Introducción: Las enfermedades crónicas no transmisibles del adulto son el principal desafío de los sistemas de salud en el mundo. Se requiere información local para planificación sanitaria.Objetivos: Estimar la magnitud y distribución de problemas de salud crónicos prioritarios y sus determinantes en una muestra nacional representativa de la población general chilena.Métodos: ENS 2016-2017 es un estudio transversal con muestra de hogares aleatoria, estratificada, multietápica y por conglomerados representativa del nivel nacional, regional, urbano rural de 6233 personas de 15 y más años. Personal capacitado (encuestadores y enfermeras) en sucesivas visitas al hogar,  administraron cuestionarios, examen dental, presión arterial, antropometría, recolectaron muestras de sangre en ayunas y orina. Se estimó la magnitud de 72 problemas de salud.Resultados: Se observa un elevado nivel absoluto de morbilidad por enfermedades crónicas y sus factores de riesgo. Se estima una magnitud de al menos 11 millones de personas con multimorbilidad que requieren atención médica y control crónico anual de por vida. Algunos ejemplos de altas prevalencias son: hipertensión (27,6%), dislipidemia HDL (46%), obesidad (34,4%), caries cavitadas (55%), diabetes (12,3%), tabaquismo actual (33,4%), problemas asociados al consumo de alcohol (12%), síntomas depresivos (15,8%), consumo excesivo de sal (98%), bajo consumo de frutas y verduras (85%), sedentarismo de tiempo libre (87%). Las mayores diferencias entre hombres y mujeres se observan en el uso riesgoso de alcohol y los síntomas depresivos.Conclusiones: la magnitud de población que requiere atención médica y cuidados crónicos supera la capacidad de respuesta del sistema de salud. Urgen fuertes estrategias preventivas de tipo poblacional (medidas regulatorias masivas) complementadas con una priorización de las estrategias de alto riesgo individual más costo efectivas. ENS aporta a la evaluación y vigilancia de ambas estrategias.

BackgroundMaule Cohort (MAUCO), a Chilean cohort study, seeks to analyze the natural history of chronic diseases in the agricultural county of Molina (40,000 inhabitants) in the Maule Region, Chile. Molina´s population is of particular interest because in the last few decades it changed from being undernourished to suffering excess caloric intake, and it currently has the highest national rates of cardiovascular diseases, stomach cancer and gallbladder cancer. Between 2009 and 2011 Molina´s poverty rate dropped from 24.1 % to 13.5 % (national average 20.4 %); in this period the county went from insufficient to almost complete basic sanitation. Despite these advances, chemical pollutants in the food and air are increasing. Thus, in Molina risk factors typical of both under-developed and developed countries coexist, generating a unique profile associated with inflammation, oxidative stress and chronic diseases.Methods/DesignMAUCO is the core project of the recently established Advanced Center for Chronic Diseases (ACCDiS), Universidad de Chile & Pontificia Universidad Católica de Chile. In this study, we are enrolling and following 10,000 adults aged 38 to 74 years over 10 years. All eligible Molina residents will be enrolled. Participants were identified through a household census. Consenting individuals answer an epidemiological survey exploring risk factors (psycho-social, pesticides, diet, alcohol, and physical activity), medical history and physical and cognitive conditions; provide fasting blood, urine, and saliva samples; receive an electrocardiogram, abdominal ultrasound and bio-impedance test; and take a hand-grip strength test. These subjects will be re-interviewed after 2, 5 and 7 years. Active surveillance of health events is in place throughout the regional healthcare system. The MAUCO Bio-Bank will store 30 to 50 aliquots per subject using an NIH/NCI biorepository system for secure and anonymous linkage of samples with data.DiscussionMAUCO´s results will help design public health interventions tailored to agricultural populations in Latin America.

(Rev Med Chile 2016; 144: 417-425)

The maternal weight gain chart proposed by Rosso and Mardones (RM) was subsequently modified by Atalah et al. (AEA). Both charts are widely used in Latin America. The purpose of this study was to compare birth length (BL) and birth weight (BW) outcomes of both charts. A prospective study of pregnant women and their offspring's was performed in Santiago, Chile. From a total sample of 27,613 pregnant women a sub-sample of 11,465 term healthy singleton pregnant women was selected for additional analyses. κ statistics was used to study the degree of agreement of both charts in the diagnosis of maternal nutritional status. Obese and underweight women were classified using both standards at the beginning of pregnancy and compared in terms of BL4250 g proportions. Sensitivity and specificity values of at risk newborns, whose categories were considered as gold standard, were obtained for obese and underweight women of each chart. There was a moderate agreement in the nutritional classification of these charts. Proportions of BL4250 g were similar at each nutritional category; however, absolute figures for at risk newborns were much higher in the RM underweight and obese women. The RM chart showed higher sensitivity values than the AEA chart. The higher sensitivity of the RM chart would support its use for prevention purposes. This chart is advisable for Latin American countries and also for most developing countries.