Conocimiento de los costarricenses sobre parasitosis en la población infantil / Knowledge of Costa Ricans about parasitosis in children population / Conhecimento dos costarriquenhos sobre parasitoses na população infantil

Objetivo: los parásitos son organismos que viven en el interior o sobre otra especie para su propio beneficio. Logran afectar plantas, animales y humanos. Los niños son más vulnerables a infectarse, pero la incidencia ha disminuido en Costa Rica gracias a la mejora en salubridad. El objetivo de este estudio fue evaluar el conocimiento general que tiene la población costarricense con respecto a las parasitosis infantiles. Metodología: se realizó un estudio observacional, descriptivo de tipo transversal, a una muestra de 196 sujetos. Se presentó encuesta a costarricenses mayores de 18 años que tuvieran un dispositivo con acceso a internet. Se consultó sobre el conocimiento del cuadro clínico de las parasitosis infantiles en Costa Rica. Resultados: la mayoría de los participantes eran universitarios (68.3%). El 89.9% cree que los parásitos de las mascotas pueden infectar a los humanos. Los parásitos más conocidos fueron los piojos 173 (88.3%). La parte del cuerpo que se considera más afectada por los parásitos es el estómago (75.5%). La principal medida preventiva contra las parasitosis más conocidas es lavarse las manos (67.9%). Conclusión: muchos participantes creen que los humanos se pueden infectar por los mismos parásitos de los animales. Los piojos fueron los parásitos más conocidos y las garrapatas las menos conocidas. La mayoría considera el vómito o la diarrea como los síntomas principales de las parasitosis y creen que el estómago es el más afectado en una infección. Además, señalan que la principal medida preventiva para evitar el contagio es el lavado de manos.

Objective: parasites are organisms that live inside or on another species for their own benefit, managing to affect plants, animals, and humans. Children are more vulnerable to infection, but the incidence has decreased thanks to the improvement in Costa Rican sanitation. The aim was to evaluate the general knowledge that the Costa Rican population has regarding childhood parasitosis. Methodology: an observational, descriptive, cross-sectional study was carried out on a sample of 196 subjects. A survey was conducted among Costa Ricans over 18 years of age who had a device with internet access. The participants were asked about their knowledge on the clinical picture of childhood parasitosis in Costa Rica. Results: most of the participants were college students (68.3%). 89.9% of them believe that pet parasites can infect humans. The best-known parasites were lice, marked by 173 (88.3%) people. The stomach is the part of the body considered most affected, with 148 (75.5%) responses. The main known preventive measure is washing hands with soap and water, answered by 133 participants (67.9%). Conclusion: Many participants believe that humans can be infected by the same parasites as animals. Lice were the best known and ticks the least. Most of the people consider vomiting and/or diarrhea as one of the main symptoms and believe that the stomach is the most affected part during the infection. In addition, they consider that the main preventive measure to avoid contagion is hand washing.

Objetivo: Parasitas são organismos que vivem em ou sobre outra espécie para seu próprio benefício. Eles conseguem afetar plantas, animais e humanos. As crianças são mais vulneráveis à infecção, mas a incidência diminuiu na Costa Rica graças a melhorias no saneamento. O objetivo deste estudo foi avaliar o conhecimento geral que a população costarriquenha tem sobre parasitas infantis.Metodologia: estudo observacional, descritivo, transversal, com amostra de 196 sujeitos.Uma pesquisa foi apresentada a costarriquenhos maiores de 18 anos que possuíam um dispositivo com acesso à internet. O conhecimento do quadro clínico de parasitas infantis na Costa Rica foi consultado.Resultados:a maioria dos participantes era universitária (68.3%). 89.9% acreditam que parasitas de animais de estimação podem infectar humanos. Os parasitas mais conhecidos foram os piolhos 173 (88.3%). A parte do corpo considerada mais afetada pelos parasitas é o estômago (75.5%). A principal medida preventiva contra os parasitas mais conhecidos é a lavagem das mãos (67.9%).Conclusão: muitos participantes acreditam que humanos podem ser infectados pelos mesmos parasitas de animais. Os piolhos foram os parasitas mais conhecidos e os carrapatos os menos conhecidos. A maioria considera vômito ou diarreia como os principais sintomas dos parasitas e acredita que o estômago é o mais afetado em uma infecção. Além disso, apontam que a principal medida preventiva para evitar o contágio é a lavagem das mãos.

Educação ambiental como instrumento da gestão do saneamento em aglomerados subnormais / Environmental education as a tool for sanitation management in subnormal agglomerates

Como resultado do crescimento desordenado dos centros urbanos no país, surgiram regiões nas cidades com déficits de infraestruturas básicas, incluindo as sanitárias, desencadeando consequências ambientais como a poluição dos córregos, e socias com a formação dos aglomerados subnormais, com perda da qualidade de vida e prejuízos à saúde. Visando solucionar em parte os problemas de poluição dos corpos hídricos no município de São Paulo, a Sabesp em conjunto com parceiros institucionais lançou o Programa Córrego Limpo, com ações focadas em instalação de infraestruturas físicas e ações educacionais, de modo a envolver a sociedade com a problemática, conscientizando-a quanto ao seu papel. Neste contexto, a pesquisa visa avaliar a efetividade da educação ambiental na eficácia das ações de saneamento em aglomerados subnormais, utilizando os resultados obtidos com o Programa Córrego Limpo para uma amostra de três córregos (Charles de Gaulle, Novo Mundo/Biquinha e Adão Ferraris). Mediante análise dos dados, conclui-se que o nível de envolvimento social nos córregos Charles de Gaulle e Novo Mundo/Biquinha foram mais elevados, culminando em melhores condições de qualidade das águas dos corpos hídricos ao longo dos anos de monitoramento realizados, cujos fatores identificados como influenciadores no engajamento da população foram a presença de fortes lideranças locais, elaboração de projeto de educação ambiental, atuação junto à ONGs locais, realização de eventos com chamamento público e atividades informativas e de comunicação. Assim, constata-se que o envolvimento da população é fator determinante para o sucesso de projetos de despoluição de córregos. Complementarmente, comparando as ações do Programa Córrego Limpo com as do Projeto Novo Rio Pinheiros, em implantação, tem-se como perspectiva e expectativa que os resultados de despoluição desejados neste segundo tendam a ser alcançados, já que possui em suas diretrizes exigências em comum com os fatores positivos identificados no primeiro programa, e melhoria quanto aos menos eficientes. Logo, o caminho a ser seguido para que as ações de saneamento atuem como barreiras sanitárias em regiões de vulnerabilidade social requer estruturação e planejamento de atividades de educação ambiental abrangentes, além de intensa informação e comunicação junto à sociedade.

As a result of the disorderly growth of urban centers in the country, some city regions emerged with deficit in basic infrastructure, including sanitation. It triggered serious environmental consequences such as water pollution, and also social issues with the formation of subnormal agglomerates, which resulted in reduced quality of life and damage to health. Aiming to partially solve the problems of water bodies pollution in the city of São Paulo, Sabesp, together with institutional partners, launched the Clean Stream Program, with actions focused on the installation of physical infrastructure and education actions. The idea is to engage the society with the problematic scenario, making them aware of their role in it. In this context, the research aims to evaluate the effectiveness of environmental education in the efficiency of sanitation actions in subnormal agglomerates, using the results obtained from the Clean Stream Program for a sample of three streams (Charles de Gaulle, Novo Mundo/Biquinha and Adão Ferraris). Through data analysis, it is concluded that the level of social engagement in the Charles de Gaulle and Novo Mundo/Biquinha streams were higher, culminating in better water quality conditions in water bodies over the monitored years. In this case, the main factors that influenced the population engagement were the presence of strong local leaders, the elaboration of an environmental education project, working with local NGOs, holding public call events, and performing information/communication activities. This way, it appears that the involvement of the population is a determining factor for the success of stream clean-up projects. In addition, comparing the actions of the Clean Stream Program with those of the New Pinheiros River Project (which is currently being implemented), the perspective and expectation is that the desired depollution results of the latter tend to be achieved, since it has guidelines requirements in common with the positive factors identified in the first program, while also improving the less efficient ones. Therefore, in order to form real sanitary barriers in regions of social vulnerability through sanitation actions, it requires the structuring and planning of comprehensive environmental education activities, in addition to intense information and society communication.

Exportación y sanitación internacional en empresas productoras de prendas de alpaca de Huancayo y Lima / Exportation and international sanitation in companies producing alpaca garments in Huancayo and Lima

El Perú se considera un país potencia en cuanto a la exportación textil de la alpaca, cuya fibra natural es muy fina, ligera y con alto valor a nivel mundial. Para el año 2019, la exportación total de fibra de alpaca en Perú llegó a un total de 23 países, incluyendo mercados en Europa, Asia y Norteamérica. La tendencia en el comercio exterior incluyendo las empresas textiles de alpaca, se ha dirigido a garantizar el cuidado del medio ambiente y la inocuidad de los productos respecto a la salud humana. Se realizó un estudio desde el paradigma post-positivista, con enfoque cualitativo y el método hermenéutico, para interpretar la situación de exportación y sanitación internacional en empresas peruanas productoras de prendas de alpaca en Huancayo y Lima. Se obtuvo información a partir de cuatro informantes voluntarios de cada empresa acerca de aspectos relacionados con exportación de las prendas de alpaca: competitividad, promoción, proveedores, producción, calidad de producto, valor agregado, calidad de servicio, mercados destino, demanda y herramientas de inteligencia comercial, entre otros. Asimismo, se indagó sobre la concepción y cumplimiento del Reglamento Sanitario Internacional. Las empresas evaluadas, emplean excelente materia prima, garantizan un control de calidad de sus productos ofreciendo textiles competitivos que se distribuyen en diversos mercados internacionales, emplean herramientas de comercialización que favorecen la identificación de regulaciones arancelarias y la capacitación de su personal. No obstante, muestran carencias en el cumplimiento del RSI, requiriendo adoptar medidas que garanticen la salud pública al comercializar sus productos(AU)

Peru is considered a powerful country in terms of alpaca textile exports, whose natural fiber is very fine, light and highly valued worldwide. For the year 2019, the total export of alpaca fiber in Peru reached a total of 23 countries, including markets in Europe, Asia and North America. The trend in foreign trade, including alpaca textile companies, has been aimed at guaranteeing care for the environment and the safety of products with respect to human health. A study was carried out from the post-positivist paradigm, with a qualitative approach and the hermeneutical method, to interpret the export situation and international sanitation in Peruvian companies that produce alpaca garments in Huancayo and Lima. Information was obtained from four volunteer informants from each company about aspects related to the export of alpaca garments: competitiveness, promotion, suppliers, production, product quality, added value, service quality, destination markets, demand and marketing tools. commercial intelligence, among others. Likewise, the conception and compliance with the International Health Regulations were inquired about. The evaluated companies use excellent raw material, guarantee quality control of their products by offering competitive textiles that are distributed in various international markets, use marketing tools that favor the identification of tariff regulations and the training of their personnel. However, they show deficiencies in compliance with the RSI, requiring the adoption of measures that guarantee public health when marketing their products(AU)

Proposition and application of an environmental salubrity index in rural agglomerations / Proposição e aplicação de um índice de salubridade ambiental em aglomerados rurais

ABSTRACT OBJECTIVE Propose an Índice de salubridade ambiental (ISARural - environmental salubrity index) that expresses the conditions experienced in rural agglomerations, including indicators and subindicators for its subsequent application in rural communities in the state of Goiás. METHODS We developed the research in three phases: 1) previous analysis for the proposition of an ISARural, with the participation of seven specialists; 2) proposition of the ISARural by means of the Delphi method, starting with 168 specialists from 26 federative units of Brazil and Distrito Federal; and 3) application of the ISARural in 43 rural communities in the state of Goiás. RESULTS The proposed ISARural resulted in the composition of eight indicators, four of which related to basic sanitation, and the others to health, socioeconomic conditions, public services offered, and housing conditions. The weight assigned to each indicator ranged from 22.82% for the water supply indicator to 6.35% for the service indicator, it is possible to apply the ISARural fully or to evaluate each indicator individually. The application of ISARural in communities of Goiás classified 86% of them with low salubrity, highlighting the worst conditions for quilombola communities. The sanitary sewage had the lowest score among the ISARural indicators, requiring greater attention from public authorities. CONCLUSIONS This study contributed to the proposition of an index in line with the concept of environmental salubrity, useful in the scope of public policies as a conditioner for the prioritization of actions needed to improve the salubrity conditions identified. The proposed ISARural can be fully applied or used in the individual evaluation of each indicator of its composition. The results of its application made it possible to identify the communities with the worst environmental salubrity conditions and the indicators that require greater priority attention in the communities studied.

RESUMO OBJETIVO Propor um índice de salubridade ambiental que expresse as condições vividas em aglomerados rurais (ISARural), englobando indicadores e subindicadores para sua posterior aplicação em comunidades rurais do estado de Goiás. MÉTODOS A pesquisa foi desenvolvida em três fases: 1) análise prévia para proposição de um ISARural, contando com a participação de sete especialistas; 2) proposição do ISARuralpor meio do método Delphi, iniciando com 168 especialistas das 26 unidades federativas do Brasil e do Distrito Federal; e 3) aplicação do ISARuralem 43 comunidades rurais do estado de Goiás. RESULTADOS O ISARuralproposto resultou na composição de oito indicadores, sendo quatro relacionados ao saneamento básico, e os demais à saúde, às condições socioeconômicas, aos serviços públicos ofertados e às condições de moradia. O peso atribuído para cada indicador variou de 22,82%, para indicador de abastecimento de água, a 6,35%, para o indicador de serviços, podendo o ISARuralser aplicado na sua totalidade ou para avaliação de cada indicador individualmente. A aplicação do ISARuralem comunidades de Goiás evidenciou que 86% se classificam com baixa salubridade, destacando as piores condições para as comunidades quilombolas. Dentre os indicadores do ISARural, o de esgotamento sanitário foi caracterizado com a menor pontuação, o que demanda uma maior atenção do poder público. CONCLUSÕES Esse estudo cumpriu o papel de contribuir com a proposição de um índice em consonância com o conceito de salubridade ambiental, podendo ser empregado no âmbito das políticas públicas como um condicionante para a priorização das ações necessárias à melhoria das condições de salubridade identificadas. O ISARuralproposto pode ser aplicado na sua totalidade ou ainda na avaliação individual de cada indicador de sua composição. Os resultados da sua aplicação possibilitaram identificar as comunidades com piores condições de salubridade ambiental e os indicadores que requerem maior atenção prioritária nas comunidades estudadas.

Diseases caused by pathogens in the urban water system in the metropolitan region of Belém, Pará, Brazil, and their relationship with the socio-economic context of the population

The metropolitan region of Belém-PA suffers human fecal pollution in the local water supply system favoring the increase in cases of water circulating diseases in the population, especially the most socioeconomically vulnerable. Therefore, it is necessary to compile information on cases of these diseases over the years in this region, in order to better define public health policies. Thus, this work aims to contribute to the gathering of this information through a literature review selecting articles found in the SciELO, Pubmed and Google Academic databases with publications between 2005 and 2021 in Portuguese and English. The neighborhoods most affected by water circulation diseases proved were Guamá, Marco, Jurunas, Tapanã, Telegrafo and Terra Firme, located close to hydrographic basins, rivers and canals and are subject to flooding due to high tides and overflowing canals. In addition, the population in these neighborhoods is considered underprivileged. The most cited diseases and symptoms were leptospirosis, worms and diarrhea, which are easily prevented. Total and thermotolerant coliforms were also widely described, being the main indicators of fecal water contamination. The importance of sanitary measures is evidenced, as these reduce cases of water supply diseases in urban centers and improve population health. The quality of the water in the supply network is also important to mitigate the prevalence of these diseases.

Los nuevos retos en la ingeniería sanitaria en Perú: Pandemia COVID-19 y enseñanza remota / The new challenges in sanitary engineering in Peru: COVID-19 pandemic and remote teaching

La Ingeniería Sanitaria surge como una rama de la ingeniería que involucra tanto materias propias de la ingeniería tales como: matemáticas, física, química hidráulica o mecánica, como aquellas relacionada con la medicina y la higiene, tales como la microbiología y conservación. Tiene como función principal crear y fomentar condiciones de salubridad en las poblaciones siendo vigilante de las aguas, el aire y la tierra, evitando que la contaminación alcance a los seres humanos. En Perú, la ingeniería sanitaria se creó como un apéndice de la ingeniería civil, pero pronto tomó el lugar merecido, declarándose una carrera de ingeniería independiente. Actualmente, la Ingeniería sanitaria es la encargada de llevar agua potabilizada a la población, y tratar las aguas servidas. Por otra parte, con la llegada del SARS-CoV-2, el mundo fue sacudido, y una situación de pandemia emergió, lo que hizo que los diferentes países tomasen las acciones necesarias, tal como sucedió con el Perú. Allí, la Ingeniería Sanitaria, accionó sus funciones, buscando la potabilización del agua de consumo. En estos tiempos de pandemia, también determinaron el resguardo de la población, lo que fomentó la educación remota. En el caso de la Ingeniería Sanitaria, los laboratorios presenciales y convencionales fueron sustituidos por laboratorios virtuales y remotos, lo cual permitió que la educación continuase sin contratiempos(AU)

Sanitary Engineering emerges as a branch of engineering that involves both engineering subjects such as: mathematics, physics, hydraulic or mechanical chemistry, as well as those related to medicine and hygiene, such as microbiology and conservation. Its main function is to create and promote healthy conditions in the populations, being vigilant of the waters, the air and the land, preventing contamination from reaching human beings. In Peru, sanitary engineering was created as an appendix to civil engineering, but it soon took its deserved place, declaring itself an independent engineering career. Currently, Sanitary Engineering is in charge of bringing drinking water to the population, and treating wastewater. On the other hand, with the arrival of SARS-CoV-2, the world was shaken, and a pandemic situation emerged, which made the different countries take the necessary actions, as happened with Peru. Over there, the Sanitary Engineering, activated its functions, seeking the potabilization of drinking water. In these times of pandemic, they also determined the protection of the population, which promoted remote education. In the case of Sanitary Engineering, face-to-face and conventional laboratories were replaced by virtual and remote laboratories, which allowed education to continue without setbacks(AU)

Angiostrongylus cantonensis en Achatina fulica en la provincia del Napo, Ecuador y el riesgo incrementado de angiostrongiliasis / Angiostrongylus cantonensis in Achatina fulica in Napo province, Ecuador and the increased risk of angiostrongyliasis

Introducción: Angiostrongylus cantonensis es reconocido como uno de los principales patógenos causantes de la meningoencefalitis eosinofílica, fue identificado en Ecuador por primera vez en 2008. Métodos: se recolectaron 1476 ejemplares de Achatina fulica con el método de captura por unidad de esfuerzo durante 30 minutos, en 3 cantones de la provincia del Napo, con el fin de establecer la prevalencia de infección por A. cantonensis Resultados: el porcentaje total de caracoles infectados fue de 46,5% (687/1476). Conclusiones: Los resultados revelan una amplia distribución de A. fulica infectado con A. cantonensis, lo que, sumado a la gran cantidad de hospederos definitivos presentes, indica que un número considerable de personas tiene riesgo de adquirir angiostrongiliasis. Se necesita intervenciones educativas comunitaria orientadas a formación sanitaria, recalcando el riesgo de adquirir la infección parasitaria, principalmente por el consumo de A. fulica, crudos y/o con cocción inadecuada, principal forma de contagio. Además, se recomienda vigilancia rigurosa y control de los hospedadores involucrados, saneamiento ambiental, haciendo insistencia en factores relacionados con los hábitos biológico del caracol gigante africano, entre ello alimentos (vegetales), suelos y derivados del caracol de uso artesanal; para prevenir la aparición de casos esporádicos y de brotes de la enfermedad(AU)

Introduction: Angiostrongylus cantonensis is recognized as one of the main pathogens that cause eosinophilic meningoencephalitis, it was identified in Ecuador for the first time in 2008. Methods: 1476 specimens of Achatina fulica were collected using the capture method per unit of effort for 30 minutes, in 3 cantons of the Napo province, in order to establish the prevalence of infection by A. cantonensis Results: the total percentage of infected snails was 46.5% (687/1476). Conclusions: The results reveal a wide distribution of A. fulica infected with A. cantonensis, which, added to the large number of definitive hosts present, indicates that a considerable number of people are at risk of acquiring angiostrongyliasis. Community educational interventions aimed at health training are needed, emphasizing the risk of acquiring parasitic infection, mainly due to the consumption of A. fulica, raw and/or inadequately cooked, the main form of contagion. In addition, rigorous surveillance and control of the hosts involved, environmental sanitation, insisting on factors related to the biological habits of the giant African snail, including food (vegetables), soil and snail derivatives for artisanal use; to prevent the appearance of sporadic cases and outbreaks of the disease(AU)

Câncer de colo de útero e componentes de saneamento nos municípios do estado do Mato Grosso do Sul: seria uma questão de má qualidade da água? / Cervical cancer and sanitation components in the municipalities of the state of Mato Grosso do Sul: would it be a question of poor water quality?

Resumo Este artigo investiga relações entre a incidência de câncer de colo de útero (ICC) e os componentes e indicadores de qualidade da água nos municípios do Mato Grosso do Sul, entre 2014 e 2017, por correlação estatística (Determinante de Pearson) e espacial (agrupamentos por k-médias). Houve maior resposta estatística de ICC em relação à tarifa média dos serviços de abastecimento praticado (-36,28%) e de água (-34,15%); à quantidade de suas interrupções sistemáticas (28,3%) e paralizações (22,28%); ao consumo médio per capita de água (20,74%) e à quantidade de serviços executados (-17,98%), todas as respostas sob p-valor ≤ 0,001. Em Costa Rica, cidade sob maior ICC média, os agrupamentos espaciais identificaram maior efeito daquelas interrupções (z-valor = 8,741) e das paralizações (z = 7,6097); enquanto em Rochedo, também sob alta ICC, houve maior efeito à incidência de análises com resultados fora do padrão para coliformes totais (z = 8,6803) e turbidez (z = 5,7427), sob correlação estatística de 12,05% (p-valor = 0,032) e 15,18% (p-valor = 0,007), respectivamente. Dados do SISAGUA revelaram a presença de coliformes e de altos níveis de turbidez, por exemplo, em Antônio João e Tacuru, cidades sob altas ICC médias. Recomenda-se maiores investigações sobre as relações aqui apresentadas entre ICC e água.

Abstratct This article investigates relationships between the incidence of cervical cancer (CCI) and the water components and quality indicators, in the municipalities of Mato Grosso do Sul, between 2014 and 2017, by statistical (Pearson's Determinant) and spatial (k-means Clustering) correlation. There was a greater statistical response of CCI in relation to the average tariff of the practiced supply (−36.28%) and water (−34.15%) services; the number of their systematic interruptions (28.3%) and outages (22.28%); the average per capita consumption of water (20.74%); and the number of services performed (−17.98%), all answers under p-value ≤ 0.001. In Costa Rica, city with the highest average CCI, the spatial clustering identified a greater effect of those interruptions (z-value = 8.741) and outages (z = 7.6097); whereas, in Rochedo, also under high CCI, the analyses showed greater effect with non-standard results for total coliforms (z = 8.6803) and turbidity (z = 5.7427), under a statistical correlation of 12.05% (p-value = 0.032) and 15.18% (p-value = 0.007), respectively. Data from SISAGUA revealed the presence of coliforms and high levels of turbidity, for example, in Antônio João and Tacuru, cities with high average ICC. We recommend further investigation into the relationships presented here between CCI and water.

Status of water, sanitation, and hygiene and standard precautions in healthcare facilities and its relevance to COVID-19 in Afghanistan

BACKGROUND@#To protect the health and safety of healthcare workers (HCWs), it is essential to ensure the provision of sustainable water, sanitation, and hygiene (WASH) services and standard precautions in healthcare facilities (HCF). The objectives of this short communication were 1) to assess the availability of WASH services and standard precautions in HCFs in seven provinces in Afghanistan before the COVID-19 pandemic, and 2) to elucidate the relevance of these patterns with the number of reported HCW infections from COVID-19 in the mentioned provinces.@*METHODS@#We analyzed secondary data from the 2018-19 Afghanistan Service Provision Assessment survey, which included 142 public and private HCFs in seven major provinces in Afghanistan. Data on COVID-19 cases were obtained from the Afghanistan Ministry of Public Health Data Warehouse. Weighted prevalence of WASH services and standard precautions were calculated using frequencies and percentages. ArcGIS maps were used to visualize the distribution of COVID-19 cases, and scatter plots were created to visualize the relevance of WASH services and standard precautions to COVID-19 cases in provinces.@*RESULTS@#Of the 142 facilities surveyed, about 97% had improved water sources, and over 94% had improved toilet for clients. Overall, HCFs had limited availability of hygiene services and standard precautions, which was lower in private than public facilities. More than half of the facilities had safe final disposal and appropriate storage of sharps and medical waste. Of the seven provinces, Herat province had the highest cumulative COVID-19 case rate among HCWs per 100,000 population and reported lower availability of WASH services and standard precautions in HCFs compared to other provinces.@*CONCLUSION@#Our findings show disparities in the availability of WASH services and standard precautions in public and private facilities. Private facilities had a lower availability of hygiene services and standard precautions than public facilities. Provinces with higher availability of WASH services and standard precautions in HCFs had a lower cumulative COVID-19 case rate among HCWs per 100,000 population. Pre-pandemic preparation of adequate WASH services and standard precautions in HCFs could be potentially important in combating infectious disease emergence.

Política ambiental institucional / Institutional environmental policy

La Dirección de Salud Ambiental (DISAM) a través de la Unidad Ambiental, formula la presente Política Ambiental Institucional, que contiene las estrategias y acciones a implementar con la finalidad de proteger y conservar el ambiente, englobadas en los componentes de saneamiento ambiental, agua y cambio climático. Estrategias que contribuyan a proteger el ambiente a través de acciones del personal que labora en las diferentes dependencias del MINSAL

The Environmental Health Directorate (DISAM) through the Environmental Unit, formulates this Institutional Environmental Policy, which contains the strategies and actions to be implemented in order to protect and conserve the environment, encompassed in the components of environmental sanitation, water and climate change. Strategies that contribute to protecting the environment through actions of the personnel that work in the different dependencies of the MINSAL

Higienización y eliminación fúngica en instalaciones industriales para la disminución de riesgos ocupacionales / Sanitization and fungal elimination in industrial facilities to reduce occupational risks

Se ha comprobado que la exposición a bioaerosoles se asocia con varios efectos sobre la salud, como enfermedades pulmonares y alergias. El presente estudio transversal tuvo como objetivo investigar la contaminación por hongos en varias superficies pertenecientes a dos industrias de alimentos. La toma de muestra se realizó en tres semanas, inmediatamente después de realizada la limpieza y desinfección y antes de iniciar la producción. Se recolectaron 400 muestras de superficie (vidrio, acero inoxidable, aluminio, goma y plástico), también se evaluó la eficacia del programa de higienización en el control de la población de hongos. Todas las muestras presentaron recuentos fúngicos <10 ufc/cm2, sin haber diferencias significativas entre los tipos de superficie, sin embargo, las superficies plásticas exhibieron mayor crecimiento logarítmico de los hongos. Se determinó que 49,60% de las especies identificadas correspondieron al género Penicillium. Aunque los niveles de hongos en las industrias estudiadas fueron inferiores a los niveles recomendados por la Organización Mundial de la Salud, algunas medidas de salud ambiental como lavar y desinfectar las superficies después de cada turno de trabajo, y se recomiendan inspecciones periódicas para garantizar la seguridad de los trabajadores y de los productos que allí se manufacturan(AU)

It has been proven that exposure to bioaerosols is associated with several health effects, such as pulmonary diseases and allergies. The present crosssectional study aimed to investigate fungal contamination on various surfaces belonging to two food industries. The sampling was carried out in three weeks, immediately after cleaning and disinfection and before starting production. 400 surface samples were collected (glass, stainless steel, aluminum, rubber and plastic), the effectiveness of the sanitation program in controlling the fungal population was also evaluated. All the samples presented fungal counts <10 cfu / cm2, with no significant differences between the types of surfaces, however, the plastic surfaces exhibited higher logarithmic growth of the fungi. It was determined that 49.60% of the identified species corresponded to the Penicillium genus.Although the levels of fungi in the studied baths were lower than the levels recommended by the World Health Organization, some environmental health measure ssuch as washing and disinfecting surfaces after each working shift and periodic inspections are recommended ensuring the safety of the workers and the products that are manufactured there(AU)

Evaluación higiénico-sanitaria de restaurantes vinculados a la actividad turística / Hygienic-sanitary evaluation of restaurants linked to tourist activity

RESUMEN Introducción: en los servicios gastronómicos, la garantía higiénico-sanitaria es vital para su funcionamiento, dada la incidencia directa en la salud de los consumidores. Objetivo: diagnosticar la situación higiénico-sanitaria de restaurantes asociados a la actividad turística en el balneario de Varadero. Materiales y métodos: se evaluaron 33 restaurantes en operación, mediante 10 dimensiones compuestas por 116 indicadores, integrados en el Índice Global de Cumplimiento de los Prerrequisitos Sanitarios. La valoración del cumplimiento por dimensiones se llevó a cabo mediante la matriz importancia-cumplimiento, identificándose por el método combinatorio la existencia de clústeres. Se estableció la relación de los resultados con la capacitación de los recursos humanos y la forma de administración de las entidades. Resultados: se evidenció un elevado cumplimiento de los indicadores evaluados (87 %). Aunque se hallaron deficiencias higiénico-sanitarias en un alto porcentaje de restaurantes, el 67 % requiere de una atención inmediata. Se determinó una relación moderadamente fuerte entre el nivel de gestión de la inocuidad, la capacitación de los recursos humanos y la forma de gestión. Conclusiones: las dimensiones almacenamiento en seco y abastecimiento de agua presentaron un comportamiento adecuado. Las mayores deficiencias se asociaron a las dimensiones control de vectores, elaboración de alimentos y mantenimiento. Son necesarios la capacitación del personal vinculado a la actividad gastronómica y el incremento, en el sector privado, de las inspecciones sanitarias con un mínimo de requisitos predefinidos que avalen la operación gastronómica (AU).

ABSTRACT Introduction: the hygiene-sanitary guarantee is vital for the functioning of the gastronomic services, given the direct impact on the health of consumers. Objective: to diagnose the hygienic-sanitary situation of restaurants associated with tourist activity at Varadero resort. Materials and methods: 33 restaurants in operation were evaluated, using 10 dimensions composed of 116 indicators, integrated in the Global Index of Compliance with Health Prerequisites. The assessment of compliance by dimensions was carried out using the importance-compliance matrix, identifying the existence of clusters by the combinatorial method. The relationship of results with human resources training and entity management was established. Results: it was evidenced high compliance with the indicators assessed (87%). Although hygienic-sanitary deficiencies were found in a high percentage of restaurants, 67% of them, require immediate attention. A moderately strong relationship was identified between the level of food safety management, the training of human resources and the form of management. Conclusions: the dry storage and water supply dimensions had an adequate performance. The greatest deficiencies were associated with vector control, food processing and maintenance dimensions. The training of the staff linked to gastronomic activity is necessary and also the increase, in the private sector, of health inspections with a minimum of predefined requirements that endorse the gastronomic operation (AU).

Perfil epidemiológico das parasitoses intestinais em moradores de uma comunidade da Ilha de Boipeba, Bahia, Brasil / Epidemiological profile of intestinal parasites in residents of a community on the island of Boipeba, Bahia, Brazil

Introdução: as parasitoses intestinais constituem-se um importante problema de saúde pública mundial. Estas infecções são mais prevalentes em regiões tropicais impactando na morbimortalidade e aumento nos custos para o sistema de saúde. Objetivo: avaliar a prevalência das enteroparasitoses e sua associação com as condições socioeconômicas, sanitárias, ambientais e hábitos de vida em uma comunidade costeira do Nordeste brasileiro. Metodologia: estudo epidemiológico, descritivo e transversal, realizado de modo não probabilístico entre março a junho de 2017, com 105 moradores da Ilha de Boipeba, localizada no Sul da Bahia. O exame parasitológico de fezes foi realizado pelos métodos de sedimentação espontânea, Baermann-Moraes e FAUST. Um questionário foi aplicado para avaliar o perfil sociodemográfico da população. Resultados: do total de indivíduos avaliados, 52,4% eram do sexo feminino e 57,1% tinham entre 15 a 59 anos. Todos os indivíduos possuíam água encanada, porém não tratada, enquanto 91,4% referiu ingerir vegetais crus e 45,7% não higienizavam as mãos antes as refeições. Sintomas gastrointestinais foram relatados em 82,8% dos indivíduos e infecções enteroparasitárias foram diagnosticadas em 69,6%. Os parasitos mais frequentemente encontrados foram Ancilostomídeo (18,1%) e Entamoeba coli (43,8%). O principal fator de risco potencial para contrair a infecção por ancilostomídeos foi a não existência de poço artesiano na residência (RP=4,35), enquanto para Trichuris trichiura foi não dispor de pia no banheiro (RP=3,82). Conclusão: a comunidade analisada apresentou elevada prevalência de enteroparasitoses. Os hábitos precários de higiene e de acesso à água tratada, associados às condições ambientais e climáticas do local, podem ter contribuído para a elevada transmissão de geohelmintos observada.

Introduction: Intestinal parasitic infections are an important public health problem worldwide. They are more prevalent in tropical regions impacting in morbidity and mortality and costs for the health system. Objective: To evaluate the prevalence of enteroparasitosis and its association with socioeconomic, sanitary and environmental conditions and lifestyle habits in a coastal community in the Northeast Brazil. Methodology: This is an epidemiological, descriptive and cross-sectional study, carried out in a non-probabilistic manner between March and June 2017, with 105 residents of Boipeba Island in the Southern Bahia. The parasitological examination of feces was carried out by the methods of spontaneous sedimentation, Baermann-Moraes and FAUST. A questionnaire was applied to assess the sociodemographic profile of the population. Results: Of the total of individuals evaluated, 52.4% were female and 57.1% were between 15 and 59 years old. All individuals had piped, but untreated water, while 91.4% reported eating raw vegetables and 45.7% did not wash their hands before meals. Gastrointestinal symptoms were observed in 82.8% individuals and 69.6% were diagnosed with enteroparasitic infections. The most frequent parasites were the hookworm (18.1%) and Entamoeba coli (43.8%). The main potential risk factor for hookworm infection was the non-existence of an artesian well in the residence (PR=4.35) and Trichuris trichiura it was not having a sink in the toilet (PR=3.82). Conclusion: The analyzed community has a high prevalence of enteroparasitosis, in addition to environmental and climatic conditions that contribute to the transmission of these infections.

Uma abordagem integral para saneamento ecológico em comunidades tradicionais e rurais / An integral approach of ecological sanitation in traditional and rural communities

Resumo Este artigo apresenta uma abordagem integral para atuar em projetos comunitários, baseada nas três ecologias de Guattari e do seu diálogo com teóricos da psicossociologia, por envolver a necessidade de conjugar intervenções tecnológicas com abordagens sociais. Explora-se essas contribuições para apontar a necessidade do diálogo na implementação de ações de saneamento, principalmente na zona rural e em Comunidades Tradicionais, envolvendo o indivíduo, os grupos atendidos e sua cultura territorial. A abordagem apresentada foi implementada em uma pequisa-ação, junto com a Comunidade Caiçara da Praia do Sono e o Fórum de Comunidades Tradicionais de Angra dos Reis, Paraty e Ubatuba (FCT), a partir do projeto Observatório de Territórios Sustentáveis e Saudáveis da Bocaina (OTSS/Fiocruz). Pode-se constatar que a inclusão dos atores na mobilização social para o saneamento pode estabelecer uma participação social efetiva, que gere tanto uma mudança subjetiva na consciência dos diversos atores locais, como ganhos estruturais que promovam saúde e qualidade de vida. O panorama abordado mostra a importância de uma compreensão global do problema, mas também, simultaneamente, uma atuação local, territorializada, adaptada a cada realidade por meio do diálogo genuíno e uma participação horizontal.

Abstract This article presents an integral approach to work in community projects, based on Guattari's three ecologies and its dialogue with psychosocial theorists, since it involves the need to combine technological interventions with social approaches. These contributions are explored to point out the need for dialogue in the implementation of sanitation actions, mainly in the rural area and in traditional communities, involving the individual, the groups served and their territorial culture. The approach presented was implemented in a joint action with the Caiçara Community of Praia do Sono and the Forum of Traditional Communities of Angra dos Reis, Paraty and Ubatuba (FCT), based on the Observatory of Sustainable and Healthy Territories of Bocaina (OTSS / Fiocruz). It could be verified that the inclusion of the actors in the social mobilization for the sanitation can entail an effective social participation that generates both a subjective change in the conscience of the diverse local actors and structural gains that promote health and quality of life. The panorama covered shows the importance of a global understanding of the problem, but also, of a simultaneous local, territorialized action, adapted to each reality through genuine dialogue and horizontal participation.

Poor sanitation and transmission of COVID-19 in Brazil

ABSTRACT Coronavirus is a family of viruses that cause respiratory infections. From cases first recorded in China at the end of 2019, a new type of virus in this family, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was discovered. The disease caused by this virus, COVID-19, was brought into Brazil by people in social classes with greater purchasing power, but groups with larger demographic dimensions have tended to become more affected over time. Poor sanitation can generate risky situations and behavior among people who live in spaces with characteristics that limit their quality of life. Installation of piped water in homes and basic education for the population are fundamental measures for disease control, including in relation to COVID-19. In this updating article, the COVID-19 pandemic was analyzed in the context of iniquities in Brazil (comparing these with the situation in other countries). A bibliographic search of texts relating to basic sanitation, socioeconomic development and transmission of COVID-19 in Brazil and worldwide was conducted.

Índice de desenvolvimento humano em municípios que possuem sistema integrado de saneamento rural: uma análise comparativa / Human development index in municipalities with the integrated rural sanitation system: a comparative analysis

Resumo Este estudo investigou o desenvolvimento humano de oito municípios cearenses rurais que possuem o Sistema Integrado de Saneamento Rural (SISAR) e 170 que não o possuem. Desenvolveu-se um estudo a partir de Indicadores de Desenvolvimento Humano Municipal (IDHM) que constam na plataforma Atlas do Desenvolvimento Humano, extraindo-se dados dos Censos Demográficos de 1991, 2000 e 2010. Contou-se com o auxílio do software R para realização das análises estatísticas. Os resultados encontrados para o IDHM geral mostraram uma diferença significativa entre as médias dos dois grupos, o que não ocorreu quando analisadas as dimensões renda, longevidade e educação. Em suma, verificou-se que, no geral, a implantação de sistemas de abastecimento de água contribui para o aumento dos níveis de desenvolvimento humano, mas, no que se refere às dimensões mais específicas, essa premissa não foi estatisticamente confirmada.

Abstract This study investigated the human development of eight rural municipalities in the state of Ceará that have the Integrated Rural Sanitation System (SISAR) and 170 that do not. The study was developed based on the Municipal Human Development Indicators (MHDIs), which feature in the Atlas of Human Development, by drawing data from the 1991, 2000 and 2010 Demographic Censuses. The R software was used to carry out the statistical analyses. The results found for the general MHDI showed a significant difference between the means of the two groups, which did not occur when the income, longevity, and education dimensions were analyzed. In sum, it was verified that, in general, implementing water supply systems contributes to increasing human development levels, but as regards the more specific dimensions, this premise was not statistically confirmed.

Inequalities in the access to healthy urban structure and housing: an analysis of the Brazilian census data / Desigualdades no acesso a infraestrutura urbana e moradia saudáveis: uma análise dos dados do censo brasileiro / Inequidades en el acceso a entornos urbanos saludables y vivienda: un análisis de datos del censo brasileño

Abstract: This study aims (1) to test the association between access to basic sanitation/hygiene services in Brazilian households with their householders' socioeconomic and demographic characteristics; (2) to analyze the distribution of urban health-relevant elements in the census tracts according to their income, education and race/color composition. The information come from the 2010 Brazilian Demographic Census, which collected data regarding both household conditions and urban structure of the census tracts. Prevalence ratios were calculated using crude and adjusted Poisson regression models. The proportional distribution of the census-tract urban structure was performed, according to the deciles of the exploratory variables, and the ratios and the absolute differences between the extreme deciles were calculated. Around 4.8% of the households had no piped water, 34.7% had no sewage collection system, 9.8% had no garbage collection and 39% were considered inadequate. Families whose householders were black, indigenous or brown had lower income and educational level, and lived in the North, Northeast, and Central West regions. They were more likely to be considered inappropriate for not having piped water, sewage collection system, and garbage collection. Moreover, sectors where the majority of the population was black, had lower educational levels and lower income had significantly poor paving, street lighting, afforestation, storm drain, sidewalk and wheelchair ramp. This study analyzed national data from 2010 and provides a baseline for future studies and government planning. The relevant social inequalities reported in this study need to be addressed by effective public policies.

Resumo: Os objetivos do estudo foram: (1) testar a associação entre os serviços de saneamento básico/higiene nos domicílios brasileiros e as características socioeconômicas e demográficas dos/das chefes de família e (2) analisar a distribuição dos elementos urbanos relacionados à saúde nos distritos sanitários de acordo com a composição de renda, escolaridade e raça/cor. Os dados foram obtidos do Censo Demográfico de 2010, que coletou informações sobre as condições do domicílio e a infraestrutura urbana dos distritos censitários. Foram calculadas as razões de prevalência, usando modelos de regressão Poisson simples e ajustada. Foi avaliada a distribuição proporcional da infraestrutura urbana nos distritos censitários de acordo com os decis das variáveis exploratórias, e foram calculadas as razões e diferenças absolutas entre os decis extremos. Cerca de 4,8% dos domicílios não dispunham de água encanada, 34,7% faltavam esgotamento sanitário, 9,8% não tinham coleta de lixo e 39% das moradias eram consideradas inadequadas. Os domicílios chefiados por pretos/as, pardos/as ou indígenas apresentavam níveis mais baixos de renda e escolaridade, e aqueles localizados no Norte, Nordeste e Centro-oeste tinham níveis maiores de moradia inadequada e falta de água encanada, esgotamento sanitário e coleta de lixo. Além disso, os distritos com maioria negra e com menores níveis de escolaridade e renda apresentavam menores coberturas de pavimentação, iluminação e arborização de ruas, galerias pluviais, calçadas e rampas para cadeira de rodas. O estudo analisou os dados de 2010 e estabeleceu uma linha de base para estudos futuros e planejamento de políticas de governo. As desigualdades sociais relevantes relatadas no estudo devem ser enfrentadas com políticas públicas efetivas.

Resumen: Los objetivos de este estudio son: (1) probar la asociación entre el acceso a servicios básicos de higiene y saneamiento en los hogares brasileños con sus principales características socioeconómicas y demográficas; (2) analizar la distribución de elementos urbanos relevantes para la salud en secciones censales, según la composición de sus ingresos, educación y raza/color. Los datos provienen del Censo Demográfico de 2010, que recogió datos, tanto respecto a las condiciones de los hogares, como al entorno urbano de las secciones censales. Las ratios de prevalencia se calcularon usando modelos de regresión crudos y ajustados de Poisson. Se realizó una distribución proporcional de las secciones censales relacionadas con el entorno urbano, según deciles de las variables exploratorias y las ratios, y se calcularon las diferencias absolutas entre los deciles extremos. Alrededor de un 4,8% de los hogares no contaban con agua canalizada, 34,7% no tenían un sistema de alcantarillado, un 9,8% no tenían recogida de basuras y un 39% de los hogares fueron considerados inadecuados. Hogares, cuyas cabezas de familia eran negros, indígenas o mulatos/mestizos, tenían bajos ingresos, educación, y vivían en el Norte, Noreste, y Centro-oeste tuvieron más probabilidad de ser considerados inapropiados, no contar con agua canalizada, sistema de alcantarillado y recogida de basuras. Además, los sectores donde la mayoría de la población era negra, con bajos niveles educativos e ingresos más bajos tenían significativamente menos cobertura de pavimentación, iluminación de calles, forestación, alcantarillado pluvial, aceras y rampas de acceso para sillas de ruedas. Este estudio analizó los datos nacionales desde 2010 y proporciona una base de referencia para futuros estudios y planificación gubernamental. Las inequidades relevantes sociales reflejadas en este estudio necesitan que ser tratadas mediante políticas públicas eficientes.

O saneamento e a politização da higiene no Rio Grande do Sul (1828-1930) / Sanitation and the politicization of hygiene in Rio Grande do Sul (1828-1930)

Oferece elementos para uma reflexão sobre as dificuldades enfrentadas pelo Brasil para promover a desejada universalização do abastecimento de água e para prover as cidades de sistemas de coleta e tratamento de esgoto

The role of Environmental Health in preventing antimicrobial resistance in low- and middle-income countries

Antimicrobial resistance (AMR) is increasingly becoming a threat to global public health, not least in low- and middle-income countries (LMICs) where it is contributing to longer treatment for illnesses, use of higher generation drugs, more expenditure on antimicrobials, and increased deaths attributed to what should be treatable diseases. Some of the known causes of AMR include misuse and overuse of antimicrobials in both humans and animals, unnecessary use of antimicrobials in animals as growth promoters, and lack of awareness among the public on how to protect antimicrobials. As a result, resistant organisms are circulating in the wider environment, and there is a need to consider the One Health approach to minimise the continuing development of AMR. Environmental Health, specifically water, sanitation and hygiene (WASH), waste management, and food hygiene and safety, are key components of One Health needed to prevent the spread of antimicrobial-resistant microorganisms particularly in LMICs and reduce the AMR threat to global public health. The key Environmental Health practices in the prevention of AMR include: (1) adequate WASH through access and consumption of safe water; suitable containment, treatment and disposal of human excreta and other wastewater including from health facilities; good personal hygiene practices such as washing hands with soap at critical times to prevent the spread of resistant microorganisms, and contraction of illnesses which may require antimicrobial treatment; (2) proper disposal of solid waste, including the disposal of unused and expired antimicrobials to prevent their unnecessary exposure to microorganisms in the environment; and (3) ensuring proper food hygiene and safety practices, such as sale and consumption of animal products in which adequate antimicrobial withdrawal periods have been observed, and growing vegetables on unpolluted soil. Environmental Health is therefore crucial in the prevention of infectious diseases that would require antimicrobials, reducing the spread of resistant organisms, and exposure to antimicrobial residues in LMICs. Working with other professionals in One Health, Environmental Health Practitioners have a key role in reducing the spread of AMR including health education and promotion, surveillance, enforcement of legislation, and research.