Social epidemiology of a large outbreak of chickenpox in the Colombian sugar cane producer region: a set theory-based analysis

Lay-Based Morbidity Profiles of Sugar Cane Workers: Testing a New Method Using Free Lists

Epidemiological profiles are key elements in preventive medicine and public health planning activities. There are no standard methods to identify these profiles. We explored the epidemiological profile of sugar cane workers in the municipality of Ginebra (Valle del Cauca, Colombia) using free lists of municipal morbidity data. We administered an instrument to 30 sugar cane workers, 15 health care workers and 15 people from the general community in order to compare the health problems experienced by the community. Sugar cane workers reported their own health problems and health professionals and community members served as informants for health problems in the general community. Respiratory problems were part of the morbidity profile of all groups evaluated, flu was part of the profile of the general community, and other respiratory problems were part of the profile of sugar cane workers and health personnel. Musculoskeletal problems were predominant only for sugar cane workers, and we found differences between the health problems expressed by the community and those reported by health personnel. The free lists method constitutes a quick, efficient, and useful tool to develop an approximation of an epidemiological profile and is easily interpreted, especially when typical and previously described occupational diseases are considered together with diseases associated with occupational groups. Epidemiological profiles based on free lists are useful to identify new opportunities for prevention strategies.

Burden of varicella in Latin America and the Caribbean: findings from a systematic literature review

BACKGROUND

Varicella is typically mild and self-limiting, but can be associated with complications and even death. The limited data available on varicella in Latin America and the Caribbean (LAC) indicate substantial burden in countries where varicella vaccine is not part of publicly funded childhood national immunization programs.

METHODS

A systematic literature review of published studies was complemented by "gray" literature on varicella incidence, complications, mortality, and economic consequences, in the absence and presence of universal varicella vaccination (UVV) in LAC.

RESULTS

Seroprevalence data indicate that varicella is usually a disease of childhood in LAC. Varicella incidence rates, while unreliable in the absence of mandatory reporting, show a trend to increased incidence due to greater urbanization and population density. The introduction of UVV in national immunization programs has led to significant reductions in varicella incidence in these areas.

CONCLUSIONS

Varicella continues to pose a substantial healthcare burden in LAC. The future introduction of UVV in additional countries is predicted to provide substantial reductions in cases, with important economic benefits. For countries that have already implemented UVV, the challenge is to maintain high rates of coverage and, where relevant, consider inclusion of a second dose to reduce breakthrough cases. Given the significant proportion of the region now implementing UVV, a regional recommendation in order to prevent any potential for age-shifts in varicella infection might be considered.

[Lead and mercury exposure in populations on the banks of the Bogotá River: a multi-method study]

OBJECTIVES

This study sought to understand the health problems associated with the presence of lead and mercury in the water of the Bogotá River.

MATERIALS AND METHODS

A mixed methods study was conducted using interviews, surveys and measurements of zinc protoporphyrin (ZPP) and mercury in blood from 172 individuals. Variables associated with the highest concentrations were identified, as well as the attributes of the cases with increased exposure by means of a qualitative comparative analysis.

RESULTS

Interviews reported that river pollution is associated with diseases, although direct exposure to water is rare. River water is widely used for irrigation of crops that are sold in other municipalities. Communities with greater exposure to river water are Tocaima and Girardot. The highest levels of ZPP were observed among those living in these municipalities, did activities at home and performed non-work activities using metals. Increased ZPP levels were associated with depression, nasal bleeding and loss of appetite. The highest concentrations of mercury were found in the inhabitants of Girardot, and were associated with sweating, disorientation, nausea and diarrhea.

CONCLUSION

Low levels of lead and mercury were observed in the study population, although there are specific cases with high social vulnerability that require special attention.

Effect of households' social networks on lice infestation among vulnerable Mexican children: a qualitative comparative analysis

The prevalence of pediculosis is high among elementary and secondary school children, which favors the belief that infestation occurs more often in schools than in homes. This study explored the role of households' social networks in the transmission of head lice. Seventeen school children and their social networks (n = 22) from Acatlipa (Morelos, Mexico) participated in a prospective observational study during school vacation. The hair of all the school children was washed with shampoo containing permethrin at the beginning of the study and the incidence of pediculosis (O) was evaluated at the beginning of the school term (follow-up at 1.5 months). The sets included in the qualitative comparative analysis were sex (S), length of hair (H), baseline diagnostic of pediculosis (I) and degree (D) and infestation index (N) obtained through the analysis of social networks. The prevalence of pediculosis was the same at the beginning and the end of follow-up (17.6%). The degree of the school children's networks ranged between 2 and 14. There were 8 configurations, the most frequent being F*i*d*n*h. The most parsimonious configuration associated with the incidence of pediculosis was F*I*d*H (female, previous infestation, low degree and long hair), with a coverage of 0.344 and a consistency of 0.941. Indicators of social networks made it possible to identify the role of households' social networks in the transmission of lice. Individual actions such as the use of shampoo containing insecticides are temporary and, therefore, structural actions should be favored.