Background: Exposure to 2.5-micron diameter air pollutants (PM2.5) has been associated with an increased risk of illness and death worldwide; however, in Latin American health impacts assessment of this risk factor is scarce. Medellín is one of the most polluted cities in the region, with a population growth rate that is twice as high as that of other Colombian cities, which implies a growing population at risk. Methods: A descriptive study of the disease burden was carried out using the city as the unit of observation. Health events were selected based on epidemiologic evidence and the availability of the population attributable fraction associated with PM2.5. The mortality records were taken from the module of deceased of the Single Registry of Affiliates of the Health System; the morbidity records were taken from the Individual Health Services Registries. For the estimation of the burden of disease, the current Global Burden of Disease guidelines were followed. Results: Attributable disability-adjusted life years to exposure to ambient PM2.5 pollution (DALYsPM2.5) constituted 13.8% of total burden of the city. Males showed the greatest loss of DALYsPM2.5 due to acute events, while in women the greatest loss was due to chronic events. Ischemic heart disease, chronic diseases of the lower respiratory tract, and influenza and pneumonia were the events that contributed the most to DALYsPM2.5. 71.4% of the DALYsPM2.5 corresponded to mortality, mainly in the population over 65 years of age. Regarding attributable morbidity, acute events were more prevalent in both sexes, especially due to respiratory diseases Conclusion: Premature death among the elderly population has the greatest weight on burden of disease attributable to ambient PM2.5 pollution, mainly due to respiratory and cardiovascular diseases, without significant differences according to gender.

Objective: To determine the association between chronic exposure to fine particulate matter (PM2.5), sociodemographic aspects, and health conditions and COVID-19 mortality in Colombia. Methods: Ecological study using data at the municipality level, as units of analysis. COVID-19 data were obtained from official reports up to and including July 17th, 2020. PM2.5 long-term exposure was defined as the 2014-2018 average of the estimated concentrations at municipalities obtained from the Copernicus Atmospheric Monitoring Service Reanalysis (CAMSRA) model. We fit a logit-negative binomial hurdle model for the mortality rate adjusting for sociodemographic and health conditions. Results: Estimated mortality rate ratios (MRR) for long-term average PM2.5 were not statistically significant in either of the two components of the hurdle model (i.e., the likelihood of reporting at least one death or the count of fatal cases). We found that having 10% or more of the population over 65 years of age (MRR=3.91 95%CI 2.24-6.81), the poverty index (MRR=1.03 95%CI 1.01-1.05), and the prevalence of hypertension over 6% (MRR=1.32 95%CI1.03-1.68) are the main factors associated with death rate at the municipality level. Having a higher hospital beds capacity is inversely correlated to mortality. Conclusions: There was no evidence of an association between long-term exposure to PM2.5 and mortality rate at the municipality level in Colombia. Demographics, health system capacity, and social conditions did have evidence of an ecological effect on COVID-19 mortality.

Resultados. Se encontraron cinco casos de malaria neonatal, todos por Plasmodium vivax, de los cuales, sólo uno cumplió los criterios de infección congénita. Aunque tres de los pacientes tuvieron parto institucional y dos antecedentes maternos de malaria gestacional, ninguno fue tamizado para malaria; 25% (1 de 4) de las madres eran primíparas y la mitad eran menores de 20 años. Todos los neonatos tuvieron fiebre, algún signo de enfermedad grave al examen físico de ingreso y cifras de hemoglobina compatibles con anemia neonatal grave. Ninguno recibió el esquema antipalúdico recomendado. Conclusión. Se trata de un reporte de cinco casos de malaria neonatal grave por P. vivax, especie que habitualmente no se relaciona con complicaciones, sin que existiera en ningún caso la sospecha clínica y con tratamiento inadecuado.Palabras clave: Plasmodium vivax, malaria paludismo, recién nacido, estudios de casos, Colombia.

Mortality inequalities have been described across Latin American countries, but less is known about inequalities within cities, where most populations live. We aimed to identify geographic and socioeconomic inequalities in mortality within the urban areas of four main cities in Colombia. We analyzed mortality due to non-violent causes of diseases in adults between 2015 and 2019 using census sectors as unit of analysis in Barranquilla, Bogotá, Cali, and Medellín. We calculated smoothed Bayesian mortality rates as main health outcomes and used concentration indexes (CInd) for assessing inequalities using the multidimensional poverty index (MPI) as the socioeconomic measure. Moran eigenvector spatial filters were calculated to capture the spatial patterns of mortality and then used in multivariable models of the association between mortality rates and quintiles of MPI. Social inequalities were evident but not consistent across cities. The most disadvantaged groups showed the highest mortality rates in Cali. Geographic inequalities in mortality rates, regardless of the adults and poverty distribution, were identified in each city, suggesting that other social, environmental, or individual conditions are impacting the spatial distribution of mortality rates within the four cities.

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