ABSTRACT
INTRODUCTION: Community dermatology (CD) is integrated by dermatologists, epidemiologists and interested people. It has 27 years of experience at the Guerrero State. Due to unsafety issues, the teaching and medical attention model had to be changed from presential to virtual trough telemedicine. METHOD: Transversal, descriptive, observational and analytic study, in which results from teaching-learning of the health personal that was capacitated throughout the telemedicine network at the Guerrero State were evaluated, during nine courses that reached 35 telemedicine centers. RESULTS: 2465 health workers were capacitated in basic dermatology, which were evaluated in their general knowledge of dermatology before and after every course. The utility of this modality of teaching was statistically evaluated with a random simple in 611 attendees with satisfactory results. DISCUSSION: Teaching through telemedicine network, represents an improvement for CD by reaching a higher number of attendees to several reception centers simultaneously, minimizing transportation expenses and improving the safety of the participants at the activities, with the advantage of allowing continuity of the CD purposes.
INTRODUCCIÓN: La dermatología comunitaria (DC) está integrada por dermatólogos, epidemiólogos y personal afín. Tiene 27 años de existencia en el Estado de Guerrero. Por condiciones de inseguridad se cambió el modelo presencial de enseñanza y atención dermatológica a la forma virtual, a través de teledermatología. OBJETIVO: Determinar la utilidad de la capacitación y enseñanza virtual a través de la telemedicina en DC. MÉTODO: Estudio transversal, descriptivo, observacional y analítico, en el que se evaluaron los resultados de la enseñanza-aprendizaje en el personal de salud capacitado por la red de telemedicina mediante nueve cursos que llegaron a 35 centros de telemedicina en el Estado de Guerrero. RESULTADOS: Se capacitó en dermatología básica a 2465 trabajadores de la salud, evaluando sus conocimientos antes y después de cada curso. Se validó estadísticamente la utilidad de esta modalidad de enseñanza con una muestra al azar de 611 asistentes, con resultados satisfactorios. DISCUSIÓN: La enseñanza a través de la red de telemedicina representa un avance en DC al llegar a un mayor número de asistentes en varios centros de recepción en forma simultánea, minimizando los gastos de transporte y salvaguardando la integridad de los participantes, con la ventaja de dar continuidad a los propósitos de DC.
Subject(s)
Community Health Services/organization & administration , Dermatology/education , Health Personnel/education , Telemedicine/organization & administration , Cross-Sectional Studies , Dermatology/organization & administration , Humans , Mexico , Primary Health Care/organization & administrationABSTRACT
BACKGROUND: Understanding the breeding patterns of Aedes aegypti in households and the factors associated with infestation are important for implementing vector control. The baseline survey of a cluster randomised controlled trial of community mobilisation for dengue prevention in Mexico and Nicaragua collected information about the containers that are the main breeding sites, identified possible actions to reduce breeding, and examined factors associated with household infestation. This paper describes findings from the Mexican arm of the baseline survey. METHODS: In 2010 field teams conducted household surveys and entomological inspections in 11,995 households from 90 representative communities in the three coastal regions of Guerrero State, Mexico. We characterized Ae. aegypti breeding sites and examined the effect of two preventive measures: temephos application in water containers, and keeping the containers covered. We examined associations with household infestation, using bivariate and multivariate analysis adjusted for clustering effects. RESULTS: We conducted entomological inspections in 11,995 households. Among 45,353 water containers examined, 6.5% (2958/45,353) were positive for larvae and/or pupae. Concrete tanks (pilas) and barrels (tambos) together accounted for 74% of pupal productivity. Both covering water containers and inserting temephos were independently associated with a lower risk of presence of larvae or pupae, with the effect of covering (OR 0.22; 95% CIca 0.15-0.27) stronger than that of temephos (OR 0.66; 95% CIca 0.53-0.84). Having more than four water containers was associated with household infestation in both rural areas (OR 1.42; 95% CIca 1.17-1.72) and urban areas (1.81; 1.47-2.25), as was low education of the household head (rural: 1.27; 1.11-1.46, and urban: 1.39; 1.17-1.66). Additional factors in rural areas were: household head without paid work (1.31; 1.08-1.59); being in the Acapulco region (1.91; 1.06-3.44); and using anti-mosquito products (1.27; 1.09-1.47). In urban areas only, presence of temephos was associated with a lower risk of household infestation (0.44; 0.32-0.60). CONCLUSION: Concrete tanks and barrels accounted for the majority of pupal productivity. Covering water containers could be an effective means of Ae. aegypti vector control, with a bigger effect than using temephos. These findings were useful in planning and implementing the Camino Verde trial intervention in Mexico.
