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Neurology ; 95(19): e2605-e2609, 2020 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-33004606


OBJECTIVE: Asylum seekers experience a high burden of physical and psychological trauma, yet there is a scarcity of literature regarding the epidemiology and sequelae of head injury (HI) in asylum seekers. We examined HI prevalence and association with neuropsychiatric comorbidities in asylum seekers. METHODS: A retrospective cross-sectional study was performed through review of 139 medical affidavits from an affidavit database. Affidavits written from 2010 to 2018 were included. Demographic and case-related data were collected and classified based on the presence of HI. For neuropsychiatric sequelae, the primary study outcome was headache and the secondary outcomes were depression, posttraumatic stress disorder, and anxiety. Multivariable logistic regression was performed to examine the association between HI and neuropsychiatric sequelae, adjusted for demographic and clinical characteristics. RESULTS: A total of 139 medical affidavits of asylum seekers were included. The mean age was 27.4 ± 12.1 years, 56.8% were female, and 38.8% were <19 years. Almost half (42.5%) explicitly self-reported history of HI. Compared to clients who did not report HI, clients with HI were older and more likely to report a history of headache, physical abuse, physical trauma, concussion, and loss of consciousness. After adjustment for demographic and clinical characteristics, clients with HI had greater odds for neuropsychological sequelae such as headache (odds ratio [OR] 4.2, 95% confidence interval [CI] 2.0-8.7) and depression (OR 2.5, 95% CI 1.1-5.7). CONCLUSIONS: We observed a high prevalence of HI in asylum seekers. Comprehensive screening for HI and neuropsychiatric comorbidities is encouraged when evaluating asylum seekers.

Ansiedade/epidemiologia , Traumatismos Craniocerebrais/epidemiologia , Depressão/epidemiologia , Cefaleia/epidemiologia , Refugiados/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Violência/estatística & dados numéricos , Adolescente , Adulto , Ansiedade/psicologia , Concussão Encefálica/epidemiologia , Concussão Encefálica/psicologia , Traumatismos Craniocerebrais/psicologia , Estudos Transversais , Depressão/psicologia , El Salvador/etnologia , Feminino , Guatemala/etnologia , Haiti/etnologia , Cefaleia/psicologia , Honduras/etnologia , Humanos , Masculino , Transtornos da Memória/epidemiologia , Transtornos da Memória/psicologia , México/etnologia , Nicarágua/etnologia , Razão de Chances , Questionário de Saúde do Paciente , Prevalência , Trauma Psicológico/epidemiologia , Trauma Psicológico/psicologia , Refugiados/psicologia , Estudos Retrospectivos , Distribuição por Sexo , Delitos Sexuais/psicologia , Delitos Sexuais/estatística & dados numéricos , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inconsciência/epidemiologia , Inconsciência/psicologia , Estados Unidos/epidemiologia , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/psicologia , Adulto Jovem
BMC Public Health ; 20(1): 1385, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32912177


BACKGROUND: In El Salvador, Aedes aegypti mosquitoes transmitting Zika and other arboviruses use water storage containers as important oviposition sites. Promotion of water storage container cleaning is a key element of prevention programs. We explored community perceptions surrounding cleaning practices among pregnant women, male partners of pregnant women, and women likely to become pregnant. METHODS: Researchers conducted 11 focus groups and 12 in-depth interviews which included individual elicitations of Zika prevention measures practiced in the community. Focus group participants rated 18 images depicting Zika-related behaviors according to effectiveness and feasibility in the community context, discussed influencing determinants, voted on community intentions to perform prevention behaviors, and performed washbasin cleaning simulations. In-depth interviews with male partners of pregnant women used projective techniques with images to explore their perceptions on a subset of Zika prevention behaviors. RESULTS: General cleaning of the home, to ensure a healthy environment, was a strong community norm. In this context, participants gave water storage container cleaning a high rating, for both its effectiveness and feasibility. Participants were convinced that they cleaned their water storage containers effectively against Zika, but their actual skills were inadequate to destroy Aedes aegypti eggs. A further constraint was the schedule of water availability. Even during pregnancy, male partners rarely cleaned water storage containers because water became available in homes when they were at work. Furthermore, prevailing gender norms did not foster male participation in domestic cleaning activities. Despite these factors, many men were willing to provide substantial support with cleaning when their partners were pregnant, in order to protect their family. CONCLUSIONS: Behavior change programs for the prevention of Zika and other arboviruses need to improve community members' mosquito egg destruction skills rather than perpetuate the promotion of non-specific cleaning in and around the home as effective. Egg elimination must be clearly identified as the objective of water storage container maintenance and programs should highlight the effective techniques to achieve this goal. In addition, programs must build the skills of family members who support pregnant women to maintain the frequency of effective egg destruction in all water storage containers of the home.

Aedes/virologia , Conhecimentos, Atitudes e Prática em Saúde , Controle de Mosquitos/métodos , Abastecimento de Água , Água , Infecção por Zika virus/prevenção & controle , Zika virus , Adolescente , Adulto , Animais , El Salvador , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Pesquisa Qualitativa , Características de Residência , Adulto Jovem , Zika virus/crescimento & desenvolvimento , Infecção por Zika virus/transmissão , Infecção por Zika virus/virologia
Toxicon ; 186: 26-28, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-32738247


This study describes the basic epidemiological features of snakebites in El Salvador for the period 2014-2019 on the basis of data provided by the national system of information on morbidity and mortality (Sistema de Morbi-Mortalidad via Web, SIMMOW) of the Ministry of Health of El Salvador. The total number of cases per year ranged from 161 (2017) to 215 (2016). Incidences ranged from 2.52 cases to 3.38 cases per 100,000 population per year, corresponding to the years 2017 and 2016, respectively. Five deaths were recorded in the six-year period, four in 2015 and one in 2016, for a case fatality rate of 0.44%. Snakebites peaked during the rainy season (May to November) and mostly affected people in the age groups of 10-30 years. The male/female ratio was 1.59. The Departments (local political units) showing the highest number of cases were Santa Ana, Libertad, Chalatenango, Sonsonate, and La Unión. Most cases were attended at departmental and regional hospitals (second level of attention). The incidence and mortality due to snakebite envenoming in El Salvador are the lowest reported for Central America. This may be related to the fact that Bothrops asper, the medically most important snake species in the region, is not distributed in El Salvador, where the rattlesnake Crotalus simus predominates.

Mordeduras de Serpentes/epidemiologia , Animais , Bothrops , Crotalus , El Salvador/epidemiologia , Feminino , Humanos , Incidência , Masculino
Artigo em Inglês | MEDLINE | ID: mdl-32679717


A cross-sectional, self-administered survey was used to gather information about dental outcomes, sugar-containing food behaviors and intake, and sociodemographic characteristics of adults of Mexican and Central-American (Guatemala, El Salvador, Honduras) origin (n = 517). Bivariate and multiple-variable logistic regressions were used to examine the associations of behaviors related to added sugar-containing foods/beverages (overall intake and consumption before bed) with dental outcomes. Outcome measures involved dental outcomes, dental self-care practices, and added sugar intake. Estimated daily added sugar intake among all participants was 98 (SD = 99) g, with no difference in consumption among participants from different countries. The majority of added sugar (63 (SD = 74) g) was provided by sugar-sweetened beverages. Participants who reported consuming sugar-containing foods or beverages within an hour before bed were more likely to report having a fair/poor/very poor condition of teeth and gums and having felt dental pain (p < 0.05 for all). The amount of sugar intake was associated with being prescribed medication for oral or dental problems (p = 0.008) and dental pain (p = 0.003). Findings support the association between sugar containing food-related behaviors and dental problems among Hispanic immigrants to the U.S. Health promotion and preventive interventions for this population should consider these behaviors as modifiable contributors to adverse dental outcomes.

Sacarose na Dieta/administração & dosagem , Emigrantes e Imigrantes , Hispano-Americanos , Saúde Bucal , Adulto , Bebidas , Estudos Transversais , El Salvador , Ingestão de Energia , Feminino , Honduras , Humanos , Seguro Odontológico , Masculino , México/epidemiologia , Açúcares
MHSalud ; 17(1): 1-18, ene.-jun. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1091027


Resumen: El objetivo de este estudio fue determinar el IMC (índice de masa corporal), la autoestima y el nivel de actividad física de los niños y las niñas de II ciclo de la ciudad de San Salvador. Participaron 11 centros escolares: 359 (47 %) fueron niñas y 399 (53 %) niños, con edad promedio de 11.49 ±1.34 años, una talla de 147.11 ± 0.10 cm y un peso de 47.53 ± 13.758 kg. Se evaluó peso, talla, IMC, la percepción de actividad física y autoestima, por medio del cuestionario de actividad física para niños y niñas mayores (PAQ-C) y el cuestionario sobre autoestima (LAWSEQ). En los resultados obtenidos se encontró que un 29 % (n= 227) tienen bajo peso, un 46.7 % (n= 354) tienen peso saludable, un 18.3 % (n= 139) tiene sobrepeso y un 5 % (n= 38) tiene obesidad. En el caso de la actividad física los datos recabados muestran que un 53.7 % (n= 407) muestran valores de baja actividad física, un 43.8 % (n= 332) valores de actividad física media y un 2.5 % (n= 19) valores de actividad física alta. En el caso de la autoestima los datos evidencian que un 52. 9% (n= 401) están en condición de baja autoestima, un 43.1 % (n= 327) tiene autoestima promedio y un 4.0 % (n= 30) presenta valores de alta autoestima. Se concluye que los datos obtenidos en las variables de IMC, nivel de actividad física y autoestima en el grupo de estudiantes evaluados son alarmantes, lo que propone la necesidad de desarrollar estrategias para intervenir esta problemática.

Abstract: The objective of this study was to determine the BMI (Body Mass Index), the self-esteem and the level of physical activity of the children of the second cycle of the city of San Salvador. 11 schools participated: 359 (47 %) were girls and 399 (53 %) girls, with an average age of 11.49 ± 1.34 years, a height of 147.11 ± 0.10 cm and a weight of 47.53 ± 13.758 Kg. Weight, height was evaluated, body mass index, the perception of physical activity and self-esteem, through the Physical Activity Questionnaire for Older Children (PAQ-C), and Lawrence Self-Esteem Questionnaire (LAWSEQ). In the results obtained it was found that 29% (n= 227) are underweight, 46.7 % (n= 354) have a healthy weight, 18.3% (n= 139) are overweight and 5% (n= 38) He is obese. In the case of physical activity, the data collected show that 53.7% (n= 407) show values ​​of low physical activity, 43.8% (n= 332) values ​​of physical activity means and 2.5% (n= 19) values of high physical activity. In the case of self-esteem, the data show that 52.9% (n= 401) are in a low self-esteem condition, 43.1% (n= 327) have average self-esteem and 4.0% (n= 30) have high self-esteem values. It is concluded that the data obtained in the variables of body mass index, physical activity level and self-esteem in the students evaluated are alarming, which suggests the need to develop strategies for the intervention of this problem.

Resumo O objetivo deste estúdio foi determinar o IMC, a autoestima e o nível de atividade física dos estudantes do segundo ciclo do município de San Salvador. Participaram 11 centros educativos: 359 (47%) meninas e 399 (53%) meninos, com uma idade aproximada de 11,49 ± 1,34 anos, com 147,11 ± 0,10 cm de altura e 47,53 ± 13,758 kg de peso. Foi avaliado peso, altura, índice de massa corporal, percepção de atividade física e autoestima, por meio do questionário de atividade física para crianças e adolescentes (PAQ-C) e pesquisa sobre autoestima (LAWSEQ). Nos resultados obtidos, encontrou-se que 29% (n = 227) estão com baixo peso, 46,7% (n = 354) estão com peso saudável, 18,3% (n = 139) estão com sobrepeso e 5% (n = 38) tem obesidade. No caso da atividade física, os dados recuperados mostram que 53,7% (n = 407), tem uma atividade física baixa, 43,8% (n = 332) tem atividade física média e 2,5% (n = 19) tem atividade física alta. Sobre a autoestima, os dados deixam em evidencia que 52,9% (n = 401) estão em condição de autoestima baixa, 43,1% (n = 327) têm autoestima regular e 4,0% (n = 30) apresentam uma alta autoestima. As conclusões indicam que os dados obtidos nas variáveis de índice de massa corporal, nível de atividade física e autoestima dos estudantes avaliados são alarmantes, indicando a necessidade de propor estratégias para a intervenção desta problemática.

Humanos , Criança , Autoimagem , Estudantes , Exercício Físico , Criança , El Salvador , Sobrepeso , Obesidade Pediátrica , Atividade Motora
BMC Health Serv Res ; 20(1): 474, 2020 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-32460769


BACKGROUND: Non-communicable Diseases (NCDs) are the leading cause of global mortality and disability with a rising burden in low- and middle-income countries. Their multifactorial aetiology, and their requirement of long-term care, implies the need for comprehensive approaches. From 2009, the Ministry of Health (MoH) in El Salvador has developed a national public health system based on comprehensive primary health care. This study aims to describe the different stakeholders' perceptions about the management of NCDs along the pathways of care in this health system. METHODS: During three fieldwork periods in 2018, three complementary qualitative data collection methods were deployed and conducted in settings with high prevalence of NCDs within El Salvador. First, illness narrative methodology was used to document the life histories of people living with a chronic disease and being treated in second and third level health facilities. Second, through social mapping, support resources that NCD patients used throughout the process of their illness within the same settings were analysed. Third, semi-structured interviews were conducted in the same locations, with both chronic patients and health personnel working at different levels of the primary health care setting. Participants were recruited through purposive and snowball sampling, and a deductive approach was implemented for coding during the analysis phase. After grouping codes into potential themes, a thematic framework was developed using a reflexive approach and following triangulation of the data. RESULTS: This innovative approach of combining three well-defined qualitative methods identified key implications for the implementation of a comprehensive approach to NCD management in resource-poor settings. The following elements are identified: 1) social risk factors and barriers to care; 2) patient pathways to NCD care; 3) available resources identified through social connections mapping; 4) trust in social connections; and 5) community health promotion and NCD prevention management. CONCLUSIONS: The Salvadoran public health system has been able to strengthen its comprehensive approach to NCDs, combining a clinical approach - including long-term follow-up - with a preventive community-based strategy. The structural collaboration between the health system and the (self-) organised community has been essential for identifying failings, discuss tensions and work out adapted solutions.

Assistência à Saúde , Gerenciamento Clínico , Corpo Clínico/psicologia , Doenças não Transmissíveis/terapia , El Salvador , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Entrevistas como Assunto , Masculino , Assistência Médica , Atenção Primária à Saúde , Pesquisa Qualitativa
BMC Public Health ; 20(1): 687, 2020 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-32410611


BACKGROUND: The World Health Organization (WHO-2007) and the International Obesity Task Force (IOTF-Cole) systems assess child weight status. However, derived estimations often differ. We aimed to a) compare the prevalence of overweight and obesity, b) analyze individual and contextual factors associated with child weight using multilevel analysis and c) explore the spatial distribution of overweight and obesity using both classification systems. METHODS: We used data from the 2015/2016 National School Height and Weight Census in El Salvador. Information on 111,991 children aged 6.0-9.9 years attending the first grade was analyzed. Body mass index Z-score (BMIZ), overweight and obesity were defined with both classification systems. Weighted kappa was used to measure agreement. Child, school and municipal potential determinants of BMIZ were examined by multilevel analysis. Municipal spatial clustering of overweight and obesity was tested using Moran's Index and Getis-ord Gi* statistics. RESULTS: The combined prevalence of overweight and obesity was higher according to the WHO system than the IOTF (30.4% vs 23.1%). The weighted kappa was 0.83. Boys, children attending urban schools, children attending private schools, and children residing in municipalities with high human development index had higher BMIZ than their counterparts. The Moran's indexes were positives and significant. Clusters of high prevalence (above the national prevalence) of overweight and obesity were found in 29 municipalities using the WHO and IOTF systems. For obesity, 28 and 23 municipalities in clusters of high prevalence were detected using the WHO and IOTF criteria, respectively. CONCLUSIONS: Overweight and obesity is high among school-age children in El Salvador. The prevalence of overweight and obesity was higher when using the WHO system, as compared to the IOTF system. Irrespective of the classification system, the multilevel and spatial analysis derived similar interpretations. These results support the need for national preventive interventions with targeting strategies to reduce overweight and obesity in school-age children.

Índice de Massa Corporal , Peso Corporal , Obesidade Pediátrica/epidemiologia , Vigilância da População/métodos , Comitês Consultivos , Criança , Cidades , El Salvador/epidemiologia , Feminino , Humanos , Masculino , Sobrepeso/classificação , Sobrepeso/epidemiologia , Obesidade Pediátrica/classificação , Prevalência , Características de Residência , Instituições Acadêmicas , Análise Espacial , População Urbana , Organização Mundial da Saúde
PLoS One ; 15(4): e0231875, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32330174


Coffea arabica is a highly traded commodity worldwide, and its plantations are habitat to a wide range of organisms. Coffee farmers are shifting away from traditional shade coffee farms in favor of sun-intensive, higher yield farms, which can impact local biodiversity. Using plant-associated microorganisms in biofertilizers, particularly fungi collected from local forests, to increase crop yields has gained traction among coffee producers. However, the taxonomic and spatial distribution of many fungi in coffee soil, nearby forests and biofertilizers is unknown. We collected soil samples from a sun coffee system, shade coffee system, and nearby forest from Izalco, Sonsonate, El Salvador. At each coffee system, we collected soil from the surface (upper) and 10 cm below the surface (lower), and from the coffee plant drip line (drip line) and the walkway between two plants (walkway). Forest soils were collected from the surface only. We used ITS metabarcoding to characterize fungal communities in soil and in the biofertilizer (applied in both coffee systems), and assigned fungal taxa to functional guilds using FUNGuild. In the sun and shade coffee systems, we found that drip line soil had higher richness in pathotrophs, symbiotrophs, and saprotrophs than walkway soil, suggesting that fungi select for microhabitats closer to coffee plants. Upper and lower soil depths did not differ in fungal richness or composition, which may reflect the shallow root system of Coffea arabica. Soil from shade, sun, and forest had similar numbers of fungal taxa, but differed dramatically in community composition, indicating that local habitat differences drive fungal species sorting among systems. Yet, some fungal taxa were shared among systems, including seven fungal taxa present in the biofertilizer. Understanding the distribution of coffee soil mycobiomes can be used to inform sustainable, ecologically friendly farming practices and identify candidate plant-growth promoting fungi for future studies.

Coffea/crescimento & desenvolvimento , Fungos/classificação , Microbiologia do Solo , Luz Solar , Coffea/efeitos da radiação , El Salvador
Int J Equity Health ; 19(1): 50, 2020 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-32252764


BACKGROUND: One of today's greatest challenges in public health worldwide - and especially its key management from Primary Health Care (PHC) - is the growing burden of non-communicable diseases (NCDs). In El Salvador, since 2009 the Minister of Health (MoH) has scaled up a national public health system based on a comprehensive PHC approach. A national multi-sectorial strategic plan for a comprehensive approach to NCDs has also been developed. This analysis explores stakeholders' perceptions related to the management of NCDs in PHC and, in particular, the role of social participation. METHODS: A case-study was developed consisting of semi structured interviews and official document reviews. Semi-structured interviews were developed with chronic patients (14) and PHC professionals working in different levels within PHC (12). Purposive sampling was used to recruit participants. A non-pure, deductive approach was implemented for coding. After grouping codes into potential themes, a thematic framework was elaborated through a reflexive approach and the triangulation of the data. The research was conducted between March and August of 2018 in three different departments of El Salvador. RESULTS: The structure and the functioning of the Salvadoran PHC system and its intersectoral approach is firstly described. The interdisciplinary PHC-team brings holistic health care closer to the communities in which health promoters play a key role. The findings reflect the generally positive perception of the PHC system in terms of accessibility, quality and continuity of care by chronic patients. Community engagement and the National Health Forum are ensuring accountability through social controllership mechanisms. However, certain challenges were also noted during the interviews related to the shortage of medication and workforce; coordination between the levels of care and the importance of prevention and health promotion programmes for NCDs. CONCLUSIONS: The Salvadoran PHC and its comprehensive approach to NCDs with an emphasis on intersectoral participation has been positively perceived by the range of stakeholders interviewed. Social engagement and the NHF works as a driving force to ensure accountability as well as in the promotion of a preventive culture. The challenges identified provide keys to amplify knowledge for addressing inequalities in health by strengthening PHC and its NCDs management.

Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/terapia , Atenção Primária à Saúde/organização & administração , Adulto , Idoso , Doença Crônica , Continuidade da Assistência ao Paciente , El Salvador/epidemiologia , Feminino , Saúde Global , Acesso aos Serviços de Saúde , Mão de Obra em Saúde , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Estudos de Casos Organizacionais , Atenção Primária à Saúde/normas , Qualidade da Assistência à Saúde
Artigo em Inglês | MEDLINE | ID: mdl-32326320


Despite increasing interest in understanding the factors influencing awareness and acceptability of the human papillomavirus (HPV) vaccine among Latino parents, to date limited information is available specific to Central American parents living in the United States (US). Therefore, this pilot cross-sectional study was designed to explore and assess Central American immigrant parents' awareness, acceptability, and willingness to vaccinate their children against HPV, and interest in participating in future HPV-associated cancer prevention study. Fifty-six Central American parents, majority immigrant (96.4%; n = 54) from four countries, El Salvador-50% (n = 27); Guatemala-25.9% (n = 14); Honduras-22.2% (n = 12); and Panama-1.9% (n = 1) participated in this study. Participants completed an interviewer-administered questionnaire survey in their preferred language (i.e., Spanish or English). A little over half of the participants were mothers (57.1%; n = 32) and parents' mean age was 43.2 years (SD = 6.4). The majority was married or cohabitating (76.8%, n = 43), and 39.3% (n = 22) reported having two children. Seventy-five percent (n = 42) of parents reported they had heard of the HPV vaccine. Fewer fathers were aware of the HPV vaccine (58.3%; n = 14 vs.87.5%, n = 28; p = 0.01) than mothers. Among parents who had heard of the HPV vaccine (n = 42), 85.7% (n = 36) reported their children had received at least one dose of the HPV vaccine. Fewer fathers reported their child had been vaccinated against HPV (64.3%, n = 9 vs. 96.4%, n = 27; p = 0.06) than mothers. Moreover, 90% of parents (n = 18) whose children were unvaccinated reported willingness to vaccinate their adolescent children against HPV if recommended by their child's physician. Findings indicate parents' low to moderate awareness of the HPV vaccine, and high willingness to vaccinate their adolescent children if recommended by their child's physician. Findings also demonstrate fathers' lower awareness and acceptability of the HPV vaccine than mothers. Despite limitations and the need for more research, findings of this pilot study serve as a valuable first step toward building a knowledge foundation that is needed for developing future studies and interventions targeting Central American immigrant parents living in the US. Future studies can build on the findings of this exploratory study with other research designs and address its limitations by having a larger sample size and accounting for additional factors associated with Central American immigrant parents' HPV awareness, knowledge, beliefs, attitudes, and vaccine acceptability from other communities across the US.

Emigrantes e Imigrantes , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Infecções por Papillomavirus , Vacinas contra Papillomavirus/administração & dosagem , Vacinação/psicologia , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , El Salvador , Feminino , Guatemala , Hispano-Americanos , Honduras , Humanos , Masculino , Pessoa de Meia-Idade , Panamá , Papillomaviridae , Infecções por Papillomavirus/prevenção & controle , Pais , Projetos Piloto , Estados Unidos , Adulto Jovem
San Salvador; Ministerio de Salud; 1; abr.2020. 5 p.
Não convencional em Espanhol | LILACS, BISSAL | ID: biblio-1087811


A medida que la pandemia COVID-19 se acelera, los sistemas de salud a nivel mundial se han saturado con pacientes que buscan una atención rápida y eficiente. La prevención de la propagación del virus entre los trabajadores de la salud (PS) y los pacientes depende del uso efectivo de equipos de protección personal (EPP), como guantes, mascarillas, gafas protectoras, protectores faciales, cofias, protectores de calzado y batas. Debido a la magnitud del problema, se prevé una escasez de EPP, convirtiéndose en uno de los principales problemas en la atención de la pandemia. Un aumento en el suministro de EPP requiere un gran aumento en el proceso de fabricación, un proceso que requiere de mucho tiempo y recursos, sin embargo, el número de enfermos aumenta en una velocidad alarmante. En vista de esta situación, la comunidad científica comenzó a generar recomendaciones sobre las posibles soluciones, entre estas se pueden mencionar: la reorientación de material de protección que se utiliza en otras áreas como construcción, laboratorios de investigación, salones de belleza, dentistas, veterinarios y granjas, a los servicios de salud1. Otras propuestas están orientadas a la reutilización del EPP previo a un proceso de esterilización. Para esto se propone la utilización de óxido de etileno, radiación UV o gamma, ozono y alcohol. Otras propuestas son la impregnación de las mascarillas con cobre o cloruro de sodio. Muchos científicos han reconocido que estos métodos de esterilización pueden comprometer la integridad estructural del EPP degradando las fibras de las máscaras y respiradores perdiendo su eficacia en el filtrado de partículas virales1. Otros planteamientos han descrito la utilización de EPP de tela, esto facilita su limpieza y desifección para su reutilzación segura, tal como se realizaba en épocas anteriores2. Este documento presenta las recomendaciones dadas hasta la fecha para la esterilización del EPP, en caso sea pertinente, ya que en algunos elementos la esterilización no es recomendada ya que compromete la capacidad de protección de los elementos, poniendo en riesgo la salud del personal de salud.

As the COVID-19 pandemic accelerates, healthcare systems worldwide have become saturated with patients seeking prompt and efficient care. Prevention of the spread of the virus among healthcare workers (PS) and patients depends on the effective use of personal protective equipment (PPE), such as gloves, masks, goggles, face shields, caps, shoe protectors, and gowns. . Due to the magnitude of the problem, a shortage of EPP is anticipated, becoming one of the main problems in the attention of the pandemic. An increase in the supply of PPE requires a great increase in the manufacturing process, a process that requires a lot of time and resources, however, the number of patients increases at an alarming rate. In view of this situation, the scientific community began to generate recommendations on possible solutions, among these we can mention: the reorientation of protective material that is used in other areas such as construction, research laboratories, beauty salons, dentists, veterinarians and farms, to health services1. Other proposals are aimed at reusing the PPE prior to a sterilization process. For this, the use of ethylene oxide, UV or gamma radiation, ozone and alcohol is proposed. Other proposals are the impregnation of the masks with copper or sodium chloride. Many scientists have recognized that these sterilization methods can compromise the structural integrity of EPP by degrading the fibers of the masks and respirators, losing their effectiveness in filtering viral particles1. Other approaches have described the use of fabric PPE, this facilitates its cleaning and disinfection for its safe reuse, as was done in previous times2. This document presents the recommendations given to date for the sterilization of PPE, if applicable, since in some elements sterilization is not recommended as it compromises the protection capacity of the elements, putting the health of health personnel at risk. .

Humanos , Pneumonia Viral/prevenção & controle , Desinfecção/métodos , Infecções por Coronavirus/prevenção & controle , Assistência à Saúde/normas , Pandemias/prevenção & controle , Equipamento de Proteção Individual/normas , El Salvador
San Salvador; Ministerio de Salud; 2 ed; mar. 2020. 19 p.
Não convencional em Espanhol | LILACS | ID: biblio-1087562


Las directrices para el manejo y disposición final de cadáveres por COVID­2019, requieren de medidas de bioseguridad y precaución estándar encaminadas para este fin y lograr la prevención de esta infección en el personal responsable del manejo y disposición final de cadáveres. Los presentes lineamientos técnicos contienen las actividades que el personal de salud debe cumplir para el manejo y disposición final de cadáveres en los diferentes escenarios y durante el traslado en busca de atención. Asimismo se establecen las indicaciones para la inhumación ante el fallecimiento por caso confirmado o sospecho de COVID-19. Todo lo anterior con el objetivo de proteger la salud de la población en general fortaleciendo la prevención y evitando la transmisibilidad. Objetivo general: Establecer las disposiciones técnicas y de bioseguridad para la prevención de infecciones en el personal responsable del manejo y disposición final de cadáveres por COVID­19, familiares, comunidad en general y otros actores que intervengan en estos procesos por mandato legal. Objetivos específicos: a)Brindar las directrices sobre el manejo y disposición final del cadáver dentro y fuera de los establecimientos de salud. b)Orientar a las instituciones funerarias sobre el procedimiento a seguir durante la pandemia COVID-19. c)Disponer de un instrumento legal que garantice evitar la transmisibilidad de la enfermedad COVID-19 por la manipulación de cadáveres. Ámbito de aplicación: Están sujetos al cumplimiento de los presentes Lineamientos técnicos el personal del Sistema Nacional Integrado de Salud, municipalidades, personas naturales y jurídicas que estén vinculadas al manejo y disposición final de cadáveres por COVID-19

Humanos , Pneumonia Viral/prevenção & controle , Cadáver , Exposição Ocupacional/prevenção & controle , Infecções por Coronavirus/prevenção & controle , Sistemas Nacionais de Saúde/normas , Pandemias/prevenção & controle , Práticas Mortuárias/normas , Pessoal de Saúde/normas , Exumação/normas , El Salvador , Rituais Fúnebres
San Salvador; FUNDE; 1a; mar.2020. 56 p.
Não convencional em Espanhol | LILACS, BISSAL | ID: biblio-1104320


Este estudio hace un diagnóstico del sistema tributario salvadoreño, explorando la posibilidad, factibilidad y viabilidad para la adopción de mecanismos impositivos que permitan, por un lado, aumentar la recaudación tributaria, obteniendo importantes recursos para financiar los programas de gasto público y, por el otro, servir de incentivos para modificar las conductas de los agentes económicos en la dirección de buscar la sustentabilidad ambiental. El estudio comienza revelando el problema ambiental en el planeta y en El Salvador, en particular, mostrando la necesidad de mover la agenda de protección del medioambiente, tanto a nivel global, como a nivel nacional. En este último ámbito se ilustra sobre la institucionalidad existente en el país. Luego se caracteriza el sistema tributario salvadoreño y se hace énfasis en un examen de los tributos medioambientales vigentes, con el objeto de proponer otros instrumentos acorde a las mejores prácticas a nivel mundial. El estudio concluye con la presentación de los impactos recaudatorios de las reformas propuestas, así como con una serie de recomendaciones de políticas públicas; todo, con el objetivo de lograr un medioambiente sustentable.

This study makes a diagnosis of the Salvadoran tax system, exploring the possibility, feasibility and viability for the adoption of tax mechanisms that allow, on the one hand, to increase tax collection, obtaining important resources to finance public spending programs and, on the other. , serve as incentives to modify the behavior of economic agents in the direction of seeking environmental sustainability. The study begins by revealing the environmental problem on the planet and in El Salvador, in particular, showing the need to move the environmental protection agenda, both globally and nationally. In this last area, the institutional framework in the country is illustrated. Then the Salvadoran tax system is characterized and an emphasis is made on an examination of the environmental taxes in force, with the aim of proposing other instruments according to the best practices worldwide. The study concludes with the presentation of the collection impacts of the proposed reforms, as well as a series of public policy recommendations; everything, with the aim of achieving a sustainable environment.

Legislação , El Salvador , Meio Ambiente , Indicadores de Desenvolvimento Sustentável
Acta Trop ; 205: 105392, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32061627


There are 8 million people with Chagas disease worldwide and in El Salvador approximately 39% of the population is at risk of contracting the disease. One of the principal challenges in mitigating Chagas is evaluating the role of the vector ecology of triatomine species in the transmission of the Trypanosoma cruzi parasite in anthropogenically modified habitats, where new patterns of transmission frequently arise. Field studies of triatomine vector ecology in El Salvador have largely focused on describing parameters that contribute to infestation patterns, which may themselves be rooted in the morphological variability that exists in triatomine populations. The objective of this study was to evaluate the morphology of the vector species Triatoma dimidiata with respect to the characteristics of the ecological landscape the vector inhabits throughout El Salvador. We used image analyses to evaluate T. dimidiata morphological variability and then used Geographic Information Systems to intersect the morphological point-data with map layers containing different environmental characteristics. Our study found that the variation in the size, shape, and coloration of T. dimidiata varied in relation to elevation, Holdridge life zone, soil type and land use. We further characterize the local morphological adaptations of T. dimidiata with respect to the local ecological, biological, and geographical conditions in El Salvador. We suggest that future studies consider a molecular exploration of local T. dimidiata species complex in El Salvador, especially since morphological studies of triatomine species complex have found that variability correlate with the genetic variability of the population.

Distribuição Animal , Doença de Chagas/transmissão , Ecossistema , Insetos Vetores/fisiologia , Triatoma/fisiologia , Trypanosoma cruzi/fisiologia , Animais , Doença de Chagas/epidemiologia , El Salvador/epidemiologia , Insetos Vetores/parasitologia , Triatoma/parasitologia , Trypanosoma cruzi/genética
Artigo em Inglês | PAHO-IRIS | ID: phr-51900


[ABSTRACT]. Objective. To present summary measures of socioeconomic inequalities in access barriers to health services in Colombia, El Salvador, Paraguay, and Peru. Methods. This cross-sectional study used data from nationally - representative household surveys in Colombia, El Salvador, Peru, and Paraguay to analyze income-related inequalities in barriers to seeking health services. Households that reported having a health problem (disease/accident) and not seeking professional health care were considered to be facing access barriers. The measures of inequality were the slope index of inequality and relative index of inequality. Results. Inequality trends were mixed across the four countries. All showed improvement, but large inequality gaps persisted between the highest and lowest income quintiles, despite health care reforms. Relative inequality gaps were highest in Colombia (60%), followed by Paraguay (30%), Peru (20%), and El Salvador (20%). Conclusions. The effect of national policy initiatives on equity to accessing health services should be the object of future analysis. There is also a need for research on national and regional monitoring of access barriers and explanatory factors for why people do not seek care, even when having a health problem.

[RESUMEN]. Objetivo. Presentar algunas mediciones de las desigualdades socioeconómicas que representan obstáculos para el acceso a los servicios de salud en Colombia, El Salvador, Paraguay y Perú. Métodos. En este estudio transversal se tomaron datos de encuestas realizadas en hogares representativas a nivel nacional en Colombia, El Salvador, Perú y Paraguay. Mediante estos datos se analizaron las desigualdades en los ingresos como obstáculos para recurrir a los servicios de salud. Los hogares donde se informó algún problema de salud (enfermedad o accidente) y sus habitantes no recurrieron a ningún tipo de atención profesional fueron considerados como población que enfrenta obstáculos para acceder a estos servicios. Para medir la desigualdad se usó el índice de desigualdad de la pendiente y el índice relativo de desigualdad. Resultados. Las tendencias de desigualdad fueron divergentes entre estos países. Se observó un grado de avance en cada país, aunque subsistieron grandes brechas entre el quintil de ingresos superiores y el inferior, a pesar de que hubo reformas en la atención de salud. Las brechas en cuanto al índice relativo de desigualdad fueron más elevadas en Colombia (60%), seguido de Paraguay (30%), Perú (20%) y El Salvador (20%). Conclusiones. La repercusión que tienen las iniciativas de política nacional sobre la igualdad de acceso a los servicios de salud debería ser objeto de análisis en un futuro. Asimismo, es necesario que se realicen investigaciones en cuanto al seguimiento a nivel nacional y regional de los obstáculos al acceso a los servicios de salud y los factores explicativos que indiquen porqué las personas no acuden a los servicios incluso cuando presentan un problema de salud.

[RESUMO]. Objetivo. Apresentar indicadores das desigualdades socioeconômicas no acesso aos serviços de saúde na Colômbia, El Salvador, Paraguai e Peru. Métodos. Este estudo transversal utilizou dados de pesquisas domiciliares representativas da realidade nacional na Colômbia, El Salvador, Peru e Paraguai com o objetivo de analisar as desigualdades relacionadas à renda no acesso aos serviços de saúde. Os domicílios que relataram a presença de um problema de saúde (doença/acidente) e não buscaram cuidados de saúde profissionais foram considerados como domicílios que apresentavam barreiras no acesso aos serviços de saúde. Os indicadores de desigualdade foram o índice absoluto de desigualdade (slope index of inequality, SII) e o índice relativo de desigualdade. Resultados. As tendências relativas à desigualdade foram mistas nos quatro países. Todos apresentaram melhorias, mas ainda persistem grandes disparidades entre os quintis com renda mais alta e mais baixa, apesar das reformas nos sistemas de saúde. A desigualdade relativa foi mais elevada na Colômbia (60%), seguida do Paraguai (30%), Peru (20%) e El Salvador (20%). Conclusões. O efeito das iniciativas políticas nacionais sobre a equidade no acesso aos serviços de saúde deve ser o tema de análises futuras. Também é preciso pesquisar o monitoramento nacional e regional das barreiras no acesso aos serviços e os fatores que explicam por que as pessoas não buscam cuidados de saúde, mesmo quando apresentam um problema de saúde.

Acesso aos Serviços de Saúde , Gradiente Socioeconômico de Saúde , Reforma dos Serviços de Saúde , América Latina , Colômbia , El Salvador , Paraguai , Peru , Acesso aos Serviços de Saúde , Gradiente Socioeconômico de Saúde , Reforma dos Serviços de Saúde , América Latina , Peru , Acesso aos Serviços de Saúde , Gradiente Socioeconômico de Saúde , Reforma dos Serviços de Saúde , Colômbia , Paraguai