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Previous studies have shown the influence of the physical and social environments on the development of obesity and non-communicable diseases (NCD). An obesogenic environment promotes higher dietary energy intakes and sedentary behaviors while limiting opportunities or incentives for active living. This paper presents a dataset with key attributes of the food and physical activity built environment, including green spaces, quality of streets and sidewalks, and different types of food retail outlets in four cities of the Southern Cone of Latin America. A total of 139 representative neighborhoods randomly selected from: Marcos Paz and Bariloche (Argentina), Temuco (Chile) and Canelones-Barros Blancos (Uruguay) were evaluated, where standardized community walks were conducted for direct observation of the built environment. This dataset will contribute valuable data to the evaluation of obesogenic environments in the region, and could be linked to additional ecological information about risk factors for NCDs and socio-economic features from other sources. Understanding environmental influences on cardiovascular risk factors and individual habits may help explain NCD outcomes and plan urban policies., Measurement(s)features of the built environmentTechnology Type(s)ObservationSample Characteristic - Environmentbuilt environmentSample Characteristic - LocationArgentina • Chile • Uruguay Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.14892147

Objective:To determine the optimal anthropometric cut-off points for predicting the likelihood ratios of hypertension and diabetes in the Peruvian population.Design:A cross-sectional study was performed to establish cut-off values for body mass index (BMI), waist circumference (WC), waist:height ratio (WHtR) and Conicity index (C-index) associated with increased risk of hypertension and diabetes. Youden’s index (YIndex), area under the curve (AUC), sensitivity and specificity were calculated.Setting:Peruvian households.Participants:Peruvian population over the age of 18 years.Results:A total of 31 553 subjects were included, 57 % being women. Among the women, 53·06 % belonged to the 25- to 44-year-old age group [mean age: 41·66 in men and 40·02 in women]. The mean BMI, WHtR and C-index values were higher in women 27·49, 0·61, 1·30, respectively, while the mean WC value was higher in men 92·12 cm (sd± 11·28). The best predictors of hypertension in men were the WHtR (AUC = 0·64) and the C-index (AUC = 0·64) with an optimal cut-off point of 0·57 (YIndex = 0·284) and 1·301 (YIndex = 0·284), respectively. Women showed an AUC of 0·63 and 0·61 in the WHtR and C-index, respectively, with an optimal cut-off of 0·61 (YIndex = 0·236) and 1·323 (YIndex = 0·225). The best predictor for diabetes was the C-index: with an AUC = 0·67 and an optimal cut-off of 1·337 (YIndex = 0·346) for men and an AUC = 0·66 and optimal cut-off of 1·313 (YIndex = 0·319) for women.Conclusions:Our findings show that in Peruvian adults, the WHtR and the C-index have the strongest association with hypertension in both sexes. Likewise, the C-index had the strongest association with diabetes.

Background The northeastern region of Argentina has the highest age-adjusted cervical cancer mortality rates. Given the strong link between HPV infections and cervical cancer, one of the main interventions is the population-based use of HPV vaccines. However, the acceptability is not very clear in low- and middle-income countries. The purpose of this study was to estimate the level of HPV vaccine acceptance and associated determinants among caregivers of girls in a northeastern city of Argentina. Methods A school-based survey was conducted in 2015 using a multistage sampling method. The primary sample unit were schools stratified by socioeconomic status selected at random, and caregivers of school girls were interviewed. The acceptability was determined using the adapted Theory of Planned Behavior. We performed logistic regression models to assess associated determinants. Results The study included 347 caregivers. The intention to vaccinate was 59.88%. A positive attitude of caregivers (aOR 4.67; 3.11-7.03) and positive influence of social norms (aOR 1.95; 1.03-3.70) were the main predictors independently associated to the intention to vaccinate against HPV. In contrast, practicing a Christian non-Catholic religion decreased the intention to vaccinate against HPV (OR 0.59; 0.36-0.95). All other factors evaluated were not significantly associated with intention to vaccinate against HPV. Conclusions This study shows that evaluating attitudes, normative social beliefs, and perceived self-efficacy regarding HPV vaccination can be of utmost importance for mapping and planning of health-related strategies in developing countries.

The Healthy Municipalities and Communities Strategy (HMCS) was developed by the Pan American Health Organization in 1990. Evaluation and monitoring are fundamental components of health promotion policies. The aim of this study is to explore the indicators used in Latin America and the Caribbean (LAC) countries to assess the performance of HMCS. We searched MEDLINE, EMBASE, LILACS, BVSDE and Google Advanced Search for documents published between January 2000 and April 2016. We included only documents with assessment indicators of the strategy. All articles were independently assessed for eligibility by pairs of reviewers. We classified the indicators with a supporting framework proposed by O’Neill and Simard (Choosing indicators to evaluate Healthy Cities projects: a political task? Health Promot Int 2006, 21, 145–152.). Local level indicators figured far more prominently among countries and were distributed both in projects and specific activities. Regarding the evolution of the HMCS, indicators were reported in the five levels of analysis (local projects and activities, provincial, national and international networks). Empowerment was represented through the presence of active community organizations and different methods of community participation (forums, open hearing and participation maps). Public policies (such as for tobacco cessation) and bylaws adherence and changes in school’s curricula regarding healthy eating were frequently mentioned. However, this review demonstrated that impact indicators related to lifestyle changes or built environment are not clearly defined and there is a lack of indicators to measure progress in achieving change in long-term outcomes in LAC. We highlight the importance of designing validated indicators for measuring the impact of health promotion policies in partnership with each country involved.

Introduction and objectives Heart failure is a major public health concern. The aim of this review was to estimate the burden of heart failure in Latin America. Methods Systematic review and meta-analysis following a search in MEDLINE, EMBASE, LILACS, and CENTRAL for articles published between January 1994 and June 2014, with no language restrictions. We included experimental and observational studies with at least 50 participants aged ≥ 18 years. Results In total, 143 of the 4792 references retrieved were included in the study. Most studies had been conducted in South America (92%), and mainly in Brazil (64%). The mean age of the patients was 60 ± 9 years, and mean ejection fraction was 36% ± 9%. The incidence of heart failure in the single population study providing this information was 199 cases per 100 000 person-years. The prevalence of heart failure was 1% (95% confidence interval [95%CI], 0.1%-2.7%); hospital readmission rates were 33%, 28%, 31%, and 35% at 3, 6, 12, and 24 to 60 months of follow-up, respectively; and the median duration of hospitalization was 7.0 days. The 1-year mortality rate was 24.5% (95%CI, 19.4%-30.0%). In-hospital mortality was 11.7% (95%CI, 10.4%-13.0%), and the rate was higher in patients with a reduced ejection fraction, ischemic heart disease, or Chagas disease. Conclusions Few studies have evaluated the incidence and prevalence of heart failure in Latin America. High mortality and hospitalization rates were found, and the main limitation was heterogeneity between studies. The results presented provide useful epidemiologic information for decision-making related to this disease. Further studies with standardized methods and representative populations are needed in this line.

Resumen Introduccion y objetivos La insuficiencia cardiaca es un grave problema de salud publica. El objetivo de la revision es estimar la carga de insuficiencia cardiaca en Latinoamerica. Metodos Revision sistematica y metanalisis, tras busqueda en MEDLINE, EMBASE, LILACS y CENTRAL desde enero de 1994 a junio de 2014, sin restriccion de idioma. Se incluyeron estudios experimentales y observacionales con al menos 50 participantes de edad ≥ 18 anos. Resultados Se incluyeron 143 de las 4.792 referencias recuperadas. La mayoria de los estudios se realizaron en Sudamerica (92%), principalmente en Brasil (64%). La media de edad era 60 ± 9 anos y la fraccion de eyeccion media, del 36 ± 9%. La incidencia de insuficiencia cardiaca en el unico estudio poblacional identificado fue de 199/100.000 personas-anos; la prevalencia, del 1% (intervalo de confianza del 95% [IC95%], 0,1-2,7%); las tasas de rehospitalizacion, del 33, el 28, el 31 y el 35% a 3, 6, 12 y 24-60 meses de seguimiento respectivamente, y la mediana de estancia hospitalaria, 7,0 dias. La tasa de mortalidad al ano fue del 24,5% (IC95%, 19,4-30,0%). La mortalidad intrahospitalaria fue del 11,7% (IC95%, 10,4-13,0%), y aumentaba en pacientes con fraccion de eyeccion reducida, cardiopatia isquemica y enfermedad de Chagas. Conclusiones Pocos estudios han evaluado la incidencia y la prevalencia de insuficiencia cardiaca en Latinoamerica. Se hallaron altas tasas de mortalidad y de hospitalizacion, y la heterogeneidad es su principal limitacion. Este estudio brinda la informacion epidemiologica disponible para la toma de decisiones sobre esta enfermedad. Se requieren mas estudios con metodologias estandarizadas y en poblaciones representativas.

Background: A recent cluster randomized trial evaluating a multicomponent intervention showed significant reductions in blood pressure in low-income hypertensive subjects in Argentina. Objectives: To assess the cost-effectiveness of this intervention. Methods: A total of 1432 hypertensive participants were recruited from 18 primary health care centers. The intervention included home visits led by community health workers, physician education, and text messaging. Resource use and quality of life data using the three-level EuroQol five-dimensional questionnaire were prospectively collected. The study perspective was that of the public health care system, and the time horizon was 18 months. Intention-to-treat analysis was used to analyze cost and health outcomes (systolic blood pressure [SBP] change and quality-adjusted life-years [QALYs]). A 1 time gross domestic product per capita per QALY was used as the cost-effectiveness threshold (US $14,062). Results: Baseline characteristics were similar in the two arms. QALYs significantly increased by 0.06 (95% confidence interval [CI] 0.04–0.09) in the intervention group, and SBP net difference favored the intervention group: 5.3 mm Hg (95% CI 0.27–10.34). Mean total costs per participant were higher in the intervention arm: US $304 in the intervention group and US $154 in the control group (adjusted difference of US $140.18; 95% CI US $75.41–US $204.94). The incremental cost-effectiveness ratio was $3299 per QALY (95% credible interval 1635–6099) and US $26 per mm Hg of SBP (95% credible interval 13–46). Subgroup analysis showed that the intervention was cost-effective in all prespecified subgroups (age, sex, cardiovascular risk, and body mass index). Conclusions: The multicomponent intervention was cost-effective for blood pressure control among low-income hypertensive patients. Fil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Chaparro, Martin. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Palacios, Alfredo. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Shi, Lizheng. University of Tulane; Estados Unidos Fil: Beratarrechea, Andrea Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Mills, Katherine. University of Tulane; Estados Unidos Fil: He, Jiang. University of Tulane; Estados Unidos Fil: Pichón-Riviere, Andrés. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

After vector-borne transmission, the congenital form is the most important to maintain the endemic. The probability of congenital transmission may depend on factors that vary between different countries and geographic areas. This study was carried out with the objective of estimating the proportion of congenital transmission of Chagas disease and maternal factors associated to the T. cruzi infection in newborns and their siblings during 2011 in four hospitals of the Province of Chaco.A cross sectional study was performed. A home visit was made to children aged above 10 months born during 2011 whom their mother present T cruzi infection. Blood samples were taken from both the newborns and their siblings and were processed for diagnosis of T. cruzi infection with HAI and ELISA. We found 247 mothers infected with T cruzi, and blood samples were obtained from 246 newborns and 556 of their siblings.Of the 246 children born in 2011, a total of 6.1% (95% CI = 3.6-9.6) resulted with positive serology, as well as 7.7% of their siblings (95% CI = 5.7-10.1) and the clinic visits of those born in 2011 and their siblings in the health center was associated with a lower probability of congenital transmission (OR = 0.21 and 0.36, respectively).The transmission rate is consistent with the values reported in Argentina and only multiparity was a mother factor associated with the higher probability of congenital transmission.Luego de la transmisión vectorial, la congénita, es la forma más importante para mantener la endemia. La probabilidad de transmisión congénita puede depender de factores que varían entre los diferentes países y áreas geográficas. Se realizó este trabajo con el objetivo de estimar la proporción de transmisión congénita y explorar factores maternos asociados a la enfermedad de Chagas en niños al nacer y sus respectivos hermanos en cuatro hospitales de la Provincia del Chaco.Estudio transversal. Se realizó una visita al domicilio de niños de 10 meses de edad o mayores, nacidos durante el año 2011, hijos de mujeres con infección por T cruzi. Se extrajeron muestras sanguíneas tanto de los niños al nacer como de sus hermanos y se procesaron para diagnóstico de infección por T cruzi con HAI y ELISA.Se localizaron a 247 madres infectadas con T. cruzi, y se obtuvieron muestras de sangre de 246 niños al nacer y de 556 de sus hermanos. Del total de nacidos en el año 2011, el 6,1% (IC 95%= 3,6-9,6) resultaron con serología positiva, así como 7,7%; de sus hermanos (IC 95%= 5,7-10,1) y el control de salud de ambos niños en el centro de atención primaria se asoció con una menor probabilidad de transmisión congénita (OR=0,21 y 0,36 respectivamente).Conclusión. La tasa de transmisión es consistente con los valores reportados en el país y solo la multiparidad fue un factor asociado a la mayor probabilidad de transmisión congénita.La tasa de transmisión es consistente con los valores reportados en el país y solo la multiparidad fue un factor asociado a la mayor probabilidad de transmisión congénita.

To explore the motivations and expectations of the users of the Program for Healthy Centers in the Autonomous City of Buenos Aires and to evaluate its potential health impact.In-depth interviews were conducted (n = 34) and a self-administered survey was sent to users of the program (n = 605). An epidemiological model was developed to estimate the impact of the program on cardiovascular events (CVE) and disability-adjusted life years (DALYs).The main motivating factors for using the healthy centers were geographic and economic accessibility (free services) and satisfaction with the care received. 14.4% (95% CI, 10.3-18.5%) of hypertensive users and 24.8% (95% CI, 17.6-32.0%) of diabetic users reported having learned of their altered values in the healthy center. More than half of the respondents reported some improvement in their knowledge about the benefits of physical activity and healthy eating; this was more frequent among those who were younger, of lower educational level, users of the public health system, users of a healthy center in the South zone and those who had a cardiometabolic risk factor (p0.05). It was estimated that the healthy centers would prevent 12.5 cardiovascular and cerebrovascular events per year in the assisted population (4.75 events/100 000) and 47.75 DALYs due to these causes.The healthy centers are a favorable space for the implementation of health promotion and prevention actions, contributing to the detection of and facilitating the monitoring of risk factors, with a potential to prevent cardiovascular events and its consequences.Explorar as motivações e expectativas dos usuários do Programa Estações Saudáveis na Cidade Autônoma de Buenos Aires e avaliar seu impacto potencial na saúde.Foram realizadas entrevistas em profundidade (n = 34) e uma pesquisa auto-administrada (n = 605) a usuários do programa. Um modelo epidemiológico foi desenvolvido para estimar o impacto do programa em eventos cardiovasculares e anos de vida ajustados por incapacidade (DALY).Os principais fatores motivadores para o uso do estações saudáveis foram a acessibilidade geográfica, econômica (serviços gratuitos) e a satisfação com o atendimento recebido. 14,4% (intervalo de confiança de 95% [IC95%] 10,3-18,5%) de usuários hipertensos e 24,8% (IC95% 17,6-32,0%) dos diabéticos relataram ter aprendido sobre seus valores alterados na estação saudável. Mais da metade dos entrevistados relataram alguma melhora no conhecimento sobre os benefícios da atividade física e da alimentação saudável, com maior freqüência entre os mais jovens, de menor escolaridade, usuários do sistema público de saúde, usuários de estações saudáveis na zona sul e aqueles que apresentaram algum fator de risco cardiometabólico (p0,05). Estimou-se que, devido à existência de estações saudáveis, 12,5 eventos cardiovasculares e cerebrovasculares por ano seriam evitados na população atendida (4,75 eventos/100 000) e 47,75 DALY por essas causas.As estações saudáveis são um espaço propício para a implementação de ações de promoção e prevenção da saúde, contribuindo para a detecção e facilitação do monitoramento dos fatores de risco, com potencial para prevenir os eventos cardiovasculares e suas consequências.

Four million people in Argentina are exposed to arsenic contamination from drinking waters of several center-northern provinces. A systematic review to examine the geographical distribution of arsenic-related diseases in Argentina was conducted, searching electronic databases and gray literature up to November 2013. Key informants were also contacted. Of the 430 references identified, 47 (mostly cross-sectional and ecological designs) referred to arsenic concentration in water and its relationship with the incidence and mortality of cancer, dermatological diseases and genetic disorders. A high percentage of the water samples had arsenic concentrations above the WHO threshold value of 10. μg/L, especially in the province of Buenos Aires. The median prevalence of arsenicosis was 2.6% in exposed areas. The proportion of skin cancer in patients with arsenicosis reached 88% in case-series from the Buenos Aires province. We found higher incidence rate ratios per 100. μg/L increment in inorganic arsenic concentration for colorectal, lung, breast, prostate and skin cancer, for both genders. Liver and skin cancer mortality risk ratios were higher in regions with medium/high concentrations than in those with low concentrations. The relative risk of mortality by skin cancer associated to arsenic exposure in the province of Buenos Aires ranged from 2.5 to 5.2. In the north of this province, high levels of arsenic in drinking water were reported; however, removal interventions were scarcely documented. Arsenic contamination in Argentina is associated with an increased risk of serious chronic diseases, including cancer, showing the need for adequate and timely actions. Fil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Ciapponi, Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Soto, Natalie. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Chaparro, Raul Martin. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Calderon, Maria. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Briatore, Agustina. Hospital Italiano; Argentina Fil: Cadoppi, Norma. Foro Estratégico para el Desarrollo Nacional; Argentina Fil: Tassara, Roberto. Foro Estratégico para el Desarrollo Nacional; Argentina Fil: Litter, Marta Irene. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Comisión Nacional de Energía Atómica; Argentina

INTRODUCTION:Hypercholesterolaemia is estimated to cause 2.6 million deaths annually and one-third of the cases of ischaemic heart disease. In Argentina, the prevalence of hypercholesterolaemia increased between 2005 and 2013 from 27.9% to 29.8%. Only one out of four subjects with a self-reported diagnosis of coronary heart disease is taking statins. Since 2014, statins (simvastatin 20 mg) are part of the package of drugs provided free-of-charge for patients according to cardiovascular disease (CVD) risk stratification. The goal of this study is to test whether a complex intervention targeting physicians and pharmacist assistants improves treatment and control of hypercholesterolaemia among patients with moderate-to-high cardiovascular risk in Argentina.METHODS AND ANALYSIS:This is a cluster trial of 350 patients from 10 public primary care centres in Argentina to be randomised to either the intervention or usual care. The study is designed to have 90% statistical power to detect a 0.7 mmol/L reduction in low-density lipoproteins cholesterol from baseline to 12 months. The physician education programme consists of a 2-day initial intensive training and certification workshop followed by educational outreach visits (EOVs) conducted at 3, 6 and 9 months from the outset of the study. An on-site training to pharmacist assistants during the first EOV is performed at each intervention clinic. In addition, two intervention support tools are used: an app installed in physician´s smartphones to serve as a decision aid to improve prescription of statins according to patient´s CVD risk and a web-based platform tailored to send individualised SMS messages to patients.ETHICS AND DISSEMINATION:Ethical approval was obtained from an independent ethics committee. Results of this study will be presented to the Ministry of Health of Argentina for potential dissemination and scale-up of the intervention programme to the entire national public primary care network in Argentina.TRIAL REGISTRATION NUMBER:NCT02380911. Fil: Gulayin, Pablo. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Lozada, Alfredo. Universidad Austral; Argentina Fil: Chaparro, Raul Martin. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Santero, Marilina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Poggio, Rosana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Beratarrechea, Andrea Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina

Background: Obesogenic environments promote sedentary behavior and high dietary energy intake. The objective of the study was to identify barriers and facilitators to the implementation and impact evaluation of projects oriented to promote physical activity and healthy diet at community level. We analyzed experiences of the projects implemented within the Healthy Municipalities and Communities Program (HMCP) in Argentina. Methods: A mixed methods approach included (1) in-depth semi-structured interviews, with 44 stakeholders, and (2) electronic survey completed by 206 individuals from 96 municipalities across the country. Results: The most important barriers included the lack of: adequate funding (43%), skilled personnel (42%), equipment and material resources (31%), technical support for data management and analysis (20%), training on project designs (12%), political support from local authorities (17%) and acceptance of the proposed intervention by the local community (9%). Facilitators included motivated local leaders, inter-sectorial participation and seizing local resources. Project evaluation was mostly based on process rather than outcome indicators. Conclusions: This study contributes to a better understanding of the difficulties in the implementation of community-based intervention projects. Findings may guide stakeholders on how to facilitate local initiatives. There is a need to improve project evaluation strategies by incorporating process, outcome and context specific indicators.

In Argentina, every year, 3000 new cases of cervical cancer are diagnosed and more than 2000 deaths occur as a result of this disease. Human papillomavirus (HPV) is the main risk factor for cervical carcinogenesis.To establish the extent of acceptance of HPV vaccines and associated factors among legal guardians of candidate girls in an area of Resistencia, Chaco.Qualitative and quantitative study. A single randomized sampling was done based on school enrollment lists. Guardians who reported making decisions regarding girls' health in 2012 were included. A structured questionnaire made up of four constructs was used to measure overall acceptability. The association between overall acceptability and sociodemographic outcome measures was assessed.The rate of acceptance was 46.6% (95% confidence interval: 34.8-58.6). Among guardians, 84.2% were women; their mean age was 38.3 years old (95% confidence interval: 36.7-39.8). Religion was practiced by 86.8% (77.1-93.5), 55.2% were Catholic and 44.8%, Evangelical Protestants. Guardians with more than one candidate girl for the vaccine accounted for 18.9%. Also, 85.5% referred having heard about the virus at some point, and 52.7% knew that a vaccine could prevent it. Acceptance was significantly higher among guardians of those girls who had received the first vaccine dose (OR: 8.02, 95% confidence interval: 2.29-28.01, p= 0.0011).The rate of acceptance was low and no association was observed between sociodemographic and psychosocial factors and the decision to have girls vaccinated with the HPV vaccine.En Argentina, se diagnostican 3000 nuevos casos y más de 2000 muertes por cáncer de cuello uterino cada año. El virus del papiloma humano es el principal factor de riesgo en la carcinogénesis cervical.Determinar el nivel de aceptación de la vacuna contra el virus del papiloma humano por parte de los tutores de las niñas candidatas y los factores asociados en un área de Resistencia, Chaco.Estudio cualicuantitativo. Se utilizó un muestreo aleatorio simple sobre la base de listas escolares. Se incluyeron los tutores que refirieron tomar decisiones respecto a la salud de sus niñas, en el año 2012. Se utilizó un cuestionario estructurado en 4 constructos, que medían la aceptabilidad global. Se estudió la asociación entre aceptabilidad global y las variables sociodemográficas.La frecuencia de aceptación fue 46,6% (IC 95%: 34,8-58,6). De los tutores, el 84,2% fueron mujeres; la media de edad fue 38,3 años (IC 95%: 36,7-39,8). La frecuencia de práctica de religión fue 86,8% (77,1-93,5); el 55,2% practicaban la religión católica y el 44,8%, evangelista. El 18,9% tenia más de una niña candidata a recibir la vacuna. El 85,5% refirió que había escuchado hablar del virus en algún momento y el 52,7% conocía la existencia de la vacuna para prevenirlo. La aceptación fue significativamente mayor en los tutores de las niñas que habían recibido la primera dosis de la vacuna (OR 8,02; IC 95%: 2,29-28,01; p= 0,0011).La frecuencia de aceptación fue baja y no se encontró una asociación de los factores sociodemográficos y psicosociales con la decisión de vacunar a las niñas contra el virus del papiloma humano.

Introducción. Luego de la transmisión vectorial, la congénita, es la forma más importante para mantener la endemia. La probabilidad de transmisión congénita puede depender de factores que varían entre los diferentes países y áreas geográficas. Se realizó este trabajo con el objetivo de estimar la proporción de transmisión congénita y explorar factores maternos asociados a la enfermedad de Chagas en niños al nacer y sus respectivos hermanos en cuatro hospitales de la Provincia del Chaco. Métodos. Estudio transversal. Se realizó una visita al domicilio de niños de 10 meses de edad o mayores, nacidos durante el año 2011, hijos de mujeres con infección por T cruzi. Se extrajeron muestras sanguíneas tanto de los niños al nacer como de sus hermanos y se procesaron para diagnóstico de infección por T cruzi con HAI y ELISA. Resultados. Se localizaron a 247 madres infectadas con T. cruzi, y se obtuvieron muestras de sangre de 246 niños al nacer y de 556 de sus hermanos. Del total de nacidos en el año 2011, el 6,1% (IC 95%= 3,6-9,6) resultaron con serología positiva, así como 7,7%; de sus hermanos (IC 95%= 5,7-10,1) y el control de salud de ambos niños en el centro de atención primaria se asoció con una menor probabilidad de transmisión congénita (OR=0,21 y 0,36 respectivamente).Conclusión. La tasa de transmisión es consistente con los valores reportados en el país y solo la multiparidad fue un factor asociado a la mayor probabilidad de transmisión congénita.

Background: Leisure time is a human right and has to be considered part of any health promotion initiative aimed at children and adolescents. The objective of this study was to analyze the relationship between social vulnerability and the healthy use of leisure time in children and adolescents in urban contexts of Argentina, in 2012. Methods: A cross-sectional and analytical study using data from the Module on Activities of Girls, Boys and Adolescents of the Annual Urban Household Survey was carried out. In this survey, a self-administered instrument was applied to 25,915 individuals aged from 5 to 17. A Social Vulnerability Index (SVI) was developed. Association was estimated by multilevel logistic regression. Results: Children and adolescents use most of their leisure time to carry out school activities (90.1%) with art activities having the lowest percentage (21.8%). In the multilevel models on the relationship between a Moderate/High SVI and non-performance of art activities, the OR was 1.398 (p = 0.002, 95% CI: 1.251-1.561). The association between Moderate/High SVI and non-use of Information and Communications Technology (ICT) gave an OR of 1.580 (p < 0.001, 95% CI: 1.435-1.741), and between Moderate/High SVI and non-use of internet, an OR of 1.586 (p < 0.001, 95% CI: 1.447-1.729). Conclusions: A Moderate/High SVI negatively impacts on some healthy activities of leisure time for children and adolescents in Argentina. The SVI could be a useful tool to guide health promotion initiatives in this population.

Introducción. En la localidad de Avia Terai, Noreste de Argentina, se desarrolló un programa local de Prevención y Control de la enfermedad de Chagas orientado en los principios de la Atención Primaria de la Salud. El objetivo general de este trabajo fue evaluar el cambio en los conocimientos respecto a la enfermedad de Chagas luego de la implementación de la estrategia del componente de información, educación y comunicación social del programa local en la zona urbana de la localidad de Avia Terai en el año 2012. Métodos. Se empleó un diseño de corte transversal en dos momentos. Se realizó un muestreo polietápico por conglomerados. La unidad de análisis correspondió a jefes y jefas de hogar de la vivienda sorteada. Se utilizó el cuestionario adaptado de Sanmartino y Crocco, el cual incluye 3 dimensiones y 15 conocimientos básicos, referidos a la enfermedad de Chagas. Resultados. En cuanto al nivel de conocimientos básicos sobre la enfermedad de Chagas, en el nivel III se observó un aumento en el año 2012 respecto del año anterior, de 56,6% al 66,2% (p>0,0001). Mientras que en cuanto a la forma de transmisión congénita, se observó una disminución de la proporción de respuestas correctas respecto al año anterior. Conclusión. Luego de la implementación de un programa local de información, educación y comunicación social, se observó un aumento en los conocimientos básicos sobre la enfermedad de Chagas.

The United States Health Information Knowledgebase (USHIK) is an online, publicly accessible registry/repository of healthcare metadata originally developed by Center for Medicare and Medicaid Services (CMS) and the Department of Defense (DoD) and currently maintained by the Agency for Healthcare Research and Quality (AHRQ). It contains metadata for various healthcare standards, measures, forms and other data sets. Its users include researchers, Standards Development Organisations (SDOs), clinicians, Electronic Health Record (EHR) developers and users, and various Federal- and state-level government entities. USHIK provides the capability to visually organise summary metadata, analyse metadata sets and interactively compare metadata sets. This functionality can be used for analysing and harmonising standards, measures and other healthcare data sets.