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PubMed2002

[Malaria in Chile: 1913-2001].

BACKGROUND: Malaria was restricted to the I Region of Chile, being Anopheles pseudopunctipennis the only vector species. In 1936 the parasitosis affected more than 50% of the population and 62.4% of military recruits, proceeding from Southern regions became infected. From 1937 to 1947, an antimalaria campaign was carried out, stressing actions on the battle against the vector and the treatment of malaria infected individuals. Since April 1945 no autochthonous cases of malaria have been detected. AIM: To update the situation of malaria in Chile. METHODS: 1) Imported malaria: Analysis of occasional publications on the subject (1945-1988) and the annual reports of the Ministry of Health Department of Epidemiology (1990-2001). Annual reports on the Anopheles specimens collected--mostly larvae--in the provinces of Arica and Iquique and examined in the Parasitology Unit of the School of Medicine, University of Chile, during the period 1980-2001. RESULTS: 1) Imported malaria. A total of 24 cases were published in the period 1945-1988. In the 1980-2001 period, the Ministry of Health recorded 66 cases with 5 (8.8%) deaths. 2) Anophelines: Only in 1984, 1985, 1998 and 2001 A. pseudopunctipennis foci were detected. Entomological surveillance was stressed and insecticides were applied on these focuses. CONCLUSIONS: Autochthonous malaria does not exist in Chile since 1945. The detection of malaria cases in countries where the parasitosis was eradicated, can be the result of tourism or migrations. In Chile, the Environmental Programs of Arica and Iquique perform periodical surveys in localities where mosquitoes exist. When A. pseudopunctipennis is found, the entomological vigilance is stressed and insecticide applications are reiterated until the situation is controlled.

Animals↗
PubMed2004

[Epidemiology of intoxications in Chile: ten years of registry].

BACKGROUND: The existence of Poison Centers for management and prevention of intoxications has been endorsed by the international experience. In Chile, the Toxicological Information Center at the Pontifical Catholic University of Chile has been active since 1992, receiving about 130,000 calls until 2002. AIM: To analyze the statistical data gathered throughout the first ten years of our Research Center. To delineate the epidemiological pattern of intoxications in Chile. MATERIAL AND METHODS: Retrospective study in which records from calls for toxicological information received during the 1992-2002 period reviewed. Analyzed data were total calls per year, place of call, exposure circumstances, age, sex, route of exposure and involved agents. RESULTS: 96,468 calls analyzed. The main exposure circumstance was "unintentional" (78.6%), followed by "intentional" (16.9%). Intoxications in children under 5 years old motivated 50% of calls. According to route of exposure, ingestions involved 75,992 calls (78.8%). Medications were the most common substances, accounting for 49.2% of calls, followed by cleaning products (12.1%), pesticides (11.3%), industrial and chemical products (10.5%) and cosmetics (2.7%). Medications acting on the CNS were the most recurrent, with 19,096 reports. CONCLUSIONS: The epidemiological pattern for intoxications in Chile is very similar to that reported in developed and other Latin American countries. Children under 5 years old, are a high risk group for intoxications. It is imperative to improve the recording and follow-up of patients that call to the Center, to improve epidemiological data of intoxications in Chile.

Adolescent↗
PubMed2005

[Vibrio parahaemolyticus infections and algal intoxications as emergent public health problems in Chile].

There is interest in the paradigm that relates environmental sea changes to the emergence of diseases that affect both aquatic organisms in the sea and human beings. The emergence of Vibrio parahaemolyticus as an important cause of epidemic summer diarrhea in 2004 and 2005, confined mainly to the tenth region in Chile, could be a manifestation of this trend. This and other areas of the country have also experienced several outbreaks of paralytic shellfish poisoning (PSP), diarrheal shellfish poisoning (DSP) and amnesic shellfish poisoning (ASP) caused by harmful algal blooms (HAB) of Alexandrium catenella, Dinophysis acuta and Pseudonitzchia species, respectively. The short historical record of these pathological phenomena in Chile suggests that they are increasing in frequency and expanding their geographical range. The V parahaemolyticus isolates responsible for the Chilean outbreaks correspond mainly to the pandemic strain O3:K6. HAB found in Chile and the intoxications caused by them have similar biological characteristics to those described in other areas of the world. The tenth region, the area where these problems are emerging, produces approximately 80-90% of the shellfish consumed in Chile and a large proportion of the shellfish that is exported. Prevention of these public health problems can be attained by developing policies that increase environmental surveillance for Vibrios and toxic algae, improve the epidemiological surveillance of acute diarrhea and algal intoxications after the ingestion of raw bivalves, and educate the population on the mode of transmission of these diseases. Scientific capacity and laboratories need to be developed to widen the limited knowledge of the biology of Vibrio and toxic algae and the environmental factors that favor their emergence as public health and economic problems in Chile.

Bacterial Toxins↗
PubMed2000

[The use of molecular biology techniques in the articles published in Revista Médica de Chile].

BACKGROUND: Molecular biology is a new branch of biological sciences, with novel laboratory techniques that are being progressively applied into biomedical and clinical research and, furthermore, into medical practice. AIMS: To evaluate the use of molecular biology techniques in Chilean biomedical and clinical research and its evolution in the recent decade. METHODS: All papers published as research articles, clinical experiences or case reports, in Revista Médica de Chile, during two time periods: 1987-1989 and 1997-1999, were reviewed to find out whether molecular biology techniques had been used or not. This journal publishes roughly 40% of papers generated in Chile, in biomedical or clinical topics, while another 15% appears in foreign journals. RESULTS: Among 341 papers published in 1987-1989, 57 (16.7%) had used one or more molecular biology techniques; in contrast, among 318 papers published in 1997-1999, 91 (28.8%) had used them (p < 0.001). Most papers using molecular biology techniques were research articles. Immunology, genetics, endocrinology, hematology, hepatology and rheumatology were the specialties providing a greater number and proportion of papers using molecular biology techniques. Chilean universities were the main institutions sponsoring these articles and FONDECYT (the Chilean Government Research Granting Office) was the main source of funding. The University of Chile (State-owned) provided most centers where these publications had been generated, followed by the Pontifical Catholic University of Chile. CONCLUSIONS: Molecular biology techniques have been rapidly and progressively incorporated as research tools in biomedicine and clinical medicine, in Chile. At the present time, these techniques are predominantly used in research conducted in University settings and funded by Governmental research grants.

Biomarkers↗
PubMed2000

[Number of physicians in Chile: current and prospective estimate, and an international comparison].

BACKGROUND: In the last decades, the number of Universities with medical schools has increased dramatically in our country. AIM: To introduce a conceptual model to estimate the number of physicians that are incorporated to the profession in Chile every year as well as the cumulative number of active physicians in specific time frame. To provide information about the number of available physicians in the country and compare it with the international context. MATERIAL AND METHODS: This model includes information about the number of students that are admitted in all medical schools of the country, the dropout rate, the number of immigrant physicians from other countries, and the cumulative number of active physicians in the previous period. RESULTS: There is an increased number of new medical students starting in 1994 that will produce, starting in 2001, a significant increased in the number of new physicians graduated from Chilean Universities. Meanwhile the increased number of new physicians in recent years is mainly explained by a significant increase in immigrant physicians. The number of active physicians estimated by the year 2000 is 18,549 and this number will be 25,704 by the year 2007. With these estimated numbers, we introduce a qualitative model that allowed us to compare the current number of active physicians in Chile with other countries, especially those with a comparable degree of development. This model uses first The Human Development Index and later the per capita income of different countries adjusted by purchasing power in USA. According to these calculations, Chile has a lower number of physicians than similar countries, and this difference will persist, even after the significant increase in the new physicians expected for the new future. CONCLUSIONS: Chile continues to have a lower number of physicians than countries with similar human development indices (Rev Méd Chile 2000; 128: 1167-76).

Chile↗
PubMed1991

Assessing the scientific strength of Chile.

We use analysis of co-citation and relative citation rates to assess the scientific strength of Chile as compared with other developing countries and to evaluate the potential for increased international collaboration between Chile and the United States in science and engineering. Co-citation is the citation of two scientific papers by a third paper. By examining frequency and patterns of co-citation, the intellectual structure and evolution of scientific disciplines and research specialties can be traced. Chile is especially "strong", as defined by the co-citation model we employ, in biomedicine and clinical medicine, and in astronomy. A relative citation rate is the ratio of the number of citations a paper receives to the average number of citations for all papers published in the same journal over time. Analysis of relative citation rates of papers published by authors with Chilean addresses show that Chilean physics, including earth and space sciences, is of unusually high quality, considerably higher than any other developing country and comparable to several industrialized countries. We conclude that Chile's scientific capacity is advanced enough to absorb and benefit significantly from strategic additions to the country's resources and capabilities for research. These would include increases in: exchanges of researchers in specific fields with U.S. and other Latin American academic, industrial, and government scientists and engineers; training at outstanding U.S. and Latin American institutions; laboratory equipment, computer time, communications links, and library materials; and funding from U.S. and international organizations. It is also apparent that Chile is strong enough in certain fields to cooperate with the U.S. in mutually beneficial international efforts.

Authorship↗
PubMed1986

[Undergraduate and postgraduate studies in the biological sciences in Chile (1985)].

A study group of scientists was convened by the Sociedad de Biología de Chile (Biological Society of Chile) and the Regional Program for Graduate Training in Biological Sciences, PNUD-Unesco, RLA 78/024, to assess undergraduate and graduate studies in life sciences in Chile. The group presented this report at the 28th Annual Meeting of the Society. Discussion centered on the features that should characterize the studies leading to the academic degrees of Licenciado (Licenciate), Magíster (Master) and Doctor (Ph. D) in Sciences, and also on the qualifications that the universities should satisfy in order to grant them. After analyzing the present situation of undergraduate and graduate studies in Biological Sciences in Chilean universities, the group made the following main suggestions: 1. It is recommended that Chilean universities agree on a 4-year plan for the Licenciado degree, without the requirement of a thesis. The importance of providing the students with good laboratory exercises and field experience and with the opportunity to perform short research projects is stressed. In addition, a sound theoretical training on mathematics, physics and chemistry in the education of a modern Biologist is important. Licenciate studies ought to be the basis for professional careers and the universities should offer to the Licenciados free access to their professional schools. 2. It is considered appropriate for Chile and its universities to develop graduate programs in those disciplines that have reached a level of excellence. To accomplish this aim, adequate finance of the universities is necessary to permit them to provide the essential facilities for doing research, and to create a wide system of fellowships for graduate students. Direct government support for research and graduate student fellowships is requested. 3. Research experience of the kind needed for the preparation of a doctoral thesis is recommended as the academic level appropriate for those engaged in teaching undergraduate students in sciences. Teachers in graduate programs should be qualified active researchers. 4. The creation is proposed of a Consejo Nacional de Universidades (National Council of Universities), to be autonomous and composed primarily of outstanding scientists. One of the main functions of this Council would be to licence universities to grant undergraduate and graduate academic degrees in science. 5. The Sociedad de Biología de Chile must maintain an interest in the evaluation of undergraduate and graduate studies in life sciences.

Academic Dissertations as Topic↗
PubMed1994

[The evolution theory in the medical sciences in Chile].

The evolutionist ideas of Lamarck, Darwin and Haeckel entered the country through the arrival of their books. "On the origin of Species" arrived in Chile in 1869. The most outstanding immigrant european physicians that discussed these ideas were Rodulfo A Phillippi (1808-1904) and Juan José Brunner (1825-1899). Both discussed Darwin's ideas in their books and conferences as academics of the Faculty of Medicine of the University of Chile. The first Chilean physicians that read and discussed the validity of evolution theory were Adolfo Valderrama (1834-1902) and Pedro Candia Salgado. Both wrote articles about this matter in Revista Médica de Chile in 1872 and 1874. The professor of general biology, Juan Noé Crevani, italian physician and zoologist that arrived in Chile in 1912, was the first to teach directly the concepts of the evolution theory until his death in 1947. Professor Noé founded the great biological school of the twentieth century in Chile and his disciples introduced the concepts of Mendelian theory and neodarwinism in the decade of fifties. The theory of evolution was taught as a chapter of general biology in the Faculty of Medicine between 1913 and 1947, but its practical applications to medicine were introduced with the birth of medical genetics in the decade of fifties and the foundation of Chilean Genetics society in 1964, under the direction of professors Danko Brncic and Gustavo Hoecker, both awarded with the National Sciences Prize.

Biological Evolution↗
PubMed1995

[Who finances medical research in Chile?].

To identify those institutions granting medical research in Chile, every issue of Revista Médica de Chile published between 1987 and 1994 was reviewed, under the assumption that a vast majority (over 70%) of papers released by Chilean authors in topics of internal medicine and related subspecialties would have been submitted for publication in this journal. This assumption was based in the solid prestige of Revista Médica de Chile among Chilean physicians and investigators: it is one of the oldest medical journals in the world (founded in 1872) and its inclusion in the most important international indexes (e.g. Index Medicus, Current Contents) qualifies it in the "mainstream literature". Papers classified as "Original Articles", "Clinical Experiences", "Review Articles", "Public Health", "Case Reports", "Clinical Laboratory", "Special Articles" and "Medical Education" were screened for acknowledgment of financial support beyond the resources needed for routine clinical work. Among 1,528 manuscripts published, 344 were "Original Articles" and 61.3% of them acknowledged special financial support. Five hundred and one manuscripts were "Clinical Experiences" and 21.5% of them received special financial support; similar proportions were detected in "Review Articles" and "Public Health" topics. The institution ranked as providing support most often was the "Fondo Nacional de Ciencias y Tecnología" (FONDECYT), a governmental fund that assigns resources to research in all areas of science and technology through a peer-reviewed nationwide annual contest. FONDECYT was identified as provider of financial support to 45.2% of the "Original Articles" and "Clinical Experiences"; Chilean universities were mentioned by 33.6% and other entities (including pharmaceutical companies, other national and foreign organizations) by 23.1%. The University of Chile was the main Chilean university mentioned in the acknowledgments. The proportion of papers receiving special financial support was lower in Revista Médica de Chile than in three leading journals from developed countries (70% of Articles published in Annals of Internal Medicine, 74% in Lancet and 78% in The New England Journal of Medicine) but this proportion has been steadily increasing since 1987. The increase has been due only to FONDECYT and it would be unreasonable to expect that this institution will maintain such an expansion indefinitely. Therefore, Chilean investigators should attract more resources from the universities, the pharmaceutical companies and other non-governmental institutions.

Chile↗
PubMed2003

Body composition by hydrometry (deuterium oxide dilution) and bioelectrical impedance in subjects aged >60 y from rural regions of Cuba, Chile and Mexico.

BACKGROUND: In Latin American and Caribbean countries such as Chile, Mexico and Cuba, the population over 60 y has increased steadily. In this age group, there is scarce information about body composition, particularly for those living in rural areas. OBJECTIVE: The purpose of this study was to determine body composition in free-living and healthy elderly subjects >60 y from rural areas of Chile, Cuba and Mexico using deuterium oxide dilution and bioelectrical impedance (BIA) and to develop and cross-validate a predictive equation for this group of subjects by BIA for future use as a field technique. SUBJECTS: The study included 133 healthy subjects (73 males and 60 females) >60 y from rural regions of Cuba, Chile and Mexico. MEASUREMENTS: Total body water, body weight, height and other anthropometric and BIA variables (resistance and reactance) were measured. METHODS: Total body water was determined by deuterium oxide dilution, and fat-free mass (FFM)/fat mass were derived from this measurement. The total sample was used in a split-sample internal cross-validation. BIA and other anthropometric variables were integrated to multiple regression model to design the best predictive equation, which was validated in the other sample. ANOVA, multiple regression and Bland and Altman's procedure were used to analyze the data. RESULTS: Body weight, percentage of fat and fat-free mass were lower in the Cuban men and women compared with Chilean and Mexican men and women. The best predictive equation of the FFM was: FFM kg=(-7.71+(H(2)/R x 0.49)+(country or ethnicity x 1.12)+(body weight x 0.27)+(sex x 3.49)+(Xc x 0.13)), where H(2) is height(2) (cm); R is resistance (Omega); country: Chile=1, Mexico=2 and Cuba=3; sex: women=0 and men=1; body weight (kg) and Xc is reactance (Omega). R(2) was 0.944 and the root mean square error (RMSE) was 2.08 kg. The mean+/-s.d. of FFM prediction was 44.2+/-9.2 vs 44.6+/-10.1. The results of cross-validation showed no significant difference with the line of identity, showing that the predicted equation was accurate. The intercept (=-0.32) was not significantly different from zero (P=0.89) and the slope (=1.02) not significantly different from 1.0 (P>0.9). The R(2) was 0.86, RMSE=3.86 kg of FFM and the pure error was 3.83. CONCLUSION: The new BIA equation is accurate, precise and showed good agreement. The use of this equation could improve the estimates of body composition for the elderly population for these regions, as well as enhancing the opportunity to conduct studies in the elderly population from Latin America.

Aged↗
PubMed2004

Partner violence as a risk factor for mental health among women from communities in the Philippines, Egypt, Chile, and India.

Although studies have documented the associations between Intimate Partner Violence (IPV) and mental health, few have been done in developing countries. In this study, the association between IPV and mental health in women from different developing countries was established. Women, 15 to 49 years old with at least one child 18 years old or younger, were randomly selected from communities in Chile, Egypt, India, and the Philippines (N = 3974). The Self Report questionnaire (SRQ) was used to assess mental health. Women with a score on the SRQ of 8 or more, or who reported ever attempting suicide, were classified as having poor mental health. Physical IPV was defined as being slapped, hit, kicked, beaten or threatened by a male partner during the past year. Psychological violence included being insulted or belittled, threatened or abandoned. Between 22.5% (in Egypt) to 41% (in Chile) of participating women reported a score of eight or more on the SRQ. High score on the SRQ were significantly associated with current physical and psychological IPV in the samples from all participating countries except Chile. Twelve percent of women in Chile, 2.6%, in Egypt, 7.5% in India and 1.6% in the Philippines reported attempting suicide. Suicide attempts were also associated with current physical IPV in the Philippines, Egypt, and India, and with psychological violence in Egypt and India. IPV is significant risk factor for poor mental health in these developing countries. Efforts to reduce IPV should be considered as part of a mental health program.

Adolescent↗
PubMed1997

Cesarean birth trends in Chile, 1986 to 1994.

BACKGROUND: Despite indications of high cesarean section rates in various parts of Latin America, relatively few comprehensive studies of national birth intervention trends have been conducted in that continent. Recent national statistics suggest that Chile may now have the highest reported cesarean section rate in the world. This paper examines cesarean birth trends in Chile with reference to changing patterns in health care financing. METHODS: The growth in the national cesarean birth rate is analyzed, with reference to regional patterns, differences according to insurance coverage, and recent shifts in the financing pattern of health care provision, using insurance fund data and hospital reporting systems data for both public and private sector care from the mid-1980s to mid-1990s. RESULTS: Chile had a cesarean birth rate of 37.2 percent for the 301,955 births covered by either the National Health Fund or private health insurance in 1994. This was a one-third increase from the 1986 rate of 27.7 percent. The private health insurance sector revealed consistently far higher cesarean section rates than the National Health Fund sector (59% vs 28.8% in 1994); intrasectoral rates remained fairly stable over the 8-year period. CONCLUSIONS: The overall increase in Chile's cesarean section rate correlates with the growth in the proportion of all births whose care was privately insured during these years (from 7.5% to 24.8%). This change may be partly explained by the doubling (to 32%) of the percentage of women with a personal obstetrician rather than a "duty" practitioner attending the birth of their baby.

Birth Rate↗
PubMed2001

Identification of a founder mutation in the protoporphyrinogen oxidase gene in variegate porphyria patients from chile.

Variegate porphyria (VP; OMIM 176200) is characterized by a partial defect in the activity of protoporphyrinogen oxidase (PPO), the seventh enzyme of the porphyrin-heme biosynthetic pathway. The disease is usually inherited as an autosomal dominant trait displaying incomplete penetrance. In an effort to characterize the spectrum of molecular defects in VP, we identified 3 distinct mutations in 6 VP families from Chile by PCR, heteroduplex analysis, automated sequencing, restriction enzyme digestion and haplotyping analysis. The mutations consisted of 2 deletions and 1 missense mutation, designated 1239delTACAC, 1330delT and R168H. The occurrence of the missense mutation R168H had been reported previously in American, German and Dutch VP families, suggesting that this may represent a frequent recurrent mutation. Interestingly, the mutation 1239delTACAC was found in patients from 4 unrelated families living in different parts of Chile, suggesting that it might represent a common mutation in Chile. Haplotype analysis using 15 microsatellite markers which closely flank the PPO gene on chromosome 1q22, spanning approximately 21 cM, revealed the presence of R168H on different haplotypes in 6 VP patients from 3 unrelated families. In contrast, we found the occurrence of 1239delTACAC on the same chromosome 1 haplotype in 11 mutation carriers from 4 unrelated families with VP. These findings are consistent with R168H representing a hotspot mutation and 1239delTACAC existing as a founder mutation in the PPO gene. Our data comprise the first genetic studies of the porphyrias in South America and will streamline the elucidation of the genetic defects in VP patients from Chile by allowing an initial screening for the founder mutation 1239delTACAC.

Chile↗
PubMed2025

Human papillomavirus (HPV) genotypes extended prevalence in the female population from a city in Northern Chile.

BACKGROUND: Cervical cancer is primarily associated with the presence of human papillomavirus (HPV), with high-risk genotypes HPV-16 and HPV-18 being the focus of vaccination programs in developing countries such as Chile. Preventive screening for cervical cancer in women aged 25 to 64 years remains centered on cytological techniques and is primarily performed based on clinical suspicion of cervical lesions. However, extended screening for HPV genotypes using DNA amplification methods is not routinely applied to the Chilean female population yet. This study aimed to determine the prevalence of high- and low-risk HPV genotypes in women without known risk factors in a city in northern Chile. METHODS: Cervicovaginal brushing samples were obtained from 390 women from Antofagasta city, Northern Chile, aged between 25 and 64 years; genomic DNA was extracted, and multiplex real-time PCR analysis was used to identify a larger group of high- and low-risk HPV genotypes. RESULTS: Among 390 samples, HPV prevalence was 36.9%, of which 54.9% were high-risk genotypes, 18.7% were low-risk genotypes, and 26.4% showed mixed infection with both high- and low-risk genotypes. High-risk genotypes 16, 58, 39, and 31 were the most frequently identified among HPV-positive samples. Furthermore, a significant association was observed between HPV presence and both age and suspicion of cervical alteration, and women testing positive for other sexually transmitted infections (STIs) were more likely to acquire HPV. CONCLUSIONS: Implementing a screening program that incorporates extended HPV genotyping in Chile, including testing for high-risk genotypes 16, 18, 31, 39, and 58, is crucial to optimize control, early detection, and vaccination efforts for Chilean circulating HPV genotypes that are not covered by the actual vaccine, thus contributing to a more effective reduction in the burden of disease associated with the virus.

Humans↗
PubMedDate not supplied

[Information for health equity in Chile].

OBJECTIVES: To estimate the magnitude of geographical health inequalities in Chile through key indicators based on data and information that are routinely collected and easily obtained, and to characterize the current situation with respect to the availability, quality, and access to information on health equity that official sources routinely collect. METHODS: A conceptual framework proposed by the World Health Organization was used to study health equity in terms of four dimensions: 1) state of health, 2) health determinants, 3) resources for and the supply of health system services, and 4) utilization of health system services. For each of these four dimensions, indicators were selected for which there was available information. The information was aggregated according to geographical and administrative units in the country: communes (342 in Chile), sanitary districts called "Health Services" (28), and regions (13). The aggregated information was analyzed using univariate analysis (distribution characteristics), bivariate analysis (correlations and frequency tables), and tabulation of values for selected indicators for the communes. RESULTS: With respect to the first dimension, state of health, we found an inverse relationship between mortality and average family income in the communes (r = -0.24; P < 0.001; n = 191 communes). With health determinants, there were important differences among the communes with regard to average household income, years of schooling, literacy, quality of housing, drinking water supply, and the wastewater disposal system. In terms of resources for and the supply of health system services, the municipal governments of the communes with higher average household incomes tended to contribute more funds per beneficiary (r = 0.19; P = 0.013). The financial contributions from the national government were targeted well, but they only partially compensated for the more limited resources available in poorer communes. With respect to the utilization of health care services per beneficiary in the different sanitary districts, we found some large differences. In terms of the ratio between the highest rate of utilization in any of the districts and the lowest rate in any other district, the ratio for primary-care visits per beneficiary was 2.8, the ratio for emergency-care visits was 3.9, and the ratio for hospitalizations was 2.0. CONCLUSIONS: There are important geographical differences in Chile with respect to mortality and other health outcomes, income and environmental conditions, and the financing and utilization of health care services. The information that is collected regularly and is available to characterize the health-related variables frequently has limitations in terms of quality, sustainability, and access. In Chile it would be pointless to focus the greatest efforts on reorganizing the information systems. The existing indicators showing marked inequalities are adequate to support the planning of interventions aimed at making urgently needed improvements in the situation of the worst-off Chileans.

Chile↗
PubMed2004

[The reduction in maternal mortality in Chile, 1990-2000].

OBJECTIVE: To determine if Chile achieved the objective of reducing maternal mortality by 50% between 1990 and 2000, in line with the provisions of the Regional Plan of Action for the Reduction of Maternal Mortality in the Americas, which the governments of the Americas approved in 1990 at the 23rd Pan American Sanitary Conference. METHODS: A descriptive, observational study was designed, making it possible to analyze the trend in maternal mortality in Chile from 1990 through 2000. The variables that were evaluated were the maternal mortality ratio, the causes of death, and the age of the mothers who died. The causes of death were classified according to the ninth revision of the International Classification of Diseases (ICD-9), and the raw data were obtained from the yearbooks of the National Institute of Statistics of Chile. The changes in the variables were estimated according to the percentage of cumulative change, and trends were analyzed with the Pearson correlation coefficient. RESULTS: The study found a 60.3% reduction in maternal mortality from 1990 to 2000. The lowest maternal mortality ratio, 18.7 per 100 000 live births, occurred in the year 2000. The five leading causes of maternal mortality were hypertension, miscarriage, other current conditions in the mother, puerperal sepsis, and postpartum hemorrhage. There was a significant downward trend in maternal mortality due to hypertension (r = -0.712; P = 0.014), abortion (r = -0.810; P = 0.003), and puerperal sepsis (r = -0.718; P = 0.013), but there were no statistically significant changes in mortality from other current conditions in the mother or from postpartum hemorrhage. The highest level of maternal mortality was found in women who were 40 years of age or older (100.2/100 000 live births), and the lowest level was in adolescents 15 to 19 years old (18.7/100 000 live births). CONCLUSIONS: Chile achieved the objective of the Regional Plan of Action for the Reduction of Maternal Mortality in the Americas, with a decrease of more than 50% in maternal mortality in the 1990-2000 period. That reduction is due mainly to the decline in maternal mortality from hypertension, abortion, and puerperal sepsis.

Adolescent↗
PubMedDate not supplied

[The National Mental Health Plan in Chile: 10 years of experience].

Dealing with mental health problems is undoubtedly an increasingly important public health responsibility around the world. In Chile, because of the changes in the epidemiological profile of the population, the lifetime prevalence of mental and behavioral disorders has reached 36%. In response, the Ministry of Health of Chile, through its Mental Health Unit, prepared the National Plan for Mental Health and Psychiatry. The Plan establishes objectives, strategies, and steps to improve the well-being and mental health of Chileans. This piece describes the model of care for mental health and psychiatry used in Chile's public health care system, analyzes the main difficulties encountered and the achievements made in the 10 years that the Plan has been in place, and makes recommendations for improving the Plan. Over the 10-year period, the new model for mental health and psychiatry has managed to make a place for itself in the public health care system. Indicators show that the beneficiaries of the public health care system in Chile now have greater access to mental health services than before the new model of community care was established, have broader health care coverage, and receive better quality services.

Chile↗
PubMed2005

Spatial and temporal variations in sea lice (Copepoda: Caligidae) infestations of three salmonid species farmed in net pens in southern Chile.

Sea lice infestations have become a major health problem for farmed salmonids throughout the world including Chile. In southern Chile, 6 geographical areas, divided into 22 geographical zones with a total of 127 salmon farming centers and 1519 sea pens, were regularly sampled from December 1999 to April 2002. A linear mixed-effects model (LME) approach was used to describe the infestations of adult forms of sea lice on 3 salmonid species farmed in southern Chile. The variables fish species, water temperature, water salinity, fish weight, juvenile parasite count, pen shape, treatment status in previous month and the interaction of previous and current month treatments were found to be statistically significant fixed effects for the population sampled. The most susceptible species to sea lice infestation was rainbow trout Oncorhynchus mykiss, while the least susceptible species was coho salmon O. kisutch. Fishes in pens treated in the previous month with avermectins were associated with the smallest sea lice count compared to fishes in pens not treated or treated with other products. The variability in sea lice infestations in areas and zones within areas was not statistically significant when controlling for the previously mentioned fixed variables. The variability between centers, the within-pen variability, and the interaction between within-pen effect and the date of measurement were statistically significant and not explained by the fixed effects. Potential sources for this variability are discussed. We conclude that the epidemiology of sea lice infestations in farmed salmonids in southern Chile is complex and in need of further study.

Animals↗