La seguridad social en salud en el contexto del nuevo modelo de desarrollo

Desde la década de 1980 empieza a perfilarse un cambio de gran trascendencia en la concepción y valoración del Estado, como resultado de los cambios que a nivel mundial se operan en la relación entre economía y política. El llamado Estado benefactor, con

The position value as a centrality measure in social networks

The position value, introduced by Meessen (1988), is a solution concept for cooperative games in which the value assigned to a player depends on the value of the connections or links he has with other players. This concept has been studied by Borm et al. (1992) and characterised by Slikker (2005). In this paper, we analyse the position value from the point of view of the typical properties of a measure of centrality in a social network. We extend the analysis already developed in Gomez et al. (2003) for the Myerson centrality measure, where the symmetric effect on the centralities of the end nodes of an added or removed edge is a fundamental part of its characterisation. However, the Position centrality measure, unlike the Myerson centrality measure, responds in a more versatile way to such addition or elimination. After studying the aforementioned properties, we will focus on the analysis and characterisation of the Position attachment centrality given by the position value when the underlying game is the attachment game. Some comparisons are made with the attachment centrality introduced by Skibski et al. (2019).Depto. de Estadística e Investigación OperativaFac. de Ciencias MatemáticasInstituto de Matemática Interdisciplinar (IMI)FALSEMinisterio de Ciencia e Innovaciónunpu

Self-avoiding walks and connective constants in small-world networks

Long-distance characteristics of small-world networks have been studied by means of self-avoiding walks (SAW's). We consider networks generated by rewiring links in one- and two-dimensional regular lattices. The number of SAW's $u_n$ was obtained from numerical simulations as a function of the number of steps $n$ on the considered networks. The so-called connective constant, $\mu = \lim_{n \to \infty} u_n/u_{n-1}$, which characterizes the long-distance behavior of the walks, increases continuously with disorder strength (or rewiring probability, $p$). For small $p$, one has a linear relation $\mu = \mu_0 + a p$, $\mu_0$ and $a$ being constants dependent on the underlying lattice. Close to $p = 1$ one finds the behavior expected for random graphs. An analytical approach is given to account for the results derived from numerical simulations. Both methods yield results agreeing with each other for small $p$, and differ for $p$ close to 1, because of the different connectivity distributions resulting in both cases.Comment: 7 pages, 5 figure

Prevalencia e intensidad de la infección por geohelmintos y prevalencia de la malaria en escolares de El Salvador

Introduction: El Salvador does not have recent data on the prevalence of infection with soil-transmitted helminths among children aged under 15 years of age. As one of the countries in the Americas that reports few malaria cases, eradication of this disease from El Salvador is considered to be feasible.Objective: To determine the prevalence and intensity of infection by soil-transmitted helminths, as well as the prevalence of Plasmodium spp. in schoolchildren aged 8-10.Materials and methods: A cross-sectional study was carried out in each of the five eco-epidemiological zones of the country (coastal plain, central basin, volcanic range, coastal range and mountain zone). In all 1,325 students we studied the presence of geohelminthiasis, with 152 of them also being tested for malaria. The Kato–Katz technique was used to detect geohelminths while diagnosis of malaria was performed using the rapid diagnostic test, microscopy and polymerase chain reaction.Results: The overall prevalence of geohelminthiasis was 7.9% (95%CI 6.6-9.5%). Values for the five eco-epidemiological zones were as follows: coastal plain, 14.9% (95%CI 10.9-19.7%); central plateau, 9.4% (95%CI 6.5-13.3%); volcanic range, 6.6% (95%CI 4.2-10.5%); coastal range, 5.9% (95%CI 3.8-9.4%), and mountain zone, 2.6% (95%CI 1.4-5.7%). The overall rate of high intensity infection with any of the geohelminth species was 0.3%. No schoolchildren were found infected with Plasmodium spp. by any of the three diagnostic techniques used.Conclusion: Prevalence of geohelminths was low and Trichuris trichiura was the predominant species. Intensity of infection with any of the species of geohelminths was light (<1%). The risk factors associated with infection by soil-transmitted helminths were defecation in the open air, being barefoot and living in coastal areas.Introducción. El Salvador no cuenta con datos actualizados de prevalencia en menores de 15 años de la infección por helmintos transmitidos por contacto con el suelo. Además, al ser uno de los países en las Américas que reporta un número bajo de casos de malaria, se considera que su eliminación allí es factible.Objetivo. Determinar la prevalencia y la intensidad de la infección por geohelmintos y la prevalencia de Plasmodium spp. en escolares de 8 a 10 años de El Salvador.Materiales y métodos. Se hizo un estudio de corte transversal en las cinco zonas eco-epidemiológicas del país (planicie costera, depresión central, cadena volcánica, cadena costera y zona montañosa). La presencia de geohelmintiasis se estudió en 1.325 estudiantes y, la de malaria, en 152. Se utilizó la técnica de Kato-Katz para la detección de geohelmintos, y para el diagnóstico de la malaria, una prueba rápida, el estudio mediante microscopía y la prueba de reacción en cadena de la polimerasa.Resultados. La prevalencia total de geohelmintiasis fue de 7,9 % (IC95% 6,6-9,5). En la planicie costera fue de 14,9 % (IC95% 10,9-19,7); en la depresión central, de 9,4 % (IC95% 6,5-13,3); en la cadena volcánica, de 6,6 % (IC95% 4,2-10,5); en la cadena costera, de 5,9 % (IC95% 3,8-9,4), y en la cadena montañosa, de 2,6 % (IC95% 1,4-5,7). La proporción de infección de gran intensidad debida a cualquiera de las especies de geohelmintos fue de 0,3 %. No se encontraron escolares infectados con Plasmodium spp.Conclusión. La prevalencia de geohelmintos fue baja y la especie más prevalente fue Trichuris trichiura. La intensidad de la infección debida a cualquiera de las especies de geohelmintos fue leve (<1 %). Los factores de riesgo asociados a la infección por geohelmintos fueron la defecación al aire libre, no usar calzado y vivir en la planicie costera

Association of vision impairment and blindness with socioeconomic status in adults 50 years and older from Alto Amazonas, Peru.

OBJECTIVE: To determine the relationship between socioeconomic status (SES) and visual impairment (VI) or blindness in the rural Peruvian Amazon, hypothesizing that higher SES would have a protective effect on the odds of VI or blindness. METHODS: In this cross-sectional study of 16 rural communities in the Peruvian Amazon, consenting adults aged ≥ 50 years were recruited from ~30 randomly selected households per village. Each household was administered a questionnaire and had a SES score constructed using principal components analysis. Blindness and VI were determined using a ministry of health 3-meter visual acuity card. RESULTS: Overall, 207 adults aged ≥ 50 were eligible; 146 (70.5%) completed visual acuity screening and answered the questionnaire. Of those 146 participants who completed presenting visual acuity screening, 57 (39.0%, 95% CI 30.2-47.1) were classified as visually impaired and 6 (4.1%, 95% CI 0.9-7.3) as blind. Belonging to the highest SES tercile had a protective effect on VI or blindness (OR 0.29, 95% CI 0.09 to 0.91, p = 0.034), with a linear trend across decreasing levels of SES (p = 0.019). This observed effect remained significant regardless of how SES groups were assigned. CONCLUSION: Belonging to a higher SES group resulted in a lower odds of VI or blindness compared to those in the lowest SES group. The observation of a dose response provides confidence in the observed association, but causality remains unclear. Blindness prevention programs could maximize impact by designing activities that specifically target people with lower SES

Integrated survey methodologies for neglected tropical diseases.

The 2021-2030 Neglected Tropical Diseases road map calls for intensified cross-cutting approaches. By moving away from vertical programming, the integration of platforms and intervention delivery aims to improve efficiency, cost-effectiveness and programme coverage. Drawing on the direct experiences of the authors, this article outlines key elements for successful integrated surveys, the challenges encountered, as well as future opportunities and threats to such surveys. There are multiple advantages. Careful planning should ensure that integration does not result in a process that is less efficient, more expensive or that generates data driving less reliable decisions than conducting multiple disease-specific surveys

Accuracy, acceptability and feasibility of photography for use in trachoma surveys: a mixed methods study in Tanzania

BACKGROUND: Photography could be used to train individuals to diagnose trachomatous inflammation-follicular (TF) as trachoma prevalence decreases and to ensure accurate field TF grading in trachoma prevalence surveys. We compared photograph and field TF grading and determined the acceptability and feasibility of eyelid photography to community members and trachoma survey trainers. METHODS: A total of 100 children ages 1-9 y were examined for TF in two Maasai villages in Tanzania. Two images of the right everted superior tarsal conjunctiva of each child were taken with a smartphone and a digital single-lens reflex (DSLR) camera. Two graders independently graded all photos. Focus group discussions (FGDs) were conducted with community members and Tropical Data trainers. RESULTS: Of 391 photos, one-fifth were discarded as ungradable. Compared with field grading, photo grading consistently underdiagnosed TF. Compared with field grading, DSLR photo grading resulted in a higher prevalence and sensitivity than smartphone photo grading. FGDs indicated that communities and trainers found photography acceptable and preferred smartphones to DSLR in terms of practicalities, but image quality was of paramount importance for trainers. CONCLUSIONS: Photography is acceptable and feasible, but further work is needed to ensure high-quality images that enable accurate and consistent grading before being routinely implemented in trachoma surveys

Population Prevalence of Trachoma in Nine Rural Non-Indigenous Evaluation Units of Brazil.

Purpose: To assess the contemporary prevalence of trachoma in Brazil's non-indigenous population, surveys of those thought to be at greatest risk of disease were conducted.Methods: Rural census tracts of non-indigenous population from nine mesoregions were selected to compose the survey evaluation units (EUs) by considering previously endemic municipalities at greatest risk of trachoma. In each of the nine EUs, we conducted a population-based prevalence survey. Every resident of selected households aged ≥1 year was examined for trachomatous inflammation - follicular (TF) and trachomatous trichiasis (TT). Additionally, data were collected on household-level access to water, sanitation, hygiene (WASH) and education.Results: A total of 27,962 individuals were examined across nine EUs. The age-adjusted TF prevalence in 1-9-year-olds was 99% of surveyed children.Conclusions: The prevalence of TF was well below the target for elimination as a public health problem in all EUs. Because EUs surveyed were selected to represent the highest-risk non-indigenous areas of the country, TF prevalence is unlikely to be ≥5% in non-indigenous populations elsewhere. In one EU, the prevalence of TT was above the target threshold for elimination. Further investigation and possibly improvement in TT surgical provision are required in that EU

Tropical Data: Approach and Methodology as Applied to Trachoma Prevalence Surveys

PURPOSE: Population-based prevalence surveys are essential for decision-making on interventions to achieve trachoma elimination as a public health problem. This paper outlines the methodologies of Tropical Data, which supports work to undertake those surveys. METHODS: Tropical Data is a consortium of partners that supports health ministries worldwide to conduct globally standardised prevalence surveys that conform to World Health Organization recommendations. Founding principles are health ministry ownership, partnership and collaboration, and quality assurance and quality control at every step of the survey process. Support covers survey planning, survey design, training, electronic data collection and fieldwork, and data management, analysis and dissemination. Methods are adapted to meet local context and needs. Customisations, operational research and integration of other diseases into routine trachoma surveys have also been supported. RESULTS: Between 29th February 2016 and 24th April 2023, 3373 trachoma surveys across 50 countries have been supported, resulting in 10,818,502 people being examined for trachoma. CONCLUSION: This health ministry-led, standardised approach, with support from the start to the end of the survey process, has helped all trachoma elimination stakeholders to know where interventions are needed, where interventions can be stopped, and when elimination as a public health problem has been achieved. Flexibility to meet specific country contexts, adaptation to changes in global guidance and adjustments in response to user feedback have facilitated innovation in evidence-based methodologies, and supported health ministries to strive for global disease control targets