ABSTRACT
Natural disasters with minimal human mortality rarely capture headlines but occur frequently and result in significant morbidity and economic loss. We compared the epidemic activity observed after a flood, an earthquake, and volcanic activity in Peru. Following post-disaster guidelines, healthcare facilities and evacuation centers surveyed 10-12 significant health conditions for ~45 days and compared disease frequency with Poisson regression. The disasters affected 20,709 individuals and 15% were placed in evacuation centers. Seven deaths and 6,056 health conditions were reported (mean: 0.29 per person). Health facilities reported fewer events than evacuation centers (0.06-0.24 vs. 0.65-2.02, P < 0.001) and disease notification increased 1.6 times after the disasters (95% CI: 1.5-1.6). Acute respiratory infections were the most frequent event (41-57%) and psychological distress was second/third (7.6% to 14.3%). Morbidity increased after disasters without substantial casualties, particularly at evacuation centers, with frequent respiratory infections and psychological distress. Post-disaster surveillance is valuable even after low-mortality events.
ABSTRACT
Objetivos. Conocer el cuadro clínico, formas de diagnóstico y tratamiento de los pacientes que presentan el síndrome conocido como chacho y cuál es su prevalencia sentida en cinco distritos de Ayacucho. Materiales y métodos. Estudio cuali-cuantitativo, que incluyó dos grupos de participantes, el primero (95) fueron pobladores o familiares de éstos, que alguna vez en su vida presentaron chacho, el segundo grupo (11) constituido por curanderos de cada comunidad. Resultados. El chacho (alcanzo, hapiruzqa en quechua), se considera como una enfermedad de origen mágico, caracterizada por presentar fiebre, malestar general, rechazo a algunos derivados lácteos y carne de chancho; en la mayoría de los pacientes se menciona el antecedente de descanso cercano a un cerro o dormir en el suelo (tierra). El tiempo de duración de la enfermedad fue menor de una semana en promedio y se evidenció que el tratamiento incluye, el consumo de gasolina, creso, kerosene, así como el pagapo (pago a la tierra). El consumo de medicamentos agrava la condición de salud del paciente. La prevalencia sentida varió entre 9,1 a 38,0 casos por mil habitantes y la mortalidad sentida entre 3,8 a 16,8 por diez mil habitantes. Conclusiones. El chacho es un síndrome cultural vigente, que debeser reconocido y abordado por el personal de salud, brindándonos así la oportunidad, de armonizar los conocimientos ancestrales de la medicina tradicional con los biomédicos actuales.
Objectives. Knowing the clinical features, diagnose and treatment for patients with the syndrome mean as chacho and what is its perceived prevalence in five districts of Ayacucho (Peruvian Central Andes). Material and methods. Qualiquantitative study, which included two groups of participants, the first (95) were residents or relatives of those who have ever had in your life chacho, the second group (11) formed by traditional healers of every community. Resultados. Chacho (alcanzo, hapiruzqa in quechua), is regarded as a disease of magical origin, characterized by fever, malaise, rejection of some dairy products and pork, in most patients referred the antecedent of a to rest near hill or sleep on the floor (ground ). The duration of the disease was less than a week on average and it was shown that treatment includes the consumption of gasoline, creso (disinfectant), kerosene, as well as the pagapo (Andean ritual of payment to the ground). The consumption of drugs worsens the health condition of patients. Perceived prevalence ranged between 9.1 to 38.0 cases per thousand people habitants, and perceived mortality from 3.8 to 16.8 per ten thousand habitants. Conclusions. Chacho is a present cutlural syndrome, which must be recognized and addressed by health personnel, thus giving them the opportunity to bring the ancestral knowledge of traditional medicine with the current biomedical.
Subject(s)
Humans , Cultural Diversity , Medicine, Traditional , Treatment Refusal , PeruABSTRACT
Outbreaks of rapidly growing mycobacteria have been occasionally described. The article reports an outbreak of cutaneous abscesses due to Mycobacterium chelonae following mesotherapy in Lima, Peru. From December 2004 through January 2005, 35 subjects who had participated in mesotherapy training sessions presented with persistent cutaneous abscesses. Thirteen (37 percent) of these suspected cases consented to underwent clinical examination. Skin punch-biopsies were collected from suspicious lesions and substances injected during mesotherapy were analyzed. Suspected cases were mainly young women and lesions included subcutaneous nodules, abscesses and ulcers. Mycobacterium chelonae was isolated from four patients and from a procaine vial. In conclusion, it is important to consider mesotherapy as a potential source of rapidly growing mycobacteria infections.
Surtos de micobactérias de crescimento rápido têm sido relatados ocasionalmente. O estudo relata um surto de abscessos cutâneos por Mycobacterium chelonae após sessões de mesoterapia em Lima, Peru. De dezembro de 2004 a janeiro de 2005, 35 pessoas que haviam passado por sessões de mesoterapia apresentaram esses abscessos cutâneos. Treze (37 por cento) desses casos suspeitos concordaram em realizar exames clínicos. Foram realizadas biópsias de punção de pele de lesões suspeitas e examinadas substâncias injetadas durante a mesoterapia. Os casos suspeitos eram predominantemente mulheres jovens e as lesões incluíram nódulos subcutâneos, abscessos e úlceras. Mycobacterium chelonae foi isolada de quatro pacientes e de um frasco de procaína. Em conclusão, é importante considerar a mesoterapia como fonte potencial de infecções de micobactérias de crescimento rápido.
Subject(s)
Mycobacterium Infections , Mycobacterium chelonae , Disease Outbreaks , PeruABSTRACT
Outbreaks of rapidly growing mycobacteria have been occasionally described. The article reports an outbreak of cutaneous abscesses due to Mycobacterium chelonae following mesotherapy in Lima, Peru. From December 2004 through January 2005, 35 subjects who had participated in mesotherapy training sessions presented with persistent cutaneous abscesses. Thirteen (37%) of these suspected cases consented to undergo clinical examination. Skin punch-biopsies were collected from suspicious lesions and substances injected during mesotherapy were analyzed. Suspected cases were mainly young women and lesions included subcutaneous nodules, abscesses and ulcers. Mycobacterium chelonae was isolated from four patients and from a procaine vial. In conclusion, it is important to consider mesotherapy as a potential source of rapidly growing mycobacteria infections.
