Intestinal parasitic infections and associated factors among street dwellers and prison inmates: A systematic review and meta-analysis

Background Intestinal parasitic infections are closely associated with low household income, poor personal and environmental sanitation, and overcrowding, limited access to clean water, tropical climate and low altitude. Street dwellers and prisoners are forced to live in deprived situations characterized by inadequate facilities. Therefore, this study aimed to estimate the pooled prevalence and associated factors of intestinal parasitic infections among street dwellers and prison inmates. Method Study searches were carried out in Electronic data bases such as PubMed/Medline, HINARI, EMBASE, Science Direct, Scopus, Google Scholar and Cochrane Library. Studies published only in English and have high quality Newcastle Ottawa Scale (NOS) scores were included for analysis using Stata version 14 software. Random-effects meta-analysis model was used for analysis. Heterogeneity was assessed using the Cochrane’s Q test and I2 test statistics with its corresponding p-values. Moreover, subgroup, sensitivity analyses and publication bias were computed. Result Seventeen eligible studies consist of 4,544 study participants were included. Majority of the study participants were males (83.5%) and the mean age of the study participants was 25.7 years old. The pooled prevalence of intestinal parasitic infections among street dwellers and prison inmates was 43.68% (95% CI 30.56, 56.79). Sub-group analysis showed that the overall pooled prevalence of intestinal parasitic infections among prison inmates and street dwellers was 30.12% (95%CI: 19.61, 40.62) and 68.39% (95%CI: 57.30, 79.49), respectively. There was statistically significant association between untrimmed fingernail and intestinal parasitic infections (AOR: 1.09 (95%CI: 0.53, 2.23). Conclusion In this study, the pooled prevalence of intestinal parasitic infections among street dwellers and prison inmates was relatively high. Fingernail status had statistically significant association with intestinal parasitic infection. The prevention and control strategy of intestinal parasitic infection should also target socially deprived segment of the population such as street dwellers and prison inmates.

The Health Equity Network of the Americas: inclusion, commitment, and action

The Health Equity Network of the Americas (HENA) is a multidisciplinary network that promotes knowledge sharing and intersectoral action for equity in health and human rights in the Americas. The objectives of HENA are: 1) to share successful experiences in the development of interventions, considering the social determinants and determination of health, to achieve participatory and community-based health responses; 2) to analyze the health, social, political, environmental and economic impacts of the COVID-19 pandemic; 3) to identify the effects of pandemic care on populations most at risk because of their age and pre-existing health conditions; 4) examine the situation at borders and population movements in the spread of the pandemic and its effects on migrant populations; 5) propose strategies to ensure access to comprehensive care for pregnant women in order to reduce maternal and neonatal suffering, morbidity, and mortality; and 6) analyze violations of human rights and the right to health of historically marginalized populations, including street dwellers and other communities that depend on public spaces and the street for survival. The analytical and intervention models for health equity at HENA are based on various approaches, including social medicine, social epidemiology, medical anthropology, human ecology, and One Health.

Narratives of city exposure: Incarnations of the street person in Zanta: The Living Legend and The Dregs

This article examines the rationale for definitions of the homeless in the public imagination and the kind of discourses used to create a physical, psychological, and moral distance between the domiciled and the destitute. In a society where the worthy individual is tied to an ideal of entrepreneurial, rational, homed, successful consumer, and where public space is solely destined for the unobstructed consumption of the privileged, street dwellers are naturally seen as a threat to the economic, social, and moral order as well as a visual blemish: an obstacle to safety and wellbeing. Drawing from a number of sociological, urban, and narrative studies on the survival tactics of homeless people, and especially from Nicholas Blomley’s (2010) insights about street mobility and Leon Anderson’s (2017) classifications of stigma management, this article describes how subjects defined as pathological, dangerous, or pitiful, negotiate street restrictions and create their own standing within a revanchist city. These individuals feature in two comic books published in Canada, Zanta: The Living Legend (2012) and The Dregs (2017), whose originality lies in the heroic role the street person assumes, a legitimate searcher for meaning that sees what most people overlook. In their different format as non-fiction comic and serialized fictional comic we find the expressive visual and narrative potential of the genre and become witnesses of the tribulations of two characters whom the world may consider as deranged but are, however, able to enhance their self-esteem, dismantle ideologies behind assumed notions of respectability, and actively contribute to the city as a place of encounter with difference.

Health, illness and healthcare-seeking behaviour of the street dwellers of Dhaka City, Bangladesh: qualitative exploratory study

ObjectiveThis study explored the illness experiences and healthcare-seeking behaviour of a cross-section of street dwellers of Dhaka City for designing a customised intervention.DesignA qualitative exploratory study of a sample of street dwellers of Dhaka City.SettingSamples were taken from three purposively selected spots of Dhaka City with a high concentration of the target population.ParticipantsFifteen in-depth interviews and six informal group discussions with 40 street dwellers (≥18 years), and key informant interviews with service providers (n=6) and policymakers (n=3) were conducted during January–June 2019 to elicit necessary data.Primary outcome measuresQualitative narrative of illness experiences of the sampled street dwellers, relevant healthcare-seeking behaviour and experiences of interactions with health systems.ResultsWe focused on three main themes, namely, reported illnesses, relevant healthcare-seeking behaviour and health system experiences of the street dwellers. Findings reveal that most of the street dwellers suffered from fever and respiratory illnesses in the last 6 months; however, a majority did not visit formal facilities. They preferred visiting retail drug shops for advice and treatment or waited for self-recovery. Formal facilities were visited only when treatment from drug shops failed to cure them or they suffered serious illnesses or traumatic injury. The reproductive-age women did not seek pregnancy care and most deliveries took place in the street dwellings. Lack of awareness, financial constraints and fear of visiting formal facilities were some of the reasons mentioned. Those who visited formal facilities faced barriers like the cost of medicines and diagnostic tests, long waiting time and opportunity cost.ConclusionsThe street dwellers lacked access to formal health systems for needed services as the latter lags far behind to outreach this extremely vulnerable population. What they need is explicit targeting with a customised package of services based on their illness profile, at a time and place convenient to them with minimum or no cost implications.

Tuberculosis control from the perspective of health professionals working in street clinics

ABSTRACT Purpose: to present the opinion of professionals about street dwellers undergoing treatment of tuberculosis and identify strategies of control of tuberculosis in this population. Method: an exploratory and descriptive study involving 17 health professionals working in street clinics. A semi-structured study composed of closed questions and a guiding question. The statements were analyzed using the discourse analysis technique, resulting in the identification of two analytical categories: 1. Meanings attributed to street dwellers with tuberculosis, and 2. Control of tuberculosis in homeless people. Results: the analysis identified situations that limited adherence to tuberculosis treatment, including the reasons for staying in the streets, living conditions, and risk factors (dependence on alcohol and other drugs, short-sightedness, constant relocations, and lack of perspectives). Street dwellers were knowledgeable about the disease. Furthermore, there were difficulties in solving several problems of people living in the streets, including living conditions and lifestyle, social stigma, relocations, drug abuse, and lack of life project. Conclusion: coping with the complexity of situations related to living in the streets limits to the work of health professionals because these situations go beyond health care and require intersectoral actions.

ESCAVAÇÕES

"Escavações" é uma experimentação artística realizada pelo Coletivo Fabulografias, ligado ao Laboratório de Estudos Audiovisuais - OLHO da Faculdade de Educação - Universidade Estadual de Campinas - Unicamp (SP), exposta em 2015 no Museu da Imagem e Som de Campinas - SP na Mostra "Aparições" organizada pelo Laboratório de Estudos Avançados em Jornalismo - LABJOR - Unicamp. Inspirados nas fotografias de Francesca Woodman, nas imagens de Tom Lisboa (Palimpsestos) e Leila Danzinger (Todos os nomes da melancolia) em obras que tem como suporte o papel jornal, e pela poesia Escova, de Manoel de Barros, o Coletivo Fabulografias propõe nesta exposição pensar uma intervenção pela poética do fragmento e fazer surgir das palavras-jornal o indizível e o insuportável. As produções imagéticas foram disparadas por minicontos escritos pelo Coletivo Fabulografias a partir de encontros dos pesquisadores-artistas com grupos minoritários: moradores de rua, profissionais do sexo, trabalhadores dos serviços de limpeza da universidade, indígenas... A partir dos contos lançamo-nos as produções imagéticas com o jornal, escavando nas matérias jornalísticas as narrativas que não se fazem presente, esvaziando as letras e palavras e imagens e compondo uma narrativa poética que faz pulsar o silenciamento e a invisibilidade. PALAVRAS-CHAVES: Fotografia, experimentação, jornal. ABSTRACT “Excavations” is an artistic experiment conducted by the Collective Fabulografias, linked to the Laboratory of Audiovisual Studies – OLHO, of the Faculty of Education – Universidade Estadual de Campinas (Unicamp - SP) , which was exposed in 2015 at the Image and Sound Museum of Campinas - SP at the Mostra “Aparições” organized by the Laboratory of Studies Advanced in Journalism - LABJOR - Unicamp. Inspired by the photographs of Francesca Woodman, in the images of Tom Lisboa (Palimpsestos) and Leila Danzinger (All Names of Melancholy) in works supported by the newspaper, and by the poetry by Manoel de Barros, the Fabulogfrafias Collective proposes in this exhibition to think an intervention by the poetics of the fragment and to make appear from the newspaper words the unspeakable and the unbearable. The imagery productions were triggered by texts written by the Collective Fabulographs from meetings of researchers-artists with minority groups: street dwellers, university cleaning workers, indigenous people... From the short stories we launched the imaginary productions with the newspaper, digging in the journalistic subjects the narratives that are not present, emptying the letters and words and images and composing a poetic narrative that makes pulsate the silence and the invisibility. KEYWORDS: Photography, experimentation, newspaper. RESUMEN "Excavaciones" es una experimentación artística realizada por el Colectivo Fabulografías, ligado al Laboratorio de Estudios Audiovisuales - OLHO de la Facultad de Educación - Universidad Estadual de Campinas - Unicamp (SP), expuesta en 2015 en el Museo de la Imagen y el Sonido de Campinas - SP en la Muestra "Apariciones" organizada por el Laboratorio de Estudios Avanzados en Periodismo - LABJOR - Unicamp. Inspirado por las fotografías de Francesca Woodman, las imágenes de Tom Lisboa (Palimpsestos) y Leila Danziger (Todos los nombres de abatimiento) en las obras que se apoya en el papel de periódico, y el cepillo poesía, Manoel de Barros, el colectivo propone este Fabulografias la exposición pensar una intervención por la poética del fragmento y hacer surgir de las palabras-periódico lo indecible y lo insoportable. Las producciones imaginales fueron disparadas por minicontos escritos por el Colectivo Fabulografías a partir de encuentros de los investigadores-artistas con grupos minoritarios: moradores de calle, profesionales del sexo, trabajadores de los servicios de limpieza de la universidad, indígenas... A partir de los cuentos nos lanzamos las producciones imagéticas con el periódico, excavando en las materias periodísticas las narrativas que no se hacen presentes, vaciando las letras y palabras e imágenes y componiendo una narrativa poética que hace pulsar el silenciamiento y la invisibilidad. PALABRAS CLAVES: Fotografía, ensayo, periódico.