Agua y Salud en Latinoamérica

H. R. POMA; M.C. CRUZ; V.B. RAJAL

Gramado

Encuentro; XXI Encontro Nacional de Virologia y VI Encontro de Virologia do Mercosur; 2010

Sociedade Brasileira de Virologia

In Latin America, economic globalization has meant the increased movement of people and goods and changes in environmental and occupational health hazards, often occurring in the context of political and economic instability. Of the estimated 183 million people living in poverty in Latin America, more than half are children and teenagers, 72 % of them live in urban areas, and mortality and morbidity impact especially the infant population. Acute respiratory infections (mainly pneumonia) and diarrhea, followed by measles, malaria (and frequently a combination of them) are the most common causes of morbidity and mortality among children under the age of five in the developing world. Malnutrition, socioeconomic status, disruption of traditional lifestyles, accessibility to clean water and sanitation facilities, age and their breast-feeding status are the main factors that influence the incidence of diarrhea. The World Health Organization (2006) estimated that about 1.5 million deaths per year from diarrheal diseases, mainly in children, are attributable to environmental factors such as contaminated drinking water, poor sanitation and poor hygiene. In the Americas, for the period of 2000-2005 the children mortality due to acute diarrheas was 3.7 % and the Andean region was the most affected with 7.8 %. A large portion of the total burden of diarrheal disease is caused by fecal-oral pathogens from both human and animal sources that are discharged into the aquatic environments. A great variety of pathogens, including bacteria (Escherichia coli, Shigella, Salmonella, Campylobacter, Aeromonas, Clostridium dificile), mycobacteria (Mycobacterium tuberculosis and Mycobacterium avium-intracellulare), viruses (rotavirus, adenovirus, enterovirus serotypes 40 and 41, norovirus, astroviruses), fungi (the role is not clear but Candida is frequently associated with persistent diarrhoea), and parasites (Giardia lamblia, Entamoeba histolytica, Microsporidia, Strongyloides stercoralis), can contribute to persistent, as well as to acute, diarrheal illnesses. The pathogenic parasites and bacteria on this non-extensive list have been well studied; numerous drug treatments have been developed that are accessible and affordable for most of the population. Conversely, viruses are difficult to detect and because of the lack of effective treatments the main strategy to decrease viral impact must be monitoring and prevention.