RESUMEN
Introducción: Los brotes recurrentes de dengue subrayan la necesidad de abordajes más efectivos en la prevención y control de vectores. A menudo, las intervenciones se centran en un enfoque biomédico y de promoción de la salud desde un enfoque individual, sin integrar factores socioambientales ni ser evaluados científicamente Objetivo: Evaluar el impacto de la recolección de residuos domésticos de gran tamaño sobre potenciales criaderos de mosquitos transmisores del dengue en Asunción, Paraguay durante los años 2017 a 2021. Material y métodos: Estudio cuasiexperimental, longitudinal, donde se encuestaron 350 hogares, como línea de base durante el 2017 y una línea de cierre en 108 hogares en 2021. Se utilizó el método de Diferencia en Diferencia (DID) para comparar la presencia de criaderos antes y después de la intervención en 43 hogares intervenidos y 65 no intervenidos. Resultados: La recolección diferenciada fue utilizada principalmente por aquellos hogares que tenían una gran cantidad de residuos sólidos de gran tamaño, pero no para deshacerse de todos estos objetos, sino sólo de una parte (DID de -52% en el número total de criaderos y DID de 1% en número de hogares con criaderos). Encontramos una reducción significativa en el número de total de criaderos de gran tamaño, pero no observamos diferencias en el número total de hogares con criaderos. Factores subjetivos, como la creencia de que los objetos en desuso podrían llegar a ser útiles en el futuro explicaban en gran medida su presencia en los hogares, incluso con el servicio disponible. Conclusiones: El enfoque de la gestión municipal en los residuos voluminosos puede contribuir a la prevención del dengue por el hecho de que no constituyen residuos de generación rápida en los hogares, y su eliminación puede tener un impacto relativamente duradero. El factor subjetivo relacionado con la presencia de estos criaderos en los hogares debe ser objeto de mayores estudios.
Introduction: Recurrent dengue outbreaks underscore the need for more effective approaches to vector prevention and control. Often, interventions focus on a biomedical and health promotion approach from an individual approach, without integrating socio-environmental factors or being scientifically evaluated. Objetive: To evaluate the impact of large household waste collection on potential breeding sites of dengue-transmitting mosquitoes in Asuncion, Paraguay during the years 2017 to 2021. Material and methods: Quasi-experimental, longitudinal study, where 350 households were surveyed, as a baseline during 2017 and a closing line in 108 households in 2021. The Difference-in-Difference (DID) method was used to compare the presence of breeding sites before and after the intervention in 43 intervened and 65 non-intervened households. Results: Differentiated collection was mainly used by those households that had a large amount of large solid waste, but not to dispose of all these objects, but only part of them (DID of -52% in the total number of breeding sites and DID of 1% in the number of households with breeding sites). We found a significant reduction in the total number of large breeding sites but did not observe differences in the total number of households with breeding sites. Subjective factors, such as the belief that disused objects could become useful in the future, were largely responsible for the reduction in the number of large breeding sites. Conclusions: The municipal management approach to bulky waste can contribute to dengue prevention because it does not constitute rapidly generated waste in households, and its disposal can have a relatively long-lasting impact. The subjective factors related to the presence of these breeding sites in households warrant further study.
RESUMEN
AIM: To describe the pattern of use of the Internet as a source of health information by participants of antenatal classes. Background. There is a lack of information about the frequency of Internet use amongst expectant mothers and fathers who attend antenatal classes. DESIGN: A cross-sectional descriptive study. METHODS: Women (n = 114) and men (n = 21) were recruited. Data were collected anonymously using a self-administered questionnaire, containing questions about Internet use, the frequency of that use, sources of information about pregnancy, preference over other non-Internet sources, positive and negative feelings generated due to the use of the Internet and willingness to receive instructions on Internet use. RESULTS: The average age of participants was 31·4 (SD 6·1) and their stage of pregnancy ranged from 24-38 weeks. 83·5% were expecting their first child. 93·5% reported that they used the Internet on a regular basis and no significant difference was found between men and women. Amongst Internet users, 97·7% sought, at some point, information on pregnancy on the Internet and 26·9% had done so in the last 24 hours. The Internet was the most popular source of information on pregnancy topics (18·5% of women and 25·8% of men used it as their primary source of information) after a physician. Commercial websites were more frequently used by people looking for information on pregnancy than sites maintained by not-for-profit organisations or professional unions. CONCLUSIONS: The Internet is widely used as a source of information amongst participants of antenatal classes, both male and female. Approximately 95% have used it at some point to find information during pregnancy, but the majority (approximately 90%) had no knowledge of websites run by not-for-profit organisations and preferred commercial websites. Relevance to clinical practice. Instead of disregarding the use of the Internet as a source of information during pregnancy, midwives should keep up to date and give their patients links to high-quality sites.