OBJECTIVE:Chagas disease, caused by the parasite Trypanosoma cruzi, is endemic in many Latin American countries but has become a global health concern due to increasing migration. Vertical transmission, particularly in non-endemic regions, underscores the importance of proper screening in pregnant women to enable early treatment of infected newborns and prevent long-term complications. This study aimed to compare the prevalence of Chagas serological screening in pregnant women before and after the implementation of an automated screening system at Hospital Universitario Infanta Sofía in Madrid (Spain), and to assess its impact on detection rates. METHODS:We conducted an observational, descriptive-analytical, retrospective, cross-sectional study through the analysis and comparison of two defined time periods: before and after automation. Serological testing for T. cruzi was performed using a chemiluminescence immunoassay (CLIA). Statistical analysis was performed using SPSS software version 28.0.1.1, with a significance level of p<0.05. RESULTS:A total of 736 women from World Health Organization-defined Chagas-endemic regions gave birth at the hospital during the study periods. Of these, 283 (38,2%) underwent screening. A statistically significant increase in screening was observed after the implementation of automation (from 0.5% in the first period to 76.4% in the second; p<0.001). Two positive cases of Chagas disease were detected, both during the second period, with no evidence of congenital transmission. CONCLUSIONS:The growing number of women of reproductive age migrating from endemic areas highlights the need for national policies ensuring universal Chagas screening during pregnancy, including at delivery, to facilitate early diagnosis and treatment of congenital cases.
OBJECTIVE:Childhood obesity is one of the leading global public health challenges, with a sustained increase in prevalence since 1975. Spain has one of the highest prevalence rates in Europe, highlighting the need for continuous epidemiological surveillance to inform prevention policies. This study aimed to analyse trends in the prevalence of overweight and obesity among the paediatric population of Navarre, Spain, from 2007 to 2023, and to assess the statistical significance of temporal changes. METHODS:A population-based descriptive study was conducted among children aged <15 years living in Navarre during 2007-2023. Data were obtained from the electronic primary care health records of the Navarre Health Service (Servicio Navarro de Salud-Osasunbidea), covering approximately 93% of the paediatric population. Body mass index (BMI) was expressed as age- and sex-standardised z-scores according to World Health Organization growth standards. Overweight and obesity prevalence rates were directly age-standardised using the 2016 Navarre population as the reference. Statistical analyses were performed using IBM SPSS Statistics version 25 and Joinpoint Regression Program version 4.5.0 softwares, comparing eight three-year periods stratified by age and sex. RESULTS:A statistically significant decrease in the prevalence of excess weight was observed in both sexes and in all age groups between 2007 and 2023, mainly explained by a reduction in overweight of more than 5 percentage points in boys (from 21.8% to 16.5% in six-nine years and from 24.6% to 19.6% in ten-fourteen years) and somewhat less in girls (from 23% to 18.2% in six-nine years and from 22.1% to 20.5% in ten-fourteen years). In contrast, the prevalence of obesity only decreased in boys aged six-nine years (from 13.9% to 12.7%), remained stable in the rest (around 10% in girls aged six-nine years and 12% in boys aged ten-fourteen years), and showed an increasing trend in girls aged ten-fourteen years (from 6.9% to 7.8%). CONCLUSIONS:Although the prevalence of childhood overweight has declined, obesity remains a major public health concern in Navarre. These findings highlight the need to strengthen preventive strategies and implement targeted interventions according to sex and the severity of excess weight.
OBJECTIVE:Childhood obesity is a Public Health problem that is unequally distributed across the population. The aim of this paper was to assess baseline socioeconomic determinants (ages four or six) and their association with obesity during follow-up up to age fourteen. METHODS:Participants from the ELOIN cohort (Estudio Longitudinal de Obesidad Infantil) with four standardized weight and height measurements at ages four or six, nine, twelve, and fourteen years old (follow-up 2012-2024) were included. Obesity was defined as BMI (Body mass index) greater than 2 standard deviations according to World Health Organization 2017 growth charts. Socioeconomic variables included: Family Affluence Scale (FAS-II), occupational social class, age, country of birth, and parental educational level. The prevalence of obesity was estimated with 95% confidence intervals (95% CI) and crude (cPR) and adjusted prevalence ratios (aPR) (95% CI) were estimated by socioeconomic factors using Poisson regression models. RESULTS:Among 2,124 participants (51% girls), 19.8% had at least one parent born outside Spain and 15.6% reported low family affluence. The highest point prevalence of obesity was observed at age nine (14.7%). Overall, 20.1% (95% CI:18.4-21.8) were classified in obesity in at least one of the four assessments. Higher obesity prevalence was observed in socioeconomically disadvantaged groups. Obesity was associated with being a boy (aPR:1.40; 95% CI:1.17-1.68 vs. girls) and low family affluence (aPR:1.36; 95% CI:1.03-1.80 vs. highest affluence). CONCLUSIONS:A positive association between childhood obesity and being male, as well as, lower socioeconomic status was confirmed. Strategies for prevention and intervention should de prioritised for these groups.
Interacting with nature has significant benefits for our physical and psychosocial health. However, a lack of contact with nature has been linked to various pathologies such as obesity, asthma, neurodevelopmental disorders, and learning disabilities. Furthermore, excessive screen use is also associated with health problems in children and adolescents, such as obesity, mental health problems (anxiety, depression), and sleep disorders. Lack of contact with nature from an early age, combined with excessive screen use, contributes to an unhealthy lifestyle and has been associated with the development of these pathologies. This study aims to analyze the relationship between the degree of connection with nature, and the incidence of childhood and adolescent obesity and other common pathologies in Primary Care pediatric clinics: asthma, neurodevelopmental disorders, emotional and psychiatric disorders, as well as sleep disorders and worsening perceived quality of life. A descriptive cross-sectional study will be conducted through the PAPenRed research group of the Spanish Association of Primary Care Pediatrics (AEAPap) over a 12-month period (July 2025 to June 2026). During health visits for children aged seven to fourteen, three surveys will be administered simultaneously: one for the child, another for the parents, and a third for the pediatrician.
Childhood obesity figures in Spain have stabilized but remain among the highest in Europe, with 34.1% of the population aged three to twenty-four showing excess weight, 10.3% obesity, and 31.2% abdominal obesity. Between 2019 and 2023, rates of overweight and obesity among children aged six to nine fell by 3.1 and 1.4 percentage points, respectively, yet remained stable in low-income families, thereby widening the social gap associated with the issue. Paradoxically, a follow-up study involving over a million Spanish children revealed that between 2006 and 2016-the decade following the launch of the NAOS Strategy (Nutrition, Physical Activity, and Obesity Prevention)-obesity prevalence rose solely among those in the most disadvantaged areas; consequently, the ratio of obesity in the lower class compared to the upper class increased from 1.59 to 2.03.
BACKGROUND // Hearing loss is a significant Public Health challenge, with an estimated annual economic impact of 750 billion dollars. It is more critical in low-and middle-income countries, where prevalence is higher and institutional support is limited. The objective of this review was to determine how telemedicine can address the challenges faced by people with hearing impairment and its role as a tool for more inclusive care. METHODS//A narrative review was conducted in Science Direct, PubMed, and Scopus, including full-text articles published between 2015 and 2025 in English or Spanish, complemented with grey literature and the snowball technique. A total of twent-five studies were analyzed on individuals aged twelve years or older with mild to severe hearing impairment. The narrative synthesis was structured into four thematic categories. Methodological rigor was ensured through the application of SANRA criteria. RESULTS // The main barriers identified were lack of infrastructure, insufficient healthcare personnel training, institutional unawareness, and communication difficulties. The development of mobile applications and digital platforms for assessment, auditory rehabilitation, and clinical interaction was reported. Tele-audiology proved useful in remote areas, conditioned on adequate connectivity, professional training, cultural sensitivity, and appropriate regulatory frameworks. CONCLUSIONS // Digital technologies represent a promising approach to improve equity in access and quality of hearing care. Their effectiveness depends on inclusive policies, ethical standards, and active collaboration of multidisciplinary teams.
The VUCA model (Volatility, Uncertainty, Complexity, Ambiguity) has provided a useful framework for understanding public health challenges in crisis contexts. However, globalization, climate change, digitalization, and disinformation demand a new approach: the BANI model (Brittle, Anxious, Nonlinear, Incomprehensible). This paper adopts a conceptual and reflective review, drawing on academic literature and national and international health policy documents, to explore the applicability of the BANI model to public health. Recent examples beyond COVID-19 are analyzed, such as antimicrobial resistance, the opioid crisis, monkeypox, and heatwaves linked to climate change. Furthermore, public policies aligned with BANI are highlighted, including Spain's National Mental Health Strategy, the National Plan against Antimicrobial Resistance (PRAN), climate change and health adaptation plans, and the 2030 Agenda for Sustainable Development Goals. Findings suggest that BANI provides a more accurate framework to understand and address contemporary health challenges, enabling the design of adaptive and resilient strategies that integrate mental health, communication, and planetary health.
The prescription of funded pharmacological treatments to help people quit smoking by nursing represents a significant advance for the National Health System. We highlight its potential to improve monitoring, adherence, and effectiveness in Public Health. However, only four regions have implemented this measure, leading to disparities and limiting equity of access. This article analyses the main challenges and opportunities of this new regulatory framework, which may contribute to increasing the number of people who successfully quit smoking.
Childhood obesity is a complex public health challenge intertwined with social inequalities. Addressing it requires going beyond individual-level interventions and acting on the social, economic, and environmental determinants that shape obesogenic environments and people's living conditions. This article examines intersectoral action to address childhood obesity through the Childhood Obesity Prevention and Management Programme in Catalonia (POICAT). The programme combines community action and territorial coordination to foster institutional and community collaboration across sectors such as education or social services, generating co-benefits that extend beyond health. From a Health for All Policies perspective, it seeks to transform living environments, reduce inequalities, and strengthen community cohesion. The POICAT experience shows that inter-sectoral action and community governance are essential for implementing effective, equitable, and sustainable policies to address a structural issue such as childhood obesity.
Pilates Method during pregnancy can improve mental health, well-being perception, and physical condition in healthy pregnant women. This study conducted a preference-based randomized clinical trial with 108 participants to evaluate the implementation of Pilates Method sessions within Primary Care. Group sessions, held twice weekly over twelve weeks, included strength, flexibility, postural control, breathing, and relaxation exercises. Results showed significant improvements in mental health and a positive trend in general health in the experimental group compared to the control. The intervention also enhanced social interaction, support network creation, and adherence to healthy habits, reinforcing primary prevention and overall well-being. These findings support incorporating Pilates Method as a complementary tool in prenatal care, promoting a holistic approach that combines physical, psychological, and social benefits.
Psychosocial risks have a significant impact on the physical and mental health of healthcare professionals. They regularly face heavy workloads, job insecurity, and considerable emotional strain. These factors not only affect their well-being but also influence the quality of care they provide. The transition into professional practice is often challenging, as many new professionals feel they lack sufficient practical training, making adaptation more difficult. In addition, temporary contracts increase uncertainty and can disrupt continuity of care. Long working hours also contribute to fatigue, which may negatively affect both workers' health and patient safety. In this context, adopting more flexible work models, providing appropriate psychological support, and encouraging continuous training are key strategies. These measures can help improve job stability, reduce burnout, and strengthen leadership within Primary Care teams.
OBJECTIVE:Service quality determines user perception and satisfaction with the service. Therefore, a low perception of quality reflects dissatisfaction and potential problem areas. The objective of this research was to analyze the perception of quality of care in the Tuberculosis Control Program among adult patients treated at the La Troncal Type C Health Center (Ecuador). This research aimed to identify critical issues as opportunities for improvement in service delivery. METHODS:This was a descriptive cross-sectional study. A sample of 257 individuals was established. Patients were treated in the Tuberculosis Control Program from February to May 2023 at the La Troncal Type C Health Center (Ecuador). Simple random sampling was used. A sociodemographic and clinical data survey and ServQual were administered simultaneously to participants after receiving care at the tuberculosis service. Descriptive statistics tools, absolute and relative frequencies were used for qualitative variables. For quantitative variables, the Kolgomorov-Smirnov test, mean, standard deviation, median, and interquartile range were used. An inferential analysis was performed, determining differences in the level of perceived quality using the Kruskal-Wallis H test and the Mann-Whitney U test. RESULTS:A mean of 4 was obtained for all dimensions of perceived quality. With the exception of age group and marital status, no other sociodemographic variables led to significant differences in the scores for the ServQual dimensions. The 18-25 age group had significant differences in the dimensions of reliability, security, sensitivity, and empathy. Statistical significance was observed for singles and people in a common-law relationship (p<0.05). CONCLUSIONS:Patients treated in the Tuberculosis Control Program at the La Troncal Type C Health Center report a high level of satisfaction, reflected by a positive perception of the quality of care in the service. Quality perception allow us to identify opportunities for improvement related to service performance and records, as well as the root causes of these problems.
Recent Andes virus outbreaks have reignited international debate regarding Public Health preparedness for hantaviruses with documented interpersonal transmission capacity. Unlike other orthohantaviruses, Andes virus has demonstrated person-to-person transmission in specific epidemiological settings, including household and nosocomial environments. The recent emergence of cases linked to multinational outbreaks has prompted renewed assessments and recommendations from international public health organizations. This manuscript presents an epidemiological reflection on current surveillance challenges associated with emerging hantaviruses following the experience gained during the COVID-19 pandemic. It also reviews aspects related to zoonotic surveillance, molecular monitoring, early detection, and integrated One Health approaches applied to preparedness against future emerging threats. Available evidence highlights the need to strengthen multidisciplinary surveillance systems capable of integrating human, environmental, and zoonotic information in order to improve responses to complex epidemiological scenarios associated with emerging hantaviruses.
OBJECTIVE:The university provides a crucial opportunity for advocating health and well-being, both at the individual level and within the society it serves. The aim of this study was to assess university students' attitudes toward health promotion and to identify the factors that influence these attitudes. METHODS:A cross-sectional descriptive study was conducted with a randomly selected sample of 1,486 first-year students at the University of Huelva. Descriptive statistics were calculated, and attitudes toward health promotion were assessed using the ATT-HP (Attitude-Health Promotion) scale and its subscales. Bivariate correlations and multiple linear regression analyses were performed. RESULTS:The overall attitude toward health promotion was high (M=56.63, SD=6.94). Higher scores were observed among older students, female students, those coming from vocational training programs, and those enrolled in social sciences and health-related degrees. Entry route into the degree program was the strongest predictor of attitude toward health promotion (β=0.10) and of the Predisposition subscale (β=0.11). Age was the most influential factor for the Valuation subscale (β=0.07). CONCLUSIONS:First-year students at the University of Huelva exhibit a high level of positive attitudes toward health promotion. The degree entry route and age are the most influential factors. These sociodemographic variables should be considered when identifying health assets that support the implementation of more systemic health promotion models, as well as when designing health promotion interventions aimed at consolidating healthy practices.
BACKGROUND//The CRISP (Consensus Reporting Items for Studies in Primary Care) Statement is the result of an international collaborative effort, involving the participation of health professionals, users, community representatives, editors, policy managers and researchers in order to strengthen published research in Primary Care (PC). Our aim was to rendera Spanish version of the CRISP Checklist and reflecton the translation process, itsdevelopments and contributions. METHODS // A linguistic adaptation through translation, back translation and consensus building was carried out, with an emphasis on conceptual, pragmatic and semantic equivalence between the original (English) text and the target(Spanish) text. RESULTS // The resulting adaptation rendered a version which is culture-specific,inclusive and conceptually equivalent to the original. After the first Spanish draft, of the 33 items, 54.5% remained unchanged, 30.3% required adjustments, and 15.2% were reformulated by consensus. Like the original Checklist, the Spanish text attempted to capture the disciplinary diversity of the professionals that constitute the PC community, as well as the active role of the actors resorting to the different services, through the use of terms such as health teams and PC users. Moreover, the Spanish version uses inclusive language and follows updated recommendations to avoid offensive or sexist terms. CONCLUSIONS // A Spanish version of the CRISP Checklist, equivalent to the original but situatedin the broad Spanish-speaking community is produced. Adaptation involves conceptual and linguistic tensions which fostered serious reflection upon professional discourse in the field of the Health Sciences and the ways to produce useful and contextualized knowledge committed to the improvement of PC.
Intervention about addictive behaviours, especially in substance use, has been advancing from traditional therapeutic communities and drug-free programs to comprehensive care networks and harm reduction programs. Addiction recovery is based on the development of capabilities, skills, and competencies that allow the person who has had an addiction problem to generate an alternative lifestyle to the use of substances (or other addictive behaviours) and not only approach treatment from the presence or absence of the main substance. During the 21st century, the so-called Recovery Science has been developed, identifying the theoretical and practical aspects, concepts and constructs of addiction recovery. This article presented a narrative review of the main theories, aspects, and strengths of Recovery Science, as well as its limitations and applications. The main findings are that recovery-based programs are highly effective for the individuals for whom they are designed, but are more difficult for specific groups (women, especially those with children; young people with conduct disorders; users of new psychoactive substances). In conclusion, it is necessary to strengthen experimental and quasi-experimental studies that allow for a better understanding of what works and what doesn't in Recovery Science.
BACKGROUND // Drowning and suicide are interconnected complex phenomena and represent significant Public Health issues. The aim of this paper was to identify and describe the characteristics and factors associated with intentional drownings in Galicia (Spain), analyzing a retrospective cohort of twenty-one years. METHODS // A descriptive, retrospective, and longitudinal study (2004-2021) was conducted analyzing a cohort of patients aged 0 to 100 years who were treated by Basic and Advanced Life Support (BLS/ ALS) units of the FPUS 061 and by hospitals within the Galician Health Service (SERGAS). Records coded with a diagnosis of drowning or near-drowning were included and were recoded as fatal or non-fatal drowning according to international recommendations. Additionally, records containing the terms suicide, self-harm, or suicide attempt in prehospital or hospital documentation were also included. RESULTS // Ninety-nine cases were documented, representing 9% of all drownings in Galicia and 14% of individuals aged over sixty five who drowned. Eighty-two percent of the victims were residents of the municipality where the incident occurred, and 60% were women. Ninety-nine percent had a prior diagnosis of mental health disorder. Individuals over sixty five accounted for 53%of the cases, with a mortality rate of 50%. The presence of witnesses was associated with lower mortality. CONCLUSIONS // There is a relationship between intentional drownings and mental health disorders. In these events, the presence of witnesses is a protective factor, while advanced age is a risk factor for mortality. Intentional drowning isa complex and understudied health issue, so prevention and Public Health strategies should be implemented to reduce these preventable deaths.
OBJECTIVE:The sexual transmission of hepatitis A virus (HAV) has been documented, particularly in men who have sex with men (MSM) engaging in high-risk behaviors. In recent years, HAV outbreaks have been increasingly reported among MSM. This study aimed to analyze the temporal trends of HAV cases in Málaga from 2007 to 2024 to identify changes in the disease's epidemiological pattern. METHODS:This was a retrospective descriptive study of HAV cases reported in the Andalusian Epidemiological Surveillance System (SVEA) from January 2007 to November 24, 2024. Annual incidence rates per 100,000 inhabitants were calculated. Age and sex distributions were analyzed annually and for outbreak periods (2008-2009; 2016-2017) and inter-outbreak periods (2010-2015; 2018-2022; 2023-2024). Data were analyzed using Microsoft Excel and the Poisson method was applied to calculate the 95% confidence intervals of the male-to-female ratio. RESULTS:Two periods were identified with an IR exceeding seven cases per 100,000 inhabitants, primarily due to cases among men aged fifteen-fourty-four years old. In other years, the IR remained below four cases per 100,000 inhabitants, with no significant differences between sexes and with children under fifteen years being the most affected group. However, in 2023-2024, cases among men and older age groups began to increase. CONCLUSIONS:Men aged fifteen-fourty-four play a critical role in recent HAV outbreaks. Collecting detailed data on transmission mechanisms and risk behaviors is essential to enable early outbreak detection.
OBJECTIVE:Urban and social environments strongly shape adolescents' opportunities to engage in physical activity, with inequalities in socioeconomic status, infrastructure and neighbourhood conditions creating uneven access. This study explored the determinants underlying unequal participation in physical activity among adolescents in Madrid and Bilbao. METHODS:A constructivist qualitative case study informed by grounded theory was conducted in secondary schools in Madrid and Bilbao between February 2022 and April 2024. Schools were selected from neighbourhoods with differing socioeconomic profiles. Fieldwork included thirty six semi structured interviews and twenty-four focus groups, analysed through open, axial and selective coding supported by Atlas.ti. RESULTS:Four major thematic categories were identified: 1) Household socioeconomic conditions as a determinant of physical activity; 2) The role of the educational community in shaping physical activity engagement; 3) Perceived insecurity, the appropriation of public space and gender; 4) Urban realities and their influence on physical activity practices. Distinct patterns emerged between Madrid and Bilbao, linked to urban structure, the use of sports facilities, and accessibility. CONCLUSIONS:Economic, spatial and social inequalities limit equitable access to physical activity. The findings underscore the need for context sensitive policies that integrate socioeconomic and urban factors and strengthen the role of schools in reducing adolescent health inequalities.
