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Determinantes Ambientales y Sociodemográficos Asociados a Conglomerados Espacio-Temporales de Infección Respiratoria Aguda Grave Inusitada en Colombia

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dc.contributor.advisorGutiérrez Torres, Juan-David
dc.contributor.advisorMartínez Vega, Ruth Aralí
dc.contributor.authorLeón Garrido, Diana María
dc.date.accessioned2021-08-11T02:37:24Z
dc.date.available2021-08-11T02:37:24Z
dc.date.issued2020-06-12
dc.descriptionDigitalspa
dc.description.abstractLa infección respiratoria aguda es una de las principales causas de morbilidad y mortalidad en el mundo, sus formas graves, impactan los sistemas de salud y económicos de manera considerable. Existen factores que propician el desarrollo del evento y por consiguiente deben ser objeto de investigación. El objetivo del estudio fue establecer los determinantes ambientales y sociodemográficos asociados a la incidencia de Infección respiratoria aguda grave (IRAG) inusitada en Colombia entre 2009 y 2017, a partir de la identificación de conglomerados espacio-temporales. Se desarrolló un estudio ecológico de series de tiempo. Se recolectó la información de los casos de IRAG inusitada notificados al Sistema Nacional de Vigilancia en Salud Pública, se construyeron conglomerados espacio-temporales utilizando el Software SaTScan9.6 y se analizaron los determinantes ambientales y sociodemográficos asociados a los conglomerados. La vigilancia durante 2009 y 2010 fue irregular en el país, por tanto, se analizaron los casos de IRAG inusitada que ocurrieron en el periodo 2011 a 2017. La mayor notificación del evento se presentó en junio de 2013, alcanzando una incidencia cercana a los 12 casos/1.000.000 habitantes. Se identificaron 8 conglomerados espacio-temporales. El patrón secular de los virus influenza A(H1N1)pmd09, AH3, Virus Sincitial Respiratorio y Adenovirus, mostraron relación con el comportamiento del evento a nivel nacional. Factores como el porcentaje de edad menor de 35 años, el porcentaje de área antrópica, las dimensiones urbana y económica, estuvieron asociadas con pertenecer a un conglomerado espacio-temporal de IRAG inusitada. Los extremos de precipitación y de temperatura, mostraron una relación inversa con pertenecer a los conglomerados. En el país se observó un patrón endémico con un pico epidémico durante el 2013. Sin embargo, se identificaron conglomerados espacio-temporales en diferentes regiones distribuidos durante toda la serie de tiempo analizada.spa
dc.description.abstractAcute respiratory infection is one of the main causes of illness and death in the world, it’s severe forms impact health and economic systems in a considerable way. There are factors that promote the development of the event, therefore they must be a research target. The main objective of this research was to establish the environmental and sociodemographic determinants associated with unusual severe acute respiratory illness (SARI) incidence reported in Colombia between 2009 to 2017, based on the identification of spatio-temporal clusters. An ecological time series research was developed. The information was collected from unusual SARI cases reported to the National Public Health Surveillance System; spatio-temporal clusters were built using SaTScan9.6 software and environmental and sociodemographic determinants associated with the clusters were analyzed. Surveillance during 2009 and 2010 was irregular in the country, therefore, the unusual severe acute respiratory infection cases that occurred during the period 2011 to 2017 were analyzed. The highest notification of the event was presented on June 2013, reaching an incidence close to 12 cases / 1,000,000 inhabitants. Eight spatio-temporal clusters were identified. The secular and seasonal patterns of Influenza A(H1N1)pmd09, AH3, Respiratory Syncytial Virus and Adenovirus, showed a relationship with the behavior of the event at the national level. Factors such as percentage of population under 35, percentage of anthropic area, urban and economic dimensions were associated with belonging to a spatio-temporal cluster of unusual SARI. The temperature and precipitation extremes showed an inverse relationship with belonging to the conglomerates. The country showed an endemic pattern with an epidemic pike during 2013. However, space-time conglomerates were identified through different regions distributed during all the time series analyzed.eng
dc.description.degreelevelMaestríaspa
dc.description.degreenameMagister en Investigación en enfermedades Infecciosasspa
dc.description.edition1 ed.spa
dc.description.tableofcontentsIntroducción ........................................................................................................................... 1 1. Marco Referencial ........................................................................................................... 3 1.1. Definición Operacional de Caso .................................................................................. 3 1.2. Epidemiología .............................................................................................................. 3 1.3. Fisiopatología y Respuesta Inmune ............................................................................. 5 1.4. Estado del Arte ............................................................................................................. 7 2. Objetivos ....................................................................................................................... 11 2.1. Objetivo General ........................................................................................................ 11 2.2. Objetivos Específicos ................................................................................................. 11 3. Metodología .................................................................................................................. 12 3.1. Hipótesis Operativa .................................................................................................... 12 3.2. Diseño del Estudio ..................................................................................................... 12 3.3. Población y Tamaño de Muestra ................................................................................ 12 3.4. Criterios de Inclusión ................................................................................................. 12 3.5. Criterios de Exclusión ................................................................................................ 12 3.6. Fuentes de información .............................................................................................. 12 3.7. Variables..................................................................................................................... 13 3.7.1. Variable Dependiente: ........................................................................................ 13 3.7.2. Variables Independientes .................................................................................... 14 3.7.3. Otras variables: ................................................................................................... 18 3.8. Análisis de Datos ........................................................................................................ 19 3.8.2. Construcción de mapa de riesgo ......................................................................... 19 3.8.3. Construcción de los conglomerados Espacio-temporales ................................... 20 3.8.4. Identificación de determinantes ambientales y sociodemográficos para conglomerados .................................................................................................................. 21 4. Resultados ..................................................................................................................... 23 4.1. Incidencia de IRAG Inusitada 2009-2017 .................................................................. 23 4.2. Características sociodemográficas del evento IRAG inusitada.................................. 24 4.3. Etiología de la IRAG inusitada 2011-2017 ................................................................ 25 4.4. Comportamiento secular de los virus respiratorios .................................................... 28 4.5. Comportamiento estacional de los virus respiratorios ............................................... 31 4.6. Mapa de Riesgo Excesivo .......................................................................................... 31 4.7. Descripción de conglomerados espacio-temporales .................................................. 33 4.8. Etiología viral en los conglomerados de IRAG inusitada .......................................... 39 4.9. Análisis de los determinantes asociados a Conglomerado espacio-temporales de IRAG inusitada ..................................................................................................................... 41 5. Discusión....................................................................................................................... 45 6. Conclusiones ................................................................................................................. 54 7. Recomendaciones ......................................................................................................... 55 8. Referencias ....................................................................................................................... 56 9. Apéndices ...................................................................................................................... 67spa
dc.format.extent93 pspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.localT 86.21 L266d
dc.identifier.urihttps://repositorio.udes.edu.co/handle/001/5464
dc.language.isospaspa
dc.publisherBucaramanga : Universidad de Santander, 2020spa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.placeBucaramanga, Colombiaspa
dc.publisher.programMaestría en Investigación en enfermedades Infecciosasspa
dc.rightsDerechos Reservados - Universidad de Santander, 2021spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)spa
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/spa
dc.subject.proposalInfecciones del sistema respiratoriospa
dc.subject.proposalDeterminantes sociales de la saludspa
dc.subject.proposalTemperaturaspa
dc.subject.proposalPrecipitación atmosféricaspa
dc.subject.proposalClimaspa
dc.subject.proposalRespiratory system infectionseng
dc.subject.proposalSocial determinants of healtheng
dc.subject.proposalTemperatureeng
dc.subject.proposalAtmospheric precipitationspa
dc.subject.proposalClimatespa
dc.titleDeterminantes Ambientales y Sociodemográficos Asociados a Conglomerados Espacio-Temporales de Infección Respiratoria Aguda Grave Inusitada en Colombiaspa
dc.typeTrabajo de grado - Maestríaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_bdccspa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/masterThesisspa
dc.type.redcolhttps://purl.org/redcol/resource_type/TMspa
dc.type.versioninfo:eu-repo/semantics/acceptedVersionspa
dcterms.audienceTodas las Audienciasspa
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