Communities In Colombia Research Articles

Validación del signo de palidez palmar para diagnóstico de anemia en niños de Bucaramanga (Colombia)

The prevalence of anemia in children from Santander (Colombia), is nearly 28 %. Economic conditions make it difficult to perform the hemoglobin test in all children with suspected anemia. The palmar pallor sign has been recommended by the World Health Organization (WHO) and the Pan-American Health Organization for the diagnosis of anemia in children aged less than 5 years old; however, the yield of the test has not been established in Colombian communities. The aims of the present study were to establish the efficiency of the test and to determine its reproducibility. The palmar pallor sign was evaluated in a sample of 167 children attending a low complexity hospital located in a deprived area of Bucaramanga city. Two pediatricians determined the presence of the sign, according to criteria from the "Integrated Management of Childhood Illness" strategy of the WHO and the Pan-American Health Organization. A hospital laboratory determined the concentration of hemoglobin in each of the children. Based on these data, the sensitivity, specificity, positive predictive value and negative predictive value were determined and the agreement between observers was established. The prevalence of anemia in the sample evaluated was 28.74 %. Sensitivity was 33.33 %, specificity was 79.83 %, the positive predictive value was 40 % and the negative predictive value was 74.8 %. The reproducibility of the test was low. The yield of the test substantially improved when the hemoglobin cut-off point was reduced from 11 g/dl, which is the value proposed by the WHO, to 10.5 g/dl. Anemia is frequent in children aged less than 5 years old in Bucaramanga city. The Palmar pallor sign is a valuable tool for the diagnosis of severe anemia, but is much less useful in mild or moderate anemia. If the hemoglobin level proposed by the WHO were lower, the palmar pallor sign would be more useful.

HOUSEHOLD-BASED CERAMIC WATER FILTERS FOR THE PREVENTION OF DIARRHEA: A RANDOMIZED, CONTROLLED TRIAL OF A PILOT PROGRAM IN COLOMBIA

Household water treatment is increasingly recognized as an effective means of reducing the burden of diarrheal disease among low-income populations without access to safe water. Oxfam GB undertook a pilot project to explore the use of household-based ceramic water filters in three remote communities in Colombia. In a randomized, controlled trial over a period of six months, the filters were associated with a 75.3% reduction in arithmetic mean thermotolerant coliforms (TTCs) (P < 0.0001). A total of 47.7% and 24.2% of the samples from the intervention group had no detectible TTCs/100 mL or conformed to World Health Organization limits for low risk (1-10 TTCs/100 mL), respectively, compared with 0.9% and 7.3% for control group samples. Overall, prevalence of diarrhea was 60% less among households using filters than among control households (odds ratio = 0.40, 95% confidence interval = 0.25, 0.63, P < 0.0001). However, the microbiologic performance and protective effect of the filters was not uniform throughout the study communities, suggesting the need to consider the circumstances of the particular setting before implementing this intervention.

Attention-Deficit/Hyperactivity Disorder and Comorbidities in 18 Paisa Colombian Multigenerational Families

Eighteen extended multigenerational families were recruited from the genetically isolated Paisa community in Colombia to conduct genetic studies of attention-deficit/hyperactivity disorder (ADHD). This report describes the inclusion strategy and clinical features of participants to facilitate comparisons with other data sets. Families were selected through a fixed-sampling scheme beginning with child probands referred for clinical evaluation for ADHD. Direct structured psychiatric interviews were conducted with 433 informative individuals, including 92 children aged 4 to 11, 57 adolescents aged 12 to 17, and 284 adults. Best estimate ADHD diagnoses were established for each informative pedigree member. These families contained a high proportion of individuals affected with ADHD (32.8%), which was highly comorbid with conduct disorder (50%; odds ratio 11.5, 95% confidence interval = 6.4-20.9), oppositional defiant disorder (25.4%; odds ratio 2.7, confidence interval = 1.5-4.8), and associated conditions including nicotine dependence and alcohol abuse and/or dependence. ADHD in these extended Paisa families is highly comorbid with conduct and oppositional defiant disorders. This pattern of comorbidity, as well as the large dense pedigrees of the sample, suggests that it will be particularly useful for molecular genetic studies that are currently under way.

Drugs, alcohol and community tolerance: an urban ethnography from Colombia and Guatemala

Drug and alcohol abuse is identified increasingly in Latin America as a significant source of insecurity. Yet, there has been little research on consump- tion and on the social norms surrounding it. This paper explores the nature of drugs and alcohol consumption among urban poor communities in Colombia and Guatemala, where use is widespread. It also looks at levels of community tolerance of drug and alcohol use, and in particular at the complex ways in which these atti- tudes relate to levels of violence and insecurity. The paper, drawing on the percep- tions of the poor themselves, argues for the need to take the issue of community tolerance into account in designing responses which, in order to be effective, should also be linked with wider sustainable development goals.

Norms from outside and from inside: an experimental analysis on the governance of local ecosystems

Abstract Many forest ecosystems provide multiple goods and services to both local users (e.g. firewood, water) and to other external beneficiaries (biodiversity conservation, carbon sequestration). This calls for alternative approaches in the governance of these local ecosystems. Even if local users solve the commons dilemma they face regarding the optimal provision of the direct benefit, there might still be a need for introducing mechanisms that also address the externality that involves those outside of the group. This paper addresses the analysis of different types of mechanisms, endogenously emerged from groups vs. externally imposed to them, when facing the typical tragedy of the commons. During 2000–2002 we conducted a series of economic experiments in several rural communities in Colombia. The sub-set reported here of 53 sessions with 265 actual users of local ecosystems, were focused specifically on the effect of external and self-governing rules for inducing cooperative behavior within groups. A group extraction or ‘commons’ game was used to explore how rules, formal and informal, emerge and how individual behavior responds to regulatory mechanisms aimed at solving the dilemma. Three treatments were compared to a baseline design: Two external regulations (high and low penalties, and only 20% of the players monitored), and a self-governed system where individuals were allowed to have in each round a few minutes of non-binding face-to-face communication. Surprisingly, both external regulations generated very similar results regardless of the level of the penalty, and they induced behaviors very similar to those achieved by the self-governed treatment. The experimental results suggest that individuals do not seem to follow entirely the conventional economic prediction of a minimizer of expected costs of regulations against the benefits from over extracting the resource, and that humans can develop norms based on non-enforceable rules of cooperation. Instead, other elements related to social norms and subjective valuation of the benefits and costs of the regulations might be in play.

Periodontal treatment needs in a native island community in Colombia determined with CPITN

To identify the prevalence and different degrees of periodontal disease in an isolated community (Isla Grande, Colombia) with no dental services and low educational level with the use of CPITN, and to establish periodontal treatment needs in different age groups. Of 116 people examined, 0.9% were in periodontal health (CPITN value 0), 18.1% had gingival bleeding (CPITN value 1), 51.7% had supra or subgingival calculus (CPITN value 2), 18.1% presented pockets 3.5-5.0 mm deep (CPITN value 3), and 11.2% had pathological pockets of 5.5mm or deeper (CPITN value 4). No clear differences were observed between sexes. This study shows that 81% of the sample has some type of periodontal treatment need, with 69.8% of them requiring periodontal treatment that may be supplied by a hygienist and 11.2% requiring specialised treatment. Implementation of oral health education and oral prevention programmes was recommended to the authorities for this community.

EYEWITNESS: Peacebuilding in a War Zone: The Case of Colombian Peace Communities

EYEWITNESS: Peacebuilding in a War Zone: The Case of Colombian Peace Communities

Discursos ocultos de resistencia: tradición oral y cultura política en comunidades negras de la costa pacífica colombiana

El texto presenta una muestra de la literatura oral de poblaciones afrocolombianas, incluyendo coplas y versos inéditos recogidos por el autor en Guapi, en la costa caucana del Pacífico. Se resalta la importancia de los ancianos, sabios y decimeros en los procesos actuales de re-construcción de memoria colectiva en el Pacífico, y cómo sus narrativas revelan un sentido de lugar que habla de patrones históricos de asentamiento, migraciones y viajes reales e imaginarios. Se sostiene que la tradición oral y sus formas poéticas como documento literario constituyen “discursos ocultos de resistencia” que desafían a las representaciones dominantes del Pacífico y sus pobladores, y que se dejan movilizar como articulación política en la lucha por el reconocimiento de derechos culturales y territoriales de comunidades negras en Colombia.

Introduction: The Colombian Pacific in Perspective

In many Latin American nations, black history, identity, and culture have become public and political issues in unprecedented ways as multiculturalism becomes an official ideology of nationhood in such countries (Assies, Haar, and Hoekema 2000; Van Cott 2000). In some contexts, black people have become the subjects of legislation directed specifically at them, giving them particular rights. Nowhere is this so evident as in Colombia, a nation unique in Latin America in having very detailed legislation directed at so-called black communities. Beginning in 1991 with a transitory article in the reformed Constitution and culminating in Law 70 of 1993, along with a series of associated decrees, legislation has opened the way for rural black communities in Colombia's Pacific coastal region to gain collective title to land. In addition, two special seats were, between 1993 and 1997, reserved for black delegates in the House of Representatives, while black representatives now participate in important state bodies such as INCORA (Colombian Institute of Land Reform), Ministry of Mines, Ministry of the Environment, and Ministry of Education, as well as in organisms created especially to oversee the development of black communities, such as the Division of Black Community Affairs. Recent legislation has promoted the creation of Afro-Colombian studies in the national curriculum and given black students special access to grants for university studies. A great deal of all this activity is directed at the country's Pacific coastal region, a mainly rural area inhabited predominantly by black people, alongside indigenous and white/mestizo minorities. This region is not unique to Colombia, since the northern part of Ecuador's Pacific coast is very similar historically and culturally (Whitten 1986), but the combination of this very particular regional complex with the recent changes in the legislative panorama make the Colombian case of great interest.

The "Drug War" in Colombia: Echoes of Vietnam

NJuly 2000, President Clinton signed into law a $I.3 billion aid package to set up the "war on X 2 drugs" in Colombia and neighboring countries in South America. Of this sum, $86o million is designated for Colombia itself, mainly as aid to the mili>#cX4.5 tary (i). For three decades Colombia has been torn by civil war, and the Colombian military has a well-documented record of human rights abuses including disappearances, arbitrary detentions, kidnappings, and torture of civilians [z, pg. 20]. The U.S. Congress made its "drug war" military aid dependent upon the Colombian government improving its human rights profile, but in August President Clinton waived this requirement so that funds could begin to flow south. For a number of years the U.S. has sponsored herbicide spraying in Colombia, intending to curb illegal drugs at their source. Starting in January zoOI under U.S. oversight, the Colombian government escalated its "crop eradication" activities, in which aircraft spray herbicides containing glyphosate to kill opium poppy and coca plants. Glyphosate is the active ingredient in the well-known herbicide called Roundup. Opium poppy and coca are the raw materials for making heroin and cocaine. Representatives of Colombian indigenous communities recently traveled to Washington, D.C. to explain how they have been affected by spraying that has already occurred. Glyphosate, they said, kills more than drug crops-it also kills food crops that many rural Colombians depend on for survival. In some places, the spraying has

Leishmaniasis: knowledge and practice in populations of the Pacific coast of Colombia

In 1997 a descriptive study with a qualitative emphasis was carried out in order to document, by gender, the knowledge and practices related to cutaneous leishmaniasis among inhabitants 14 years and older in seven communities of Colombia's Pacific coastal department of Chocó. Since the control activities carried out by the Chocó Sectional Health Services had not had the desired results, the residents of the region were at high risk of contracting leishmaniasis, which they called bejuco (liana) and yateví. Qualitative data were collected by directly involving each community in discussion workshops and by interviewing knowledgeable informants. Using these materials as a foundation, the researchers prepared a survey with 10 closed-ended questions, which they administered to all persons over 14 years of age in each randomly chosen home visited. The results indicate that 94% of the population knew that leishmaniasis appeared as a skin disease; those not knowing that were more often women than men. With respect to the mode of transmission, 35% of the respondents connected the disease to the bite of an insect, but they did not what the etiologic agent was and thought that the bite was inflicted by a worm that lives in the mountains. In the communities studied, the residents used a great variety of treatments to cure the disease. The treatments were based on plants, chemical substances, burning the lesions with a piece of heated metal, and, to a lesser degree, drugs. Despite being responsible for taking care of sick persons in the household, women were not acquainted with the traditional treatments used in the community. This gender difference in treatment knowledge was statistically significant, the only such statistically significant gender difference found in the research. Of the people surveyed, 45% did not know how to prevent the disease. This was more often true for women; 102 of the 155 respondents saying they did not know how to prevent the disease were women. This research emphasizes the importance of studying the knowledge and practices of local inhabitants before designing and organizing educational programs to control leishmaniasis.

Clonal Population Structure of Colombian Sylvatic Trypanosoma cruzi

Isoenzyme variability and evidence of genetic exchange were evaluated in 75 wild stocks of Trypanosoma cruzi obtained from different hosts from 5 geographical regions within the endemic area in Colombia. Cluster analysis of genetic variability was attempted. Thirty-three multilocus enzyme genotypes (clonets) were identified from 75 stocks, 27 of which clustered with zymodeme Z1 and 6 with zymodeme Z3. Two stocks isolated from human infections showed the potential risk to rural communities in Colombia. The stocks exhibited departures from Hardy-Weinberg expectations, including both fixed heterozygote and fixed homozygote demes, where both segregation and recombination were absent. To inspect for population subdivision that might falsely imply clonality in these stocks, Wright's F statistics were calculated. Theta values (Fst) were significantly different from 0 when 33 clonets, 27 Z1-like clonets, and 5 geographical subpopulations were compared; thus, a significant amount of divergence has occurred between and within them. In addition, linkage disequilibrium was detected for most possible pairwise comparisons of loci. In conclusion, the above results all support a scenario of long-term clonal evolution in Colombian sylvatic T. cruzi populations.

Pathways to Marijuana Use Among Adolescents: Cultural/Ecological, Family, Peer, and Personality Influences

To examine the linkages, cultural/ecological factors, and major psychosocial risk factors as they relate to drug use in a sample from Colombia, South America. The participants were 1.687 adolescents living in mixed urban-rural communities in Colombia, South America. An individual interview was administered to youths in their homes by Colombian interviewers. The scales used were based on item intercorrelations grouped into the following risk categories: (1) adolescent personality, (2) family traits, (3) peer factors, and (4) cultural/ecological variables. Pearson correlations were computed for each variable and the frequency of marijuana use. Results show that each of the domains was related to adolescent marijuana use, with some notable gender differences. As regards the interrelation of domains, a mediational model was operative. Findings support a family interactional theory. The domains of family, personality, and peer factors had a direct effect on the adolescents' marijuana use. Implications for prevention are also addressed.

Larval microhabitats of Lutzomyia longipalpis (Diptera: Psychodidae) in an endemic focus of visceral leishmaniasis in Colombia.

An intensive search for the larval habitats of Lutzomyia longipalpis (Lutz & Neiva) was conducted from November 1992 to October 1993 at a small rural community in Colombia where American visceral leishmaniasis is endemic. Emergence traps constructed from polyvinyl chloride pipes were used to sample a variety of soil microhabitats that included edge areas of covered pigpens, cattle corrals, the base of trees, and leaf litter at sites within 40 m of a house, rocks in fields located between 50 and 500 m from houses, and sites within a patch of secondary forest (rocks, base of palm trees, and leaf litter). The teneral status of the sand flies captured in the emergence traps was confirmed by laboratory studies that determined the rate of terminalia rotation in male L. longipalpis and the rate of cuticular growth layer formation of the thoracic phragma in both sexes of this species. A total of 58 teneral sand flies was captured during the study period (49 wk). Fifteen specimens were L. longipalpis; of these 11 (5 sand flies per square meter) were captured near pigpens, 3 (1.4 sand flies per square meter) were captured near rock resting sites, and 1 (1.6 sand flies per square meter) was collected at the base of a tree. The remainder of the sand flies were either L. trinidadensis (Newstead) or L. cayennensis (Flock & Abonnenc). Our results indicate that L. longipalpis larvae were dispersed widely in sites near houses, rather than concentrated in a few optimal microhabitats.

Age structure, blood-feeding behavior, and Leishmania chagasi infection in Lutzomyia longipalpis (Diptera: Psychodidae) at an endemic focus of visceral leishmaniasis in Colombia.

Ecological studies on the sand fly Lutzomyia longipalpis (Lutz & Neiva) were conducted during 1990-1992 in a small rural community in Colombia where American visceral leishmaniasis (AVL) is endemic. Subsamples of sand flies collected weekly from pigpens, the interior of houses, and natural outdoor resting sites were dissected to determine physiological age and Leishmania chagasi Cunha & Chagas infection rates. Eleven female L. longipalpis had flagellates in their gut, 2 of which were successfully cultured and identified as Leishmania chagasi. The reproductive status, stage of ovarian development, and trophic history of female sand flies varied among sites, habitats, and time of collection. The percentage of parous females ranged from about one-third to two-thirds overall and varied seasonally. Of most relevance to AVL transmission was the finding that 8% of L. longipalpis females were multiparous. In addition, our data suggest that L. longipalpis rest inside houses after blood-feeding outdoors, and that this species can blood-feed more than once during a single gonotrophic cycle.

Nocturnal activity patterns of Lutzomyia longipalpis (Diptera: Psychodidae) at an endemic focus of visceral leishmaniasis in Colombia.

Nocturnal activity of the sand fly Lutzomyia longipalpis (Lutz & Neiva) was studied from August 1991 to July 1992 in a small rural community in Colombia where American visceral leishmaniasis is endemic. During 2 or 3 nights each month, sand flies were collected with hand-held aspirators each hour between 1730 and 0630 hours, from a pigpen and a cattle corral located 30 m apart. Host-seeking activity of L. longipalpis adults was characterized by 2 general patterns: (1) adult sand fly activity increased shortly after sunset and continued until just after sunrise, and (2) peak sand fly activity was greatest early in the evening (1830-2330 hours) and then declined steadily toward morning. Female L. longipalpis activity generally increased after 2030 hours, whereas that of males remained constant or declined as the evening progressed. There were seasonal differences in sand fly abundance between the 2 sites: peak abundance in the cattle corral occurred during hot, dry periods, whereas maximum abundance in the pigpen occurred when relative humidity was higher. Influence of relative humidity on activity varied with season. Sand fly activity tended to decrease at temperatures below 24 degrees C and increase in the presence of moonlight.

Seasonal abundance of Lutzomyia longipalpis (Diptera: Psychodidae) at an endemic focus of visceral leishmaniasis in Colombia.

Ecological studies on the sand fly Lutzomyia longipalpis (Lutz & Neiva) were conducted during 1990-1993 in a small rural community in Colombia where American visceral leishmaniasis is endemic. Standardized weekly sand fly collections made from pigpens and natural resting sites displayed a bimodal annual abundance cycle, with a small peak occurring in October-November and a larger one in April-May. Time series analysis was employed to quantify the associations between sand fly abundance and weather factors (temperature, relative humidity, and rainfall). In addition to a prominent 6-mo cycle. Fourier analysis of the collection data demonstrated that the L. longipalpis population also exhibited a 5- to 8-wk cycle that may represent the length of larval development. Autoregressive moving average models were fit to weekly collection data and their residuals were regressed against rainfall, temperature, and relative humidity. A significant positive association between female L. longipalpis abundance and the relative humidity and rainfall recorded 3 wk earlier was found, indicating that these factors may be of value in predicting sand fly abundance. Additionally, these data indicated that L. longipalpis larvae may become quiescent during adverse conditions.

Species composition and relative abundance of sand flies of the genus Lutzomyia (Diptera: Psychodidae) at an endemic focus of visceral leishmaniasis in Colombia.

Ecological studies on the sand fly Lutzomyia longipalpis (Lutz & Neiva) were conducted during 1990-1993 at a small rural community in Colombia where American visceral leishmaniasis is endemic. Weekly sand fly collections were made from pigpens, houses, and natural resting sites, using hand-held aspirators, sticky (oiled) paper traps, and opossum-baited Disney traps. In total, 263,094 sand flies were collected; L. longipalpis predominated (86.1%), followed by L. trinidadensis (11.0%), L. cayennensis (2.7%), and 8 other Lutzomyia species. The species composition and sex ratio of these sand flies varied among sites and by collection method. L. longipalpis were captured most efficiently by direct aspiration from animal bait. Conversely, sticky paper traps, especially inside houses and at rock resting sites, collected a greater diversity of species, but a lower relative abundance of L. longipalpis.

The socioeconomic impact of malaria in Colombia and Ecuador

In-depth studies in three communities of Colombia and Ecuador, over a period of two to three months in each, were the basis of the economic analysis presented in this paper. In Santa Cruz, located at the rio Naya in Colombia, the average cost per case of malaria was US$17.30 (indirect costs US$15.80 and direct costs US$1.50); the loss corresponded to 20.1% of a minimum monthly wage (1986) or to a value of 5.6 days' work. In Perla de Sade, in the Cant6n Quininde of Ecuador, the average cost per case of malaria amounted to US$10.40 (indirect costs US$5.90 and direct costs US$4.50); the losses corresponded to 20.8% of a minimum monthly wage (1989) and to a value of 5.7 days' work. In Calder6n in the Cant6n of San Lorenzo in Ecuador, the average cost per case of malaria was US$4.80 (indirect costs US$3.50 and direct costs US$1.30); the losses corresponded to 16.0% of a minimum monthly wage (1991) with a value of 4.4 days' work. The results in these three communities, and in four additional ones, showed that the major economic impact of malaria is in the reduction of the labour force of families (indirect costs), and less so in the direct costs of care and cure. This emphasizes the economic importance of malaria because the rural familes with economies at subsistence level depend for survival particularly upon the maintenance of their labour force.

Factors associated with Paracoccidiodes brasiliensis infection among permanent residents of three endemic areas in Colombia.

The natural habitat of Paracoccidioides brasiliensis, the aetiologic agent of paracoccidioidomycosis, has not been determined. Consequently, the events leading to the acquisition of infection remain controversial. To identify factors associated with infection in endemic areas we conducted a survey in three rural communities in Colombia where we had previously diagnosed paracoccidioidomycosis in children. Permanent residents were surveyed taking into consideration environmental and occupational variables. Skin tests were used to classify subjects as infected or non-infected. Variables found associated with infection were: (i) community A: previous residence around Porce river and agriculture in vegetable gardens; (ii) community C: frequent use of specific water sources; (iii) community V: housekeeping activities, and (iv) total group: age > 25 years and contact with bats. Residents in communities with higher prevalence of infection were older, had more complex residence history, and referred more contact with armadillos than residents of communities with lower infection.