Enfoque Rápido en Contexto Comunitario (ERCC):
evaluando las medidas preventivas para Hantavirus en la Comarca Andina Patagónica desde la perspectiva de la participación comunitaria.
Palabras clave:
Hantavirus, participación comunitaria , prevención, Argentina, planificación.
Resumen
Introducción: la creciente preocupación por eventos epidémicos de origen antropozoonótico generó la necesidad de estrategias integrales que corrigiesen la baja adaptabilidad y tensiones que se generan al implementar acciones de orden jerárquico superior en el contexto comunitario. Con el objeto de explicar un Enfoque Rápido en Contexto Comunitario (ERCC), este trabajo se propone evaluar dentro del contexto de un programa de salud pública la participación comunitaria en la prevención del Hantavirus en la Comarca Andina del Paralelo 42. Metodología: El presente ERCC utilizó visitas y observaciones al sitio, entrevistas cara a cara y grupales, precedidas por una revisión documental de la literatura. La información se recopiló en un corto período de tiempo y el análisis se utilizó para desarrollar recomendaciones informadas para los tomadores de decisiones de salud pública. Resultados: Se observo que cada comunidad enfrenta desafíos más allá del hantavirus y es esencial que epidemiólogos, prestadores de servicios asistenciales y municipalidades trabajen más estrechamente con la población local para prevenir y manejar mejor cualquier brote de enfermedad. Se pudieron identificar 6 recomendaciones que le permitirían a las comunidades un mejor manejo de futuros brotes con un enfoque participativo. Conclusiones: El ERCC es una intervención rápida y discreta que puede ser llevada a cabo por un pequeño equipo con una interferencia mínima en la comunidad. El ERCC también podría ser adaptado por las autoridades de salud pública a muchos contextos diferentes, incluso con grupos vulnerables, para ayudar a que la promoción y la prevención sean más relevantes y efectivas a nivel local.Citas
1. Binot A, Duboz R, Promburom P, Phimpraphai W, Cappelle J, Lajaunie C, et al. A framework to promote collective action within the One Health community of practice: Using participatory modelling to enable interdisciplinary, cross-sectoral and multi-level integration. One Health [Internet]. 2015 Dec 1 [cited 2023 Sep 13];1:44–8. Disponible en: https://www.sciencedirect.com/science/article/pii/S2352771415000075
2. Berrian AM, Smith MH, van Rooyen J, Martínez-López B, Plank MN, Smith WA, et al. A community-based One Health education program for disease risk mitigation at the human-animal interface. One Health [Internet]. 2018 Jun 1 [cited 2023 Sep 13];5:9–20. Disponible en: https://www.sciencedirect.com/science/article/pii/S2352771417300289?via%3Dihub
3. Steele SG, Toribio JA, Booy R, Mor SM. What makes an effective One Health clinical practitioner? Opinions of Australian One Health experts. One Health [Internet]. 2019 Dec 1 [cited 2023 Sep 13];8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6838466/
4. Lorca Diaz J, Dierssen Sotos T, Gomez Acebo I, Rodriguez Cundin I. BASES GENERALES PARA LA PREVENCIÓN Y CONTROL DE LAS ENFERMEDADES TRANSMISIBLES. In: Medicina Preventiva y Salud Pública. 12th ed. Barcelona: Elsevier; 2016. p. 516–27.
5. De Vries DH, Rwemisisi JT, Musinguzi LK, Benoni TE, Muhangi D, De Groot M, et al. The first mile: Community experience of outbreak control during an Ebola outbreak in Luwero District, Uganda. BMC Public Health [Internet]. 2016 Feb 16 [cited 2023 Sep 13];16(1). Disponible en: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-2852-0
6. Lin H, Liu T, Song T, Lin L, Xiao J, Lin J, et al. Community Involvement in Dengue Outbreak Control: An Integrated Rigorous Intervention Strategy. PLoS Negl Trop Dis [Internet]. 2016 Aug 22 [cited 2023 Sep 13];10(8). Disponible en: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0004919
7. Laverack G, Manoncourt E. Key experiences of community engagement and social mobilization in the Ebola response. Glob Health Promot [Internet]. 2016 Mar 1 [cited 2023 Sep 13];23(1):79–82. Disponible en: https://journals.sagepub.com/doi/abs/10.1177/1757975915606674?journalCode=pedb
8. Laverack G, Labonte R. A planning framework for community empowerment goals within health promotion. Health Policy Plan [Internet]. 2000 Sep;15(3):255–62. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/11012399
9. Vindrola-Padros C, Vindrola-Padros B. Quick and dirty? A systematic review of the use of rapid ethnographies in healthcare organisation and delivery [Internet]. Vol. 27, BMJ Quality and Safety. BMJ Publishing Group; 2018 [cited 2023 Sep 13]. p. 321–30. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29263139/
10. Koofman A, Eggers P, Brown S, Morales-Betoulle M, Graziano J, Zufan S, et al. Contact Tracing Investigation Case of Andes Virus in the United States-Delaware, February 2018. Morbidity and Mortality Weekly Report [Internet]. 2018 Nov 13 [cited 2023 Sep 13];67(41):1162–3. Disponible en: https://www.cdc.gov/mmwr/volumes/67/wr/mm6741a7.htm
11. Kuenzli AB, Marschall J, Schefold JC, Schafer M, Engler OB, Ackermann-Gäumann R, et al. Hantavirus Cardiopulmonary Syndrome Due to Imported Andes Hantavirus Infection in Switzerland: A Multidisciplinary Challenge, Two Cases and a Literature Review. Clinical Infectious Diseases [Internet]. 2018 Nov 13 [cited 2023 Sep 13];67(11):1796–7. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233683/
12. Steffens TS, Finnis E. Context matters: Leveraging anthropology within one health. One Health [Internet]. 2022 Jun 1 [cited 2023 Sep 13];14. Disponible en: https://www.sciencedirect.com/science/article/pii/S2352771422000258
13. Grundy J, Annear P. KNOWLEDGE HUBS FOR HEALTH Strengthening health systems through evidence in Asia and the Pacific HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB Health-seeking behaviour studies: a literature review of study design and methods with a focus on Cambodia [Internet]. Disponible en: www.ni.unimelb.edu.au
14. Karlsson L, Takahashi R. A resource for developing an evidence synthesis report for policy-making [Internet]. Copenhagen; 2017 [cited 2023 Sep 13]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK453541/
15. Laverack G. Evaluating community capacity: Visual representation and interpretation. Community Dev J [Internet]. 2006 Jul [cited 2023 Sep 13];41(3):266–76. Disponible en: https://academic.oup.com/cdj/article-abstract/41/3/266/494888?redirectedFrom=fulltext
16. Cavaye J. Governance and Community Engagement-The Australian Experience [Internet]. Disponible en: https://www.researchgate.net/publication/268254917
17. Sudi L, Olomi W, Mangu C, Tarimo M, Ntinginya N, Shirima G. Assessment of Knowledge, Attitude and Practices (KAP) on Hantavirus Infections at Community Level in Mbeya Region, Tanzania. J Trop Dis [Internet]. 2018 [cited 2023 Sep 13];07(01). Disponible en: https://www.researchgate.net/profile/Lwitiho_Sudi/publication/331035720_assessment-of-knowledge-attitude-and-practices-kap-on-hantavirus-infections-at-community-level-in-mbeya-region-tanzania-2329-891X-1000290/links/5c627246299bf1d14cbf8ccf/assessment-of-knowledge-attitude-and-practices-kap-on-hantavirus-infections-at-community-level-in-mbeya-region-tanzania-2329-891X-1000290.pdf
18. News Desk. Outbreak News Today. 2021 [cited 2023 Sep 13]. Hantavirus: Argentina reports 5 cases in Salta since beginning of 2021. Disponible en: https://outbreaknewstoday.com/hantavirus-argentina-reports-5-cases-in-salta-since-beginning-of-2021/
19. Martínez VP, Di Paola N, Alonso DO, Pérez-Sautu U, Bellomo CM, Iglesias AA, et al. “Super-Spreaders” and Person-to-Person Transmission of Andes Virus in Argentina. New England Journal of Medicine [Internet]. 2020 Dec 3 [cited 2023 Sep 13];383(23):2230–41. Disponible en: https://www.nejm.org/doi/full/10.1056/NEJMoa2009040
20. Laverack G, Manoncourt E. Key experiences of community engagement and social mobilization in the Ebola response. Glob Health Promot [Internet]. 2016 Mar 1 [cited 2023 Sep 13];23(1):79–82. Disponible en: https://journals.sagepub.com/doi/abs/10.1177/1757975915606674?journalCode=pedb
21. South J, Raine G, White J. COMMUNITY HEALTH CHAMPIONS EVIDENCE REVIEW [Internet]. Leeds; 2010 [cited 2023 Sep 13]. Disponible en: https://eprints.leedsbeckett.ac.uk/id/eprint/7368/1/CommunityHealthChampionsEvidenceReviewPV-SOUTH.pdf
22. Laverack G. Using a “domains” approach to build community empowerment. Community Dev J [Internet]. 2006 Jan [cited 2023 Sep 13];41(1):4–12. Disponible en: https://www.researchgate.net/publication/31109751_Using_a_’domains’_approach_to_build_community_empowerment
23. Laverack G, Jaime S. Bottom-up strategy for public health to address COVID-19 in Patagonia [Internet]. Trelew; 2021. Disponible en: https://www.researchgate.net/project/Bottom-up-strategy-for-public-health-to-address-COVID-19-in-Patagonia
24. Johnson GA, Vindrola-Padros C. Rapid qualitative research methods during complex health emergencies: A systematic review of the literature [Internet]. Vol. 189, Social Science and Medicine. Elsevier Ltd; 2017 [cited 2023 Sep 13]. p. 63–75. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0277953617304628?via%3Dihub
25. Baquero OS. One Health of Peripheries: Biopolitics, Social Determination, and Field of Praxis. Front Public Health [Internet]. 2021 Jun 30 [cited 2023 Sep 13];9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8278197/
26. Bhattacharyya K, Winch P, Leban K, Tien M. Community Health Worker Incentives and Disincentives: How They Affect Motivation, Retention, and Sustainability. [Internet]. Arlington; 2001. Disponible en: chw_incentives-basics-2001.pdf (fsnnetwork.org)
27. WHAT DO WE KNOW ABOUT COMMUNITY HEALTH WORKERS? A SYSTEMATIC REVIEW OF EXISTING REVIEWS. Human Resources for Health Observer N°19 [Internet]. Geneve; 2020 [cited 2023 Sep 13]. Available from: https://www.who.int/publications/i/item/what-do-we-know-about-community-health-workers-a-systematic-review-of-existing-reviews
28. Gholipour K, Shokri A, Yarahmadi AA, Tabrizi JS, Iezadi S, Naghibi D, et al. Barriers to community participation in primary health care of district health: a qualitative study. BMC Primary Care [Internet]. 2023 Dec 1 [cited 2023 Sep 13];24(1). Available from: https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-02062-0
29. Bardosh KL, Ryan S, Ebi K, Welburn S, Singer B. Addressing vulnerability, building resilience: Community-based adaptation to vector-borne diseases in the context of global change [Internet]. Vol. 6, Infectious Diseases of Poverty. BioMed Central Ltd.; 2017 [cited 2023 Sep 13]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5725972/
30. Vatcharavongvan P, Hepworth J, Marley J. The application of the parallel track model in community health promotion: A literature review [Internet]. Vol. 21, Health and Social Care in the Community. 2013 [cited 2023 Sep 13]. p. 352–63. Available from: https://onlinelibrary.wiley.com/doi/10.1111/hsc.12017
31. Dintrans PV, Valenzuela P, Castillo C, Granizo Y, Maddaleno M. Bottom-up innovative responses to COVID-19 in Latin America and the Caribbean: addressing deprioritized populations. Revista Panamericana de Salud Pública [Internet]. 2023 Jun 12 [cited 2023 Sep 13];47:1. Available from: https://iris.paho.org/handle/10665.2/57666
2. Berrian AM, Smith MH, van Rooyen J, Martínez-López B, Plank MN, Smith WA, et al. A community-based One Health education program for disease risk mitigation at the human-animal interface. One Health [Internet]. 2018 Jun 1 [cited 2023 Sep 13];5:9–20. Disponible en: https://www.sciencedirect.com/science/article/pii/S2352771417300289?via%3Dihub
3. Steele SG, Toribio JA, Booy R, Mor SM. What makes an effective One Health clinical practitioner? Opinions of Australian One Health experts. One Health [Internet]. 2019 Dec 1 [cited 2023 Sep 13];8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6838466/
4. Lorca Diaz J, Dierssen Sotos T, Gomez Acebo I, Rodriguez Cundin I. BASES GENERALES PARA LA PREVENCIÓN Y CONTROL DE LAS ENFERMEDADES TRANSMISIBLES. In: Medicina Preventiva y Salud Pública. 12th ed. Barcelona: Elsevier; 2016. p. 516–27.
5. De Vries DH, Rwemisisi JT, Musinguzi LK, Benoni TE, Muhangi D, De Groot M, et al. The first mile: Community experience of outbreak control during an Ebola outbreak in Luwero District, Uganda. BMC Public Health [Internet]. 2016 Feb 16 [cited 2023 Sep 13];16(1). Disponible en: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-2852-0
6. Lin H, Liu T, Song T, Lin L, Xiao J, Lin J, et al. Community Involvement in Dengue Outbreak Control: An Integrated Rigorous Intervention Strategy. PLoS Negl Trop Dis [Internet]. 2016 Aug 22 [cited 2023 Sep 13];10(8). Disponible en: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0004919
7. Laverack G, Manoncourt E. Key experiences of community engagement and social mobilization in the Ebola response. Glob Health Promot [Internet]. 2016 Mar 1 [cited 2023 Sep 13];23(1):79–82. Disponible en: https://journals.sagepub.com/doi/abs/10.1177/1757975915606674?journalCode=pedb
8. Laverack G, Labonte R. A planning framework for community empowerment goals within health promotion. Health Policy Plan [Internet]. 2000 Sep;15(3):255–62. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/11012399
9. Vindrola-Padros C, Vindrola-Padros B. Quick and dirty? A systematic review of the use of rapid ethnographies in healthcare organisation and delivery [Internet]. Vol. 27, BMJ Quality and Safety. BMJ Publishing Group; 2018 [cited 2023 Sep 13]. p. 321–30. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29263139/
10. Koofman A, Eggers P, Brown S, Morales-Betoulle M, Graziano J, Zufan S, et al. Contact Tracing Investigation Case of Andes Virus in the United States-Delaware, February 2018. Morbidity and Mortality Weekly Report [Internet]. 2018 Nov 13 [cited 2023 Sep 13];67(41):1162–3. Disponible en: https://www.cdc.gov/mmwr/volumes/67/wr/mm6741a7.htm
11. Kuenzli AB, Marschall J, Schefold JC, Schafer M, Engler OB, Ackermann-Gäumann R, et al. Hantavirus Cardiopulmonary Syndrome Due to Imported Andes Hantavirus Infection in Switzerland: A Multidisciplinary Challenge, Two Cases and a Literature Review. Clinical Infectious Diseases [Internet]. 2018 Nov 13 [cited 2023 Sep 13];67(11):1796–7. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233683/
12. Steffens TS, Finnis E. Context matters: Leveraging anthropology within one health. One Health [Internet]. 2022 Jun 1 [cited 2023 Sep 13];14. Disponible en: https://www.sciencedirect.com/science/article/pii/S2352771422000258
13. Grundy J, Annear P. KNOWLEDGE HUBS FOR HEALTH Strengthening health systems through evidence in Asia and the Pacific HEALTH POLICY AND HEALTH FINANCE KNOWLEDGE HUB Health-seeking behaviour studies: a literature review of study design and methods with a focus on Cambodia [Internet]. Disponible en: www.ni.unimelb.edu.au
14. Karlsson L, Takahashi R. A resource for developing an evidence synthesis report for policy-making [Internet]. Copenhagen; 2017 [cited 2023 Sep 13]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK453541/
15. Laverack G. Evaluating community capacity: Visual representation and interpretation. Community Dev J [Internet]. 2006 Jul [cited 2023 Sep 13];41(3):266–76. Disponible en: https://academic.oup.com/cdj/article-abstract/41/3/266/494888?redirectedFrom=fulltext
16. Cavaye J. Governance and Community Engagement-The Australian Experience [Internet]. Disponible en: https://www.researchgate.net/publication/268254917
17. Sudi L, Olomi W, Mangu C, Tarimo M, Ntinginya N, Shirima G. Assessment of Knowledge, Attitude and Practices (KAP) on Hantavirus Infections at Community Level in Mbeya Region, Tanzania. J Trop Dis [Internet]. 2018 [cited 2023 Sep 13];07(01). Disponible en: https://www.researchgate.net/profile/Lwitiho_Sudi/publication/331035720_assessment-of-knowledge-attitude-and-practices-kap-on-hantavirus-infections-at-community-level-in-mbeya-region-tanzania-2329-891X-1000290/links/5c627246299bf1d14cbf8ccf/assessment-of-knowledge-attitude-and-practices-kap-on-hantavirus-infections-at-community-level-in-mbeya-region-tanzania-2329-891X-1000290.pdf
18. News Desk. Outbreak News Today. 2021 [cited 2023 Sep 13]. Hantavirus: Argentina reports 5 cases in Salta since beginning of 2021. Disponible en: https://outbreaknewstoday.com/hantavirus-argentina-reports-5-cases-in-salta-since-beginning-of-2021/
19. Martínez VP, Di Paola N, Alonso DO, Pérez-Sautu U, Bellomo CM, Iglesias AA, et al. “Super-Spreaders” and Person-to-Person Transmission of Andes Virus in Argentina. New England Journal of Medicine [Internet]. 2020 Dec 3 [cited 2023 Sep 13];383(23):2230–41. Disponible en: https://www.nejm.org/doi/full/10.1056/NEJMoa2009040
20. Laverack G, Manoncourt E. Key experiences of community engagement and social mobilization in the Ebola response. Glob Health Promot [Internet]. 2016 Mar 1 [cited 2023 Sep 13];23(1):79–82. Disponible en: https://journals.sagepub.com/doi/abs/10.1177/1757975915606674?journalCode=pedb
21. South J, Raine G, White J. COMMUNITY HEALTH CHAMPIONS EVIDENCE REVIEW [Internet]. Leeds; 2010 [cited 2023 Sep 13]. Disponible en: https://eprints.leedsbeckett.ac.uk/id/eprint/7368/1/CommunityHealthChampionsEvidenceReviewPV-SOUTH.pdf
22. Laverack G. Using a “domains” approach to build community empowerment. Community Dev J [Internet]. 2006 Jan [cited 2023 Sep 13];41(1):4–12. Disponible en: https://www.researchgate.net/publication/31109751_Using_a_’domains’_approach_to_build_community_empowerment
23. Laverack G, Jaime S. Bottom-up strategy for public health to address COVID-19 in Patagonia [Internet]. Trelew; 2021. Disponible en: https://www.researchgate.net/project/Bottom-up-strategy-for-public-health-to-address-COVID-19-in-Patagonia
24. Johnson GA, Vindrola-Padros C. Rapid qualitative research methods during complex health emergencies: A systematic review of the literature [Internet]. Vol. 189, Social Science and Medicine. Elsevier Ltd; 2017 [cited 2023 Sep 13]. p. 63–75. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0277953617304628?via%3Dihub
25. Baquero OS. One Health of Peripheries: Biopolitics, Social Determination, and Field of Praxis. Front Public Health [Internet]. 2021 Jun 30 [cited 2023 Sep 13];9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8278197/
26. Bhattacharyya K, Winch P, Leban K, Tien M. Community Health Worker Incentives and Disincentives: How They Affect Motivation, Retention, and Sustainability. [Internet]. Arlington; 2001. Disponible en: chw_incentives-basics-2001.pdf (fsnnetwork.org)
27. WHAT DO WE KNOW ABOUT COMMUNITY HEALTH WORKERS? A SYSTEMATIC REVIEW OF EXISTING REVIEWS. Human Resources for Health Observer N°19 [Internet]. Geneve; 2020 [cited 2023 Sep 13]. Available from: https://www.who.int/publications/i/item/what-do-we-know-about-community-health-workers-a-systematic-review-of-existing-reviews
28. Gholipour K, Shokri A, Yarahmadi AA, Tabrizi JS, Iezadi S, Naghibi D, et al. Barriers to community participation in primary health care of district health: a qualitative study. BMC Primary Care [Internet]. 2023 Dec 1 [cited 2023 Sep 13];24(1). Available from: https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-02062-0
29. Bardosh KL, Ryan S, Ebi K, Welburn S, Singer B. Addressing vulnerability, building resilience: Community-based adaptation to vector-borne diseases in the context of global change [Internet]. Vol. 6, Infectious Diseases of Poverty. BioMed Central Ltd.; 2017 [cited 2023 Sep 13]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5725972/
30. Vatcharavongvan P, Hepworth J, Marley J. The application of the parallel track model in community health promotion: A literature review [Internet]. Vol. 21, Health and Social Care in the Community. 2013 [cited 2023 Sep 13]. p. 352–63. Available from: https://onlinelibrary.wiley.com/doi/10.1111/hsc.12017
31. Dintrans PV, Valenzuela P, Castillo C, Granizo Y, Maddaleno M. Bottom-up innovative responses to COVID-19 in Latin America and the Caribbean: addressing deprioritized populations. Revista Panamericana de Salud Pública [Internet]. 2023 Jun 12 [cited 2023 Sep 13];47:1. Available from: https://iris.paho.org/handle/10665.2/57666
Publicado
2024-03-03
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Derechos de autor 2024 Sergio Jaime, Glenn Laverack
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