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1.

Impacto económico del tabaquismo en los sistemas de salud de América Latina: un estudio en siete países y su extrapolación a nivel regional/ Financial impact of smoking on health systems in Latin America: A study of seven countries and extrapolation to the regional level

Pichon-Riviere, Andrés; Bardach, Ariel; Augustovski, Federico; Alcaraz, Andrea; Reynales-Shigematsu, Luz Myriam; Pinto, Márcia Teixeira; Castillo-Riquelme, Marianela; Torres, Esperanza Peña; Osorio, Diana Isabel; Huayanay, Leandro; Munarriz, César Loza; de Miera-Juárez, Belén Sáenz; Gallegos-Rivero, Verónica; Puente, Catherine De La; Navia-Bueno, María del Pilar; Caporale, Joaquín
| Idioma(s): Español
RESUMEN Objetivo Estimar los costos médicos directos atribuibles al tabaquismo en los sistemas de salud de América Latina. Métodos Se utilizó un modelo de microsimulación para cuantificar el impacto económico en enfermedad cardiovascular y cerebrovascular, enfermedad pulmonar obstructiva crónica (EPOC), neumonía, cáncer de pulmón y otras nueve neoplasias. Se realizó una búsqueda sistemática de datos epidemiológicos y de costos de los eventos. El modelo se calibró y validó para Argentina, Bolivia, Brasil, Chile, Colombia, México y Perú, países que representan el 78% de la población de América Latina; luego se extrapolaron los resultados a nivel regional. Resultados Cada año el tabaquismo es responsable de 33 576 millones de dólares en costos directos para el sistema de salud. Esto equivale a 0,7% del producto interno bruto (PIB) de la región y a 8,3% del presupuesto sanitario. La enfermedad cardiovascular, la EPOC y el cáncer fueron responsables de 30,3%, 26,9% y 23,7% de este gasto, respectivamente. El costo atribuible al tabaquismo varió entre 0,4% (México y Perú) y 0,9% (Chile) del PIB y entre 5,2% (Brasil) y 12,7% (Bolivia) del gasto en salud. En la región, la recaudación impositiva por la venta de cigarrillos apenas cubre 37% del gasto sanitario atribuible al tabaquismo (8,1% en Bolivia y 67,3% en Argentina). Conclusiones El tabaquismo es responsable de una importante proporción del gasto sanitario en América Latina, y la recaudación impositiva por la venta de cigarrillos está lejos de llegar a cubrirlo. La profundización de medidas como el aumento de impuestos al tabaco debería ser seriamente considerada por los países de la región. ABSTRACT Objective Estimate smoking-attributable direct medical costs in Latin American health systems. Methods A microsimulation model was used to quantify financial impact of cardiovascular and cerebrovascular disease, chronic obstructive pulmonary disease (COPD), pneumonia, lung cancer, and nine other neoplasms. A systematic search for epidemiological data and event costs was carried out. The model was calibrated and validated for Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, and Peru, countries that account for 78% of Latin America’s population; the results were then extrapolated to the regional level. Results Every year, smoking is responsible for 33 576 billion dollars in direct costs to health systems. This amounts to 0.7% of the region’s gross domestic product (GDP) and 8.3% of its health budget. Cardiovascular disease, COPD, and cancer were responsible for 30.3%, 26.9%, and 23.7% of these expenditures, respectively. Smoking-attributable costs ranged from 0.4% (Mexico and Peru) to 0.9% (Chile) of GDP and from 5.2% (Brazil) to 12.7% (Bolivia) of health expenditures. In the region, tax revenues from cigarette sales barely cover 37% of smoking-attributable health expenditures (8.1% in Bolivia and 67.3% in Argentina). Conclusions Smoking is responsible for a significant proportion of health spending in Latin America, and tax revenues from cigarette sales are far from covering it. The region’s countries should seriously consider stronger measures, such as an increase in tobacco taxes.
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2.

Pathways from education to fertility decline: a multi-site comparative study.

Snopkowski, Kristin; Towner, Mary C; Shenk, Mary K; Colleran, Heidi
| Idioma(s): Inglés
Women's education has emerged as a central predictor of fertility decline, but the many ways that education affects fertility have not been subject to detailed comparative investigation. Taking an evolutionary biosocial approach, we use structural equation modelling to examine potential pathways between education and fertility including: infant/child mortality, women's participation in the labour market, husband's education, social network influences, and contraceptive use or knowledge across three very different contexts: Matlab, Bangladesh; San Borja, Bolivia; and rural Poland. Using a comparable set of variables, we show that the pathways by which education affects fertility differ in important ways, yet also show key similarities. For example, we find that across all three contexts, education is associated with delayed age at first birth via increasing women's labour-force participation, but this pathway only influences fertility in rural Poland. In Matlab and San Borja, education is associated with lower local childhood mortality, which influences fertility, but this pathway is not important in rural Poland. Similarities across sites suggest that there are common elements in how education drives demographic transitions cross-culturally, but the differences suggest that local socioecologies also play an important role in the relationship between education and fertility decline.
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3.

Progress in reducing inequalities in reproductive, maternal, newborn,' and child health in Latin America and the Caribbean: an unfinished agenda/ Avances en la reducción de las desigualdades en materia de salud reproductiva, materna, neonatal e infantil en América Latina y el Caribe: un programa inacabado

Restrepo-Méndez, María Clara; Barros, Aluísio J. D.; Requejo, Jennifer; Durán, Pablo; Serpa, Luis Andrés de Francisco; França, Giovanny V. A.; Wehrmeister, Fernando C.; Victora, Cesar G.
| Idioma(s): Inglés
OBJECTIVE: To expand the "Countdown to 2015" analyses of health inequalities beyond the 75 countries being monitored worldwide to include all countries in Latin America and the Caribbean (LAC) that have adequate data available. METHODS: Demographic and Health Surveys and Multiple Indicator Cluster Surveys were used to monitor progress in health intervention coverage and inequalities in 13 LAC countries, five of which are included in the Countdown (Bolivia, Brazil, Guatemala, Haiti, and Peru) and eight that are not (Belize, Colombia, Costa Rica, Dominican Republic, Guyana, Honduras, Nicaragua, and Suriname). The outcomes included neonatal and under-5 year mortality rates, child stunting prevalence, and the composite coverage index-a weighted average of eight indicators of coverage in reproductive, maternal, newborn, and child health. The slope index of inequality and concentration index were used to assess absolute and relative inequalities. RESULTS: The composite coverage index showed monotonic patterns over wealth quintiles, with lowest levels in the poorest quintile. Under-5 and neonatal mortality as well as stunting prevalence were highest among the poor. In most countries, intervention coverage increased, while under-5 mortality and stunting prevalence fell most rapidly among the poor, so that inequalities were reduced over time. However, Bolivia, Guatemala, Haiti, Nicaragua, and Peru still show marked inequalities. Brazil has practically eliminated inequalities in stunting. CONCLUSIONS: LAC countries presented substantial progress in terms of reducing inequalities in reproductive, maternal, newborn, and child health interventions, child mortality, and nutrition. However, the poorest 20% of the population in most countries is still lagging behind, and renewed actions are needed to improve equity. OBJETIVO: Extender los análisis de la "Cuenta Regresiva para 2015" de las desigualdades en materia de salud más allá de los 75 países sometidos a vigilancia en todo el mundo para incluir a todos los países de América Latina y el Caribe (ALC) que disponen de datos adecuados. MÉTODOS: Se utilizaron encuestas de demografía y salud y encuestas agrupadas de indicadores múltiples para vigilar el progreso de la cobertura de las intervenciones de salud y de las desigualdades en 13 países de ALC, 5 de ellos incluidos en la Cuenta Regresiva (Bolivia, Brasil, Guatemala, Haití y Perú) y 8 no incluidos (Belice, Colombia, Costa Rica, Guyana, Honduras, Nicaragua, República Dominicana y Suriname). Los resultados incluyeron las tasas de mortalidad neonatal y en menores de 5 años, la prevalencia del retraso del crecimiento en niños y el índice compuesto de cobertura (un promedio ponderado de 8 indicadores de cobertura en materia de salud reproductiva, materna, neonatal e infantil. Para evaluar las desigualdades absolutas y relativas, se emplearon el índice de desigualdad de la pendiente y el índice de concentración. RESULTADOS: El índice compuesto de cobertura mostró patrones monotónicos en función de los quintiles de riqueza, con los niveles más bajos en el quintil más pobre. La mortalidad neonatal y en menores de 5 años, así como la prevalencia del retraso del crecimiento, fueron más elevadas entre los pobres. En la mayor parte de los países aumentó la cobertura de las intervenciones, mientras que la mortalidad en menores de 5 años y la prevalencia del retraso del crecimiento disminuyeron más rápidamente entre los pobres, de manera que las desigualdades se redujeron con el transcurso del tiempo. Sin embargo, en Bolivia, Guatemala, Haití, Nicaragua y Perú aún se observan marcadas desigualdades. Brasil prácticamente ha eliminado las desigualdades en cuanto a retraso del crecimiento. CONCLUSIONES: Los países de ALC mostraron avances considerables en la reducción de las desigualdades con respecto a las intervenciones de salud reproductiva, materna, neonatal e infantil, y en materia de mortalidad y nutrición infantil. Sin embargo, el 20% más pobre de la población en la mayor parte de los países sigue quedándose a la zaga, y son necesarias iniciativas renovadas para mejorar la equidad.
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4.

Aspectos interculturales de la reforma del sistema de salud en Bolivia/ Intercultural aspects of the health system reform in Bolivia

Ramírez Hita, Susana
| Idioma(s): Español
Este artículo es una reflexión sobre cómo la interculturalidad entendida como el camino para mejorar la salud de la población boliviana, unida al concepto de vivir bien, no está contribuyendo a la mejora de la calidad de vida y de salud de las poblaciones más vulnerables del país. El discurso va unido a la intención de salvar la vida en su más amplio sentido, sin embargo, para ello es necesario la toma de decisiones sobre la salud ambiental y la política extractivista que no son tomados en cuenta en los problemas de salud que afectan a las pueblos indígenas, población a la que se dirigen los aspectos interculturales de la reforma de salud. This article is a reflection on how interculturality, understood as the way to improve the health of the Bolivian population and coupled with the concept of living well, is not contributing to improving the quality of life and health of the most vulnerable populations in the country. The discourse is coupled with the intention of saving lives in its broadest sense; however, for this it is necessary to make decisions about environmental health and extractivist policies that are not taken into account in the health issues affecting indigenous communities, a population targeted by the intercultural aspects of the health reform.
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5.

Lessons learned in evaluating the Familias Fuertes program in three countries in Latin America/ Lecciones aprendidas al evaluar el programa Familias Fuertes en tres países de América Latina

Orpinas, Pamela; Ambrose, Ashley; Maddaleno, Matilde; Vulanovic, Lauren; Mejia, Martha; Butrón, Betzabé; Gutierrez, Gonzalo Sosa; Soriano, Ismael
| Idioma(s): Inglés
This report describes 1) the evaluation of the Familias Fuertes primary prevention program in three countries (Bolivia, Colombia, and Ecuador) and 2) the effect of program participation on parenting practices. Familias Fuertes was implemented in Bolivia (10 groups, 96 parents), Colombia (12 groups, 173 parents), and Ecuador (five groups, 42 parents) to prevent the initiation and reduce the prevalence of health-compromising behaviors among adolescents by strengthening family relationships and enhancing parenting skills. The program consists of seven group sessions (for 6-12 families) designed for parents/caregivers and their 10-14-year-old child. Parents/caregivers answered a survey before the first session and at the completion of the program. The survey measured two important mediating constructs: "positive parenting" and "parental hostility." The Pan American Health Organization provided training for facilitators. After the program, parents/caregivers from all three countries reported significantly higher mean scores for "positive parenting" and significantly lower mean scores for "parental hostility" than at the pre-test. "Positive parenting" practices paired with low "parental hostility" are fundamental to strengthening the relationship between parents/caregivers and the children and reducing adolescents' health-compromising behaviors. More research is needed to examine the long-term impact of the program on adolescent behaviors. Este informe describe 1) la evaluación del programa de prevención primaria Familias Fuertes en tres países (Bolivia, Colombia y Ecuador) y 2) el efecto de la participación en el programa sobre las prácticas de crianza. El programa Familias Fuertes se llevó a cabo en Bolivia (10 grupos, 96 padres), Colombia (12 grupos, 173 padres) y Ecuador (5 grupos, 42 padres) para prevenir el inicio y reducir la prevalencia de comportamientos que constituyen un riesgo para la salud de los adolescentes, mediante el fortalecimiento de las relaciones familiares y la mejora de las habilidades de crianza. El programa consta de siete sesiones de grupo (para 6 a 12 familias) dirigidas a padres o cuidadores y sus hijos de 10 a 14 años de edad. Los padres o cuidadores respondieron a una encuesta antes de la primera sesión y al término del programa. La encuesta midió dos conceptos importantes: la "crianza positiva" y la "hostilidad parental". La Organización Panamericana de la Salud capacitó a los facilitadores. Después del programa, los padres o cuidadores de los tres países presentaron puntuaciones ­ medias significativamente mayores en "crianza positiva" y significativamente menores en "hostilidad parental" que en la encuesta previa. La prácticas de "crianza positiva" asociadas con una baja "hostilidad parental" son fundamentales para fortalecer la relación entre los padres o cuidadores y los niños, y reducen los comportamientos que constituyen un riesgo para la salud de los adolescentes. Es necesaria una investigación más amplia para analizar la repercusión a largo plazo del programa sobre los comportamientos de los adolescentes.
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6.

Salud, globalización e interculturalidad: una mirada antropológica a la situación de los pueblos indígenas de Sudamérica/ Health, globalization and interculturalism: an anthropological approach to the situation of indigenous peoples in South America

Hita, Susana Ramírez
| Idioma(s): Español
Este artículo es un ensayo sobre la incidencia que tiene la globalización y la interculturalidad en las condiciones de vida de las poblaciones indígenas de Sudamérica. A través de dos ejemplos - Bolivia y Argentina - se plantea como la interculturalidad en salud ha devenido en un discurso y una práctica que han utilizado, tanto los organismos globales como la mayoría de países latinoamericanos, para asimilar y seducir a las comunidades indígenas. Se revaloriza la medicina tradicional, sin proponer cambios en la mejora de las condiciones de vida de estas poblaciones. Sobre todo en aquellas zonas en las que se están expropiando las tierras o contaminándolas: con la extracción de gas, petróleo, minerales, construcción de represas, junto con la deforestación indiscriminada de la selva. La salud/enfermedad no puede separarse de las condiciones territoriales de estos pueblos ya que la salud ambiental es fundamental para su supervivencia. This article reflects upon the impact of globalization and interculturalism on the living conditions of indigenous peoples in South America. Through two examples - Bolivia and Argentina - it is seen how health interculturalism has transformed into a discourse and a practice that both global organizations and most Latin American countries have used to assimilate and attract indigenous communities. Traditional medicine is respected and valued without proposing changes to improve the living conditions of these population groups. This is especially true in those areas where land is being expropriated or contaminated with the extraction of gas, oil, minerals and the construction of dams, along with indiscriminate deforestation of the rainforest. Health/illness cannot be separated from the territorial conditions of these peoples since environmental health is critical for their survival.
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7.

Saúde e ambiente nos seringais do Acre boliviano (1870-1903): o papel de fatores e processos exógenos/ Health and environment in the rubber-tree plantations in the Bolivian Acre (1870-1903): the role of exogenous factors and processes

Almeida Neto, Domingos José de; Heller, Léo
| Idioma(s): Portugués
Situação particular marca as condições da saúde humana e do ambiente no primeiro surto da produção gomífera na Amazônia Ocidental, região do Acre, sendo que a maior parte dele (1870-1903) ocorreu em território ainda pertencente à Bolívia. Com base nesse quadro histórico, o trabalho busca descrever e compreender como fatores e processos exógenos a esses dois campos de análise mediavam os riscos, com origem no ambiente, para o adoecimento e a morte nas populações dos seringais "brasileiros" em território boliviano. Explora-se, assim, a inter-relação entre saúde e ambiente, a partir das configurações historicamente específicas das condições físico-naturais, socioeconômicas, políticas e culturais. O trabalho evidencia que esses fatores e processos extrínsecos às atividades produtivas exerceram não só influência, tanto em seu aspecto organizativo quanto funcional, como determinaram as condições insalubres que se observaram nas regiões produtoras. Aponta, ainda, que a infraestrutura então existente era suficiente para a produção e a reprodução extrativista. A peculiar situation marks the conditions of human and environmental health in the first major cycle of rubber production in the Acre region of the Western Amazon, whereby the bulk of the boom (1870-1903) occurred in the territory that at that time still belonged to Bolivia. Based on this historical background, this work seeks to describe and comprehend how these factors and processes, which are exogenous to these two fields of analysis mediated the risks that originated in the environment, gave rise to sickness and death in the population of the "Brazilian" rubber-tree plantations established in Bolivian territory. In this manner, the inter-relations between health and environment linked to historically specific configurations of the physical-natural, socioeconomic, political, and cultural conditions, are examined. The work shows that these extrinsic factors and processes to the productive activities exerted an influence not only on its organizational but also functional aspects, while also resulting in the unhealthy conditions observed in the productive regions. It further highlights the fact that the extant infrastructure of the time was sufficient for extractive production and reproduction.
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8.

Building alliances for improving newborn health in Latin America and the Caribbean/ Alianzas para mejorar la salud de los recién nacidos en América Latina y el Caribe

Miller-Petrie, Molly K.; Mazia, Goldy; Serpa, Magdalena; Pooley, Bertha; Marshall, Margaret; Meléndez, Carlos; Vicuña, Marisol
| Idioma(s): Inglés
The regional Latin American and Caribbean (LAC) Neonatal Alliance and national neonatal alliances in Bolivia, El Salvador, and Peru were studied through in-depth interviews and a review of publications. Findings were analyzed to distill successful strategies, structures, and tools for improving neonatal health by working through alliances that can be replicated at the regional or national level. The studies found the following factors were the most critical for successful outcomes from alliance work: inclusion of the Ministry of Health as a leader or primary stakeholder; a committed, diverse, technically expert, and horizontal membership; the presence of champions for neonatal health at the national level; development of a shared work plan based on feasible objectives; the use of shared financing mechanisms; the use of informal and dynamic organizational structures; and a commitment to scientific evidence-based programming. The relationship between the regional and national alliances was found to be mutually beneficial. Se estudiaron la Alianza de Salud Neonatal para América Latina y el Caribe a escala regional, y las alianzas nacionales de salud neonatal de Bolivia, El Salvador y Perú, mediante entrevistas exhaustivas y un análisis de las publicaciones. Se analizaron los resultados para extraer las estrategias, las estructuras y las herramientas eficaces para mejorar la salud neonatal trabajando mediante alianzas que puedan repetirse a escala regional o nacional. Los estudios descubrieron que los factores más decisivos para obtener resultados exitosos del trabajo mediante alianzas fueron los siguientes: la inclusión de los ministerios de salud como líderes o interesados directos principales; una afiliación comprometida, diversa, técnicamente experta y horizontal; la presencia de promotores de la salud neonatal a escala nacional; la formulación de un plan de trabajo compartido basado en objetivos factibles; la utilización de mecanismos de financiamiento compartido; el uso de estructuras organizativas informales y dinámicas; y un compromiso con la programación científica basada en datos probatorios. Se observó que la relación entre las alianzas regionales y nacionales resultaba mutuamente beneficiosa.
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9.

Saúde e modos de vida em contextos amazônicos: Brasil, Peru e Bolívia/ Health and ways of life in Amazonian contexts Brazil, Peru and Bolivia

Pessôa, Isabela Nogueira
| Idioma(s): Portugués
Os modos de vida contemporâneos, quando experimentados em fronteiras internacionais com significativa porosidade sociocultural, apresentam especificidades para o planejamento e execução do trabalho em saúde. Nesse contexto, nosso objetivo foi compreender as relações sociais entre moradores da fronteira Brasil, Peru e Bolívia, especialmente as relacionadas aos itinerários de saúde, a partir do município brasileiro de Assis Brasil, considerando a intensificação da mobilidade migratória com a construção da Estrada Interoceânica Sul, esclarecendo assim, de que forma o processo de transnacionalização sociocultural propicia nova organização nas práticas locais de cuidados à saúde. A construção metodológica teve essencialmente um caráter social com abordagens na perspectiva etnográfica, sendo realizada de fevereiro a julho de 2011. Iniciou-se em Assis Brasil e avançou em direção à cidade acriana de Brasileia, considerando ainda a participação das vizinhas Epitaciolândia e Rio Branco, além das cidades bolivianas de Bolpebra e Cobija e da cidade peruana de Iñapari. Os itinerários considerados (de comércio e trabalho; de lazer; de estudos; de religiosidade e de cuidados à saúde) são compostos e organizados pelas práticas ordinárias, constituem esquemas de ação, maneiras de fazer, através dos quais os sujeitos se reapropriam do espaço e agenciam sua inserção na sociedade. Essas maneiras de fazer são possibilidades de interpretação da dinâmica sociocultural local e podem auxiliar o planejamento e a organização das ações e dos serviços de saúde nessa fronteira amazônica. The contemporary ways of life, when experienced on international borders with significant sociocultural porosity, can produce specific obstacles for planning and implementing health work. In this context, the aim of this study was to understand the social relationships among people living on the border involving Brazil, Peru and Bolivia, particularly those related to health itineraries, from the Brazilian city of Assis Brazil, by considering the intensification of migratory mobility with the construction of the South Inter-Oceanic Highway, thereby clarifying the way in which the process of sociocultural transnationalization provides a new organization in local health care practices. The methodological construction essentially had a social character with approaches in ethnographic perspective. The survey was held from February to July 2011. It started in Assis Brazil and, subsequently, moved towards the city of Brasileia (which belongs to the Brazilian State of Acre), and it also has considered the participation of neighboring cities as Epitaciolândia and Rio Branco, besides the Bolivian cities of Bolpebra and Cobija and the Peruvian city of Iñapari. The considered itineraries (of trade and job; of leisure; of studies; of religiosity and of health care) are composed and organized by ordinary practices, they constitute schemes of action, ways of doing, through which the individuals reappropriate the space and conduct their insertion into society. These ways of doing are possibilities to interpret the local sociocultural dynamics and can assist the planning and organization of activities and health services on this Amazonian border.
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10.

Uso inadecuado de plaguicidas y sus consecuencias en la salud de la población La Villa, Punata, Cochabamba, Bolivia, 2013/ Analysis of the use of pesticides and result in population health in Villa in Punta, Bolivia Cochabamba 2013

Bustamante Villarroel, Sandra; Jarro Mena, Ruth; Segales Rojas, Dennis Javier; Zurita Herrera, Loyda; Fernandez Arancibia, Mauricio; Torrico Condarco, Sergio
| Idioma(s): Español
Objetivos: El objetivo del estudio fue describir las características del manejo de plaguicidas en la zona de la villa (Punata) así como las posibles manifestaciones clínicas que presentan los pobladores. Métodos: Se realizó un estudio descriptivo transversal, observacional, considerándose como universo la totalidad de pobladores la zona, tomando en cuenta un total de 50 familias, dividiendose en dos grupos de muestra como directamente expuestos e indirectamente expuestos. Los datos fueron tabulados y analizados en el programa SPSS 17, la tabulación de datos se hizo en escalas numéricas. El análisis de datos incluye frecuencias, medianas, comparación de datos, correlación de datos. Resultados: Del total de muestra 50 familias se realizaron 26 encuestas, ocho a No Expuestos directamente y 18 a Expuestos directamente. 10 familias no aceptaron estar en el estudio y 14 casas estaban abandonadas. Se obtuvo que el 100% de los productores usa plaguicidas, dosificando al cálculo visual. El 77,8% prepara los plaguicidas en un balde, solo el 27,8% usa guantes para preparar. El 44% de la población refiere sintomatologia relacionada al uso de plaguicidas. Conclusiones: En la población de la villa encontramos, afección sintomatológica y falta de medidas de bioseguridad y conocimiento. La bibliografía nacional es escasa en cuanto a estos datos, es necesaria la implementación de difusión de información en la población agrícola y estudios masivos de mayor profundidad, haciendo necesario difundir el uso racional de plaguicidas. Objectives: The aim of the study was to describe the characteristics of pesticide management in the area of the villa ( Punata ) and possible clinical manifestations presented by the settlers. Methods: Transversal descriptive, observational study was conducted , considering the entire universe as settlers in the area, taking into account a total of 50 families, splitting into two groups as sample exposed directly and indirectly exposed . Data were tabulated and analyzed using SPSS 17 program data tabulation was made in numerical scales . Data analysis included frequencies, medians, data comparison, data correlation. Results: 50 shows the total 26 families surveyed, eight straight and 18 Not Exposed to Exposed directly. 10 families did not accept being in the studio and 14 houses were abandoned. It was found that 100% of the farmers use pesticides, dosing visual calculation. 77,8% pesticides prepared in a bucket, only 27.8% used gloves to prepare. 44% of the population regards symptomatology related to pesticide use. Conclusions: In the population of the town are, symptomatic condition and lack of biosecurity and knowledge; the literature reviewed in the national and international level , epidemiological characterization found associated with lower incidences however data.The national literature is sparse regarding these data , the implementation of information dissemination in the farm population and massive further studies necessary. Share necessitating rational use of pesticides.
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