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Background: Tropics have some particularities that can impact the natural history and fac-tors associated with allergic diseases. However, few studies described the characteristics of patients with allergic rhinitis (AR) and combined AR and asthma syndrome (CARAS) in Latin American tropical countries. Objective: This study aimed to determine the medical, social, and environmental factors associated with AR and CARAS in children aged 5–18 years treated with immunotherapy in two allergy referral centers in Bogotá (Colombia).Material and methods: An observational, cross-sectional study was conducted between January 2018 and January 2019. International Study Asthma Allergies Childhood-III and socio-demographic questionnaires were applied to adolescents and parents of children undergoing immunotherapy at the allergy consult in the Hospital Universitario Fundación Santa Fe de Bogotá and UNIMEQ-ORL. Results: Among 830 children aged 5–18 years, 38.1% (n = 316) were women. Up to 63.25% of the population had a positive skin prick test for house dust mites: 63.25% for Dermatophagoides pteronyssinus, 61.81% for Dermatophagoides farinae, and 31.57% for Blomia tropicalis. The fac-tors associated with AR were male sex (PR: 1.31, 95% CI: 1.08–1.57), antibiotic consumption during the first year of life (PR: 0.80; 95% CI: 0.63–0.99), and exposure to dogs (PR: 1.32; 95% CI: 1.06–2.66). The factors associated with CARAS were older age (PR=0.95; 95% CI: 0.95–0.99), acetaminophen consumption over four times a year (PR: 1.31; 95% CI: 1.03–1.55), and antibiotic consumption during the first year of life (PR: 1.21; 95% CI: 1.06–1.34). Conclusion: A high prevalence of B. tropicalis was found in this study. The factors associated with AR and CARAS are like those described in high-income tropical countries. Further studies are needed in low- or middle-income tropical countries to identify modifiable factors associ-ated with allergic diseases.

Few studies compare the post-operative nasal symptoms, quality of life, and costs in the microscopic vs. endoscopic transsphenoidal approaches for pituitary adenomas, particularly in low/middle-income Latin American populations. This ambispective study correlated the perception of nasal obstruction, quality of life and costs of endoscopic vs. microscopic transsphenoidal pituitary surgery at the Fundación Santa Fe de Bogotá, Colombia between January 2018, and December 2019. A total of 46 patients (mean age: 50.57 years) who underwent pituitary resection for adenomas either by microscopic or endoscopic approach in the Neurosurgery and/or Otolaryngology departments of the Fundación Santa Fe de Bogotá were included. Postoperative perception of nasal obstruction was assessed through the Nasal Obstruction Symptom Evaluation (NOSE) and a visual analog scale (VAS). Quality of life was assessed with the Glasgow Benefit Inventory (GBI). Surgical-related and hospitalization costs were extracted from the hospital’s finances database. A median difference of 45 points favoring the microscopic approach was found in the global scores of the NOSE scale. A median difference of 4 points was found in the VAS score (p

Background: Sensorineural hearing loss (SNHL) is the most common auditory deficit in older adults and may lead to quality-of-life deterioration. However, few studies have been performed in low/middle-income countries, particularly in Latin America. This study aimed to assess the audiological benefit, quality of life, and factors associated with functional gain in elderly hearing aid users in the Fundación Santa Fe de Bogotá and UNIMEQ-ORL, two otology referral centers in Colombia. Design: Pre-post study that included hearing aid users at the otology consult of the Fundación Santa Fe de Bogotá and UNIMEQ-ORL between June 2017 and December 2020. Glasgow Benefit Inventory (GIB) and Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaires were applied. Audiometric (0,5kHz to 4kHz) and logoaudiometric results were collected. Results: A total of 75 participants (132 ears) were included. The mean age was 70.73 years (SD: 12.66). The median hearing aid use in years was 0.71 (IQR: 0.64-0.90). Mean change in logoaudiometry was -26.53dB (95%CI: -28.09, -24.97; pConclusion: The number of years of hearing aids use may impact on the functional gain in these populations. A significant clinical benefit was found in terms of quality of life, communication, and reverberation related to the use of hearing aids. Access to hearing aids should be granted, and public health strategies are needed to grant the access to hearing rehabilitation in these populations. Trial registration: Fundación Santa Fe de Bogotá (Protocol Number: CCEI-12666-2020)

Introduction: The prevalence of allergic diseases is increasing worldwide, affecting about 30% of the population in low to middle-income countries. Research trends on allergic diseases within rural pediatric populations of Latin American countries is scarce. This study aimed to determine the prevalence of allergic diseases (allergic rhinitis, asthma, and atopic dermatitis) and their associated factors using the International Study of Asthma and Allergies in Childhood-III (ISAAC-III) questionnaire in school-aged children from two rural municipalities in Colombia.Materials and methods: This is a cross-sectional study. The ISAAC-III questionnaire was applied to school-aged children attending elementary schools in the municipalities of Soracá and Palmas del Socorro during 2018. The questionnaires were applied to adolescents aged 13–14 years and the parents of 6–7 years old children. Associations were estimated via bivariate and multivariate analysis. Results: Among 261 school-aged children (58.2% adolescents), the prevalence of allergic dis-eases was: allergic rhinitis 11.49% (95% CI: 8.05–15.78), asthma 8.81% (95% CI: 5.82–12.7), and atopic dermatitis 6.13% (95% CI: 3.69–9.53). Associated factors for allergic rhinitis included: female sex (PR: 2.68, 95% CI: 1.17–5.26), asthma (PR: 4.69, 95% CI: 1.96–8.31), atopic dermatitis (PR: 3.55, 95% CI: 1.09–7.83), and higher maternal education (PR: 4.16, 95% CI: 1.45–8.25).Conclusions: The prevalence of allergic diseases in this rural pediatric population was lower compared with that of the previous reports from urban populations. Associated factors found in this study support previous studies. Research addressing modifiable environmental associ-ations is so far scarce in Latin America; further studies are needed to reduce the burden of these diseases in rural populations.

This study aimed to describe the tinnitus severity in patients with chronic otitis media (COM) and describe the sociodemographic and clinical variables associated with tinnitus severity.Cross-sectional study. Two otology-referral centers in Bogotá (Colombia) were included. Sociodemographic, clinical associated factors and quality of life questionnaires were applied. Otoscopic evaluation and audiometric data were collected.About 231 adults with COM.Up to 51.5% of the patients reported severe tinnitus discomfort, 21.7% moderate discomfort, and 26.8% minor discomfort. Factor associated with increased tinnitus severity in patients with COM were older age (aOR: 1.02; 95% CI: 1.01-1.05), higher education (aOR: 2.24; 95% CI: 1.03-4.87), ear discharge during childhood (aOR: 1.88; 95% CI: 1.02-3.45), cholesteatoma in one ear (aOR: 2.26; 95% CI: 1.05-4.88), and pure-tone air average over 15 dB (aOR: 2.08; 95% CI: 1.28-3.36). Differences of 10-points in symptoms severity and 15-points in the total score of the "Chronic Suppurative Otitis Media Questionnaire-12" were found between the tinnitus severity groups.Our results highlight the need for further research on the associated factors of tinnitus severity on COM patients. COM patients with higher tinnitus severity presented worse audiometric results and worse quality of life outcomes.

Background Evaluation of health-related quality of life (HRQoL) is considered an important aspect of clinical assessment and health research. Chronic Otitis Media (COM) is related to the quality of life deterioration subsequent to COM symptoms, social communication impairments, and lower work performance. However, there is no reliable information regarding the impact of this disease on health and quality of life in many resource-poor countries. Therefore, we translated into Spanish the Chronic Otitis Media Questionnaire-12 (COMQ-12) for the evaluation of HRQoL of Chronic Otitis Media (COM) in adult patients. Also, we assessed the psychometric properties of the Spanish version of the questionnaire. Methods Two otology referral centers in Bogotá, Colombia were included. The Spanish version of COMQ-12 was applied twice to 200 adult patients with confirmed COM diagnosis and 31 healthy controls to perform the validation process and assess the internal consistency of this questionnaire. Psychometric characteristics (internal consistency, test–retest reliability, and construct validity) of the COMQ-12 were assessed. Exploratory Factor Analysis and Confirmatory Factor Analysis were conducted via structural equation modeling to test the questionnaire’s structure. Results The Spanish version of the COMQ-12 showed good internal consistency (Cronbach’s Alpha: 0.86, McDonald’s Omega: 0.89). Coefficients corresponding to Lin’s Concordance test and test–retest reliability were 0.95 and 0.83 respectively. Correlation between the Visual Analogue Scale (VAS) and the COMQ-12 was 0.68 (95% CI 0.59–0.75, p value Conclusion This Spanish version of the COMQ-12 showed high reliability and high internal consistency. This questionnaire can be used as an objective clinical tool to assess the HRQoL of patients who have a COM diagnosis. Trial registration Hospital Universitario Fundación Santa Fe, Ethical Committee Registration ID: CCEI-8807-2018. Hospital de San José, Ethical Committee: Record number 500, DI-I-0632-18.

Objective: Worldwide research trends on the prevalence of hearing loss within young rural populations are scarce. Current evidence suggests extended high-frequency audiometry could be a sensitive predictor to detect subclinical hearing loss. This study aimed to determine the prevalence of hearing loss through conventional pure tone (0.25–8 kHz) and extended high-frequency (9–20 kHz) audiometry tests in a group of adolescents aged 13 to 19 years old from two rural areas of Colombia. A sociodemographic and associated factor for hearing loss questionnaire was applied. Design: Cross-sectional study. Study Sample: Three hundred sixty-six adolescents aged 13 to 19 years old from two rural municipalities in Colombia: Soracá, and Palmas del Socorro. Results: Hearing loss prevalence assessed through pure tone audiometry was 3.28% in right ears and 3.83% in left ears while through extended high-frequency audiometry was 14.21% and 13.11%, respectively. Associated factors found by the logistic regression were age (OR: 1.36; CI 95% 1.13-1.64) and obesity (OR: 3.74; CI 95% 1.07-13.11). Conclusions: Using 15 dB as the normal hearing threshold parameter for audiometric frequencies, our results suggest that extended high-frequency hearing loss is already widespread among rural adolescents. This highlights the need for research on extended high-frequency audiometry in rural school-aged children.

Atopic dermatitis (AD, eczema) is driven by a combination of skin barrier defects, immune dysregulation, and extrinsic stimuli such as allergens, irritants, and microbes. The role of environmental allergens (aeroallergens) in triggering AD remains unclear.We systematically synthesized evidence regarding the benefits and harms of allergen immunotherapy (AIT) for AD.As part of the 2022 American Academy of Allergy, AsthmaImmunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters AD Guideline update, we searched the MEDLINE, EMBASE, CENTRAL, CINAHL, LILACS, Global Resource for Eczema Trials, and Web of Science databases from inception to December 2021 for randomized controlled trials comparing subcutaneous immunotherapy (SCIT), sublingual immunotherapy (SLIT), and/or no AIT (placebo or standard care) for guideline panel-defined patient-important outcomes: AD severity, itch, AD-related quality of life (QoL), flares, and adverse events. Raters independently screened, extracted data, and assessed risk of bias in duplicate. We synthesized intervention effects using frequentist and Bayesian random-effects models. The GRADE approach determined the quality of evidence.Twenty-three randomized controlled trials including 1957 adult and pediatric patients sensitized primarily to house dust mite showed that add-on SCIT and SLIT have similar relative and absolute effects and likely result in important improvements in AD severity, defined as a 50% reduction in SCORing Atopic Dermatitis (risk ratio [95% confidence interval] 1.53 [1.31-1.78]; 26% vs 40%, absolute difference 14%) and QoL, defined as an improvement in Dermatology Life Quality Index by 4 points or more (risk ratio [95% confidence interval] 1.44 [1.03-2.01]; 39% vs 56%, absolute difference 17%; both outcomes moderate certainty). Both routes of AIT increased adverse events (risk ratio [95% confidence interval] 1.61 [1.44-1.79]; 66% with SCIT vs 41% with placebo; 13% with SLIT vs 8% with placebo; high certainty). AIT's effect on sleep disturbance and eczema flares was very uncertain. Subgroup and sensitivity analyses were consistent with the main findings.SCIT and SLIT to aeroallergens, particularly house dust mite, can similarly and importantly improve AD severity and QoL. SCIT increases adverse effects more than SLIT. These findings support a multidisciplinary and shared decision-making approach to optimally managing AD.

Background: The COVID-19 pandemic has placed an unprecedented physical and mental burden on healthcare workers who are frequently at high risk of infection, particularly in low-income countries. This study aimed to assess the prevalence and associated factors of anxiety, depression, and stress, as well as changes in daily and occupational activities among healthcare professionals due to the COVID-19 pandemic in Colombia.Methods: An observational, cross-sectional study was conducted between February and June 2021. The survey incorporated validated mental health tools such as the Generalized Anxiety Disorder–7, the Patient Health Questionnaire-9, and the Perceived Stress Scale-10. Multivariable ordinal logistic regression analysis was performed to determine the factors associated with severe mental health outcomes.Results: Among 1345 healthcare workers the prevalence of anxiety, depression, and stress were 75.61%, 59.18%, and 53.09%, respectively. Anxiety (OR:1.44; 95%CI:1.16-1.8), depression (OR:1.74; 95%CI:1.27-2.37), and stress (OR:1.51; 95%CI:1.18-1.94) were more frequent in women, and individuals who expressed fear of a negative outcome (death, sequelae) (OR:2.25; 95%CI:1.60-3.25), (OR:1.49; 95%CI:1.03-2.16) and (OR:2.36; 95%CI:1.69-3.29) respectively. Age was negatively associated with anxiety (OR:0.98; 95%CI:0.98-0.99), stress (OR:0.98; 95%CI:0.97-0.99), and depression (OR:0.97; 95% CI:0.96-0.98). Reduction in consultations and surgeries (OR:1.01; 95%CI:1.0-1.01) was positively associated with anxiety. Due to the pandemic, most specialists expected to incorporate drastic long-term (>1 year) changes in their clinical setting and daily activities.Conclusions: The prevalence of anxiety, depression, and stress is higher among Colombian healthcare workers compared to previous reports. Further research regarding these psychological outcomes is needed to achieve early mental health intervention strategies.Trial Registration: Hospital Universitario Fundación Santa Fe, Ethical Committee Registration ID: CCEI-12992-2021.

Background The COVID-19 pandemic has placed an unprecedented physical and mental burden on healthcare workers who are frequently at high risk of infection, particularly in low-income countries. This study aimed to assess the prevalence and associated factors of anxiety, depression, and stress, as well as changes in daily and occupational activities among healthcare professionals due to the COVID-19 pandemic in Colombia. Methods An observational, cross-sectional study was conducted between February and June 2021. The survey incorporated validated mental health tools such as the Generalized Anxiety Disorder–7, the Patient Health Questionnaire-9, and the Perceived Stress Scale-10. Multivariable ordinal logistic regression analysis was performed to determine the factors associated with severe mental health outcomes. Results Among 1345 healthcare workers the prevalence of anxiety, depression, and stress were 75.61, 59.18, and 53.09%, respectively. Anxiety (OR:1.44; 95%CI:1.16–1.8), depression (OR:1.74; 95%CI:1.27–2.37), and stress (OR:1.51; 95%CI:1.18–1.94) were more frequent in women, and individuals who expressed fear of a negative outcome (death, sequelae) (OR:2.25; 95%CI:1.60–3.25), (OR:1.49; 95%CI:1.03–2.16) and (OR:2.36; 95%CI:1.69–3.29) respectively. Age was negatively associated with anxiety (OR:0.98; 95%CI:0.98–0.99), stress (OR:0.98; 95%CI:0.97–0.99), and depression (OR:0.97; 95% CI:0.96–0.98). Reduction in consultations and surgeries (OR:1.01; 95%CI:1.0–1.01) was positively associated with anxiety. Due to the pandemic, most specialists expected to incorporate drastic long-term (> 1 year) changes in their clinical setting and daily activities. Conclusions The prevalence of anxiety, depression, and stress is higher among Colombian healthcare workers compared to previous reports. Further research regarding these psychological outcomes is needed to achieve early mental health intervention strategies. Trial registration Hospital Universitario Fundación Santa Fe, Ethical Committee Registration ID: CCEI-12992-2021.

Symptoms-based models for predicting SARS-CoV-2 infection may improve clinical decision-making and be an alternative to resource allocation in under-resourced settings. In this study we aimed to test a model based on symptoms to predict a positive test result for SARS-CoV-2 infection during the COVID-19 pandemic using logistic regression and a machine-learning approach, in Bogotá, Colombia. Participants from the CoVIDA project were included. A logistic regression using the model was chosen based on biological plausibility and the Akaike Information criterion. Also, we performed an analysis using machine learning with random forest, support vector machine, and extreme gradient boosting. The study included 58,577 participants with a positivity rate of 5.7%. The logistic regression showed that anosmia (

Coronavirus disease-19 (COVID-19) "lockdowns" caused an abruptly restricted access to health care services such as immunotherapy for allergic rhinitis (AR) and led to higher exposure to indoor allergens. This study aimed to assess the impact of COVID-19 lockdowns on AR symptoms reported by the patients treated with immunotherapy who attended the Hospital Fundación Santa Fe de Bogotá and Unidad Médico Quirúrgica de Otorrinolaringología, Colombia.Pre-post study that included patients with AR confirmed diagnosis (prick test), treated with immunotherapy before and after COVID-19 lockdowns on March-June 2020. Visual analog scales (VAS) and sociodemographic questionnaires were applied to assess AR symptoms (nasal obstruction, pruritus, rhinorrhea, and ocular symptoms) and their associated factors.A total of 318 participants were included, and their mean age was 18.9 years (SD: 12.8). The median number of immunotherapy doses applied before isolation was 11 (interquartile range [IQR]: 6-19), and the median number of immunotherapy doses missed during isolation was three doses (IQR: 2-3). Up to 38.4% of the AR patients reported that their symptoms got worse during lockdowns. A pre-post mean difference in the VAS score of 0.5 was found for nasal obstruction (A large proportion of patients reported worsening of their AR symptoms, probably due to higher exposure to indoor AR allergens and interruption of immunotherapy during COVID-19 lockdowns.

BackgroundOtolaryngologists have a higher risk of physical/psychological problems due to their frequent exposure to SARS-CoV-2. There is no information about the impact of COVID-19 on the mental health of these specialists in low/middle-income countries from Latin America. This study aimed to assess the frequency of anxiety, depression, and stress, as well as the changes in occupational and daily activities due to the COVID-19 pandemic in a group of pediatric otolaryngologists in Latin America.MethodsObservational, cross-sectional study conducted between October and December 2020. Mental health tools such as the Generalized Anxiety Disorder−7, the Patient Health Questionnaire-9, and the Perceived Stress Scale-10 were applied. Fear to COVID-19 scale and questionnaires about occupational and daily activities were also applied.ResultsAmong 55 pediatric otolaryngologists, the frequency of anxiety, depression, and stress were 67.3%, 45.5, and 40%, respectively. Up to 27.3% of the specialists reported moderate to severe symptoms of anxiety, while 7.3 and 40% presented moderate depression and stress symptoms. The specialists reported a reduction of 58.3% of their consultations, as well as a 51.7% reduction in their monthly income compared to the same period before the pandemic. Up to 14.6% of the specialists expect to incorporate long-term (>1 year) drastic changes in their daily activities due to the pandemic.ConclusionsThe frequency of anxiety, depression, and stress was high among pediatric otolaryngologists in Latin America compared to previous studies performed in high-income countries. Further research on these psychological outcomes is needed to achieve early mental health strategies.

Background: As Bogotá is one of the regions with the highest prevalence of chronic malnutrition (13%) in Colombia, exceeding the national figure of 10.8%, a public-private alliance was established to address this situation within the framework of intersectoral action: the private organizations Fundación Santa Fe de Bogotá and Fundación Éxito, local government agencies of the Mayor's Office of Bogotá (Secretaría Distrital de Salud and the Secretariat de Integración Social) and agencies at the national level (Instituto Colombiano de Bienestar Familiar [Colombian Institute of Family Welfare], including its regional office in Bogotá). Therefore, the objective was to determine the effectiveness of an intersectoral public health intervention with the population under one year of age, classified as at risk of chronic malnutrition and with chronic malnutrition by anthropometry, residing in 3 prioritized territories of the Capital District. Methods: Pre-experimental, before and after study that sought to determine the magnitude of the change in nutritional status in children under one-year-old residing in 3 prioritized territories of Bogotá through a ten months public health nutrition intervention. Results: The intervention comprised 1126 children living in the following territories in Bogotá: Kennedy, San Cristóbal, and Engativá. A total of 43.3% children presented delay in height for age, and 56.7% presented risk of short stature. In the final measurement, data were obtained from 686 children, identifying that 17% of the children progressed from stunting to a stunting risk and that 4.5% recovered their growth trajectory, achieving an adequate height for their age. Conclusions: That children classified as at risk or stunting at the beginning of the intervention showed an increased probability of approaching or being in the appropriate growth trajectory according to the height-for-age indicator after the intervention. In addition, the risk of stunting is a reversible condition if interventions are implemented in a timely manner and with intersectoral action for which it is imperative to link the community itself as a key sector for direct action and to organize all actors and sectors having missionary purposes with this population.

The prevalence of allergic diseases is increasing worldwide, affecting about 30% of the population in low to middle-income countries. Research trends on allergic diseases within rural pediatric populations of Latin American countries is scarce. This study aimed to determine the prevalence of allergic diseases (allergic rhinitis, asthma, and atopic dermatitis) and their associated factors using the International Study of Asthma and Allergies in Childhood-III (ISAAC-III) questionnaire in school-aged children from two rural municipalities in Colombia.This is a cross-sectional study. The ISAAC-III questionnaire was applied to school-aged children attending elementary schools in the municipalities of Soracá and Palmas del Socorro during 2018. The questionnaires were applied to adolescents aged 13-14 years and the parents of 6-7 years old children. Associations were estimated via bivariate and multivariate analysis.Among 261 school-aged children (58.2% adolescents), the prevalence of allergic diseases was: allergic rhinitis 11.49% (95% CI: 8.05-15.78), asthma 8.81% (95% CI: 5.82-12.7), and atopic dermatitis 6.13% (95% CI: 3.69-9.53). Associated factors for allergic rhinitis included: female sex (PR: 2.68, 95% CI: 1.17-5.26), asthma (PR: 4.69, 95% CI: 1.96-8.31), atopic dermatitis (PR: 3.55, 95% CI: 1.09-7.83), and higher maternal education (PR: 4.16, 95% CI: 1.45-8.25).The prevalence of allergic diseases in this rural pediatric population was lower compared with that of the previous reports from urban populations. Associated factors found in this study support previous studies. Research addressing modifiable environmental associations is so far scarce in Latin America; further studies are needed to reduce the burden of these diseases in rural populations.

Background Despite the high prevalence of chronic otitis media (COM) in low to middle-income countries, there are few studies regarding its associated factors, health-related quality of life, and treatment costs. This study aimed to identify associated factors of COM, assess its impact on the quality of life as well as estimate the patients’ reported costs of COM treatment in Colombia. Methods Cross-sectional study. Two otology-referral centers in Bogotá (Colombia) were included. Questionnaires focusing on sociodemographic and clinical associated factors, quality of life, and patients’ reported costs were administered to 200 adults with COM diagnosis and 144 control adults. Otoscopic evaluation and audiometric data were collected. Results The mean age was 42.2 years (SD: 14.44). The median length of COM was 26.13 years (SD: 17.06), and 79.5% of the COM patients reported otorrhea during childhood (P-value: 0.01). The most frequently reported allergic disease among our study population was allergic rhinitis (26.5%). COM was less frequent in patients with a medium-high socioeconomic status (PR: 0.54; 95% CI: 0.39–0.72), and more frequent in patients who reported increased ear discharge due to upper respiratory tract infections (PR: 1.69; 95% CI: 1.68–1.70). The global score of the “Chronic Suppurative Otitis Media Questionnaire-12” showed a difference of 9 points between patients with active and inactive COM (P < 0.001). Patients spent between 12.07% to 60.37% of their household income on expenses related to COM. Conclusions Associated factors found in this study are consistent with previous reports. COM has a significant financial impact and affects patients’ quality of life. Worldwide research addressing these issues in poor-resource countries is scarce, further studies are needed.