Dengue, políticas públicas y realidad sociocultural: una aproximación al caso colombiano

This article critically examines public policies aimed at controlling dengue fever as they are perceived in daily life. It seeks to debate the development of these policies vis à vis the affected population’s perception of the disease. Using a case study from Colombia, the text discusses the encounter between two social realities: the official sector heading public health campaigns, and those representations produced by a population that constructs alternate therapies to confront the disease.Este artículo reflexiona sobre las políticas públicas del control del dengue a partir del mundo de la vida cotidiana, desde una perspectiva crítica que busca debatir el desarrollo de las mismas frente a las percepciones que tiene la población sobre la enfermedad. El texto debate, a partir de un estudio de caso en Colombia, el encuentro de dos realidades sociales: el sector oficial en cabeza de las campañas de salud pública, y la población, que desde sus representaciones sociales sobre la enfermedad construye itinerarios terapéuticos para enfrentar la misma

Estudio comparativo entre las mediciones de ruido ambiental urbano a 1,5 m y 4 m de altura sobre el nivel del piso en la ciudad de medellín, antioquia - colombia

Con la entrada en vigencia de la Resolución 0627 de 2006, reglamentándose la altura de 4m sobre el nivel del piso como estrategia de medición para evaluar los niveles de ruido ambiental, se ha creado una gran controversia entre las entidades ambientales gubernamentales, los académicos y profesionales del sector, sobre las implicaciones económicas, logísticas y operativas para el desarrollo del trabajo de campo. Con el propósito de determinar si mediciones simultáneas de ruido urbano efectuadas a 1,5 m y 4 m representan o no la misma realidad sonora, se realizo un análisis estadístico a un conjunto de datos obtenidos en el marco de la construcción del mapa de ruido del municipio. Después de un análisis de los datos agrupados por punto, por jornada (diurna y nocturna) y por tipo de día (hábil y no hábil), se infiere que no es posible afirmar la semejanza entre muestras de ruido tomadas a 1,5 m y 4 m de altura, no solo por las diferencias numéricas, sino que representan realidades sonoras diferentes

Itinerarios terapéuticos para el cuidado de la salud en la primera infancia en Los municipios de Cundinamarca y Boyacá (Colombia)

Introduction. The aim of this article is to present the therapeutical itineraries for children from 0 to 6 years old healthcare in Soatá (Boyacá) and Sopó (Cundinamarca) municipalities. Pointedly scenarios where healthcare processes, diagnostic, treatment and cure (or alleviation) may occur in events of disease.Methods. By the use of qualitative methodologies and case studies, semi-structured interviews and field tasks, it was inquired about the therapeutical itineraries based on the experience of twelve families.Conclusion. We present the pragmatic way the primary caretakers overcome the disease episodes. The results highlight the importance of socio-cultural factors have in the diagnostic, ailment and cure processes of disease; and how this factors find answer in informal treatments that satisfy the medical and symbolic needs of families. Introducción. Se presentan los itinerarios terapéuticos para el cuidado de la salud de niños y niñas de 0 a 6 años en los municipios de Soatá (Boyacá) y Sopó (Cundinamarca) en Colombia; puntualmente en los escenarios en los cuales ocurren los procesos de cuidado, diagnóstico, tratamiento y cura en eventos de enfermedad.Métodos. Se utilizó el estudio de caso para indagar sobre los itinerarios terapéuticos a doce familias, tras un análisis etnográfico apoyado en software NVivo.Resultados. Se encontró que las cuidadoras superan los episodios de enfermedadde niños/as de forma pragmática influenciadas por sus factores socio-culturales, y que algunos padecimientos encuentran respuesta en tratamientos informales que satisfacen la necesidad médica y simbólica de las familias.Conclusión. Este estudio permite a los profesionales de la salud conocer las creencias y prácticas de las cuidadoras para facilitar el diálogo de saberes y una atención integral en salud de la primera infancia.

Bionomía de Anopheles (Nyssorhynchus) albimanus (Diptera: Culicidae) en dos rancherías del pueblo wayúu, Riohacha, La Guajira, Colombia

Introduction: Riohacha, capital of the department of La Guajira, reports the highest rates for malaria in the department, and the most vulnerable people are those of the Wayúu indigenous group.Objective: To describe some aspects of the bionomics of the Anopheles species in two Wayúu settlements.Materials and methods: Two sampling events were carried out during dry and rainy seasons in Marbacella and El Horno (Riohacha, La Guajira). Immature stages of Anopheles spp. were collected, and breeding sites were described. Adult mosquitoes were collected with human landing catches, Shannon traps and CDC traps.Results: All collected specimens were Anopheles albimanus. Biting activity occurred outdoors during all the night (n=7), while indoors, only two mosquitoes were captured between 18:00 and 20:00 hours. The positive breeding sites corresponded to jagüeyes (n=7, 38.8%), pools (n=2, 10.5%), and fishponds (n=2, 10.5%). The highest abundance of immature forms was found in the jagüeyes (n=25, 78%), which had pH values between 7.20 and 7.81 and a temperature of 25°C, and were located 150 m away from Wayúu homes.Conclusion: Anopheles albimanus was the only collected species found in water supply deposits in the villages Marbacella and El Horno. Given that the species is the main vector for malaria in the area, we suggest the implementation of a community-based entomological surveillance system which should respect Wayúu cosmology and routine activities such as fishing.Introducción. Riohacha, capital del departamento de La Guajira, registra las tasas más altas de malaria o paludismo en el departamento, especialmente entre los indígenas de la etnia wayúu.Objetivo. Describir algunos aspectos de la bionomía de las especies del género Anopheles presentes en dos rancherías de la etnia wayúu.Materiales y métodos. Se hicieron dos muestreos durante las temporadas de lluvia y sequía en las rancherías Marbacella y El Horno (municipio de Riohacha, La Guajira). Se recolectaron formas inmaduras de los mosquitos y se describieron sus hábitats. Los mosquitos adultos se recolectaron al posarse en sujetos humanos, previo consentimiento informado, y con trampas de luz Shannon y CDC.Resultados. Todos los ejemplares recolectados eran Anopheles albimanus, especie que registró actividad de picadura durante toda la noche en el peridomicilio (n=7), en tanto que en el intradomicilio se capturaron solo dos mosquitos entre las 18:00 y las 20:00 horas. Los sitios de cría positivos correspondieron a jagüeyes (n=7; 38,8 %), charcos (n=2; 10,5 %), y estanques piscícolas (n=2; 10,5 %). La mayor abundancia de formas inmaduras se encontró en los jagüeyes (n=25; 78 %), cuyo pH oscilaba entre 7,20 y 7,81 a una temperatura de 26,5 °C, y se localizaban a 150 m de distancia de las viviendas.Conclusión. Anopheles albimanus se registró en todos los depósitos de agua de ambas rancherías. Dado que la especie se considera vector primario de la malaria en la zona, debe establecerse un sistema de vigilancia entomológica local que involucre a la comunidad a la vez que respete su cosmología y actividades rutinarias como la pesca

¿A quiénes se cuenta? Narrativas sobre las métricas en salud de la población migrante venezolana en una zona de frontera en Colombia

Colombia ha sido un país receptor de la migración venezolana originada por la situación sociopolítica del país vecino. Una de las necesidades para dar respuesta a esta crisis es la recolección de datos que permitan visibilizar y monitorear las condiciones de salud de esta población. A partir de un estudio cualitativo centrado en entrevistas y observación etnográfica, el artículo se orienta a caracterizar las variadas dinámicas de inclusión y de exclusión que forman parte de la producción de datos en salud de la población migrante en Cúcuta, un territorio de la frontera colombo-venezolana. A partir de las narrativas de diversos actores que, en el territorio, trabajan directamente en la recolección, el análisis y el uso de datos de salud de la población migrante, el articulo problematiza la construcción de la categoría migrante dentro de las métricas, develando aquello que se visibiliza y aquello que se ignora en el proceso sociotécnico que está detrás de la construcción de estos dato

Estudio comparativo entre las mediciones de ruido ambiental urbano a 1,5 m y 4 m de altura sobre el nivel del piso en la ciudad de Medellín, Antioquia – Colombia

RESUMEN: Con la entrada en vigencia de la Resolución 0627 de 2006, reglamentándose la altura de 4m sobre el nivel del piso como estrategia de medición para evaluar los niveles de ruido ambiental, se ha creado una gran controversia entre las entidades ambientales gubernamentales, los académicos y profesionales del sector, sobre las implicaciones económicas, logísticas y operativas para el desarrollo del trabajo de campo. Con el propósito de determinar si mediciones simultáneas de ruido urbano efectuadas a 1,5 m y 4 m representan o no la misma realidad sonora, se realizó un análisis estadístico a un conjunto de datos obtenidos en el marco de la construcción del mapa de ruido del municipio. Después de un análisis de los datos agrupados por punto, por jornada (diurna y nocturna) y por tipo de día (hábil y no hábil), se infiere que no es posible afirmar la semejanza entre muestras de ruido tomadas a 1,5 m y 4 m de altura, no sólo por las diferencias numéricas, sino que representan realidades sonoras diferentes.ABSTARCT: Since Resolution 0627 has been brought into force in 2006, regulating a height of 4 m for measurements of environmental noise, urban noise management policies in Colombia have taken a new course. However, a controversy has arisen involving government officers, academics and professionals as regards economic, logistic and operational implications for the fieldwork. With the objective of assessing whether there is or not a statistically significant difference between urban environmental noise measurements at 1,5 m and 4 m above the floor, a statistical analysis of a large amount of data gathered during the development of the noise map of Medellin, data have been grouped according to measurement site, time of day (daytime and nighttime) and type of day (working and weekend). It is not possible to affirm the noise samples taken at 1,5 m and 4 m above the floor are similar, not only by the numerical differences, but they represent different noise landscapes

Characterization of airborne particulate matter and its toxic and proarrhythmic effects: A case study in Aburrá Valley, Colombia

Particle matter (PM) is a complex mixture of particles suspended in the air, mainly caused by fuel combustion from vehicles and industry, and has been related to pulmonary and cardiovascular diseases. The Metropolitan Area of Aburrá Valley in Colombia is the second most populous urban agglomeration in the country and the third densest in the world, composed of ten municipalities. Examining the physicochemical properties of PM is crucial in comprehending its composition and its effects on human health, as it varies based on the socioeconomic dynamics specific to each city. This study characterized the PM collected from the north, south, and central zones to evaluate its chemical composition and morphology. Different elements such as silicon, carbon, aluminum, potassium, calcium, sodium, iron, magnesium, and copper and the presence of unburned fuel, motor oil, and silicon fibers were identified. In vitro and in silico studies were conducted to evaluate the toxicity of the PM, and it was found that the PM collected from the central zone had the greatest impact on cell viability and caused DNA damage. The in silico study demonstrated that PM has concentration-dependent proarrhythmic effects, reflected in an action potential duration shortening and an increased number of reentries, which may contribute to the development of cardiac arrhythmias. Overall, the results suggest that the size and chemical composition of ambient PM can induce toxicity and play an important role in the generation of arrhythmiasThis work was supported by the Ministerio de Ciencia Tecnología e Innovación (MINCIENCIAS) from Colombia, through grant No. 120677757994 and by the Dirección General de Política Científica de la Generalitat Valenciana PROMETEO/2020/043. The work of Palacio was supported by the “Programa de excelencia doctoral del Bicentenario 2019” of MINCIENCIAS. The work of Durango-Giraldo and Zapata-Hernandez was supported by the “Convocatoria para el fortalecimiento de proyectos en ejecución de CTeI en ciencias de la salud con talento joven e impacto regional” of MINCIENCIASPostprint (published version

Effectiveness and feasibility of long-lasting insecticide-treated curtains and water container covers for dengue vector control in Colombia : a cluster randomised trial

The combination of long-lasting insecticide-treated net (LLIN) curtains with targeted interventions on water containers showed a significant reduction in vector densities when measured through pupae per person index (PPI). If a mosquito was able to escape the effects of the curtains, they would still encounter difficulties in laying eggs and, even if successful, the emerging mosquitoes would be killed by treated container covers. This underlines the importance of combined vector control strategies. In the intervention group, the PPI index showed a clear decline of 71% compared with 25% in the control group. Program acceptance was achieved through community participation strategies

Inequalities in catastrophic health expenditures in conflict-affected areas and the Colombian peace agreement : an oaxaca-blinder change decomposition analysis

Abstract Background The present study analyzes inequalities in catastrophic health expenditures in conflict-affected regions of Meta, Colombia and socioeconomic factors contributing to the existence and changes in catastrophic expenditures before and after the sign of Colombian Peace Agreement with FARC-EP guerilla group in 2016. Methods The study uses the results of the survey Conflicto, Paz y Salud (CONPAS) conducted in 1309 households of Meta, Colombia, a territory historically impacted by armed conflict, for the years 2014 and 2018. We define catastrophic expenditures as health expenditures above 20% of the capacity to pay of a household. We disaggregate the changes in inequalities in catastrophic expenditures through the Oaxaca-Blinder change decomposition method. Results The incidence of catastrophic expenditures slightly increased between 2014 to 2018, from 29.3 to 30.7%. Inequalities in catastrophic expenditures, measured through concentration indexes (CI), also increased from 2014 (CI: -0.152) to 2018 (CI: -0.232). Results show that differences in catastrophic expenditures between socioeconomic groups are mostly attributed to an increased influence of specific sociodemographic variables such as living in rural zones, being a middle-aged person, living in conflict-affected territories, or presenting any type of mental and physical disability. Conclusions Conflict-deescalation and the peace agreement may have facilitated lower-income groups to have access to health services, especially in territories highly impacted by conflict. This, consequently, may have led to higher levels of out-of-pocket expenditures and, therefore, to higher chances of experiencing catastrophic expenditures for lower-income groups in comparison to higher-income groups. Therefore, results indicate the importance of designing policies that guarantee access to health services for people in conflict -affected regions but also, that minimize health care inequalities in out-of-pocket payments that may arouse between people at different socioeconomic groups

A light of hope? Inequalities in mental health before and after the peace agreement in Colombia : a decomposition analysis

Background The present study seeks to evaluate the change in mental health inequalities in the department of Meta after the signing of Colombia’s Peace Agreement in 2016 with the FARC guerrilla group. Using a validated survey instrument composed of 20 questions (‘SRQ-20’), we measure changes in mental health inequalities from 2014, before the signing of the agreement, to 2018, after the signing. We then decompose the changes in inequalities to establish which socioeconomic factors explain differences in mental health inequalities over time. Methods Our study uses information from the Conflicto, Salud y Paz (CONPAS) survey conducted in the department of Meta, Colombia, in 1309 households in 2018, with retrospective information for 2014. To measure inequalities, we calculate the concentration indices for both years. Through the Oaxaca change decomposition method, we disaggregate changes in mental health inequalities into its underlying factors. This method allows us to explain the relationship between changes in mental health inequalities and changes in inequalities in several sociodemographic factors. It also identifies the extent to which these factors help explain the changes in mental health inequalities. Results Mental health inequalities in Meta were reduced almost by half from 2014 to 2018. In 2018, the population at the lower and middle socioeconomic levels had fewer chances of experiencing mental health disorders in comparison to 2014. The reduction in mental health differences is mostly attributed to reductions in the influence of certain sociodemographic variables, such as residence in rural zones and conflict-affected territories, working in the informal sector, or experiencing internal displacement. However, even though mental health inequalities have diminished, overall mental health outcomes have worsened in these years. Conclusions The reduction in the contribution of conflict-related variables for explaining mental health inequalities could mean that the negative consequences of conflict on mental health have started to diminish in the short run after the peace agreement. Nevertheless, conflict and the presence of other socioeconomic inequalities still contribute to persistent adverse mental health outcomes in the overall population. Thus, public policy should be oriented towards improving mental health care services in these territories, given the post-accord context