Problem In Colombia Research Articles

Situación de la tuberculosis en Colombia, 2002.

Tuberculosis (TB) remains an important public health problem in Colombia. Therefore, in 2002, the epidemiological behavior of TB was described in order to identify priority interventions for its control. Data were analyzed from the 2002 ?Quarterly Report of Cases and Activities? collected by the National TB Program. TB demonstrated a fluctuating behavior during the past decade, particularly until 1997, when regularly increasing trend began. Two thirds of the 32 departments of Colombia had incidence rates above the national average (>26 per 100,000); six departments were classified as being at very high risk (incidence >50 per 100,000). Of 11,376 cases, 7,787 were new pulmonary smear-positive cases; most of them were males aged 25 to 34 years, with the highest incidence in age group 65 or older. A decrease was observed in respiratory symptomatic patients aged 15 years or older. Smear positivity from all patients was 3.8% and the smear average was 1.6 per patient. Follow up indicators are still under the desirable levels.The application of health care guidelines to TB patients by health care institutions, as well as the development of monitoring activities, the report feedback are essential elements in an effective TB control program. However, successful implementation also requires careful supervision at each level of application and political will at local and department levels to adhere to DOTS.

Comparación de la prueba de inmunofluorescencia indirecta, un inmunoensayo enzimático y la prueba comercial Chagatek para la detección de anticuerpos anti-Trypanosoma cruzi.

Chagas disease is a public health problem in Colombia, particularly in the eastern region. Because of human migration from rural areas to urban centers, the possibility of transfusional transmission becomes increasingly important. However the risk can be minimized by a careful screening of blood donors by means of serological tests. Colombian blood banks use comercial, foreign serological tests for screening for T. cruzi infection. The purpose of the current study was to compare the IFAT and ELISA tests (both use antigen obtained from Colombian strains) with the comercially available Chagatek tests. Sera of blood donors were classified in two groups on the basis of the IFAT: group I, 15 positive patients and group II, 14 negative patients. Sera from each group were tested by the ELISA and Chagatek tests. The ELISA test detected 100% of the patients as positive in group I and 7% (1/14) of patients as positive in group II. The Chagatek test detected 93% (14/15) of the patients as positive in group I and 50% (7/14) in group II. The kappa index for concordance between the ELISA and IFAT tests was 0.93 (95% C.I.: 0.80-1.00); between IFAT and Chagatek 0.43 (95% C.I.: 0.26-0.62), and between ELISA and Chagatek 0.49 (95% C.I.: 0.31-0.67). These results highlighted the importance of using autochtonous Colombian strains as antigens in screening tests for blood donors.

Colombia's Resilient Democracy

Colombia's problems are far from over. But the current signs of strength stand in sharp contrast with the gloomy and even fatalistic climate of opinion, predominant among Colombians just a couple of years ago, that was loudly echoed in international circles.

A social-medical approach to violence in Colombia.

Violence is the main public health problem in Colombia. Many theoretical and methodological approaches to solving this problem have been attempted from different disciplines. My past work has focused on homicide violence from the perspective of social medicine. In this article I present the main conceptual and methodological aspects and the chief findings of my research over the past 15 years. Findings include a quantitative description of the current situation and the introduction of the category of explanatory contexts as a contribution to the study of Colombian violence. The complexity and severity of this problem demand greater theoretical discussion, more plans for action and a faster transition between the two. Social medicine may make a growing contribution to this field.

Eficacia terapéutica de tres esquemas de tratamiento de malaria no complicada por Plasmodium falciparum, Antioquia, Colombia, 2002.

High resistance of Plasmodium falciparum malaria to chloroquine poses malaria as a major public health problem in Colombia. In this context, the therapeutic response of uncomplicated P. falciparum malaria patients to chloroquine (CQ), sulfadoxine/pirymethamine (SDXP) and combined therapy (SDXP/CQ) was evaluated according to the WHO/PAHO protocols of 1998. The comparisons were based on a sample of 160 patients with uncomplicated P. falciparum malaria in Turbo and Zaragoza (Antioquia, Colombia). Patients were randomly assigned each of the treatment categories. The results were statistically similar in each municipality. In Turbo percentage of treatment failure was 87.5%, 22.2% and 22.6% for CQ, SDXP and SDXP/CQ, respectively, whereas in Zaragoza, the corresponding treatment failure was 77.7%, 26.5% and 12.1%. During follow up, 50% of subjects with late treatment failure were asymptomatic in Turbo, while 33.3% were asymptomatic in Zaragoza. A high level of treatment failure occurred with CQ monotherapy, while SDXP and SDXP/CQ had acceptable levels of failure, i.e., below 25%. The high percentage of late treatment failure in asymptomatic patients may contribute to increased risk of persistent transmission.

Road traffic injuries in Colombia

Road traffic injuries are a leading public health problem in Colombia. Pedestrians are the most vulnerable road users, especially in the main urban centers of Bogotá, Medellin and Cali. Data analyzed in this report include official statistics from the National Police and the National Institute of Legal Medicine and Forensic Sciences for 1996-2000, and results of a study conducted at the National University of Colombia in 2000. Methods from the Highway Capacity Manual were used for determining physical and technical variables, and a Geographical Information System tool was used for the location and spatial analysis of the road traffic crashes. Pedestrians accounted for close to 32% of injuries and 40% of the deaths from road traffic crashes. The problem of road traffic crashes existed predominately in urban areas. In the main urban centers, pedestrians constituted nearly 68% of road traffic crash victims. The high level of risky road use behaviors demonstrated by pedestrians and drivers, and inadequate infrastructure for safe mobility of pedestrians in some sections of the road network were the main contributing factors. Major improvements were achieved in Bogotá following enhancements to the municipal transport system and other policies introduced since 1995. In conclusion, policies and programs for improving road safety, in particular pedestrian safety, and strengthening urban planning are top priority.

Estudio de la variabilidad de seis cepas colombianas de Trypanosoma cruzi mediante polimorfismos de longitud de fragmentos de restricción (RFLP) y amplificación aleatoria de ADN polimórfico (RAPD).

Chagas disease, caused by the hemoflagellate Trypanosoma cruzi, is a public health problem in Colombia. Previous reports have indicated the presence of heterogeneity among parasite populations. Six Colombian T. cruzi strains were obtained that differed by host, geographical region and transmission cycle. The genetic variability of each was compared by random amplified polymorphic DNA (RAPD), and isoenzymes. A restriction fragment length polymorphism (RFLP) was extracted using the 1.2 kb unit encoding the parasite's H2A histone as a probe. Genetic distances between the isolates varied greatly, from 0.611 to 0.99 as determined by RAPD profiles (M13F and M13R primers), between 0 and 0.81 by RFLP profiles (5 endonucleases), and between 0.10 and 0.55 by isoenzymes (13 enzymatic systems). Genetic distance matrixes derived from each of the three methods showed that Colombian strains exhibit a high degree of genetic differentiation. This may account for the broad clinical spectrum of Chagas disease in Colombia.

Non-State Actors in Colombia: Threats to the State and to the Hemisphere

This study seeks to explain the Colombian crisis in terms of non-state threats to the state and to the region. The problem in Colombia is that that country, and its potential, is deteriorating because of three ongoing, simultaneous, and interrelated wars involving the illegal drug industry, various insurgent organizations (primarily the Revolutionary Armed Forces of Colombia, FARC), and ‘vigilante’ paramilitary groups (the United Self- Defense Groups of Colombia, AUC). This unholy trinity of non-state actors is perpetrating a level of corruption, criminality, human horror, and internal (and external) instability that, if left unchecked at the strategic level, can ultimately threaten Colombia's survival as an organized democratic state, and undermine the political stability and sovereignty of its neighbors. In that connection, there is now explicit recognition that Colombia's current situation has reached crisis proportions. The critical point of this argument is that the substance, or essence, of the Colombian crisis centers on the general organization, activities, and threats of the major violent stateless actors at work in that country today. Each of the three armed nonstate players in Colombia generates formidable problems, challenges, and threats to the state and the region in its own right. What, then, of an alliance of the willing – even if that alliance represents a complicated mosaic of mutual and conflicting interests?

High Anxiety in the Andes: Colombia's Perpetual Quest for Peace

Despite recent progress in the government's negotiations with rebel groups, Colombia's problems remain acute: continued violence, growing human rights abuses, severe income inequality, and a depressed economy.

International dimensions of Colombian violence.

Violence is the main public health problem in Colombia, as demonstrated by current homicide rates (the highest in the world), the strong effect of violence on the health care sector, and the forceful displacement of citizens, among other factors. This violence has international dimensions and consequences: inequity resulting from the political-economic system and increased by the neoliberal adjustments; the international traffic of drugs and weapons; exile and forceful displacement of persons into bordering countries; and frequent violations of human rights and humanitarian international rights. The international community can play a role in the search for a solution to this problem, as the author discusses in terms of contributions made in the past and those that could be made in the near future. Colombian violence can be viewed as a problem, a message, and a challenge for international public health, and the author suggests specific areas in which international public health could contribute to the study and solution of this complex situation.

The real solution

Rather than tackling them at the root, the government is throwing money at Colombia's problems

The origin of internal security in Colombia: Part I — A CIA special team surveys La Violencia, 1959–60

In October 1959 the Eisenhower administration dispatched a CIA Special Team to survey the violence problem in Colombia. This article, part one of a two‐part series, examines this first significant attempt by a US administration to influence that nation's internal security situation. It investigates the Special Team's actions and analyses its recommendations for transforming Colombia's conventionally‐orientated security forces. The Team's survey, which focuses on counter‐insurgency tactics, civil action, intelligence operations, psychological warfare, and covert action, is the foundation from which Colombia's modern internal security structures are derived.

War and peace in Colombia

Colombia is a nation trapped in a downward spiral of disintegration. But why should the United States care? Already Colombia's problems are spreading beyond its borders endangering both its immediate neighbors and some more distant.

Occurrence and distribution of organochlorine residues in fish from the magdalena and meta rivers in Colombia

From sexually mature female fish of 32 different species muscle tissues and eggs were collected at four sites in the Magdalena and Meta rivers in Colombia. In most of the fishes, organochlorine residues were found both in the muscle tissues and in the eggs. On a fat basis, the level of SDDT and PCBs in the muscle tissues ranged from 55–10 700 and 5–5610 ng/g lipid weight, respectively. The concentration of these compounds in the fish eggs were generally lower than those in the tissues. The levels of the residues in the fish were highest in the middle and lower part of the Magdalena River, indicating a contamination of the whole fish community. The results show that this river, especially its lower part after merging with the River Bogotá, is heavily influenced by anthropogenic persistent compounds. The pollution of lakes, dams, rivers and coastal areas with sewage, pesticides and industrial wastes is one of the most pressing environmental problems in Colombia. Since there are no statistics or other material that permit a diagnosis of the problem and its magnitude, it is urgent to carry out such investigations to identify sources and take appropriate measures. The responsibility for the use and control of industrial and agricultural chemicals is today shared among many regional corporations. We suggest the establishment of an authority at high technical and govermental level that can initiate monitoring and coordinate actions to alleviate the present situation.

A GENERALIZED APPROACH TO MODELING THE HIERARCHICAL MAXIMAL COVERING LOCATION PROBLEM WITH REFERRAL

ABSTRACT Several investigators have developed hierarchically structured maximal covering location problems, especially for hierarchies with two levels such as clinics and hospitals: Moore and ReVelle developed and applied a hierarchical covering model to a medical service delivery problem in Houduras; and Church and Falon developed two alternate model forms of hierarchical covering that were applied to a medical services planning, problem in Colombia. In this paper, we proposed a hybrid formulation that encompasses all three of these previous models and which allows for the trade‐off of up of four different objectives. This new model formulation is also an improvement in that it has a significantly more efficient and compact structure, even while encompassing a more complete location problem, of which the three previous works are special cases. Example solutions are given for two different data sels involving regions in Colombia and Uganda. In addition, two further model formulations of a closely related nature are presented without computational results.

Manpower, Labor Absorption, and Employment in Colombia

The unemployment problem in Colombia was recently discussed by Geithman and Landers (1973) in this journal. They argue that one of the fundamental causes of unemployment is a “higher capital-labor ratio” than would otherwise exist, according to factor endowments and the structure of final demand. This is attributed to the dependency of less developed countries (LDCs) on capital from advanced countries (ACs), with laborsaving characteristics suitable for the latter (Geithman and Landers, 1973: 317). Their excessive capital intensity thesis is based on Bruton's cross-sectional statistical study (1967), which made a number of simplified assumptions which should be examined in some detail.Since Bruton and Geithman and Landers use the production function in their analysis, it is necessary to briefly discuss its most important characteristics. The quantities of capital (K), labor (L), and other inputs required by the industrial sector or the entire economy to achieve various levels of output (Q), can be viewed as a generalized production function.

Structural Change in a Developing Economy. Colombia's Problems and Prospects.

Structural Change in a Developing Economy. Colombia's Problems and Prospects.

Parks and Problems in Colombia

Colombia has a wealth of wildlife – including endangered species such as spectacled bear, mountain tapir, pudu and condor – a lot of still unexplored country, an impressive list of national parks and reserves, and an active national parks department. But there are many threats: a rapidly increasing population, haphazard settlement (with shifting ‘slash and burn’ cultivation), the increasing accessibility of formerly remote areas, the profitable trade in wild animals, and the lack of public interest in and support for conservation. Roger Perry has spent much time in South America, especially Colombia, and is a former Director of the Charles Darwin Research Station in the Galapagos Islands.

Agrarian Reform in Colombia Problems of Social Reform

Colombia's current attempt at agrarian reform began in December 1961 with the passage of Law 135, “On Social Agrarian Reform.” The Law has as its central objective a change in land tenure relationships in the densely populated western (or Andean) section of Colombia, where latifundia and minifundia often exist side by side. The Law established the Colombian Agrarian Reform Institute (Instituto Colombiano de la Reforma Agraria or INCORA) as a semiautonomous governmental agency to direct the process of reform. In recent months, however, the pace of the reform, which began ten projects during the first six months of 1962, has been slowed considerably due to a multitude of problems, among which the most serious are unswerving opposition to the program by both the large landowners and their allies on the right, the Movimiento Revolutcionario Liberal (MRL and its allies on the left, and inadequate financing.

The Rise of Barranquilla

T HE LEADING PORT of the north coast of South America is Barranquilla. Still an insignificant village when the neighboring ports of Cartagena and Santa Marta had been commercially and politically important for nearly three hundred years, it developed in the second half of the nineteenth century into Colombia's principal commercial entrepot. While there were many reasons for this phenomenon, the chief one was geographical. Barranquilla's situation on the Magdalena River and local transportation factors were the main determinants in its rise. A fundamental problem in Colombia has been the difficulty of moving people and goods between the Caribbean Sea and the interior of the country. For centuries the Magdalena River provided the main highway for travel between coast and interior, but the connections between its mouth and the coastal settlements were not convenient. Cartagena, situated on a nearly land-locked bay, had as its only natural means of communication with the interior a perennially silted