Presence of Trypanosoma cruzi TcI and Trypanosoma dionisii in sylvatic bats from Yucatan, Mexico.

BACKGROUND: Chagas disease is caused by Trypanosoma cruzi, whose genetic structure is divided into six discrete typing units (DTUs) known as TcI-TcVI. In the Yucatan Peninsula, Mexico, information regarding the DTUs circulating in wild mammals is scarce, while this is important knowledge for our understanding of T. cruzi transmission dynamics. METHODS: In the current study, we sampled wild mammals in a sylvatic site of the Yucatan Peninsula and assessed their infection with T. cruzi by PCR. Then, for infected mammals, we amplified and sequenced nuclear and mitochondrial T. cruzi genetic markers for DTU identification. RESULTS: In total, we captured 99 mammals belonging to the orders Chiroptera, Rodentia and Didelphimorphia. The prevalence of infection with T. cruzi was 9% (9/99; 95% CI [5, 16]), and we identified TcI in a Jamaican fruit bat, Artibeus jamaicensis. Moreover, we fortuitously identified Trypanosoma dionisii in another Jamaican fruit bat and detected an unidentified Trypanosoma species in a third specimen. While the latter discoveries were not expected because we used primers designed for T. cruzi, this study is the first to report the identification of T. dionisii in a bat from Yucatan, Mexico, adding to a recent first report of T. dionisii in bats from Veracruz, and first report of this Trypanosoma species in Mexico. CONCLUSION: Further research is needed to enhance our knowledge of T. cruzi DTUs and Trypanosoma diversity circulating in wildlife in Southeastern Mexico.

Determining priority control toxic metal for different protection targets based on source-oriented ecological and human health risk assessment around gold smelting area.

Determining the priority control source and pollutant is the key for the eco-health protection and risk management around gold smelting area. To this end, a case study was conducted to explore the pollution characteristics, source apportionment, ecological risk and human health risk of toxic metals (TMs) in agricultural soils surrounding a gold smelting enterprise. Three effective receptor models, including positive matrix factorization model (PMF), ecological risk assessment (ERA), and probabilistic risk assessment (PRA) have been combined to apportion eco-human risks for different targets. More than 95.0% of samples had a Nemerow pollution index (NPI) > 2 (NPImean=4.27), indicating moderately or highly soil TMs contamination. Four pollution sources including gold smelting activity, mining source, agricultural activity and atmosphere deposition were identified as the major sources, with the contribution rate of 17.52%, 44.16%, 13.91%, and 24.41%, respectively. For ecological risk, atmosphere deposition accounting for 30.8% was the greatest contributor, which was mainly loaded on Hg of 51.35%. The probabilistic health risk assessment revealed that Carcinogenic risks and Non-carcinogenic risks of all population were unacceptable, and children suffered from a greater health risk than adults. Gold smelting activity (69.2%) and mining source (42.0%) were the largest contributors to Carcinogenic risks and Non-carcinogenic risks, respectively, corresponding to As and Cr as the target pollutants. The priority pollution sources and target pollutants were different for the eco-health protection. This work put forward a new perspective for soil risk control and management, which is very beneficial for appropriate soil remediation under limited resources and costs.

Who coined the term "One Health"? Cooperation amid the siloization.

This short communication is an effort to describe and elucidate the trajectory of the modern historical concept of "One Health." It is dedicated to the many integrated approaches of health closely related to One Health, while also recognizing the contribution and origination of One Health perspectives/notions from those that have led the way and spearheaded this movement while considering Indigenous cultures across the world. The effects of synergies of those involved in building these integrative approaches are potentially bigger and better lasting than the sum of the individual players. It is only through collaboration, cooperation and diplomacy that we can achieve impactful transformation to benefit health. In this commentary, we aim to appropriately and accurately describe how the current use of "One Health" came to be and who were the main players.

Biodiversity and human health: A scoping review and examples of underrepresented linkages.

Mounting evidence supports the connections between exposure to environmental typologies(such as green and blue spaces)and human health. However, the mechanistic links that connect biodiversity (the variety of life) and human health, and the extent of supporting evidence remain less clear. Here, we undertook a scoping review to map the links between biodiversity and human health and summarise the levels of associated evidence using an established weight of evidence framework. Distinct from other reviews, we provide additional context regarding the environment-microbiome-health axis, evaluate the environmental buffering pathway (e.g., biodiversity impacts on air pollution), and provide examples of three under- or minimally-represented linkages. The examples are (1) biodiversity and Indigenous Peoples' health, (2) biodiversity and urban social equity, and (3) biodiversity and COVID-19. We observed a moderate level of evidence to support the environmental microbiota-human health pathway and a moderate-high level of evidence to support broader nature pathways (e.g., greenspace) to various health outcomes, from stress reduction to enhanced wellbeing and improved social cohesion. However, studies of broader nature pathways did not typically include specific biodiversity metrics, indicating clear research gaps. Further research is required to understand the connections and causative pathways between biodiversity (e.g., using metrics such as taxonomy, diversity/richness, structure, and function) and health outcomes. There are well-established frameworks to assess the effects of broad classifications of nature on human health. These can assist future research in linking biodiversity metrics to human health outcomes. Our examples of underrepresented linkages highlight the roles of biodiversity and its loss on urban lived experiences, infectious diseases, and Indigenous Peoples' sovereignty and livelihoods. More research and awareness of these socioecological interconnections are needed.

One Health in Somalia: Present status, opportunities, and challenges.

One Health (OH) is an integrated approach aiming at improving the health of people, animals, and ecosystems. It recognizes the interconnectedness of human health with the health of animals, plants, and the environment. Since Somali people's livelihoods are mainly based on livestock, agriculture, marine resources, and their shared environment, OH-oriented initiatives could significantly impact the country toward reducing complex problems affecting the health of humans, animals, and the environment. The term "One Health" was first introduced into the global scientific community in September 2004 and in 2013 in Somalia. After ten years, there is still a long road ahead for implementing the OH approach in the country. Herein, we present the status, opportunities, and challenges of OH in Somalia and recommend ways to promote and institutionalize it. The country has been involved in various OH initiatives solely driven by external funding, focusing on research, capacity development, and community interventions, apart from university-led initiatives such as Somali One Health Centre. In Somalia, OH initiatives face numerous challenges, ranging from limited infrastructure and resources to weak governance and institutional capacity. We urge the Somali government to address these challenges and prioritize OH as the main approach to tackling critical health issues. We suggest the Somali government institutionalize and implement OH actions at all administrative levels, including Federal, State, District, and community, through a mechanism to improve multisectoral coordination and collaboration to predict, prevent, detect, control, and respond to communicable and non-communicable diseases at the human-animal-ecosystem interface for improving health outcomes for all.

From molecules to ecosystems: Insights into a network of interactions for a Chagas disease outbreak using Triatoma brasiliensis as natural samplers.

Exploring the dynamics of disease transmission involves an understanding of complex interactions within the eco-epidemiologic framework. In the context of Chagas disease (CD), elements are mainly represented by the interactions among the pathogen, insect vector, host, humans and the environment. We performed quantitative and qualitative analyses on a dataset derived from 98 Triatoma brasiliensis infected by trypanosomatids, which were linked to a CD outbreak in the semi-arid region of northeastern Brazil. We extracted invertebrate-derived DNA (iDNA) from these insects, comprising 18 populations around the outbreak area, each indicative of various strata of anthropogenic influence. Food source (FS) diversity, representing potential parasite reservoirs, was determined through mitochondrial gene (cyt b) sequencing of vertebrates, and parasite genotyping was accessed using fluorescent amplified fragment barcodes (FFLB) of trypanosomatids. We also assessed the residents' awareness of breeding sites for CD vectors in the inspected houses. The quantification of Trypanosoma cruzi was estimated via real-time PCR and is denominated here as the average parasite load (PL) per insect (T. cruzi/intestinal unit). We aimed to address vector-parasite-host-environment interactions that were discussed based on their significance among the components. Notably, among the significant interactions, we observed that the PL in the insects was significantly influenced by FS. Infected insects that fed on the classic reservoir, Didelphis albiventris, and Galea spixii exhibited higher PLs, compared to those that fed on Kerodon rupestris (p < 0.04)-a primary host. While D. albiventris is already recognized as a synanthropic species, we propose that G. spixii may also be undergoing a synanthropic process. Conversely, domestic cats are frequently identified as FS in infected insects from the sylvatic environment, suggesting a possible change in their behavior towards a wild state. Therefore, we propose that neglected anthropogenic actions have facilitated the reciprocal (sylvatic-peridomestic) circulation of T. cruzi-especially noted for TcI because it was predominant in insects found in peridomestic environments. Residents are often unaware of the existence of insect breeding grounds near their homes, particularly when it involves the storage of materials without planning for use, such as piles of tiles, bricks and wood. Although indirect inferences about the interaction among vector-parasite-host-environment are still incipient, we highlight the potential use of vectors as natural samplers of biological and ecological components in transmitting the disease.

Competencias en salud ambiental y cambio climático en estudiantes universitarios / Competences in environmental health and climate change in university students

El deterioro del medio ambiente ha acelerado el cambio climático (CC) afectando mútiples escenarios, el aumento de la temperatura ha conllevado a la proliferación de diversas enfermedades trasmitidas por vectores de importancia a nivel de salud pública. Como objetivo, se propuso determinar la cultura ecosaludable ante el cambio climático en estudiantes del Área Ciencias de la Educación, Universidad Nacional Experimental Rómulo Gallegos (UNERG), Calabozo, Venezuela 2022. El estudio fue cuantitativo exploratorio no experimental de corte transversal con una muestra de 180 estudiantes. Para la recolección de datos se aplicó el Cuestionario de Dimensiones Ambientales (CDA) compuesto de 75 ítems distribuidos en tres dimensiones; conocimientos, actitudes, emociones y comportamientos. El análisis de los datos fue por estadística descriptiva con porcentajes a través del programa Epidat 3.0. Como resultado, 63% indicó la importancia atribuida de los elementos de ecosalud afectados sobre el agua y 55% al calentamiento global. No obstante, solo 12% indicó la educación como un elemento de ecosalud afectado por el cambio climático, así mismo, en la dimensión de conocimientos se encontró 54,50% a CSN, 6,50% a CPR y 39,50% a CEA, en la dimensión de actitudes y emociones se encontró 55,50% a la subcategoria TD, 44,00% a CVA y 36,50% a E, finalmente, en la dimensión de comportamiento, se evidenció 36,50% a la subategoria de PC, 29,00% a IC y 20,00% a PI. Se debe evitar el daño ambiental a través del cambio de comportamiento individual que debe ser enseñado desde los recintos universitarios(AU)

The deterioration of the environment has accelerated climate change (CC) affecting multiple scenarios, the increase in temperature has led to the proliferation of various diseases transmitted by vectors of importance at the public health level. As an objective, it was proposed to determine the eco-healthy culture in the face of climate change in students of the Educational Sciences Area, Rómulo Gallegos National Experimental University (UNERG), Calabozo, Venezuela 2022. The study was quantitative, exploratory, non-experimental, cross-sectional with a sample of 180 students. For data collection, the Environmental Dimensions Questionnaire (CDA) was applied, consisting of 75 items distributed in three dimensions; knowledge, attitudes and emotions and behaviors. Data analysis was by descriptive statistics with percentages through the Epidat 3.0 program. As a result, 63% indicated the importance attributed to the affected ecohealth elements on water and 55% on global warming. However, only 12% indicated education as an element of ecohealth affected by climate change, likewise, in the knowledge dimension, 54.50% were found to CSN, 6.50% to CPR and 39.50% to CEA, in the dimension of attitudes and emotions, 55.50% were found in the TD subcategory, 44.00% in CVA and 36.50% in E, finally, in the behavior dimension, 36.50% were found in the subcategory of PC, 29.00% to IC and 20.00% to PI. Environmental damage must be avoided through individual behavior change that must be taught from university campuses(AU)

Participação e transdisciplinaridade em Ecosaúde: a perspectiva da análise de redes sociais / Participation and transdisciplinarity in Ecohealth: a social network analysis perspective

Resumo A Ecosaúde usa abordagens participativas e transdisciplinares com o intuito de compreender as inter-relações entre os componentes dos sistemas socioecológicos e como estas interações influenciam a saúde das populações humanas. O objetivo do artigo é usar a Análise de Redes Sociais (ARS) para entender o papel das relações de colaboração entre os diversos atores envolvidos nos processos participativos e transdisciplinares em projetos de Ecosaúde. Apresentamos um conjunto de indicadores de ARS para caracterizar a evolução e a equidade de participação e diferenciar a inter e a transdisciplinaridade. A análise foi feita com base na rede de colaboração entre os atores da Iniciativa de Liderança em Ecosaúde para as Enfermidades Transmitidas por Vetores (ETV) na América Latina e Caribe. O processo participativo ficou mais intenso ao longo do projeto, com mais sujeitos envolvidos e um número crescente de colaborações. A cooperação entre os atores das ciências sociais, ambientais e da saúde é pouco equitativa; assim, predominam as ciências da saúde. Os poucos cientistas ambientais presentes estão, porém, ativamente envolvidos em colaborações interdisciplinares. A abordagem tem aplicação ampla para estudar a participação e a transdisciplinaridade em projetos sobre saúde e meio ambiente.

Abstract Ecohealth uses participatory and transdisciplinary approaches to understand the relationships between the components of socio-ecological systems and how these interactions influence the health of human populations. This article aims to use Social Network Analysis (SNA) to understand the role of collaborative relationships between the various actors involved in participatory and transdisciplinary processes in Ecohealth projects. We present a set of SNA indicators to characterize the evolution and equity of participation and to differentiate inter- and transdisciplinarity. The analysis was based on the collaboration network among the members of the Iniciativa Para el Liderazgo y Desarrollo del Campo de Ecosalud y Enfermedades Transmitidas por Vectores (ETV) en América Latina y el Caribe. The participatory process intensified throughout the project, with more individuals involved and increasing collaborations. Cooperation between members from social, environmental, and health sciences is unbalanced and health scientists predominate. The few environmental scientists are, however, actively involved in interdisciplinary collaborations. The proposed approach has wide application to study participation and transdisciplinarity in projects about health and environment.

Efecto de la educación comunitaria para control integrado del Triatoma Dimidiata (Hemiptera: Reduviidae) / EEffect of community education in an integrate control for Triatoma dimidiata (Hemiptera: Reduviidae) / EEffect of community education in an integrate control for Triatoma dimidiata (Hemiptera: Reduviidae)

Introduction: The Mesoamerican endemic specieTriatoma dimidiata is the main vector of Chagas disease in Central America, after the elimination of an introduced vector Rhodnius prolixus. The traditional method of vector control using insecticides results in reinfestation. An integrated Ecohealth approach, including education, house improvements and domestic animal management was shown effective for long-term control ofT. dimidiata, and it was applied in several villages in Guatemala. Objective: To evaluate the changes in community practices after an Ecohealth intervention in La Prensa, Olopa Chiquimula. Methods: Through three surveys, we measured risk factors associated withT. dimidiatainfestation, the infestation index, blood sources of T. dimidiata, the presence of Trypanosoma cruzi were analyzed using PCR. Statistics analysis included Wilcoxon signed-rank tests, Mc-Nemar test, Chi-square test and Fisher exact test to compare the surveys. Results: Over the years, risk factors associated with the presence of T. dimidiata and population density of the vector were observed. We found a decrease in consumption of human blood and the parasite in the vector population. However, we found the consumption of bird blood meal increased Conclusions: Our results provide evidence that an ecohealth approach for an endemic Chagas vector has impact on reducing vector-human contact, possibly by influencing people's behavior. Increasing the community knowledge about these risk factors can be an effective strategy to further reduce the risk of house reinfestation and Chagas transmission(AU)

Introducción: La especie endémica mesoamericana Triatoma dimidiata es el vector principal de la enfermedad de Chagas en América Central, después de la eliminación de un vector introducido Rhodnius prolixus. El método tradicional de control de vectores que utiliza insecticidas resulta en reinfestación. Se demostró que un enfoque integrado de ecosalud, que incluye la educación, mejorías en el hogar y manejo de animales domésticos, es efectivo para el control a largo plazo del T. dimidiata, y se aplicó en varias aldeas de Guatemala. Objetivo: evaluar los cambios en las prácticas comunitarias después de una intervención de ecosalud en La Prensa, Olopa Chiquimula. Métodos: a través de tres encuestas, se midieron los factores de riesgo asociados con la infestación de T. dimidiata, el índice de infestación, las fuentes sanguíneas de T. dimidiata y la presencia de Trypanosoma cruzi. Estas encuestas se analizaron mediante PCR. El análisis estadístico incluyó pruebas de Wilcoxon de rango con signo, la prueba de Mc-Nemar, la prueba de Chi-cuadrado y la prueba exacta de Fisher para comparar las encuestas. Resultados: A lo largo de los años, se observaron factores de riesgo asociados con la presencia de T. dimidiata y la densidad de población del vector. Encontramos una disminución del parásito en la población de vectores y en el consumo de sangre humana. Sin embargo, encontramos que aumentó el consumo de harina de sangre de aves. Conclusiones: Nuestros resultados proporcionan evidencia de que un enfoque de ecosalud para un vector de Chagas endémico impacta en la reducción del contacto vector-humano, posiblemente al influir en el comportamiento de las personas. Aumentar el conocimiento de la comunidad sobre estos factores de riesgo puede ser una estrategia efectiva para reducir aun más el riesgo de reinfestación en la casa y la transmisión de Chagas(AU)

Intervención educativa para modificar conocimientos, actitudes y prácticas sobre la malaria en escolares indígenas Ye´kwana / Educational intervention to modify knowledge, attitudes and practices about malaria in Ye´kwana schools

En zonas endémicas y remotas con población indígena vulnerable, es necesario aplicar medidas que contribuyan a contrarrestar el aumento de la malaria, adicionales al diagnóstico temprano, tratamiento y control vectorial. Se evalúa el cambio en niveles de conocimiento, actitudes y prácticas (CAP) en relación a la prevención y control de la malaria en una población escolar indígena de nivel primario, luego de la aplicación de un proyecto pedagógico de aula. Se realizó una evaluación cuantitativa, siguiendo un diseño cuasi-experimental, tipo preintervención y postintervención de carácter exploratorio, con población escolar de 3er y 4to grado,en cinco comunidades del pueblo Ye´kwana de la cuenca del río Caura (Estado Bolívar, Venezuela). Docentes interculturales bilingües, previo consentimiento informado, realizaron la intervención educativa y evaluaron resultados con el uso de un cuestionario sobre conocimientos, actitudes y prácticas traducido al Ye´kwana. Se analizaron los datos de la intervención mediante prueba de rangos con signo de Wilcoxon para datos pareados (prueba de dos colas), antes de la intervención (T1), al finalizar la misma (T2) y un tiempo después de la intervención (T3=45-60 días). En el intervalo T1-T3 se registraron cambios positivos y mejoras significativas (P<0,05) en todas las preguntas de conocimiento, y en el área de actitud hubo cambios no significativos. En el área de práctica para el control de la malaria, las respuestas registradas fueron mixtas. Los resultados indican que el proyecto pedagógico de aula evaluado puede ser muy útil en la prevención y control de la malaria, desde las escuelas comunitarias indígenas.

In remote areas with endemic and vulnerable indigenous population, it is necessary to implement measures that help to offset the increase of malaria, in addition to theearly diagnosis, treatment and vector control. Here, we evaluate a classroom project to change levels of knowledge, attitudes and practices (KAP) in relation to the prevention and control of malaria in amerindian school population of primary level. We carried out a quantitative assessment, under a quasi-experimental “before and after” design, with children from 3rd and 4th grades in five Ye'kwana communities inthe Caura River Basin (Bolivar State, Venezuela). According to previously informed community consent, intercultural bilingual teachers performed and evaluated results of the educational intervention using a questionnaire on knowledge, attitudes and practices translated into Ye'kwana language. Intervention data were analyzed by Wilcoxon signed pairedtests. We compared differences between before intervention (T1), immediately after (T2), and also some time afterthe intervention (T3 = 45-60 days).In the T1-T3 interval significant improvements (P<0.05) were recorded in all questions of knowledge and a positive, non-significant changes in all attitude questions. Changes in practices for malaria prevention were mixed.The results show thepotentialforthe classroom-teaching project tested toassist in the prevention and control of malaria at indigenous community schools.

Intrusive versus domiciliated triatomines and the challenge of adapting vector control practices against Chagas disease

Chagas disease prevention remains mostly based on triatomine vector control to reduce or eliminate house infestation with these bugs. The level of adaptation of triatomines to human housing is a key part of vector competence and needs to be precisely evaluated to allow for the design of effective vector control strategies. In this review, we examine how the domiciliation/intrusion level of different triatomine species/populations has been defined and measured and discuss how these concepts may be improved for a better understanding of their ecology and evolution, as well as for the design of more effective control strategies against a large variety of triatomine species. We suggest that a major limitation of current criteria for classifying triatomines into sylvatic, intrusive, domiciliary and domestic species is that these are essentially qualitative and do not rely on quantitative variables measuring population sustainability and fitness in their different habitats. However, such assessments may be derived from further analysis and modelling of field data. Such approaches can shed new light on the domiciliation process of triatomines and may represent a key tool for decision-making and the design of vector control interventions.

Population health diagnosis with an ecohealth approach / Diagnóstico de salud poblacional con enfoque de ecosalud

OBJECTIVE To analyze the characteristics of health diagnosis according to the ecohealth approach in rural and urban communities in Mexico.METHODS Health diagnosis were conducted in La Nopalera, from December 2007 to October 2008, and in Atlihuayan, from December 2010 to October 2011. The research was based on three principles of the ecohealth approach: transdisciplinarity, community participation, gender and equity. To collect information, a joint methodology and several techniques were used to stimulate the participation of inhabitants. The diagnostic exercise was carried out in five phases that went from collecting information to prioritization of problems.RESULTS The constitution of the transdisciplinary team, as well as the participation of the population and the principle of gender/equity were differentials between the communities. In the rural community, the active participation of inhabitants and authorities was achieved and the principles of transdisciplinarity and gender/equity were incorporated.CONCLUSIONS With all the difficulties that entails the boost in participation, the incorporation of gender/equity and transdisciplinarity in health diagnosis allowed a holistic public health approach closer to the needs of the population.

OBJETIVO Analizar las características del diagnóstico de salud según el enfoque de ecosalud en comunidades rural y urbana en México.MÉTODOS Los diagnósticos de salud se efectuaron en La Nopalera, de diciembre 2007 a octubre 2008 y en Atlihuayan de diciembre 2010 a octubre de 2011. Se basó en tres principios del enfoque de ecosalud: transdiciplina, participación comunitaria, género y equidad. Para colectar la información se utilizó una metodología mixta y diversas técnicas para estimular la participación de los habitantes. El ejercicio de diagnóstico se efectuó en cinco fases que oscilaron desde la recolección de información hasta la priorización de problemas.RESULTADOS La constitución del equipo transdisciplinario, así como la participación de la población y el principio de género/equidad fue diferencial entre las comunidades. En la comunidad rural, se logró la participación activa de los pobladores y autoridades y se incorporaron los principios de transdisciplina y género/equidad.CONCLUSIONES Con todas las dificultades que acarrea el impulso de la participación, la incorporación del género/equidad y la transdisciplina en el diagnóstico de salud, permitió un abordaje holístico de salud pública más cercano a las necesidades de la población.

El trabajo de campo con enfoque de Ecosalud, para la prevención y control de Dengue / Field work with an ecohealth approach for preventing and controllyng Dengue

In order to apply the Epidemiology knowledge and the fundamentals of the ecohealth approach for dengue prevention and control, field activities with nursing students from the Centro Occidental Lisandro Alvarado University were done, it took place in the community of Tamaquita parish Cují Tamaca, Iribarren, in Lara state, which included a) information to community residents on the aims and institutional character of the field activities; b) a Workshop on Dengue prevention and control, and ecohealth approach by integrating students, community and facilitators; c) application of a research instrument in order to know health needs, social and living conditions, risk perceptions, attitudes about health and role of community members. The developed activities facilitated community participation in order to eliminate useless discarded water containers in and out their homes and the application of larvicide Abate (Temephos) to the water tanks. The results showed the role of the Community Council, the community knowledge about Aedes aegypti breeding sites, and the identification of the houses where Dengue cases occurred; however low motivation of young people for the Prevention and Control of Dengue were perceived. We conclude on the need to promote community work to encourage behavioral changes in young people about health care and especially activated for the Dengue prevention and control.

Con el objetivo de aplicar los conocimientos de Epidemiología y los fundamentos del enfoque de ecosalud, para la prevención y control de Dengue, se realizo una jornada de trabajo de campo con estudiantes de enfermería, de la Universidad Centro Occidental Lisandro Alvarado, en la comunidad de Tamaquita, parroquia Cují Tamaca, municipio Iribarren en el estado Lara, que incluyo a) información a los habitantes de la comunidad, sobre los propósitos y carácter institucional de la Jornada; b) un Taller sobre ecosalud y control de Dengue integrando a estudiantes, comunidad, facilitadores; c) aplicación de un instrumento para conocer necesidades prioritarias de salud, condiciones sociales y de vida, percepciones de riesgo, actitudes sobre la salud y rol de los miembros de la comunidad. Las actividades desarrolladas facilitaron la participación de la comunidad en la eliminación de recipientes inservibles de las viviendas y de sus sitios cercanos y la aplicación del larvicida Abate (Temephos) a los depósitos de agua. Los resultados evidenciaron el protagonismo del Consejo Comunal, el conocimiento que tiene la comunidad sobre los criaderos de Aedes aegypti, y la identificación de las casas donde ocurrieron casos de Dengue; no obstante se percibió baja motivación de jóvenes para la prevención y el control de Dengue. Se concluye en la necesidad de promover el trabajo comunitario para incentivar cambios de conducta en los jóvenes sobre los cuidados a la salud y en especial activarse a la prevención y control de Dengue.

El servicio comunitario y sus potencialidades para el apoyo de las enfermedades transmitidas por vectores en Venezuela / Communitary service and its potencialities for the support of vector borne diseases in Venezuela

The next article is result from diverse experiences in the communitarian service, practice at the Economic and Social Sciences Faculty at the Carabobo University, Aragua Nucleus. Its objective is a critic exploration of the capacity of this social pedagogic strategy for sustention of vector borne diseases studies, into the Ecohealth paradigm and its interdisciplinary character. The conclusion of this experiences allowed three aspects that are necessary review so the Communitarian Service can be an activity in accord this objectives: 1. - Proportionate the legal mark, 2.- Review the academic structure of the university, intended for befall a the interdisciplinary formation, 3.- Assume a methodology accord with the ample and active community participation. This are a adequate beginning point for integral studies, under approach of Complex Theory and, this will allow that the university students boards the local reality with share strategies and activities with the diverse communal actors, for bring knowledge that can serve in the prevention and attention of vector borne diseases, by this way incise in the live quality.

El siguiente artículo es resultado de experiencias en el Servicio Comunitario, llevadas a cabo en la Facultad de Ciencias Económicas y Sociales, Núcleo Aragua, de la Universidad de Carabobo. El objetivo del mismo es una exploración crítica de las potencialidades que subyacen a esta estrategia socio - pedagógica, para apoyar el estudio de las ETVs, enmarcándose en el paradigma de la Ecosalud y, su carácter interdisciplinario. La sistematización de tales experiencias permitió concluir en tres aspectos, que deben ser revisados para que el Servicio Comunitario logre ser una actividad acorde a tales objetivos: 1.- Adecuar el marco legal de sustento, 2.- Repensar la estructura académica de la Universidad para darle cabida a la formación interdisciplinaria, 3.- Asumir una metodología acorde con la participación amplia y activa de las comunidades. Esto constituirá un adecuado punto de partida para estudios integrales, bajo enfoques del pensamiento complejo, permitirá que el estudiante universitario aborde la realidad local con estrategias y actividades compartidas con diversos actores comunales, para propiciar conocimientos que sirvan en la prevención y atención de las enfermedades transmitidas por vectores (ETVs) y, con ello incidir en la calidad de vida.

Ecosalud: Un Enfoque Multi Sapiencial que transciende Fronteras / Ecohealth: A Multi wisdow approach that Transcends Borders

The present paper outlines an approach to the Ecohealth approach, providing a theoretical substrate on approach and the support of institutions referenced in the article. Building on initiatives that serve as precedents in Venezuela, then variety of projects as a sign of global context, where Ecohealth has transcended borders are presented. These projects have dissimilar realities have in common systemic health-environmental complex approaches that integrate natural and social sciences, through interventions of transdisciplinary, multi Wisdom groups. The Ecohealth projects presented, applied to localized problems in Latin America: Venezuela (Malaria), Brazil (Mercury), Colombia (ETV), Mexico (Malaria). In Asia: Continental Initiative (Aviar Influenza). On the territory of Sub-Saharan Africa: Malawi (poor soils). Closing this tour, with the area of the Middle East and North Africa: Morocco (Impact of small dams in Health). The holistic and integrative feature Ecohealth, seen in the light of these successful initiatives, evidence strengthening relationships and execution of actions that transcend without discrimination, the boundaries of the geographic, cultural and political, to assume positions of co-responsibility in addressing health problems that affect the world, and that drive achieving optimized, sustainable responses over time.

El presente escrito esboza una aproximación al Enfoque Ecosalud, aportando un substrato teórico sobre este enfoque, así como el apoyo de instituciones referenciadas en el artículo, partiendo de iniciativas que sirven de antecedentes en Venezuela; luego se presentan variedad de proyectos como una muestra del contexto mundial, donde Ecosalud ha transcendido fronteras. Estos proyectos presentan realidades disímiles, que tienen en común abordajes sistémicos complejos salud-ambientales que integran ciencias naturales y sociales, mediante intervenciones de grupos transdisciplinarios, multi sapienciales. Los proyectos ecosaludables presentados, se aplican a problemáticas localizadas en América Latina: Venezuela (Malaria), Brasil (Mercurio), Colombia (ETV), México (Malaria). En Asia: Iniciativa Continental (Influenza Aviaria). En el territorio del África Sub-Sahariana: Malawi (Suelos pobres), cerrando este recorrido, con la zona del Medio Oriente y Norte de África: Marruecos (Impacto de represas pequeñas en la Salud). La característica holística e integradora de Ecosalud, vista a la luz de estas iniciativas exitosas, evidencia el fortalecimiento de relaciones y ejecución de acciones que transcienden sin distingos, las fronteras de lo geográfico, lo cultural y lo político, para asumir posiciones de co-responsabilidad en el abordaje de problemas de salud que atañen al mundo, y que impulsan el logro de respuestas optimizadas, sostenibles en el tiempo.

La comunicación para la salud y el desafío del enfoque ecosistémico / Health communication and the challenge of ecosystemic approach

The health communication, a specific disciplinar practice that for decades has been used for the process of changing attitudes and behaviors in health intervention plans, faces the challenge of complexity. Different experiences and researches points to the need to change the perspective from which has been conceived and to modify their practice. EcoHealth approach provides some clues to be considered for a health communicator with inclusive, equitable , transdisciplinary and participatory attitude, responsible for creating a dialogic atmosphere in which they can contribute to build a healthy society.

La comunicación para la salud, una práctica disciplinar específica que desde hace décadas se utiliza para los procesos de cambio de actitudes y de conductas en los planes de intervención sanitaria, se enfrenta al reto de la complejidad. Diferentes experiencias e investigaciones apuntan a la necesidad de cambiar la perspectiva desde la que se ha concebido, así como de modificar su práctica profesional. El enfoque de la EcoSalud, con su mirada integradora proporciona algunas pistas que deben considerarse para lograr un comunicador para la salud con mirada integradora, equitativa, transdisciplinaria y participativa, competente para crear una atmósfera dialógica en la que se pueda construir una sociedad saludable.

Transdisciplinariedad y transectorialidad en el abordaje de los problemas sociales desde el enfoque de Ecosalud / Transdisciplinarity and transectoriality in the approach of social problems from the Ecohealth approach

A theoretical-conceptual and hermeneutics revision of Ecohealth praxis was made in order to specify the transdiciplinarity and transectoriality contributions as approximation strategies to the complex social facts. Concluding that we achieved the characterization and contextualization of every local fact through the transdiciplinary analysis. At the time the search for a new method to tackle this different realities , that give answers to specific needs found in this new contextualized transdiciplinar knowledge, which arises from the dialogue between the academic knowledge and the daily knowledge of the life's world that they possess: community, the public officials and decision makers. These two knowledge transcend, content and supera the previous boundered when they are socialized and integrated in a multidimensional way; and therefore, they cannot be translated again into isolated and uncoordinated traditional sectoriales actions, but they require urgently a new horizontal model of public management, into networks, transectorial, which can let collectively design local plans from integrated actions, integral and coordinated, oriented to the prevention and control of VTD, así como the solving of many and complex social problems at a local level.

Con el propósito de precisar los aportes de la transdisciplinariedad y la transectorialidad como estrategias de aproximación a las complejas realidades sociales se realizó una revisión teórica conceptual y hermenéutica de la praxis en Ecosalud, concluyendo que a través del análisis transdisciplinario, logramos caracterizar y contextualizar cada realidad local. Al mismo tiempo que se transita en la búsqueda de un nuevo método para abordar estas diversas realidades, que dé respuestas a las necesidades específicas encontradas en este nuevo conocimiento transdisciplinar contextualizado, que emerge del dialogo entre el conocimiento académico y el conocimiento cotidiano del mundo de la vida que poseen: la comunidad, los funcionarios públicos y los tomadores de decisiones. Estos dos conocimientos al ser socializados e integrados de una manera multidimensional, trasciende, contiene y supera el conocimento anterior parcelado y por lo tanto, no puede ser traducido de nuevo en tradicionales acciones sectoriales aisladas e incoordinadas, sino que exigen la emergencia de un nuevo modelo de gestión pública horizontal, en redes, transectorial, que permita diseñar colectivamente planes locales de acciones integradas, integrales y coordinadas dirigidas a la prevención y control de las ETVs, así como a la resolución de las múltiples y complejas problemáticas sociales a nivel local.

Ecosalud: Una mirada género sensitiva / Ecohealth: A gender sensitive outlook

To recognize the interdependence between human health and the environment from the perspective of ecohealth, involves a look from the complexity which incorporate the gender category, has represented an epistemological rupture with the universalizing essentialism. The article is divided into three major sections. A first development, which attempts to make visible as it has been the construction of the feminine as an expression of social and sexual division of work impacting relations of knowledge- power -submission and thus, differential forms of living, sick, dying women and their relationships with the ecosystem. The World Health Organization, points out that women are which support larger the impact of climate change and its effects on health, representing almost all of the global deaths from preventable diseases. A second aspect that has to do with the challenges of the approach of eco health, in relation to the construction of knowledge, involving a look ecosystem, transdisciplinary social, gender equity and the community actively participating. Finally, some key moments which allow to specify how have been the advances that have been achieved thanks to the feminist movement, who have been insisting on the need to empower women in such a way that the State and the health sector, to become aware of their right to participate in public affairs.

Reconocer la interdependencia entre la salud humana y el ambiente desde el enfoque de ecosalud, implica una mirada desde la complejidad donde incorporar la categoría de género ha representado una ruptura epistemológica con el esencialismo universalizante. El artículo se estructura en tres grandes apartes. Un primer desarrollo, que intenta visibilizar como ha sido la construcción de lo femenino como expresión de la división social y sexual del trabajo impactando unas relaciones de saber-poder- sumisión y de esta manera, formas diferenciadas de vivir, enfermar, morir de las mujeres y sus relaciones con el ecosistema. La Organización Mundial de la Salud, precisa que las mujeres son las que soportan en mayor magnitud el impacto del cambio climático y sus efectos en la salud, representando casi la totalidad de las muertes mundiales a consecuencia de enfermedades prevenibles. Un segundo aspecto que tiene que ver con los desafíos del enfoque de ecosalud, en lo referente a la construcción del conocimiento, implicando una mirada ecosistémica, transdisciplinaria con equidad social, de género y con la comunidad participando activamente. Finalmente, se hilvanan algunos momentos claves los cuales permiten precisar cómo han sido los avances que se han logrado gracias a los movimientos feministas, quienes han venido insistiendo en la necesidad de empoderar a las mujeres de forma que ellas, el estado y el sector salud, tomen conciencia de su derecho a participar en los asuntos públicos.

Aproximación a la problemática de la coendemicidad enfermedad de Chagas-Leishmaniasis desde un enfoque de Ecosalud / Approximation to the problem of coendemicity chagas-Leishmaniasis diseases from and Ecohealth approach

Chagas disease and leishmaniasis belong to the group of Neglected Tropical Diseases are zoonosis considered as a public health problem in Venezuela, present in rural, suburban and urban areas. The transmission of both is given by complex processes, which modifies the environment favoring infection with these two groups of protozoa have a common susceptible host, human, many of their geographical foci coincide and can also exist, practices and attitudes linked to ignorance of the modes of transmission of these diseases could encourage contact and infection /coinfection. To study these the Ecohealth approach, which allows to identify interactions between social and ecological systems, which connects to the complex thought, with a view from its fundamental principles proposed: 1) systems thinking, 2) transdisciplinary research 3) social participation, 4) social and environmental sustainability 5) gender equality and social, and 6) the approach of the gap between knowledge and action, which could provide important information of great help to propose public health policies, to strengthen the control programs for these diseases.

La enfermedad de Chagas y leishmaniasis pertenecen al grupo de las Enfermedades Tropicales Desatendidas, son zoonosis consideradas problemas de salud pública en Venezuela, presentes en zonas rurales, suburbanas y urbanas. La transmisión de ambas se da por procesos complejos, en los cuales se modifica el medio ambiente favoreciendo la infección con estos dos grupos de protozoarios, tienen un hospedador susceptible común, el humano, muchos de sus focos geográficos coinciden y pueden existir además, prácticas y actitudes que unidas al desconocimiento de las formas de transmisión de estas enfermedades, pudiesen favorecer el encuentro y la infección/coinfección. Para el estudio de estas se propone el enfoque de Ecosalud, el cual permite identificar interacciones entre los sistemas sociales y ecológicos, que se conecta con el pensamiento complejo, con una mirada desde sus principios fundamentales: 1) pensamiento sistémico, 2) investigación transdisciplinaria 3) participación social, 4) sostenibilidad social y ambiental, 5) equidad de género y social, y 6) el acercamiento de la brecha entre conocimiento y acción, los cuales podrían aportar datos importantes de gran ayuda para proponer políticas públicas de salud, que fortalezcan los programas de control para estas enfermedades.

Leishmaniasis en Venezuela: Situación actual, acciones y perspectivas para el control vectorial en el marco de un programa de control multisectorial / Leishmaniasis in Venezuela: Current status, actions and prospects for vector control in the context of a multi-sectorial control program

El Programa de Control de Leishmaniasis en Venezuela, a cargo del Servicio Autónomo Instituto de Biomedicina (IB) del Ministerio del Poder Popular para la Salud (MPPS), ha sido reforzado en los últimos años a través del fortalecimiento de la asistencia médica, en especial la consolidación de la base diagnóstica y una mayor interacción con los Servicios de Zoonosis para la LV. Sin embargo, indicadores entomológicos y epidemiológicos de la dispersión y en algunos casos urbanización, de la leishmaniasis cutánea (LC) y visceral (LV) han resaltado la necesidad del control antivectorial para un abordaje sistémico y transdisciplinario de este problema de salud, en el marco de la protección ambiental. Se presenta en este documento una revisión de los datos epidemiológicos, de los conocimientos sobre las especies de flebótomos incriminadas en la transmisión, su respuesta a los insecticidas y los ensayos de control conducidos en el país. Como perspectiva factible a corto plazo se propone un programa multisectorial en el cual concurran en primera instancia el IB, la Dirección General de Salud Ambiental (DGSA) y el Sector Educativo en una acción concertada para el control de leishmaniasis y Enfermedad de Chagas y leishmaniasis-malaria en áreas de co-endemicidad. Se hace especial énfasis en la necesidad de buenos programas educativos de salud que deben aplicarse antes de la selección de las medidas de control, de acuerdo a las características epidemiológicas y socio-culturales de la zona. Es importante tener en cuenta los conocimientos, actitudes y prácticas (CAP) de la población de riesgo con el fin de promover la aceptación del programa y de la participación comunitaria en la prevención de estas "enfermedades desatendidas", a través de la gestión ambiental y la protección personal. Sobre la base de estas premisas, estas acciones de lucha integrada, concertadas en un programa multisectorial, en el marco del enfoque Ecosalud conducirían hacia la optimización de los recursos y la sostenibilidad del programa en sí.

The Leishmaniasis Control Program in Venezuela, directed by the Institute of Biomedicine (IB) of the Ministry of Popular Power for Health (MPPH) has been strengthened in recent years by the improvement of health care, especially with regard to the establishment of diagnostic procedures and for Visceral Leishmaniasis (VL), tighter relations with the Zoonosis Department of the MPPH. However, entomological and epidemiological indicators of the dispersion, and in some cases urbanization, of cutaneous and visceral leishmaniasis (CL and VL, respectively) have highlighted the need for vector control in order to approach this health problem from a transdisciplinary systemic perspective in the context of environmental protection. We present a review of epidemiological data, our knowledge about the species of phlebotomine sand flies incriminated in transmission, and their response to insecticides and control assays undertaken in Venezuela. A multisectorial program managed between the Institute of Biomedicine (MPPH), the General Directorate of Environmental Health (GDEH) (MPPH) and the Education Sector (MPPE) for the control of leishmaniasis-Chagas disease and leishmaniasis-malaria in co-endemic areas, has been proposed as a feasible short term strategy. The need for high quality health education programs implemented according to the epidemiological and socio-cultural features of the regions, before control measures are selected, is also emphasized. It is important to take into account the knowledge, attitudes and practices (KAP) of the population at risk in order to a) ensure acceptance of the program and b) promote community participation, through environmental management and personal protection, for the prevention of these "neglected diseases". Based on this approach, these integrated control actions within a multi-sectorial program would lead towards the optimization of resources and the sustainability of the program itself.