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PubMed2005

Identification and biochemical characterization of Leishmania strains isolated in Peru, Mexico, and Spain.

Eight Leishmania promastigotes were isolated from different geographical areas: three (LP1, LP2, and LP3) from the provincial department La Libertad and the fourth (LP4) from the department of Cajamarca (northern Peru); another three (LM1, LM2, and LM3) in the province of Campeche (Mexico); and the last (LS1) from a clinical case of a dog in Madrid (Spain). The isolates were characterized by carbohydrate cell-surface residues using agglutinations with four purified lectins, by isoenzyme analysis using different isoenzymes, by analysis of kinetoplast DNA (kDNA) restriction fragment length polymorphism using four different restriction endonucleases and by the final metabolite patterns after in vitro culture. These isolates were compared with four reference strains and typified as: Leishmania (Leishmania) donovani, two strains of L. (L.) infantum, and one species of L. (Viania) peruviana. According to our results and the statistical study, the Peruvian isolates represent three different strains: one would be L. (V.) peruviana, another the strain isolated in Cajamarca (LP4) and the third would include the three strains from the department of La Libertad (LP1, LP2, and LP3), these latter three isolates being phylogenetically closer to the reference strain L. (L.) donovani. Meanwhile, the three isolates from Mexico form a group with close phylogenetic relationships to each other. The isolate from Spain belongs to the species L. (L.) infantum. Thus, a close correlation was drawn between the identity of each strain and its geographical origin.

Acetates↗
PubMed2006

KIR gene in ethnic and Mestizo populations from Mexico.

Killer cell immunoglobulin-like receptors are characterized by their great diversity of genes and alleles. Population studies have identified the presence of a broad variety of genotypes. In Mexico, there are diverse ethnic groups representing 9% of the total population and the rest is composed of Mestizos with a more varied biology. For the purpose of this study, genotyping was performed in Mestizos, in Mexico City inhabitants, and in three ethnic groups. The frequencies of genes KIR2DL2, 2DL5, 2DS1-3, 2DS5, and 3DS1 showed a greater variability in the groups studied. A total of 12 different genotypes were identified, the higher number for the Mestizos and the lower number for the Tarahumaras. Genotype 1 was found at a greater frequency in all the groups, except for the Tarahumaras, in which genotype 4 was more frequent. The frequency of genotypes 4 and 8 in Mexicans was higher than that for other populations analyzed. By subtyping of KIR3DL1, 3DL2, 2DL1, and 2DL3, two B haplotypes were identified in families; both were absent in Caucasian families. Our results indicated a greater diversity of genes in the Mestizos group than in the ethnic groups.

American Indian or Alaska Native↗
PubMed2006

Cardiovascular risk stratification by means of the SCORE system in health care workers in Veracruz, Mexico.

BACKGROUND: To assess cardiovascular disease risk by means of the SCORE system (Systematic Coronary Risk Evaluation) in health care workers (HCW) from Veracruz, Mexico. METHODS: A cross-sectional study was undertaken at the Mexican Institute of Social Security from Veracruz. Seventy six HCW without physical limitations (NYHA Functional Class I) were included. All HCW answered a standardised medical history questionnaire and were evaluated by physical examination and lab tests. The cardiovascular risk was assessed through the SCORE system. RESULTS: The median age of participants was 47 years (90% range 42-57 years), female HCW had higher prevalence of obesity and lower prevalence of overweight compared to male HCW (52% vs 23% for obesity and 26% vs 63% for overweight; p=0.014). The prevalence of hypertension was 22%, type 2 diabetes 8%, hypercholesterolemia 70%, hypertriglyceridemia 47% and mixed hyperlipidemia 26%. Cardiovascular risk assessed by the SCORE system showed that 14% of all patients had a cardiovascular risk higher than 2% and 51% had a risk lower than 1%. CONCLUSIONS: In this first study of cardiovascular risk assessment by means of the SCORE system in HCW in Mexico, we found that 14% of them have a cardiac risk higher than 2% and that it is double than expected for their age but it is lower than reported in a European population. Also, we found a higher prevalence of hypercholesterolemia and mixed hyperlipidemia showing poor education and treatment for cardiovascular prevention.

Adult↗
PubMed2006

Isolation and characterization of Shiga toxin-producing Escherichia coli O157:H7 and non-O157 from beef carcasses at a slaughter plant in Mexico.

The contamination of beef carcasses with Shiga toxin-producing O157:H7 and non-O157 Escherichia coli (STEC) obtained from a slaughter plant in Guadalajara, Mexico was investigated. A total of 258 beef carcasses were sampled during a 12-month period. All samples were assayed for STEC by selective enrichment in modified tryptone soy broth supplemented with cefixime, cefsulodin and vancomycin, followed by plating on Sorbitol MacConkey Agar supplemented with cefixime and tellurite (CT-SMAC). Simultaneously, all samples were assayed by immunomagnetic separation (IMS) and plated on CT-SMAC and CHROMagar. The presence of the stx1, stx2, eaeA and hly933 genes, recognized as major virulence factors of STEC, was tested for O157:H7 and non-O157 E. coli isolates by multiplex polymerase chain reaction (PCR). STEC was detected in two (0.8%) samples. One of these STEC isolates corresponded to the serotype O157:H7 showing stx2, eaeA and hyl933 genes. The other isolate corresponded to non-O157 STEC and only had the stx1 gene. Thirteen carcasses (5%) were positive for nonmotile E. coli O157 and 7 (2.7%) were positive for E. coli O157:H7. The presence of O157:H7 and non-O157 STEC on beef carcasses in this slaughter plant in Guadalajara, Mexico, emphasizes the importance of implementing the Hazard Analysis and Critical Control Point (HACCP) system, as well as the need for implementing, evaluating, and validating antimicrobial interventions to reduce the presence of potential pathogenic microorganisms.

Abattoirs↗
PubMed2005

Cholera in Mexico: the paradoxical benefits of the last pandemic.

OBJECTIVES: To describe the impact of preventive and control measures in Mexico prior to, and during, the cholera epidemic of 1991-2001. METHODS: When cholera appeared in Latin America in January 1991, the Mexican government considered that it represented a national security problem. Therefore, actions were implemented within the health sector (e.g. epidemiological surveillance, laboratory network and patient care) and other sectors (public education and basic sanitation). RESULTS: The first case occurred in Mexico in June 1991. The incidence rate remained below 17.9 per 100,000 inhabitants and affected mainly rural areas. The last cholera report occurred in 2001. The disease never became endemic. The population benefited not only from acquisition of knowledge about preventive measures, but also from modification of risky practices and from reinforcement of city and municipal drinking water supplies. CONCLUSION: Control strategies had an overall impact in decreasing diarrheal mortality among children under five years of age. Additionally the country did not suffer from a decrease in tourism or economic consequences. This experience can be considered as the operationalization of a new public health system spanning multisectorial activities, involving community participation, political will and with impact on public health and economic issues.

Adolescent↗
PubMed2004

Emergency contraception use is correlated with increased condom use among adolescents: results from Mexico.

PURPOSE: To evaluate the association between knowledge about, or experience with, emergency contraception (EC), and condom use among school-attending adolescents in the state of Morelos, Mexico. METHODS: We analyzed data from anonymously self-administered questionnaires (n = 10,918), from a cluster-randomized controlled trial among first year students from 40 (75%) public high schools in Morelos, Mexico. The survey included specific questions about EC knowledge and experience as well as questions about perceived ability to negotiate and condition sexual relations on condom use; and condom use at first and last sexual intercourse. RESULTS: Overall, 61% (6384) of students had heard of EC, and 36% (1964) of girls and 39% (1997) of boys had correct knowledge about EC. Correct knowledge was based upon knowing that EC is pills taken up to 3 days after unprotected sex to prevent pregnancy. Of 1695 (15.6%) reporting lifetime sexual activity, 16.4 % (275) reported they had tried to obtain EC and almost of all them (263) reported having used EC. The probability of a student reporting he/she is capable of interrupting sexual intercourse to use a condom was significantly higher for those who had correct EC knowledge, and a history of EC use was strongly correlated with condom use at last sexual intercourse. CONCLUSIONS: Experience with emergency contraception has no adverse effects on condom use, but rather is associated with an increased probability of condom use and an increased perceived capacity to negotiate condom use. Despite concern that information about, and access to EC may encourage sexual risk taking, our results suggest the reverse is true. These data support the position that there is no justification to withhold EC information or access from adolescents.

Adolescent↗
PubMed2004

Water quality and presence of pesticides in a tropical coastal wetland in southern Mexico.

The water quality of the Pozuelos-Murillo lagoon system in southern Mexico was evaluated during three periods between March and October 2002, with particular emphasis on the detection of organochlorine and organophosphorous pesticide residues in water and sediments. Physicochemical and microbiological parameters of water were also measured and integrated in a water quality index (WQI). Multivariate analysis was used to regionalise the lagoon system as a function of the behaviour of all measured parameters. Solid phase micro-extraction followed by gas chromatography (SPME-GC) was used for pesticide analysis. The concentration of phosphorous was found to be higher than that of nitrogenous compounds. This, besides a deficiency in dissolved oxygen and a high organic matter concentration (as COD), reflects eutrophication processes in some areas of the system. Measured levels of faecal coliforms and oils and greases were above the limits established by Mexican law and comparable to the concentrations reported for other highly polluted systems in Mexico. Residues of DDD (2.0 microg L(-1)) in water and DDE (247 ng g(-1)) and endosulfan I (814 ng g(-1)) sediments were detected by SPME-GC. The spatial distribution of these contaminants implies major potential risks because the most polluted sites were found to be those with the highest fishing activity. Although in general the WQI is on acceptable levels (65-80%), some contamination problems are evident.

Chromatography, Gas↗
PubMed2006

Molecular studies of Onchocerca volvulus isolates from Mexico.

DNA from Onchocerca volvulus from Oaxaca and Chiapas, Mexico were used as templates to amplify members of the O-150 Onchocerca specific repeat sequence family. The resulting PCR amplicons all hybridized with OVS2, an oligonucleotide that has been previously shown to recognize amplicons derived from O. volvulus with 100% sensitivity. However, when PCR products amplified from the O. volvulus specific plasmid pOVS134 were used as a probe, most samples did not hybridize. Similarly, when PCR products amplified from DNA isolated from adult O. volvulus from Oaxaca were used as a probe, amplicons from adult worms from both Oaxaca and Chiapas were recognized, but PCR products from infected black flies from Chiapas were not recognized. Amplicons derived from an adult worm from Chiapas hybridized with PCR products produced from adult parasites from both Oaxaca and Chiapas and to PCR products derived from the DNA of infected black flies from Chiapas. These data, when taken together, suggest that differences exist among the repeat sequence populations of parasites from Oaxaca and Chiapas in Mexico, suggesting that the O-150 repeat sequence family may be a useful tool for biogeographic studies of O. volvulus in the Americas.

Animals↗
PubMed2004

Lip cancer experience in Mexico. An 11-year retrospective study.

Lip cancer is the most frequent malignant neoplasm of the oral cavity; however, there is no information available on the incidence of this type of cancer in Mexico. This study provides information about the clinico-pathological features of lip cancer patients admitted at a cancer hospital in Mexico City during an 11-year period and describes the treatment modalities performed and their results. A total of 113 patients were studied. There were 74 men (65.5%) and 39 women (34.5%), ranging in age from 14 to 106 years (mean 70 years). In 53 cases (46.9%) an association was found between the disease and chronic sun exposure. Additionally, positive smoking antecedents were recorded in 58 cases (51.3%). As 15 patients were followed for less than 1 month, they were excluded for further analysis. There were 82 cases (83.7%) of squamous cell carcinoma, 10 (10.2%) basal cell carcinomas, and one case (1%) each of adenocarcinoma NOS, melanoma, adenoid cystic carcinoma, Merkel cell carcinoma, lymphoepithelioma and angiosarcoma. We observed an incidence of malignant neoplasms in the upper lip of 33.7%, which is higher than most of the published series and may be due to the fact that in this series we included all histological types of lip cancers. Fifty percent of the cases were found in stages III and IV. Cervical lymph node metastases were found in 21% of patients with no previous treatment, and they developed in 5.3% after treatment. Our data suggest that tumoral size is directly related to the possibility of developing node metastases, as none of them occurred in patients T1, whereas 10 (62.5%) of the patients in T4 presented them. Seven deaths were documented (7.1%), five of which corresponded to squamous cell carcinoma, one to Merkel cell carcinoma, and one to adenocarcinoma. Deaths were directly related to the disease in six cases, and one patient died due to surgical complications. Distant metastases were found in only two patients, one of which coursed with an adenocarcinoma and the other with a Merkel cell carcinoma. Based on the present results, we suggest that the differences encountered with respect to other series, particularly the higher incidence found in women, the frequent presentation of this type of neoplasms in the upper lip, the wide variety of histopathological diagnoses and the high frequency of cases with cervical lymph node affection, should lead us to search for multi-modal treatment alternatives in this population.

Adolescent↗
PubMed2004

Canine ecology and socioeconomic factors associated with dogs unvaccinated against rabies in a Mexican city across the US-Mexico border.

A cross-sectional study was conducted to identify ecologic and socioeconomic factors associated with dogs unvaccinated against rabies in Mexicali, the capital city of Baja California, Mexico (located across the US-Mexico border). A total of 1100 households were selected by random sampling from a list of all 180,000 households. A questionnaire was filled in during a personal interview with the household head or another adult person to gather information of epidemiological interest (such as canine ecology, social and economic factors that might influence owners' decision to allow their dog to be vaccinated). There were 910 dogs identified. The human-to-dog ratio was 4.3:1. The male-to-female dog ratio was 1.5:1. Out of 791 dogs > or = 3 months old, 577 (73%) were classified as vaccinated against rabies. Most dogs (95%) were not spayed. Neighborhood dogs had 25 times higher risk of nonvaccination compared to dogs owned by a family. Dogs 3-11 months old had three times higher risk of nonvaccination compared to dogs > or = 1 year old. Dogs that were obtained as a gift, born at home or found had two times higher risk of nonvaccination compared to dogs that were reportedly purchased. Crossbred dogs had 1.5 times higher risk of nonvaccination compared to purebred dogs. The canine-ecology structure is similar to that in regions were rabies is endemic.

Animals↗
PubMed2005

Who pays more for health services in middle-income countries: lessons from Mexico.

An evaluative study with a cross-sectional design was carried out on healthcare cost indicators reported by the 2000 National Health Survey in Mexico, to determine which population group had higher health costs/expenditures in relation to family income. The results suggest that in middle-income countries such as Mexico, families with lower incomes tend to pay more for healthcare services.

Cross-Sectional Studies↗
PubMed2006

Exploring differences in caseloads of rural and urban healthcare providers in Alaska and New Mexico.

OBJECTIVES: Although it is commonly accepted that rural healthcare providers face demands that are both qualitatively and quantitatively different from those faced by urban providers, this conclusion is based largely on data from healthcare consumers and relies on qualitative work with small sample sizes, surveys with small sample sizes, theoretical reviews and anecdotal reports. To enhance our knowledge of the demands faced by rural healthcare providers and to gain the perspectives of healthcare providers themselves, this study explored the caseloads of rural providers compared with those of urban providers. METHOD: An extensive survey of over 1500 licensed clinicians across eight physical and behavioural healthcare provider groups in Alaska and New Mexico was undertaken to explore differences in caseloads based on community size (small rural, rural, small urban, urban), state (Alaska, New Mexico) and discipline (health, behavioural). RESULTS: Findings indicated numerous caseload differences between community sizes that were consistent across both states, with complex case presentations being described most commonly by small rural and rural providers. Substance abuse, alcohol use, cultural diversity, economic disadvantage and age diversity were issues faced more often by providers in rural and small rural communities than by providers in small urban and urban communities. Rural, but not small rural, providers faced challenges around work with prisoners and individuals needing involuntary hospitalization. Although some state and discipline differences were noted, the most important findings were based on community size. CONCLUSIONS: The findings of this study have important implications for provider preparation and training, future research, tailored resource allocation, public health policy, and efforts to prevent 'burnout' of rural providers.

Adolescent↗
PubMed2005

Characterization of a spatial gradient of nitrogen dioxide across a United States-Mexico border city during winter.

A gradient of ambient nitrogen dioxide (NO(2)) concentration is demonstrated across metropolitan El Paso, Texas (USA), a city located on the international border between the United States and Mexico. Integrated measurements of NO(2) were collected over 7 days at 20 elementary schools and 4 air quality monitoring stations located throughout the city during typical winter atmospheric conditions. Replicate passive monitors were co-located with chemiluminescence analyzers at the monitoring stations for two consecutive 7-day periods. The passive measurements correlated with the analyzer measurements (R(2)=0.74) with precision of 2.5+/-2.2 ppb. Nitrogen dioxide concentrations ranged from 11.0 to 37.5 ppb (mean 20.6+/-7.1 ppb). In a multivariate regression model, the site elevation and distances to a main highway and to an international port of entry from Mexico explained 81% of the variance in the passive measurements. The results of this pilot study indicate that proximity to vehicle-related sources of NO(2) and site elevation are key predictors for future, more detailed assessments of vehicle-related air pollution exposure in the El Paso region.

Air Pollutants↗
PubMed2004

Los Años de la Crisis: an examination of change in differential infant mortality risk within Mexico.

The main aim of the present analysis is to test the possibility that the period of economic hardship characterizing Mexico over the decade 1986-1996 has negatively influenced infant health outcomes. Data on births from two installments of the Encuesta Nacional de la Dinámica Demográfica, a nationally representative demographic survey, are used to determine whether a reduction in mortality differentials has paralleled the overall drop in the national infant mortality rate. The findings indicate that the decrease observed in the overall infant mortality rate has been matched by decreases in several disparities at the same time that it has been marred by increases in others. The data support the possibility that where you live has become an increasingly salient factor in determining the odds of infant mortality. High parity, low education and unemployment status have also become more salient factors in predicting post neonatal infant mortality risk in the more recent period as compared to the earlier period. As Mexico's infant mortality rate begins to stabilize in the near future, this research highlights the need to re-focus our research efforts on the causes and consequences of differential mortality trends.

Adult↗
PubMed2005

Pregnancy outcomes, site of delivery, and community schisms in regions affected by the armed conflict in Chiapas, Mexico.

The Zapatista armed conflict began in the state of Chiapas, Mexico, in 1994, and overlaps pre-existing local disputes about land, religion, and other issues. Related disruptions in access to and utilization of health services have been alleged to have compromised local health status, particularly in vulnerable subgroups such as indigenous women and infants. The study objective was to measure maternal and perinatal mortality ratios and utilization of pregnancy-related health services in the region affected by the Zapatista conflict, and to describe associations between these primary outcome measures, socioeconomic and demographic factors, and factors associated with inter-party and intra-community conflict. A cross-sectional, population-based survey was conducted in 46 communities in three regions. The study subjects were 1227 women, 13-49 years old, who had been pregnant during the preceding 2 years (1999-2001). Principal outcome measures were maternal and perinatal mortality, and site of delivery. Secondary analyses explored associations between primary outcomes and socioeconomic, demographic, and conflict-related factors. Most births (87.1%) occurred at home. The crude observed maternal and perinatal mortality ratios were 607/100,000 and 23.5/1000 live births, respectively. Those who died had difficulty accessing emergency obstetrical care. Both home birth and mortality were associated with descriptors of intra-community conflict. Observed maternal and perinatal mortality ratios were substantially higher than those officially reported for Mexico or Chiapas. Reduction of high reproductive mortality ratios will require attention to socioeconomic and conflict-related problems, in addition to improved access to emergency obstetrical services.

Adolescent↗
PubMed2005

Experience of a successful pediatric liver transplant program in Mexico.

Orthotopic liver transplantation (OLT) has been very difficult to develop in Mexico and for many years its occurrence was anecdotal. This report presents the results of a pediatric liver transplant program, analyzing the variables that affect outcomes. Between June 1998 and March 2004, 35 OLT were performed in 34 recipients including 80% cadaveric whole-organ grafts and 20% segmental grafts, with 11% from cadaveric and 9% from living donors. Most of the recipients were infants or toddlers weighing less than 15 kg. There was only 1 case of arterial thrombosis (2.8%); the graft was saved with a Kasai procedure. Biliary complications were present in 22% of cases, all resolved with reoperations. Posttransplant cytomegalovirus infection or reactivation (28%), acute rejection (25%), or posttransplant lymphoproliferative disorders (5.7%) were not a cause of graft or patient loss. Overall, 1- and 5-year patient survival rates are 77.1% and 74.2%, respectively; however, when the 1998-2000 cohort was compared with the 2001-2004 cohort, there was a significant difference in survival (P = .004). The 1-year patient survival for the later group is 91.6%. We performed the first successful living donor liver transplantation and the first simultaneous liver-kidney transplantation in a child in our country. Our results demonstrate that pediatric liver transplantation is a feasible undertaking in Mexico, with survival rates comparable to those of foreign centers.

Cadaver↗
PubMed2004

Dynamics of Fasciola hepatica infection in two species of snails in a rural locality of Mexico.

The aim of the present study was to identify the species that are natural intermediate hosts of Fasciola hepatica in a Research Centre in Chapa de Mota, State of Mexico, Mexico, where temperate and humid conditions prevail. Also, the magnitude and dynamics of the natural infection in four biotopes were analysed. The study was performed between October 2000 and November 2001. The molluscs were collected, identified and studied for trematode infection. Soil humidity and temperature were determined monthly. A total of 4042 snails were collected 3372 (83%) were Fossaria humilis and 670 (17%) F. bulimoides. F. hepatica was present in 2537 (75.2%) and 515 (76.9%) of the two snail species, respectively. Temperature, soil humidity and microenvironment affected the dynamics of the host population and the parasite infestation, with a significant increase from August to November 2001. The highest prevalence was observed in the warmer and more humid biotopes.

Animals↗
PubMed2005

Ehrlichia canis in dogs in Yucatan, Mexico: seroprevalence, prevalence of infection and associated factors.

The aim of this study was to determine the prevalence of infection, seroprevalence, and factors associated with antibody response to Ehrlichia canis in dogs of Yucatan, Mexico. The study was carried out in four veterinary clinics located in Merida, the capital city of Yucatan, Mexico. Blood samples were obtained from a total of 120 dogs, and each animal was physically examined to determine age and sex, as well as to record any clinical signs of platelet-related bleeding. Blood samples were analyzed for antibodies to E. canis using an ELISA test, and thrombocyte counts were calculated. Blood smears were prepared to detect typical morulae in leukocytes. The prevalence of infection, seroprevalence and associated factors were calculated. A primary screening was performed using 2 x K contingency tables of exposure variables. All variables with P< or =0.20 were analyzed by a logistic-binomial regression. Fifty-three (44.1%) of the 120 dogs were found to be seropositive to E. canis. In six dogs (5.0%) typical morulae of E. canis were observed in monocytes. These six cases were positive for antibodies and were thrombocytopenic. The following factors associated with seropositive animals were: platelet-related bleeding (Yes: OR=10.26, CI=2.50-42.16, P=0.001), thrombocytopenia (Yes: OR=18.91, CI=4.47-80.03, P=0.000) and age (2-4 years: OR=6.77, CI=1.76-25.97, P=0.005; >4 years: OR=4.24, CI=1.04-17.21, P=0.043).

Animals↗