Diagnóstico de la gestión del riesgo biológico a los programas territoriales de enfermedades transmitidas por vectores de las direcciones territoriales de salud en Colombia 2021

Abstract

Introduction: In the program of promotion, prevention, control and elimination of Diseases Transmitted by ETV Vectors, approximately 1500 auxiliaries and technicians develop activities with exposure to biological risk factors of occupational origin, requiring a diagnosis for the adequate management of the risk that avoids the corresponding diseases and mortality. Objective: To carry out a diagnosis of biological risk management in the territorial programs of ETV in Colombia 2021. Methodology: a descriptive, quantitative study is developed, following the reference framework established in ISO 31000. 24 of 37 Territorial Directorates of Health DTS participated in the phases of analysis of external and internal context, identification of hazards by the methodology of Risk Analysis by Office -ARO-, risk assessment by the methodologies established in GTC 45 (n = 14) and BIOGAVAL NEO (n = 24) and the generation of recommendations from a logical framework. Descriptive analysis of frequencies, analysis of concordance of risk assessment and comparison of proportions of the results by region, company size and category of the DTS were performed. Results: In the analysis of the context, it was observed that it was adequate in 96% and 25% of the DTS in the external and internal spheres respectively. In the comparative evaluation of the GTC 45 risk matrices elaborated, 12 DTS (85.71%) were found, the agreement was weak. In the risk assessment with BIOGAVAL NEO, the level of biological action (NAB) was observed for rabies virus (66.67%), Plasmodium falciparum, Plasmodium vivax (52.38%), SARS CoV-2 (29.17%), Trypanosoma cruzi (20%) and Dengue virus (37.5%); it should be noted that in no biological agent was the biological exposure limit level (LEB) observed. Conclusions: According to the information collected, adequate biological risk management is lacking and no statistically significant differences are observed by region, company size and category of the entity. It is necessary to update the risk matrix for technicians and assistants of territorial ETV programmes, in order to correctly identify, assess and control the risks associated with biological agents. It requires the creation of biosecurity manuals for all DTS and the creation and implementation of epidemiological surveillance programs in DTS where the risk (possible work-related disease) corresponding to 25% of the DTS that participated materialized.