Browsing by Author "Atero Fredericksen, Nicolhole Alejandra"

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    An assessment of the owned canine and feline demographics in Chile: registration, sterilization, and unsupervised roaming indicators
    (2024) Atero Fredericksen, Nicolhole Alejandra; Córdova Bührle, Francisca; Salgado Caxito, Marília; Benavides, Julio A.; Fernández, Miriam; Diethelm Varela, Benjamín; Ramos, Romina; Sapiente Aguirre, Claudia; Trujillo, Florencia; Dürr, Salome; Mardones, Fernando O.
    The global rise in companion animal populations, particularly dogs and cats, is driven by emotional and social benefits for owners, and their population management is becoming critically important to avoid a plethora of adverse effects on themselves, humans, and wildlife. We estimated the size and density of the owned canine and feline population in Chile and evaluated the status of microchipping, registration, sterilization rates, and the proportion of owned animals that roam unsupervised. A cross-sectional household survey in 36 districts was conducted and standard inferential statistics was employed to analyze differences between cats and dogs, sexes within each species, and between rural and urban areas. Additionally, two negative binomial models with mixed effects were developed to predict the number of dogs and cats per households. Two methods were used to compare population size estimates at the country level, multiplying: (1) the estimated mean number of companion animals per household by the estimated number of households at the country level, and (2) the estimated human:dog and human:cat ratios by the total human population. The study involved 6333 respondents, of which 76% (74% urban; 83% rural) owned companion animals (dogs and/or cats). Individuals in rural multi-person households increase the probability of owning dogs and/or cats. Additionally, women exhibit a greater inclination towards cat and dog ownership compared to men, while those over 30 years old demonstrate lower rates of companion animal ownership in contrast to the 18–30 age group for both species. The overall human:dog and human:cat ratios estimated were 2.7:1, and 6.2:1, respectively. The estimated total number of owned dogs and cats in Chile ranged from 9.6 to 10.7 million, depending on the methodological approach, while national median density of companion animals was 12 dogs per km2 (ranging from 0.02 to 7232) and 5 cats per km2 (ranging from 0.01 to 3242). This nationwide study showed one of the highest percentages of households with companion animals in Latin America and relatively low registration and sterilization rates, highlighting the need to strength long-term public policies to control populations of companion animals and promote responsibility in pet ownership.
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    Enfermedad de Chagas en Chile: caracterización epidemiológica en base a notificaciones obligatorias y egresos hospitalarios (2010-2019)
    (2022) Atero Fredericksen, Nicolhole Alejandra; Torres Hidalgo, Marisa; Domínguez, Angélica; Pontificia Universidad Católica de Chile. Facultad de Medicina
    Antecedentes: La Enfermedad de Chagas (ECh) es una zoonosis causada por el parásito Trypanosoma cruzi. En Chile es considerada endémica, los casos son de notificación obligatoria y se realiza pesquisa en embarazadas y donantes de sangre. Sin embargo, no se ha realizado una caracterización epidemiológica de los casos graves que han requerido hospitalización, los que producen un alto costo en el sistema sanitario, económico y social. Objetivo: Caracterizar la magnitud y distribución de la presencia y gravedad de la enfermedad de Chagas en Chile en el periodo 2010-2019. Materiales y métodos: Con datos de notificación obligatoria y egresos hospitalarios se caracterizó la distribución espacial de la enfermedad mediante Sistemas de Información Geográfica, y temporal por medio de modelos de regresión Joinpoint. Asimismo, se identificó factores asociados a las hospitalizaciones mediante análisis de regresión multivariados, entre ellos, edad, sexo, diagnóstico, intervención quirúrgica, condición de egresos, entre otros. Resultados: Durante el periodo se observó un total de 13.329 notificaciones sin cambios en la tendencia, y 680 egresos hospitalarios con tendencia a la disminución (12,2% solo en el sexo femenino). La ocurrencia de notificaciones se observó en todas las regiones del país, sin embargo tres clusters de alto riesgo fueron identificados en la zona norte. Mientras que las hospitalizaciones se concentraron en la zona de alta endemia, con un gran cluster de alto riesgo en las regiones de Coquimbo y Atacama. La mayor proporción de notificaciones se observó en mujeres en edad fértil (61,4%), mientras que los egresos se registraron mayormente en hombres de edad avanzada (56,8%). El 14% de los egresos hospitalarios reingresó por diagnóstico de ECh, un 33,2% recibió intervención quirúrgica y el 9,6% falleció. Los principales diagnósticos fueron ECh que afecta al sistema digestivo (49,3%) y que afecta al corazón (36,5%). La probabilidad de fallecer de un hospitalizado se asoció significativamente con la edad (OR=1.05), recibir intervención quirúrgica (OR=0.45) y diagnóstico crónico digestivo (OR=0.45). Asimismo, la chance de recibir IQ fue menor en el sexo femenino (OR=0.65) y en aquellos con diagnóstico crónico al corazón (OR=0.21). La probabilidad de reingresar al hospital se asoció significativamente con un diagnóstico digestivo (OR=2,87). Conclusión: Se notifican casos de ECh todos los años y en todas las regiones del país, mientras que las hospitalizaciones se concentran en zona de alta endemia. La edad y el sexo son factores clave en el acceso a diagnóstico y tratamiento. Sin embargo, existen múltiples factores que determinan el curso de la enfermedad en etapas graves, por lo que es imprescindible estudiarla de manera transdisciplinaria. Este estudio permitió comprender el comportamiento de los casos notificados y hospitalizados de la enfermedad de Chagas en tiempo, lugar y persona. Este análisis es una primera aproximación al conocimiento de los casos graves de la enfermedad y sus factores asociados, y será útil tanto para prevenir complicaciones, así como para facilitar su tratamiento en zonas de alta y baja endemia.
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    Spatio-temporal distribution of hospitalizations for chronic Chagas disease and risk factors associated with in-hospital mortality and surgical intervention in Chile
    (2024) Atero Fredericksen, Nicolhole Alejandra; Torres Hidalgo, Marisa Lorena De Los Lour; Domínguez De Landa, María Angelica; Diethelm Varela, Benjamín Manuel; Córdova Buhrle, Francisca Alexandra; Mardones Loyola, Fernando Otoniel
    Chagas disease (CD) is a neglected parasitic zoonotic disease that affects over 6 million people worldwide. We conducted a retrospective study to analyze the spatiotemporal trends and risk factors for hospitalization rates of CD with cardiac and digestive diagnoses in Chile. We used the Mann-Kendall analysis for temporal trends, Global Moran’s Index, and Local Indicators of Spatial Association to identify spatial autocorrelation, and regression models to determine the risk factors associated with in-hospital mortality and surgical intervention. Between 2010 and 2020, a total of 654 hospitalizations were reported, corresponding to 527 individuals. The hospitalization rate steadily decreased over the years (t = -0.636; p = 0.009). The Global Moran’s I for the study period showed a positive spatial autocorrelation for hospitalization municipality and for residence municipality of CD patients (I = 0.25, p<0.001 and I = 0.45, p<0.001 respectively), indicating a clustering of hospitalizations in northern municipalities. The most frequent diagnosis was a chronic CD with digestive system involvement (55.8%) followed by a chronic CD with heart involvement (44.2%). The highest percentage of hospital discharges was observed among males (56.9%) and in the 60–79 age group (52.7%). In-hospital mortality risk was higher with increasing age (OR = 1.04), and in patients with cardiac involvement (OR = 2.3), whereas factors associated with the risk of undergoing a surgical intervention were sex (OR = 1.6) and diagnosis of CD with digestive involvement (OR = 4.4). The findings of this study indicate that CD is still a significant public health burden in Chile. Efforts should focus on improving access to timely diagnoses and treatment, reducing disease progression and hospitalization burden, and supporting clinicians in preventing complications and deaths.