Colombia

The Caribbean region presents the highest prevalence of HIV/AIDS worldwide after sub-Saharan Africa; leading to serious social, economic and health consequences at the local scale but also at the regional and global levels. In Colombia, a national plan to tackle the epidemic was formulated with little evidence that its implementation in the local context is effective.

Findings from a qualitative research study of the context of adolescent pregnancy are presented. Participants were 21 pregnant adolescents from MedellÌn, Colombia, and nearby villages in the region. Data were collected by means of 21 qualitative interviews, and analysis followed grounded theory procedures. The study reveals that adolescent pregnancy occurs in the context of a "genuine love affair" in which ideas of romantic love and gender rules guide young women's behaviour.

OBJECTIVES: This research aimed to understand how cooperation and collaboration work in interagency arrangements using a case study of the public management of food security and nutrition in Bogot·, Colombia. STUDY DESIGN: This study explored the available scientific literature on Collaborative Governance within the Public Management body of knowledge and the literature on Cooperation from the Sociobiology field. Then, proposals were developed for testing on the ground through an action-research effort that was documented as a case study.

INTRODUCTION: Chronic diseases represent the greatest burden of disease in Colombia for which smoking is the major risk factor. OBJECTIVES: To provide clinical practice recommendations based upon efficacy and safety of smoking cessation therapies for Colombian adults. MATERIALS AND METHODS: An adaptation of clinical practice guidelines (CPG) based on the ADAPT methodology was performed. We searched CPG on Medline, EMBASE, CINAHL, LILACS, and Cochrane databases.

BACKGROUND: Artemisinin-based combination therapy (ACT) is being widely promoted as a strategy to counteract the increase in Plasmodium falciparum antimalarial drug resistance. METHODS: A randomized, double-blind, placebo-controlled, clinical trial of the efficacy, effect on gametocytes and safety of the addition of artesunate/placebo (4 mg/kg/day x 3 d) to amodiaquine (10 mg/kg/day x 3 d) was conducted in Choco department, a low intensity transmission area in northwest Colombia.

INTRODUCTION: Antimalarial treatment effects on Plasmodium falciparum gametocytemia has been the focus of few studies in the Americas. OBJECTIVE: Relationships are described that occur between falciparum gametocytemia and the treatment with amodiaquine-sulfadoxine-pyrimethamine, artesunate-sulfadoxine-pyrimethamine or amodiaquine-artesunate. MATERIALS AND METHODS: The experimental design consisted of a randomized selection of patients not balanced or blinded. A total of 241 patients were evaluated, residents of Turbo, El Bagre and Zaragoza (Antioquia, Colombia).

Selecting suitable anti-malarial treatment represents one of the best tools for reducing morbidity and mortality caused by this disease. Sexual and asexual parasite dynamics were thus evaluated in patients involved in antimalarial drug efficacy studies by using combined treatment with and without artemisinin derivatives for treating uncomplicated acute Plasmodium falciparum malaria in Antioquia, Colombia. All treatment doses were supervised and administered according to patients' weight; sexual and asexual parasitemia were evaluated during 28- or 42-days follow-up in 468 patients.

BACKGROUND: The objective of this study was to implement a rapid assessment of the performance of four malaria control strategies (indoor spraying, insecticide-treated bed nets, timely diagnosis, and artemisinin-based combination therapy) using adequacy criteria. The assessment was carried out in five countries of the Amazon subregion (Bolivia, Colombia, Ecuador, Guyana, and Peru).

The safety of artemether-lumefantrine in patients with acute, uncomplicated Plasmodium falciparum malaria was investigated prospectively using the auditory brainstem response (ABR) and pure-tone thresholds. Secondary outcomes included polymerase chain reaction-corrected cure rates. Patients were randomly assigned in a 3:1:1 ratio to either artemether-lumefantrine (N = 159), atovaquone-proguanil (N = 53), or artesunate-mefloquine (N = 53).

INTRODUCTION: In Colombia, there are no published studies for the treatment of uncomplicated Plasmodium falciparum malaria comparing artemisinin combination therapies. Hence, it is intended to demonstrate the non-inferior efficacy/safety profiles of artesunate + amodiaquine versus artemether-lumefantrine treatments. METHODS: A randomized, controlled, open-label, noninferiority (??5%) clinical trial was performed in adults with uncomplicated P. falciparum malaria using the 28-day World Health Organization validated design/definitions.