Precarious Socioeconomic Conditions Research Articles

Child Nutritional Status in the Changing Socioeconomic Region of the Northern Amazon, Brazil.

The living conditions (i.e., socioeconomic, healthcare-related, nutritional, and environmental) to which children are exposed may influence their ability to reach their optimal growth potential. This review focuses on the relationship between the nutritional status of children under five years of age and social and environmental factors in Northern Brazil. Children living in this region have limited access to healthcare and face precarious socioeconomic and environmental conditions. This analysis was based on data from national health surveys, the consolidated food, nutrition surveillance system (SISVAN), and indicators of the DPSEEA (driving force, pressure, state, exposures, health effects, and actions) framework. The northern region has the worst living conditions in the country, and children under five years of age have significant height-for-age, weight-for-age, and weight-for-height deficits. Concomitantly, the prevalence of children who are overweight has increased significantly, although it remains lower than that in more developed Brazilian regions. Insufficient and/or inadequate dietary practices and early exposure to unfavorable living conditions are risk factors for nutritional deviations. Further advances in public health policies that consider regional characteristics, particularly in the north, where progress has been slower, are needed.

Blastocystis Hominis infection and Its Relation with Other Intestinal Parasites among Outpatients, Sohag, Egypt

Intestinal parasites have a worldwide distribution, mainly in regions with precarious socio-economic and hygiene conditions. Blastocystis spp. is an anaerobic enteric protozoan inhabits human intestinal tract. Blastocystis hominis elicits a big controversy about its pathogenicity and its relation to bowel disease conditions. Our aim for this work is to determine the frequency of Blastocystis hominis infection among outpatients attending Ministry of Health hospitals and units in Sohag City and if there is a relation between Blastocystis hominis and other intestinal parasitic infections. The present research involved 150 cases from outpatient clinics of randomly selected hospitals and units in Sohag City from June 2016 to January 2017. Fresh stool samples were gathered and examined. Thirty-three samples (22%) were positive for parasitic infection, of whome, only 25 cases (75.8%) were positive for B. hominis whether single or mixed with other parasites. Single B. hominis infection represented 36% of positive cases. Out of 25 cases infected with B. hominis, 4 cases had mixed infection with G. lamblia (16%) (P-value = 0.027) and 10 cases had combined infection with E. coli (40%) (P-value < 0.001). In conclusion, 33 cases had parasitic infections of whom, 25 cases were positive for B. hominis. G. lamblia and E. coli were more common with B. hominis than other parasitic infection. This might be attributed to symmetry in genetic characters or the need for the same environmental conditions. To confirm this relation and its reasons we need further investigations.

Psychopathological approach of unsafe games among teenagers: A case report

IntroductionVoluntary asphyxiation by practicing unsafe games such as choking, hanging, strangulation or other means of inducing hypoxia/anoxia is not uncommun among adolescents and can lead to unintended death but it stills not very well-known so underestimated by parents and underdiagnosed by health professionals.ObjectivesStudy of clinical, psychological and psychopathological features in adolescent practicing unsafe games through a case report and a literature review.MethodsWe will present the case of a 14-year-old boy followed up in the Child and Adolescent Psychiatry Department of Mongi Slim Hospital (La Marsa, Tunisia) for behavioral disorders and recurrent syncope. This case report will be supported by a literature review.Case reportS.B., 14-year-old boy, unique child of two divorced parents, with precarious family socio-economic conditions, no apparent medical problems and no known history of drug or alcohol abuse, suicidal ideation or suicide attempts, consulted first time in the department for behavioral disorders. The diagnostic of dysthymia was made. Seven months later, he was hospitalized in the medical intensive care unit for postictal coma. All medical investigations were normal. In the following, S.B. revealed that he used to practice voluntary asphyxiation by compressing the two carotids using his fingers until loss of consciousness. The diagnosis of paraphilia (DSM-5) was established.ConclusionsEarly recognition of such cases and awareness of psychological and psychopathological motivations might prevent serious complications and lethal outcome for these “unsafe-young-players”.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Evaluating the Adaptation Process of Sandfly Fauna to Anthropized Environments in a Leishmaniasis Transmission Area in the Brazilian Amazon.

Phlebotomines (Diptera: Psychodidae) are vectors of several etiological agents of human and animal diseases, including protozoans of the gender Leishmania. Precarious socioeconomic conditions and uncontrolled population growth directly influence the transmission risk of parasites and the urbanization of vector species, previously restricted to wild environments. The Marajó Archipelago is considered a high incidence area of leishmaniasis in the Brazilian Amazon. However, it is poorly studied. The aim of this study was to assess the adaptation processes of phlebotomine species to anthropized environments in this region. For this purpose, the phlebotomine fauna was compared between three municipalities of the Marajó Archipelago: Anajás, Portel, and São Sebastião da Boa Vista. To survey the phlebotomine fauna, CDC (Center for Disease Control) light traps were installed in the wild areas and in the intra and peridomiciliary areas of rural and urban environments. The environments studied presented a diversified phlebotomine fauna, with higher richness in the wild environment (15 species), followed by the rural (seven species), and finally, the urban environment (three species). A migration of wild fauna to the adjacent anthropized areas (rural environment) and to urban areas was observed, evidencing the adaptation process of this vector to anthropized environments in the studied region. Thus, our study evidenced that the disorganized human occupation and utilization of the landscape might cause the invasion of urban areas by wild populations of phlebotomines, in this way enabling the settlement of urban leishmaniasis transmission cycles.

Acesso à água proporcionado pelo Programa de Formação e Mobilização Social para Convivência com o Semiárido: Um Milhão de Cisternas Rurais: combate à seca ou ruptura da vulnerabilidade?

RESUMO Está em curso no Brasil um dos maiores programas mundiais de aproveitamento de água de chuva para consumo humano: o Programa de Formação e Mobilização Social para Convivência com o Semiárido: Um Milhão de Cisternas Rurais (P1MC). Neste artigo, avalia-se o P1MC a partir do ponto de vista dos seus usuários. O marco empírico é composto por trabalho de campo que, entre fevereiro de 2009 e julho de 2011, envolveu a realização de um survey, com aplicação de 623 questionários em 63 municípios alcançados pelo programa no semiárido do estado de Minas Gerais, realização de 32 entrevistas semiestruturadas com gestores e técnicos envolvidos nos processos e de 15 entrevistas semiestruturadas com a população atingida. Foram também utilizadas técnicas de observação, bem como avaliação por meio de fotografias das cisternas implantadas. Os resultados indicam que a presença dos sistemas de aproveitamento de água de chuva reduziu em quase 90% o total de tempo despendido na busca de água. No entanto, existem problemas relacionados à qualidade e à quantidade de água disponibilizada. Evidenciou-se ainda a persistência de elevada precariedade das condições socioeconômicas, sendo esse um fator limitante para o alcance da efetividade do programa. Observou-se que o programa tem atingido suas metas de construção das estruturas físicas, mas que ainda são significativos os desafios, especialmente os relacionados à oferta adequada de água em quantidade e qualidade. Sendo assim, é necessário que as políticas públicas de abastecimento de água no espaço rural semiárido associem questões técnicas com elementos de gestão considerando as especificidades sociais, climáticas e econômicas locais.

Commercial relationships between intermediaries and harvesters of the mangrove crab Ucides cordatus (Linnaeus, 1763) in the Mamanguape River estuary, Brazil, and their socio-ecological implications

The large mangrove crab Ucides cordatus (“caranguejo-uçá”) is a key fisheries resource in Brazil, critical for the sustenance of livelihoods of thousands of people in coastal rural areas. Today's crab populations suffer from habitat degradation, disease, and increasing fishing pressure. Crabs are sold alive on local and regional markets, or traded as processed meat and the market chains typically involve intermediaries (i.e. traders). The present study examined the relationship between crab harvesters and the intermediaries, and the socio-ecological implications thereof. The research was performed between September 2013 and October 2014 in the Mamanguape River estuary, northeastern Brazil. Socioeconomic information and data regarding the catch (sex and carapace width of the crabs), the processing of U. cordatus meat and the commercial relationship between harvesters and intermediaries were obtained through structured (questionnaires) and semi-structured interviews and direct observations. The crab harvesters exist under precarious socioeconomic conditions that place them at the edge of society and therefore often seek loans offered by the intermediaries, generating loyalty and dependence that guarantees the intermediaries a stable supply of crabs needed to supply an avid market. Within this relationship, the intermediaries create pressure on natural crab populations by stimulating non-selective captures, as they buy specimens below the legal size limit (6cm wide carapace) for meat processing. During crab meat processing, the intermediaries themselves report that the meat is often mixed with cooked and shredded of other marine vertebrates, such as spotted eagle ray (Aetobatus narinari) and nurse shark (Ginglymostoma cirratum), to increase the weight of the final product. As with the crab harvesters, the women involved in processing the crabmeat often accept loans, resulting in the same type of dependence and loyalty to the intermediaries. The intermediaries, with their strong influence on the crab harvesting, are directly linked to the commercial, social and ecological implications of these harvesting activities, together with the crab harvesters themselves. Hence, to ensure sustainability of the U. cordatus fishery and maintain (better improve) dependant livelihoods, all actors involved in the production chain of U. cordatus must be considered when developing management strategies, rather than the current approach of considering the crab harvesters only. We advise the development and implementation of fisheries associations to give the crab harvesters (and regulating bodies) greater control over and capital gains from their catches.

Social determinants of child mortality in Niger: Results from the 2012 National Verbal and Social Autopsy Study.

BackgroundUnderstanding the determinants of preventable deaths of children under the age of five is important for accelerated annual declines – even as countries achieve the UN’s Millennium Development Goals and the target date of 2015 has been reached. While research has documented the extent and nature of the overall rapid decline in child mortality in Niger, there is less clear evidence to provide insight into the contributors to such deaths. This issue is the central focus of this paper.MethodsWe analyzed a nationally representative cross–sectional sample of 620 child deaths from the 2012 Niger Verbal Autopsy/Social Autopsy (VASA) Survey. We conducted a descriptive analysis of the data on preventive and curative care, guided by the coverage of proven indicators along the continuum of well child care and illness recognition and care–seeking for child illnesses encompassed by the BASICS/CDC Pathway to Survival model.ResultsSix hundred twenty deaths of children (1–59 months of age) were confirmed from the VASA survey. The majority of these children lived in households with precarious socio–economic conditions. Among the 414 children whose fatal illnesses began at age 0–23 months, just 24.4% were appropriately fed. About 24% of children aged 12–59 months were fully immunized. Of 601 children tracked through the Pathway to Survival, 62.4% could reach the first health care provider after about 67 minutes travel time. Of the 306 children who left the first health care provider alive, 161 (52.6%) were not referred for further care nor received any home care recommendations, and just 19% were referred to a second provider. About 113 of the caregivers reported cost (35%), distance (35%) and lack of transport (30%) as constraints to care–seeking at a health facility.ConclusionDespite Niger’s recent major achievements in reducing child mortality, the following determinants are crucial to continue building on the gains the country has made: improved socio–economic state of the poor in the country, investment in women’s education, adoption of the a law to prevent marriage of young girls before 18 years of age, and implementation of health programs that encourage breastfeeding and complementary feeding, immunization, illness recognition, prompt and appropriate care–seeking, and improved referral rates.

An ethnomedicinal study of the Seri people; a group of hunter-gatherers and fishers native to the Sonoran Desert

BackgroundWorldwide, coastal communities’ ethnomedicinal knowledge has been sporadically recorded and poorly understood. Based on the ethnomedicinal knowledge of the Seri people; a hunting-gathering and fishing society of Northwestern Mexico, this study assesses a) the biological richness of Seri ethnomedicinal knowledge, b) the fidelity level of Seri remedies, and c) the association between gender, age, years of formal schooling and Seri ethnomedicinal knowledge.MethodsTo assess the degree of ethnomedicinal knowledge proficiency, we conducted 75 open-ended semi-structured interviews collecting information on ethnomedicinal knowledge of marine and terrestrial organisms and the socio-demographic profile of each collaborator. With the support of primary collaborators, we collected the materials to be used as stimuli along our interviews. A correlation analysis was used to determine the relationship between gender, literacy and age with the ethnomedicinal knowledge proficiency. A paired t-test was used to determine differences in the number of remedies known by gender among members of the Seri community.ResultsA total of 28 medicinal specimens were presented as stimuli material. Marine remedies (12 species), were represented by 4 algae, 3 mollusks, 3 echinoderms, on reptile, and one annelid. Terrestrial plants (13 species) were distributed in 12 families. About 40 % of marine preparations used the organism in whole. In contrast, 29 % of of the remedies involving plants made use of leafy branches. Stimuli materials are used against 17 ailments mainly, being diarrhea, colds, menstrual problems, and swelling the ailments against most organisms (44 %) are used for. Marine organisms presented higher fidelity level values overall, suggesting that lower fidelity levels in terrestrial plants reflect a process of continuous and ongoing experimentation with easily accessible biological materials. Highest fidelity level values were recorded for Atriplex barclayana (93.87 %) Batis maritima (84.37 %), and Turbo fluctuosus (84.21 %). Age moderately correlates to ethnomedicinal knowledge proficiency (r = 0.41). Conversely, years of formal schooling show a negative correlation with ethnomedicinal knowledge proficiency (r = -0.49). Significant differences (p <0.05) were observed on ethnomedicinal knowledge proficiency when gender groups were compared under a paired t-test.ConclusionsThis research contributes to describing the complex biodiversity present in the ethnomedicinal systems of coastal non-agricultural societies. In addition, our research improves our understanding of the role that gender plays in the intra-cultural distribution of ethnomedicinal knowledge among Seri. Our results broaden our understanding of human adaptations to coastal and xeric environments. This research can potentially benefit the development of proposals to improve coastal and marine resource management and conservation while strengthening ethnomedicinal knowledge systems in populations, such as the Seri, limited by precarious socio-economic conditions and inadequate health services.

Lampedusa in Berlin: (Im)Mobilität innerhalb des europäischen Grenzregimes

Lampedusa in Berlin. Im-mobility of Migrants within the European Border Regime. Abstract This paper analyses the mobility practices of forced migrants within the European border regime. It investigates the relation between the control and management mechanisms of migration and the attempts of forced migrants to move freely, crisscrossing territorial and juridical borders in Europe. The paper focuses on the experiences of a group of forced migrants, who, after escaping the war in Libya, obtained humanitarian protection in Italy, but because of the current precarious socio-economic conditions in Southern Europe, decided to leave for North European countries. A group settled in Berlin, which gave rise to a protest claiming the right to stay and work against what is foreseen by European Union law. This paper draws on ethnographic work to show the tension between individual desires and practices of free mobility and the structural and juridical constraints implemented by institutions in order to control it and contain it. Focusing on this (im)mobility highlights the internal borders of Europe and how they are continuously challenged by migrant subjects. Three different kinds of mobility emerge across the European space: mobility within national territory, infranational mobility, and “commuting-mobility”. In this way, migrant subjects create new geographies and experience the whole European territory as one place: living in Berlin, renewing documents in Milan, attending education courses in Turin, and working seasonally in Sicily or Apulia. Such mobilities are supported by networks of migrants, who continuously move, and their supporters. This suggests a process of “Europeanisation from below” that continuously challenges EU internal borders. Keywords: Borders, mobility, forced migrants, everyday practices, Europe ----- Schlagworter: Grenzen, Mobilitat, Gefluchtete, Alltagspraktiken, Europa ----- Bibliographie: Borri, Giulia/Fontanari, Elena: Lampedusa in Berlin: (Im)Mobilitat innerhalb des europaischen Grenzregimes, PERIPHERIE, 2-2015, S. 193-211. https://doi.org/10.3224/peripherie.v35i138-139.24296

Alternativas de seguridad de una población víctima de desplazamiento forzado. El caso de la comuna 8 de Medellín.

¿Es posible que poblaciones que viven en condiciones socioeconómicas precarias y en contextos violentos, puedan proveerse una seguridad diferente a la ofrecida por el Estado y por actores armados ilegales? Es la pregunta que responde este artículo, con base en la investigación realizada en Medellín, con población víctima de desplazamiento forzado de la comuna 8, que trabaja con enfoque de seguridad humana y metodología desde abajo. Analiza las políticas de seguridad del Estado, contrastándolas con las iniciativas comunitarias para enfrentar sus inseguridades mediante estrategias de acción y agendas comunitarias para proveer seguridad humana y conformarse como ciudadanos y colectivos sociales empoderados políticamente. Señala limitaciones y potencialidades de una propuesta de seguridad aplicada por un grupo poblacional altamente vulnerado y vulnerable.

Conceptual Maps of the Mental Health of Children and Adolescents: A Systematic Review and Meta-cognitive Procedures in the Architecture Information in Northeastern of Brazil

Introduction: The Northeast Region is the third largest region of Brazil, with 49 million inhabitants, almost 30% of the population, being the second most populated region in the country, behind only Southeast. Investments related to mental health in the Northeast are increasing by the Federal Government. Despite huge investments directed to care to affective disorders, significant losses still occur. Our goal was to address the peculiarities of the evolutionary process of mental health in Brazil and in the Northeast, focusing on the juvenile age group. Method: Original analyzes were performed on secondary data from the Hospital Information System (SIH) belonging to the Unified Health System (SUS) in Brazil, Primary Care Information System (SIAB) and the Brazilian Institute of Geography and Statistics (IBGE). The original data of juvenile mental health were complemented by through the information mapping (Cmap Tools) in the databases: LILACS, SciELO, VHL, MEDLINE. Results: In the Northeast, the precarious socioeconomic conditions contribute to the involvement of children and adolescents with psychopathology. Between 2008 and August 2011, 470 deaths were recorded in mental health in the Northeast. This shows us that not only just create Center for Psychosocial Care-CAPS to improve instantly the health indicators, is still a need for greater training of health professionals who are involved in treating these patients. Conclusions: Some challenges remain in mental health, such as promoting care network, domain and expansion of diagnostic and therapeutic resources, stimulating the social rehabilitation of psychiatric patients, joint approach to mental and socioeconomic status, training of health professionals and interventions in respect to autonomy and the individuality of the bearer of affective disorder.

Empowered Leaders and Alone in Community: Stories of Romanian Roma Health Mediators

This article investigates the experiences of Roma women who work as health mediators to build bridges between Romani patients and the public health system. Given the precarious socioeconomic conditions, overt discrimination, policy changes, and rights advocacy that mark these women's lives—and at the same time the near invisibility of Roma women in scholarship—this study offers women's stories as communicative practices of telling oneself. The mediators narrate stories of successes and challenges in their profession, of discrimination, of empowerment, and of identity shifts toward hybridity and contextual alliances. This study suggests that although a sense of entitlement makes sense in the context of much responsibility on the Romni's shoulders, speaking for their own ethnicity may become problematic and is accompanied by feelings of loneliness.

Campagne de vaccination hors centre contre la rougeole des populations précaires en période de pic épidémique, Marseille 2011

BackgroundFrom 2008 to the end of 2011, Europe experienced a major outbreak of measles. The outbreak hit France especially hard, with measles hotspots in the South-East of France. It is known that people living in precarious socio-economic conditions are more exposed to infectious diseases. Regarding the local situation, the NGO “MdM-Marseille” decided to conduct a vaccination campaign among the Roma community living in camps. MethodsThe campaign was planned with two injections of a combined measles, mumps and rubella vaccine (MMR) in a one month interval for all young people born since 1980 and over the age of one year, regardless of antecedents. Twenty-four camps were selected. The target population was estimated at 720 people. Each site was the subject of an information visit. A letter was sent to the Prefecture to inform them and ask for a moratorium on evictions for the identified camps. ResultsBetween May 15th and September 15th 2011, 326 primary immunizations were performed during 34 visits (covering 45.3% of the target population). Over the same period, almost all the camps were evacuated, forcing teams to stop the vaccination campaign. The second injection campaign covered only 37 persons. ConclusionThe vaccination campaign among Roma populations in Marseilles was organized in a context of a major national outbreak of measles in the general population. Although the Prefecture was informed, camp evictions were not interrupted. This highlights the discrepancy between public health policy and security policy. In the context of an epidemic, innovative actions should be focused on vulnerable populations in partnership with health authorities. The main objective is to find procedures that can protect populations at risk in the event of a health crisis but which are also useful for routine prevention.

Uso de drogas por jovens infratores: perspectiva da família

The purpose of this work was reporting the view of relatives of institutionalized youngsters about the reasons for their initiation on the drug’s use. Descriptive cross-sectional study developed in the municipalities of Rolandia and Cambe - Parana, at New Life Recovery Center, with 11 family members responsible for the youngsters. We used a script for semi structured interview. Analysis of the data followed the content analysis technique by proposed by Minayo. Family and social relations, family structure and family communication were related to the initiation of drug use by the institutionalized youngsters. The studied group presented several unfavorable events at the home environment, which may have been a. inducing factor on the drug abuse: precarious socioeconomic conditions; loss of family member in childhood by death; diseases in the family, especially the use of alcohol and drugs; fights and separation of parents; physical and psychological intra-family violence; social violence and coexistence with the crime. It is concluded that the identification of factors, by family members, which led the youngster to the use of drug is on the overvaluation of peer group relationship and to a lesser extent to lack of parental affection. Parents did not feel mutually responsible by the initiation of their children on drugs.

‘Sufferings Start from the Mothers’ Womb’: Vulnerabilities and Livelihood War of the Small-Scale Fishers of Bangladesh

Due to its deltaic geographical position and precarious socioeconomic and demographic conditions, Bangladesh is recognized worldwide for its exposure to recurring environmental hazards. Based on a 21-month long field study in two fishing villages that are characterized by distinct ecological settings and ethnic groups, this article examines the arrays of cross-scale environmental, social and institutional stressors that singly or cumulatively impact fishers’ livelihood well-being and generational poverty. Analysis of the vulnerabilities makes it clear that the degree to which poor fishers suffer from environmental stressors and calamities is determined not only by the frequency of abnormal events, but also by their internal capabilities of self-protection, resilience against those stressors, position in the social network and asset and resource ownership. Coastal and floodplain fishers identified cyclone and long-standing floods as strong drivers of poverty as their bundles of ‘safety net’ capital are usually disrupted or lost. For a majority of the fishers, income/day/family declines to as low as US$ 0.7–0.9. Fishers lack appropriate sets of endowments and entitlements that would allow them immediate buffer against livelihood stressors. Vulnerability here is intricately related to one’s socio-economic status; poor and ‘socially vulnerable’ ethnic fishers are concurrently ‘biologically vulnerable’ too. The corollary of multi-faceted stressors is that, poverty persists as an ever-increasing haunting presence that thousands of floodplain and coastal fishers of Bangladesh are forced to cope with. It is evident that nature-induced stressors exert ‘ratchet effects’ on fishers with low endowments who critically risk nutritional deprivation and social standing. Lucidly, most of the fishers are trapped in a form of ‘livelihood war’.

Uma analise da utilização de serviços de saúde por sistema de financiamento: Brasil 1998 -2008

This article analyzes the use of health services from the perspective of financing based on PNAD/IBGE micro-data related to 1998, 2003 and 2008. Among the main results, the following can be highlighted: 1) The Unified Health System (SUS) continues to be the major financing agent of most consultations and hospitalizations in Brazil; its participation increased significantly between 1998 and 2003 and remained almost stable between 2003 and 2008; 2) SUS participation in financing the use of the health services has been predominant in all Brazilian regions, especially in the North and North-East, which feature the most precarious socio-economic and health conditions; 3) SUS is the major financing agent of the two extreme levels of complexity of health care: primary care and high complexity services. 4) In spite of a significant rise in utilization rates of SUS services for consultations and hospitalizations, great inequities can still be observed between the population that exclusively uses SUS and that which has private health insurance; 5) There has been an increase in the use of SUS health services by part of the population with private health insurance plans.

Factors associated with stunted growth in children below 11 years of age in Antioquia, Colombia, 2004

Objective: To explore some factors associated to stunted growth in children below 11 years of age in the Department of Antioquia. Methodology: Cross-sectional study using the databases of alimentary and nutritional profiles in homes of Antioquia in 2004, based on a representative random sample of homes in the department (95% reliability and error margin of 3%). For this study, 100% of the records of children below 11 years of age were used. A model of generalized equations estimation was constructed for stunted growth classified by a Z score smaller than -2 standard deviation with respect to p 50 of the 1978 NCHS (Centro Nacional de Estadísticas de la Salud - National Center for Health Statistics). Data were analyzed using the GLIMMIX Procedure: SAS version 9.1. Results: We found 18.6% of the children with stunted growth, 75% of the homes with male head of household, 70% of heads of household with maximum 5 years of schooling; 47% of homes were nucleated bi-parental, and 40% extensive with a 5-member median per home; 56.4% poor per unsatisfied basic needs, and 80% in alimentary insecurity. The factors associated to stunted growth were: female gender, 1-5 years of age, head of household with less than 6 years of schooling, more than 5 people in the home, more than two household members under 7 years of age, coming from a poor home per unsatisfied basic needs, belonging to a sub-region different from Medellin, food availability of less than 30 different foods per week, no production of food, and head of household under 40 years of age. Conclusions: Herein, we show evidence of the magnitude of poverty and association of precarious socioeconomic conditions with stunted growth in Antioquia. The study shows the importance of considerin

Perfil dos casos novos de tuberculose notificados em Ribeirão Preto (SP) no período de 2000 a 2006

The World Health Organization estimates that one third of the world population is infected by the Mycobacterium tuberculosis, while 8-9 million of people develop the disease and 2 million die each year due to tuberculosis, especially in countries and regions with precarious socioeconomic conditions. This study describes the profile of new cases of Tuberculosis notified in Ribeirão Preto, São Paulo State, in the period between 2000 and 2006. A cohort descriptive design was used. The database Epi-Tb was used for the data collection. The clinical form predominant was pulmonary. It was verified that 71.7% of patients were male and young adults (20-39 years). Regarding the type of supervision, it was observed that the supervised form presented a progressive increase along the period considered, with exception of 2003. The Tb/HIV co-infection was superior to 25%, while 12.9% of the patients performed the test. Regarding the treatment result, cure varied from 62.7% to 76.7%, the abandonment mean was 4.3% and death by tuberculosis was 3.9%. The results presented contribute for the knowledge of the tuberculosis epidemiological situation along the years studied, providing support to decision making related to prevention actions and control of the disease in the municipality.

Satisfação e limitação no cotidiano de trabalho do agente comunitário de saúde

The Health System Unity gained sustentation from the implantation of the Communitarian Health Agents Program in 1991 and the Family Health Program in 1994. Such strategies are based on the work of the Community Health Agents (ACS) that it exerts important paper in the construction of the bond and liability, promoting the link between team and community. The aim was to investigate the satisfaction and limitation in the daily work of the ACS. Qualitative study, that applied a questionnaire with 23 ACSs, in Teixeira city, on may of 2006. The Discourse Technique of the collective subject was made for the data analysis. The evidenced reasons of satisfaction were: the recognition of the families with their work, the improvement of the health of the families, the pointers of morbi-mortality. The limitations include the difficulties of work, the lack of recognition of the managers, the precarious socioeconomic conditions of the families and the health of the ACS. The satisfaction lived deeply for the ACSs is reason of pleasure and professional accomplishment, on the other hand, the limitations, make the course of the work difficult, affecting the physical and psychosocial health. Descriptors: Health Services; Family Health Program; Health Personnel.

Enteroparasitos e condições socioeconômicas e sanitárias de uma comunidade Quilombola do semi-árido Baiano

Intestinal parasites have been exhaustively studied in different communities in Brazil throughout the years although data concerning remaining “quilombolas” (descendants of former black slaves that escaped to hiding places, the quilombos) communities are poor. The current study aimed to investigate the frequency of intestinal parasites and potential risk factors for these infections in children and teenagers (2-14 years old), living in a remaining quilombola community in Bahia. Stool samples were collected and standardized questionnaires were applied to 348 subjects. 276 (79.3%) were infected by protozoa or helminth parasites. In relation to socioeconomic characteristics, of 180 interviewed families, 122 (67%) reported to live with a half minimum salary, most of them (61%) have no treated water, 51% have no toilet in their houses. Sewage system was absent in 96.6% of the houses. These results show the high frequency of intestinal parasites in this population, once they live in precarious socioeconomic and environmental conditions, highlighting the immediate need of governmental interventions on this community.