ABSTRACT
Introducción. El agua de consumo humano puede ser vehículo de transmisión de agentes patógenos. La detección de virus entéricos en estas muestras de agua es esencial para establecer las acciones adecuadas de control y prevención de las enfermedades asociadas. Objetivo. Analizar los resultados del diagnóstico de virus entéricos en muestras de agua para el consumo humano recibidas en el Instituto Nacional de Salud y establecer su asociación con los datos sobre la calidad del agua en los municipios de Colombia. Materiales y métodos. Se hizo un análisis descriptivo retrospectivo de los resultados obtenidos en la detección de rotavirus, enterovirus, virus de la hepatitis A y adenovirus, en muestras de agua recibidas para estudios complementarios en la investigación de brotes de hepatitis entérica, de enfermedad diarreica aguda y de enfermedades transmitidas por alimentos. Dicha información se correlacionó con los datos de la vigilancia de la calidad del agua municipal determinada según el índice de riesgo de la calidad del agua (IRCA). Resultados. Se procesaron 288 muestras de 102 municipios de Colombia, de las cuales el 50,7 % fue positivo para algún virus: 26,73 %, para el virus de la hepatitis A; 20,48 %, para enterovirus y rotavirus, y 18,05 % para adenovirus. Se detectaron virus en 48,26 % de las muestras de agua no tratada y en 45,83 % de las de agua tratada. El IRCA no mostró correlación con la presencia de virus. Conclusiones. La presencia de virus en el agua representa un riesgo para la salud pública. La prevención de la transmisión de virus por medio del agua requiere políticas para fortalecer los sistemas de suministro y para mejorar la vigilancia epidemiológica.
Introduction: Since drinking water can be a vehicle for the transmission of pathogens, the detection of enteric viruses in these water samples is essential to establish the appropriate measures to control and prevent associated diseases. Objective: To analyze the results obtained for enteric viruses in water samples for human consumption received at the Colombian Instituto Nacional de Salud and establish their association with the data on water quality in Colombian municipalities. Materials and methods: We conducted a descriptive-retrospective analysis of the results obtained in the detection of rotavirus, enterovirus, hepatitis A virus and adenovirus in water samples received for complementary studies of enteric hepatitis, acute diarrheal disease and foodborne diseases. Data were correlated with the results of water quality surveillance determined by the national human consumption water quality index (IRCA). Results: Of the 288 samples processed from 102 Colombian municipalities, 50.7% were positive for viruses: 26.73% for hepatitis A virus, 20.48% for enterovirus and rotavirus and 18.05% for adenovirus. Viruses were detected in 48.26% of non-treated water samples and in 45.83% of treated water samples. The IRCA index showed no correlation with the presence of viruses. Conclusions: The presence of viruses in water represents a public health risk and, therefore, the prevention of virus transmission through water requires appropriate policies to reinforce water supply systems and improve epidemiological surveillance.
Subject(s)
Enterovirus , Hepatitis A , Rotavirus , Water Pollution , Water SupplyABSTRACT
Introducción. La calidad del agua para consumo humano se ha asociado con la aparición de diversas enfermedades. El estudio de la relación entre estos eventos permitiría reflejar el impacto de la calidad del agua de consumo en la salud de la población, con el fin de orientar acciones de prevención y promoción en salud ambiental. Objetivo. Analizar la calidad del agua para consumo humano y su asociación con la morbimortalidad en Colombia, 2008-2012. Materiales y métodos. Se analizó la base de datos de la vigilancia de la calidad del agua mediante métodos de estadística descriptiva en lo referente a las principales características indicadoras de calidad (coliformes totales, Escherichia coli , turbiedad, color, pH, cloro residual libre e índice del riesgo de la calidad del agua). Los resultados se correlacionaron con la mortalidad infantil y la morbilidad por enfermedad diarreica aguda, enfermedades transmitidas por alimentos y hepatitis A. Se elaboró un mapa de riesgo para identificar los municipios con alto riesgo de contaminación del agua y mortalidad infantil. Resultados. Se encontró un alto porcentaje de municipios en los que el valor de potabilidad del agua no se ajustaba a lo establecido por la norma vigente; se identificaron los problemas relacionados con la presencia de E. coli , de coliformes totales y la ausencia de cloro residual libre, los cuales fueron más agudos en la zona rural. La calidad del agua tuvo una mayor correlación con la mortalidad infantil, constatándose así su importancia para la salud de la población infantil. Conclusión. La calidad del agua demostró tener un impacto importante en la mortalidad infantil, por lo que se requiere la adopción de políticas que fortalezcan los sistemas de suministro de agua en el país. Es esencial fortalecer los programas de vigilancia en salud ambiental, para orientar las acciones de mejoramiento de la calidad del agua e influir positivamente en la salud.
Introduction: The quality of water for human consumption has been correlated with the occurrence of different diseases. Studying the relationship between these parameters would allow determining the impact of water quality on human health, and to direct preventative measures and promote environmental health. Objective: To analyze the quality of water intended for human consumption and its association with morbimortality in Colombia, 2008-2012. Materials and methods: The database for surveillance of water quality was analyzed by means of descriptive statistics of the principal indicators (total coliforms, Escherichia coli , turbidity, color, pH, free residual chlorine and water quality risk index). The results were correlated with infant mortality and morbidity due to acute diarrheal diseases, foodborne diseases and hepatitis A. A risk map was prepared to identify those municipalities with the highest risk of water contamination and infant mortality. Results: A high percentage of municipalities did not conform to existing standards for water potability values. Problems were identified that were related to presence of E. coli and total coliforms, as well as absence of free residual chlorine, a situation that was exacerbated in rural areas. Water quality showed a high correlation with infant mortality, highlighting its importance for children´s health. Conclusion: Water quality was found to have an important impact on infant mortality. Improving water quality in Colombia will require policies that strengthen water supply systems in this country. Strengthening of environmental health surveillance programs is essential to guide actions aimed at improving water quality and exert a positive impact on health.
Subject(s)
Child, Preschool , Humans , Infant , Infant, Newborn , Child Mortality , Drinking Water , Water Quality , Colombia , Time FactorsABSTRACT
O presente estudo teve como objetivo avaliar a implementação do Sistema de Vigilância da Qualidade da Água para Consumo Humano (VQACH), na Colômbia. O estudo foi realizado mediante a metodologia de avaliação da implementação, integrando avaliação normativa e pesquisa de avaliação. Para a avaliação foi desenvolvida metodologia Delphi, permitindo definir uma matriz avaliativa, composta por 14 atributos e 62 critérios, e a construção de um sistema de escores e parâmetros, que possibilitou a avaliação de cada um dos critérios definidos. A coleta de dados envolveu a realização de entrevistas semiestruturadas com atores institucionais de 39 unidades territoriais. A avaliação mostrou que o sistema de VQACH está parcialmente implementado, com diferentes estados de implementação nas unidades territoriais. O sistema mostra um fortalecimento nas ações relacionadas com produção de dados sobre as condições da qualidade da água, com ausência de ações que permitam o aproveitamento desses dados para o melhoramento da qualidade de água, e de ações de VQACH na perspectiva de promoção da saúde. Foram identificadas algumas limitações conceituais nas legislações, o que afeta o cumprimento da universalidade das ações de VQACH.
This study aims to evaluate the Drinking-Water Quality Surveillance Programme (DWQS) implemented in Colombia. The study was conducted using methodology for assessing the implementation, integrating a normative assessment and evaluation research. For this assessment, Delphi methodology was developed that allowed the definition of an evaluation matrix, composed of 14 attributes and 62 criteria, as well as the building of a score system and parameters that permitted the evaluation of each of the defined criteria. Data collection involved conducting semi-structured interviews with institutional actors from 39 territorial units. The system evaluation showed that the DWQS in Colombia is partially implemented, with different stages of implementation in territorial units. The system showed a strengthening in actions related to data production on the aspect for improving water quality and DWQS actions from the standpoint of health promotion. However, some conceptual limitations were identified in terms of legislation thereby affecting the fulfilment of the universality of DWQS actions.