Interdisciplinary Journal of Epidemiology and Public Health https://revistas.unilibre.edu.co/index.php/iJEPH <p>The Interdisciplinary&nbsp;Journal of Epidemiology and Public Health (IJEPH) is an open access, peer-reviewed, online journal committed to advance knowledge in the fields of epidemiology, public health and preventive medicine, by publishing original contributions coming from any related discipline with direct impact to the health of the international community.&nbsp;The iJEPH aims to publish innovative articles on all aspect of epidemiology and public health including preventive medicine, social determinants of health, and the impact of population interventions, practices and policies on health worldwide.</p> <p>The iJEPH also aims to significantly contribute to improve health globally by becoming an essential novel teaching resource for the academic community and a source of new and rigorous scientific evidence for health care providers and policy makers.</p> en-US iJEPH@unilibre.edu.co (Ivan L. Cepeda, MD, MSc) yesid-solarte@unilibre.edu.co (Yezid Solarte) Fri, 15 Mar 2019 21:31:35 +0000 OJS 3.1.1.4 http://blogs.law.harvard.edu/tech/rss 60 The Role of Epidemiology and Public Health: Past, Present and Future; a Permanently Current Debate in the Life of the Communities https://revistas.unilibre.edu.co/index.php/iJEPH/article/view/3889 <p>The application of epidemiological knowledge is aimed at the control and prevention of diseases and the study of the health and disease process itself. This defines it as a science (with methodological rules, contributions to knowledge over time, hypothesis and analysis proposals with their valuations and rejections, and the generation of useful information for decision and action).</p> ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 https://revistas.unilibre.edu.co/index.php/iJEPH/article/view/3889 Thu, 08 Nov 2018 00:00:00 +0000 Is Consumption of Fruit Juice Associated with an Increased Risk of Overweight or Obesity in Canadian School Age Children? https://revistas.unilibre.edu.co/index.php/iJEPH/article/view/1610 <p><strong>Introduction:</strong> Obesity rates in Canada have tripled in the last three decades. Currently, 32% of 5-17-year-olds in Canada are overweight (20%) or obese (12%). Excess weight in childhood has been linked to health issues that are major public health concern. For children, fruit juice is an important proportion of their daily fruit and vegetable intake. However, little is known about the association of fruit juice consumption and obesity.</p> <p><strong>Objective:</strong> To investigate the association of consumption of fruit juice and the risk of overweight or obesity in 12 to 17 year-olds in Canada.</p> <p><strong>Methods:</strong> Using the Canadian Community Health Survey (CCHS 2011-1012) we examined the association of fruit juice consumption and the risk of overweight or obesity in Canadian youth, while controlling sex, household income, healthy diet, and physical activity.</p> <p><strong>Results:</strong> After adjusting for relevant confounders,</p> <p>consumption of more than one fruit juice a day remained associated with a lower odds of overweight or obesity. Even though the 95% CI for all the daily fruit juice consumption categories examined in the adjusted model included ‘1’, fruit juice consumption was associated with a reduction in the odds of being overweight or obese between 16% and 27%.</p> <p><strong>Conclusion:</strong> We found a moderate negative association of daily consumption of fruit juice and overweight or obesity.&nbsp;Before any dietary recommendation on this age group of children are established, more research is needed to clarify the role of sex and healthy diet in this association.</p> Ivan L. Cepeda ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 https://revistas.unilibre.edu.co/index.php/iJEPH/article/view/1610 Sat, 20 Oct 2018 00:00:00 +0000 Epidemiology of Tuberculosis in a Cohort of Children in the Colombian Pacific Coast 2009- 2013 https://revistas.unilibre.edu.co/index.php/iJEPH/article/view/3871 <p><strong>Introduction:</strong> The diagnosis of pulmonary tuberculosis in children is a challenge in all tuberculosis programs. The adverse social and economic conditions of the Colombian Pacific Coast make it a complex area for the management of the disease, especially in children.</p> <p><strong>Objective:</strong> To describe the demographic and clinical characteristics, and the outcomes in the pediatric population with pulmonary tuberculosis in Buenaventura, Colombia. Methods: We conducted a descriptive observational study of a historical cohort (2009-2013) of children enrolled in the tuberculosis control program of Buenaventura.</p> <p><strong>Results:</strong> A total of 163 cases were found and analyzed. There was no significant difference in sex distribution. The most frequent age group was 1-5 years (51%) and 55% belonged to the subsidized health system. The clinical TB diagnosis prevailed (55%), while the laboratory diagnosis was significant in patients older than 7 years. 92% entered the program as new cases, and 40% had their treatment finished at discharge. Adherence to treatment compliance was less than 50% in both phases of treatment. The incidence of childhood pulmonary tuberculosis during the study period ranged between 2 and 4 x 100,000 inhabitants. There were inconsistences in the information between the Tuberculosis program of the Municipality and the National Surveillance System of Colombia.</p> <p><strong>Conclusion:</strong> The social and political difficulties in depressed areas of Buenaventura, a remote town in the Pacific Coast of Colombia, have a negative impact on the control of TB, despite strategies of childhood pulmonary tuberculosis based on timely diagnosis and treatment; effective follow-up of cases; study of contacts; and efficient, timely notification.</p> Johanna Cándelo Montenegro, Liliana Forero, Robinson Pacheco López ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 https://revistas.unilibre.edu.co/index.php/iJEPH/article/view/3871 Wed, 07 Nov 2018 00:00:00 +0000 Prediction of Medical Costs in a Health Insurance Carrier according to Risk Profiles and Uses by its Affiliates https://revistas.unilibre.edu.co/index.php/iJEPH/article/view/3872 <p><strong>Objective:</strong> To find a model of prediction of the medical cost of a Health Benefits Management Company (EAPB) with adequate statistical criteria.</p> <p><strong>Methods:</strong> A Cross-sectional study with retrospective follow-up of the use of health services in an EAPB during a one-year period. The sampling frame consisted of a population of 1,529,188 affiliates who were assigned to a primary care IPS group. By simple random sampling size was estimated at 190,917 users. The dependent variable was the cost of the services used deflated to the year 2013. As independent variables besides the traditional sociodemographic variables chosen in this type of prediction models, variables of the insurance were added; Variables of risk management (inclusion or not in promotion and prevention program) and of comorbidities.</p> <p><strong>Results:</strong> Simple Linear Regression modeling showed errors of inappropriate statistical criteria such as violating the principle of normality in cost errors. The Generalized Linear Models, proposed to estimate POS average costs, have an appropriate goodness of fit and evaluated with small Deviations and minimum Akaike criterion (AIC) compared to other models of the exponential family</p> <p><strong>Conclusions:</strong> The appropriate statistical model to predict medical costs was the Generalized Linear Model with two parts segmented by age groups and gender. This research suggests that to estimate the benefit premium of any EAPB, besides socio-demographic variables, insurance variables, membership or not in promotion programs and risk prevention and/or management and the burden of disease of that population should be used.</p> Rodolfo Herrera Medina, Jaime Lee, Ferney Herrera Cruz ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 https://revistas.unilibre.edu.co/index.php/iJEPH/article/view/3872 Wed, 07 Nov 2018 00:00:00 +0000 Performance of the Clinical Breast Examination Performed by Examiners with Visual Impairment to Detect Breast Nodules Compared to Ultrasonography https://revistas.unilibre.edu.co/index.php/iJEPH/article/view/3873 <p><strong>Abstract.</strong></p> <p><strong>Introduction:</strong> Clinical examination of the breast is a simple method to detect nodules, which is useful to determine its nature, of low cost, non-invasive and of great value as a diagnostic tool when necessary. Traditionally, clinical examination is carried out by trained health personnel with a sensitivity of 54% and a specificity of 94%; it is unknown its usefulness compared to mammography, since the physical examination in patients without previous screening has not been evaluated.</p> <p><strong>Objective:</strong> to determine the performance of the clinical examination of tactile auxiliary examiners for detecting mammary nodules, compared with the ultra-sonography findings in the detection of mammary nodules.</p> <p><strong>Methods:</strong> a validation study of diagnostic tests was carried out with a random sample of 325 women from the San Juan de Dios Hospital, aged between 18 and 70 years, during a period of 2 months.</p> <p><strong>Results:</strong> The sensitivity was 64.8% (95% CI 57.5-71); specificity, 45.6% (95% CI 37.8-53.6); positive predictive value, 58.5% (95% CI 51.4-65.1); negative predictive value, 52.3% (95% CI 43.8-60.7). Proportion of false positives, 54.4% (95% CI 46.4-62.2); proportion of false negatives, 35.2% (95% CI 28.6-42.5).</p> <p><strong>Conclusion:</strong> The study showed that the clinical examination of the breast by trained personnel with visual impairment is a diagnostic test sensitive to the detection of mammary nodules; but it has little specificity. In addition, it is a complement to screening for mammary pathology, even though it does not replace the medical examination nor the screening tests recommended by the clinical practice guidelines.</p> Luis Alberto Olave Asprilla, Diego Fernando Botero Henao, Yiset Adriana Fernández De Córdoba Florez ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 https://revistas.unilibre.edu.co/index.php/iJEPH/article/view/3873 Wed, 07 Nov 2018 00:00:00 +0000 Is it time to leave the Body Mass Index (BMI)? https://revistas.unilibre.edu.co/index.php/iJEPH/article/view/3877 <p><strong>Background:</strong> This study was conducted to assess the accuracy when calculating the nutritional status using<br>the new Body Mass Index formula (BMI), taking as Gold Standard the traditional BMI.<br><strong>Methods:</strong> The diagnostic accuracy compared the new BMI formula to the traditional BMI. Accuracy analysis included sensitivity, specificity, and predictive values (positive and negative), Youden index, Kappa index, ROC, and maximum likelihood ratio.<br><strong>Results:</strong> The new BMI formula yielded good results for all indicators used for measuring the accuracy, in all groups. These results are a good evidence that the new BMI formula could replace the traditional BMI for screening population based nutritional status. However, the new BMI formula detected less subjects in subnormal, normal, and overweight groups; and, more in the obese group. The distribution is<br>biased to the right in both formulas. In overweight and obese groups, the skewness is bigger in the new formula than the original formula; being the skewness 5.91 and 4.81; and 30.9 and 30.3, respectively.<br><strong>Conclusion:</strong> Although the results are good evidence that new BMI formula yields similar results to the BMI formula for screening nutritional status at population level, and therefore, could be used interchangeably. Both formulas lack some validity in measuring the obese nutritional status, which do not allow recommending either of these formulas, due to the large dispersion of both formulas.</p> Gustavo Bergonzoli ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc-nd/4.0 https://revistas.unilibre.edu.co/index.php/iJEPH/article/view/3877 Wed, 07 Nov 2018 00:00:00 +0000