 % of the squirrel monkey brainstem nuclei/tracts/regions. This relationship is less marked for met-enk and ACTH (60.5 %) and even lower for leu-enk and ACTH (52.5 %). In 42.5 % of the nuclei/tracts/regions of the squirrel monkey brainstem (colliculus superior, substantia grisea centralis, nucleus interpeduncularis, nucleus tractus spinalis nervi trigemini, nucleus tractus solitarii, nucleus parabrachialis, formatio reticularis, substantia nigra), we observed fibers containing all three neuropeptides. The widespread distribution reported here suggests that enkephalins and ACTH can be involved in several physiological functions. The distribution of the immunoreactive fibers reported here is quite similar to that previously reported for enkephalins and ACTH in Macaca species and humans.
Anatomical Science International
The application of complex systems theory to physiology and medicine has provided meaningful information about the nonlinear aspects underlying the dynamics of a wide range of biological processes and their disease-related aberrations. However, no studies have investigated whether meaningful information can be extracted by quantifying second-order moments of time-varying cardiovascular complexity. To this extent, we introduce a novel mathematical framework termed complexity variability, in which the variance of instantaneous Lyapunov spectra estimated over time serves as a reference quantifier. We apply the proposed methodology to four exemplary studies involving disorders which stem from cardiology, neurology and psychiatry: Congestive Heart Failure (CHF), Major Depression Disorder (MDD), Parkinson\'s Disease (PD), and Post-Traumatic Stress Disorder (PTSD) patients with insomnia under a yoga training regime. We show that complexity assessments derived from simple time-averaging are not able to discern pathology-related changes in autonomic control, and we demonstrate that between-group differences in measures of complexity variability are consistent across pathologies. Pathological states such as CHF, MDD, and PD are associated with an increased complexity variability when compared to healthy controls, whereas wellbeing derived from yoga in PTSD is associated with lower time-variance of complexity.
Scientific Reports
Introduction Mathematical models and field data suggest that human mobility is an important driver for Dengue virus transmission. Nonetheless little is known on this matter due the lack of instruments for precise mobility quantification and study design difficulties. Materials and methods We carried out a cohort-nested, case-control study with 126 individuals (42 cases, 42 intradomestic controls and 42 population controls) with the goal of describing human mobility patterns of recently Dengue virus-infected subjects, and comparing them with those of noninfected subjects living in an urban endemic locality. Mobility was quantified using a GPSdata logger registering waypoints at 60-second intervals for a minimum of 15 natural days. Results Although absolute displacement was highly biased towards the intradomestic and peridomestic areas, occasional displacements exceeding a 100-Km radius from the center of the studied locality were recorded for all three study groups and individual displacements were recorded traveling across six states from central Mexico. Additionally, cases had a larger number of visits out of the municipality?s administrative limits when compared to intradomestic controls (cases: 10.4 versus intradomestic controls: 2.9, p = 0.0282). We were able to identify extradomestic places within and out of the locality that were independently visited by apparently non-related infected subjects, consistent with houses, working and leisure places. Conclusions Results of this study show that human mobility in a small urban setting exceeded that considered by local health authority\'s administrative limits, and was different between recently infected and non-infected subjects living in the same household. These observations provide important insights about the role that human mobility may have in Dengue virus transmission and persistence across endemic geographic areas that need to be taken into account when planning preventive and control measures. Finally, these results are a valuable reference when setting the parameters for future mathematical modeling studies.
PLoS ONE
Lippia alba (Verbenaceae Family) is an aromatic shrub native to Latin America, with recognized medicinal properties and a well-known high phenotypical plasticity in response to environmental factors. In order to identify the parameters that potentiate its in vitro anti-proliferative effect on human leukemia cells (K562), a matrix was designed for the production of 76 essential oils (EOs) with variations in plant growing season, harvested part from the plant, and preservation and distillation material conditions. The results show that EOs obtained from the same L. alba chemotype (Citral or Carvone), but acquired under different environmental or extraction conditions, presented significant differences in their primary components, oil yield, and cytotoxic activity on K562 cells. Citral EOs produced under diverse conditions displayed a cytotoxic effect on tumour cells ranging from 54 to 95% (IS 1.8–8.6) and IC50 from 13 to 38.8 μg/mL. The differences in antiproliferative activity were significantly correlated with variations in the β-caryophyllene oxide concentration. These results show the value of using standardized production conditions for the commercial utilization of L. alba EOs.
Industrial Crops and Products
Cardiorespiratory fitness (CRF) provides protection against the elevated blood pressure in overweight youth. Less is known regarding any similar protective effect of muscular fitness. We investigated how handgrip strength, an easy to implement measure of muscular strength, interacted with CRF and BMI to determine blood pressure in youth. We measured systolic (SBP) and diastolic (DBP) blood pressure, handgrip strength (HG), CRF and body mass index (BMI) in n = 7329 10–16 year-olds (47% girls). We defined elevated blood pressure as > 91st percentile and Good HG as > 33rd percentile. Participants were classified as Fit or Unfit and as Normal or Overweight/Obese based on international standards. The prevalence of elevated SBP was 23%, and 44% of participants had elevated DBP. In unfit participants Good HG was associated with lower SBP (z = 0.41 (95%CI: 0.20–0.61) and DBP (z = 0.29 (95%CI: 0.12–0.47). In Overweight/Obese participants, DBP was z = 0.24 (95%CI: 0.14–0.34) lower in the Good (versus Low) HG group. Overweight/Obese participants with Good HG also had a 32% lower risk of elevated DBP (OR: 0.68, 95%CI: 0.57–0.82). This association was attenuated but remained important after adjusting for BMI (20% risk reduction, OR: 0.80, 95%CI: 0.63–1.01). Muscular fitness appears to play some protective role against the risk of elevated blood pressure; particularly for the more prevalent measure: elevated DBP (44%). Effects may be restricted to Overweight and Unfit youth it is these the increased risk of elevated BP is and are less likely to engage in traditional cardiorespiratory fitness training. Research to determine the effects of muscular fitness training on blood pressure is warranted in these subgroups.
Preventive Medicine
The effect of the external magnetic field on the spectral properties of one-electron non-uniform quantum ring with radially directed hills is analysed. The corresponding one-particle wave equation is separable in the adiabatic limit, when the layer thickness is essentially smaller than its lateral dimension. Our calculations show that the presence of a single axially directed hill as well as a rise of the central hole thickness produce a quenching of the Aharonov-Bohm (AB) oscillations of the lower energy levels and of the magnetic momentum. However, as the number of radially directed hills is increased, the system exhibits again oscillations, resulted from an enhancement of tunnelling circular currents.
Journal of Physics: Conference Series
Background: The transmission of Dengue virus (DENV) and Chikungunya virus (CHIKV) has increased worldwide, due in part to the lack of a specific antiviral treatment. For this reason, the search for compounds with antiviral potential, either as licensed drugs or in natural products, is a research priority. The objective of this study was to identify some of the compounds that are present in Mammea americana (M. americana) and Tabernaemontana cymosa (T. cymosa) plants and, subsequently, to evaluate their cytotoxicity in VERO cells and their potential antiviral effects on DENV and CHIKV infections in those same cells. Methods: Dry ethanolic extracts of M. americana and T. cymosa seeds were subjected to open column chromatographic fractionation, leading to the identification of four compounds: two coumarins, derived from M. americana; and lupeol acetate and voacangine derived from T. cymosa.. The cytotoxicity of each compound was subsequently assessed by the MTT method (at concentrations from 400 to 6.25 μg/mL). Pre- and post-treatment antiviral assays were performed at non-toxic concentrations; the resulting DENV inhibition was evaluated by Real-Time PCR, and the CHIKV inhibition was tested by the plating method. The results were analyzed by means of statistical analysis. Results: The compounds showed low toxicity at concentrations ≤ 200 μg/mL. The compounds coumarin A and coumarin B, which are derived from the M. americana plant, significantly inhibited infection with both viruses during the implementation of the two experimental strategies employed here (post-treatment with inhibition percentages greater than 50%, p < 0.01; and pre-treatment with percentages of inhibition greater than 40%, p < 0.01). However, the lupeol acetate and voacangine compounds, which were derived from the T. cymosa plant, only significantly inhibited the DENV infection during the post-treatment strategy (at inhibition percentages greater than 70%, p < 0.01). Conclusion: In vitro, the coumarins are capable of inhibiting infection by DENV and CHIKV (with inhibition percentages above 50% in different experimental strategies), which could indicate that these two compounds are potential antivirals for treating Dengue and Chikungunya fever. Additionally, lupeol acetate and voacangine efficiently inhibit infection with DENV, also turning them into promising antivirals for Dengue fever.
BMC Complementary and Alternative Medicine
Dengue, the predominant arthropod-borne viral disease affecting humans, is caused by one of four distinct serotypes (DENV-1, -2, -3 or -4). A literature analysis and review was undertaken to describe the molecular epidemiological trends in dengue disease and the knowledge generated in specific molecular topics in Latin America, including the Caribbean islands, from 2000 to 2013 in the context of regional trends in order to identify gaps in molecular epidemiological knowledge and future research needs. Searches of literature published between 1 January 2000 and 30 November 2013 were conducted using specific search strategies for each electronic database that was reviewed. A total of 396 relevant citations were identified, 57 of which fulfilled the inclusion criteria. All four dengue virus serotypes were present and co-circulated in many countries over the review period (with the predominance of individual serotypes varying by country and year). The number of countries in which more than one serotype circulated steadily increased during the period under review. Molecular epidemiology data were found for Argentina, Bolivia, Brazil, the Caribbean region, Colombia, Ecuador, Mexico and Central America, Paraguay, Peru and Venezuela. Distinct lineages with different dynamics were found in each country, with co-existence, extinction and replacement of lineages occurring over the review period. Despite some gaps in the literature limiting the possibility for comparison, our review has described the molecular epidemiological trends of dengue infection. However, several gaps in molecular epidemiological information across Latin America and the Caribbean were identified that provide avenues for future research; in particular, sequence determination of the dengue virus genome is important for more precise phylogenetic classification and correlation with clinical outcome and disease severity.
PLoS Neglected Tropical Diseases
Introduction: Young people who start the university life face a key stage for the acquisition of habits and lifestyles. The test Course Navette is one of the most used worldwide because of its easy measurement, validity, effectiveness and sensitivity in different age ranks. Material and methods: An observational, descriptive and transversal study with quantitative approach; with 100 students participating (43 men and 57 women) with an average age of 21.06 ± 2.43 at the University of Santander, Cúcuta. For the development of this research, were obtained measurements anthropometric, hematological, physiological and performance on an empty stomach Leger test. Results: 62% of participants had a BMI of normal weight, 24% overweight and obesity and underweight was 8 and 6% respectively. In turn 32% of men and 17.5% of women have high cardiovascular risk according to abdominal circumference. VO2max. in the Leger test was 32.92 ± 7.12 to 533.80 ± 371.34 meters traveled. Regarding glycemia before the test was 80.99 ± 11.91 and after 105.59 ± 20.89. Conclusion: No significant differences in fat percentage were found (p = 0,863), muscle (p = 0,740) and water (p = 0,804) after Leger test. However, there were significant changes in FC, TAS, TAD, red cells, white cells, hemoglobin, platelets and blood glucose levels (p = 0,000). Regarding the VO2max. (p = 0,597) and travel meters (p = 0,619) no differences were found by gender.
Revista Mexicana de Cardiologia
During EOR recovery processes, asphaltenes macromolecules can flocculate and cause drastic changes in the petrophysical properties of the reservoir, therefore it is very important to determine the time at the flocculation begins and further the size of the aggregates, since ultimately this depends on whether these can be trapped in the porous media. This work aims to evaluate the change in the asphaltene hydrodynamic radius of at different concentrations of n-heptane and to detect the onset asphaltene floculation using a new technique known as 1H Diffusion ordered spectroscopy-NMR (DOSY-NMR). H-DOSY NMR is a method based on the pulsed field gradient spin-echo from nuclear magnetic resonance (PFGSE NMR) and it allows the identification of the molecular components of a mixture sample and at the same time obtain information of their size through the diffusion coefficient. For our specific case, the asphaltene hydrodynamic radius was 16.8 Å and the onset of asphaltene floculation can be observed when the concentration of solvent nheptane was 30 wt %.
SPE Latin American and Caribbean Petroleum Engineering Conference Proceedings
Introduction: Candidiases is a group of opportunistic infections caused by yeasts belonging to the genus Candida. Candida albicans is the most prevalent species in both superficial and deep infections, however, the clinical importance of non-albicans Candida has increased during the last decade, driving an urgent need for diagnostic tests that allow for species-level resolution and selection of the optimum therapeutic approach. Objective: To design and to optimize a new multiplex PCR assay for the simultaneous identification of the five most relevant species of Candida involved in human candidiasis etiology. Materials and methods: For primers design, the physical and thermodynamic restrictions that affect multiplex PCR performance were analyzed using Gene Runner and Mult-PSOS. As templates, the internal transcribed region 2 (ITR2) was selected for C. albicans (AJ249486.1), and topoisomerase II (TOPII) for C. parasilopsis (AB049144.1), C. krusei (AB049139.1), C. tropicalis (AB049141.1), and C. guillermondii (AB049145.1). We used ATCC strains of all these five species and clinical isolates as templates. Results: We designed ten oligonucleotides for the simultaneous amplification of the Candida species. The electrophoresis band profile was: C. albicans (206 bp), C. guillermondii (244 bp), C. tropicalis (474 bp), C. parasilopsis (558 bp), and C. krusei (419 bp). Conclusion: The new multiplex PCR assay designed in this study allowed a simultaneous and efficient amplification of the amplicons corresponding to the five species of Candida under study, with an adequate resolution in standard agarose gel.
Biomedica
Investigacion y Educacion en Enfermeria
The research describes the inspiring principles of electronic government in the Mayor\'s Office of Valledupar, Cesar. It is supported theoretically by the authors Rivera (2006), the Ibero-American Charter (2007) and Criado and others (2002). It is contextualized in the quantitative-positivist epistemological tendency, of descriptive type, under a field design, not experimental. Among the conclusions are that the principles that inspire e-government: equality, legality, conservation, transparency, technological adequacy; Must be evident in the egovernment policy to ensure its effectiveness.
Espacios
This article shows the first part of a study aimed at strengthening of the formation for the entrepreneurship (FFE) in higher education. To do that, the aim of the study was the construction of a searching proposal and compilation of information sources in order to make a state of the art about the FFE. Methodologically, the proposal was made in three moments: consultation of guides, design and implementation. The results are: i) guidelines for the development of the heuristic phase of the state of art and ii) the construction of instruments for the searching stages and specialized information compilation about FFE in university contexts.
Espacios
An alternative microeconomic model from the design and development of rural production units in three associations of fishermen swampy Zapatosa complex, from the use of Taruya (Eichornia cressipis) to diversify productive activities of these communities was implemented. Within a population of 47 associations of peasant stock declared in the region of influence of the swamp complex The Zapatosa 4 chose a craft, two of fishermen and the elderly; of these was selected the most organized and formalized for who could act as an anchor association or leader. One of the strategies developed was to present the project to the European Aid/128929/M/ACT//CO in Colombia led by the Ministry of Industry, Trade and Tourism, once approved and availability of resources, a second strategy was used inclusive development model project where they were able to strengthen three production units from innovative processes based Taruya, thus improving the income of its members. A third strategy was achieving different co-funding sources IDECESAR, ADEL Zapatosa (Agency for Local Economic Development), SENA, governor of Cesar, in this regard technical training was obtained in the different alternatives to transform Taruya SENA and ADEL Zapatosa and resources for adaptation of installations of the UPR by the governor of Cesar whose contributions were important for the improvement of the processes of transformation of Taruya. Strategies for identifying markets and industry studies were also used, they could acquire innovative equipment and machinery as well as other goods and services, high quality according to the needs reflected to achieve standardize and make inroads with the regional market competitive products.
Espacios
This paper aims the dynamics of science, technology and innovation (CTeI) inside Colombia and Venezuela from the CTeI observatories\' role. We made a bibliographical review of the different justifications that define the CTeI of some countries (USA, Brasil) and documents review of observatories. The results show differences in the legal nature, in the strategic and operational conception of these observatories. In Colombia, the observatory is supported on a research group, while in Venezuela, it is a public administration entity.
Espacios
Toxoplasma infection, an aspect included in the Integral Care Guidelines for prevention, early detection and treatment of complications during pregnancy developed and sponsored by the Department of Science, Technology and Innovation, Colciencias and the Ministry of Health and Social Protection; was selected to develop recommendations that may contribute to its prevention diagnostic and treatment. Guidelines were developed through systematic review of literature, two panels of evaluation, gradation of evidence: SIGN (Scottish Intercollegiate Guidelines Network), discussion panel with users and patients, external evaluation and socioeconomical evaluation of the impact of recommendations. The Toxoplasma gondii infection that occurs during pregnancy may cause serious complications for the fetus and important sequelae for the newborn. A clinical guideline based on the best available scientific evidence, with emphasis on Colombian references, was performed. Experts in parasitology, neonatology and infectious diseases (adult and pediatric) developed the recommendations. It is suggested that the recommendations included in this guideline be followed by healthcare professionals in pregnancy care programs nationwide, with the purpose of lowering the morbidity and mortality related to this disease. Specific recommendations for diagnosis during the first trimester of the pregnancy, recommendations for prevention in noninfected women, identification of fetal or newborn infection and recommendations for treatment in those given cases are included.
Infectio
This paper analyzes the knowledge\'s generation in companies providing occupational safety and health in Valledupar, Colombia. It is supported by the theories of Davenport & Prusak (2001); and, Molina & Marsal (2001). This research is descriptive, non experimental, transversal and with field design. We applied the research to the all 17 companies. We interview the managers through a questionnaire of 25 items, validated by five experts, and 0.89 Cronbach\'s a reliability. We found the most common way of generating knowledge is informal networks. We discover there are deficiencies in the acquisition, merge, and adaptation of knowledge.
Espacios
Objectives: Describe, compare and associate the perception of safety conditions for chronically ill patients in the hospital environment in Colombia and in its five geographic macro-regions (Amazon, Andean, Caribbean, Orinoquía and Pacifico). Method: This is a descriptive, comparative and relationship-based study. The sample was comprised of 484 persons who have a chronic illness. The instruments used were the Characterization Survey for Care of the Person with Chronic Disease and the patient version of the Survey of the Perception of Safety Conditions in the Hospital. Results: Compared to the risk perception categories, only half are aware of the risks to which they are exposed and how to prevent them, and only half reported knowing their rights and obligations during hospitalization. Falls and phlebitis are the risks that are more likely to materialize. Conclusion: There is little appropriation of risk prevention and care. Consequently, there is a high degree of vulnerability to the conditions of the hospital environment in Colombia’s five geographic macro-regions.
Aquichan
Objective: To determine sociodemographic factors associated with handgrip (HG) strength in a representative sample of children and adolescents from a middle income country. Methods: We evaluated youth between the ages of 8 and 17 from a representative sample of individuals from the Department of Santander, Colombia. Anthropometric measures, HG strength, and self-reported physical activity were assessed, and parents/guardians completed sociodemographic questionnairres. Multinomial logistic regression models were used to estimate the association between sociodemographic and anthropometric characteristics and tertiles of relative HG strength. We also produced centile data for raw HG strength using quantile regression. Results: 1,691 young people were evaluated. HG strength increased with age, and was higher in males than females in all age groups. Lower HG strength was associated with indicators of higher socioeconomic status, such as living in an urban area, residence in higher social strata neighborhoods, parent/guardian with secondary education or higher, higher household income, and membership in health insurance schemes. In addition, low HG strength was associated with lower physical activity levels and higher waist-to-hip ratio. In a fully adjusted regression model, all factors remained significant except for health insurance, household income, and physical activity level. Conclusions: While age and gender specific HG strength values were substantially lower than contemporary data from high income countries, we found that within this middle income population indicators of higher socioeconomic status were associated with lower HG strength. This analysis also suggests that in countries undergoing rapid nutrition transition, improvements in socioeconomic conditions may be accompanied by reduction in muscle strength.
American Journal of Human Biology
Background Caries is a public health problem, given that it prevails in 60 to 90% of the school-age global population. Multiple factors interact in its etiology, among them dental plaque is necessary to have lactic acid producing microorganisms like Streptococcus from he Mutans group. Existing prevention and treatment measures are not totally effective and generate adverse effects, which is why it is necessary to search for complementary strategies for their management. Aim The study sought to evaluate the eradication capacity of Streptococcus mutans biofilms and the toxicity on eukaryotic cells of Lippia alba and Cymbopogon citratus essential oils. Methodology Essential oils were extracted from plant material through steam distillation and then its chemical composition was determined. The MBEC-high-throughput (MBEC-HTP) (Innovotech, Edmonton, Alberta, Canada) assay used to determine the eradication concentration of S. mutans ATCC 35668 strain biofilms. Cytotoxicity was evaluated on CHO cells through the MTT cell proliferation assay. Results The major components in both oils were Geraniol and Citral; in L. alba 18.9% and 15.9%, respectively, and in C. citratus 31.3% and 26.7%. The L. alba essential oils presented eradication activity against S. mutans biofilms of 95.8% in 0.01 mg/dL concentration and C. citratus essential oils showed said eradication activity of 95.4% at 0.1, 0.01 mg/dL concentrations and of 93.1% in the 0.001 mg/dL concentration; none of the concentrations of both essential oils showed toxicity on CHO cells during 24 h. Conclusion The L. alba and C. citratus essential oils showed eradication activity against S. mutans biofilms and null cytotoxicity, evidencing the need to conduct further studies that can identify their active components and in order to guide a safe use in treating and preventing dental caries.
Journal of Ethnopharmacology
Nonintrusive Load Monitoring (NILM) systems aim to estimate the individual appliance operation and consumption in a household from measurements at a single point, in order to motivate energy conservation behaviors. Power estimation based on appliance rated powers is not always accurate because of the voltage supply variations, thus misleading load disaggregation algorithms. In this paper we propose models of power as a function of voltage for correcting the power estimation. Measurements in the laboratory of residential loads are performed under multiple voltage levels. These data are processed to find regression models. Moreover, some analytic expressions to calculate the powers are proposed. Proposed models result more accurate than the rated powers and other models in the scientific literature.
Proceedings of International Conference on Harmonics and Quality of Power, ICHQP
Background: Effective policies to control hypertension require an understanding of its distribution in the population and the barriers people face along the pathway from detection through to treatment and control. One key factor is household wealth, which may enable or limit a household\'s ability to access health care services and adequately control such a chronic condition. This study aims to describe the scale and patterns of wealth-related inequalities in the awareness, treatment and control of hypertension in 21 countries using baseline data from the Prospective Urban and Rural Epidemiology study. Methods: A cross-section of 163,397 adults aged 35 to 70 years were recruited from 661 urban and rural communities in selected low-, middle- and high-income countries (complete data for this analysis from 151,619 participants). Using blood pressure measurements, self-reported health and household data, concentration indices adjusted for age, sex and urban-rural location, we estimate the magnitude of wealth-related inequalities in the levels of hypertension awareness, treatment, and control in each of the 21 country samples. Results: Overall, the magnitude of wealth-related inequalities in hypertension awareness, treatment, and control was observed to be higher in poorer than in richer countries. In poorer countries, levels of hypertension awareness and treatment tended to be higher among wealthier households; while a similar pro-rich distribution was observed for hypertension control in countries at all levels of economic development. In some countries, hypertension awareness was greater among the poor (Sweden, Argentina, Poland), as was treatment (Sweden, Poland) and control (Sweden). Conclusion: Inequality in hypertension management outcomes decreased as countries became richer, but the considerable variation in patterns of wealth-related inequality - even among countries at similar levels of economic development - underscores the importance of health systems in improving hypertension management for all. These findings show that some, but not all, countries, including those with limited resources, have been able to achieve more equitable management of hypertension; and strategies must be tailored to national contexts to achieve optimal impact at population level.
International Journal for Equity in Health
Universidad de Santander UDES. Vigilada Mineducación.
Resolución otorgada por el Ministerio de Educación Nacional: No. 6216 del 22 de diciembre de 2005 / Personería Jurídica 810 de 12/03/96.
Institución sujeta a inspección y vigilancia por el Ministerio de Educación Nacional. Resolución 12220 de 2016.
Notificaciones administrativas y judiciales:
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