ABSTRACT
Resumen Introducción: la pandemia de COVID-19 llegó al departamento de Santander el 17 de marzo de 2020; los primeros casos fueron importados y relacionados, manteniendo una baja ocurrencia generalizada hasta finales de mayo. Desde ese momento empiezan a aumentar los casos de manera rápida, consecuencia de la flexibilización laboral de mitad de mayo y el desconfinamiento desde el 1 de junio. Se tiene como objetivo generar un insumo a los tomadores de decisiones en el mejoramiento de la respuesta a la pandemia Materiales y métodos: se realizó un análisis del comportamiento de la pandemia por COVID-19 en Santander, a partir de datos de registros oficiales y análisis de efectos colaterales desde la visión de la salud pública y un enfoque de Una Salud. Resultados: Se comienzan a evidenciar los efectos colaterales de la pandemia que no afectan únicamente al sector salud. Aún no se conocen las consecuencias del día sin IVA (19 de junio) en la ocurrencia de infectados. Una evaluación preliminar de la respuesta gubernamental en Santander sugiere falta de preparación; es notoria la disminuida capacidad de vigilancia en salud pública, en epidemiología de campo y capacidad diagnóstica, incapacidad de aumentar el número de unidades de cuidado intensivo, inadecuada comunicación con la sociedad, limitada capacidad de acción de las comunidades y falta de claridad en el manejo intersectorial de las diversas manifestaciones y efectos colaterales de la pandemia. Discusión: con base en el análisis, a comienzos de julio 2020 el panorama de respuesta a la pandemia es desalentador en Santander.
Abstract Introduction: the COVID-19 pandemic reached Santander on March 17, 2020. The first cases were imported and related, keeping a low occurrence in general, until the end of May. Since then the cases increased rapidly, consequence of the occupational flexibilization of mid-May and the lack of confinement since June 1. The objective of the study is to provide supplies to decision-makers to improve the response to the pandemic. Materials and methods: An analysis of the behavior of the COVID-19 pandemic in Santander was carried out, using data from official records and analysis of side effects from the public health perspective and a One Health approach. Results: the side effects of the pandemic that do not only affect the health sector are beginning to be evident. The consequences of the day without VAT (June 19) on the occurrence of infected people are still unknown. A preliminary evaluation of the government response in Santander suggests lack of preparation; It is evident the diminished capacity for surveillance in public health, field epidemiology and diagnostic capacity, inability to increase the number of intensive care units, inadequate communication with community, limited capacity for community action, and lack of clarity in intersectoral management of the various manifestations and side effects of the pandemic. Discussion: based on the analysis, in July 2020 the panorama of response to the pandemic is discouraging in Santander.
Subject(s)
Humans , Coronavirus Infections , Pandemics , Social Change , Public Health , Colombia , Disease Notification , Epidemics , Epidemiological Monitoring , Health GovernanceABSTRACT
La contaminación ambiental es un problema creciente que afecta negativamente la salud y tiene un alto costo social y económico, lo que exige una vigilancia articulada de las condiciones y los riesgos ambientales de la exposición y sus efectos en la salud, con el fin de orientar la adopción de decisiones. El objetivo de este ensayo fue describir un eventual sistema de vigilancia de contaminantes ambientales para Colombia y los antecedentes de su diseño. Con base en los lineamientos técnicos de la Organización Panamerica de la Salud, se hizo una revisión bibliográfica y normativa para detectar los elementos clave necesarios y ya existentes en el contexto colombiano, orientados a la formulación de tal sistema. Además, se compararon los elementos estructurales de experiencias exitosas en Latinoamérica. El sistema de vigilancia requiere cinco componentes: la vigilancia epidemiológica, la vigilancia ambiental, la vigilancia biológica-sanitaria, la vigilancia clínica, y la orientación de políticas e intervenciones en salud ambiental. Los factores críticos de éxito son el trabajo interdisciplinario y entre los sectores involucrados y el establecimiento de funciones, actividades, fuentes de datos y flujos de información. La implementación del sistema será eficiente si se aprovechan las iniciativas regionales y las estructuras o herramientas existentes en el país. Las principales entidades implicadas en la creación del sistema, son las comisiones intersectoriales para la salud ambiental y la salud pública, y las instituciones técnicas gubernamentales relacionadas con la investigación y la vigilancia en salud, saneamiento, ambiente, regulación de medicamentos y alimentos. En conclusión, Colombia cuenta con los recursos técnicos y normativos para desarrollar el sistema de vigilancia en salud ambiental. La acción articulada de los diferentes sectores asegura la idoneidad del sistema para orientar acciones costo-efectivas en salud ambiental.
Environmental pollution is a growing problem that negatively impacts health with social and economic high costs. In this sense, coordinated surveillance of conditions, risks, exposures and health effects related to pollution is a useful tool to guide decision-making processes. The objective of this essay was to describe a surveillance system for environmental contaminants in Colombia and its design background. Using the technical guidelines proposed by the Pan American Health Organization, a literature review was conducted to identify the key elements to be included in such surveillance system and to establish which of these elements were already present in the Colombian context. Moreover, these findings were compared with successful experiences in Latin America. The surveillance system includes five components: Epidemiological, environmental and biological surveillance, clinical monitoring and recommendations to guide policies or interventions. The key factors for a successful surveillance system are: interdisciplinary and inter-sector work, clear definition of functions, activities, data sources and information flow. The implementation of the system will be efficient if the structures and tools existing in each country are taken into account. The most important stakeholders are inter-sector public health and environmental commissions and government institutions working in research and surveillance issues related to health, sanitation, environment, drugs and food regulation and control. In conclusion, Colombia has the technical resources and a normative framework to design and implement the surveillance system. However, stakeholders´ coordination is essential to ensure the efficacy of the system so it may guide the implementation of cost-effective actions in environmental health.
Subject(s)
Humans , Environmental Monitoring/methods , Environmental Pollution/prevention & control , ColombiaABSTRACT
É fundamental a promoção de ações em equipe que tragam resultados e impactos no controle das doenças exantemáticas. Para tanto, as informações de saúde devem ter uma retroalimentação, de modo que as medidas sejam efetivas e tenham um controle de qualidade nos dados. O objetivo deste estudo é descrever o perfil das doenças exantemáticas no Distrito Sanitário Barra/Rio Vermelho (DSBRV) no período de 2003 a 2007. Trata-se de um estudo não-experimental e descritivo. Como base de dados foi utilizado o Sistema de Informação de Agravos de Notificação e Tabwin. Para a análise dos dados foi utilizado um instrumento de pesquisa criado com as variáveis de frequência dos casos notificados, classificação final, critério de confirmação ou descarte, distribuição por faixa etária e por sexo. Os resultados evidenciaram que durante o período estudado foram notificados 122 casos suspeitos, sendo 43% do ano 2007, devido ao surto de rubéola no estado da Bahia. Concluiu-se que é necessária a realização de investigação oportuna e adequada dos casos e o seguimento de contatos, de modo a interromper a transmissão das doenças exantemáticas.
It is of vital relevance to promote team work actions that bring results and impacts in the control of measles and rubella. To meet this end, health information must have a feedback, so that the measures are effective and have quality data control. The aim of this study is to describe the profile of measles and rubella in Barra / Rio Vermelho District (DSBRV) in the period from 2003 to 2007. This is a non-experimental and descriptive study. Database used was the Information System for Notifiable Diseases and TABWIN. For data analysis, we used a research tool created with the variables of frequency of reported cases, the final classification, criteria for confirmation or disposal, distribution by age and sex. Results showed that during the study period 122 suspected cases were reported, of which approximately 43% in the year 2007 due to rubella outbreak in the state of Bahia. Therefore, it is necessary to carry out proper investigation of cases and follow-up contacts in order to interrupt transmission of measles and rubella.