ABSTRACT
Objetivos. Explorar algunos de los factores de riesgo demográficos que se asocian con la presencia de problemas conductuales o emocionales en los niños, y examinar la posibilidad de una relación entre el estrés psicológico en los padres y trastornos psicológicos en los niños. Materiales y métodos. En el presente estudio la presencia del estrés psicológico en lo padres y ciertas características psicosociales que aumentan el riesgo de sufrir trastornos mentales en la niñez fueron examinados en una muestra de niños uruguayos de dos comunidades urbanas y una rural. La investigación , que se llevó a cabo en Ciudad Vieja y Barrio Sur, en Montevideo, y en el pueblo de la Colonia de Sacramento, abarcó a 115 niños entre las edades de 5 a 15 años. Las madres contestaron por sus hijos el Cuestionario de Morbilidad Psiquiátrica Infantil(QMPI), instrumento para la detección de problemas conductuales que podrían ser indicio de trastornos emocionales en los niños. Adicionalmente, ambos padres proporcionaron la información demográfica solicitada en la Psychiatric Epidemiology Research Interview Demoralization Scale (PERI-D)(Escala de Desmoralización para la Investigación Epidemiológica en Psiquiatría);contestaron el cuestionario CAGE5 para el tamizaje del alcoholismo;se sometieron al Social Support Network Inventory (Inventario de la Red de Apoyo Social), y respondieron preguntas sobre su propio estado de salud mental. Resultados. Cincuenta y tres por ciento de los niños tuvieron puntajes mayores de 6 en el QMPI, resultado que señala la presencia de problemas conductuales o emocionales. La autopercepción de un trastorno emocional y de desmoralización en las madres mostró una asociación significativa con un mayor riesgo de problemas conductuales o emocionales en los hijos. Discusión. Ajuzgar por nuestros resultados, la salud mental del niño es un problema social y sanitario cuya epidemiología debe explorarse más a fondo en el Uruguay
Subject(s)
Child Behavior , Affective Symptoms , Mental Health , Uruguay , Stress, PsychologicalABSTRACT
Between 1979 and 1994, epidemiological surveillance of meningitides in Uruguay showed a progressive increase in suppurative meningitides due mainly to Neisseria meningitidis and Haemophilus influenzae type b (Hib). The cases were concentrated in children under 5; however, among the cases caused by Hib, 70 per cent affected children from 1 to 11 months old. Facing this situation, the Ministry of Public Health resolved, as of August 1994, to include the Hib vaccine in the country's Expanded Program on Immunization, which has been in place since 1982. The Hib vaccination is done without charge and is obligatory for all children under 5 years of age. It is done using the following series of vaccinations: a) three doses, given at 2, 4, and 6 months, with a booster dose at age 1; b) children from 7 to 11 months old receive two doses two monts apart and a booster dose a year later; and c) a single dose for children 12 months to 4 years old. Between August and December 1994 a coverage rate of 76.6 per cent was reached among children between 2 months and 4 years old, and the coverage has remained above 80 per cent in the new cohorts. In Uruguay, this vaccination strategy had a spectacular impact on morbidity and mortality due to meningitides caused by Hib. One of the results was that the incidence of 15.6 per 100 000 registered in children under 5 in the prevaccination years declined to 0.03 per 100 000 in 1996
Subject(s)
Humans , Male , Female , Child, Preschool , Meningitis, Bacterial , Haemophilus Vaccines/administration & dosage , Haemophilus influenzae type b , UruguayABSTRACT
In some countries, the invasive disease caused by Haemophilus influenzae type b (Hib) has been practically eliminated thanks to vaccination. However, in much of the developing world, meningitides and pneumonias caused by these bacteria continue to be a major cause of childhood morbidity and mortality, as well as high hospitalization costs. Because safe and effective conjugate vaccines are now available, the Special Program for Vaccines and Immunization of the Pan American Health Organization has recommended introducting them into the regular vaccination regimen of as many countries as possible. This has been done in Chile and Uruguay, where the Hib vaccine now forms part of the regular vaccination routine. When the vaccine was being introduced, both countries had difficulties they could have avoided if they had known of the experiences of other nations. Therefore, these two countries now offer the lessons they learned to other nations considering introducing the vaccine into their immunization programs. The most important lessons were to: strengthen the epidemiological surveillance system sufficiently in advance of introducing the vaccine; with the support of scientific societies, present the technical information that justifies introducing the vaccine; seek community baking and acceptance; precisely establish in advance the presentation and dosage of the vaccine that is most appropriate for the country; and be certain to have the political and legal decisions needed to ensure the continuity of Hib vaccination in the future