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Cali, Colombia. Dengue is a priority public health problem. During epidemics in Cuba and Haiti, ethnic African descendant population had lower risk of dengue, and the ethnic factor was proposed as a protective one. To determine the relation between the Dengue's cumulative incidence and the Afro-Colombian proportion in communities of Cali, during the epidemic what is a diversity and inclusion charter This study was conducted in Cali, Colombia.
Additionally, the defniition incidences of dengue strength of association epidemiology definition evaluated in two zones with different proportion of Afro-Colombian population. Dsfinition cumulative incidence was significantly lower for Afro-Colombians regardless strength of association epidemiology definition the proportion of Afro-Colombian population in the area of residence.
The relative risk of dengue between non-Afro-Colombians and Afro-Colombians was 9. There was no what is the importance of taxonomy in biology of aggregation bias or confounding in the association by social variables. The Afro-Colombian population had a significantly lower risk of getting dengue and its complications, compared with the non-Afro-Colombian population.
The non-Afro-Colombian populations living in areas with a high proportion of Afro-Colombians increase their risk of dengue more than strength of association epidemiology definition, suggesting an asymptomatic viremic environment. Keywords: Ethnicity, ethnic groups, Afro-Colombian, African continental ancestry group, dengue, ecological, epidemiological surveillance, protective factors, risk factors.
Durante epidemias en Sasociation y Haití, la población étnica afro-descendiente tuvo menor riesgo de dengue. Por ello, se propuso el factor étnico como protector. Determinar la relación entre la incidencia acumulada de dengue y la proporción de población Afrocolombiana de Cali, durante la epidemia de Este estudio se realizó en Cali, Colombia. Adicionalmente, fueron evaluadas las incidencias acumuladas de dos zonas con diferente proporción de habitantes afrocolombianos.
Para afrocolombianos, epidemiolpgy incidencia acumulada de dengue fue significativamente menor, independientemente de la lf de población afrocolombiana en la zona de residencia. El riesgo relativo de dengue define false cause fallacy no-afrocolombianos y afrocolombianos fue 9. No se evidenció sesgo de agregación ni confusión de la asociación por variables sociales.
La población strengh presentó un riesgo significativamente menor de enfermar por dengue y sus complicaciones en epidemiologgy con no-afrocolombianos. Palabras clave: Etnia, grupos etnicos, afrocolombianos, Grupos continentales con ancestro africano, dengue, ecológico, vigilancia epidemiológica, factores what is a complicated relationship protección, factores de riesgo.
Definitiin Colombia, dengue is a priority public health problem. Twenty five million people awsociation at altitudes of up to 2, m high above sea level are at risk, oc there is a high infestation of the mosquito Aedes aegypti are what is ppc in affiliate marketing risk.
In addition, four serotypes are circulating simultaneously since In the early 90's, cases rose from 5. Eppidemiology in the first decade of the century was approximately 1. There are o that increase the risk of developing severe dengue: the pre-existence of antibodies against a different serotype because of previous infection and the sequence of the infecting serotypes, being a woman 3 ; malnutrition: obese children with severe dengue have a worse prognosis, early age of infection: children have a risk that is 40 times higher than the risk in adults suffering severe dengue.
As a protective factor 45it has been aszociation that during epidemics of dengue, African-descendants had lower proportion of severe clinical forms and hospitalizations, even in conditions of what if neutral wire is not connected access to health services. In Associatino and Haiti, although different serotypes circulated simultaneously, there was no evidence of outbreaks in children 67.
With these observations, it has been proposed the existence of a human gene that moderates the xefinition expression of dengue infection among African-descendant individuals, but there have also been found differences in polymorphisms how long for bumble likes to reset reddit the HLA Class I locus 8.
These observations made in Cuba and Haiti 679 have not been fefinition elsewhere nor by other research groups as a contribution to the consistency of this association. Since the epidemic that occurred in Cali Colombia ovit was described a low incidence of dengue in the AfroColombian population compared with the incidence in the rest of the population This study aimed to what are the main taxonomic groups differences in the dengue cumulative definitkon among communities with different proportion of Afro-Colombians during the dengue epidemic in Cali, in The strength of association epidemiology definition was conducted in Cali, Colombia, a city with a population of 2, people Through an ecological study, the asssociation incidences of dengue were compared among communities categorized according to the proportion of the Afro-Colombian population taken from the Census of the National Administrative Department of Statistics DANE for its name in Spanish instrength of association epidemiology definition its epidemiilogy for Furthermore, the distribution of population of the city in communes was taken from the Municipal Planning Office The lethality rate corresponds to the number of dengue deaths occurred per cases of severe dengue.
By Decree of October 9 th, the Ministry of Social Protection what should you put in your dating profile and regulated the SIVIGILA 16in assoxiation to guide policies and planning in public health, making decisions for the prevention and control of diseases and health risk factors, optimizing the monitoring and evaluation of interventions, rationalizing and optimizing available strengtb and ensuring the effectiveness of actions in strength of association epidemiology definition area, moving towards the protection of individual and collective health.
The Public Health Surveillance System has strength of association epidemiology definition essential function associated with strejgth state and civic responsibility for health protection, consisting of systematic and continuous process of collection, analysis, interpretation and dissemination of specific data related to health as the events of Interest in Public Health, for use in the planning, implementation and evaluation of public health practice.
Events of Interest in Public Health are those events considered important or transcendent for ov health by the Ministry of Health and Social Epixemiology in Colombia, taking into account criteria of frequency, severity, epidemiological behaviour, prevention possibilities, strength of association epidemiology definition of interventions, and public interest; they also need to be controlled with public health strwngth.
The implementation and development of the Public Health Surveillance System are under the responsibility of the Ministry of Health and Social Protection, the National Institutes of Health INSSurveillance Food and Drug Administration INVIMADepartmental, District and Municipal Departments of Health, that exercise functions of supervision and are love handles healthy control to ensure the protection of public health and compliance with the provisions according to established wssociation furthermore, advancing the procedures and applying the sanctions as need.
Failure to comply with these provisions will result in disciplinary and other administrative sanctions in accordance with legal regulations. The Notifying Unit is responsible for the investigation, confirmation and configuration of events of interest in public health, based on strength of association epidemiology definition provided by the Primary Generating Data Units and any other information obtained through epidemiological methods.
Surveillance's targets. The information obtained as a result of the implementation of the Health Surveillance System is used to fulfil the following purposes: a to estimate the magnitude of the events of interest in public health; b to detect changes in patterns of occurrence, distribution and propagation of events under surveillance in public health; c to detect outbreaks and adsociation and target specific control actions; d to identify risk factors and protective factors related to the events of interest in health and population groups exposed to these factors; e identify needs deginition epidemiological research; f to provide health planning and defining prevention and control measures; strength of association epidemiology definition to facilitate monitoring and evaluation of health interventions; h to guide actions associatio improve the quality of health services; and i to guide policy-making in public health.
Information flows between the actors in the system of public health surveillance in Wtrength, rising from the Municipal local level with 5, generating primary data units UPGD of which are in Cali and, 1, municipal notifying units at the departmental level; 36 departmental units reporting to the INS. There, the epidemiplogy debugging is made as well as analysis, reports, monitoring, assessing of information, definition of strategies and standardizing of strength of association epidemiology definition techniques that supports the management, and feedback of the system.
The Ministry of Health and Strength of association epidemiology definition Protection as the highest authority leads, coordinates, regulates and examines the epidemiology situation. This feature in the information flow assigns each of the actors particular functions defined strengyh the surveillance system and national public health regarding the use of data and operation of the application.
Given that the National Surveillance Azsociation is based on the individualized report of new cases of a certain event of interest in public health, it was necessary to have technological tools that streamline and simplify this procedure for the SIVIGILA application system, which for clarity and understanding is accompanied by the corresponding operation manual Also, were included cases by epidemiological link, defined as those that occurred at a distance of up to meters of a laboratory-confirmed case epidemioloy 3 weeks 21 days before or after the confirmed case, and in accordance with the national guidance for care of patients with dengue and the protocol of Public Health Surveillance 1defihition Fatal cases were obtained from SIVIGILA, death certificates from the vital statistics area, and the records of mortality analysis of every probable death case of Dengue.
The classification of ethnicity could introduce a classification's bias, when the physicians decide to classify the case only on the basis of phenotypic characteristics. But, in our study, ethnicity was classified according with the strength of association epidemiology definition of each patient. Aggregation bias. Attributable in ecological studies to the fact that the association found at added level does not necessarily correspond to an association at individual level, so it must be assessed.
The data base was adjusted according to the algorithm of the National Institute of Health of Colombia INS to identify and eliminate duplicated cases, those discarded by laboratory, and those from out of town Dengue cases were obtained by communities, strength of association epidemiology definition and epidemilogy Afro-Colombians and non-Afro-Colombians. The proportion of Afro-Colombians in the communities was calculated. The cumulative incidence of dengue in the communities and the two Afro-Colombian zones high and low proportion strength of association epidemiology definition adjusted by ddefinition and ethnic group using the direct method, because the population pyramids strength of association epidemiology definition the proportion of Afro-Colombians contained in the communities are different.
The reference population was that of the city of Cali by age groups Table 1 Table 1. Cali, Projections according to the census It was evaluated the level of relation of the proportion of Afro-Colombian population with the cumulative incidence of dengue among the communities, through the correlation method, and the value of the Pearson's statistical coefficient r was obtained.
Next, the cumulative incidence of dengue for Afro-Colombians and non-Afro-Colombians was calculated and assocation first stength taken as the reference category because strength of association epidemiology definition was the lowest incidence. That was compared with the cumulative incidence of dengue in the non-Afro-Colombian category, with the what does food mean incidence in the "zone with low proportion of Afro-Colombians" category and finally with the cumulative incidence of dengue in the "zone with a high proportion of Afro-Colombians" category.
The relative and the attributable risks were estimated with their respective confidence intervals. Two maps were compared: One, with a distribution of communities according to the proportion of Afro-Colombians contained in them; and another map, with the distribution of dengue risk in the communities. The maps were constructed using the Deefinition versionSoftware of geospatial analysis 19 and posteriorly overlaid in one Fig. Overlay between strength of association epidemiology definition of population Afro-Colombians and strength of association epidemiology definition risk by communes, Cali, Four groups of communes were grouped according to AfroColombian population distribution and the risk of dengue.
An assessment epdiemiology aggregation bias was made by epidemillogy the consistency of the association. The proportion of Afro-Colombians was compared between the group cases and non-cases. The association was assessed for potential confusion caused by the following variables: area of residence according to the proportion of Afro-Colombians, population density, density of land lots, density of schools, access to safe drinking water, cleaning services and, building permits.
Each one was stratified in three categories. It was evaluated for interaction by comparing the homogeneity of ethnicity effects on the incidence of dengue in each area, and also by the method of comparing the observed and expected joint effects of ethnicity on the incidence of dengue. The statistical analysis was performed using the Stata program 6. In Cali, This zone with high proportion had This other zone with low proportion had Duringthere was an epidemic with 13, cases of dengue The cumulative incidence of dengue in the general population of Cali was When cumulative incidence was adjusted by ethnicity, it was estimated at The cumulative incidence of only Afro-Colombians was The cumulative incidence in the zone with high proportion of Afro-Colombians strenfth Two maps were constructed on the concentration of Afro-Colombians and the risk of disease and then, they were overlaid.
A pattern of opposite or inverse distribution between the concentration of Afro-Colombians and the risk of dengue disease can be observed; so, the communities with the higher proportion of Afro-Colombian population showed the lowest risk of dengue Fig. This result was verified with the negative and perfect Pearson's correlation coefficient r value equal strength of association epidemiology definition Figure 2.
Pearson correlation was Dots strength of association epidemiology definition the dengue cumulative incidence by levels of proportions of populations of Afro-Colombians; left dot is the dengue incidence for only Non-Afro-Colombians, next dot is the dengue incidence for low proportions of populations of Afro-Colombians; central dot is the dengue incidence for Cali population; next dot is the dengue cumulative incidence for high proportion of Afro-Colombians; right dot is the what is halo effect in assessment cumulative incidence for only population Afro-Colombians.
We evaluated the ecological association between cumulated dengue incidence and ethnicity comparing the proportions of Afro-Colombian population between cases and non-cases of dengue and so, discarding ecological fallacy. We found that these proportions of Afro-Colombians were different. It was found that the proportion of Afro-Colombians among cases was 5. This means that among defonition cases, there are proportionally fewer Afro-Colombians than among the non-cases; and that they do not have the same probability for a dengue case to appear.
It was preserved the same strength of association epidemiology definition and direction that those found in the ecological study, indicating that there was no ecological fallacy; therefore, the association found at the ecological level can be inferred at individual level. Table 2. Evaluation of ecological fallacy through of the comparison of the proportion of AfroColombian population between cases and non cases. It was preserved strenyth same association and direction that those found in the ecological devinition, indicating that there was no ecological fallacy; therefore the association found at the ecological level definution be inferred at individual level.

