ABSTRACT
Resumen Introducción: Actualmente existe un fenómeno inédito para Colombia de migración masiva desde Venezuela que representa grandes retos para la sociedad y el sistema de salud colombiano. Barranquilla es uno de los principales municipios receptores en el norte del país. En esta ciudad, los asentamientos de zonas marginadas están siendo habitados por migrantes venezolanos y colombianos de retorno, a menudo en condiciones de alta vulnerabilidad ambiental y social. Objetivo: El presente estudio realiza una exploración rápida de las necesidades sociales y en salud del asentamiento de Villa Caracas, usando una técnica semi-cualitativa de listados libres para explorar los dominios culturales asociados a tales necesidades. Presentación de caso: Villa Caracas, se encuentra en el Suroccidente de Barranquilla y se cree que la ocupan alrededor de unas 100 familias de venezolanos, sumados a los colombianos de retorno y nativos que nunca se re-ubicaron. Sus habitantes se encuentran en condiciones de vulnerabilidad, pero no se conocen cuáles son las problemáticas más relevantes. Métodos: Se aplicaron 96 listados libres en habitantes de Villa Caracas, a cada sujeto se les interrogó el sexo, la edad, la ocupación, la escolaridad y su estado migratorio. Se hicieron tres preguntas para los listados libres sobre: problemas del asentamiento, problemas de salud, y puntos donde reciben atención en salud. Se calcularon los índices de relevancia de Smith (IRS) para cada dominio. Resultados: En total participaron 96 personas, de los cuales 33 fueron hombres. La edad promedio fue de 31,2 años (SD: 9,6; Rango: 18-65). Del total de la muestra, un 82,3% fueron venezolanos, 8,3% colombianos de retorno y un 9,4% manifestó tener doble nacionalidad. Todos los venezolanos participantes se encontraban en condición migratoria irregular. Se encontraron como principales necesidades sociales percibidas las siguientes: alcantarillado (Índice de relevancia de Smith (IRS): 0,38), agua potable (IRS: 0,31) y fluido eléctrico (IRS: 0,30). Por otro lado, con respecto a los problemas de salud, resaltaron: infección respiratoria aguda (IRS: 0,39) y fiebre no especificada (0,20). Todos los habitantes refirieron no ser atendidos por ser venezolanos. Conclusiones: La aproximación permite destacar las condiciones de vulnerabilidad de los migrantes siendo un punto de partida para un diagnóstico más detallado que permita el desarrollo de planes de respuesta del nivel local. En particular, sobre el saneamiento ambiental como el principal problema del asentamiento que genera un riesgo potencial para la transmisión de diversas enfermedades infecciosas.
Abstract Introduction: An unreported phenomenon currently exists in Colombia, namely, massive emigration from Venezuela that is presenting a great challenge for Colombia's society and health system. Barranquilla is one of the principal recipient municipalities in northern Colombia. Venezuelan emigrants and returning Colombians are settling in this city's marginal zones, frequently under highly vulnerable environmental and social conditions. Objective: The present study is a brief exploration of the social and health needs in the Villa Caracas settlement. It is based on a semi-qualitative technique using free lists to explore the cultural domains associated with these needs. Presentation of Case: Villa Caracas is in southwestern Barranquilla, where roughly 100 Venezuelan families are believed to reside, in addition to returning and native Colombians who never relocated. While the inhabitants live in vulnerable conditions, the most important problems are not known. Methods: A total of 96 free lists were administered to inhabitants in Villa Caracas. Each subject was asked their sex, age, occupation, schooling, and migration status. The free lists included three questions: problems with the settlement, health problems, and where they go for medical care. Smith's salience index was calculated for each domain. Results: A total of 96 persons participated, 33 of which were men. The average age was 31.2 years (s.d. 9.6; range 18-65). Of the total sample, 82.3% were Venezuelan, 8.3% were returning Colombians, and 9.4% reported having dual nationality. All of the participating Venezuelans had an irregular migration status. The principal perceived social needs were: sewer systems (Smith´s salience Index (SSI): 0.38), drinking water (SSI: 0.31), and electricity (SSI: 0.30). With regard to health problems, those that stood out were acute respiratory infection (SSI: 0.39) and unspecified fever (SSI: 0.20). All of the inhabitants reported that they were not treated due to being Venezuelan. Conclusions: This approach made it possible to highlight the vulnerable conditions of the immigrants, serving as a starting point for a more in-depth diagnostic which will enable developing a local response plan, especially with regard to environmental sanitation since this was the principal problem in the settlement and it poses a potential risk for the transmission of various infectious diseases.
Subject(s)
Humans , Emigration and Immigration , Venezuela , Environmental Health , Public Health , Colombia , Social Determinants of HealthABSTRACT
BACKGROUND: An outbreak of Guillain-Barré syndrome (GBS), a disorder characterized by acute, symmetric limb weakness with decreased or absent deep-tendon reflexes, was reported in Barranquilla, Colombia, after the introduction of Zika virus in 2015. We reviewed clinical data for GBS cases in Barranquilla and performed a case-control investigation to assess the association of suspect and probable Zika virus disease with GBS. METHODS: We used the Brighton Collaboration Criteria to confirm reported GBS patients in Barranquilla during October 2015-April 2016. In April 2016, two neighborhood and age range-matched controls were selected for each confirmed GBS case-patient. We obtained demographics and antecedent symptoms in the 2-month period before GBS onset for case-patients and the same period for controls. Sera were collected for Zika virus antibody testing. Suspected Zika virus disease was defined as a history of rash and ≥2 other Zika-related symptoms (fever, arthralgia, myalgia, or conjunctivitis). Probable Zika virus disease was defined as suspected Zika virus disease with laboratory evidence of a recent Zika virus or flavivirus infection. Conditional logistic regression adjusted for sex and race/ethnicity was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: We confirmed 47 GBS cases. Incidence increased with age (10-fold higher in those ≥60years versus those <20years). We interviewed 40 case-patients and 79 controls. There was no significant difference in laboratory evidence of recent Zika virus or flavivirus infection between case-patients and controls (OR: 2.2; 95% CI: 0.9-5.1). GBS was associated with having suspected (OR: 3.0, 95% CI: 1.1-8.6) or probable Zika virus disease (OR: 4.6, CI: 1.1-19.0). CONCLUSIONS: Older individuals and those with suspected and probable Zika virus disease had higher odds of developing GBS. KEY POINTS: We confirmed a Guillain-Barré syndrome (GBS) outbreak in Barranquilla, Colombia, during October 2015-April 2016. A case-control investigation using neighborhood controls showed an association of suspected and probable Zika virus disease with GBS.
