Características sociodemográficas, de trabalho e saúde de homens e mulheres deficientes residentes em contexto rural / Características sociodemográficas, de trabajo y salud de hombres y mujeres discapacitados residentes en un contexto rural / Sociodemographic characteristics of work and health of disabled men and women living in a rural setting

RESUMO Objetivo: Comparar as características sociodemográficas, de saúde e de trabalho de homens e mulheres com deficiência que residem em contexto rural. Método: Estudo transversal analítico, com 276 pessoas com deficiência residentes em cenário rural de oito municípios da região noroeste do Estado do Rio Grande do Sul, Brasil. Os dados foram coletados por meio de um questionário fechado, com variáveis sociodemográficas, de trabalho e saúde, aplicado na residência dos participantes nos meses de setembro de 2018 a julho de 2019. Esses foram digitados e analisados no programa estatístico software Statistical Package for the Social Sciences for Windows, versão 18.0 por meio de estatística analítica descritiva (comparação de frequência). Para comparar os dois grupos (homens e mulheres) empregou-se o teste Qui-Quadrado. Resultados: Dos homens, 27,8% apresentaram deficiência física e a deficiência múltipla foi mais frequente na mulher (p<0,001). O trabalho na agricultura e do lar eram mais frequentes no sexo feminino e as atividades autônomas e empregatícias, no sexo masculino. Ambos recebiam BPC, ainda que 18% não tivessem nenhum tipo de benefício. Homens tinham duas vezes mais chance de serem tabagistas e quase três vezes maior risco de etilismo que as mulheres (p<0,001). Conclusão: As características de pessoas com deficiência que residem em contexto rural se diferenciam entre os sexos, no que se refere à deficiência, trabalho e hábitos que vulnerabilizam a saúde.

RESUMEN Objetivo: comparar las características sociodemográficas, de salud y de trabajo de hombres y mujeres con discapacidad que residen en contexto rural. Método: estudio transversal analítico, con 276 personas con discapacidad residentes en escenario rural de ocho municipios de la región noroeste del Estado de Rio Grande do Sul, Brasil. Los datos fueron recogidos a través de un cuestionario cerrado, con variables sociodemográficas, de trabajo y salud, aplicado en la residencia de los participantes en los meses de septiembre de 2018 a julio de 2019. Estos fueron introducidos y analizados en el programa estadístico software StatisticalPackageforthe Social Sciencesfor Windows, versión 18.0. por medio de estadística analítica descriptiva (comparación de frecuencia). Para comparar los dos grupos (hombres y mujeres) se empleó la Prueba de chi-cuadrado. Resultados: de los hombres, el 27,8% presentó discapacidad física y la discapacidad múltiple fue más frecuente en la mujer (p<0,001). El trabajo en la agricultura y en el hogar eran más frecuentes en el sexo femenino y las actividades autónomas y de empleo, en el sexo masculino. Ambos recibían BPC, aunque el 18% no tenía ningún tipo de beneficio. Los hombres tenían dos veces más probabilidades de ser fumadores y casi tres veces mayor riesgo de etilismo que las mujeres (p<0,001). Conclusión: las características de las personas con discapacidad que residen en un contexto rural se diferencian entre los sexos, en lo que se refiere a la discapacidad, trabajo y hábitos que vulneran la salud.

ABSTRACT Objective: Comparing the sociodemographic characteristics of health and work of men and women with disabilities living in a rural context. Method: A cross-sectional analytical study with 276 people with disabilities living in a rural setting in eight cities in the Northwest Region of the State of Rio Grande do Sul, Brazil. Data were collected through a closed questionnaire with sociodemographic, work and health variables applied at the participants' residence from September 2018 to July 2019. These were typed and analyzed in the software Statistical Package for the Social Sciences for Windows, version 18.0 by means of descriptive analytical statistics (frequency comparison). To compare the two groups (men and women) the Chi-Square test was used. Results: Of the men, 27.8% had physical disabilities and multiple disability was more frequent in women (p<0.001). Work in agriculture and home was more frequent in females and autonomous and employment activities in males. Both received PB, although 18% did not have any kind of benefit. Men were twice as likely to be smokers and almost three times higher risk of alcohol than women (p<0.001). Conclusion: The characteristics of people with disabilities living in a rural setting differ between the genders, with regard to disability, work and habits that make health vulnerable.

Network to combat violence against rural women: articulation and communication of services / Red de enfrentamiento a la violencia contra las mujeres rurales: articulación y comunicación de los servicios / Rede de enfrentamento à violência contra mulheres rurais: articulação e comunicação dos serviços

ABSTRACT Objective: to identify the constituent services of the network to combat violence against rural women in municipalities in the northwestern region of Rio Grande do Sul and to analyze the articulation and communication of services in search of the resolution of situations of violence. Method: descriptive-exploratory, qualitative study, carried out through semi-structured interviews with 26 professionals from intersectoral services, as well as managers and/or those responsible for these services. Data were systematized through content analysis. Results: although the professionals collectively discuss and plan coping actions, difficulties were identified in the approximation between services, related to the definition of flow, knowledge of actions/referrals, fear of seeing and reporting violence, understanding that it is not a question of demand of their field of action, and women's access to services. Final considerations: it is evident the need to implement public policies that address the singularities of violence against women in rural settings.

RESUMEN Objetivo: identificar los servicios constituyentes de la red de enfrentamiento a la violencia contra mujeres rurales en municipios de la región noroeste de Rio Grande do Sul y analizar la articulación y la comunicación de los servicios en la búsqueda de la resolutividad de las situaciones de violencia. Método: estudio descriptivo-exploratorio, cualitativo, realizado por medio de entrevistas semiestructuradas con 26 profesionales de servicios intersectoriales, además de gestores y/o responsables de estos servicios. Los datos se sistematizaron mediante el análisis de contenido. Resultados: aunque los profesionales discuten y planifican colectivamente las acciones de enfrentamiento, se identificaron dificultades en la aproximación entre los servicios, relacionadas a la definición de flujo, conocimiento de las acciones/encaminamientos, miedo de ver y notificar la violencia, entendimiento de que no se trata de una demanda de su campo de actuación, y el propio acceso de las mujeres a los servicios. Consideraciones finales: se evidencia la necesidad de implementación de políticas públicas que atiendan las singularidades de la violencia contra las mujeres en el escenario rural.

RESUMO Objetivo: identificar os serviços constituintes da rede de enfrentamento à violência contra mulheres rurais em municípios da região noroeste do Rio Grande do Sul e analisar a articulação e a comunicação dos serviços na busca da resolutividade das situações de violência. Método: estudo descritivo-exploratório, qualitativo, realizado por meio de entrevistas semiestruturadas com 26 profissionais de serviços intersetoriais, além de gestores e/ou responsáveis por estes serviços. Os dados foram sistematizados mediante a análise de conteúdo. Resultados: embora os profissionais discutam e planejem coletivamente as ações de enfrentamento, identificaram-se dificuldades na aproximação entre os serviços, relacionadas à definição de fluxo, conhecimento das ações/encaminhamentos, medo de ver e notificar a violência, entendimento de que não se trata de uma demanda do seu campo de atuação, e o próprio acesso das mulheres aos serviços. Considerações finais: evidencia-se a necessidade de implementação de políticas públicas que atendam as singularidades da violência contra as mulheres no cenário rural.

Desigualdade no acesso à saúde entre as áreas urbanas e rurais do Brasil: uma decomposição de fatores entre 1998 a 2008 / Inequality in access to health services between urban and rural areas in Brazil: a disaggregation of factors from 1998 to 2008 / Desigualdad en el acceso a la salud entre áreas urbanas y rurales de Brasil: una descomposición de factores entre 1998 a 2008

O acesso à saúde é uma importante dimensão das desigualdades entre áreas urbanas e rurais. O acesso é menor nas áreas rurais em função da maior vulnerabilidade social de sua população e das maiores dificuldades de acesso que seus grupos sociais estão submetidos. A partir de dados do suplemento de saúde da Pesquisa Nacional por Amostra de Domicílios, foram analisados os determinantes do acesso e das diferenças entre áreas urbanas e rurais nos anos de 1998 a 2008. A análise dos determinantes do acesso aos serviços de saúde foi realizada pelo modelo de regressão logística binária. As diferenças entre áreas urbanas e rurais foram decompostas em fatores observáveis (fatores de capacitação, necessidade e predisposição) e não observáveis (oferta e dificuldade de acesso). Os resultados destacam que a desigualdade de acesso é elevada e maior nas áreas rurais. Os fatores de necessidade são determinantes fundamentais do acesso à saúde, enquanto que os fatores de capacitação são mais importantes para explicar as diferenças entre as áreas urbanas e rurais. A tênue redução das diferenças no período se deveu fundamentalmente a mudanças na composição da população rural.

Access to healthcare is an important dimension of inequalities between urban and rural areas. Access is lower in rural areas due to the population's greater social vulnerability and greater difficulties in access among its social groups. Based on data from the health supplement of the Brazilian National Household Sample Survey, we analyzed the determinants of access and differences between urban and rural areas from 1998 to 2008. The analysis of determinants of access to health services used binary logistic regression. Differences between urban and rural areas were disaggregated as observable factors (enabling, need, and predisposing) and non-observable factors (supply and difficulty in access). The results highlight that inequality in access is higher in rural areas. Need factors are fundamental determinants of access to health, while enabling factor are more important for explaining the differences between urban and rural areas. The slight reduction in differences during the period was due mainly to changes in the rural population's composition.

El acceso a la salud es una importante dimensión de las desigualdades entre áreas urbanas y rurales. El acceso es menor en las áreas rurales, en función de una mayor vulnerabilidad social de su población y de las mayores dificultades de acceso a la que están sometidos sus grupos sociales. A partir de los datos del suplemento de salud de la Encuesta Nacional por Muestra de Domicilios, se analizaron los determinantes de acceso y diferencias entre áreas urbanas y rurales, desde el año 1998 a 2008. El análisis de los determinantes de acceso a los servicios de salud se realizó mediante un modelo de regresión logística binaria. Las diferencias entre áreas urbanas y rurales se dividieron en factores observables (factores de capacitación, necesidad y predisposición) y no observables (oferta y dificultad de acceso). Los resultados destacan que la desigualdad de acceso es elevada y superior en las áreas rurales. Los factores de necesidad son determinantes fundamentales del acceso a la salud, mientras que los factores de capacitación son más importantes para explicar las diferencias entre áreas urbanas y rurales. La tenue reducción de las diferencias en el período se debió fundamentalmente a cambios en la composición de la población rural.

The experience of rural families in the face of cancer / La experiencia de las familias campesinas con el padecimiento del cáncer / A experiência de famílias rurais frente ao adoecimento por câncer

ABSTRACT Objective: To understand the meanings of cancer within the experience of rural families and how such meanings influence family dynamics. Method: Qualitative study guided by Symbolic Interactionism as a theoretical framework and Grounded Theory as a methodological framework. Six rural families (18 participants) undergoing the experience of having a relative with cancer participated in the interview. Results: Constant comparative analysis of data allowed the elaboration of an explanatory substantive theory, defined by the main category Caregiving to support the family world, which represents the family's symbolic actions and strategies to reconcile care for the patient and care for family life. Final considerations: Throughout the experience, rural families seek to preserve the interconnected symbolic elements that provide support for the family world: family unit, land, work and care.

RESUMEN Objetivo: Entender los significados del padecimiento por cáncer en la experiencia de las familias campesinas, y cómo influyen en el entorno familiar. Método: Estudio cualitativo con base teórica en el Interaccionismo Simbólico y metodológica en la Teoría Fundamentada en los Datos. Se entrevistaron a seis familias campesinas (18 participantes) que pasaban por la experiencia de tener un familiar con cáncer. Resultados: El análisis comparativo constante de los datos posibilitó la elaboración de una teoría explicativa de la experiencia, con la categoría Cuidando para que se mantenga sostenido el mundo de la familia, que representa las acciones y estrategias simbólicas de la familia con el fin de conciliar el cuidado del familiar enfermo con el cuidado de la vida familiar. Consideraciones finales: Durante la experiencia, la familia campesina intenta preservar los elementos simbólicos que interconectados constituyen el sostenimiento del mundo de la familia: la unidad familiar, la tierra, el trabajo y el cuidado.

RESUMO Objetivo: Compreender os significados do câncer presentes na experiência de famílias rurais e como esses significados influenciam a dinâmica familiar. Método: Estudo qualitativo orientado pelo Interacionismo Simbólico como referencial teórico e pela Teoria Fundamentada nos Dados como referencial metodológico. Participaram, por meio de entrevista, seis famílias rurais (18 participantes) que estavam vivendo a experiência de ter um familiar com câncer. Resultados: A análise comparativa constante dos dados permitiu a elaboração de uma teoria substantiva explicativa da experiência, definida pela categoria central Cuidando para manter o mundo da família amparado, que representa as ações e estratégias simbólicas da família visando a conciliar o cuidado do familiar doente e o cuidado da vida familiar. Considerações finais: Ao longo da experiência, a família rural procura preservar os elementos simbólicos que, conectados, constituem o amparo do mundo da família: a unidade familiar, a terra, o trabalho e o cuidado.

Factores de riesgo cardiovascular en comunidades urbana y rural Tinaquillo: Venezuela / Cardiovascular risk factors in urban and rural communities from Tinaquillo: Venezuela

RESUMEN Objetivo Comparar la frecuencia de los principales factores clínicos, bioquímicos y antropométricos de riesgo cardiovascular entre una comunidad rural y una urbana de Tinaquillo, Venezuela. Métodos Se evaluaron 118 individuos mayores de 18 años (52 pertenecientes a la comunidad urbana y 66 a la comunidad rural) a los cuales se les determinó peso, talla, circunferencia abdominal, presión arterial, glicemia y perfil lipídico. Se aplicó una encuesta para medir antecedentes personales de enfermedad cardiovascular y estilo de vida. Resultados Se evidenció que alrededor del 60 % de los individuos de la comunidad rural presentaron entre obesidad y sobrepeso. Cifras similares fueron obtenidas en la comunidad urbana, no encontrándose diferencias estadísticamente significativas entre ambas. Casi la mitad de los participantes mostró obesidad abdominal, así como una frecuencia importante de individuos con HDLc bajo (mayor al 70 %). Cabe destacar que si bien, se obtuvieron bajos porcentajes de hipertrigliceridemia, los mismos fueron significativamente superiores en la comunidad rural (Chi-cuadrado=4,82; p=0,0281). Caso contrario ocurre con la frecuencia del hábito tabáquico, el cual es estadísticamente superior en la comunidad urbana (Chi-cuadrado=4,48; p=0,0342). Conclusión Los resultados muestran una elevada frecuencia de factores de riesgo cardiovascular en ambas comunidades. En consecuencia, los programas de promoción en salud emergentes deben tener alcance hasta las comunidades rurales, pues el riesgo a padecer una enfermedad cardiovascular es similar al de la comunidad urbana, además de estar igualmente propensas a la adquisición de hábitos no saludables.(AU)

ABSTRACT Objective To compare the frequency of major clinical, biochemical and anthropometric cardiovascular risk factors between a rural community and an urban community from Tinaquillo, Venezuela. Method 118 individuals older than 18 years (52 of the urban community and 66 of the rural community) were included; their weight, height, waist circumference, blood pressure, blood glucose and lipid profile were assessed. A survey to measure personal history of cardiovascular disease and lifestyle was applied. Results About 60 % of the individuals of the rural community were either obese or overweight; similar figures were obtained in the urban community with no statistically significant differences. Almost half of the participants had abdominal obesity, and also a significant frequency of individuals with low HDLc (greater than 70 %) was observed. It should be noted that although low percentages of hypertriglyceridemia were obtained, they were significantly higher in the rural community (chi-square=4.82, p=0.0281). The opposite occurs with the frequency of smoking, which is statistically higher in the urban community (chi-square=4.48, p=0.0342). Conclusions The results show a high prevalence of cardiovascular risk factors in both communities. Consequently, health promotion programs should reach out to rural communities, as the risk of cardiovascular disease is similar to that of the urban community, who are equally prone to acquire unhealthy habits.(AU)

Satisfaction levels with family physician services: a pilot national health programme in the Islamic Republic of Iran

Family physicians in the Islamic Republic of Iran have been providing health and medical services to residents from rural areas since 2005, and from 2011 these services have been delivered to urban residents in Fars and Mazandaran provinces. This study was conducted in 2014 to measure the rate of user satisfaction with services provided by family physicians to the rural and urban population of the second most populated county in Fars province [Marvdasht county, population > 330 000]. In urban and rural areas, 1650 houses [825 in rural and 825 in urban areas] were selected, of which 1561 houses were inhabited [2908 individuals in urban and 3062 individuals in rural areas] and an interview-administered doorstep questionnaire was completed. Overall satisfaction rate was 59.2%: 54.5% for urban areas and 63.2% for rural areas. This study suggests that satisfaction is higher among rural residents and that better quality services from family physicians are needed in both rural and urban communities

À espera da seca que vem: capacidade adaptativa em comunidades rurais do semiárido / Waiting for the coming drought: adaptive capacity in rural communities of the Brazilian semiarid / Esperando de la sequía que viene: la capacidad de adaptación de las comunidades rurales en el Semiárido brasileño

Este artigo avalia a disponibilidade de recursos necessários para criação de capacidade adaptativa em comunidades rurais do semiárido brasileiro. A pesquisa utiliza dados primários obtidos por meio de aplicação de questionários. Dada a grande extensão geográfica da região, adota-se como recorte uma amostra de comunidades rurais inseridas em áreas susceptíveis à desertificação no Estado do Ceará. A discussão é feita a partir de um sistema de indicadores definido por meio de consultas a especialistas (método Delphi) e subdividido em quatro dimensões da capacidade adaptativa: capital social, capital econômico, capital humano e capital natural, pressupondo que a capacidade adaptativa é definida pela disponibilidade de um conjunto de recursos capazes de promover o bem-estar local. A análise da distribuição dos indicadores selecionados mostra que as comunidades possuem baixos níveis de recursos necessários para adaptação, sendo que os pontos mais críticos são destacados na dimensão de capital humano. No contexto observado acredita-se que as ações governamentais que poderiam melhorar a capacidade adaptativa das comunidades rurais do semiárido em relação às secas não encontram ambiente social propício para expressarem seu potencial, sendo o maior desafio a adoção de estratégias integradas de educação e capacitação da população que atuem de forma transversal em todas as políticas voltadas para o desenvolvimento local.

Abstract This article evaluates the availability of resources needed to create adaptive capacity in rural communities of the Brazilian semiarid. The research uses primary data obtained with the application of questionnaires. Given the large geographic extent of the region, rural communities inserted in areas susceptible to desertification of Ceará were selected to the sample. The discussion is made based on a system of indicators defined by consulting with experts (DELPHI - Methodology ), and divided into four dimensions of adaptive capacity: social capital, economic capital, human capital and natural capital, assuming that adaptive capacity is the availability of a set of resources to promote local welfare. The analysis of the distribution of selected indicators shows that communities have lower levels of resources needed for adaptation, and the critical points are highlighted in the human capital dimension. It is believed that government actions that could improve adaptive capacity of rural communities in the semiarid does not find user-friendly environment for expressing their potential. The biggest challenge is the adoption of integrated strategies for education, and training of the population, which act crosswise in all public policies aimed to local development.

Resumen Este artículo evalúa la disponibilidad de los recursos necesarios para crear la capacidad de adaptación de las comunidades rurales de la región semiárida de Brasil. La investigación utiliza datos primarios obtenidos mediante la aplicación de cuestionarios. Dada la gran extensión geográfica de la región, se adopta una muestra de comunidades rurales situadas en áreas propensas a la desertificación en el estado de Ceará. La discusión se produce a partir de indicadores definidos con consultas a expertos (Delphi) y divididos en cuatro dimensiones de la capacidad de adaptación: capital social, capital económico, capital humano y capital natural, suponiendo que la capacidad de adaptación se define como la disponibilidad de un conjunto de recursos que puede promover el bienestar de la población. El análisis de la distribución de los indicadores seleccionados muestra que las comunidades tienen niveles bajos de los recursos necesarios para la adaptación, y los puntos más críticos están en la dimensión del capital humano. Se cree que las acciones del gobierno que podrían mejorar la capacidad de adaptación de las comunidades rurales no encuentran un ambiente social propicio para expresar su potencial, siendo el mayor reto la adopción de estrategias integradas de educación y formación de la población actuando de de forma transversal en todas las políticas de desarrollo local.

Relación entre el estado nutricional y el ausentismo escolar en estudiantes de escuelas rurales / Relationship between nutritional status and school absenteeism among students in rural schools

Objetivo Determinar el estado nutricional, las prevalencias de desnutrición y sobrepeso de estudiantes en escuelas rurales y su relación con tasas de ausentismo escolar. Métodos Estudio descriptivo en 34 escuelas rurales de Anapoima y La Mesa en 2013. Una muestra de 785 (82,4 %) estudiantes fueron seleccionados por muestreo por conveniencia. Criterios de inclusión: estudiante matriculado en 2013 de los grados 0-5 (edades 5-16) con consentimiento de padres o acudientes y asentimiento del estudiante. Se tomaron medidas de peso y talla. Se registraron tasas de ausencia (general y por enfermedad). Resultados Del total, 422 estudiantes fueron varones (53,8 %) y 524 (66,8 %) tenían entre 5-9 años. La prevalencia de talla baja para la edad fue 10,1 % (n=79). La delgadez fue 1,75 % (n=13), el sobrepeso 14,3 % (n=112) y la obesidad 4,5 % (n=45). Las tasas de episodios de ausentismo general y por enfermedad por niño al año fueron 5,7 y 1,4 respectivamente. Los estudiantes con baja talla para la edad y sobrepeso tuvieron un número significativamente mayor de días de ausencias en comparación con los estudiantes con adecuado estado nutricional (p<0,01). Los estudiantes con talla baja para la edad tuvieron las tasas más altas de ausentismo. Conclusiones Coexistencia de desnutrición y obesidad en el área de estudio. Relación significativa entre el mayor número de días de ausentismo general y por enfermedad con el retardo en el crecimiento y el sobrepeso en los escolares.(AU)

Objective To determine the nutritional status and prevalence of malnutrition and overweight in students in rural schools and their relationship with school absence rates. Methods Descriptive study carried out in 34 rural schools in Anapoima and La Mesa in 2013. A sample of 785 (82.4 %) students was selected by convenience sampling. The inclusion criteria were students registered for the period 2013 in grades 0-5 (ages 5-16) with parental consent and student assent. Weight and height of all subjects were taken. Overall absence rates and illness-related absence rates were recorded. Results 422 pupils were male (53.8 %) and 524 (66.8 %) had between 5-9 years old. A lower than average height for age occurred in 10.1% (n=79) of the students. The thinness was recorded at 1.75 % (n=13), the overweight at 14.3% (n=112) and the obesity at 4.5 % (n=45) of the students. The number of absence episodes per child per year due to any reason and due to disease was 5.7 and 1.4, respectively. Stunted growth and overweight students had a significantly higher number of absence days compared to students with adequate nutritional status (p <0.01). Stunted growth had the highest absence rates. Conclusions Malnutrition and obesity coexist in the study area. There is a significant relationship between school absence days (both general and illness-related) and stunting and overweight in students.(AU)

Formação, sucessão e migração: trajetórias de duas gerações de agricultores do Alto Jequitinhonha, Minas Gerais / Training, succession and migration: histories of two generations of farmers in the Upper Jequitinhonha River Area, Minas Gerais / Formación, sucesión y migración: trayectorias de dos generaciones de agricultores del Alto Jequitinhonha, Minas Gerais

A agricultura familiar é um segmento fundamental para o abastecimento alimentar, a geração de ocupações e a conservação das culturas próprias do rural brasileiro. De acordo com vários autores, a continuidade desse segmento de agricultores tem sido ameaçada pela grande emigração de jovens em decorrência de transformações ocorridas no urbano e no rural. Este artigo analisa tal situação em dois municípios do Alto Jequitinhonha, Minas Gerais - região fortemente marcada pela presença da agricultura familiar -, investigando as trajetórias emigratórias de duas gerações de agricultores. Os resultados indicam mudanças no padrão sucessório, nos níveis de escolaridade e na dinâmica tradicional de capacitação de jovens, o que influi nos percursos e na inserção dos migrantes no mercado de trabalho. O artigo conclui que, comparativamente à geração anterior, um menor número de jovens permanece no rural. Mas isto não coloca em risco a reprodução da unidade familiar, pois continuam a existir sucessores, embora estes tendam a assumir a unidade produtiva com mais idade e escolaridade do que a geração anterior.

Family farming is a key sector for supplying food, generating employment and maintaining traditional cultures in the Brazilian countryside. According to several authors, the reproduction of family farming is threatened by the emigration of young people, due to current changes in urban and rural settings. This paper investigates this situation in two municipalities in the upper Jequitinhonha Valley - a region strongly characterized by the presence of family farming - through an analysis of the history of two generations of farmers. The results indicate changes in inheritance patterns, educational levels and the traditional dynamics of the empowerment of youth, all of which in turn influence the life histories and the integration of migrants into the labor market. The article concludes that, in comparison with previous generations, fewer young people stay in the countryside, although this does not put the reproduction of family units in risk, because many people do stay in rural areas and take over properties at more advanced ages and higher educational levels than did previous generations.

La agricultura familiar es un sector clave para el abastecimiento alimentario, la generación de ocupaciones y el mantenimiento de las culturas propias del medio rural brasileño. De acuerdo con varios autores, la continuidad de este sector de agricultores ha sido amenazada por la gran emigración de jóvenes en función de transformaciones ocurridas en los medios urbano y rural. En este artículo se analiza esta situación en dos municipios del Alto Jequitinhonha, Minas Gerais - región fuertemente marcada por la presencia de la agricultura familiar -, investigando las trayectorias emigratorias de dos generaciones de agricultores. Los resultados indican cambios en el estándar sucesorio, en los niveles de escolaridad y en la dinámica tradicional de capacitación de los jóvenes, lo que influye en los recorridos y en la inserción de los migrantes en el mercado laboral. El artículo concluye que, en comparación con la generación anterior, un menor número de jóvenes permanece en el medio rural. Pero esto no pone en riesgo la reproducción de la unidad familiar, ya que siguen existiendo sucesores, aunque estos tiendan a asumir la unidad productiva con más edad y escolaridad que la generación anterior.

Masculinização rural: uma abordagem a partir da regionalização por sistemas agrários no Rio Grande do Sul / Rural masculinization: an approach based on the regionalization of agrarian systems in Rio Grande do Sul, Brazil / Masculinización rural: un abordaje a partir de la regionalización por sistemas agrarios en Rio Grande do Sul

Este trabalho objetivou analisar o processo de masculinização da população rural nos diferentes sistemas agrários do Rio Grande do Sul, buscando interpretar suas eventuais particularidades e diferentes configurações. Para tanto, utilizaram-se os dados do Censo Demográfico de 1950 e da Contagem Populacional 2007 do IBGE, que foram sistematizados e submetidos à análise estatística. Foram calculadas as razões de sexo da população rural e, no caso de 2007, para quatro faixas etárias. Estas razões foram agrupadas por sistema agrário (Campanha, Serra do Sudeste, Depressão Central, Litoral Norte, Litoral Sul, Colônias Velhas, Campos de Cima da Serra, Colônias Novas e Planalto) para aplicação do teste de Kruskal-Wallis. De forma complementar, ainda foi calculada a razão de sexo do Rio Grande do Sul em 1960, 1970, 1980, 1991, 2000 e 2010. Verificou-se que o processo de masculinização rural, que vem se desenvolvendo lentamente no Estado, apresenta comportamentos diferenciados conforme as regiões. De forma geral, as regiões pecuaristas são as que apresentam as maiores proporções de homens, enquanto aquelas caracterizadas pela agricultura familiar e pelos sistemas produtivos intensivos possuem as menores proporções. As regiões Depressão Central e Planalto, onde a produção mecanizada de soja e arroz é representativa, assumiram, em 2007, uma posição intermediária entre as altas razões de sexo das regiões pecuaristas e os baixos valores das Colônias, onde a agricultura familiar é característica. Entende-se que a intensidade do processo de masculinização rural possa estar relacionada a aspectos dos diferentes sistemas agrários, como a importância socioeconômica da agricultura familiar, ou ainda a intensificação dos principais sistemas de produção.

This study is aimed at analyzing the process of masculinization of the rural population in different agrarian systems of the State Rio Grande do Sul, Brazil, and seeks to interpret different circumstances and settings. For this purpose we used census data from the 1950 Demographic Census and the 2007 Population Count, both conducted by IBGE. The data were systematized and subjected to statistical analysis. Scores were calculated for sex ratios of total and rural populations and, in the 2007 Population Count, for sex ratios of four age groups. These indices were grouped by agrarian system (Campanha, Serra do Sudeste, Depressão Central, Litoral Norte, Litoral Sul, Colônias Velhas, Campos de Cima da Serra, Colônias Novas, and Planalto), by applying the Kruskal-Wallis Test. We also calculated the sex ratio of the population of Rio Grande do Sul in 1960, 1970, 1980, 1991, 2000 and 2010. It was found that the process of rural masculinization, which has been gradually growing in the state, shows different behaviors, depending on the region. In general, the cattle grazing regions show the highest levels of masculinity whereas the regions characterized by family farming and intensive production systems show the lowest levels. In 2007, the regions of Depressão Central and Planalto, where mechanized production of soybeans and rice are more common, took on an intermediate position between high levels of masculinity in the cattle-raising regions and low levels in colonies, where family farming is characteristic. The intensity of the process of rural masculinization may be related to characteristics of different agrarian systems, such as the socioeconomic importance of family farming, or even increased intensification of production systems.

Este trabajo tuvo el propósito de analizar el proceso de masculinización de la población rural en los distintos sistemas agrarios de Rio Grande do Sul, buscando interpretar sus eventuales particularidades y diferentes configuraciones. Para ello se utilizaron los datos del Censo Demográfico de 1950 y del Conteo Poblacional 2007 del IBGE, que fueron sistematizados y sometidos al análisis estadístico. Se calcularon las razones de sexo de la población rural y, en el caso de 2007, para cuatro grupos de edad. Estas razones fueron agrupadas por sistema agrario (Campanha, Serra do Sudeste, Depressão Central, Litoral Norte, Litoral Sul, Colônias Velhas, Campos de Cima da Serra, Colônias Novas y Planalto) para la aplicación del test de Kruskal-Wallis. De forma complementaria, se calculó asimismo la razón de sexo de Rio Grande do Sul en 1960, 1970, 1980, 1991, 2000 y 2010. Se verificó que el proceso de masculinización rural, que se viene desarrollando lentamente en el estado, presenta comportamientos diferenciados según las regiones. En general, las regiones ganaderas son las que presentan las mayores proporciones de hombres, mientras las caracterizadas por la agricultura familiar y los sistemas productivos intensivos poseen las menores proporciones. Las regiones Depressão Central y Planalto, en las que la producción mecanizada de soya y arroz es representativa, asumieron en el 2007 una posición intermedia entre las altas razones de sexo de las regiones ganaderas y los bajos valores de las Colônias, donde la agricultura familiar es característica. Se entiende que la intensidad del proceso de masculinización rural puede relacionarse con aspectos de los diferentes sistemas agrarios, como la importancia socioeconómica de la agricultura familiar, o aún la intensificación de los principales sistemas de producción.

Prevalence and risk factors of onychomycosis in primary school children living in rural and urban areas in Central Anatolia of Turkey.

Background: Onychomycosis is a world-wide public health concern in children, requiring epidemiological data for different regions for control and prevention. Aim: The aim of this study was to evaluate the predominant pathogens and risk factors for onychomycosis in school children living in Kayseri, Turkey. Methods: This study included 8122 school children, aged 5-16 years, living in the rural and urban areas around Kayseri. Onychomycosis was clinically classifi ed as distal and lateral subungual (DLSO), proximal subungual, superfi cial white, endonyx and totally dystrophic onychomycosis. Nail samples from children with clinically diagnosed onychomycosis were collected, examined by direct microscopy and inoculated for culture study. The demographic features and possible risk factors were recorded and assessed by logistic regression models. Results: We clinically diagnosed onychomycosis in 152 out of 8,122 (0.18%) school children. DLSO was the most frequent clinical diagnosis (120/152, 78.9%). Culture-positive onychomycosis was detected in 27/152 (17.7%) children. The prevalence of culture-positive onychomycosis was determined as 0.33%. All culture-positive samples were only from toenails. The onychomycosis causative agents were dermatophytes in 17/27 cases (62.9%), including Trichophyton rubrum 12 (44.4%), Trichophyton mentagrophytes 1 (3.7%), Trichophyton tonsurans 1 (3.7%) and Trichophyton spp. 3 (11.1%) and yeasts in 10/27 cases (37.1%), including Candida glabrata 4 (14.8%), Candida parapsilosis 1 (3.7%), Trichosporon 2 (7.4%) and Rhodotorula 3 (11.1%). Age, father’s occupation, number of siblings and rooms were statistically associated with the frequency of onychomycosis. Conclusions: Although to be prevalence of onychomycosis in school children in central Anatolia of Turkey seems very low degree, pediatric onychomycosis is a growing public health concern all over the world. Children having more siblings or unemployed fathers and children living in small house as well as older children should be examined carefully for onychomycosis.

Changes in Demographic Features of Gallstone Disease: 30 Years of Surgically Treated Patients

BACKGROUND/AIMS: The aim of this study was to investigate changes in the clinical and demographical characteristics of gallstone disease in Korea, based on 30 years of surgically treated patients at a single institute. METHODS: In total, 7,949 gallstone patients who underwent surgery between 1981 and 2010 were analyzed. Patients were divided into six time periods: period I (1981 to 1985, n=831), period II (1986 to 1990, n=888), period III (1991 to 1995, n=1,040), period IV (1996 to 2000, n=1,261), period V (2001 to 2005, n=1,651) and period VI (2006 to 2010, n=2,278). RESULTS: The total number and mean age of the patients gradually increased, and the male/female ratio decreased. The proportion of gallbladder (GB)-stone cases increased, whereas the proportions of common bile duct (CBD)- and intrahepatic duct (IHD)-stone cases decreased. Differences in patient geographical origins also decreased. Based on the relationship between changes in the prevalence of gallstone disease and socioeconomic status, the prevalence of CBD stones showed a strong correlation with Engel's coefficient (p<0.001). CONCLUSIONS: Our study indicates that although the total number of cases and the mean age of gallstone patients have continuously increased, there are trends of increasing GB-stone cases and decreasing CBD- and IHD-stone cases.

Investigación de blastocystis sp. en agua de consumo humano en una población escolar de la zona rural del estado Mérida, Venezuela / Blastocystis sp. in drinking water at a rural school in Mérida, Venezuela

Para detectar la presencia de Blastocystis sp. en el agua de consumo de una escuela rural del estado Mérida, se recolectaron 36 muestras provenientes de la fuente natural que surte el tanque de distribución, del tanque y de los grifos, durante los meses de Septiembre 2008, Febrero y Diciembre del 2009 y Mayo 2010. El procesamiento de las muestras se realizó siguiendo la técnica propuesta por Suresh y col. (2005). Los resultados sugieren que el agua de consumo estaba exenta de Blastocystis o que la cantidad de quistes viables presentes en las muestras fue muy baja, lo que no permitió lograr la recuperación del parásito en el cultivo. Por ello se requiere el uso de técnicas más sensibles que permitan detectar cantidades bajas del microorganismo en aguas de consumo humano. El estudio de los hábitos de consumo de agua de la población estudiantil de la escuela rural, mostró que más de la mitad de la población consume agua hervida, esto probablemente se deba a que están conscientes que el agua a la cual tienen acceso proviene de una fuente natural no tratada

In order to determine the presence of Blastocystis sp. in drinking water at a rural school in Merida, 36 water samples were collected from natural sources that feed the distribution tank and faucets during the months of September, 2008, February and December, 2009, and May, 2010. Samples were processed using the technique proposed by Suresh et al. (2005). All samples were negative. These results suggest that the water was exempt from Blastocystis or that the quantity of viable cysts present in the samples was very low, not permitting reproduction in the culture. This report suggests the importance of using more sensitive techniques to detect low amounts of the organismin drinking water. The study of student water consumption habits at the rural school showed that more than half the population consume boiled water; probably, they are aware that the water source has not been treated for drinking

Envelhecimento e rede de apoio social em território rural do Pantanal matogrossense / Aging and social support networks in rural area of the Pantanal in Mato Grosso, Brazil

No processo de envelhecimento populacional, em território rural, as redes de apoio social são fundamentais para a reprodução do grupo que, por força da tradição destaca-se a família como unidade essencial de cooperação econômica e principal fonte de apoio social. As transformações no território afetam, reciprocamente, as possibilidades desse apoio. No contexto desse artigo, foram enfocados aspectos do apoio social entre famílias de campesinos idosos tendo como referência a noção de rede social em território rural e como universo empírico duas comunidades rurais (São Pedro e Retiro São Bento), no distrito de Joselândia, município de Barão de Melgaço/MT. Trata-se de estudo orientado pela perspectiva socioantropológica, que permitiu apreender os pontos de vista dos sujeitos, valendo-se da abordagem qualitativa. Foram entrevistados 18 idosos, pertencentes a 11 famílias, sendo 8 delas de São Pedro e 3 de São Bento. De modo geral, os moradores idosos entrevistados não desvinculam a dimensão física da terra, da sua simbologia - que é todo o sentido de sua existência. O parentesco, a amizade e a identidade interligam as pessoas em relações de reciprocidade, por diversos motivos, em situações cotidianas, chamando a atenção para o papel dos vínculos para a manutenção da saúde. As redes de apoio se ampliam, no caso do cuidado com as doenças, e outras são estabelecidas para o acesso aos serviços de saúde. Essa elasticidade/plasticidade da rede para o apoio coaduna-se à noção de territorialidade pela sua conotação material e simbólica.

In the process of population aging in rural area, social support networks are essential for the reproduction of the group in which, due to tradition in the rural area, the family stands out as an essential unit of economic cooperation and main source of social support in this context. Considering the dynamism of the territory, the transformations it can affect, mutually, the possibilities of this support. In this paper, aspects of social support among families of elderly farmers were focused having as a reference the notion of social network in rural area and as empiric universe two rural communities (São Pedro and Retiro São Bento), in the district of Joselândia, municipality of Barão de Melgaço, state of Mato Grosso, Brazil. It is a study guided by the socioanthropological perspective that allowed understanding the subjects' viewpoint, using the qualitative approach. Eighteen elderly people from 11 families, eight families from São Pedro and three from São Bento were interviewed. Overall, the elderly inhabitants interviewed do not separate the physical dimension of the land from its symbol - which is the whole meaning of their existence. In various everyday situations, kinship, friendship and identity joined people in reciprocity relations, for several reasons, with attention to the role of the ties for health maintenance. The support networks widen, in the case of care for diseases and other support networks are set up for the access to health services. This elasticity/plasticity from network to support combines with the notion of territoriality due to its material and symbolic connotation.

Knowledge, attitudes and beliefs about epilepsy among rural and urban populations in cairo governorate and shebeen elkoum district

This study used a cross-sectional design aiming to assess the knowledge, attitudes and beliefs about epilepsy among rural and urban populations in Cairo Governorate as an urban area and Shebeen Elkoum district, as a rural area. The study was conducted at the outpatient clinics in Ain Shams University Hospital, which is situated in Cairo Governorate as an urban population; and Shebeen Elkoum University Hospital which is situated in Shebeen Elkoum district as rural population. The study population included 1320 individuals [males and females], 660 individuals from rural population, residing in Shebeen Elkoum district, and 660 individuals from urban population, residing in Cairo Governorate. They were recruited during their visit to the outpatient clinics, either alone or accompanied by others .They were chosen stratified random sample over a period of 10 weeks. Epileptic patients were excluded from this study. - A questionnaire lo assess participants' demographic data which included age,- sex, marital status, educational level and occupation. The questionnaire derived from literature reviews [Diamantopoulos et al., 2006., Daoudet al., 2007; Tuan et al., 2007] also dealt with population knowledge ,regarding causes of epilepsy, manifestations of the disease,, awareness and preference of treatment option and sources of their information about epilepsy. 2]Attitudes were measured with questions designed by Cohn [1987] about willingness to socialize with persons with epilepsy, persons with epilepsy having jobs like other people, epilepsy as a mental illness, the danger of epileptic seizures while driving, also the sheet included their attitude toward what is to be done when a seizure or fit occurs [9 items]. revealed that, population with university education were more likely to exhibit positive attitudes toward the epileptic patients when compared to non-literate population [P< 0.001].The study concluded that knowledge about epilepsy is scant among rural population, and the majority of the negative attitudes toward epilepsy were significantly associated with the misunderstanding of epilepsy and can vary substantially by culture. This study recommended the development of public awareness strategies through:- creation of effective health education of materials to address misconceptions and the development of other means of publicity to reach the underprivileged population, such as ;role-playing for rural areas and hotlines for urban areas

Prevalencia de hipertensión arterial y dislipidemias en adultos del páramo del Estado Mérida y su relación con obesidad: resultados preliminares del estudio VEMSOLS / Prevalence of hypertension and dyslipidemia in adults from venezuelan Andes (Mérida) and its relationship with obesity: preliminary results from the VEMSOLS study

Determinar la prevalencia hipertensión arterial(HTA) y dislipidemias en una población adulta del páramo del Estado Mérida (Venezuela), y su relación con el grado de obesidad. Fueron estudiados 138 sujetos (87 mujeres y 51 hombres) adultos obtenidos por un muestreo aleatorio simple proveniente de una población rural de Los Andes que habita a más de 3 000 metros sobre el nivel del mar. Cada sujeto fue evaluado en su vivienda y se midió presión arterial, peso, talla y se analizó la concentración plasmática de colesterol total, HDL colesterol, LDL colesteroly triglicéridos en ayunas. La prevalencia de HTA fue del 25,0%. Las dislipidemias más prevalentes fueron la hipertrigliceridemia (45%) y la disminución del HDL-Col(hipoalfalipoproteinemia) (43,1%); esta última más frecuente en mujeres (55,1%) que en hombres (20,8%). Sin embargo, prevalencia de dislipidemia aterogénica definida como hipertrigliceridemia + HDL-Col bajo (16,8%) fue similar enambos sexos. La hipercolesterolemia, LDL-Col elevado y la dislipidemia mixta (hipercolesterolemia+hipertrigliceridemia) se encontraron en el 22,1%, 12,9% y 20,0% de la población respectivamente, sin diferencia según género. Se observó una mayor prevalencia de HTA y dislipidemia aterogénica en sujetoscon sobrepeso y obesidad en ambos sexos. Los datos presentados son resultados preliminares del Estudio Venezolano de Síndrome Metabólico, Obesidad y Estilo devida (VEMSOLS). Se encontró que en el páramo del Estado Mérida (Venezuela) la prevalencia de HTA y dislipidemia es significativa y se incrementa en la misma medida con la presencia de sobrepeso u obesidad.

The objective of this study was to assess the prevalence of hypertension and dyslipidemia in an adult population from mountains of Venezuelan Andes (Mérida), and its relationship with the degree of obesity. One hundred thirty-eight subjects (87 women and 51 men) obtained by simple random sampling from a rural population that inhabits the Andes over 3 000 meters above sea level were studied. Each participant was evaluated in their home and blood pressure, weight, height, and fasting blood lipids (total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides) were measured. The prevalence of hypertension was 25.0%. The most prevalent dyslipidemias were hypertriglyceridemia (45%) y low HDL-Chol (hypoalphalipoproteinemia) (43.1%), being the last more frequent in females (55.1%) than males (20.8%). However,atherogenic dyslipidemia prevalence, defined by hypertriglyceridemia+low HDL-Chol (16.8%), was similar in males and females. Hypercholesterolemia, high LDL-Chol and mixed dyslipidemia (hypercholesterolemia+hypertriglyceridemia ) were present in 22.1%, 12.9% and 20.0% respectively with no difference by gender. Both hypertension and atherogenic dyslipidemia prevalence increased in subjects with overweight and obesity. Data presented are preliminary results of the Venezuelan Metabolic Syndrome, Obesity and Lifestyle Study (VEMSOLS). The prevalence of hypertension and dyslipidemias in a population of Venezuelan Andes (Mérida) is significant and equally incerased in both overweight and obese subjects.

Meglumina en series terapéuticas de 10 días en niños con leishmaniosis tegumentaria americana / Meglumine therapeutic series of 10 days in children with american tegumentary leishmaniasis

La cátedra de Medicina Tropical de la Universidad Central de Venezuela viene empleando el antimoniato de meglumina en series terapéuticas de 10 días en el tratamiento de leishmaniosis tegumentaria americana, la cual continúa como problema de salud del medio rural venezolano. Se evalúa una experiencia con una dosis de 70 mg/kg/día de meglumina en niños con la enfermendad. A los pacientes con presunción diagnóstica de leishmaniosis tegumentaria americana (clínica y antecedentes epidemiológicos) se les efectuó la prueba de leishmania, la demostración de anticuerpos flurescentes antileishmania y la visualización de amastigotes en frotis teñidos con Giemsa. Los casos identificados ingresaron al Hospital Universitario (Pediatría médica infecciosa), recibieron 70 mg/kg/día de antimoniato de meglumina en series terapéuticas de 10 días con reposo intercalados por el mismo número de días. Se incluyeron 33 niños con la enfermedad, 21 de género femenino (64%) con promedio de edad 7,12 años y predominio de escolar (70%). Del Estado Miranda procedía el 85%, una sola úlcera la tenía el 88%, localizada en miembros inferiores (49%). La Leishmanina y los anticuerpos fluorescentes antileishmania fueron positivos en todos los pacientes y el frotis para amastigotes en 45%. Dos series de antimoniato de meglumina las recibió 91% de los pacientes; una de 10 días 6%. Egresaron con cicatrizaciones de sus procesos ulcerosos y fueron evaluados durante seis meses en la consulta de endemias rurales y no se evidenciaron recaídas. La variedad cutánea localizada de la enfermedad fue la única identificada, el Estado Miranda continúa aportando la mayoría de los pacientes atendidos en medicina tropical. El antimoniato de meglumina en leishmaniosis tegumentaria americana a la dosis de 70 mg/kg/día en series terapéuticas fue tan eficaz como la anterior de 100 mg/kg/día que dejó de administrarse hace ocho años.

The Tropical Medicine Department of the Universidad Central de Venezuela employs the meglumine pentavalent antimonial in series of 10 days of treatment for American Tegumentary Leishmaniosis, which continues being a health problem in the Venezuelan rural areas. We are reporting a clinical experience of treatment in children at a dose of 70 mg/kg/day. Patients with diagnostic suspición of American Tegumentary Leishmaniosis (clinical and epidemiologic antecedents) who attended the Rural Endemics Clinic at the Instituto de Medicina Tropical of the Universidad Central de Venezuela and to the Medical Infectious Pediatrics Service at the Hospital Universitario de Caracas (HUC), were tested for leishmanine, fluorescent antileishmania antibodies and for the presence of amastigotes of the parasite in smear for apposition from the ulcer that were treated by the Giemsa method. Patients hospitalized at the Medical Infectious Pediatric Service (Hospital Universitario de Caracas) received 70 mg/kg/day of meglumine pentavalent antimonial during 10 days, a rest period of 10 days without treatment and, if 20 days after ulcers were unhealed, was administred a new 10 days meglumine pentavalent antimonial series. We included 33 children with the disease with a mean age of 7,12 years, 70% in school age and 30% preschool children, and 21 (64%) were girls. The 85% of patients came from Miranda`s state, 88% had only ulcer and in 49% of them the lesions where localized in the legs. The apposition smear showed Leishmania amastigotes in 45% od cases. One series of treatment was given to 91% of cases, two children received two series and one three. At discharge from the hospital all ulcers were healed and follow-up control for a 6 months period showed no relapses. The cutaneous localized from was the clinical form of presentation in the children studied. The great majority of patients that assits to the Tropical Medicine Institute come from the Miranda`s state area...

Menopausal and post-menopausal women of health status at Assiut Governorate

According to the WHO increase in life - expectancy and aging associated problems are increased, in developing countries 5 to 8% of the population arc postmenopausal women [WHO 1996]. The aim of this study is to assess menopausal and postmenopausal women health status in Assiut Governorate. A descriptive study was conducted; the target population was four hundred postmenopausal women, 220 from urban [Assiut city] and 180 women from rural [El-Asara and Mosha village].During the period from first March 2009 to the end of August 2009, Data was collected through home visits by using an interview questionnaire sheet developed by the investigator. . It includes three parts. First part includes socio demographic characteristics [age, residence, education, occupation, marital status, and income]. Second Part includes Physical characteristics, [height, weight, blood pressure, elimination, nutritional habits, teeth, sleeping hours and daily activities]. Third Part includes Health characteristics; [periodic check-up, health problems, exposure to accident some physiological changes related to age].The results reveled that the mean age of the studied sample at menopause was 45.9+3.7.The most common symptoms hot flushes [61%] and insomnia [51%].About Three quarter [76%] percent of women had health problems, the most common were hypertension [36.5] and diabetes [20.5%]. The percentage of agreement was statistically significant higher among women of post- menopause more than 60 years p<0.05. In .conclusion most of postmenopausal women were suffering from hot flushes and insomnia with menopause and had health problems .The present study recommended Increase the awareness of women regarding menopausal changes through mass media, educational programs in postmenopausal clinics

Parasitosis intestinales y factores higiénicos sanitarios asociados en individuos de localidades rurales del estado Sucre / Intestinal parasitism and associated sanitary-hygienic factors in individuals of rural localities in Sucre state

El presente trabajo de investigación tuvo como objetivo general determinar la frecuencia de las parasitosis intestinales y su asociación con los factores higiénicos sanitarios en localidades rurales Orinoco La Peña, Quebrada Seca y Río San Juan. Se analizaron un total de 562 muestras de heces, por métodos coproparasitológicos: evaluación microscópica en solución salina fisiológica al 0,85 por ciento y lugol, Ritchie, además de la coloración de Zielh-Neelsen. La mayor frecuencia de parásitos intestinales se encontró en Orinoco La Peña y Río San Juan, seguido de Quebrada Seca. Blastocystis hominis fue el parásito mayormente observado (44,9 por ciento, 21,82 por ciento, 33,74 por ciento) y como patógeno Giardia duodenalis (20,41 por ciento, 9,7 por ciento, 19,02 por ciento) para Orinoco La Peña, Quebrada Seca y Río San Juan respectivamente. Los helmintos variaron de acuerdo a la localidad de estudio, encontrándose presentes Ascaris lumbricoides, Trichuris trichiura y los Ancylostomídeos en mayores frecuencias. Al evaluar los factores higiénicos sanitarios se obtuvo asociación de la disposición de excretas (X²: 23,85***; p<0,001), tratamiento del agua (X²: 34,00***; p<0,001), hábitos higiénicos con protozoarios en individuos de Quebrada Seca, así como el servicio de aseo urbano (X²: 5,17*; p<0,05), mientras que los helmintos se asociaron con la fuente de agua (X²: 13,97***; p<0,001) y hábitos higiénicos. En Orinoco La Peña y Río San Juan resultó asociado el tratamiento de agua (X²: 11,56*; p<0,05), (X²: 21,5**; p<0,01) con los protozoarios. Las elevadas frecuencias de parásitos indican que las condiciones sanitarias e higiene son favorables para las infecciones parasitarias, además de factores ambientales propios de estas zonas rurales y a la carencia de servicios de salud; resultando indispensable la intervención de las autoridades sanitarias y gubernamentales para aplicar programas de saneamiento ambiental y educación sanitaria preventiva

The present study was carried out to determination the frequency intestinal parasitisms and its associated sanitary hygienic factors in the rural localities Orinoco La Peña, Quebrada Seca and San Juan River. A total of 562 feces samples were analyzed, by different coproparasitological methods: microscopic evaluation in 0.85 percent physiological saline solution and lugol, Ritchie, as well as the Zielh-Neelsen stainin. The highest frequencies of intestinal parasites was found in Orinoco La Peña and Quebrada Seca. Blastocystis hominis (44.9 percent, 21.82 percent, 33.74 percent) and Giardia duodenalis (20.41 percent, 9.7 percent, 19.02 percent) were most commonly observed. The frequency of helminths varied depending on the studied community, but observing more frequently Ascaris lumbricoides, Trichuris trichiura and Ancylostomids. When evaluating the sanitary and hygienic factors associated to parasitosis we found a relationship between feces excretion (X²: 23,85***; p<0,001), water treatment (X²: 34,00***; p<0,001), and hygienic habits with presence of protozoans in individuals from Quebrada Seca, as well as with the presence of garbage disposal services (X²: 5,17*; p<0,05 ), presence of helminths were associated with the water source (X²: 13,97***; p<0,001) and hygienic habits. In Orinoco La Peña and San Juan River water treatment (X²: 11,56*; p<0,05; and X²: 21,5 **; p<0,01 ) was associate to presence of protozoans. The high frequencies of parasites indicates that the sanitary conditions and hygienic habits were favorable factors for the infection and infestation of parasites, combined to the environmental factors and deficiency health of services characteristic of these rural communities. Sanitary intervention from governmental authorities is necessary to improve environmental reparation and preventive sanitary education