Estrategias para la eliminación de malaria: una perspectiva afro-colombiana / Strategies for malaria elimination: an Afro-Colombian perspective

RESUMEN Objetivo Describir las estrategias para la eliminación de la malaria a partir de la percepción de pobladores afro-colombianos residentes en Guapi en el contexto de la Estrategia de Gestión Integrada para la promoción, prevención y control de las Enfermedades Transmitidas por Vectores en Colombia (EGI). Métodos Estudio de tipo cualitativo basado en el análisis de discurso de grupos focales. Ocho participantes residentes en zona urbana de Guapi, divididas en dos grupos: el primero correspondió a tres mujeres auxiliares de enfermería, denominadas "mujeres con mayor experiencia", trabajadoras en el actual sistema de salud y funcionarias del antiguo Servicio de Erradicación de la Malaria. El segundo correspondió a cinco mujeres auxiliares de enfermería, denominadas "mujeres con limitada experiencia", trabajadoras en el actual sistema de salud y no tuvieron formación directa con el programa de malaria. Análisis inductivo e interpretativo. Resultados Emergieron ocho subcategorias enmarcadas en la EGI, con énfasis en la promoción y prevención orientadas a disminuir la malaria, especialmente en el área rural. El abordaje del problema debe hacerse de forma integral incluyendo otras problemáticas en salud y determinantes sociales que los afectan como: saneamiento básico, acceso al servicio de salud, falta de educación, uso de tratamientos populares, fragilidad de infraestructura, entre otros. Conclusión Las participantes consideran que la malaria en Guapi se puede reducir pero no eliminar. Se requiere abordar este problema desde una perspectiva institucional y comunitaria, teniendo en cuenta las diferencias culturales, a partir de estrategias que incluyan el empoderamiento comunitario y fortalecimiento administrativo e institucional del programa.(AU)

ABSTRACT Objective To describe strategies for malaria elimination based on the perception of Afro-Colombian residents in Guapi, in the context of the Integrated Management Strategy for the Promotion, Prevention and Control of Vector-Borne Diseases in Colombia (EGI-ETV). Materials and Methods Qualitative study based on focus group discourse analysis. Eight participants from the urban area of Guapi were divided into two groups. The first group included three female nursing assistants, and was called "women with more experience"; they were workers in the current health system and former Malaria Eradication Service officers. The second group was made up of female nursing assistants, and was called "women with limited experience"; they were workers in the current health system and were not directly trained in the malaria program. An inductive and interpretative analysis was performed. Results Eight subcategories emerged, framed in the EGI-EVT, making emphasis on promotion and prevention aimed at reducing malaria, especially in rural areas. This problem must be addressed comprehensively, including other health issues and social determinants that affect them, such as: basic sanitation, access to health services, lack of education, use of popular treatments, and lack of infrastructure, among others. Conclusion Participants consider that malaria in Guapi can be reduced but not eliminated. This problem needs to be addressed from an institutional and community perspective, taking into account cultural differences, based on strategies that include community empowerment and administrative and institutional strengthening of the program.(AU)

Potential impact of climatic variability on the epidemiology of dengue in Risaralda, Colombia, 2010 - 2011

Dengue continues to be the most important viral vector-borne disease in the world, particularly in Asia and Latin America, and is significantly affected by climate variability. The influence of climate in an endemic region of Colombia, from 2010 to 2011, was assessed. Epidemiological surveillance data [weekly cases] were collected, and incidence rates were calculated. Poisson regression models were used to assess the influence of the macroclimatic variable ONI [Oscillation Nino Index] and the microclimatic variable pluviometry [mm of rain for Risaralda] on the dengue incidence rate, adjusting by year and week. During the study period, 13,650 cases were reported. In 2010, the rates ranged from 8.6 cases/100,000 pop. up to a peak of 75.3 cases/100,000 pop. for a cumulative rate of 456.2 cases/100,000 pop. in that week. The climate variability in 2010 was higher [ONI 1.6, El Nino to -1.5, La Nina] than in 2011 [ONI -1.4, La Nina to -0.2, Neutral]. The mean pluviometry was 248.45 mm [min 135.9-max 432.84]. During El Nino, cases were significantly higher [mean 433.81] than during the climate neutral period [142.48] and during the La Nina [52.80] phases [ANOVA F = 66.59; p < 0.001]. Regression models showed that the ONI [coefficient 0.329; 95%CI 0.209-0.450] and pluviometry [coefficient 0.003; 95%CI 0.002-0.004] were highly significant independent variables associated with dengue incidence rate, after adjusting by year and week [p < 0.001, pseudo r[2] = 0.6913]. El Nino significantly affected the incidence of dengue in Risaralda. This association with climate change and variability should be considered in the elements influencing disease epidemiology. In addition, predictive models should be developed further with more available data from disease surveillance

Malformaçäo arteiovenosa vullvar: a propósito de um caso / congenital arteiovenous malformations: case report

Um caso de malformaçÝo arteriovenosa numa adolescente de 17 anos é relatado. essa anomalia congênita rara se apresentou como aumento de volume em grande lábio vaginal direito associado a desconforto local sem outras sintomatologias. após investigaçÝo diagnóstica, submeteu-se a embolizaçÝo transcateter com excelente resultado. devido a raridade desta desordem vascular descrita na literatura optou-se pelo presete relato