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PubMed2006

Overweight with concurrent stunting in very young children from rural Mexico: prevalence and associated factors.

OBJECTIVE: To document the prevalence of overweight or obesity concurrent with stunting in rural low-income Mexican children and to identify demographic and socio-economic characteristics that could help identify families at risk of having an overweight/obese and stunted young child in this population. DESIGN: Cross-sectional analysis of the nutritional status of very young children, using primary data from a rural community-based survey conducted in 2003. Overweight, obesity and stunting were documented along with several maternal, household and community characteristics. SETTING: Impoverished areas of rural Mexico. SUBJECTS: Pre-school children (n=7555), aged 24-72 months. RESULTS: The combined prevalence of overweight and obesity was equal to or greater than 20% in all children, as was the prevalence of stunting. The prevalence of concurrent overweight or obesity and stunting was approximately 5% in non-indigenous children, and over 10% in indigenous children 24-60 months. A multinomial logistic analysis revealed that the factors associated with coexisting stunting and overweight/obesity were lower socio-economic status (SES), lower maternal age, education, intelligence (vocabulary) and perceived social status, shorter maternal height, and larger household size. Among only stunted children, the risk of also being overweight or obese was associated with younger maternal age (relative risk ratios (RRR): 0.98, P=0.05), lower maternal perceived social status (RRR: 0.95, P<0.01) and maternal obesity (RRR: 2.93, P<0.0001) or overweight (RRR: 1.50, P=0.002). CONCLUSIONS: These analyses highlight that concurrent overweight or obesity and stunting is an important public health issue in low-income areas of rural Mexico beginning in early childhood. Even within this impoverished population, children living in households with low relative SES are the most vulnerable. SPONSORSHIP: Financial support for this research was provided by the National Institutes of Child Health and Human Development, the Fogarty International Center at NIH, the John D and Catherine T MacArthur Foundation 'Research Network on Socioeconomic Status and Health' and the Mexican Government.

Body Height↗
PubMedDate not supplied

Organochlorine pesticide exposure in rural and urban areas in Mexico.

The objective of this study was to determine the level of organochlorine pesticides in maternal milk of women living in urban and rural areas in central Mexico. High levels of the DDT (1,1,1,-trichloro-2,2-bis (p-chlorophenyl) ethane) and metabolites, p,p'-DDT (1.83, 0.66 and 3.13 mg/kg) and p,p'-DDE (2.49, 4.28 and 13.32 mg/kg), were encountered for Mexico City, Cuemavaca and rural Morelos, respectively. As was expected, the highest levels of exposure to these pesticides were found in the rural areas of the State of Morelos.

Adolescent↗
PubMed2006

Personal PM2.5 and CO exposures and heart rate variability in subjects with known ischemic heart disease in Mexico City.

Cardiovascular diseases are the main cause of death in Mexico City and have shown a rising trend over the past 20 years. Various epidemiological studies have reported an association between respirable particles and carbon monoxide (CO), with cardiorespiratory outcomes. The purpose of this study was to assess the effect of particulate matter with aerodynamic diameters of less than 2.5 microm (PM(2.5)), also known as respirable or fine particles and CO on heart rate variability (HRV) in 5-min periods in patients with known ischemic heart disease. 30 patients were selected from the outpatient clinic of the National Institute of Cardiology of Mexico and followed during 11 h, using electrocardiography (ECG) ambulatory electrocardiograms and personal monitors for CO and PM(2.5). We calculated frequency-domain measurements using power spectral analysis and assessed the association with pollutants using mixed models analysis in 5-min periods. We found a decrease in HRV measured as high frequency (Ln) (coefficient=-0.008, 95% confidence interval (CI), -0.015, 0.0004) for each 10 microg/m(3) (micrograms per cubic meter) increase of personal PM(2.5) exposure. We also found a decrease of low (ln) (coefficient=-0.024, 95% CI, -0.041, -0.007) and very low frequencies (ln) (coefficient=-0.034, 95% CI, -0.061, -0.007) for 1 parts per million (p.p.m.) increase in CO personal exposure after adjustment for potential confounding factors. These results show that for this high-risk population, the alteration of the cardiac autonomic regulation was significantly associated with both PM(2.5) and CO personal exposures.

Adult↗
PubMed1998

Molybdenum intake of adults in Germany and Mexico.

Molybdenum is an essential micronutrient. It plays a complex role in the ecosystem, because the metal is a part of a cofactor for several important enzymes in human, animal and plant metabolism. The physiological requirement for this element is relatively low. Our investigations were aimed at determining the Mo intake of adults in Germany and Mexico by means of duplicate portion technique. Molybdenum was estimated in the food duplicate samples by inductively coupled plasma atomic emission spectrometry. In 1988, 1992 and 1996 the Mo consumption of humans was investigated in 14 test groups of persons with mixed diets. Each test population consisted of seven men and seven women. Furthermore, in 1996 the Mo intake of 10 female and 10 male vegetarians and of two Mexican test groups was also determined. Different factors, such as sex, time of investigation, location and eating habits have an effect on the individual Mo intake, Molybdenum intake of adults with mixed diets has increased significantly from 1988 to 1996. Furthermore, results of our study showed that Mo intake of German adults differs depending on location and the kind of diet. German women with a mixed diet consumed 89 micrograms d-1 in 1996 and men 100 micrograms d-1. In comparison, female and male vegetarians consumed 179 micrograms d-1 and 170 micrograms d-1, respectively. There was a significant difference in Mo consumption between German and Mexican test persons. Mexican women consumed on average 162 micrograms d-1 and Mexican men 208 micrograms d-1. The Mo requirement of adults amounts to about 25 micrograms d-1. Our investigations showed that the Mo requirement is met by normal intake. An intake of 150 micrograms kg-1 body weight may be toxic for humans. Therefore, people in Germany and Mexico are not endangered by Mo exposure.

Adult↗
PubMed2001

A case of gnathostomiasis in a European traveller returning from Mexico.

Hundreds of human cases of gnathostomiasis have recently been reported from Mexico, where the disease is becoming a public health problem. We report a case of gnathostomiasis in a French tourist returning from Mexico. Tourists travelling in endemic countries are at risk of gnathostomiasis and should be advised about the risks of eating raw fish as a suspected source of infection.

Adult↗
PubMed2002

Voices from the Gila: health care issues for rural elders in south-western New Mexico.

BACKGROUND AND RATIONALE: A goal of the Healthy People 2010 initiative is to reduce or eliminate health disparities in vulnerable populations, including populations from rural and minority ethnic backgrounds. Rural communities, including elderly populations, experience lower rates of personal income, educational attainment, health-insurance coverage, access to emergency and specialty care services, and reported health status than do urban communities. A need exists to address identified research priorities, such as the perceptions of rural elders, their family members, and health care providers. AIMS: The purposes of this study were to explore the health care perceptions, needs, and definitions of health for multicultural rural elders in one county of south-western New Mexico, and to consider practice implications. ETHICAL ISSUES AND APPROVAL: Informed consent procedures followed the University of New Mexico Health Sciences Center Human Research Review Committee guidelines. Research methods. This critical ethnography incorporated ethnographic interviews, ethnographic participant observation, photography, review of pertinent documents, and analysis of contextual factors. The sample consisted of 22 participants. RESULTS/FINDINGS: Definitions of health varied with socioeconomic status, encompassing avoidance of contact with the health care system, obtaining needed medications, remaining independent, a sense of spiritual belonging, eating wisely, and exercising moderately. Three major concerns emerged from the analysis: the escalating cost of prescription drugs, access-to-care issues, and social isolation. STUDY LIMITATIONS: The primary limitation was the small sample size. Although the researcher's position as an outsider to local communities may also have affected the outcome, it provided fresh insight to regional problems. CONCLUSIONS: The study addressed national research priorities for a vulnerable group of rural elders. Nursing implications include the need for expanded knowledge and educational preparation regarding elder issues and community-level services, inclusion of elders' perspectives in the planning and delivery of health services, and the need for community-level, interdisciplinary collaboration and advocacy.

Aged↗
PubMed2000

Distribution of domestic triatominae and stratification of Chagas Disease transmission in Oaxaca, Mexico.

Mexico has 18 species of Triatomine bugs (Hemiptera: Reduviidae) reported to be vectors of Trypanosoma cruzi. Chagas Disease is widespread in Mexico, with up to 3.5% seropositivity of human transfusion blood. The State of Oaxaca has the longest history of endemic Chagas Disease, based on acute and chronic case reports, and of entomological surveys in the country. However, the State health care services need more information on current risks of vector transmission. In order to identify and characterize areas of transmission in Oaxaca and to stratify the vector potential, the distribution of domestic Triatominae was surveyed during 1996-98 in collaboration with the primary health care services and local communities. Villages were studied in 11% of 570 municipalities in Oaxaca. Eight triatomine species were found in domestic and peri-domestic habitats: Triatoma barberi Usinger, T. bolivari Carcavallo et al., T. dimidiata (Latreille), T. mazzottii Usinger, T. nitida Usinger, T. pallidipennis (Stal), T. phyllosoma (Burmeister) and Rhodnius prolixus Stal. For each triatomine species in Oaxaca, the range of distribution and habitat characteristics are described. Habitat partitioning, principally based on altitude and mean annual precipitation, limited the overlap of distribution between species. Relatively consistent altitude of human settlements facilitates the dispersion of individual species within microregions. Entomological indices of house infestation were used to estimate that approximately 50% of the human population (1,874,320 inhabitants) would be at risk of vector transmission, with a minimum of 134,320 infected people and 40,280 chronic cases of Chagas Disease currently in Oaxaca.

Adolescent↗
PubMed2003

Peritoneal dialysis in Mexico.

While Mexico has the thirteenth largest economy, a large portion of the population is impoverished. About 90% of the population is Mestizo, the result of the admixture of Mexican Indians and Spaniards, with the Indigenous peoples concentrated in the southeastern region. Treatment for end-stage renal disease (estimated 268 patients per million population) is largely determined by the limited healthcare system and the individual's access to resources such as private insurance ( approximately 15%) and governmental sources ( approximately 85%). With only 5% of the gross national product spent on healthcare and most treatment providers being public health institutions that are often under severe economic restrictions, it is not surprising that many Mexican patients do not receive renal replacement therapy. Mexico uses proportionately more peritoneal dialysis than other countries; 1% of the patients are on automated peritoneal dialysis, 19% on hemodialysis and 80% on CAPD. Malnutrition and diabetes, important risk factors for poor outcome, are prevalent among the patients in CAPD programs.

Humans↗
PubMed1998

New observations on Mexiconema cichlasomae (Nematoda: Dracunculoidea) from fishes in Mexico.

The dracunculoid nematode Mexiconema cichlasomae Moravec, Vidal et Salgado Maldonado, 1992, originally described from the abdominal cavity and viscera of Cichlasoma spp. from Mexico, was recorded from the abdominal cavity of the poeciliid Xiphophorus helleri Heckel in Lake Catemaco and its small tributary Arroyo Agrio, Veracruz and from the intestine of the nurse shark Ginglystoma cirratum (Bonnaterre) off the southern coast of the Gulf of Mexico in Campeche; both these findings represent new host records. The nematode specimens from these hosts are briefly described and illustrated. Whereas X. helleri evidently served as the true definitive host of this parasite, G. cirratum probably acquired Mexiconema infection accidentally while feeding on fish definitive hosts in the brackish or salt-water environment. The ability of M. cichlasomae to utilize fishes of different orders (Perciformes and Cyprinodontiformes) as definitive hosts is rather exceptional among dracunculoid nematodes.

Animals↗
PubMed1976

Travelers' diarrhea in Mexico. A prospective study of physicians and family members attending a congress.

We conducted a prospective study of travelers' diarrhea on 73 physicians and 48 family members attending a medical congress in Mexico City, in October, 1974. Fecal and blood specimens were collected before, during and after their visit and examined for enteric bacterial pathogens, viruses and parasites. In 59 (49 per cent) participants travelers' diarrhea developed. Median duration of illness was five days. Onset occurred a median of six days after arrival. An etiologic agent was found in 63 per cent of ill participants. Enterotoxigenic Escherichia coli of different, non-"enteropathogenic" serotypes was the most common cause; other responsible pathogens included salmonellae, invasive Esch. coli., shigellae, Vibrio parahaemolyticus, Giardia lamblia and the human reovirus-like agent. Consumption of salads containing raw vegetables was associated with enterotoxigenic Esch. coli infection (P = 0.014). Travelers' diarrhea in Mexico is a syndrome caused by a variety of pathogens, the most common of which is enterotoxigenic Esch. col.

Diarrhea↗
PubMed2000

Malignant neoplasms of the nasal cavity and paranasal sinuses: a series of 256 patients in Mexico City and Monterrey. Is air pollution the missing link?

Air pollution is a serious health problem in major cities in Mexico. The concentrations of monitored criteria pollutants have been above the US National Ambient Air Quality Standards for the last decade. To determine whether the number of primary malignant nasal and paranasal neoplasms has increased, we surveyed 256 such cases admitted to a major adult oncology hospital located in metropolitan Mexico City (MMC) for the period from 1976-1997 and to a tertiary hospital in Monterrey, an industrial city, for the period from 1993-1998. The clinical histories and histopathologic material were reviewed, and a brief clinical summary was written for each case. In the MMC hospital the number of newly diagnosed nasal and paranasal neoplasms per year for the period from 1976-1986 averaged 5.1, whereas for the next 11 years it increased to 12.5. The maximal increase was observed in 1995-1997, with an average of 20.3 new cases per year (P = 0.0006). The predominant neoplasms in these series were non-Hodgkin's lymphoma, squamous cell carcinoma, melanoma, adenocarcinoma, Schneiderian carcinoma, and nasopharyngeal carcinoma. In the Monterrey hospital a 2-fold increase in the numbers of newly diagnosed nasal and paranasal neoplasms was recorded between 1993 and 1998. The predominant MMC neoplasm in this series, namely nasal T-cell/natural killer cell non-Hodgkin's lymphoma, is potentially Epstein-Barr virus related. Nasal and paranasal malignant neoplasms are generally rare. Environmental causative factors include exposure in industries such as nickel refining, leather, and wood furniture manufacturing. Although epidemiologic studies have not addressed the relationship between outdoor air pollution and sinonasal malignant neoplasms, there is strong evidence for the nasal and paranasal carcinogenic effect of occupational aerosol complex chemical mixtures. General practitioners and ear, nose, and throat physicians working in highly polluted cities should be aware of the clinical presentations of these patients. Identification of this apparent increase in sinonasal malignant neoplasms in two urban Mexican polluted cities warrants further mechanistic and epidemiologic studies.

Adenocarcinoma↗
PubMed2002

Attitudes toward HIV-infected individuals and infection control practices among a group of dentists in Mexico City--a 1999 update of the 1992 survey.

BACKGROUND: The teaching of infection control (IC) was introduced at dental schools in Mexico during the 1990s. A 1992 survey indicated that some dentists had limited access to current IC standards. Deficient knowledge of bloodborne pathogens may influence dentists' attitudes about infected individuals and reduce compliance with IC recommendations. OBJECTIVE: To update the 1992 appraisal of attitudes about persons infected with HIV or the hepatitis B virus (HBV) and IC knowledge and practices in a nonrepresentative sample of dentists in Mexico City. METHOD: One hundred eighty dentists were interviewed in 1999 (response rate, 84.1%) with the same methods used in 1992. RESULTS: Seventy-nine percent of respondents perceived the risk of HIV infection as "considerable" to "very strong." The risk of HBV infection was considered higher than that of HIV. Only 32% of respondents had not been immunized against HBV. Reported use of personal protective equipment remained high. Dry heat was the preferred method for sterilization in 1992, but by 1999 it had been displaced by steam under pressure. Reported preference for more effective disinfectants was also evident overall. CONCLUSIONS: We found certain improvements in IC knowledge and practices between 1992 and 1999, and the results suggest targets for educational and regulatory efforts that are needed to promote better adherence to current IC standards.

Adult↗
PubMed2003

Ethnic differences at risk for gestational trophoblastic disease in New Mexico: A 25-year population-based study.

OBJECTIVE: The purpose of this study was to compare gestational trophoblastic disease incidence rates with the use of population-based data. STUDY DESIGN: All incident cases between 1973 and 1997 and live birth, pregnancy, and women at risk were tabulated with the use of data that were derived from the New Mexico Tumor Registry and Vital Records and Health Statistics Annual Reports. Statistical methods included trends analyses, odds ratios, and Poisson regression. RESULTS: Of 939 total cases, 312 non-Hispanic white women, 399 Hispanic white women, 201 American Indian women, and 27 other women were affected. Age-adjusted incidence rates were significantly higher for American Indian women (11.16%) compared with non-Hispanic (3.57%) or Hispanic white women (5.32%); the probability value was <.001. When live birth (1:438 women) and pregnancy (1:486 women) denominators were considered, American Indian women alone were at increased risk, and the ratio increased by 56% over 25 years. American Indian women were also at increased risk for partial mole (relative risk, 4.03; 95% CI, 2.57-6.31), invasive mole (relative risk, 26.7; 95% CI, 7.81-93.14), and choriocarcinoma (relative risk, 6.29; 95% CI, 1.81-22.66) variants. CONCLUSION: American Indians are at increased risk relative to the other predominant ethnic groups in New Mexico. Age-adjusted standardization provided a reproducible measurement that may be applicable across other registries.

Adolescent↗
PubMed2001

The earliest archaeological maize (Zea mays L.) from highland Mexico: new accelerator mass spectrometry dates and their implications.

Accelerator mass spectrometry age determinations of maize cobs (Zea mays L.) from Guilá Naquitz Cave in Oaxaca, Mexico, produced dates of 5,400 carbon-14 years before the present (about 6,250 calendar years ago), making those cobs the oldest in the Americas. Macrofossils and phytoliths characteristic of wild and domesticated Zea fruits are absent from older strata from the site, although Zea pollen has previously been identified from those levels. These results, together with the modern geographical distribution of wild Zea mays, suggest that the cultural practices that led to Zea domestication probably occurred elsewhere in Mexico. Guilá Naquitz Cave has now yielded the earliest macrofossil evidence for the domestication of two major American crop plants, squash (Cucurbita pepo) and maize.

Agriculture↗
PubMed2002

Epidemiological and nutritional transition in Mexico: rapid increase of non-communicable chronic diseases and obesity.

OBJECTIVE: The objective of this paper is to characterise the epidemiological and nutritional transition and their determinants in Mexico. DESIGN: Age-adjusted standardised mortality rates (SMRs) due to acute myocardial infarction (AMI), diabetes mellitus and hypertension were calculated for 1980-1998. Changes in the prevalences of overweight and obesity in women and children and of dietary intake from 1988 to 1999 were also used in the analysis. Quantities of food groups purchased by adult equivalent (AE) and food expenditures away from home between 1984 and 1989 were used to assess trends. All information was analysed at the national and regional levels, and by urban and rural areas. RESULTS: SMR for diabetes, AMI and hypertension increased dramatically parallel to obesity at the national and regional levels. Fat intake in women and the purchase of refined carbohydrates, including soda, also increased. DISCUSSION: The results suggest that obesity is playing a role in the increased SMRs of diabetes, AMI and hypertension in Mexico. Total energy dietary intake and food purchase data could not explain the rise in the prevalence of obesity. The increases in fat intake and the purchase of refined carbohydrates may be risk factors for increased mortality. Information on physical activity was not available. CONCLUSION: SMRs due to diabetes, hypertension and AMI have increased dramatically in parallel with the prevalence of obesity; therefore actions should be taken for the prevention of obesity. Reliable information about food consumption and physical activity is required to assess their specific roles in the aetiology of obesity.

Acute Disease↗
PubMed2001

Inadequate drug advice in the pharmacies of Guatemala and Mexico: the scale of the problem and explanatory factors.

A study of urban pharmacies in Guatemala and in Chiapas, southern Mexico, was undertaken to analyse the scale of the inadequate drug advice provided, and to identify the contributing factors. The estimate of the scale of the problem was based on the results of 969 approaches to 191 pharmacies by 'magic clients' (i.e. researchers pretending to be looking for treatment for relatives who had one of three 'tracer' diseases), interviews with 4469 pharmacy users as they left the same 191 pharmacies, and a comparison of the quality of advice offered by public and private pharmacies in Guatemala (based on exit interviews with 150 users). The contributing factors were explored using a provider survey (interviews with 166 pharmacy supervisors and 371 drug vendors), an in-depth study analysing large-chain and independent Mexican pharmacies, and a review of the national drug policies in both countries. Although only about 11% of all drug treatments were recommended in pharmacies (the rest being prescribed by physicians or recommended by kin-groups), this still represents large numbers of treatments. Overall, 501 individuals who visited the 191 study pharmacies over 2 days of observation received drugs recommended by pharmacy staff. Much of the pharmacy advice was revealed to be poor: > 80% of the treatments recommended to the 'magic clients' for diarrhoeal disease or acute respiratory infection included unnecessary or dangerous drugs. Few of those who worked in the pharmacies based their advice on careful case histories. Drug advice in pharmacies was much more likely to be of poor quality than that from physicians or even kin-groups. The factors behind this poor advice were identified as a lack of knowledge about standard treatments and legal regulations, incompetence among pharmacy staff, commercial pressures (particularly in the large-chain pharmacies of Mexico), and a failure to implement the existing regulations covering the drug market and its retail practices. It is recommended that: (1) pharmacy owners and drug vendors be made more aware that the selling of drugs should involve provision of healthcare (as well as reasonable profit-making); (2) existing drug-related legislation be reinforced (through consensus-building rather than coercion); and (3) mass training of pharmacy supervisors and drug vendors, in the standard treatment of common diseases, be undertaken. This process will be challenging and slow.

Clinical Competence↗
PubMed1998

Onchocerciasis: changes in transmission in Mexico.

There are now three endemic foci of onchocerciasis in Mexico, all located in mountainous areas in the south-east: two in the state of Chiapas and one in the state of Oaxaca. Together, these three foci cover 16,900 km2 and contain about 286,000 people in 947 localities, most of the localities being small and scattered. The main economic activity in all the foci is coffee farming. Introduction of Mectizan (ivermectin, MSD) into Mexico in 1989 revolutionized control of onchocerciasis in the country and made elimination of the disease a reasonable goal. Concerted efforts between 1989 and 1997, supported by Merck & Co., the River Blindness Foundation and the Onchocerciasis Elimination Programme in the Americas, have led to steady decreases in the incidence of new cases, nodule prevalence and skin-snip positivities. The improvement has been most marked in the Oaxaca focus, where transmission may have been interrupted. As prior to attempts at control, the largest populations at risk are in the Chiapas foci, where logistical problems and migration have combined to limit the success of local control programmes.

Filaricides↗
PubMed1999

Epidemiological study of Taenia solium taeniasis/cysticercosis in a rural village in Yucatan state, Mexico.

A survey to detect human taeniasis and cysticercosis was conducted in a community in Yucatan state, Mexico, an area endemic for Taenia solium. Information on the environmental, demographic and risk factors associated with transmission of T. solium within the community was recorded on questionnaires. Although no Taenia eggs or proglottides were found in the initial faecal samples collected from each of the 475 subjects, the results of a capture-ELISA for T. solium coproantigen were positive for 10 of the subjects (of both genders and various ages). After treatment with niclosamide, proglottides were detected in purge samples from seven of these 10 subjects. The prevalence of parasitologically confirmed taeniasis was therefore 1.5% (seven in 475). The other three ELISA-positive cases delayed supplying faecal material post-treatment, and it is nuclear whether they had expelled proglottides before providing the samples. All 10 ELISA-positive subjects became ELISA-negative after treatment. Seroprevalence of human cysticercosis, based on the detection in immunoblots of antibodies to antigens of 8- and 26-kDa from a crude saline extract of T. solium metacestodes, was 3.7% (i.e. five positives out of 134 subjects). None of the seropositive cases demonstrated clinical symptoms of infection. Again, the positive cases were of both genders and various ages. Although tongue palpation indicated that 17 (23%) of 75 pigs kept within the community had T. solium cysticercosis, the results of immunoblotting demonstrated antibodies to the 8- and/or 26-kDa antigens of T. solium in 26 (35%). The pigs allowed to roam throughout the community were far more likely to have cysticercosis than those kept in pens (odds ratio = 42, with a 95% confidence interval of 5.05-920.2; P < 0.00001). Not surprisingly, the risk factors associated with human taeniasis and cysticercosis included the eating of infected pork and close proximity to a carrier of T. solium. The main risk factor identified for porcine cysticercosis was free-range husbandry, permitting access to human faeces. This is the first comprehensive report of taeniasis and cysticercosis in a rural population from the Yucatan peninsula of Mexico.

Adolescent↗