Salud para todos en el año... A propósito de las parasitosis intestinales y de las deficiencias nutricionales ¿Qué hemos hecho? Una reflexión sobre la práctica de la Salud Pública en Brasil
Purpose: To study the prevalence of intestinal parasitosis, anaemia and protein-energy malnutrition (PEM) and to analyse the possible association between these diseases and other variables of a biological, clinical and socio-economic nature.
Method: A cross-sectional study was conducted in the Joana Bezerra (urban) and Jaboatão (rural) areas of Pernambuco, Brazil. The groups were selected at random and consisted of children and adolescents between 1 and 16 years of age and of both sexes. Two samples of faeces and one of blood were collected. The anthropometric indicators used were height/age (H/A), weight/age (W/A) and weight/height (W/H) ratios. The cut-off point to estimate the prevalence of malnutrition was established at 1,5 standard deviations (SD) beneath the mean of reference used at the National Center for Health Statistics (NCHS). The association between the variables was measured by Pearsons c2 test, the linear trend test, and Fishers exact test, when necessary. The level of significance was established at 5% for all the tests. The construction of a multi-variant logistic model was proposed to evaluate the impact of each factor associated to a greater prevalence of parasite infection.
Results: The global prevalence of intestinal parasitosis was 86.9% in Joana Bezerra and 87.4% in Jaboatão. A. lumbricoides, T. trichiura, E. histolytica and G. Lamblia were the most common species in both areas. The prevalence of anaemia was 32.2% in Joana Bezerra and 22.7% in Jaboatão. Malnutrition calculated by the H/A, W/A and W/H ratios was 17.8%, 18.6% and 11.9%, respectively, in Joana Bezerra and 27.9%, 21.6% and 7.1% in Jaboatão. The final logistic regression analytical models did not provide information that helped us to further improve the interpretation of the results.
Conclusions: The health of the population depends on conditions of a biological, environmental, cultural, economic and social nature. In Latin America, and particularly in Brazil, inequality related to health emerges from a social context marked by an enormous concentration of wealth. However, health care activities continue to be based on information that ignores the profound division of society into classes or the populations concentration into cities and metropolitan regions. On the other hand, practice has shown how disease-control measures based on an ecological model to interpret the health-disease process that favours the clinical approach, centres on the medical act of individual care, have failed. This is particularly evident in relation to parasite diseases and nutritional deficiencies.
Advisor:María del Mar García Gil; Oriol Vall Combelles
School:Universitat Autónoma de Barcelona
Source Type:Master's Thesis
Keywords:418 departament de pediatria obstetricia i ginecologia
Date of Publication:09/28/2001