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Environmental risk factors associated with intestinal parasitic infections and respiratory symptoms in pregnant women residing in low income neighborhoods in Bogotá, Colombia
Environmental risk factors associated with intestinal parasitic infections and respiratory symptoms in pregnant women residing in low income neighborhoods in Bogotá, Colombia
Background: Colombia is a country with high socioeconomic inequality, where women living in low-income vulnerable areas are exposed to environments that may negatively affect their health. The aim of this study was to identify the sociodemographic and environmental conditions associated with intestinal parasitic infections (IPI) and respiratory symptoms (RS), both health problems of unknown prevalence, in pregnant women residing in neighborhoods with low socioeconomic conditions in three districts of Bogotá. Methods: A cross-sectional community-based study was done. For IPI prevalence, stool analyses by direct, concentration and qPCR techniques were made. For RS prevalence, questions from the European Community Respiratory Health Survey were applied. Based on a questionnaire and home visit, environmental and socioeconomic factors, as well as health, living and hygiene conditions were identified. As exposure variables for RS, we used residential proximity to greenness, and air pollution, indirectly determined by distance to closest streets and to a waste disposal site. Results: Of 750 pregnant women invited to participate, 550 accepted and answered the questionnaire. For the IPI study, 331 participants were included since they gave at least one stool sample. The prevalence of any parasite was 41%, highest for Blastocystis hominis with 25%. Prevalence of pathogenic parasites and polyparasitism were 1.2% and 9%, respectively. Women who had never dewormed had a significantly higher prevalence of any parasite. Women from minority groups and those not having handwashing facilities in their homes had a higher not significant prevalence of polyparasitism. In 310 participants from Ciudad Bolivar, who provided their home address, the prevalence of physician-diagnosed asthma and rhinitis were 4.5% and 21%, respectively. We identified a significantly higher prevalence of rhinitis in areas with low access to greenness, and increased odds for rhinitis and asthma when participants lived further away from main streets. Conclusions: In pregnant women living in vulnerable conditions, this study revealed a low prevalence of pathogenic intestinal parasites, and a lower prevalence of asthma and rhinitis, when compared with the general population in Bogota. Associated factors identified support generation of hypothesis for future mixed methods studies with active participation of local and community leaders. This research will require adequate sample size and total probabilistic selection to better establish associations affecting the health of women living in vulnerable conditions.
Pregnant women, Intestinal parasitic infections, Asthma, Rhinitis, Sociodemographic characteristics, Housing Conditions, Vulnerable populations, Green Spaces, Air Pollution, NDVI
Espinosa Aranzales, Ángela Fernanda
2019
English
Universitätsbibliothek der Ludwig-Maximilians-Universität München
Espinosa Aranzales, Ángela Fernanda (2019): Environmental risk factors associated with intestinal parasitic infections and respiratory symptoms in pregnant women residing in low income neighborhoods in Bogotá, Colombia. Dissertation, LMU München: Faculty of Medicine
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Abstract

Background: Colombia is a country with high socioeconomic inequality, where women living in low-income vulnerable areas are exposed to environments that may negatively affect their health. The aim of this study was to identify the sociodemographic and environmental conditions associated with intestinal parasitic infections (IPI) and respiratory symptoms (RS), both health problems of unknown prevalence, in pregnant women residing in neighborhoods with low socioeconomic conditions in three districts of Bogotá. Methods: A cross-sectional community-based study was done. For IPI prevalence, stool analyses by direct, concentration and qPCR techniques were made. For RS prevalence, questions from the European Community Respiratory Health Survey were applied. Based on a questionnaire and home visit, environmental and socioeconomic factors, as well as health, living and hygiene conditions were identified. As exposure variables for RS, we used residential proximity to greenness, and air pollution, indirectly determined by distance to closest streets and to a waste disposal site. Results: Of 750 pregnant women invited to participate, 550 accepted and answered the questionnaire. For the IPI study, 331 participants were included since they gave at least one stool sample. The prevalence of any parasite was 41%, highest for Blastocystis hominis with 25%. Prevalence of pathogenic parasites and polyparasitism were 1.2% and 9%, respectively. Women who had never dewormed had a significantly higher prevalence of any parasite. Women from minority groups and those not having handwashing facilities in their homes had a higher not significant prevalence of polyparasitism. In 310 participants from Ciudad Bolivar, who provided their home address, the prevalence of physician-diagnosed asthma and rhinitis were 4.5% and 21%, respectively. We identified a significantly higher prevalence of rhinitis in areas with low access to greenness, and increased odds for rhinitis and asthma when participants lived further away from main streets. Conclusions: In pregnant women living in vulnerable conditions, this study revealed a low prevalence of pathogenic intestinal parasites, and a lower prevalence of asthma and rhinitis, when compared with the general population in Bogota. Associated factors identified support generation of hypothesis for future mixed methods studies with active participation of local and community leaders. This research will require adequate sample size and total probabilistic selection to better establish associations affecting the health of women living in vulnerable conditions.