Diabetes mellitus is a major health problem in Costa Rica. Its prevalence is increasing and represents a significant burden. Objectives: To determine specific diabetes mortality rates (SDMR) in Costa Rica from 2007 to 2017 and explore it's potential causes. Methods: Death certificates (classification CIE-10) were obtained from the Instituto Nacional de Estadística y Censos. All-cause mortality, SDMR, ischemic heart disease (IHD), cerebrovascular disease (CVD), and peripheral vascular disease mortality were assessed per year, sex, age and province. We evaluated relationships between SDMR and Index of Human Development (IHUD), performed a multivariate regression negative binomial model analysis and compared SDMR with goals of metabolic control in the primary care setting. Results: All-cause mortality and SDMR increased while IHD and CVD mortality rates remained invariable. SDMR was higher in females and in provinces with predominant rural areas. The years of observation, sex, age and province were significant predictors of death at a 5% level in people with diabetes. Reports from primary care setting showed inadequeate public health care coverage and insuficient metabolic control. Conclusions: SDMR increased in elderly patients with specific complications. Age, place of residence and sex predicted SDMR. Unsatisfactory diabetes medical coverage and poorly diabetes management likely explain our findings.

Celiac disease, gluten sensitivity and gluten intolerance are health conditions that require consumers to avoid their gluten intake. In Costa Rica, Law 8975 regulates the amount of gluten permitted in prepackaged products labeled as "gluten-free", but the parameters to be followed are not mandated for food service operations. This study investigated whether restaurants with gluten-free (GF) options in a gastronomic area of the city of San José, Costa Rica, achieved the requirements of the legislation that the dishes offered should contain less than 20 ppm gluten. Using data collected from five restaurants offering GF dishes, two provided dishes with quantities of gluten greater than 20 ppm (restaurant A, four samples and restaurant B, three samples); particularly dishes from the category "meat with sauce". Although those dishes are naturally gluten-free, when they are handled in areas of shared production, they are exposed to the risk of cross contact, furthermore the adding of misscellaneous such as: marinades, sauces and condiments, which could contain traces of gluten or hidden gluten, a risk associated with the use of ingredients without certification GF (supplier's practices and label declaration). Therefore improvements in food service procedures should be enforced. The findings of the present study emphasize the need to include restaurant foods in the relevant legislation to ensure that the gluten-intolerant sector of the population remains safe when eating out.

Coronavirus diseases 2019 (COVID-19) emerged in China in December 2019 and it rapidly widespread around the world. As of May, 2020, there had been 3.618.325 confirmed cases of COVID-19, 253.381deaths and 1.184.145 recovered persons reported globally. In this review we present the evolution of the infection in Costa Rica and analyze preventive measurements taken to contain a potential explosive dissemination of COVID-19 infection. In Costa Rica, the accumulated incidence per 100.000 habitants of COVID-19 was 14.5 and the death rate 0.81 per 100.000 habitants. By May 3, the number of recovered patients were identical to those with active disease. So far, the health care system has not collapsed as most of the COVID-19 patients have being managed at home. However, the battle is not over yet. Due to the fact that re-opening of the country gradually will take and the number of new cases of undocumented immigrants, children and youngsters is steadily increased, unfavorable consequences in the following weeks might be anticipated. The Costa Rican health authorities are vigilant and diligently managing the COVID-19 pandemic.