Impacto del Plan de Atención Básica en la Prevención de Leishmaniasis Cutánea en Zonas Rurales de Santander, Colombia

Abstract

Measuring the impact of the Basic Colombian Health Plan for Preventing Cutaneous Leishmaniasis in three towns in the Santander department. An ecologic design using housing as the analysis unit. Children aged less than ten were randomly selected from rural schools and visited in their homes by trained volunteers. Structured survey-forms were filled in and every child was examined for scars or active cutaneous leishmaniasis lesions. Cluster-adjusted binomial regression was used when analysing data. Eighteen villages, 284 houses and 609 children aged less than 10 were surveyed. Scar/lesion prevalence was 19.1%, differences being noted between municipalities: El Playón 7.1%, Landázuri 32.8% and Rionegro 13.9%. Information regarding leishmaniasis had been received by 42.8% of the houses and 39.9% had received some type of intervention from the Basic Colombian Health Plan, bed-nets being the most frequent (92.5%). Basic Health Plan intervention showed a preventative effect in bivariate analysis; however, such effect was not evident following adjustment for other socioeconomic and environmental variables (PR = 1.39 IC 95% 0.76-2.56). Basic health plan intervention for cutaneous leishmaniasis prevention has had no significant association with scar/lesion prevalence in children aged less than ten in these rural areas, probably because its effect has been exceeded by local socioeconomic and environmental conditions, as well as administrative conditions related to the programmes' poor coverage.