HPV16/18 antibodies 16-years after single dose of bivalent HPV vaccination: Costa Rica HPV vaccine trial.

Background: The Costa Rica HPV Vaccine Trial provided initial evidence that 1 dose of the bivalent human papillomavirus (HPV) vaccine induces stabilizing antibody levels that may provide extended protection against HPV-16/18 infections. We report antibody seropositivity and stability 11 to 16 years after vaccination.

Methods: We invited a random subset of Costa Rica HPV Vaccine Trial participants (n = 398) who had received 3 doses and all women (n = 203) who had received 1 dose at 18 to 25 years of age to follow-up visits 11, 14, and 16 years after vaccination.

A surveillance study of cancer incidence and mortality among young adults in Costa Rica.

Background: There has been an increase in certain cancers among young adults (YA) aged 20-39, particularly in Latin America. This is the first study to examine cancer incidence and mortality in YA in Costa Rica, focusing on sex-specific patterns.

Methods: Invasive cancer cases (excluding non-melanoma skin cancer) in YA from 2006 to 2015 were obtained from the Costa Rican National Registry of Tumors.

Health inequalities in a middle-income country: a systematic review of the Costa Rican case.

Objective: This study systematically reviews evidence of socioeconomic health disparities in Costa Rica, a middle-income country, to elucidate the relationship between socioeconomic status and health outcomes.

Methods: Published studies were identified through a systematic review of PubMed (English) and Scielo (Spanish) databases from December 2023 to January 2024, following PRISMA guidelines. Search terms included socioeconomic status, social determinants, social gradient in health, and health inequalities.

Social gradient and rural-urban disparities in cancer mortality in Costa Rica.

Introduction: Data on social inequalities in cancer mortality are sparse, especially in low- and middle-income countries. We aimed to analyze the socioeconomic inequalities in cancer mortality in Costa Rica between 2010 and 2018.

Methods: We linked 9-years of data from the National Electoral Rolls, National Birth Index and National Death Index to classify deaths due to cancer and socioeconomic characteristics of the district of residence, as measured by levels of urbanicity and wealth.

COVID-19 and long-term impact on symptoms and Health-Related Quality of Life in Costa Rica: the RESPIRA cohort study.

Background: Evidence continues to accumulate regarding the potential long-term health consequences of COVID-19 in the population. To distinguish between COVID-19-related symptoms and health limitations from those caused by other conditions, it is essential to compare cases with community controls using prospective data ensuring case-control status. The RESPIRA study addresses this need by investigating the lasting impact of COVID-19 on Health-related Quality of Life (HRQoL) and symptomatology in a population-based cohort in Costa Rica, thereby providing a robust framework for controlling HRQoL and symptoms.

Cohort profile: evaluation of immune response and household transmission of SARS-CoV-2 in Costa Rica: the RESPIRA study.

Purpose: The RESPIRA cohort aims to describe the nature, magnitude, time course and efficacy of the immune response to SARS-CoV-2 infection and vaccination, population prevalence, and household transmission of COVID-19.

Participants: From November 2020, we selected age-stratified random samples of COVID-19 cases from Costa Rica confirmed by PCR. For each case, two population-based controls, matched on age, sex and census tract were recruited, supplemented with hospitalised cases and household contacts.

Estimating the cumulative incidence of SARS-CoV-2 infection in Costa Rica: modelling seroprevalence data in a population-based cohort.

Background: The true incidence of SARS-CoV-2 infection in Costa Rica was likely much higher than officially reported, because infection is often associated with mild symptoms and testing was limited by official guidelines and socio-economic factors.

Methods: Using serology to define natural infection, we developed a statistical model to estimate the true cumulative incidence of SARS-CoV-2 in Costa Rica early in the pandemic. We estimated seroprevalence from 2223 blood samples collected from November 2020 to October 2021 from 1976 population-based controls from the RESPIRA study.

Health inequalities in the geographic distribution of dental practitioners in Costa Rica: An ecological study.

Objective: The uneven distribution of dental health services in a territory can cause an imbalance in accessibility, increasing health inequalities. This study aimed to describe the geographical distribution of dental health practitioners according to urbanicity and area-level socio-economic status in Costa Rica.

Methods: A National Dentist Survey was developed to identify employment status, number of working hours, address and list of the working clinics.

Excess mortality from COVID 19 in Costa Rica: a registry based study using Poisson regression.

Background: Official death toll related to COVID-19 has been considerably underestimated in reports from some Latin American countries. This study aimed to analyze the mortality associated with the COVID-19 pandemic in Costa Rica between March 2020 and December 2021.

Methods: A registry based study based on 2017-2021 data from the National Institute of Statistics and Census was designed (N = 128,106).

Health inequalities in cause-specific mortality in Costa Rica: a population-based cohort study.

Objective: To analyze health inequalities in cause-specific mortality in Costa Rica from 2010 to 2018, observing the main causes for inequality in the country.

Methods: The National Electoral Rolls were used to follow-up all Costa Rican adults aged 20 years or older from 2010 to 2018 (n = 2,739,733) in an ecological study. A parametric survival model based on the Gompertz distribution was performed and the event death was classified according to the ICD-10.

Estimating vaccine effectiveness against SARS-CoV-2 infection, hospitalization and death from ecologic data in Costa Rica.

Background: Clinical trials and individual-level observational data in Israel demonstrated approximately 95% effectiveness of mRNA-based vaccines against symptomatic SARS-CoV-2 infection. Individual-level data are not available in many countries, particularly low- and middle- income countries. Using a novel Poisson regression model, we analyzed ecologic data in Costa Rica to estimate vaccine effectiveness and assess the usefulness of this approach.

Social inequality in incidence and mortality of malignant neoplasms of lip, oral cavity and pharynx: Is Costa Rica an international paradox?

Objectives: Low socioeconomic position (SEP) has been associated with higher incidences and mortality of lip, oral cavity and pharynx (LOP) cancers in the vast majority of countries with available data. The origins of health inequalities in cancer are socioeconomic, although they vary by time and country. Evidence from Low-and Middle-income Countries (LMICs) remains scarce.

Relationship between childhood obesity and socio-economic status among primary school children in Costa Rica.

Objective: This article analyses the relationship between socio-economic status and the prevalence of overweight and obesity in the primary school population in Costa Rica.

Design: A National School Weight/Height Census was disseminated across Costa Rica in 2016. The percentage of children who were overweight or obese was calculated by sex, age and socio-economic indicators (type of institution: private, public, mix; type of geographic location: rural, urban and the level of development of the district of residence: quartiles).

[COVID-19 deaths: Distribution by age and universal medical coverage in 22 countriesMortes por COVID-19: distribuição por idade e universalidade da cobertura médica em 22 países].

Objective: Relate standardized age distribution of COVID-19 deaths in 22 countries in the Americas and Europe to different indicators of population characteristics and health systems.

Methods: Distributions of COVID-19 deaths by age group in 22 countries of the Americas and Europe were standardized based on the age pyramid of the world's population. Correlations were calculated between the standardized proportion of people aged <60 years among the deceased and each of six indicators.

Are traditional screening tools adequate for monitoring the nutrition risk of in-hospital patients? An analysis of the nutritionDay database.

Background: Monitoring of adequate food intake is not a priority in hospital patients' care. The present study aimed to examine selective data from the nutritionDay survey to determine the impact of food intake during hospitalization on outcomes according to the nutrition risk status.

Methods: We conducted a descriptive analysis of selected data from 7 consecutive, annual, and cross-sectional nutritionDay samples from 2009 to 2015.

Behavioral Changes During COVID-19 Confinement in France: A Web-Based Study.

Background: A global pandemic due to COVID-19 emerged in November 2019 and hit France in early March 2020. It not only resulted in a loss of lives, but also in very strict confinement measures. The objective of this study was to understand what the determinants of the changes in participants' behavior and mental state were during the confinement.

Social gradient in cancer incidence in Costa Rica: Findings from a national population-based cancer registry.

Background: The main evidence regarding social inequalities in cancer risk comes from industrialized countries. The aim of this manuscript was to analyze the association between cancer incidence and socioeconomic position (SEP) in a middle-income country (Costa Rica) between 2011 and 2015.

Methods: An ecological study at the level of the electoral district was conducted.

Nutritional risk is associated with an increase of in-hospital mortality and a reduction of being discharged home: Results of the 2009-2015 nutritionDay survey.

Background: Disease-related malnutrition is a known factor for poor outcomes. However, there is a lack of knowledge about the prevalence and the impact of nutritional risk on outcomes in Colombia. The aim of the present study was to determine the prevalence of nutritional risk, to know how nutrition screening is routinely performed and to determine the impact of nutritional risk on the outcomes of in-hospital mortality and being discharged home outcomes.

[Sociodemographic characteristics associated with the prevalence of tobacco use in Costa RicaCaracterísticas sociodemográficas associadas à prevalência do consumo de tabaco na Costa Rica].

Objective: To determine the associations between sociodemographic characteristics and the current prevalence of tobacco use in Costa Rica, based on the results of the Global Adult Tobacco Survey (GATS).

Methods: Cross-sectional observational epidemiological study, country-wide (n = 8607), that used the sociodemographic variables included in GATS 2015. A logistic regression model was designed to predict the impact of those variables on current tobacco use.

Social inequalities in cancer survival: A population-based study using the Costa Rican Cancer Registry.

Background: Social inequalities in survival after cancer diagnosis have been described in several high-income countries, all cancer sites combined and for several specific cancer sites. The objective of this study was to analyze 5-year net survival after cancer diagnosis in a middle-income country (Costa Rica), according to the characteristics at the district level.

Methods: Costa Rican Cancer Registry is a national population-based registry.

Socioeconomic inequalities in cancer mortality: Is Costa Rica an exception to the rule?

Socioeconomic inequalities in cancer mortality have been described for a range of cancers sites worldwide, using diverse measures of socioeconomic position (SEP). These studies have shown a negative social gradient where lower SEP was associated with greater odds of having cancer, particularly in men. However, there is a lack of information regarding low and middle-income countries.

On the Use of Optimal Transportation Theory to Recode Variables and Application to Database Merging.

Merging databases is a strategy of paramount interest especially in medical research. A common problem in this context comes from a variable which is not coded on the same scale in both databases we aim to merge. This paper considers the problem of finding a relevant way to recode the variable in order to merge these two databases.

Is tooth loss important when evaluating perceived general health? Findings from a nationally representative study of Costa Rican adults.

Objectives: Although previous studies have shown that oral diseases can impact certain systemic conditions, dental care has been historically separated from medical healthcare organizations in middle-income countries. There is a lack of research approaches which test the independent relationship between oral health and multidimensional measures of general health. This study analyses the influence of tooth loss on self-rated health (SRH), hypothesizing that, relatively to certain morbidity conditions, tooth loss is a health condition associated with SRH.

Disentangling the influence of living place and socioeconomic position on health services use among diabetes patients: A population-based study.

This research investigates the influence of place of residence and diabetic patient's socioeconomic position on their use of health services in a universal health care system. This retrospective cross-sectional population-based study is based on the joint use of the Health Insurance information systems, an ecological indicator of social deprivation and an indicator of potential spatial accessibility of healthcare provision in the Midi-Pyrénées region. Using French healthcare insurance population-based data on reimbursement of out-of-hospital care during the year 2012, we study the use of health services among patients aged 50 and over (n = 90,136).