Determinantes sociales del parasitismo intestinal, la desnutrición y la anemia: revisión sistemática

OBJECTIVE. Characterize the publications on social determinants of intestinal parasitism, malnutrition, and anemia at the global level. METHODS. A systematic review was conducted of the scientific literature in Pubmed, Science Direct, SciELO, LILACS, and Google Scholar with eight search strategies, guaranteeing completeness and replicability, following the phases of the PRISMA guidelines. RESULTS. The review included 18 studies on malnutrition, three on parasitism, three on anemia, and two on both parasitism and malnutrition; 65.4% of the studies were from South America and 69.2% were carried out among children. The prevalence of intestinal parasitism ranged between 30.6% and 83.3%; anemia, 19.7% to 48.0%; and malnutrition, 0.0% to 67.8%. It was found that biological and psychosocial determinants were most frequently studied; the most frequently studied intermediate determinants were related to housing and income; and structural determinants were least investigated. The social determinants common to the three conditions include: living in homes with poor sanitary conditions, rural areas, inadequate housing, inadequate water supply, access barriers to the medical system, young parents with little schooling, precarious employment, and low income. CONCLUSION. The majority of publications do not conduct a multilevel analysis for individual, intermediate, or structural determinants. Greater efforts are needed in health policies that address the social determinants of inequality with respect to parasitism, malnutrition, and anemia, mainly in categories as macroeconomic policy, social class, labor market, culture, values, and territory.