Study in the Pan American Journal of Public Health Concludes that Free Diagnosis and Treatment Are Not Sufficient for Vulnerable Groups

Washington, D.C., 19 June 2013 (PAHO/WHO) - The most recent issue of the Pan American Journal of Public Health reports that patients with tuberculosis in the Dominican Republic need better medical and social coverage because their declining incomes cannot keep pace with increased direct and indirect disease-related expenses.

Based on research on 200 patients in 2009, the study published in the journal found that the proportion of patients without a steady income increased from 1% to 54% as a consequence of having contracted the disease. The authors conclude that "free TB diagnosis and treatment are not enough to alleviate the financial constraints experienced by vulnerable groups." For that reason, they point out, "health insurance covering TB in- and outpatient costs is critical" to address the financial hardships brought on by the disease.

The study reports that total costs increased by a median of $908 for new patients, $432 for retreatment patients, and $3,557 for patients with multidrug-resistant tuberculosis. The study notes that, following a review of the results, the Ministry of Health undertook initiatives "to allocate public funds for food supplements and to include in- and outpatient TB services in the national health insurance schemes."

Social Class and Health Inequalities in Chile

This issue of the Pan American Journal of Public Health—the open-access peer-reviewed scientific journal published by the Pan American Health Organization (PAHO/WHO)—also includes a study on "Social Class, Health Inequalities, and Health-related Behaviors of Working People in Chile."

The research was conducted using the First National Survey of Employment Conditions, Work, Health, and Quality of Life of Workers in 2009-2010. After an analysis of health indicators and health-related behaviors, the study concludes "it is clear that in Chile there are health inequalities associated with social class."

According to the study, those with the greatest health problems are basic and semiskilled supervisors and informal workers, while those with better health indicators are entrepreneurs and management experts, followed by highly-skilled and semiskilled workers.

The scientific study also reports important differences in gender with regard to social class—better health behaviors are observed among men from more privileged social classes, but not women.

Prevention of Carrión's Disease in Peru

The issue also presents research on Carrión's disease among the rural population of Ancash, Peru. This disease, one of the most geographically restricted infections in human beings, is transmitted through the bite of a mosquito whose habitat is limited to valleys in the Andean mountains in Colombia, Ecuador, and Peru.

The study notes that the disease has acquired endemic characteristics in Peru, mainly in the country's mountainous regions such as Ancash, which ranges between 500 and 3,200 meters above sea level. However, the study reports that in three communities historically affected by Carrión's disease the inhabitants "did not demonstrate an adequate proficiency level, attitudes, or practices for its prevention." The study was conducted among the populations of Huaripampa, Orcosh, and Opayaco in July 2010.

Of the 276 persons interviewed, 72.5% said that they had never heard about the disease. Among those who were aware of it, 26% said they did not know how it was transmitted.

"In view of this, and taking into account that this illness has cyclical outbreaks, it has become urgent to design and implement a program that educates the inhabitants of these towns...on how to prevent Carrión's disease," the study concludes.

This issue of the Pan American Journal of Public Health also includes articles on:

  • "Setting Priorities for Surveillance, Prevention, and Control of Zoonoses in Bogotá, Colombia."
  • "A Methodology to Implement Preventive Actions against Harmful Drug Use in the Context of Primary Health Care in Latin America."
  • "Comparing Three Body Mass Index Classification Systems to Assess Excess Weight and Obesity in Children and Adolescents."
  • "Development and Application of a New Index for Assessment of Prenatal Care."
  • "Epidemiological Study of Recorded Trichinosis Cases in Santa Fe Province, Argentina, 1998-2009."
  • "Zinc Supplementation for Treating Diarrhea in Children: A Systematic Review and Meta-analysis."
  • "News Reports on Bullying-related Fatal and Non-fatal Injuries in the Americas."

The free-access and digitally distributed Pan American Journal of Public Health has as its mission to disseminate scientific public health information in order to strengthen national and local health systems and improve the health of the peoples of the Americas.

Link to current issue of the Pan American Journal of Public Health