Banguero H
Soc Sci Med. 1984;19(10):1099-104. doi: 10.1016/0277-9536(84)90313-7.
In spite of progress made to control tropical diseases many developing countries in the world still show high rates of incidence. A program for malaria eradication has been in operation in Colombia since 1953, and the malaria incidence rate was falling until 1971. However, in recent years the rate has begun to rise again in affected areas of the country. The resurgence of the disease leads one to think that traditional methods of controlling it are approaching the saturation point, and a reassessment of the determinants of the problem is needed in order to identify social and economic factors that might be playing an important role by themselves or in association with epidemiological or health determinants of the disease. The purpose of this paper is to present a methodology which is being applied to the analysis of social, economic and health determinants of malaria incidence in Colombia. The model is theoretically based on a home economics framework. However, an expansion of the original version is made to take into account social and organizational factors which are thought to be important in the Colombian case. Economic variables included in the testing of the model are income, wealth and occupation. Social variables include education and housing conditions. Health factors considered are nutrition and health services. The model is tested using data collected in July 1982 in one of the most malaria affected areas of Colombia, and preliminary results are presented.
尽管在控制热带疾病方面取得了进展,但世界上许多发展中国家的发病率仍然很高。自1953年以来,哥伦比亚一直在实施一项根除疟疾的计划,直到1971年疟疾发病率一直在下降。然而,近年来,该国受影响地区的发病率又开始上升。这种疾病的死灰复燃让人认为,传统的控制方法正接近饱和点,需要重新评估问题的决定因素,以便确定可能单独或与该疾病的流行病学或健康决定因素相关联而发挥重要作用的社会和经济因素。本文的目的是提出一种正在应用于分析哥伦比亚疟疾发病率的社会、经济和健康决定因素的方法。该模型理论上基于家庭经济学框架。然而,对原始版本进行了扩展,以考虑到在哥伦比亚案例中被认为很重要的社会和组织因素。模型测试中包括的经济变量有收入、财富和职业。社会变量包括教育和住房条件。考虑的健康因素是营养和医疗服务。该模型使用1982年7月在哥伦比亚疟疾最严重的地区之一收集的数据进行测试,并给出了初步结果。