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Background Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental condition affecting communication, social interaction, and behavior. Evidence suggests that environmental pollutants are associated with ASD incidence. This review aimed to analyze the effect of environmental pollutants on ASD. Methods Systematic review and meta-analysis of cohort studies evaluated the association between exposure to environmental pollutants and ASD. We searched COCHRANE CENTRAL, MEDLINE, CINAHL, LILACS, EMBASE, PsycINFO, Web of Science, SciELO, and gray literature from inception to January 2023. The model used for meta-analysis was inverse variance heterogeneity (IVhet). The effect measures were the beta coefficient (β) and the relative risk (RR) with their 95% confidence intervals (95% CI). Sensitivity analyses were carried out using an instrument to screen or diagnose autism. Results A total of 5,780 studies were identified; 27 were included in the systematic review, and 22 were included in the meta-analysis. These studies included 1,289,183 participants and 129 environmental pollutants. Individual meta-analyses found a significant association between nitrogen dioxide RR = 1.20 (95% CI: 1.03 to 1.38; I 2 : 91%), copper RR = 1.08 (95% CI: 1.03 to 1.13; I 2 : 0%), mono-3-carboxy propyl phthalate β = 0.45 (95% CI: 0.20 to 0.70; I 2 : 0%), monobutyl phthalate β = 0.43 (95% CI: 0.13 to 0.73; I 2 : 0%) and polychlorinated biphenyl (PCB) 138 RR = 1.84 (95% CI: 1.14 to 2.96; I 2 :0%) with ASD. Subgroup meta-analyses found a significant association with carbon monoxide RR = 1.57 (95% CI: 1.25 to 1.97; I 2 : 0%), nitrogen oxides RR = 1.09 (95% CI: 1.04 to 1.15; I 2 : 34%) and metals RR = 1.13 (95% CI: 1.01 to 1.27; I 2 :24%). Conclusion This study found positive associations nitrogen dioxide, copper, mono-3-carboxypropyl phthalate, monobutyl phthalate, and PCB 138, and the development of ASD, likewise, with subgroups of pollutants carbon monoxide, nitrogen oxides, and metals. Therefore, it is important to identify these risk factors in children and adolescents to contribute to ASD and identify prevention strategies effectively.

Background. Malaria in pregnancy (MiP) has been associated with adverse pregnancy outcomes. There is limited information on MiP in low transmission regions as Colombia. This study aimed to describe the epidemiology of MiP through active surveillance of infections by microscopy and polymerase chain reaction (PCR). Methods. A cross-sectional study was conducted between May 2016 and January 2017 in five municipalities (Apartadó, Turbo, El Bagre, Quibdó, and Tumaco) in Colombia. Pregnant women self-presenting at health centers for antenatal care visits, seeking medical care for suspected malaria, or delivery, were enrolled. Diagnosis of Plasmodium spp was made in peripheral and placental blood samples by microscopy and PCR. Results. A total of 787 pregnant women were enrolled; plasmodial infection was diagnosed by microscopy in 4.2% (95% CI 2.8-5.6; 33/787) or by nPCR in 5.3% (95% CI 3.8-6.9; 42/787) in peripheral blood. Most of the infections were caused by P. falciparum (78.5%), and 46% were afebrile (asymptomatic). Women in the first and second trimester of pregnancy were more likely to be infected (aOR=3.06, 95%CI=1.6−5.8). To live in the urban/peri-urban area (aOR=3.04, 95%CI=1.4−6.56), to have a history of malaria during last year (aOR=5.45, 95%IC=2.16−13.75), and the infrequent bed net usage (aOR=2.8, 95%CI=1.31−5.97) were associated with the infection. Pregnant infected women had a higher risk of anaemia (aOR=2.18, 95%CI=1.15−4.12) and fever (aOR=14.2, 95%CI=6.89−29.8). Conclusion. The screening for malaria during antenatal care in endemic areas of Colombia is highly recommended due to the potential adverse effects of Plasmodium spp. infection in pregnancy and as an important activity for the surveillance of asymptomatic infections in the control of malaria.

Introduction: Respiratory syncytial virus (RSV) is one of the most important childhood infections. Objective: To evaluate the effectiveness and safety of palivizumab immunoprophylaxis in preterm infants at a high risk of severe respiratory syncytial virus infection during the RSV season in Colombia. Methodology: A prospective observational non-comparative multicenter study in six Colombian cities. At the beginning of the RSV infection season, palivizumab prophylaxis, up to five doses, was administered to infants born at ≤32 weeks of gestation, infants younger than six months, infants under one year of age with bronchopulmonary dysplasia (BPD), infants one year or less of age with hemodynamically significant acyanotic and non-acyanotic congenital heart disease (CHD), and with follow-up during the immunoprophylaxis until one month after the last dose. Results: The study enrolled 600 patients, 91.8% of which were born at ≤ 32 weeks of gestation. BPD was observed in 54.9% of infants. 49% were born at < 32 weeks gestation and presented BPD. 6.9% had hemodynamically significant acyanotic and non-acyanotic CHD 53.3% received three or more doses of palivizumab. The mean interval between doses was 39.6 days. 1.8% of patients were hospitalized due to a confirmed RSV infection. Overall mortality was 1.2%, whereas the mortality by RSV in infants undergoing prophylaxis was 0.2%. Conclusions: Palivizumab was a clinically effective, well-tolerated treatment in the Colombian population. The safety profile of palivizumab reflects the findings from previous studies in developed countries.

Background & objectives : The presence of Babesia spp in humans, bovine cattle and ticks (the transmitting vector) has not been well characterized in Colombia. Babesia infection in humans can be overlooked due to similarity of the disease symptoms with malaria specially in the regions where malaria is endemic. The aim of the present work was to study the frequency of Babesia infection in humans, bovines and ticks in a malaria endemic region of Colombia, and explore the possible relationship of infection with host and the environmental factors. Methods : A cross-sectional study was carried out between August 2014 and March 2015 to determine the frequency of B. bovis and B. bigemina infection in a sample of 300 humans involved in cattle raising, in 202 bovines; and in 515 ticks obtained from these subjects, using molecular (PCR), microscopic and serological methods. In addition, the demographic, ecological and zootechnical factors associated with the presence of Babesia, were explored. Results : In the bovine population, the prevalence of infection was 14.4% (29/202); the highest risk of infection was found in cattle under nine months of age (OR = 23.9, CI 8.10-94.30, p = 0.0). In humans, a prevalence of 2% (6/300) was found; four of these six cases were positive for B. bovis. Self-report of fever in the last seven days in the positive cases was found to be associated with Babesia infection (Incidence rate ratio = 9.08; CI 1.34-61.10, p = 0.02). The frequency of B. bigemina infection in the collected ticks was 18.5% (30/162). Interpretation & conclusion : The study established the presence of Babesia spp in humans, bovines and ticks. The most prevalent species responsible for babesiosis in humans and bovines was B. bovis, while B. bigemina was the species most frequently found in the tick population. The results contribute to the knowledge of the epidemiology of babesiosis in the country and can provide guidelines for the epidemiological surveillance of this non-malarial febrile illness in humans as well as cattle.

During the COVID-19 pandemic, women disproportionately assume more unpaid activities, affecting their employment. Describe the influence of COVID-19 on the employment of caregivers of children and adolescents from a gender perspective. Cross-sectional study in three high-complexity hospitals in Bogotá, Colombia from April 2020 to June 2021. A subsample of the FARA cohort was taken, including those patients with a positive test for SARS-COV2. We took as our analysis category children older than 8 years and younger than 18 years who had a positive SARS-COV2 test, as well as, caregivers of all children with a positive SARS-COV2 test. This subsample was drawn from the FARA cohort. A survey was applied to them. We carried out a descriptive and stratified analysis by age group, educational, and socioeconomic level. We included 60 surveys of caregivers and 10 surveys of children. The main caregiver in 94.8% of the cases was a female. At the beginning of the pandemic, 63.3% of the caregivers were employed, and 78.9% of those lost their employment. The vast majority of these caregiver were women (96.6%,  = 29). A predominance of loss of work activity was documented in caregivers of children in early childhood 66.6% (  = 20), with lower education 66.6% (  = 20), and from lower strata 56.6% (  = 17). Caregivers of children with COVID-19 with low educational levels and lower socioeconomic conditions, as well as those with children under 5 years showed greater likelihood of employment loss between the interviewed subsample.

Objetivo: Esta investigación buscó establecer la distribución espacial de la morbimortalidad atribuible a la contaminación del aire ambiental por materia particulada (particulate matter 2.5) (pm2.5) en Medellín entre 2010 y 2016. Métodos: Se planteó un estudio ecológico. Se estandarizaron las direcciones de residencia de los pacientes atendidos y las defunciones por eventos de interés. Se emplearon mapas de calor, mediante el análisis de densidad de Kernel, por núcleos domiciliarios para áreas de 10 000 m2. Resultados: Se encontraron 45 487 y 2743 casos y defunciones, respectivamente, atribuibles a la contaminación del aire ambiental por pm2.5 con datos de localización geográfica. La zona suroccidental de la ciudad presentó las mayores densidades de eventos atribuibles por todas las causas estudiadas y por grupo de eventos, con algunas áreas pequeñas en otros lugares. Por su parte, la zona suroriental, con las mejores condiciones socioeconómicas, manifestó la menor concentración de eventos atribuibles. Conclusión: La información geocodificada de la morbimortalidad por núcleos domiciliarios posibilitó establecer la distribución de casos y muertes atribuibles a la contaminación ambiental del aire por pm2.5 en Medellín, con mayor concentración al suroccidente de la ciudad, lo que permite evidenciar la presencia de disparidades territoriales de este fenómeno.

Synthesize the approaches used to study the convergence between cardiometabolic and infectious diseases in adults from a syndemic perspective based on the scientific evidence available to date worldwide. Methods. Scoping review that follows the recommendations of the PRISMA statement. The protocol was registered in INPLASY202150048. The search for studies was carried out in MEDLINE, LILACS, Web of Science and Scopus. Results. Since the COVID-19 pandemic, there has been an increase in studies in the field of convergence between cardiometabolic and infectious diseases from a syndemic perspective, but only three studies were classified as true syndemics. There are weaknesses in the adherence to the elements of the syndemic theory, given a low incorporation of population measurements, and until now it has not been possible to find convincing empirical evidence that supports the bio-bio interface. Quantitative methods predominated through models focused on \"sum scores\". Conclusions. Future studies should comprehensively address the elements of syndemics, review discrepancies between additive analyses versus other modeling, and incorporate the influence of large-scale social forces. The lack of these aspects distances studies from the notion of syndemic, bringing them closer to comorbidity or multimorbidity approaches.

To characterize the clinical phenotypes of SARS-CoV-2 infection in hospitalized children as part of the EPICO multicenter cohort study. We included hospitalized children with confirmed SARS-CoV-2 infection from Colombian and Spanish institutions to assess disease evolution and outcomes. Cluster analysis was performed to identify clinical phenotypes. A total of 2318 patients were included (55% male, 36% infants). Five phenotype clusters emerged: Cluster 1 (26.5%): infants without comorbidities, low PICU admissions and mortality; Cluster 2 (18.5%): respiratory comorbidities, high microorganism co-detection and mortality; Cluster 3 (11.5%): fever, gastrointestinal symptoms, high PICU admissions; Cluster 4 (32%): mild unspecific symptoms, low mortality; Cluster 5 (11.3%): adolescents without comorbidities, low co-detection and hospitalization rates. Findings were consistent across both countries. Identifying clinical phenotypes of SARS-CoV-2 in children may improve risk stratification and guide future management strategies.

[This corrects the article DOI: 10.3389/ijph.2025.1607246.].

Objetivo: Estimar la variabilidad del pm2.5 durante 2018-2019 en el área urbana de Medellín en diferentes escalas geográficas. Métodos: Se aplicó la metodología de regresión de usos del suelo (lur), considerando como variable dependiente la concentración promedio anual de pm2.5 de las estaciones de monitoreo de Medellín y cercanas; se definieron áreas de influencia o buffers circulares con radios de 100, 150, 200, 300 y 500 m, con centro en las coordenadas de cada sitio de monitoreo; con cada buffer se construyeron modelos espaciales y se eligió el de mayor rendimiento. Resultados: Los modelos seleccionados para los años 2018 y 2019 explican entre el 40 y el 46 % de la variabilidad del pm2.5, con errores de las concentraciones previstas de 1,64 y 2,18 µg/m3, respectivamente. La distribución del contaminante fue heterogénea a nivel de barrios y manzanas. Las mayores concentraciones anuales se localizaron hacia la franja central de la ciudad, en las áreas circundantes del río Medellín, con áreas marcadas al sur y centro. Mientras que para el 2018 se estimaron concentraciones superiores que 15 µg/m3 en el 21 % de las manzanas, para el 2019, el total de las estimaciones estuvo por encima de esta concentración. Conclusión: Se evalúa la exposición de pm2.5 en diferentes escalas espaciales por medio de los modelos seleccionados para cada año, en los que predominaron variables explicativas de uso de suelo y tráfico. Se estimaron niveles de exposición inferiores a 25 µg/m3 en las diferentes escalas, una variabilidad baja que permitió la asignación de exposiciones individuales de largo plazo por sitio de residencia en los participantes del proyecto.