Pedro Barrera-López

Sexual and reproductive behaviors and mental health among indigenous peoples are influenced by structural, cultural, and territorial determinants. In Latin America, indigenous populations face inequities related to health service access, sexual education, and mental health care. We assessed the association between sexual and reproductive factors and the presence of mental health symptoms in Wayúu indigenous communities. A cross-sectional study was conducted between 2024 and 2025 in Wayúu communities in Manaure, La Guajira, Colombia. A structured survey including sociodemographic variables, sexual and reproductive history, and mental health symptoms was applied to adult Wayúu indigenous people. A composite score of mental health symptoms was constructed, and the presence of ≥3 symptoms was defined as a “high burden of mental health symptoms.” Descriptive analyses and multivariate logistic regression were performed to estimate adjusted odds ratios (OR). In total, 245 (203 women and 42 men) people participated in the study. The median age was 30 years (IQR 24–38). Forty-nine percent did not receive sex education, and 65% did not use family planning methods. Between 28% and 33% reported persistent symptoms of emotional distress. In multivariable analyses, female sex showed a non-significant association with a higher burden of mental health symptoms (aOR 2.20; 95% CI 0.91–6.19). No statistically significant associations were observed for age, lack of sex education, non-use of family planning methods, or number of children. These findings highlight the high frequency of poor sexual and reproductive health indicators and emotional distress symptoms in Wayúu communities, underscoring the need for integrated, culturally relevant approaches to sexual, reproductive, and mental health care in this population.

Background/Objectives: Indigenous children in La Guajira, Colombia, live in a context of structural vulnerability that may compromise growth and nutritional status. This study aimed to characterize anthropometric patterns and longitudinal nutritional changes in Wayúu children under five years of age. Methods: A quantitative cross-sectional analysis was conducted in 398 children from 27 Wayúu communities in Manaure, La Guajira, Colombia, with an exploratory longitudinal follow-up subgroup assessed over an 8-month period. Anthropometric measurements were obtained by trained pediatricians and classified using standard WHO growth references. Descriptive and bivariate analyses were performed for the full sample, and exploratory longitudinal changes were assessed in the follow-up subgroup. Results: At baseline, 92.46% of children presented at least one nutritional alteration, and 89.95% had malnutrition or nutritional impairment. Stunting was the most frequent condition (60.1%), whereas acute malnutrition was less common. In the exploratory longitudinal subgroup, 41.67% of children showed descriptive changes in at least one anthropometric indicator, with a significant increase in nutritional risk between visits. Older children showed significantly lower weight-for-age and height-for-age values than younger children, while no significant differences were observed by sex. Conclusions: Wayúu children under five years in Manaure show a pattern dominated by chronic growth impairment with worsening anthropometric indicators over time. These findings highlight the need for sustained, culturally adapted, and multisectoral strategies to prevent and manage childhood malnutrition in Indigenous populations.

Background/Objectives: Indigenous children in La Guajira, Colombia, live in a context of structural vulnerability that may compromise growth and nutritional status. This study aimed to characterize anthropometric patterns and longitudinal nutritional changes in Wayúu children under five years of age. Methods: We conducted a prospective cohort study in 398 children from 27 Wayúu communities in Manaure, La Guajira, over an 8-month period. Anthropometric measurements were obtained by pediatricians and classified using standard indicators based on WHO growth references. A descriptive and bivariate analysis was performed for the full sample, and longitudinal changes were evaluated in a follow-up subgroup. Results: At baseline, 92.46% of children presented at least one nutritional alteration, and 89.95% had malnutrition or developmental delay. Stunting was the most frequent condition (89.95%), whereas acute malnutrition was less common. In the longitudinal subgroup, 41.67% of children worsened in at least one indicator, with a significant increase in nutritional risk over time. Older children showed worse weight-for-age and height-for-age indicators than younger children, while no significant differences were observed by sex. Conclusions: Wayúu children under five years in Manaure show a pattern dominated by chronic, symmetrical growth impairment with worsening anthropometric trajectories over time. These findings highlight the need for sustained, culturally adapted, and multisectoral strategies to prevent and manage childhood malnutrition in Indigenous populations.

Background: Burnout syndrome is a significant issue among healthcare professionals, significantly affecting their mental well-being. Its prevalence has increased since the onset of the COVID-19 pandemic. In Colombia, data on burnout prevalence are limited, and no specific studies have been conducted in paediatrics. Therefore, this study aims to assess the risk of mental disorders and burnout syndrome among paediatricians working in various healthcare settings in Bogotá during 2023. Methods: A cross-sectional survey was conducted among paediatricians in Bogotá, Colombia. The sample size was calculated at 179 participants based on the city’s paediatrician population and previous studies on burnout prevalence in paediatric emergency services. The survey included the Maslach Burnout Inventory (MBI) for medical personnel, the Self-Report Questionnaire, the Patient Health Questionnaire-2 and the Generalised Anxiety Disorder-2. Results: A total of 186 surveys were collected, revealing that 95% of paediatricians were at risk of burnout syndrome. This was indicated by impairments in at least one of the three MBI domains: depersonalisation, emotional exhaustion and reduced personal accomplishment. Furthermore, a relationship was identified between unfavourable working conditions and the risk of mental illness, highlighting the urgent need for intervention by health authorities and medical organisations. Conclusion: There is a clear association between working conditions and mental health, highlighting the urgent need for action from health authorities and medical organisations.

Introduction: Besides the direct health implications of COVID-19, the pandemic and its containment measures have had multiple negative consequences, especially in the prevention and treatment of chronic diseases. This paper aimed to evaluate the effects of COVID-19 pandemic on mortality rates and healthcare seeking among individuals with diabetes in Colombia. Methods: Nationwide ecological panel study of secondary data from the Colombian official records of mortality and medical attentions due to diabetes between 2015 and 2021. Aggregated data of hospitalizations, ambulatory and emergency care visits, as well as death rates due to diabetes were assessed once adjusted by health care infrastructure and rurality. Results: During the COVID-19 pandemic, the mortality rate from diabetes increased by 30.4% (pre-pandemic average by semester: 7.73 deaths per 100,000 inhabitants; pandemic average: 10.08 deaths per 100,000 inhabitants), the average rate of medical attention increased by 67.2% (pre-pandemic: 3163 per 100.000; pandemic: 5290 per 100.000), in which, ambulatory care arose by 44.6% and hospitalizations by 42.3%. Rurality was inversely associated with health visits, and the availability of tertiary care institutions was associated with both diabetes mortality and consultations. Conclusions: An important increase in total number of consultations and mortality rates on diabetes patients was observed during the COVID-19 crisis in Colombia. Availability of high specialized health facilities is related to the number of medical consultations, which suggests that people that did not have access to specialized health services were neglected. Actual impact of COVID-19 pandemic in patients with diabetes remains unclear.

To evaluate the outcomes of patients with sepsis-associated organ dysfunction and septic shock who receive fluid resuscitation with balanced and unbalanced solutions in a middle-income country. An observational, analytical cohort study with propensity score matching (PSM) in children admitted to a pediatric intensive care unit (PICU). Patients from one month to 17 years old who required fluid boluses due to hemodynamic instability were included. The primary outcome was the presence of acute kidney injury and the secondary outcomes were the need to begin continuous renal replacement therapy (CRRT), metabolic acidosis, PICU length of stay and mortality. Out of the 1,074 admissions to the PICU during the study period, 99 patients had sepsis-associated organ dysfunction and septic shock. Propensity score matching was performed including each patient´s baseline characteristics. The median age was 9.9 months (IQR 4.9-22.2) with 55.5% of the patients being male. Acute kidney injury was seen less frequently in children who received a balanced solution than in those who received an unbalanced solution (20.3% vs 25.7% P = 0.006 ORa, 0.75; 95% CI, 0.65-0.87), adjusted for disease severity. In addition, the group that received balanced solutions had less need for CRRT (3.3 % vs 6.5%; P = 0.02 ORa 0.48; 95% CI, 0.36-0.64) and a shorter PICU stay (6 days IQR 4.4-20.2 vs 10.2 days IQR 4.7-26; P < 0.001) than the group with unbalanced solutions. We found no difference in the frequency of metabolic acidosis (P = 0.37), hyperchloremia (P = 0.11) and mortality (P = 0.25) between the 2 groups. In children with sepsis-associated organ dysfunction and septic shock, the use of unbalanced solutions for fluid resuscitation is associated with a higher frequency of acute kidney injury, a greater need for continuous renal support and a longer PICU stay compared to the use of balanced solutions, in a middle-income country.

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The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS‐Cov‐2) has led to the elaboration of multiple studies to increase knowledge and understanding, hence, having the ability to accomplish an adequate and timely diagnosis and give an optimal treatment according to the patient's condition. The clinical manifestations of COVID‐19 pose a series of challenges both in understanding and delimiting the disease secondary to the SARS‐CoV‐2 infection. This is due to the fact that the main axis of this disease is the endothelial compromise and the production of a “cytokine storm,” triggering multiple organ failure and death. Given that a complete understanding of its pathophysiology and clinical behavior has not yet been achieved, we wondered if coinfection with other respiratory viruses modifies its performance and outcomes described so far. A literature search was performed, obtaining 68 articles, of which 25 were analyzed. The analysis showed us that there is a high variety both in the types of associated infections and in the clinical behavior of patients and their outcomes. Therefore, we consider that the search for other infections should be performed exhaustively, especially in those cases that may be susceptible to treatment such as Influenza A, human immunodeficiency virus, or bacterial infections. As well as optimize the analysis of these cases and establish if there are characteristics that allow establishing the possibility of carrying an additional infection to that of SARS‐CoV‐2 and the implications for the management and prognosis of the patient.