Cardona-Arias Jaiberth Antonio
Universidad de Antioquia. Medellín, Colombia. La correspondencia se debe dirigir a Jaiberth Antonio Cardona-Arias. Correo electrónico:
Rev Panam Salud Publica. 2018 Feb 19;41:e143. doi: 10.26633/RPSP.2017.143.
Characterize the publications on social determinants of intestinal parasitism, malnutrition, and anemia at the global level.
A systematic review was conducted of the scientific literature in Pubmed, Science Direct, SciELO, LILACS, and Google Scholar with eight search strategies, guaranteeing completeness and replicability, following the phases of the PRISMA guidelines.
The review included 18 studies on malnutrition, three on parasitism, three on anemia, and two on both parasitism and malnutrition; 65.4% of the studies were from South America and 69.2% were carried out among children. The prevalence of intestinal parasitism ranged between 30.6% and 83.3%; anemia, 19.7% to 48.0%; and malnutrition, 0.0% to 67.8%. It was found that biological and psychosocial determinants were most frequently studied; the most frequently studied intermediate determinants were related to housing and income; and structural determinants were least investigated. The social determinants common to the three conditions include: living in homes with poor sanitary conditions, rural areas, inadequate housing, inadequate water supply, access barriers to the medical system, young parents with little schooling, precarious employment, and low income.
The majority of publications do not conduct a multilevel analysis for individual, intermediate, or structural determinants. Greater efforts are needed in health policies that address the social determinants of inequality with respect to parasitism, malnutrition, and anemia, mainly in categories as macroeconomic policy, social class, labor market, culture, values, and territory.
在全球层面描述关于肠道寄生虫病、营养不良和贫血的社会决定因素的相关出版物。
按照PRISMA指南的阶段，采用八种检索策略对PubMed、Science Direct、SciELO、LILACS和谷歌学术上的科学文献进行系统综述，以确保完整性和可重复性。
该综述纳入了18项关于营养不良的研究、3项关于寄生虫病的研究、3项关于贫血的研究以及2项关于寄生虫病和营养不良两者的研究；65.4%的研究来自南美洲，69.2%的研究是在儿童中开展的。肠道寄生虫病的患病率在30.6%至83.3%之间；贫血为19.7%至48.0%；营养不良为0.0%至67.8%。研究发现，生物和心理社会决定因素是研究最频繁的；最常研究的中间决定因素与住房和收入有关；而结构决定因素的研究最少。这三种情况共有的社会决定因素包括：生活在卫生条件差的家庭、农村地区、住房不足、供水不足、医疗系统获取障碍、受教育程度低的年轻父母、不稳定就业和低收入。
大多数出版物没有对个体、中间或结构决定因素进行多层次分析。在解决寄生虫病、营养不良和贫血方面不平等的社会决定因素的卫生政策上，需要做出更大努力，主要涉及宏观经济政策、社会阶层、劳动力市场、文化、价值观和地域等类别。
