{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T13:42:12Z","timestamp":1792590132360,"version":"4.5.0"},"reference-count":43,"publisher":"Instituto Nacional de Salud (Colombia)","issue":"Sp. 2","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["revistabiomedica.org"],"crossmark-restriction":false},"short-container-title":["Biomed."],"abstract":"<jats:p>Introduction. Vector-borne diseases pose a public health challenge in Colombia, influenced by climatic and environmental factors. El Ni\u00f1o and deforestation can alter vector habitats, affecting the incidence of dengue, Zika, chikungunya, malaria, cutaneous leishmaniasis, and yellow fever. Objective. This study analyzes the relationship between these variables and vector-borne diseases incidence in Colombia (2007-2024).Materials and methods. An ecological study was conducted using incidence and outbreak data for six vector-borne diseases, linked to climate information, El Ni\u00f1o, and deforestation. Regression models and random forests were applied to assess associations.Results. Between 2007 and 2024, 3,283,259 cases of vector-borne diseases were reported in Colombia. Of these, 49.9% (1,639,120) were dengue and 39.8% (1,307,351) malaria, accounting for 89.7% of total cases. El Ni\u00f1o was associated with increased incidence of dengue (\u03b2 = 213.24; 95% CI: 86.05-338.43), chikungunya (\u03b2 = 26.41; 95% CI: 17.54-70.36), and Zika (\u03b2 = 14.12; 95% CI: 10.06-89.30). Maximum temperature showed a positive relationship with dengue (\u03b2 = 5.74; 95% CI: 2.15-13.63) and malaria (\u03b2 = 17.28; 95% CI: 3.81-30.75). Deforestation was associated with malaria (\u03b2 = 12.35; 95% CI: 4.62-20.08) and cutaneous leishmaniasis (\u03b2 = 8.67; 95% CI: 2.21-15.13). Mean precipitation had negative associations with chikungunya and leishmaniasis.Conclusions: Climate change and deforestation impact the epidemiology of vector-borne diseases in Colombia. Integrated public health and environmental conservation strategies are needed to mitigate their effects.<\/jats:p>","DOI":"10.7705\/biomedica.7897","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T21:32:05Z","timestamp":1764624725000},"page":"17-29","update-policy":"https:\/\/doi.org\/10.7705\/crossmark","source":"Crossref","is-referenced-by-count":12,"title":["Outbreaks and incidence of vector-borne diseases in Colombia (2007-2024): Impact of climate change and deforestation","Brotes e incidencia de enfermedades transmitidas por vectores en Colombia (2007- 2024): impacto del cambio clim\u00e1tico y la deforestaci\u00f3n"],"prefix":"10.7705","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6885-6353","authenticated-orcid":false,"given":"Mario J.","family":"Olivera","sequence":"first","affiliation":[{"name":"Grupo de Parasitolog\u00eda, Direcci\u00f3n de Investigaci\u00f3n en Salud P\u00fablica, Instituto Nacional de Salud, Bogot\u00e1, D. C., Colombia;\u00a0Grupo de Investigaci\u00f3n Par\u00e1sitos y Salud, Facultat de Farm\u00e0cia i Ci\u00e8ncies de l\u2019Alimentaci\u00f3, Universitat de Val\u00e8ncia, Val\u00e8ncia, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1861-4601","authenticated-orcid":false,"given":"Juli\u00e1n Felipe","family":"Porras-Villamil","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud, Universidad de la Salle, Bogot\u00e1, D. C., Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9508-6390","authenticated-orcid":false,"given":"M\u00e0rius Vicent","family":"Fuentes","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n Par\u00e1sitos y Salud, Facultat de Farm\u00e0cia i Ci\u00e8ncies de l\u2019Alimentaci\u00f3, Universitat de Val\u00e8ncia, Val\u00e8ncia, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4444","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"155324","doi-asserted-by":"crossref","unstructured":"Molina-Guzm\u00e1n LP, Guti\u00e9rrez-Builes LA, R\u00edos-Osorio LA. Models of spatial analysis for vector-borne diseases studies: A systematic review. Vet World. 2022;15:1975-89. https:\/\/doi.org\/10.14202\/vetworld.2022.1975-1989","DOI":"10.14202\/vetworld.2022.1975-1989"},{"key":"155325","doi-asserted-by":"crossref","unstructured":"El-Sayed A, Kamel M. Climatic changes and their role in emergence and re-emergence of diseases. Environ Sci Pollut Res Int. 2020;27:22336-52. https:\/\/doi.org\/10.1007\/s11356-020-08896-w","DOI":"10.1007\/s11356-020-08896-w"},{"key":"155326","doi-asserted-by":"crossref","unstructured":"Yadav N, Upadhyay RK. Global effect of climate change on seasonal cycles, vector population and rising challenges of communicable diseases: A review. J Atmospheric Sci Res. 2023;6:21-59. https:\/\/doi.org\/10.30564\/jasr.v6i1.5165","DOI":"10.30564\/jasr.v6i1.5165"},{"key":"155327","doi-asserted-by":"crossref","unstructured":"Cai W, Santoso A, Collins M, Dewitte B, Karamperidou C, Kug J-S, et al. Changing El Ni\u00f1o- Southern oscillation in a warming climate. Nat Rev Earth Environ. 2021;2:628-44. https:\/\/doi.org\/10.1038\/s43017-021-00199-z","DOI":"10.1038\/s43017-021-00199-z"},{"key":"155328","doi-asserted-by":"crossref","unstructured":"Chretien J-P, Anyamba A, Small J, Britch S, S\u00e1nchez JL, Halbach AC, et al. Global climate anomalies and potential infectious disease risks: 2014-2015. PLoS Curr. 2015;26:7. https:\/\/doi.org\/10.1371\/currents.outbreaks.95fbc4a8fb4695e049baabfc2fc8289f","DOI":"10.1371\/currents.outbreaks.95fbc4a8fb4695e049baabfc2fc8289f"},{"key":"155329","doi-asserted-by":"crossref","unstructured":"Ortiz DI, Piche-Ovares M, Romero-Vega LM, Wagman J, Troyo A. The impact of deforestation, urbanization, and changing land use patterns on the ecology of mosquito and tick-borne diseases in Central America. Insects. 2021;13:20. https:\/\/doi.org\/10.3390\/insects13010020","DOI":"10.3390\/insects13010020"},{"key":"155330","doi-asserted-by":"crossref","unstructured":"Segura NA, Mu\u00f1oz AL, Losada-Barrag\u00e1n M, Torres O, Rodr\u00edguez AK, Rangel H, et al. Minireview: Epidemiological impact of arboviral diseases in Latin American countries, arbovirus-vector interactions and control strategies. Pathog Dis. 2021;79:ftab043. https:\/\/doi.org\/10.1093\/femspd\/ftab043","DOI":"10.1093\/femspd\/ftab043"},{"key":"155331","doi-asserted-by":"crossref","unstructured":"Khan A, Yasin M, Aqueel MA, Farooqi MA, Akram MI, Yousuf HMB, et al. Vector-borne disease and climate change. In: Shields VDC, editor. Arthropods-new advances and perspectives. IntechOpen; 2023. https:\/\/doi.org\/10.5772\/intechopen.107120","DOI":"10.5772\/intechopen.107120"},{"key":"155332","doi-asserted-by":"crossref","unstructured":"Padilla-Rodr\u00edguez JC, Olivera MJ, Padilla MC, Abril EP. Malaria epidemics in Colombia, 1970-2019. Rev Soc Bras Med Trop. 202229:55:e05592021. https:\/\/doi.org\/10.1590\/0037-8682-0559-2021","DOI":"10.1590\/0037-8682-0559-2021"},{"key":"155333","doi-asserted-by":"crossref","unstructured":"Cardona-Arias JA, Salas-Zapata W, Carmona-Fonseca J. A systematic review of mixed studies on malaria in Colombia 1980-2022: What the \u201cbifocal vision\u201d discovers. BMC Public Health. 2023;23:1169. https:\/\/doi.org\/10.1186\/s12889-023-16098-5","DOI":"10.1186\/s12889-023-16098-5"},{"key":"155334","doi-asserted-by":"crossref","unstructured":"Freitas LP, Carabali M, Yuan M, Jaramillo-Ram\u00edrez GI, Balaguera CG, Restrepo BN, et al. Spatio-temporal clusters and patterns of spread of dengue, chikungunya, and Zika in Colombia. PLoS Negl Trop Dis. 2022;16:e0010334. https:\/\/doi.org\/10.1371\/journal.pntd.0010334","DOI":"10.1371\/journal.pntd.0010334"},{"key":"155335","doi-asserted-by":"crossref","unstructured":"Mantilla-Granados JS, Sarmiento-Senior D, Manzano J, Calder\u00f3n-Pel\u00e1ez M-A, Velandia-Romero ML, Buitrago LS, et al. Multidisciplinary approach for surveillance and risk identification of yellow fever and other arboviruses in Colombia. One Health. 2022:15:100438. https:\/\/doi.org\/10.1016\/j.onehlt.2022.100438","DOI":"10.1016\/j.onehlt.2022.100438"},{"key":"155336","doi-asserted-by":"crossref","unstructured":"Thomson MC, Stanberry LR. Climate change and vectorborne diseases. N Engl J Med. 2022 4;387:1969-78. https:\/\/doi.org\/10.1056\/NEJMra2200092","DOI":"10.1056\/NEJMra2200092"},{"key":"155337","doi-asserted-by":"crossref","unstructured":"Col\u00f3n-Gonz\u00e1lez FJ, Sewe MO, Tompkins AM, Sj\u00f6din H, Casallas A, Rockl\u00f6v J, et al. Projecting the risk of mosquito-borne diseases in a warmer and more populated world: a multi-model, multi-scenario intercomparison modelling study. Lancet Planet Health. 2021;5:e404-e414 e404-14. https:\/\/doi.org\/10.1016\/S2542-5196(21)00132-7","DOI":"10.1016\/S2542-5196(21)00132-7"},{"key":"155338","doi-asserted-by":"crossref","unstructured":"Colonia CB, V\u00e1squez-Rodr\u00edguez AB, Alexander N, de la Hoz Restrepo F. Malaria, relationship with climatic variables and deforestation in Colombia, Latin America and the Caribbean from 2000 to 2020: A systematic review. Malaria J. 2024;23:347. https:\/\/doi.org\/10.1186\/s12936-024-05140-5","DOI":"10.1186\/s12936-024-05140-5"},{"key":"155339","doi-asserted-by":"crossref","unstructured":"Marinho RdSS, Duro RLS, Mota MTdO, Hunter J, Diaz RS, Kawakubo FS, et al. Environmental changes and the impact on the human infections by dengue, chikungunya and Zika viruses in northern Brazil, 2010-2019. Int J Environ Res Public Health. 2022;19:12665. https:\/\/doi.org\/10.3390\/ijerph191912665","DOI":"10.3390\/ijerph191912665"},{"key":"155340","doi-asserted-by":"crossref","unstructured":"Romero-Vega LM, Piche-Ovares M, Soto-Garita C, Barantes Murillo DF, Chaverri LG, Alfaro-Alarc\u00f3n A, et al. Seasonal changes in the diversity, host preferences and infectivity of mosquitoes in two arbovirus-endemic regions of Costa Rica. Parasit Vectors. 2023;16:34. https:\/\/doi.org\/10.1186\/s13071-022-05579-y","DOI":"10.1186\/s13071-022-05579-y"},{"key":"155341","doi-asserted-by":"crossref","unstructured":"Gagnon AS, Bush AB, Smoyer-Tomic KE. Dengue epidemics and the El Ni\u00f1o southern oscillation. Int J Biometeorol. 2002;46:81-9. https:\/\/doi.org\/10.1007\/s00484-001-0119-6 19. Petrova D, Lowe R, Stewart-Ibarra A, Ballester J, Koopman SJ, Rod\u00f3 X. Sensitivity of large dengue epidemics in Ecuador to long-lead predictions of El Ni\u00f1o. Climate Services. 2019;15:100096. https:\/\/doi.org\/10.1016\/j.cliser.2019.02.003","DOI":"10.1016\/j.cliser.2019.02.003"},{"key":"155342","doi-asserted-by":"crossref","unstructured":"Ruiz-Polo AA, Santillan-Valdivia RE, Saavedra-R\u00edos CY, N\u00fa\u00f1ez-Rodriguez CM, Ni\u00f1o-Mendoza LE. Comportamiento alimentario de Aedes aegypti en brotes de dengue de dos zonas rurales del Per\u00fa durante el cicl\u00f3n Yaku y El Ni\u00f1o Global del 2023. Revista Peruana de Medicina Experimental y Salud P\u00fablica. 2024;41:266-72.","DOI":"10.17843\/rpmesp.2024.413.13930"},{"key":"155343","doi-asserted-by":"crossref","unstructured":"Ruiz-Polo AA, Santillan-Valdivia RE, Saavedra-R\u00edos CY, N\u00fa\u00f1ez-Rodr\u00edguez CM, Ni\u00f1o-Mendoza LE. Aedes aegypti feeding behavior during dengue outbreaks in two rural \u00e1reas of Per\u00fa during the Yaku cyclone and El Ni\u00f1o phenomenon of 2023. Revista Peruana de Medicina Experimental y Salud P\u00fablica. 2024;41:266-72.","DOI":"10.17843\/rpmesp.2024.413.13930"},{"key":"155344","doi-asserted-by":"crossref","unstructured":"Messina JP, Kraemer MU, Brady OJ, Pigott DM, Shearer FM, Weiss DJ, et al. Mapping global environmental suitability for Zika virus. Elife. 2016:5:e15272. https:\/\/doi.org\/10.7554\/eLife.15272","DOI":"10.7554\/eLife.15272"},{"key":"155345","doi-asserted-by":"crossref","unstructured":"Ruiz-Polo AA, Barrera-Rivera LV. Efecto de la temperatura en el ciclo biol\u00f3gico del Aedes aegypti en condiciones de laboratorio. Revista Peruana de Medicina Experimental y Salud P\u00fablica. 2024;41:327-8.","DOI":"10.17843\/rpmesp.2024.413.13838"},{"key":"155346","doi-asserted-by":"crossref","unstructured":"Valdez LD, Sibona GJ, Condat C. Impact of rainfall on Aedes aegypti populations. Ecological Modelling. 2018;385:96-105. https:\/\/doi.org\/10.1016\/j.ecolmodel.2018.07.003","DOI":"10.1016\/j.ecolmodel.2018.07.003"},{"key":"155347","doi-asserted-by":"crossref","unstructured":"Padilla JC, Lizarazo FE, Murillo OL, Mendiga\u00f1a FA, Pach\u00f3n E, Vera MJ. Epidemiolog\u00eda de las principales enfermedades transmitidas por vectores en Colombia, 1990-2016. Biom\u00e9dica. 2017;37(Supl.2) :27-40. https:\/\/doi.org\/10.7705\/biomedica.v37i0.3769","DOI":"10.7705\/biomedica.v37i0.3769"},{"key":"155348","doi-asserted-by":"crossref","unstructured":"Guzm\u00e1n NA, Zakzuk J, Moranth RV, Olaciregui AA, Padilla DP. Dengue, Chikungu\u00f1a y Zika en Colombia 2015-2016. Revista MVZ (C\u00f3rdoba). 2017;22:2.","DOI":"10.21897\/rmvz.1069"},{"key":"155349","doi-asserted-by":"crossref","unstructured":"Paaijmans KP, Blanford S, Bell AS, Blanford JI, Read AF, Thomas MB. Influence of climate on malaria transmission depends on daily temperature variation. Proc Natl Acad Sci USA. 2010;107:15135-9. https:\/\/doi.org\/10.1073\/pnas.1006422107","DOI":"10.1073\/pnas.1006422107"},{"key":"155350","doi-asserted-by":"crossref","unstructured":"Laporta GZ, Ilacqua RC, Bergo ES, Chaves LS, Rodovalho SR, Moresco GG, et al. Malaria transmission in landscapes with varying deforestation levels and timelines in the Amazon: A longitudinal spatiotemporal study. Sci Rep. 2021;11:6477. https:\/\/doi.org\/10.1038\/s41598-021-85890-3","DOI":"10.1038\/s41598-021-85890-3"},{"key":"155351","doi-asserted-by":"crossref","unstructured":"Laporta GZ. Amazonian rainforest loss and declining malaria burden in Brazil. Lancet Planet Health. 2019;3:e4-e5. https:\/\/doi.org\/10.1016\/S2542-5196(18)30243-2","DOI":"10.1016\/S2542-5196(18)30243-2"},{"key":"155352","doi-asserted-by":"crossref","unstructured":"Valle D, Clark J. Improving the modeling of disease data from the government surveillance system: A case study on malaria in the Brazilian Amazon. PLoS Comput Biol. 2013;9:e1003312. https:\/\/doi.org\/10.1371\/journal.pcbi.1003312","DOI":"10.1371\/journal.pcbi.1003312"},{"key":"155353","doi-asserted-by":"crossref","unstructured":"Valle D, Clark J. Conservation efforts may increase malaria burden in the Brazilian Amazon. PLoS ONE. 2013;8:e57519. https:\/\/doi.org\/10.1371\/journal.pone.0057519","DOI":"10.1371\/journal.pone.0057519"},{"key":"155354","doi-asserted-by":"crossref","unstructured":"Hahn MB, Olson SH, Vittor AY, Barcellos C, Patz JA, Pan W. Conservation efforts and malaria in the Brazilian Amazon. Am J Trop Med Hyg. 2014;90:591-4. https:\/\/doi.org\/10.4269\/ajtmh.13-0323","DOI":"10.4269\/ajtmh.13-0323"},{"key":"155355","doi-asserted-by":"crossref","unstructured":"Rodrigues MGdA, Sousa JDdB, Dias \u00c1LB, Monteiro WM, Sampaio VdS. The role of deforestation on American cutaneous leishmaniasis incidence: Spatial-temporal distribution, environmental and socioeconomic factors associated in the Brazilian Amazon. Trop Med Int Health. 2019;24:348-55. https:\/\/doi.org\/10.1111\/tmi.13196","DOI":"10.1111\/tmi.13196"},{"key":"155356","doi-asserted-by":"crossref","unstructured":"Burkett-Cadena ND, Vittor AY. Deforestation and vector-borne disease: Forest conversion favors important mosquito vectors of human pathogens. Basic and applied ecology. 2018;26:101-10. Basic Appl Ecol. 2018:26:101-10. https:\/\/doi.org\/10.1016\/j.baae.2017.09.012","DOI":"10.1016\/j.baae.2017.09.012"},{"key":"155357","doi-asserted-by":"crossref","unstructured":"Kocher A, Cornuault J, Gantier Jc, Manzi S, Chavy A, Girod R, et al. Biodiversity and vectorborne diseases: Host dilution and vector amplification occur simultaneously for Amazonian leishmaniases. Mol Ecol. 2023;32:1817-31. https:\/\/doi.org\/10.1111\/mec.16341","DOI":"10.1111\/mec.16341"},{"key":"155358","doi-asserted-by":"crossref","unstructured":"Caminade C, McIntyre KM, Jones AE. Impact of recent and future climate change on vectorborne diseases. Ann N Y Acad Sci. 2019;1436:157-73. https:\/\/doi.org\/10.1111\/nyas.13950","DOI":"10.1111\/nyas.13950"},{"key":"155359","doi-asserted-by":"crossref","unstructured":"Mordecai EA, Caldwell JM, Grossman MK, Lippi CA, Johnson LR, Neira M, et al. Thermal biology of mosquito-borne disease. Ecol Lett. 2019;22:1690-708. https:\/\/doi.org\/10.1111\/ele.13335","DOI":"10.1111\/ele.13335"},{"key":"155360","doi-asserted-by":"crossref","unstructured":"Molleda P, Serra GV. El Ni\u00f1o Southern Oscillation and the prevalence of infectious diseases. La Granja: revista de Ciencias de la Vida. 2024;40:9-37. https:\/\/doi.org\/10.17163\/lgr.n40.2024.01","DOI":"10.17163\/lgr.n40.2024.01"},{"key":"155361","doi-asserted-by":"crossref","unstructured":"Kemarau RA, Eboy OV. Spatial-temporal distribution of malaria risk and its association with El Ni\u00f1o Southern Oscillation (ENSO). Malaysian Journal of Social Sciences and Humanities. 2021;6:276-86. https:\/\/doi.org\/10.47405\/mjssh.v6i4.768","DOI":"10.47405\/mjssh.v6i4.768"},{"key":"155362","doi-asserted-by":"crossref","unstructured":"Fletcher IK, Grillet ME, Moreno JE, Drakeley C, Hern\u00e1ndez-Villena J, Jones KE, et al. Synergies between environmental degradation and climate variation on malaria reemergence in southern Venezuela: A spatiotemporal modelling study. Lancet Planet Health. 2022;6:e739-e48. https:\/\/doi.org\/10.1016\/S2542-5196(22)00192-9","DOI":"10.1016\/S2542-5196(22)00192-9"},{"key":"155363","doi-asserted-by":"crossref","unstructured":"Hamlet A, Gaythorpe KA, Garske T, Ferguson NM. Seasonal and inter-annual drivers of yellow fever transmission in South America. PLoS Negl Trop Dis. 2021;15:e0008974. https:\/\/doi.org\/10.1371\/journal.pntd.0008974","DOI":"10.1371\/journal.pntd.0008974"},{"key":"155364","doi-asserted-by":"crossref","unstructured":"Hamrick PN, Aldighieri S, Machado G, Leonel DG, Vilca LM, Uriona S, et al. Geographic patterns and environmental factors associated with human yellow fever presence in the Americas. PLoS Negl Trop Dis. 2017;11:e0005897. https:\/\/doi.org\/10.1371\/journal.pntd.0005897","DOI":"10.1371\/journal.pntd.0005897"},{"key":"155365","doi-asserted-by":"crossref","unstructured":"Aliaga-Samanez A, Romero D, Murray K, Cobos-Mayo M, Segura M, Real R, et al. Climate change is aggravating dengue and yellow fever transmission risk. Ecography. 2024;2024:e06942. https:\/\/doi.org\/10.1111\/ecog.06942","DOI":"10.1111\/ecog.06942"},{"key":"155366","doi-asserted-by":"crossref","unstructured":"Hansen CA, Barrett AD. The present and future of yellow fever vaccines. Pharmaceuticals (Basel). 2021;14:891. https:\/\/doi.org\/10.3390\/ph14090891","DOI":"10.3390\/ph14090891"}],"container-title":["Biom\u00e9dica"],"original-title":[],"link":[{"URL":"https:\/\/revistabiomedica.org\/index.php\/biomedica\/article\/download\/7897\/5910","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/revistabiomedica.org\/index.php\/biomedica\/article\/download\/7897\/5931","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/revistabiomedica.org\/index.php\/biomedica\/article\/download\/7897\/5910","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T21:40:52Z","timestamp":1773265252000},"score":1,"resource":{"primary":{"URL":"https:\/\/revistabiomedica.org\/index.php\/biomedica\/article\/view\/7897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,27]]},"references-count":43,"journal-issue":{"issue":"Sp. 2","published-online":{"date-parts":[[2025,11,27]]}},"URL":"https:\/\/doi.org\/10.7705\/biomedica.7897","relation":{},"ISSN":["2590-7379","0120-4157"],"issn-type":[{"value":"2590-7379","type":"electronic"},{"value":"0120-4157","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11,27]]},"assertion":[{"value":"2025-11-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}},{"value":"Yes","order":0,"name":"peer_reviewed","label":"Peer Reviewed","group":{"name":"peer_review","label":"Peer Review"}},{"value":"Instituto Nacional de Salud","name":"publisher","label":"This article is maintained by"},{"value":"Biomedica","name":"journaltitle","label":"Journal Title"},{"value":"Art\u00edculos originales","name":"content_type","label":"Content Type"}]}}