Assessment microbial risks for the presence of Cryptosporidium spp. and Giardia spp. based on the surveillance of the water supply systems in Colombia, 2014-2018.

Cryptosporidium spp. and Giardia spp. cause gastrointestinal diseases of zoonotic origin as well transmitted from person to person, being various reported outbreaks associated with water. The infecting (oo)cyst forms of these parasites are highly resistant to water treatments such as chlorine disinfection and fast filtration. The objective of this study was to assess the microbial risk of infection and symptomatic illness by the ingestion of Giardia spp. and Cryptosporidium spp. in water for human consumption in Colombia, based on the results of water quality surveillance. The detection method was according to the USEPA method 1623. Concentration data of the different points of distribution were grouped according to the pathogen and type of treatment (no treatment; chlorine treatment; chlorine treatment + coagulant). Annual microbial risks of infection and symptomatic diseases were estimated using the quantitative microbial risk assessment approach that included parasite concentrations, the dose-response model, the ingestion rates of water by children and adults, and the morbidity rate of the diseases. The mean annual microbial risk of infection for Giardia spp. was 29.8% for treated water and 50.4% for untreated water, while being 6.0% and 17.7%, respectively, for Cryptosporidium spp. Microbial risk of symptomatic illness for Giardia spp, was 8.2% for treated water and 13.9% for untreated water, while being 3.6% and 10.6%, respectively, for Cryptosporidium spp. The estimated annual microbial risks of infection exceeded the acceptable value of 10-4 (0.01%) recommended by USEPA. Results obtained in this study suggest the need to reduce the microbial risk of infection to protozoan parasites by improving the water treatment, by adopting better handling practices for livestock manure and treatment processes of human feces. PRACTITIONER POINTS: The presence of Cryptosporidium spp was identified in 28 (6.2%) samples and Giardia spp in 29 (6.4%) in water for human consumption in Colombia. The mean annual risk of symptomatic illness due to infection by Giardia spp or Cryptosporidium spp ranges from 33.6%, for treated water, to 58.1%, for untreated water. Annual risks ingestion of protozoa studying in water for human exceed of 10-4 (0.01%) recommended by USEPA.

Evaluación de la implementación de la estrategia escuela saludable en zona rural de Ibagué: estudio de casos / Evaluation of the implementation of the healthy school strategy in the rural area of the municipality of Ibague: case studies / Avaliação da implementación da estrategia escola saudável em zona rural de Ibagué: estudo de casos

La escuela es un espacio privilegiado de promoción de la salud, en Colombia se desarrolla la estrategia escuela saludable como una herramienta integradora de políticas en salud en el ámbito escolar. Objetivo: el estudio busca evaluar la implementación de la estrategia escuela saludable en el contexto rural del municipio de Ibagué. Materiales y métodos: la evaluación de la implementación se realizó mediante la construcción de un modelo lógico y la definición de criterios evaluativos en relación con los ambientes saludables, las políticas públicas y planes para la escuela saludable, la participación social, el empoderamiento y la educación para la salud. Se evaluaron un total de 93 escuelas rurales, la información fue levantada mediante cuestionarios a los responsables de las escuelas y a través de entrevistas a los gestores de salud. Resultados: se identificaron problemáticas sanitarias y ambientales en las escuelas asociadas a las carencias de la ruralidad, falta de articulación del sector salud y educación, baja participación social, la educación enfocada a la prevención de la enfermedad. Conclusión: promover los entornos escolares saludables en la ruralidad requiere de un marco legal nacional y local que garantice la actuación estatal, la intersectorial, la participación efectiva del sector educativo, la renovación de la salud y que promueva intereses y voluntades político, sociales y administrativas.

The school is a privileged space for the promotion of health. In Colombia the Healthy School Strategy is developed as an integrating tool for health policies in the school environment. Objective: the study seeks to evaluate the implementation of the healthy school strategy in the rural context of the Municipality of Ibagué. Materials and Methods: the evaluation of the implementation was carried out through the construction of a logical model and the definition of evaluative criteria in relation to healthy environments, public policies and plans for the healthy school, social participation, empowerment and education for health. A total of 93 rural schools were evaluated and the information was raised through questionnaires to those responsible for the schools and through interviews with health managers. Results: health and environmental problems were identified in the schools associated with lack of rurality, lack of articulation of the health and educational sector, low social participation and education focused on disease prevention. Conclusions: promoting healthy school environments in rural areas requires a national and local legal framework that guarantees state, intersectoral action, effective participation of the education sector, health renewal and that promotes political, social and administrative interests and wills

A escola é um espaço privilegiado de promoção da saúde, em Colômbia se desenvolve a estratégia escola saudável como uma ferramenta integradora de políticas em saúde no âmbito escolar. Objetivo: o estudo busca avaliar a execução da estratégia escola saudável no contexto rural do município de Ibagué. Materiais e métodos: a avaliação da execução se realizou mediante a construção de um modelo lógico e a definição de critérios avaliativos em relação com os ambientes saudáveis, as políticas públicas e planos para a escola saudável, a participação social, o empoeiramento e a educação para a saúde. Avaliaram se um total de 93 escolas rurais, a informação foi levantada mediante questionários aos responsáveis das escolas e a través de entrevistas aos gestores de saúde. Resultados: se identificaram problemáticas sanitárias e ambientais nas escolas associadas às carências da ruralidade, falta de articulação do setor saúde e educação, baixa participação social, a educação enfocada à prevenção da doença. Conclusão: promover os entornos escolares saudáveis na ruralidade requer de um marco legal nacional e local que garante à atuação estadual, a intersetorial, a participação efetiva do setor educativo, a renovação da saúde e que promova interesses e vontades político, sociais e administrativas.