[Health-related needs of the displaced population due to armed conflict in Bogotá]. / Necesidades en salud de la población desplazada por conflicto armado en Bogotá.

BACKGROUND: The displacement of populations as the result of an armed conflict generally entails a worsening of the living and health conditions of those undergoing such a displacement. This paper is aimed at analyzing the health-related needs perceived by men and women displaced by the armed conflict and their main strategies to address those needs. METHODS: A qualitative study was carried out by means of semi-structured individual interviews to 31 displaced men and women in the transition stage. A narrative analysis of the contents was conducted, segmenting the information by age and sex. The area under study was made up of five localities in the city of Bogotá. RESULTS: The negative effects on their mental health and psychosocial stability, access to food and, to a lesser degree, gastrointestinal and respiratory disorders, are the main health problems reported by both groups of informants. The difficulty of accessing health care services comes up as an added problem. The precarious economic situation underlies the health care-related needs and problems. To solve their health problems, in addition to the health care services, they employ other strategies within their reach. Expressed needs are coherent with the problems perceived. Some differences between women and men and age groups were observed concerning the definition of the problems and employed strategies. CONCLUSION: In the health field, actions are required in order to improve their access to services in addition to specific strategies for the psychosocial rehabilitation of the displaced population which take into account the differences existing within this group.

Pulmonary tuberculosis in the border region of Chiapas, Mexico.

OBJECTIVES: To estimate the prevalence of pulmonary tuberculosis (PTB) in chronic cough patients seeking care at a second level hospital for any complaint, and to identify groups more likely to test TB smear-positive, within the Border Region of Chiapas, Mexico. METHODS: Active case finding of patients with chronic cough (cough of 15 days or more) was carried out among all patients aged over 14 years seeking care for whatever reason in the only hospital in the region for patients not covered by insurance. The coughers identified (n=221) were interviewed and three sputum samples requested for acid-fast smears. In order to identify groups at greater risk a logistic regression model was constructed. RESULTS: A rate of 21 positive PTB smears per hundred patients was found (95% Confidence Interval [CI]=15.5-26.6). The main factors associated with positive PTB were age, occupation and weight loss. The subgroup of chronic cough patients of those aged 35-44 years, agricultural workers and those who had lost weight, had the greatest likelihood of positive PTB smears (68.7%). CONCLUSION: In hospitals that treat rural patients, special efforts should be made to make health personnel more aware of the need to investigate respiratory symptoms in all of their patients, particularly in the subgroups identified with the greatest likelihood of being positive for TB.

[Social welfare and health services in the Fraylesca Region in Chiapas: the use of prenatal care services]. / Bienestar social y servicios de salud en la Región Fraylesca de Chiapas: el uso de servicios de atención prenatal.

OBJECTIVE: To analyze the use of antenatal care services (ACS) in the Fraylesca Region of Chiapas, Mexico, and to identify groups with lower probability of receiving ACS. MATERIAL AND METHODS: In 1994, a health survey was performed on a random sample of 1,100 households, which compiled sociodemographic information and on the use of ACS during the last pregnancy within the two years previous to the study (n = 297 women from 15 to 49 years of age). The groups with lower probability of receiving adequate ACS (5 or more visits) were identified with a log-linear model. RESULTS: Forty-two percent of women received inadequate ACS (0 to 4 visits). Women with better socioeconomic status had higher probability of using ACS adequately than women with lower socioeconomic status: OR 2.47 (Cl 95% 1.12-5.44). CONCLUSIONS: Results provide evidence of the need to improve the quality of ACS, to support the traditional midwives and to improve living conditions of the population.