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PubMed1996

Trends in motor vehicle traffic fatalities among Hispanics, non-Hispanic whites and American Indians in New Mexico, 1958-1990.

OBJECTIVE: New Mexico has had the highest motor vehicle fatality rate in the nation for many years. Our objective was to examine ethnic differences and trends in motor vehicle fatality rates. DESIGN: Using death certificate data from the New Mexico Bureau of Vital Records and Health Statistics, we compiled age-adjusted motor vehicle-related mortality rates from 1958-1990 among the three major ethnic groups in New Mexico--Hispanics, white non-Hispanics and American Indians. RESULTS: Over the 33-year study period, American Indians of both sexes had two to three times higher mortality rates than white non-Hispanics. Hispanic males also had higher motor vehicle death rates than white non-Hispanic males. During the 1970s fatality rates peaked, with age-adjusted death rates of 233/100,000 for American Indian males, 74.7 for Hispanic males and 49.3 for white non-Hispanics for the period 1973-1977. Evaluation of successive 5-year birth cohorts showed highest mortality rates for ages 15-29 years for each ethnic group and both sexes, and a dramatic decline in most ethnic, sex and age-specific rates during the last eight years of the study period. CONCLUSION: Although the recent trends indicate favorable changes in motor vehicle fatality rates, our data highlight the need for ethnic and age-specific interventions to further reduce rates of motor vehicle-related mortality in this state.

Accidents, Traffic↗
PubMedDate not supplied

Adverse birth outcomes among Mexican-Americans: are US-born women at greater risk than Mexico-born women?

OBJECTIVE: We examined adverse birth outcomes among Mexican-Americans to determine the effect of country of maternal birth, a measure of acculturation. DESIGN: We conducted a retrospective cohort analysis of birth outcomes among 4800 Mexico-born and 4800 US-born Mexican-American women using Washington State birth certificate data from 1989 to 1994. Length of residence at current address was used to help refine our measure of acculturation. RESULTS: US-born women had a slightly increased risk of preterm birth relative to Mexico-born women [relative risk (RR) 1.18, 95% confidence interval (CI) 1.04-1.33]. Among Mexico-born women, the risk of preterm birth increased with greater duration of current residence. CONCLUSIONS: US-born Mexican-American women had a slightly increased risk of preterm birth despite having more adequate prenatal care, more education, and higher socioeconomic indicators. This may be due to acculturation factors, such as earlier pregnancy, loss of social support systems, and increased smoking or alcohol use. Reducing this risk depends on recognition among health care workers and policy-makers of the potential influence of acculturation on health in this population.

Acculturation↗
PubMed2000

mtDNA affinities of the peoples of North-Central Mexico.

mtDNA haplotypes of representatives of the cosmopolitan peoples of north-central Mexico were studied. Two hundred twenty-three samples from individuals residing in vicinities of two localities in north-central Mexico were analyzed. A combination of strategies was employed to identify the origin of each haplotype, including length variation analysis of the COII and tRNALYS intergenic region, nucleotide sequence analysis of control region hypervariable segment 1, and RFLP analysis of PCR products spanning diagnostic sites. Analysis of these data revealed that the majority of the mtDNA haplotypes were of Native American origin, belonging to one of four primary Native American haplogroups. Others were of European or African origin, and the frequency of African haplotypes was equivalent to that of haplotypes of European derivation. These results provide diagnostic, discrete character, molecular genetic evidence that, together with results of previous studies of classical genetic systems, is informative with regard to both the magnitude of African admixture and the relative maternal contribution of African, European, and Native American peoples to the genetic heritage of Mexico. Phylogenetic analysis revealed that African sequences formed a basal, paraphyletic group.

Africa↗
PubMed1989

Epidemic of Serratia marcescens bacteremia and meningitis in a neonatal unit in Mexico City.

A case-control study was conducted on an epidemic of bacteremia and meningitis caused by Serratia marcescens in the neonatal intensive care unit and special care nursery of a general hospital in Mexico City, Mexico. A 19.9% incidence of bacteremia and meningitis was recorded in contrast to 1.4% and 3.7% during preepidemic and post-epidemic periods; a 69% mortality rate was observed. Peripheral IV catheters and the use of mixed IV fluids prepared in the wards were the major risk factors (P less than 0.001). Rectal and nasopharyngeal cultures were positive in 68% of asymptomatic neonates and hand cultures were positive in 16.7% of personnel. Strains were resistant to all aminoglycosides and broad-spectrum penicillins, and belonged to the A5/8 biogroup. Containment of this outbreak was difficult because of failure to identify colonized infants early in the epidemic and because of persistent carriage of S marcescens by personnel. Comparisons between this hospital and tertiary care centers in Mexico suggest that in developing countries nosocomial infections could be of greater magnitude in secondary than in tertiary level centers.

Cross Infection↗
PubMed1999

Barriers to early detection of cervical-uterine cancer in Mexico.

In Mexico, a woman dies of cervical-uterine cancer every 2 hours, indicating a low impact by the national program for early detection of this cancer, principally because of problems related to quality and coverage. Through a qualitative study, we identified the principal barriers to use of the detection program from the point of view of actual and potential program users. Four focus groups were organized in standard conditions in Mexico City (urban, developed) and in the southern state of Oaxaca (rural, economically disadvantaged area). Participants were either women with at least one previous Papanicolaou (Pap) test or women who had never had the test. Barriers to Pap test use included (1) lack of knowledge about cervical-uterine cancer etiology, (2) not knowing that the Pap test exists, (3) the conception that cancer is an inevitably fatal disease, (4) problems in doctor/medical institution-patient relationships, (5) giving priority to unmet needs related to extreme poverty, (6) opposition by the male sexual partner, (7) rejection of the pelvic examination, (8) long waits for sample collection and receiving results, and (9) perceived high costs for care. To increase coverage of the early detection program for cervical-uterine cancer in Mexico, the needs, perceptions, and beliefs of women and their partners must be taken into account when developing policy and planning, given the role these factors play in the decision-making process that leads to their participation or nonparticipation in this program.

Adult↗
PubMed1992

Estimated mineral intakes of toddlers: predicted prevalence of inadequacy in village populations in Egypt, Kenya, and Mexico.

Intakes of minerals and factors that might affect their bioavailability were estimated for 255 toddlers aged 18-30 mo living in villages in Egypt, Kenya, and Mexico. Mean intakes over 1 y were compared with international-requirement estimates by using a probability approach. The prevalence of iron intakes likely to be inadequate to prevent anemia was estimated as 35% in Egypt, 13% in Kenya, and 43% in Mexico. The prevalence of zinc intakes likely to be inadequate to meet basal requirements was estimated as 57% and 25% in Kenya and Mexico, respectively, but only 10% in Egypt, where the use of yeast-leavened breads was judged to have improved zinc availability. There was no suggestion that estimated copper or magnesium intakes were inadequate, but calcium intakes in Kenya and Egypt were well below recommended amounts. Studies of factors affecting mineral bioavailability in the diets of these countries' populations could suggest dietary changes that might improve effective mineral intake with minimal cost.

Calcium, Dietary↗
PubMed1993

Estimated vitamin intakes of toddlers: predicted prevalence of inadequacy in village populations in Egypt, Kenya, and Mexico.

Vitamin intakes of 255 toddlers (aged 18-30 mo) were estimated from food consumption recorded during 1 y at sites in Egypt, Kenya, and Mexico. Mean intakes were compared with requirements standards by using a probability approach to estimate the prevalence of inadequate intakes. There were predicted inadequacies for vitamin A (32%) and riboflavin (20%) in Egypt, vitamins A (68%) and C (63%) and riboflavin (52%) in Mexico, and vitamin B-12 (44%) in Kenya. Vitamin E was inadequate in all diets, but in relation to polyunsaturated fatty acids only the intake in Mexico was low. No diet provided the recommended amount of vitamin D, but its dietary requirement is uncertain. Correlations among nutrient intakes suggest factors that may contribute to reported associations of consumption of animal products with improved growth or development among these children: provision of vitamin B-12 and available minerals, displacement of fiber and phytate-rich energy sources, and increased energy density.

Avitaminosis↗
PubMed1999

Tuberculosis epidemiology and control in Veracruz, Mexico.

BACKGROUND: Tuberculosis (TB) rates remain high in regions of Southern Mexico despite the existence of a National Tuberculosis Program. Understanding TB epidemiology in such settings would assist in the design of improved TB control and highlight the challenges confronting TB control in developing countries. METHODS: We conducted a retrospective review of treatment control cards from 1991 to 1994 in five municipalities in a semiurban region of Southern Mexico. RESULTS: The relatively high rate of TB observed, 42.6 per 100,000 inhabitants, did not change significantly during the study period. Cure rates among new cases were 79% and significantly lower among retreatment cases (62%). Directly observed therapy (DOT) was administered to 84% of patients. Approximately one-half of the retreatment cases who were not cured were compliant with therapy, suggesting that drug resistance contributed to these poor results. Of particular concern was a core group of 16 patients who had received at least three treatments. CONCLUSIONS: This region of Mexico has persistently high TB rates despite a DOT-based TB control programme which achieves an overall cure rate of 77%. There exist many retreatment cases for whom cure rates are significantly lower. These cases may serve as a core group for the dissemination of drug resistant TB. The control programme is being reinforced by a nominal register of patients, decreasing administrative barriers for drug supply to individual patients and the availability of mycobacteria cultures. In addition to these measures, in regions which are approaching the levels of efficacy recommended by the WHO it may be appropriate to consider focusing efforts on the identification and treatment of chronic cases.

Adolescent↗
PubMed1999

Analysis of herpes simplex virus 1 and 2 infection in women with high risk sexual behaviour in Mexico.

BACKGROUND: This paper describes the seroprevalence and risk factors of Herpes simplex virus (HSV) infection in a group of female prostitutes from Mexico City. METHODS: Women who consented to participate in the study voluntarily attended a sexually transmitted disease (STD) clinic during 1992. A standardized questionnaire was administered and a blood sample was obtained from each participant. Type-specific Western blot serology was performed to determine the serostatus of HSV-1 and HSV-2 for participants. Bivariate and multivariate analyses were applied to identify variables associated with an increased risk for HSV infection. RESULTS: Prevalences of infection among the 997 prostitutes studied were 93.9% for HSV-1 and 60.8% for HSV-2. Only 1.8% of the women were seronegative for both viruses. The only variable associated with HSV-1 seropositivity was crowding index. The following variables were associated with an increased risk for infection with HSV-2: age, level of education, working site, born outside Mexico City and increasing time as a prostitute. CONCLUSIONS: This is the first assessment of HSV infection in Mexico and may be useful for the development and application of control and preventive measures among the prostitute population at risk of acquiring and transmitting human immunodeficiency virus (HIV) and other STD.

Adolescent↗
PubMed2001

Pragmatic randomized trial of home visits by a nurse to elderly people with hypertension in Mexico.

BACKGROUND: In Mexico, hypertension is a major cause of disability and death in the elderly, but the most effective way to promote behaviour change in old people is unknown. Low resource interventions that are effective in normal healthcare settings are urgently needed. We report the results of a randomized trial of nurse-provided health and lifestyle advice during home visits to elderly people with hypertension in Mexico City. METHODS: Subjects were 718 people with hypertension aged > or =60 years, who were residents of Mexico City and were registered with the Family Medicine Clinics of the Mexican Institute of Social Security (IMSS). A randomized controlled trial was carried out in which the intervention group was offered nurse visits over 6 months with blood pressure checks and negotiated lifestyle changes. The control group continued to receive usual care. RESULTS: After 6 months, 36.5% of the intervention versus 6.8% of the control group had a blood pressure of <160/90 mmHg. The difference in the mean change in systolic blood pressure was 3.31 mmHg (P = 0.03, 95% CI : 6.32, 0.29) and the same difference in diastolic blood pressure was 3.67 mmHg (P = 0.00, 95% CI : 5.22, 2.12). Weight and sodium excretion fell more in the intervention group, but the difference was not significant. CONCLUSIONS: Nurse home visits are effective in reducing blood pressure in hypertensive patients aged > or =60 years.

Aged↗
PubMed1983

Antimicrobial resistance of gram-negative bacteria isolated from foods in Mexico.

When trimethoprim-sulfamethoxazole was given to US travelers in Mexico to prevent diarrheal illness, high-level resistance to the drug emerged [2], although in previous studies such resistance had not been observed among enteric flora following administration of trimethoprim-sulfamethoxazole as prophylaxis against urinary tract infection [3]. Since food has been shown to be an important vehicle of transmission of travelers' diarrhea, food samples were examined for the presence of drug-resistant bacteria to explain the acquisition of high-level resistance among enteric flora of individuals taking antibiotics as prophylaxis against traveler's diarrhea. Of 34 strains of ETEC isolated from US students in Guadalajara, Mexico, who had acute gastroenteritis, one was resistant to trimethoprim and one was resistant to trimethoprim-sulfamethoxazole. Eight of the ETEC strains tested demonstrated multiple drug resistance. Twenty-two of 149 isolates from food produced enterotoxin. Only one isolate, which was nontoxigenic, was resistant to trimethoprim, and no coliforms were resistant to trimethoprim-sulfamethoxazole; however, 16 isolates demonstrated multiple drug resistance. Of 235 gram-negative organisms recovered from frozen food samples grown on antibiotic-containing media and tested for enterotoxin production, no isolates were enterotoxigenic. Thirty-four isolates were resistant to trimethoprim, 15 were resistant to trimethoprim-sulfamethoxazole, and 33 demonstrated multiple resistance. Multiple drug resistance was demonstrated among gram-negative organisms isolated from patients' stools and foods in Mexico.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMed2006

Epidemiology of medical complaints in Mexico: identifying a general profile.

OBJECTIVE: To determine the problems that were the sources of the complaints most frequently received at the National Commission of Medical Arbitration (CONAMED) in Mexico, as well as the diagnoses most frequently related, the institutions involved, and the populations affected. DESIGN: From all complaints received from 1 January 1998 to 31 December 2000, we chose a random sample of 639 complaints and carried out our study using a cross-sectional design. SETTING: CONAMED receives complaints from Mexico City and the surrounding areas. PARTICIPANTS: Patients attending public and private health institutions from the three levels of medical attention who submitted a complaint to the CONAMED in Mexico. MAIN OUTCOME MEASURES: Assessment of health care quality (good practice or malpractice). Type of malpractice (negligence, lack of skill, or deceit). Main motives of complaint. RESULTS: We analyzed 639 complaints; 57.6% were submitted by women, average age 41.0 years. Surgical treatment was the main cause of complaint. Most frequent diagnoses were diseases of the digestive system. Evaluation of medical practice revealed 36.5% of malpractice. Lack of skill accounted for 67.4% of those cases. CONCLUSIONS: Malpractice was identified in a third of the complaints, and lack of skill was the main reason for malpractice. Surgical patients were the most frequently affected. The other two-thirds of the complaints were related to lack of communication between patients and physicians. These results suggest potential points of intervention to decrease the risk and the conflict.

Adult↗
PubMed1990

Epizoic fauna of Plecotus mexicanus (Chiroptera: Vespertilionidae) in Tlaxcala, Mexico.

Four hundred nineteen arthropod ectoparasites were taken from Plecotus mexicanus (Vespertilionidae) collected in the state of Tlaxcala, Mexico: the insects Trichobius corynorhini Cockerell (Diptera: Streblidae) and Myodopsylla collinsi Kohls (Siphonaptera: Ischnopsyllidae) and the mites Macronyssus longisetosus (Furman) and M. unidens Radovsky (Macronyssidae), Spinturnix sp. (Spinturnicidae), Pteracarus elegans Dusbádek & Wilson and Acanthophthirius (Myotimyobia) sp. (Myobiidae), and Whartonia glenni Brennan (Trombiculidae). P. mexicanus is reported in the state of Tlaxcala for the first time. This is the first survey of ectoparasites of this bat, and all parasite associations with P. mexicanus are new host records as well as new range records for Tlaxcala. This is the first report from Mexico; it records a major southern extension of the ranges of M. longisetosus, M. unidens, and P. elegans. The genus Acanthophthirius is also reported in Mexico for the first time.

Animals↗
PubMed1994

Bionomics of adult Anopheles pseudopunctipennis (Diptera: Culicidae) in the Tapachula foothills area of southern Mexico.

Field studies on the bionomics of adult Anopheles pseudopunctipennis Theobald were conducted to assess its relative importance as a primary vector of vivax malaria in southern Mexico. In four malaria endemic villages in a foothill region near Tapachula, Mexico, population densities of A. pseudopunctipennis increased during the dry seasons of 1990 and 1991. The pattern of nocturnal host-seeking activity indoors was unimodal with a late night peak at 0100 hours enhancing its vectorial significance, because it occurred when most residents were asleep and fully exposed to the anophelines. Comparisons of trapping methods showed that a horse-baited trap was more effective than human landing catches or UV light traps. Pit shelters, on the other hand, were more effective than indoor and natural shelter resting collections. Results of enzyme-linked immunosorbent assays performed on wild-caught A. pseudopunctipennis specimens documented the presence of natural infections with the VK210 and new VK247 circumsporozoite polymorphs of P. vivax. These findings verify the importance of A. pseudopunctipennis as a major vector of vivax malaria at higher elevations and extend the geographical range of the VK247 P. vivax polymorph in Mexico.

Animals↗
PubMed1996

New records of human tungiasis in Mexico (Siphonaptera:Tungidae).

Human cases of tungiasis were recorded in Mexico until 1948. Here we report 3 new cases of infection by chigoe, Tunga penetrans (L.), with 2 from Hidalgo State and the 3rd, although acquired in Mexico City, was associated with the other 2 cases. This is the 1st record of this species in Hidalgo State and indicates a reappearance of this parasite in Mexico.

Animals↗
PubMed1994

Lactose maldigestion and milk intolerance: a study in rural and urban Mexico using physiological doses of milk.

Lactose digestion capacity after ingestion of physiological doses of milk and its effect on milk intolerance and consumption were studied in rural and urban populations from three regions of Mexico with different milk intakes. All subjects (n = 926) received two treatments: whole milk (240 mL for children and 360 mL for adults) and the same amount of 90% lactose-hydrolyzed milk; 72% of the subjects also received as a third treatment a water solution containing lactulose (8 g for children and 10 g for adults). Lactose maldigestion determined by a hydrogen breath test was detected in 2 to 43% of subjects (depending on age group) and was higher in subjects from central and southern Mexico than in subjects from northern Mexico (P < 0.01). Only the experience of major symptoms of intolerance affected milk consumption, and these symptoms were present in 0 to 11% of children > 4 y old and in 7 to 17% of the 13- to 60-y-old subjects. No significant differences were found in lactose maldigestion or milk intolerance between rural and urban populations, but milk consumption was higher in urban areas (P < 0.01). Milk consumption in our study was affected primarily by factors not related to the capacity to digest or tolerate the lactose in milk.

Adolescent↗
PubMed1996

Human immunodeficiency virus infection in Mexico City. Rectal bleeding and anal warts as risk factors among men reporting sex with men.

The objectives of this study were to evaluate the frequency and determinants of rectal bleeding and the association between rectal bleeding and risk of human immunodeficiency virus (HIV) infection among homosexual/ bisexual men in Mexico City. Men who requested anonymous HIV testing at a public clinic in Mexico City and who reported engaging in any homosexual behavior were eligible to participate in this study. Trained staff collected information on demographic factors, sexual behavior, psychological states, and HIV serostatus from all consenting, eligible clients. Logistic regression modeling was used to investigate the independent effect of risk factors among 2,758 men who were tested between June 1991 and December 1992. Bleeding during anal intercourse was a common occurrence: More than one third of the men in the study reported some bleeding, and 8% reported bleeding in half or more of their intercourse episodes. The prevalence of HIV infection among bleeders was 42% as compared with 28% in nonbleeders (p < 0.0001), and the adjusted odds ratio was 1.8 (95% confidence interval (CI) 1.1-2.8) for men who bled in more than half of their anal intercourse episodes relative to nonbleeders. There was a trend of increasing HIV seroprevalence with increasing frequency of rectal bleeding (p = 0.001). Nine percent of all HIV infections and 42% of infections among frequent bleeders were attributable to rectal bleeding. Men who reported both rectal bleeding and anal warts were 3.5 (95% CI 2.1-5.8) times more likely to be HIV-infected in multivariate analysis than men reporting neither rectal bleeding nor anal warts. Determinants of rectal bleeding included older age, more education, more receptive anal intercourse than insertive intercourse, receptive digital-anal contact, anal warts, and genital ulcers. Among men reporting sex with men in Mexico City, rectal bleeding is common. It is an independent risk factor for HIV infection, and warrants attention in acquired immunodeficiency syndrome prevention efforts. Rectal bleeding that results from rupture of anal warts may be an especially effective portal of HIV transmission.

Adult↗
PubMed1975

Arbovirus vector ecology studies in Mexico during the 1972 Venezuelan equine encephalitis outbreak.

Virus vector studies were conducted in the States of Durango, Chihuahua, and Tamaulipas, Mexico, in June and July 1972. Apparently only a low level of Venzuelan equine encephalitis (VEE) virus transmission to equines occured at the time of the study, and the infection was restricted to areas which had not experienced overt activity during the preceding year. The low level of infection was associated with a scarcity of mosquitoes. The IB (epidemic) strain of VEE virus was isolated from two pools of Anopheles pseudopunctipennis (Theo.) and the blood of one symptomatic equine. The low mosquito population, the relatively few equine cases observed, and the absence of reports of VEE human disease from the outbreak area suggested VEE virus persistence through a low-level mosquito-equine transmission cycle. Other studies have already indicated that wild vertebrates play no more than a minor role in outbreaks of epidemic VEE. Mosquito collections made in areas of the states of Durango, Chihuahua, and Tamaulipas, where considerable epidemic activity of VEE had occurred in 1971, failed to reveal evidence of VEE virus persistence. Twenty-nine ioslations of other arboviruses were also made in these studies: including 22 of St. Louis encephalitis virus (SLE), 2 of Flanders virus, 1 of Turlock virus, 1 of Trivittatus virus of the California Group, 1 of western equine encephalitis virus (VEE), and 2 (from Santa Rose) which possibly represent a hitherto unknown virus in the Bunyamwera Group. These are the first reports of SLE virus isolations from mosquitoes in Mexico, and the first demonstration of Trivittatus, VEE Turlock and Flanders viruses in Mexico from any source.

Animals↗