biblioteca virtual en salud

BVS - Literatura Cientifica y Técnica

 

Historico de búsqueda  ()

Su selección  ()

Collapse All  Ocultar
Expand All  Mostrar
Tipo
Texto completo (242)
Idioma
Año
Resultados  1-10 de 846
Enviar resultado
adicionar en sua lista
1.

Matriz de procesos críticos de la determinación social de la salud en la afectación al sistema inmune por exposición a agrotóxicos en La Paz, Bolivia/ Matrix of Critical Processes of the Social Determination of Health in the Affectation to the Immune System by Exposure to Pesticides in La Paz, Bolivia/ Matriz de processos críticos da determinação social da saúde na afetação ao sistema imune por exposição a agrotóxicos, em La Paz, Bolívia

García, Carmiña Heidy
| Idioma(s): Español
Resumen Introducción: la epidemiología crítica utiliza como herramienta metodológica la categoría de determinación social de la salud, estructurada en una matriz de procesos críticos. Esta matriz nos permite entender la complejidad del objeto salud desde diferentes dimensiones o dominios. Desarrollo: se parte de ordenar los dominios en dominio general, dominio particular y dominio individual. Al aplicar esta herramienta metodológica de la epidemiología crítica con la matriz de procesos críticos, se pretende explicar de una forma integral y objetiva la afectación -en el dominio individual- a los mecanismos de la respuesta inmune innata y adaptativa del sistema inmune. El objeto de estudio es la afectación del sistema inmune por el uso y la, mayor o menor, exposición crónica a agrotóxicos en comunarios productores de frutas y verduras en el departamento de La Paz, Bolivia. Conclusiones: se realizan acorde con el análisis cuali-cuantitativo de las variables e indicadores de cada dominio. Se interpreta la salud como un proceso, y los resultados laboratoriales de la respuesta inmune dejan de ser analizados empíricamente en su relación biológica causa-efecto y pasan a constituirse como parte del dominio individual, en el que los modos de vida y la estructura social (económica, política, cultural y geográfica) afectan los mecanismos biológicos. Abstract Introduction: Critical epidemiology uses the social determination of health category as a methodological tool, structured in an array of crucial processes. This matrix allows us to understand the complexity of the health object from different dimensions or domains: general, private, and individual, with particular typologies that allow a dialectical relationship between them. Development: The object of study related to the affectation to the immune system, by the use and the greater or lesser chronic exposure to agrochemicals in fruits and vegetables produced by communities in the department of La Paz, Bolivia. Applying critical epidemiology with the matrix of crucial processes, we tried to explain the impacts to the immune system's innate and adaptive response mechanisms, in an integral and objective way, where also the different levels relate to reality and the processes that intervene in the communities' ways of life. Conclusions: With the qualitative and quantitative analysis of the variables and indicators of each domain, health is interpreted as a process, and the laboratory results of the immune response cease to be empirically analyzed in their biological cause-effect relationship and became a constituent part of the individual domain, where the mechanisms are affected by the ways of life and the social structure (economic, political, cultural, and geographical). Resumo Introdução: A epidemiologia crítica utiliza como ferramenta metodológica a categoria determinação social da saúde estruturada em uma matriz de processos críticos. Esta matriz nos permite compreender a complexidade do objeto saúde, desde diferentes dimensões ou domínios. Desenvolvimento: Parte-se por ordenar os domínios em: Domínio Geral, Domínio Particular, e Domínio Individual. Plicando esta ferramenta metodológica da epidemiologia crítica, com a matriz de processos críticos, pretende-se explicar de uma forma integral e objetiva a afetação -no domínio individual- aos mecanismos da resposta imune inata e adaptativa, do sistema imune. O objeto de estudo está referido à afetação ao sistema imune, pelo uso e à maior ou menor e exposição crônica a agrotóxicos em produtores comunitários de fruta e verdura no departamento de La Paz, Bolívia. Conclusões: Se realizam acorde com a análise qualitativa-quantitativa das variáveis e indicadores de cada domínio se interpreta a saúde como um processo e os resultados laboratoriais da resposta imune deixam de ser analisados empiricamente em sua relação biológica causa-efeito e passam a constituir-se como parte do domínio individual onde os mecanismos biológicos são afetados pelos modos de vida e pela estrutura social (econômica, política, cultural e geográfica).
adicionar en sua lista
2.

Plan andino de salud y cambio climático 2020-2025

Organización Panamericana de la Salud; Organismo Andino de Salud-Convenio Hipólito Unanue
| Idioma(s): Español
El Plan andino de salud y cambio climático 2020-2025 establece las acciones necesarias para aumentar la resiliencia de los países andinos a la variabilidad y el cambio climático, proteger la salud de su población y conducir la región hacia un futuro sostenible. Este plan ha sido elaborado por el Organismo Andino de la Salud–Convenio Hipólito Unanue (ORAS-CONHU), en colaboración con la Organización Panamericana de la Salud (OPS), a través de un proceso participativo con los Ministerios de Salud de los países andinos y, por supuesto, el Comité Andino de Salud para la Gestión del Riesgo de Emergencias y Desastres y el Cambio Climático, así como representantes de otras entidades como los Ministerios de Ambiente. El documento, aprobado por los Ministros de Salud de Bolivia (Estado Plurinacional de), Chile, Colombia, Ecuador, Perú y Venezuela (República Bolivariana de) el 16 de abril del 2020, proporciona estrategias para la gestión integral del cambio climático, la intensificación de las redes de cooperación y la integración de los países andinos a través de cuatro líneas estratégicas: trabajo intrasectorial, intersectorial e interdisciplinario; vigilancia del riesgo y la vulnerabilidad; investigación para incidir en políticas públicas; y mitigación y adaptación. Este documento toma como base los Objetivos de Desarrollo Sostenible y la Agenda de Desarrollo Sostenible 2030, el Acuerdo de París de la Convención Marco de las Naciones Unidas sobre el Cambio Climático (CMNUCC), el Marco de Sendái para la Reducción del Riesgo de Desastres, y las propias políticas y planes de los países andinos relacionadas con la gestión del cambio climático, todos coincidentes en la necesidad de generar distintos modos de producción y de consumo, basados en el respeto a la naturaleza como requisito para avanzar en el bienestar social.
adicionar en sua lista
3.

Los últimos pueblos indígenas aislados en América del Sur (Bolivia, Brasil, Colombia, Ecuador, Paraguay, Perú y Venezuela): entre la protección de sus derechos humanos y su papel en la conservación de los bosques tropicales para la década 2020-2030/ The last uncontacted indigenous peoples in South America (Bolivia, Brazil, Colombia, Ecuador, Paraguay, Peru and Venezuela): between the protection of their human rights and their role in the conservation of tropical forests for the decade 2020-2030

Brackelaire, Vincent
;
| Idioma(s): Español
Hasta el momento se han identificado por lo menos 58 pueblos indígenas en aislamiento, sin voluntad de contacto con otros pueblos o con la sociedad circundante, entre Bolivia, Brasil, Colombia, Ecuador, Paraguay, Perú y Venezuela (y específicamente en dos regiones, la Cuenca Amazónica y el Gran Chaco), países en los que también existe un cierto número de pueblos en contacto inicial o contacto intermitente. En América del Sur son llamados Pueblos Indígenas en Aislamiento o en Contacto Inicial (PIACI). Su protección y sobrevivencia están relacionados con el desafío de salvaguardar los territorios más ricos del mundo en biodiversidad de intereses extractivistas de todo tipo, generalmente ilegales y destructivos. El mantenimiento de las formas de vida de estos pueblos que son los más vulnerables del planeta, contribuye directamente a la conservación de los recursos naturales y a la lucha contra los cambios climáticos en los extensos territorios por donde se desplazan. En pocos años, los 7 países avanzaron en la construcción de políticas y normativas de protección de sus PIACI, pero se enfrentan ahora a los desafíos de su implementación, en particular frente a los Objetivos del Milenio y la Agenda 2030. En este sentido, la cooperación entre los países amazónicos ayuda a desarrollar los instrumentos necesarios para su protección, desde sistemas para buscar informaciones sobre ellos y confirmarlas, la implementación de figuras territoriales adecuadas en medio de la depredación amazónica, hasta la definición de protocolos de contacto y medidas de salud específicas para su sobrevivencia. Este estudio presenta una sistematización de la situación de los PIACI en el 2020, los resultados hasta hoy de la estrategia de protección en cada país y los desafíos pendientes para consolidar políticas y recursos durante la próxima década que garanticen la intangibilidad de los territorios que ocupan, en interés de su bienestar y su papel para el futuro del planeta.
adicionar en sua lista
4.

"Cheaper and better": Societal cost savings and budget impact of changing from systemic to intralesional pentavalent antimonials as the first-line treatment for cutaneous leishmaniasis in Bolivia.

Eid Rodríguez, Daniel; San Sebastian, Miguel; Pulkki-Brännström, Anni-Maria
| Idioma(s): Inglés
INTRODUCTION: Cutaneous leishmaniasis (CL), endemic in Bolivia, mostly affects poor people in rainforest areas. The current first-line treatment consists of systemic pentavalent antimonials (SPA) for 20 days and is paid for by the Ministry of Health (MoH). Long periods of drug shortages and a lack of safe conditions to deliver treatment are challenges to implementation. Intralesional pentavalent antimonials (ILPA) are an alternative to SPA. This study aims to compare the cost of ILPA and SPA, and to estimate the health and economic impacts of changing the first-line treatment for CL in a Bolivian endemic area. METHODS: The cost-per-patient treated was estimated for SPA and ILPA from the perspectives of the MoH and society. The quantity and unit costs of medications, staff time, transportation and loss of production were obtained through a health facility survey (N = 12), official documents and key informants. A one-way sensitivity analysis was conducted on key parameters to evaluate the robustness of the results. The annual number of patients treated and the budget impact of switching to ILPA as the first-line treatment were estimated under different scenarios of increasing treatment utilization. Costs were reported in 2017 international dollars (1 INT$ = 3.10 BOB). RESULTS: Treating CL using ILPA was associated with a cost-saving of $248 per-patient-treated from the MoH perspective, and $688 per-patient-treated from the societal perspective. Switching first-line treatment to ILPA while maintaining the current budget would allow two-and-a-half times the current number of patients to be treated. ILPA remained cost-saving compared to SPA in the sensitivity analysis. CONCLUSIONS: The results of this study support a shift to ILPA as the first-line treatment for CL in Bolivia and possibly in other South American countries.
adicionar en sua lista
5.

Underpinnings of entangled ethnical and gender inequalities in obesity in Cochabamba-Bolivia: an intersectional approach.

Mamani Ortiz, Yercin; Gustafsson, Per E; San Sebastián Chasco, Miguel; Armaza Céspedes, Ada Ximena; Luizaga López, Jenny Marcela; Illanes Velarde, Daniel Elving; Mosquera Méndez, Paola A
| Idioma(s): Inglés
BACKGROUND: Social inequalities in obesity have been observed not only by gender but also between ethnic groups. Evidence on combined dimensions of inequality in health, and specifically including indigenous populations, is however scarce, and presents a particularly daunting challenge for successful prevention and control of obesity in Bolivia, as well as worldwide. OBJECTIVE: The aims of this study were i) to examine intersectional inequalities in obesity and ii) to identify the factors underlying the observed intersectional inequalities. METHODS: An intersectional approach study was employed, using the information collected in a cross-sectional community-based survey. The sample consisted of youth and adults with permanent residence in Cochabamba department (N = 5758), selected through a multistage sampling technique. An adapted version of the WHO-STEPS survey was used to collect information about Abdominal obesity and risk factors associated. Four intersectional positions were constructed from gender (woman vs. men) and ethnic group (indigenous vs. mestizo). Joint and excess intersectional disparities in obesity were estimated as absolute prevalence differences between binary groups, using binomial regression models. The Oaxaca-Blinder decomposition was applied to estimate the contributions of explanatory factors underlying the observed intersectional disparities, using Oaxaca command in Stata software v15.1. RESULTS: The prevalence of abdominal obesity had a higher prevalence in mestizos (men 35.01% and women 30.71%) as compared to indigenous (men 25.38% and women 27.75%). The joint disparity was estimated at 7.26 percentage points higher prevalence in the doubly advantaged mestizo men than in the doubly disadvantaged indigenous women. The gender referent disparity showed that mestizo-women had a higher prevalence than indigenous-women. The ethnic referent disparity showed that mestizo-men had a higher prevalence than indigenous men. The behavioural risk factors were the most important to explain the observed inequalities, while differences in socioeconomic and demographic factors played a less important role. CONCLUSION: Our study illustrates that abdominal obesity is not distributed according to expected patterns of structural disadvantage in the intersectional space of ethnicity and gender in Bolivia. In the Cochabamba case, a high social advantage was related to higher rates of abdominal obesity, as well as the behavioural risk factors associated with them.
adicionar en sua lista
6.

Trends in socioeconomic inequalities in stunting prevalence in Latin America and the Caribbean countries: differences between quintiles and deciles.

Flores-Quispe, Maria Del Pilar; Restrepo-Méndez, María Clara; Maia, Maria Fátima S; Ferreira, Leonardo Z; Wehrmeister, Fernando C
| Idioma(s): Inglés
BACKGROUND: With the adoption of the Sustainable Development Goals (SDGs), there is a renewed commitment of tackling the varied challenges of undernutrition, particularly stunting (SDG 2.2). Health equity is also a priority in the SDG agenda and there is an urgent need for disaggregated analyses to identify disadvantaged subgroups. We compared time trends in socioeconomic inequalities obtained through stratification by wealth quintiles and deciles for stunting prevalence. METHODS: We used 37 representative Demographic and Health Surveys and Multiple Indicator Cluster surveys from nine Latin American and Caribbean (LAC) countries conducted between 1996 and 2016. Stunting in children under-5 years was assessed according to the 2006 WHO Child Growth Standards and stratified by wealth quintiles and deciles. Within-country socioeconomic inequalities were measured through concentration index (CIX) and slope index of inequality (SII). We used variance-weighted least squares regression to estimate annual changes. RESULTS: Eight out of nine countries showed a statistical evidence of reduction in stunting prevalence over time. Differences between extreme deciles were larger than between quintiles in most of countries and at every point in time. However, when using summary measures of inequality, there were no differences in the estimates of SII with the use of deciles and quintiles. In absolute terms, there was a reduction in socioeconomic inequalities in Peru, Honduras, Dominican Republic, Belize, Suriname and Colombia. In relative terms, there was an increase in socioeconomic inequalities in Peru, Bolivia, Haiti, Honduras and Guatemala. CONCLUSIONS: LAC countries have made substantial progress in terms of reducing stunting,. Nevertheless, renewed actions are needed to improve equity. Particularly in those countries were absolute and relative inequalities did not change over time such Bolivia and Guatemala. Finer breakdowns in wealth distribution are expected to elucidate more differences between subgroups; however, this approach is relevant to cast light on those subgroups that are still lagging behind within populations and inform equity-oriented health programs and practices.
adicionar en sua lista
7.

Socio-economic and environmental factors influenced pro-poor growth process: new development triangle.

Khan, Haroon Ur Rashid; Zaman, Khalid; Yousaf, Sheikh Usman; Shoukry, Alaa Mohamd; Gani, Showkat; Sharkawy, Mohamed A
| Idioma(s): Inglés
The developmental triangle earlier comprises economic growth, income inequality, and poverty, while in this study, we extended it by incorporating environmental and resource factors, health and education factors, sectoral value added, and some other growth-specific factors for assessing pro-poor growth, by considering Bolivian economy as a case study. The elasticity estimates show that agriculture and industrial sector growth is not pro-poor due to account of high income inequality, while services sector played a vital role in country's economic development and supports poor livelihood in a country. Energy and environmental resources negatively impact on quality of life of the poor relative to non-poor, which create income differences among them. Health and education expenditures give favors to the poor and supported the notion of pro-poor growth, while country's per capita income and foreign direct investment inflows increase income inequality that lead towards pro-rich growth. The results conclude that, in general, Bolivian economy growth is fairly unstable, polluted, and unhealthy that biased to the poor relative to non-poor.
adicionar en sua lista
8.

Arsenic contamination in rainwater harvesting tanks around Lake Poopó in Oruro, Bolivia: An unrecognized health risk.

Quaghebeur, Ward; Mulhern, Riley E; Ronsse, Silke; Heylen, Sara; Blommaert, Hester; Potemans, Sid; Valdivia Mendizábal, Carla; Terrazas García, Jhonny
| Idioma(s): Inglés
Drinking water sources used by largely rural and indigenous communities around Lake Poopó in the Bolivian Altiplano are impacted by drought and a combination of natural and anthropogenic mining-related contaminants putting the long-term health and sustainability of these communities at risk. As an alternative drinking water source, 18 rainwater harvesting tanks connected to corrugated iron roofs, each with a first-flush system, were installed in 5 communities around the lake. The water quality of these tanks was monitored over 22 months and compared to alternative unprotected surface and groundwater sources the communities previously relied upon. The rainwater quality was found to be within the Bolivian and World Health Organization (WHO) limits, except for elevated arsenic concentrations two times the recommended health limit (0.01 mg/L). Tracing arsenic concentrations through the rainwater flow-path showed that the elevated arsenic concentrations result from mineral dust particles entering the system when rainwater interacts with the roof catchment, with arsenic leaching out. A leaching test showed that 24 h of contact time between 200 mL of water and <1 g of roof dust is enough to raise the arsenic levels of the water above the Bolivian and WHO limit. Currently, no other research exists evaluating the quality of harvested rainwater in the Bolivian Altiplano for human consumption or the source of arsenic in harvested water. This represents a significant knowledge gap for future development practitioners and programs addressing water security around Lake Poopó and the wider region. As a result, it is strongly recommended to include arsenic as a standard parameter in water quality monitoring of rainwater harvesting projects, especially in active mining regions, and to optimize strategies to minimize roof dust from entering the collection system.
adicionar en sua lista
10.

Indicadores de saúde ambiental nos assentamentos do município de Cáceres: faixa fronteiriça Brasil/Bolívia/ Environmental health indicators in the settlements of the county of Cáceres: border strip Brazil/Bolivia/ Indicadores de salud ambiental em los asentamientos del município de Cáceres: banda fronteriza Brasil/Bolívia

Roma Greve Nodari, Poliana; Mara Alves da Silva Neves, Sandra; Jesus Oliveira Silva, Géssica; Ehle Nodari, Douglas
;
| Idioma(s): Portugués
Objetivo: propor e avaliar indicadores de saúde ambiental dos assentados na faixa fronteiriça cacerense. Método: utilizou-se o estudo descritivo, explicativo, quanti-qualitativo e censo, abrangendo todos os responsáveis pelas propriedades (lotes) dos assentamentos Jatobá, Nova Esperança, Rancho da Saudade, Sapicuá, Corixo, Bom Sucesso e Katira. Para coleta de dados foi aplicado um formulário semiestruturado, no período de março a julho de 2016, a 136 agricultores. Na construção dos indicadores utilizou-se a abordagem derivada do modelo Pressão-Estado-Impacto-Resposta. Os indicadores propostos foram: destinação do lixo, qualidade da água e casos de diarreia em crianças. As fontes de captação de água foram submetidas a quatro análises físico-química e microbiológica. Resultados: na destinação do lixo doméstico predominou a categoria queima com 80,9%, seguida das categorias enterra com 8,8% e queima e enterra com 10,3%. Verificou-se que a água não atende as exigências do Ministério da Saúde, devido à presença de Coliformes Totais. O número de crianças nos assentamentos foi 69, destas 88,40% consomem água dos poços coletivos, 52,45% apresentaram episódios de diarreia. Conclusão: os indicadores mostraram-se eficazes, sendo necessárias ações coletivas de orientações referentes aos cuidados com a destinação do lixo e o isolamento no entorno dos poços, e análises periódicas das águas destes assentamentos.(AU) Objective: to propose and evaluate indicators of environmental health of the settlers in the border area of Caceres. Method: the descriptive, explanatory, quantitative-qualitative and census study was used, covering all those responsible for the properties (lots) of the Jatobá, Nova Esperança, Rancho da Saudade, Sapicuá, Corixo, Bom Sucesso and Katira settlements. For data collection, a semistructured form was applied, from March to July 2016, to 136 farmers. In the construction of the indicators we used the approach derived from the Pressure-State-Impact-Response model. The proposed indicators were: waste disposal, water quality and cases of diarrhea in children. The sources of water abstraction were submitted to four physical-chemical and microbiological analyzes. Results: domestic waste disposal predominated in the category burned with 80.9%, followed by the categories burial with 8.8% and burning and burial with 10.3%. It was verified that the water does not meet the requirements of the Ministry of Health, due to the presence of Total Coliforms. The number of children in the settlements was 69, of whom 88.40% consume water from the collective wells, 52.45% had episodes of diarrhea. Conclusion: the indicators were effective, requiring collective actions of guidelines regarding waste disposal and isolation in the vicinity of the wells, and periodic analysis of the waters of these settlements.(AU) Objetivo: proponer y evaluar indicadores de salud ambiental de los asentados en la franja fronteriza cacerense. En el presente trabajo se analizaron los resultados obtenidos en el análisis de los resultados obtenidos en el análisis de los resultados obtenidos. Método: para la recolección de datos se aplicó un formulario semiestructurado, en el período de marzo a julio de 2016, a 136 agricultores. En la construcción de los indicadores se utilizó el abordaje derivado del modelo Presión-Estado-Impacto-Respuesta. Los indicadores propuestos fueron: destino de la basura, calidad del agua y casos de diarrea en niños. Las fuentes de captación de agua se sometieron a cuatro análisis físico-químicos y microbiológicos. Resultados: en la destinación de la basura doméstica predominó la categoría quema con 80,9%, seguida de las categorías enterra con 8,8% y quema y enterra con el 10,3%. Se verificó que el agua no atiende las exigencias del Ministerio de Salud, debido a la presencia de Coliformes Totales. El número de niños en los asentamientos fue 69, de estas 88,40% consumen agua de los pozos colectivos, 52,45% presentaron episodios de diarrea. Conclusión: los indicadores se mostraron eficaces, siendo necesarias acciones colectivas de orientaciones referentes a los cuidados con la destinación de la basura y el aislamiento en el entorno de los pozos, y análisis periódicos de las aguas de estos asentamientos.(AU)
Resultados  1-10 de 846