Olivera Mario J, Rincón Acevedo Claudia Yaneth, Olivera Antonio José, Mendez-Cardona Sergio, Vera Soto Mauricio Javier
Grupo de Parasitología, Instituto Nacional de Salud de Colombia, Bogotá 111321, D.C., Colombia.
Dirección de Vigilancia y Análisis del Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá 111321, D.C., Colombia.
Sci One Health. 2024 Apr 23;3:100066. doi: 10.1016/j.soh.2024.100066. eCollection 2024.
Chagas disease (CD) is transmitted by vectors but can also be transmitted orally through contaminated food, drinks, or meat. The One Health perspective aims to understand the complex interaction between human, animal, and environmental health in controlling disease. This study analyzed risk factors and drew lessons from past outbreaks of orally transmitted CD to develop effective preventive strategies.
A simultaneous mixed methods study was conducted. The study consisted of two phases: an ecological epidemiological analysis at the municipal level using secondary data spanning from 1992 to 2023, and semistructured interviews with health providers and policymakers at the national level in Colombia. The results from both phases were triangulated to gain a comprehensive understanding of the topic.
A total of 64 outbreaks, infecting 302 individuals, were reported. Most of these outbreaks (89.2%) were classified as family-related, and they occurred most frequently during the months of April to June (46.6%). It is worth noting that a significant number of these outbreaks took place in municipalities that lacked vector control plans. Risk factors for oral transmission included the location of food preparation, poor housing quality, food preparation water source, the presence of vectors/marsupials, forest type, and climatic variables. Interviews conducted emphasized the importance of implementing outbreak plans and providing staff training to effectively address the issue.
A One Health approach strengthening prevention, surveillance, case management and cross-sectoral collaboration is needed to control outbreaks and reduce transmission in Colombia. Preparedness plans and education of health professionals are also important. This study identified modifiable risk factors to guide public health interventions.
恰加斯病（CD）可通过病媒传播，但也可经口通过受污染的食物、饮料或肉类传播。“同一健康”理念旨在了解人类、动物和环境健康在疾病控制中的复杂相互作用。本研究分析了风险因素，并从过去经口传播的恰加斯病疫情中吸取经验教训，以制定有效的预防策略。
开展了一项同步混合方法研究。该研究包括两个阶段：使用1992年至2023年的二手数据在市一级进行生态流行病学分析，以及在哥伦比亚国家层面与卫生服务提供者和政策制定者进行半结构化访谈。对两个阶段的结果进行三角验证，以全面了解该主题。
共报告了64起疫情，感染302人。这些疫情大多（89.2%）被归类为与家庭相关，最常发生在4月至6月（46.6%）。值得注意的是，这些疫情中有相当一部分发生在缺乏病媒控制计划的城市。经口传播的风险因素包括食物制备地点、住房质量差、食物制备水源、病媒/有袋动物的存在、森林类型和气候变量。所进行的访谈强调了实施疫情应对计划和提供人员培训以有效解决该问题的重要性。
需要采取“同一健康”方法，加强预防、监测、病例管理和跨部门协作，以控制哥伦比亚的疫情并减少传播。应急预案和对卫生专业人员的教育也很重要。本研究确定了可改变的风险因素，以指导公共卫生干预措施。
