ABSTRACT OBJECTIVE To analyze the time trend of monthly mortality rates from chronic respiratory diseases in Brazil from 1996 to 2017, with forecasts for 2022, besides analyzing the possibility of achieving the goal of the Plano de Ações Estratégicas para o Enfrentamento das Doenças Crônicas Não Transmissíveis no Brasil (Strategic Action Plan to Tackle Chronic Noncommunicable Diseases in Brazil) from 2011 to 2022. METHODS This is an ecological study that uses data from Sistema de Informações sobre Mortalidade (SIM – Mortality Information System), Sistema de Informações Demográficas e Socioeconômicas (Demographic and Socioeconomic Information System) and Pesquisa Nacional por Amostra de Domicílios Contínua (PNAD Contínua – Continuous National Household Sample Survey). We established the age range between 30 and 69 years old and the evolution of the rates over time was made by autoregressive integrated moving average models in R statistical tool. RESULTS Premature mortality rates from chronic respiratory diseases are decreasing in Brazil as a whole, mostly in state capitals. There is also a trend to reach the Ministry of Health’s goal in most of the country. For capitals that tend not to reach the goal, there is an association between mortality and social indicators, healthcare network and frequency of smoking. CONCLUSION This study intends to improve planning of the public health system for the control of chronic respiratory diseases.

RESUMO OBJETIVO Analisar a tendência temporal das taxas mensais de mortalidade por doenças respiratórias crônicas no Brasil de 1996 até 2017, com projeções para 2022, além de analisar a possibilidade de cumprimento da meta do Plano de Ações Estratégicas para o Enfrentamento das Doenças Crônicas Não Transmissíveis no Brasil de 2011 até 2022. MÉTODOS Trata-se de estudo ecológico que utiliza dados do Sistema de Informações sobre Mortalidade, do Sistema de Informações Demográficas e Socioeconômicas e da Pesquisa Nacional por Amostra de Domicílios Contínua. O recorte etário foi estabelecido entre 30 e 69 anos e a evolução das taxas no tempo foi feita por meio de modelos autorregressivos integrados de média móvel em plataforma estatística R. RESULTADOS As taxas de mortalidade precoce por doenças respiratórias crônicas apresentam-se decrescentes no Brasil como um todo e na maior parte das capitais, assim como, há tendência a atingir a meta do Ministério da Saúde na maior parte do país. Para capitais que tendem a não atingir a meta, verifica-se associação entre mortalidade e indicadores sociais, rede assistencial de saúde e frequência do tabagismo. CONCLUSÃO Pretende-se que o estudo possibilite um melhor planejamento do sistema público de saúde para o controle das doenças respiratórias crônicas.

RESUMO OBJETIVO Analisar a tendência temporal das taxas mensais de mortalidade por doenças respiratórias crônicas no Brasil de 1996 até 2017, com projeções para 2022, além de analisar a possibilidade de cumprimento da meta do Plano de Ações Estratégicas para o Enfrentamento das Doenças Crônicas Não Transmissíveis no Brasil de 2011 até 2022. MÉTODOS Trata-se de estudo ecológico que utiliza dados do Sistema de Informações sobre Mortalidade, do Sistema de Informações Demográficas e Socioeconômicas e da Pesquisa Nacional por Amostra de Domicílios Contínua. O recorte etário foi estabelecido entre 30 e 69 anos e a evolução das taxas no tempo foi feita por meio de modelos autorregressivos integrados de média móvel em plataforma estatística R. RESULTADOS As taxas de mortalidade precoce por doenças respiratórias crônicas apresentam-se decrescentes no Brasil como um todo e na maior parte das capitais, assim como, há tendência a atingir a meta do Ministério da Saúde na maior parte do país. Para capitais que tendem a não atingir a meta, verifica-se associação entre mortalidade e indicadores sociais, rede assistencial de saúde e frequência do tabagismo. CONCLUSÃO Pretende-se que o estudo possibilite um melhor planejamento do sistema público de saúde para o controle das doenças respiratórias crônicas.

ABSTRACT OBJECTIVE To analyze the time trend of monthly mortality rates from chronic respiratory diseases in Brazil from 1996 to 2017, with forecasts for 2022, besides analyzing the possibility of achieving the goal of the Plano de Ações Estratégicas para o Enfrentamento das Doenças Crônicas Não Transmissíveis no Brasil (Strategic Action Plan to Tackle Chronic Noncommunicable Diseases in Brazil) from 2011 to 2022. METHODS This is an ecological study that uses data from Sistema de Informações sobre Mortalidade (SIM – Mortality Information System), Sistema de Informações Demográficas e Socioeconômicas (Demographic and Socioeconomic Information System) and Pesquisa Nacional por Amostra de Domicílios Contínua (PNAD Contínua – Continuous National Household Sample Survey). We established the age range between 30 and 69 years old and the evolution of the rates over time was made by autoregressive integrated moving average models in R statistical tool. RESULTS Premature mortality rates from chronic respiratory diseases are decreasing in Brazil as a whole, mostly in state capitals. There is also a trend to reach the Ministry of Health’s goal in most of the country. For capitals that tend not to reach the goal, there is an association between mortality and social indicators, healthcare network and frequency of smoking. CONCLUSION This study intends to improve planning of the public health system for the control of chronic respiratory diseases.

Abstract Introduction: Identification of hepatitis B virus carriers in blood donors is imperative in order to avoid transmission of the disease via blood transfusion. Objective: To determine if blood donors with positive results for serological markers HBsAg and anti-HBc were hepatitis B virus DNA carriers. Methods: 12,745 samples were collected from six Ecuadorian blood banks and analyzed for HBsAg, anti-HBc and anti-HBs infectious markers by automated ELISA. All samples that tested positive for one, two or all three markers were analyzed with molecular techniques to determine the presence of viral DNA. Results: 27.5 % of the samples that were reactive for anti-HBc alone and 100 % of those with positive results for HbsAg and IgM/IgG anti-HBc were identified to contain hepatitis B virus DNA (p = 0.001). Conclusions: The selection of infection markers, as well as the detection methods define the results. Performing two serological and one molecular test is important in order to identify hepatitis B virus carriers and prevent its transmission.

Resumen Introducción: La identificación de portadores del virus de la hepatitis B en donantes de sangre es imperativo para evitar la transmisión de la enfermedad a través de transfusiones sanguíneas. Objetivo: Determinar si los donantes de sangre con resultados positivos de los marcadores serológicos HbsAg y anti-HBc eran portadores de ADN del virus de la hepatitis B. Métodos: Se recolectaron 12 745 muestras de seis bancos de sangre ecuatorianos, las cuales fueron analizadas con pruebas serológicas para identificar los marcadores infecciosos HBsAg, anti-HBc, anti-HBs mediante prueba ELISA automatizada. Todas las muestras positivas para uno, dos o los tres marcadores fueron analizadas con técnica molecular para determinar la presencia de ADN viral. Resultados: Se identificó que 27.5 % de las muestras reactivas solo a anti-HBc y 100 % de las muestras con resultados positivos de HBsAg/anti-HBc-IgM/IgG presentaron ADN del virus de la hepatitis B (p = 0.001). Conclusiones: La elección de los marcadores de infección y los métodos de detección definen los resultados. Es importante la realización de dos pruebas serológicas y una molecular para identificar a los portadores del virus de la hepatitis B y evitar su transmisión.

This research is framed in the context of the Peruvian public education, where the teaching of the English language has been the objective of unsuccessful reforms aimed at improving the situation of oblivion in which it has been for decades. At a time when the Ministry of Education has launched a new policy to ensure that all students who graduate from public school can express their ideas efficiently in English, it is advisable to know the effectiveness of these changes. Using data collected from the protagonists, this study gives account of the factors that are facilitating or impeding its implementation, as well as their early successes, to identify useful elements for decisions that ensure the quality of the teaching of English in public schools.

La presente investigación se enmarca en el contexto de la educación pública peruana, donde la enseñanza del idioma inglés ha sido objeto de infructuosas reformas tendientes a mejorar la situación de olvido en la que se ha encontrado por décadas. En momentos en que el Ministerio de Educación (Minedu) ha puesto en marcha una nueva política para lograr que todo egresado de la escuela pública pueda expresarse eficientemente en el idioma inglés, es oportuno conocer la eficacia de estos cambios. Mediante datos recogidos de los protagonistas, el presente estudio da cuenta de los factores que están facilitando o impidiendo su aplicación, así como de sus primeros logros, a fin de identificar elementos útiles para la toma de decisiones que aseguren la calidad de la enseñanza de inglés en los colegios públicos.

A presente investigação enquadra-se no contexto da educação pública peruana, onde o ensino da língua inglesa tem sido objeto de reformas infrutíferas tendentes a melhorar a situação de esquecimento em que se encontra há décadas. No momento em que o Ministério da Educação lançou uma nova política para garantir que todos os graduados em escolas públicas possam se expressar de maneira eficiente no idioma inglês, é oportuno conhecer a eficácia dessas mudanças. Utilizando dados coletados dos protagonistas, o presente estudo dá conta dos fatores que facilitam ou dificultam sua aplicação, bem como de suas primeiras conquistas, a fim de identificar elementos úteis para a tomada de decisões que garantam a qualidade do ensino de inglês em escolas públicas.

ABSTRACT BACKGROUND: Serological tests are practical, with low cost, but no noninvasive tests are available for diagnosing Helicobacter pylori (H. pylori) infection in Brazil. The aim here was to develop and validate enzyme-linked immunosorbent assay (ELISA) serological tests to detect anti-H. pylori immunoglobulin G antibodies, based on cultured strains from Brazilian patients. DESIGN AND SETTING: Cross-sectional, diagnostic accuracy study comparing a locally developed and validated ELISA and invasive tests among dyspeptic patients at two public hospitals in São Paulo, Brazil. METHODS: An ELISA test was prepared using whole-cell antigen from 56 strains. After genotypic characterization, it was standardized and optical density (OD) cutoffs were determined based on the serum antibody response of 100 H. pylori-negative samples, compared with 82 H. pylori-positive samples. Validation was performed on 174 symptomatic patients. RESULTS: The optimal OD cutoffs established (for monoclonal and polyclonal tests, respectively) were 0.167 and 0.164; overall ELISA sensitivity: 84.3%, 78.9%; specificity: 88.6%, 90.6%; positive predictive value (PPV): 75.4%, 80%; negative predictive value (NPV): 93.1%, 81.8%; accuracy: 87.3%, 86.2%; child and adolescent ELISA sensitivity: 74.2%, 81.8%; specificity: 90.8%, 86.7%; PPV: 66.6%, 84.3%; NPV: 95.8%, 84.8%; accuracy: 88.5%, 84.6; adult ELISA sensitivity: 84.4%, 75%; specificity: 86.9%, 93%; PPV: 81.8%, 78.3%; NPV: 88.9%, 91.8%; accuracy: 85.9%, 88.5%. CONCLUSION: The polyclonal serological test developed using local strains presented better diagnostic performance among children and adolescents, while the monoclonal test was better among adults. The results from both tests suggest that these in-house serological tests could be used to detect anti-H. pylori antibodies in our population, for screening purposes.

Abstract In this paper, we analyze the most relevant relationships between budgetary stability, the Municipal Financing System (SFM) and social expenditure policies, as fundamental pieces to define the level of Corporate Social Responsibility (CSR) that can be assigned to Spanish municipalities. We have started from the budgets of the 9,500 municipalities and other local Spanish entities, presented to the Court of Auditors in 2014, and available on the website of the Ministry of Finance. Based on this information, we developed a database (more than 1,500,000 records, big data, treated by data mining techniques) to perform an analysis of the most significant factors explaining the relationship between budgetary stability, financial sufficiency and sustainability of welfare policies. Based on the above and the level of budgetary expenditures in the Basic Public Services programs (AG1) and the Social Promotion Protection Actions program (AG2), we propose two indicators to measure the level of CSR attributable to each municipality. The main findings of our research are summarized in three conclusions: that municipalities with budget deficits prioritize the reduction of their debt with financial institutions while diluting payment to suppliers; That the relations between the income and expenditure policies of each municipality have a direct impact on their level of CSR; And that, using a logit probability model, the hypothesis according to which the RSC of the municipalities can be explained by the size of their population and the way in which they are financed is confirmed.

Resumen En este trabajo analizamos las relaciones más relevantes entre la estabilidad presupuestaria, el Sistema de Financiación de los Municipios (SFM) y las políticas de gasto social, como piezas fundamentales para definir el nivel de Responsabilidad-Social-Corporativa (RSC) asignable a los municipios españoles. Para ello, hemos partido de las liquidaciones presupuestarias de los 9.500 municipios y otros entes locales españoles presentadas ante el Tribunal de Cuentas en 2014, y disponibles en la web del Ministerio de Hacienda. A partir de la información, elaboramos una base de datos (más de 1.500.000 registros, tratados mediante técnicas de data mining) para realizar un análisis de los factores más significativos que explican las relaciones entre estabilidad presupuestaria, suficiencia financiera y sostenibilidad de las políticas de bienestar. Partiendo de lo anterior y del nivel de gastos presupuestarios en el área de gasto (AG1) de Servicios Públicos Básicos y en el área de gasto (AG2) de Actuaciones de Protección de Promoción Social proponemos dos indicadores para medir el nivel de la RSC atribuible a cada municipio. Los principales hallazgos se concretan en tres conclusiones: que los ayuntamientos con déficit presupuestario priorizan la reducción de su deuda con las entidades financieras a la vez que dilatan el pago a los proveedores; que las relaciones entre las políticas de ingresos y gastos de cada municipio repercuten directamente en su nivel de RSC; y que, mediante un modelo de probabilidad logit, se confirma la hipótesis según la cual la RSC de los municipios puede ser explicada a partir del tamaño de su población y de la forma en que se financian.

RESUMO Tanto a presença de cães com dono quanto de cães vadios permitem a disseminação de Toxocara, e o parasita está presente no solo, na água e nos alimentos. Animais, incluindo cavalos, apresentam-se como hospedeiros definitivos e paratênicos. No México, o consumo de carne de cavalo é comum, e Toxocara é um parasita zoonótico. ELISA foi escolhido para análise, já que hospedeiros paratênicos não jogam ovos de Toxocara em suas fezes. O objetivo deste estudo foi identificar a presença de anticorpos anti-Toxocara por ELISA, em cavalos de trabalho e em cavalos para o consumo humano. As amostras de sangue foram retiradas de 188 cavalos: 94 cavalos de trabalho e 94 cavalos de trabalho do matadouro. Soros dos animais foram analisados por ELISA e 44,6% dos equinos apresentaram anticorpos anti-Toxocara. Cavalos adultos para abate têm 61,7% mais elevada a presença de anticorpos anti-Toxocara (P = 0,006). Anticorpos IgG Toxocara foram encontrados em cavalos, confirmando cavalos paratênicos como hospedeiros e possíveis fontes de infecção para outros animais e pessoas.

ABSTRACT Both the presence of owned dogs and stray dogs allows the spread of Toxocara, a parasite whose eggs can be found in soil, water and food. Animals, including horses, serve as definitive and paratenic hosts. In México, where consumption of horse meat is common, Toxocara is a zoonotic parasite. The aim of this study was to identify the presence of anti-Toxocara antibodies in work horses and horses intended for human consumption by ELISA. ELISA was chosen for analysis as paratenic hosts do not shed Toxocara eggs in their feces. Blood samples were collected from a total of 188 horses, 94 of which were work horses and 94 horses from the slaughter house. Samples were analyzed by ELISA, and the general equine seroprevalence was found to be 44.6% (n = 188). Adult horses for slaughter had a 61.7% greater presence of anti-Toxocara antibodies (p = 0.006). Toxocara IgG antibodies were found in horses, confirming that horses are paratenic hosts and possible sources of infection for other animals and people.

Between 1999-2002, Médécins Sans Frontières-Spain implemented a project seeking to determine the efficacy and safety of benznidazole in the treatment of recent chronic Chagas disease in a cohort of seropositive children in the Yoro Department, Honduras. A total of 24,471 children were screened for Trypanosoma cruzi IgG antibodies through conventional enzyme-linked immunosorbent assays (ELISA) on filter paper. Recombinant ELISA (0.93% seroprevalence) showed 256 initially reactive cases, including 232 confirmed positive cases. Of these, 231 individuals were treated with benznidazole (7.5 mg/kg/day) for 60 days and were followed with a strict weekly medical control and follow-up protocol. At the end of the project, 229 patients were examined by the Honduras Secretariat of Health for post-treatment serological assessments; 88.2% seroconverted after 18 months and 93.9% seroconverted after three years. No differences were found in the seroconversion rates according to age or sex. Most of the side effects of the treatment were minor. These results support the argument that in areas where T. cruzi I is predominant and in areas affected by T. cruzi II, when vector transmission has been interrupted, Chagas disease diagnosis and treatment are feasible, necessary and ethically indisputable.

In nearly all of the previous multicentre studies evaluating serological tests for Trypanosoma cruzi infection, sera samples from Central or South American countries have been used preferentially. In this work we compared the reliability of the serological tests using Mexican sera samples that were evaluated in four independent laboratories. This included a reference laboratory in Brazil and three participant laboratories, including one in Central America and two in Mexico. The kappa index between Brazilian and Honduran laboratories reached 1.0 and the index for the Mexican laboratories reached 0.94. Another finding of this study was that the source of antigen did not affect the performance of the serological tests.

Background: Lipoprotein (a) [Lp (a)] is an independent risk factor for coronary artery disease and normal serum levels of this particle is not known in our country. Thus, the aim of this study was to determine plasma Lp (a) concentration in a population sample of Maracaibo. Patients and method: Fifth hundred out-patients, consulting at Centro de Investigaciones Endocrino-Metabólicas "Dr. Félix Gómez" were randomly underwent to venipunction to obtain a fasting blood simple to assess Lp (a) by a ELISA assay. Results: No significantly differences were found when compared by sex or age separately, higher levels in Lp (a) was found in female 40-44 year group (median: 20,9 mg/dl). Thus, female population was divided in two sub-groups: < 40 years (median: 13 mg/dl) 40 yr and more (median: 16 mg/dl), finding higher Lp (a) levels in the second group (p < 0,02). Hormonal replace therapy was assessed by age, resulting that women subjected this approach shows lower levels of Lp (a) (p < 0,01), except in 60-64 year group. Conclusions: Lp (a) in a Maracaibo was within normal levels. Hormonal replace therapy diminishes Lp (a) concentration in menopausal women, but in menopausal women without hormonal therapy Lp (a) levels experienced a sustained decrease to normal levels in a age-depended manner.

Objetivo: La lipoproteína (a) se considera un factor de riesgo para enfermedad cardiovascular. En Venezuela se desconoce su comportamiento por lo que el objetivo de este estudio fue determinar la concentración de lipoproteína (a) en individuos de la ciudad de Maracaibo. Métodos: 500 individuos sanos que acudieron al Centro de Investigaciones Endocrino-Metabólicas, a los que se les cuantificó la lipoproteína (a) por ELISA. Resultados: La lipoproteína (a) no mostró diferencias significativas ni por edad ni sexo en la población general. En el grupo de mujeres de 40-44 años se observó una tendencia a niveles mayores, por lo que el género femenino se dividió en dos grupos: a) < 40 años (mediana: 13 mg/dl); y b) 40 años y más (mediana: 16 mg/dl); (p < 0,02). Al descomponer el grupo de 40 y mas años según recibir terapia de reemplazo hormonal o no, aquellas que recibieron terapia de reemplazo hormonal siempre exhibieron una concentración de lipoproteína (a) menor; (p < 0,01), salvo en el grupo de los 60-64 años, donde no hubo diferencia. Conclusiones: La lipoproteína (a) en la muestra estudiada se encuentra dentro de los límites considerados como normales. La terapia de reemplazo hormonal disminuye la lipoproteína (a) en mujeres menopáusicas, sin embargo, en las mujeres sin terapia de reemplazo hormonal, la lipoproteína (a) experimenta una disminución progresiva para alcanzar niveles idénticos a aquellas con terapia de reemplazo hormonal en el grupo de 60-64 años.

Chemical composition (moisture, crude protein, crude fibre, ether extractables, ash, and nitrogen-free extract) was determined in three marine algae and one sea grass of the Pacific coast of Baja California Sur. Samples of Eisenia arborea, Macrocystis pyrifera, Gelidium robustum, and Phyllospadix torreyi from natural populations were evaluated in October 1995, and January, May, and August 1996. Nitrogen-free extract, mainly carbohydrates, was the most important constituent in all species, followed by ash, protein, crude fibre, and ether extractables (mainly lipids) in brown algae species. In red algae protein content was higher than ash. Sea grass (P. torreyi) had high crude fibre, followed by ash, protein, and other extractables.

Se determinó la composición química (humedad, proteína cruda, fibra cruda, extracto etéreo, cenizas y extracto libre de nitrógeno) en tres macroalgas marinas y un pasto marino abundantes en las costas del Pacífico de Baja California Sur. Poblaciones naturales de Eisenia arborea, Macrocystis pyrifera, Gelidium robustum y Phyllospadix torreyi fueron muestreadas en Octubre 1995 y en Enero, Mayo y Agosto de 1996. El extracto libre de nitrógeno, principalmente carbohidratos, fue el constituyente de mayor proporción en las especies estudiadas. En algas pardas, y en orden decreciente le siguen a los carbohidratos, cenizas, proteína cruda, fibra cruda y extracto etéreo (principalmente lípidos). En algas rojas, el contenido de proteína cruda fue mayor que el de cenizas. En contraste, en el pasto marino (P. torreyi) se obtuvieron valores altos de fibra cruda, seguidos de cenizas, proteína cruda y extracto etéreo.

This study assessed public acceptance for two new vectorial control techniques for Chagas' disease: insecticidal paint and fumigant canisters. The study compared the two with traditional fenitrothion insecticide spraying. An experimental field study was performed in an endemic area of central Honduras from August to November 1992, a year after the initial application of the treatments. The objectives of the study were to determine the acceptability of the tools on the part of the population whose homes were treated, and on the part of the personnel applying the treatments. The sample size was drawn up according to a uniform protocol applied in six Latin American countries. For this study a total of 651 persons were surveyed in 15 rural communities. Along with the surveys, focus groups were used to collect information to learn the reasons for accepting or rejecting particular treatments. The survey was done with heads of households. Focus groups were done with heads of households and also with the field operators who applied the treatments. The research showed that insecticidal paint had a low level of community acceptance (28.8%). Field operators strongly disliked the paint because of problems with its transport, application, unpleasant smell, and very low effectiveness against triatomines and pest insects. The traditional insecticide was more acceptable to the community (93.9%) and to the field operators, especially for its strong effect against the triatomines and pest insects. The results showed that in order to increase the public acceptance for insecticidal paint, it would be necessary to make the paint easier to transport and apply and to increase its effectiveness. Because of their very low effectiveness, fumigant canisters did not represent an acceptable alternative for triatomine vector control. A public educational effort should be a component of any new control method developed.

Este estudio analizó la aceptación por la comunidad de dos nuevas técnicas de control de los vectores de la enfermedad de Chagas: la pintura insecticida y los botes de fumigación. Ambas fueron comparadas con la tradicional pulverización con fenitrotión. Entre agosto y noviembre de 1992, un año después de la aplicación inicial de los tratamientos, se realizó en una zona endémica del centro de Honduras un estudio experimental de campo para determinar la aceptación de las nuevas técnicas por parte de la población cuyas casas fueron tratadas y por parte del personal que aplicó los tratamientos. El tamaño de la muestra se calculó de acuerdo con un protocolo uniforme aplicado en seis países de América Latina. Se encuestaron 651 cabezas de familia de 15 comunidades rurales y se utilizaron grupos de enfoque para obtener información sobre los motivos que llevaron a los participantes a aceptar o rechazar los tratamientos utilizados; en estos grupos, además de los cabezas de familia, también participaron los trabajadores de campo que aplicaron los tratamientos. Los resultados obtenidos revelaron que la pintura insecticida tenía un bajo nivel de aceptación por la comunidad (28,2%); a los trabajadores les gustaba muy poco por los problemas relacionados con su transporte, aplicación, olor desagradable y muy baja efectividad frente a los triatominos y otros insectos. El insecticida tradicional fue más aceptable tanto para la comunidad (93,9%) como para los trabajadores, sobre todo por su potente efecto frente a los triatominos y otros insectos. Para incrementar la aceptación de la pintura insecticida sería necesario hacer más fácil su transporte y aplicación e incrementar su efectividad. Debido a su muy baja efectividad, los botes de fumigación no representaron una alternativa aceptable para el control de los triatominos. Una iniciativa de educación pública debería ser un componente de cualquier nuevo método de control que se desarrolle.

From November to December 1991 and in March 1993 a survey was conducted in 17 rural communities located in Central Honduras. The communities belonged to two areas where Chagas' disease is endemic. In one of them, disease control activities had been conducted. A total of 849 adults, one in each of an equal number of households, was interviewed. The objective of the survey was to investigate and compare in both locations knowledge about Chagas' disease and its routes of transmission, measures aimed at avoiding the presence of triatomines within households, beliefs surrounding the vector and its control, and the population's sources of information about the disease. A 23-item questionnaire was tested and precoded. Almost 100% of the subjects who were surveyed were able to identify the vector and to describe its habits, but only 30,1% knew that Triatoma is the vector for the disease and only about 6% associated it with a chronic heart condition. Around 47,9% of survey subjects indicated that eliminating triatomines from households is a personal responsibility, although 78% identified as the control measure the institutional application of insecticides. Personal contact between a health worker and community members was the chief source of information for those who mentioned having heard of Chagas' disease (41,0%). These results suggest that health education should be included as a component in the planification of control programs. The role played by triatomines in disease transmission should be emphasized, as well as the importance of carrying out household improvements, with community participation, as an effective and sustainable measure. To achieve greater impact, this component should be developed through interpersonal communication channels.

En el período de noviembre a diciembre de 1991 y en marzo de 1993 se realizó una encuesta en 17 comunidades rurales de la parte central de Honduras. Las comunidades correspondían a dos zonas en las que la enfermedad de Chagas es endémica. En una de las zonas habían tenido lugar actividades de control de la enfermedad. Fueron entrevistados 849 adultos, uno en cada uno de otros tantos hogares familiares. El objetivo de la encuesta fue investigar y comparar en ambas zonas los conocimientos sobre la enfermedad de Chagas y sus mecanismos de transmisión, las prácticas para evitar la presencia de triatómidos en las viviendas, las creencias acerca de los triatómidos y su control, y las fuentes a partir de las cuales la población obtiene información sobre la enfermedad. Se utilizó un cuestionario de 23 preguntas validado y precodificado. Casi 100% de los entrevistados pudieron reconocer el vector y conocían sus hábitos, pero solo 30,1% sabían que el Triatoma es vector transmisor de la enfermedad y apenas 6% pudieron mencionar su relación con una afección cardíaca crónica. El 47,9% de los entrevistados indicó que la responsabilidad de eliminar los triatómidos de la vivienda es personal, aunque 78% consideraron como medida de control la aplicación institucional de insecticidas. El contacto personal entre el funcionario institucional y los miembros de la comunidad fue la principal fuente de información entre los que mencionaron haber oído de la enfermedad de Chagas (41,0%). Los resultados sugieren que al planificar medidas de control se debe incluir el componente de educación sanitaria. Ha de ponerse énfasis en el papel que desempeñan los triatómidos en la transmisión, así como en la importancia de mejorar la vivienda como medida eficaz y sostenible mediante la participación de la comunidad. Este componente deberá ser desarrollado por canales de comunicación interpersonales para obtener un mayor impacto.

It is demonstrated the lack of knowledge existing among health profesionals about certain aspects of medical ethics, in spite of their extraordinary importance. A survey model is designed and applied to different doctors working at the primary and secondary health care level at the municipality of Plaza de la Revolución, in Havana City. The results obtained corroborate our hypothesis: just one third of the doctors who participated in the survey, despite their years of experience and the high qualification in general of the sample, answered satisfactorily. Other interesting conclusions derived from the analysis of the results are offered

Se demuestra el desconocimiento que de determinados aspectos de la ética médica existe en los profesionales de la salud, a pesar de la extraordinaria importancia que éstos tienen. Se diseña un modelo de encuesta que se aplica a diferentes médicos que brindan asistencia en la atención primaria y secundaria del municipio Plaza de la Revolución en la Ciudad de La Habana; se obtiene resultados que corroboran nuestra hipótesis: sólo la tercera parte de los médicos encuestados, a pesar de sus años de experiencia y de la alta calificación en general de la muestra seleccionada, responde satisfactoriamente la encuesta. Se ofrecen otras conclusiones en el análisis de los resultados del trabajo que resultan de gran interés