Understanding the social determinants of health/disease: Intestinal parasites and malnutrition in the families of Urabá, Colombia

Adriana María Correa Botero, Jaime Carmona-Fonseca


Background: The triple burden of endemic pathogenic intestinal parasites (PIP), malaria, and hunger-malnutrition remains quite common in many countries of the Americas, Africa, and Asia.

Objective: The objective of this paper is to use the tools of critical epidemiology to examine the prevalence of PIPs and malnutrition and to describe the living conditions of children aged <15 years and their fam-ilies in the Urabá region within the Department of Antioquia in northwest Colombia.

Results: Chronic malnutrition affected 55% of male children and 45% of female children; this difference was statistically significant. (p < 0.003). Depending upon the age, 49% to 79% of children had anemia. Pathogenic parasites were found in 87% of chil-dren; 63% had protozoa and 69% had helminth infections.

Parents have little formal education and very limited training in specific trades. Their jobs pay very little and many are not stable. Gainfully employed mothers (20% of total) always held jobs involving low-skill activities.

Housing is of poor quality; more than half of homes have dirt or sand floors and metal roofs (in a region with high annual temperatures). Three quarters of the families use rainwater (alone or with another source) for drinking and cooking.


From 1965 to 2013, Urabá’s living conditions have improved little, judging from what we have learned about the prevalence of PIPs, hunger and malnutrition, and living conditions.

The current living conditions and the economic and political model in Urabá produces and maintains these conditions and prevents any improvement or solution to these problems.

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