BACKGROUND & AIMS: INTRODUCTION:Ethics committees are a necessary resource to guarantee ethical integrity in human research; they must apply international standards in their ethical evaluation of research projects involving human subjects. OBJECTIVE:The ethics committees for human research of Colombia were characterized, and recommendations for strengthening them were formulated. MATERIALS AND METHODS:In 2003, 280 groups with research projects involving human subjects were selected from a list of research groups which form part of the science and technology network of Colciencias. (Colciencias is the Colombian national agency that promotes and funds science and technology.) Eighty percent (224) of the projects were associated with 40 institutions, consisting of universities, hospitals, and public or private research centers. Thirty of these institutions had at least one ethics committee for evaluating use of human subjects. A questionnaire was mailed to each of these Committees, requesting information concerning its their compostition, regulations, multidisciplinarity, plurality, representativity and independence. The World Health Organization's Operational Guidelines for Ethic Committees that Evaluate Biomedical Research (TDR/PRD/ETHICS/2000) was used as reference for the analysis. In 5 of the cities, supplemental information was obtained by direct discussions with members of the ethics committees. RESULTS:Twenty-six committees responded to the questionnaire. The results indicated that 47% of the committee members were physicians, but only 23% of the committees had representatives from the community. In 60% of the Committees, members were not independent from the organization in which it was based. Seventy percent had established operating procedures. Lack of national regulations and limited education in research ethics were mentioned as the main drawbacks in providing effective guidance. CONCLUSIONS:These observations led to the conclusion that national guidelines must be established for ethics committees that correspond to international standards. Committee members must be trained before accepting committee responsibilities. Finally, new committees must be created along with the improvement of the currently existing committees for reinforcing and promoting the importance of ethical integrity in research.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:There is paucity in the level of knowledge on the actual insurer expenses associated with patients suffering with dementia in the developing world. Less is known about direct costs by severity and how costs vary because of the presence of other comorbidities. METHODS:Using claims data from an insurer for three years, we identified patients with AD with an algorithm that takes advantage of information on age, primary diagnosis, and services and drugs provided. RESULTS:Distribution by dementia stage was as follows: mild 21%, moderate 53%, severe 17%, and undetermined 9%. Expenses paid for all causes by the insurer were at least double than estimated in the literature and were increasing annually at rates higher than 30%. Also, 92% of patients have at least another chronic condition. CONCLUSIONS:Worldwide costs of dementia estimates maybe underestimating the actual costs to health systems in the developing world.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:To determine the spatial distribution of the risk of Zika virus disease in each region of Colombia during the 2015-2016 epidemic. METHODS:An ecological study was designed to estimate the risks for each Colombian region using first-order neighbors, covariate effects, and three adjacent periods of time (beginning, development, and end of the epidemic) to analyze the spatial distribution of the disease based on a Bayesian hierarchical model. RESULTS:Spatial distribution of the estimated risks of Zika virus disease showed that it increased in a strip that crosses the central area of the country from west to east. Analysis of the three time periods showed greater risk of the disease in the central and southern zones-Arauca and Santander-where the increase in risk was four times higher during the peak phase compared with the initial phase of the outbreak. CONCLUSION:In the identified high-risk areas, integrated surveillance systems for Zika virus disease and its complications must be strengthened to provide up-to-date and accurate epidemiological information. This information would allow those involved in policy and decision making to identify new outbreaks and risk clusters, enabling more focused and accurate measures to target at-risk populations.

背景与目标：

BACKGROUND & AIMS: :A study was conducted during 1996-1997 in 20 villages of Tumaco, Colombia, to evaluate the effectiveness of personal protective measures against cutaneous leishmaniasis (CL). The intervention was effective, but the high costs of the preventive measures and the lack of a more holistic approach hampered the intervention's sustainability. This paper analyzes the results using an ecosystem approach to human health. Using this approach, we found that CL has been present in the study area for a long time and affects farmers and those living closest to the forest. The forest constitutes the habitat for insect vectors (sandflies) and parasite reservoirs (wild mammals). Four spatial scales were identified in this ecosystem: residential, village, regional, and global. From the ecosystem perspective, three interventions are proposed to prevent CL in the 20 villages: improve housing construction, organize village housing in clusters, and make diagnosis and treatment of CL more accessible. The design and implementation of these interventions require active involvement by people with the disease (village inhabitants) and decision-makers (local authorities).

背景与目标： : 1996-1997年在哥伦比亚Tumaco的20个村庄进行了一项研究，以评估个人防护措施对皮肤利什曼病 (CL) 的有效性。干预措施是有效的，但预防措施的高昂成本和缺乏更全面的方法阻碍了干预措施的可持续性。本文使用生态系统方法分析了人类健康的结果。使用这种方法，我们发现CL在研究区域中存在很长时间，并影响农民和最靠近森林的人。森林构成了昆虫媒介 (沙蝇) 和寄生虫库 (野生哺乳动物) 的栖息地。在该生态系统中确定了四个空间尺度: 住宅，村庄，区域和全球。从生态系统的角度出发，提出了三种干预措施来预防20个村庄的CL: 改善住房建设，将村庄住房集中组织起来，并使CL的诊断和治疗更容易获得。这些干预措施的设计和实施需要疾病患者 (村庄居民) 和决策者 (地方当局) 的积极参与。

BACKGROUND & AIMS: :The study focuses on integrated malaria control in 23 communities on the Pacific Coast of Colombia, with several elements of an ecosystem approach to human health, including malaria-related sociopolitical, ecological, and economic factors. The program fostered community participation. The program presented here had 2 components: implementation and research. The first was conducted in 23 communities, 21 of which lacked adequate health services in terms of education, community participation, prompt diagnosis and complete treatment, and vector control. Research focused on specific vector control measures and the current national health services decentralization process. The project: 1) created a malaria prevention culture in the community; 2) avoided deaths from malaria (no fatal cases in the 3-year period, compared to 5-8 deaths a year previously); 3) avoided cases of cerebral malaria (no cases, as compared to 90-110 per year previously); 4) reduced malaria incidence by 45.36%; 5) decreased length of sick leave from 7.52 to 3.7 days; 6) established a permanent network of microscope technicians and 2-way radio communications; 7) integrated work by local, regional, and outside institutions; 8) demonstrated efficacy of insecticide-impregnated bednets to reduce malaria transmission.

背景与目标： : 这项研究的重点是哥伦比亚太平洋沿岸23个社区的综合疟疾控制，其中包括生态系统方法对人类健康的若干要素，包括与疟疾有关的社会政治，生态和经济因素。该计划促进了社区参与。这里介绍的程序有两个组成部分: 实施和研究。第一次在23个社区进行，其中21个社区在教育、社区参与、及时诊断和全面治疗以及病媒控制方面缺乏适当的保健服务。研究的重点是特定的病媒控制措施和当前的国家卫生服务权力下放过程。该项目: 1) 在社区中建立了预防疟疾的文化; 2) 避免了疟疾死亡 (3年内没有致命病例，而前一年有5-8例死亡); 3) 避免了脑型疟疾病例 (没有病例，与以前的每年90-110相比); 4) 将疟疾发病率降低45.36%; 5) 将病假时间从7.52天减少到3.7天; 6) 建立了一个由显微镜技术人员和双向无线电通信组成的永久网络; 7) 由地方、区域、和外部机构; 8) 证明了杀虫剂浸渍蚊帐减少疟疾传播的功效。

BACKGROUND & AIMS: BACKGROUND:Knockdown resistance (kdr) is a well-characterized target-site insecticide resistance mechanism that is associated with DDT and pyrethroid resistance. Even though insecticide resistance to pyrethroids and DDT have been reported in Anopheles albimanus, Anopheles benarrochi sensu lato (s.l.), Anopheles darlingi, Anopheles nuneztovari s.l., and Anopheles pseudopunctipennis s.l. malaria vectors in Latin America, there is a knowledge gap on the role that kdr resistance mechanisms play in this resistance. The aim of this study was to establish the role that kdr mechanisms play in pyrethroid and DDT resistance in the main malaria vectors in Colombia, in addition to previously reported metabolic resistance mechanisms, such as mixed function oxidases (MFO) and nonspecific esterases (NSE) enzyme families. METHODS:Surviving (n = 62) and dead (n = 67) An. nuneztovari s.l., An. darlingi and An. albimanus mosquitoes exposed to diagnostic concentrations of DDT and pyrethroid insecticides were used to amplify and sequence a ~ 225 bp fragment of the voltage-gated sodium channels (VGSC) gene. This fragment spanning codons 1010, 1013 and 1014 at the S6 segment of domain II to identify point mutations, which have been associated with insecticide resistance in different species of Anopheles malaria vectors. RESULTS:No kdr mutations were detected in the coding sequence of this fragment in 129 samples, 62 surviving mosquitoes and 67 dead mosquitoes, of An. darlingi, An. nuneztovari s.l. and An. albimanus. CONCLUSION:Mutations in the VGSC gene, most frequently reported in other species of the genus Anopheles resistant to pyrethroid and DDT, are not associated with the low-intensity resistance detected to these insecticides in some populations of the main malaria vectors in Colombia. These results suggest that metabolic resistance mechanisms previously reported in these populations might be responsible for the resistance observed.

背景与目标：

BACKGROUND & AIMS: INTRODUCTION:Hemolytic reactions are adverse complications associated with red blood cell transfusion. These reactions are associated with clinically important erythrocyte antigens, such as those of Duffy blood Meny (2010). Individuals with the Duffy null phenotype Fy (a-b-) are more likely to develop an alloimmunization reaction, resulting in an incompatibility with all available red blood cell units, thus increasing the risk of complications from their underlying disease Höher et al. (2018). Hence, it is important to determine the prevalence of the Fy (a-b-) phenotype in blood donors in our population and to create a database to ensure safe transfusion in patients with this phenotype. Moreover, we intend to establish whether there is any relationship between individuals with this phenotype and the sickle cell trait. We conducted this study to measure the prevalence of the Fy (a-b-) phenotype in our blood donors. MATERIALS AND METHODS:This prospective, descriptive study included black blood donors visiting the blood bank of a tertiary care university hospital between January 2019 and July 2019. We used Fitzpatrick classification phototype VI and self-identification to select donors in the study. The presence of the Duffy antigens Fya and Fyb was determined by the Coombs test using monoclonal antibodies. To establish the presence of hemoglobin S (HbS) and sickle cell traits, a hemoglobin electrophoresis test was performed. RESULTS:We included 166 patients in the study. Seventy-nine donors were identified as having Fy (a-b-). The prevalence of the Fy (a-b-) phenotype was 48 %. Sickle cell trait hemoglobinopathy was found in 6 blood donors (8%). CONCLUSION:This information is relevant for the implementation of a database of blood donors to guarantee the safety of transfusion in patients with a Fitzpatrick skin type 6at our institution. Moreover, it may provide information of interest to other blood banks in case donors with this phenotype are needed. No significant association was found between the donor Fy (a-b-) phenotype and the sickle cell trait.

背景与目标：

BACKGROUND & AIMS: :Thirty-one of 75 extracts of plants used by traditional healers for snakebites, had moderate or high neutralizing ability against the haemorrhagic effect of Bothrops atrox venom from Antioquia and Chocó, north-western Colombia. After preincubation of several doses of every extract (7.8-4000 microg/mouse) with six minimum haemorrhagic doses (10 microg) of venom, 12 of them demonstrated 100% neutralizing capacity when the mixture was i.d. injected into mice (18-20 g). These were the stem barks of Brownea rosademonte (Caesalpiniaceae) and Tabebuia rosea (Bignoniaceae); the whole plants of Pleopeltis percussa (Polypodiaceae), Trichomanes elegans (Hymenophyllaceae) and Senna dariensis (Caesalpiniaceae); rhizomes of Heliconia curtispatha (Heliconiaceae); leaves and branches of Bixa orellana (Bixaceae), Philodendron tripartitum (Araceae), Struthanthus orbicularis (Loranthaceae) and Gonzalagunia panamensis (Rubiaceae); the ripe fruits of Citrus limon (Rutaceae); leaves, branches and stem of Ficus nymphaeifolia (Moraceae). Extracts of another 19 species showed moderate neutralization (21-72%) at doses up to 4 mg/mouse, e.g. the whole plants of Aristolochia grandiflora (Aristolochiaceae), Columnea kalbreyeriana (Gesneriaceae), Sida acuta (Malvaceae), Selaginella articulata (Selaginellaceae) and Pseudoelephantopus spicatus (Asteraceae); rhizomes of Renealmia alpinia (Zingiberaceae); the stem of Strychnos xinguensis (Loganiaceae); leaves, branches and stems of Hyptis capitata (Lamiaceae), Ipomoea cairica (Convolvulaceae), Neurolaena lobata (Asteraceae), Ocimum micranthum (Lamiaceae), Piper pulchrum (Piperaceae), Siparuna thecaphora (Monimiaceae), Castilla elastica (Moraceae) and Allamanda cathartica (Apocynaceae); the macerated ripe fruits of Capsicum frutescens (Solanaceae); the unripe fruits of Crescentia cujete (Bignoniaceae); leaves and branches of Piper arboreum (Piperaceae) and Passiflora quadrangularis (Passifloraceae). When the extracts were independently administered by oral, i.p. or i.v. route either before or after an i.d. venom injection (10 microg), neutralization of haemorrhage dropped below 25% for all the extracts. Additionally, B. rosademonte and P. percussa extracts were able to inhibit the proteolytic activity of B. atrox venom on casein.

背景与目标： : 传统治疗师用于蛇咬伤的75种植物提取物中有31种具有中等或较高的中和能力，可抵抗来自哥伦比亚西北部安蒂奥基亚和乔科的Bothrops atrox毒液的出血作用。在将几种剂量的每种提取物 (7.8-4000微克/小鼠) 与六种最小出血性剂量 (10微克) 的毒液预孵育后，当混合物为i.d.时，其中12种表现出100% 的中和能力。注射到小鼠体内 (18-20g)。这些是Brownea rosademonte (Caesalpiniaceae) 和Tabebuia rosea (Bignoniaceae) 的茎皮; 百叶 (Polypodiaceae)，秀丽隐杆线虫 (Hymenophyllaceae) 和Senna dariensis (Caesalpiniaceae) 的整个植物; Heliconia curtisspatha (Heliconiaceae) 的根茎; orellana (Bixaceae) 的叶子和树枝，philodendron tripartetum (天南星科) 、弓形龙 (Loranthaceae) 和Gonzalagunia panamensis (茜草科); 柑橘利蒙 (芸香科) 的成熟果实; 若叶榕 (桑科) 的叶、枝和茎。另外19个物种的提取物以高达4 mg/小鼠的剂量显示出中等中和作用 (21-72%)，例如马兜铃 (马兜铃科)，小柱 (苦苣苔科)，Sida acuta (锦葵科)，卷柏 (卷柏科) 和假象鼻 (菊科) 的全株; 山姜属 (姜科) 的根茎; 新果属 (Loganiaceae) 的茎; 头孢属 (唇形科)，山姜属 (Ipomoea cairica) (旋花科)，小叶 (菊科)，花叶 (柳叶草科)，花叶 (唇形科)，胡椒 (胡椒科)，天花 (天花科)，天花 (天花科)，天花 (天花科)，castilla elastica (桑科) 和Allamanda cathartica (夹竹桃科); 辣椒粉 (茄科) 的浸软成熟果实; Crescentia cujete (紫花科) 的未成熟果实; Piper arboreum (Piperaceae) 和西番莲 (西番莲科) 的叶子和树枝。当提取物通过口服独立给药时，ip。或者静脉注射在身份证之前或之后的路线。对于所有提取物，注射毒液 (10微克)，出血的中和度降至25% 以下。此外，rosademonte和P. percussa提取物能够抑制B. atrox毒液对酪蛋白的蛋白水解活性。

BACKGROUND & AIMS: :Nevado del Ruiz volcano (NRV), Columbia, is one of the most dangerous volcanoes in the world and caused the death of 25,000 people in 1985. Using a new algorithm for repeated tomography, we have found a prominent seismic anomaly with high values of the Vp/Vs ratio at depths of 2-5 km below the surface, which is associated with a shallow magma reservoir. The amplitude and shape of this anomaly changed during the current phase of unrest which began in 2010. We interpret these changes as due to the ascent of gas bubbles through magma and to degassing of the reservoir. In 2011-2014, most of this gas escaped through permeable roof rocks, feeding surface fumarole activity and leading to a gradual decrease of the Vp/Vs ratio in the reservoir. This trend was reversed in 2015-2016 due to replenishment of the reservoir by a new batch of volatile-rich magma likely to sustain further volcanic activity. It is argued that the recurring "breathing" of the shallow reservoir is the main cause of current eruptions at NRV.

背景与目标： : 哥伦比亚的Nevado del Ruiz火山 (NRV) 是世界上最危险的火山之一，1985年造成25,000人死亡。使用重复层析成像的新算法，我们发现了一个突出的地震异常，在地表以下2-5 km km的深度处具有较高的Vp/Vs比值，这与浅层岩浆储层有关。在2010年开始的当前动荡阶段，这种异常的幅度和形状发生了变化。我们将这些变化解释为由于通过岩浆的气泡上升以及储层的脱气。在2011-2014年，大部分气体通过可渗透的屋顶岩石逸出，为地表喷气孔活动供料，并导致储层中Vp/Vs比逐渐降低。2015-2016年，由于一批新的富含挥发性的岩浆可能会维持进一步的火山活动，从而补充了储层，这一趋势被逆转。有人认为，浅层水库的反复 “呼吸” 是NRV当前喷发的主要原因。

BACKGROUND & AIMS: INTRODUCTION:The pfmdr1 gene of Plasmodium falciparum has been described as a gene conferring resistance to several antimalarial drugs. In particular, polymorphisms on specific codons have been associated with resistance and treatment failure with cloroquine, amodiaquine and mefloquine. However, the role of these polymorphisms in treatment response to antimalarials remains unexplored in Colombia. Furthermore, the relationship of these polymorphisms to severe malaria is unknown. OBJECTIVE:This work studied the association of the Asn 86Tyr and Asp1246Tyr pfmdr1 polymorphisms with response to cloroquine, amodiaquine and mefloquine treatment in three municipalities of Antioquia, and severe malaria cases from the municipality Tumaco. MATERIALS AND METHODS:The polymorphisms were assessed by nucleic acid amplification followed by restriction length polymorphism analysis. RESULTS:The wild-type codon Asn 86 was detected in 97% of the clinical samples from the treatment response study. No association was detected between this polymorphism and treatment failure to the three antimalarials administered. The 1246Tyr polymorphism was detected with a higher frequency in the samples from Antioquia 92% (130/141) than in those from Tumaco 22% (20/89). However, again, no association was found between the presence of a specific polymorphism and the presence of severe malaria in the municipality of Tumaco. CONCLUSIONS:The 86Tyr and 1246Tyr polymorphisms of the pfmdr1 gene are not useful as predictors of treatment failure or severe malaria in the municipalities studied. In addition, we report for the first time, the presence of the mutant codon 86Tyr in field samples in South America.

背景与目标：

BACKGROUND & AIMS: :Human hair samples from male and female people aged 6-85 years, as well as muscle of crabs (Callinectes sapidus and Callinectes bocourti) were collected from different fishing places along the Caribbean coastal shoreline of Colombia and analyzed for total mercury (T-Hg) in order to establish the impact of mercury-polluted sediments in Cartagena bay on the ecosystem. Hair T-Hg in inhabitants varied between 0.1 and 21.8 microg/g, with average and median of 1.52 microg/g and 1.1 microg/g, respectively. Differences between sampling locations were significant (P<0.01) and median values decreased in the order: Caño del Oro (1.5 microg/g)

BACKGROUND & AIMS: OBJECTIVE:To deliver, through children, educational messages to families in Neiva, the capital city of the department of Huila, in Colombia. METHODS:An educational project was developed to include, in schoolchildren's natural sciences and environmental education curriculum, basic education on dengue, its vector, and its control. Through surveys and Likert scales, the knowledge and attitudes in the schoolchildren's homes were determined. This was complemented with open-ended interviews that reflected cultural aspects in the area of health and how dengue disease is a part of people's lives. Before and after the intervention, larval infestation indices were determined for the schoolchildren's homes. RESULTS:A cultural pattern was found for the disease that differentiated between rompehuesos (breakbone fever) and "dengue". Rompehuesos corresponds, in popular terms, to classical dengue, a disease that can be dealt with using family and community resources. Institutional medicine, by means of its health agencies and health workers, as well as the communications media, has managed to superimpose another model: that which is associated with dengue hemorrhagic fever. DISCUSSION:Alternatives are considered for prevention efforts that would be sufficient for the conditions in which the vector's cycle occurs in Neiva. Also presented are the community's disease model and the survey results. Together, these elements can guide the formulation and development of educational efforts.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Aedes aegypti, the major vector of dengue, breeds in domestic water containers. The development of immature mosquitoes in such containers is influenced by various environmental, ecological and socioeconomic factors. Urban and rural disparities in water storage practices and water source supply may affect mosquito immature abundance and, potentially, dengue risk. We evaluated the effect of water and container characteristics on A. aegypti immature abundance in urban and rural areas. Data were collected in the wet season of 2011 in central Colombia from 36 urban and 35 rural containers, which were either mosquito-positive or negative. Immature mosquitoes were identified to species. Data on water and container characteristics were collected from all containers. RESULTS:A total of 1452 Aedes pupae and larvae were collected of which 81% were A. aegypti and 19% A. fluviatilis. Aedes aegypti immatures were found in both urban and rural sites. However, the mean number of A. aegypti pupae was five times higher in containers in the urban sites compared to those in the rural sites. One of the important factors associated with A. aegypti infestation was frequency of container washing. Monthly-washed or never-washed containers were both about four times more likely to be infested than those washed every week. There were no significant differences between urban and rural sites in frequency of washing containers. Aedes aegypti immature infestation was positively associated with total dissolved solids, but negatively associated with dissolved oxygen. Water temperature, total dissolved solids, ammonia, nitrate, and organic matter were significantly higher in urban than in rural containers, which might explain urban-rural differences in breeding of A. aegypti. However, many of these factors vary substantially between studies and in their degree of association with vector breeding, therefore they may not be reliable indices for vector control interventions. CONCLUSIONS:Although containers in urban areas were more likely to be infested with A. aegypti, rural containers still provide suitable habitats for A. aegypti. Containers that are washed more frequent are less likely to produce A. aegypti. These results highlight the importance of container washing as an effective vector control tool in both urban and rural areas. In addition, alternative designs of the highly productive washbasins should continue to be explored. To control diseases such as dengue, Zika and chikungunya, effective vector breeding site control must be implemented in addition to other interventions.

背景与目标：

BACKGROUND & AIMS: INTRODUCTION:American cutaneous leishmaniasis is endemic in Colombia, where approximately 6.000 new cases are reported every year. Current prevention and control measures are restricted to the diagnosis and treatment of cases. OBJECTIVE:To evaluate the efficacy of a multifaceted intervention to prevent the transmission of Leishmania in the endemic focus of Tumaco, on the Pacific Coast of Colombia. MATERIALS AND METHODS:A group-randomized trial was conducted. Twenty villages were matched according to prevalence of Leishmania infection, number of inhabitants and level of community participation, and then randomly assigned to intervention or control. The intervention included deltamethrin-impregnated bednets, repellent (20% diethyltoluamide and 0.5% permethrin), modification of sand fly resting sites, and health education. Villages were under surveillance for one year and the use of the intervention measures monitored. The incidence of American cutaneous leishmaniasis and Leishmania infection in the two groups were compared, adherence to the intervention and adverse events were monitored, and the results were adjusted for village intraclass correlation. RESULTS:Ten cases of American cutaneous leishmaniasis were confirmed in the intervention and 23 in the control group, OR = 0.42, 95% CI 0.14-1.26. The intervention had a greater effect in children < 10 years old, in people living on the periphery of the village and in villages with a prevalence of infection in small children > 1%. Adverse events associated with the use of the bednets and the repellent were reported in 2% of the participants and were always mild. CONCLUSION:Incident cases of American cutaneous leishmaniasis were reduced by 58% in the intervention group. However, the small number of cases renders the effect estimate imprecise and precludes us to claim a protective effect for the intervention. Specific populations could be the targets of simpler and more cost-effective interventions in the future.

背景与目标：

BACKGROUND & AIMS: INTRODUCTION:Anti-platelet therapy, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, beta-blockers and statins are cost-effective in patients with atherosclerotic cardiovascular diseases (ASCVD) for reducing the risk of ASCVD events. Unfortunately, there is abundant evidence that adherence to these cardiovascular medications is far from ideal. A recent Cochrane review showed a potential beneficial effect of Short Message Service (SMS) interventions on adherence to medication in ASCVD patients. METHODS AND ANALYSIS:The txt2heart study is a pragmatic randomised single-blind controlled trial. The objective is to evaluate the efficacy and safety of an intervention with SMS messages delivered by mobile phones to improve adherence to cardiovascular medications in patients with ASCVD. The intervention consists of behavioural techniques delivered via SMS. The primary outcome is change in blood serum low-density lipoprotein cholesterol levels as an indicator of adherence to statins. Secondary outcomes will include systolic blood pressure as an indicator of adherence to blood-lowering therapies and heart rate as an indicator of adherence to beta-blockers, urine levels of 11-dehydrothromboxane B2, self-reported adherence to cardiovascular medications and rates of cardiovascular death or hospitalisation due to cardiovascular disease. ETHICS AND DISSEMINATION:The study will be performed in compliance with the protocol, regulatory requirements, Good Clinical Practice and ethical principles of the Declaration of Helsinki. The Ethics Committee of Fundación Cardiovascular de Colombia evaluated and approved the trial. The txt2heart Colombia trial aims to provide robust evidence to evaluate whether SMS messages delivered through mobile telephones change the behaviour of Colombian patients who have suffered a cardiovascular event. Trial results will be presented to the local health authorities, and if the intervention is effective and safe, we hope this strategy will be implemented quickly because of its low cost and wide-reaching impact on the population. TRIAL REGISTRATION NUMBER:NCT03098186.

背景与目标：