Enfermedades contagiosas
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Item Excess mortality from COVID 19 in Costa Rica: a registry based study using Poisson regression(The Lancet Regional Health - Americas, Vol.20, 2023) Fantin, Romain Clement; Barboza Solís, Cristina; Hildesheim, Allan; Herrero, RolandoExcess mortality from COVID 19 in Costa Rica: a registry based study using Poisson regression Romain Fantin,a ,b ,c ,∗ Cristina Barboza-Solís,c Allan Hildesheim,b and Rolando Herrerob a Centro Centroamericano de Población, Universidad de Costa Rica, San Pedro, Costa Rica b Agencia Costarricense de Investigaciones Biomédicas – Fundación Inciensa, San José, Costa Rica c Facultad de Odontología, Universidad de Costa Rica, San Pedro, Costa Rica Summary Background Official death toll related to COVID-19 has been considerably underestimated in reports from some Latin American countries. This study aimed to analyze the mortality associated with the COVID-19 pandemic in Costa Rica between March 2020 and December 2021. Methods A registry based study based on 2017–2021 data from the National Institute of Statistics and Census was designed (N = 128,106). Excess deaths were defined by the WHO as “the difference in the total number of deaths in a crisis compared to those expected under normal conditions”; and were estimated using a Poisson regression, and mortality and years of potential life lost (YPLL) rates were calculated. Findings The COVID-19 pandemic represented 15% of the deaths in Costa Rica between March 2020 and December 2021. The mortality rate related to COVID-19 was 83 per 100,000 person-years. Between March and July 2020 (low- incidence period), observed number of deaths was 9%-lower than expected, whereas it was 15% and 24% higher than expected between July 2020 and March 2021 (high incidence period - no vaccination), and between March 2021 and December 2021 (high incidence period – progressive vaccination) respectively. Between July 2020 and December 2021, excess deaths observed and COVID-19 deaths reported were comparable (7461 and 7620 respectively). Nevertheless, there were more deaths than expected for conditions that predispose to COVID-19 deaths. YPLL and mortality rates increased with age, but significant excess deaths were observed in all age-groups older than 30–39 years. No large differences were noted by districts’ socioeconomic characteristics although excess death rate was lower in rural compared to urban areasItem Inequidades geográficas y tuberculosis en Costa Rica, 2008-2012(Población y Salud en Mesoamérica, Volumen 13, número 2 (enero-junio 2016), 2016) Chamizo García, Horacio AlejandroSe presenta un estudio exploratorio ecológico sobre la tuberculosis en Costa Rica, sus inequidades geográficas y determinantes sociales. Se calculó la tasa de morbilidad y mortalidad por tuberculosis, el riesgo relativo de enfermar y morir por unidades territoriales (del año 2008 al 2012) y se representó cartográficamente. Se analizó el patrón espacial de la morbilidad y la mortalidad por tuberculosis estableciendo correlaciones lineales con diversos indicadores socioeconómicos como el índice de desarrollo humano, Gini y un indicador sintético de calidad ambiental a nivel doméstico y comunal. Los territorios con mayor riesgo de enfermar y morir se localizan hacia zonas fronterizas y costeras; lo mismo sucede con las peores condiciones socioeconómicas y calidad ambiental. El artículo evidencia que, en la medida que empeoran las condiciones socioeconómicas y ambientales en los cantones, se incrementa el riesgo de tuberculosis.