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PubMedDate not supplied

[Epidemiology of rubella in Mexico].

An analysis of the transmission dynamics of rubella in Mexico based upon notified cases during 1983-1990 is presented. It is observed, for the first time, that the force of infection in the age-group of 15-44 years old and the average age of the infection at the national level show a slight increase simultaneously. The theoretical estimates of the interepidemic period coincide with the observed ones. The annual proportion of susceptible individuals is practically constant during 1983-1990. The intrinsic reproductive rate of rubella at national level and for the different age-groups is assessed. The annual estimates of Ro are small and they are practically unchanged for all age-groups, excepting the group of 15-44 years. The herd immunity of rubella for the different age-groups is evaluated and it is concluded that the best strategy for preventing congenital rubella in Mexico is to continue with the no vaccination policy against rubella. Nonetheless, the continuous monitoring of this policy is necessary.

Adolescent↗
PubMedDate not supplied

[Double-balloon enteroscopy: experience in the Hospital de Especialidades del Centro Médico Nacional Siglo XXI IMSS, Mexico City].

UNLABELLED: The methods used for the study of the small bowel are not ideal. Double-balloon enteroscopy is a new alternative with therapeutic potential. OBJECTIVE: Evaluate the utility, efficacy and safety of double-balloon enteroscopy in Mexico. MATERIAL AND METHODS: Adult patients seen in the Hospital de Especialidades Centro Médico Nacional Siglo XXI, Mexico City who were being studied for: chronic diarrhea, obscure gastrointestinal hemorrhage, weight-loss and chronic anemia were included in the study. Anterograde (oral) and retrograde (anal) approaches were used and study time, findings and complications were evaluated. RESULTS: Thirty-one enteroscopies were performed, 15 were anterograde, 8 retrograde and 8 were performed via both routes, in 23 patients studied between February and October, 2004; 10 of them were women and 13 men with ages ranging from 25 to 80 years. Fourteen patients were sedated and 9 patients were anesthetized. Study time varied form 55 to 90 minutes. With the anterograde route the ileum was reached in 56.6% of cases, 39.1% the jejunum and only in one patient (4.3%) the whole intestine was explored. With the retrograde route in 62.5% of cases the jejunum was explored and 37.5% the ileum. Four patients with obscure gastrointestinal bleeding and 1 patient with chronic anemia had vascular ecstasies, and in 40% of patients there was no identifiable cause. In 2 patients with intestinal stenosis biopsies revealed intestinal lymphoma in one and ischemic injury in another one. The adverse effects were mild and transitoru. CONCLUSIONS: Double-balloon enteroscopy is a safe diagnostic and therapeutic method that is useful in cases of obscure hemorrhage, chronic anemia; small bowel pathology was found in 64.7% of cases.

Adult↗
PubMed2005

Use of an iron superoxide dismutase excreted by Trypanosoma cruzi in the diagnosis of Chagas disease: seroprevalence in rural zones of the state of Queretaro, Mexico.

Four iron superoxide dismutase (SODI, SODII, SODIII, and SODIV) activities with pI values of 6.9, 6.8, 5.25, and 3.8, respectively, were isolated from epimastigote forms of the Maracay strain of Trypanosoma cruzi cultivated at 28 degrees C in Grace's medium supplemented with 10% heat-inactivated fetal bovine serum. The activity of SODe (pI 3.8), which coincides with that of SODIV, was detected in Grace's medium without serum in which T. cruzi epimastigotes were cultivated for 24 hours at 28 degrees C. SODe, which was excreted into the medium by the parasite, was immunogenic and antibodies to SODe were detected in serum to a dilution of 1:2,500 by Western blot. The role of SODe is related to the establishment of the parasite within the host, and its high immunogenicity and specificity make it a useful molecular marker in diagnosing infection with this parasite. To validate a Western blot result using SODe as a antigen fraction, 1,029 sera of individuals from 11 municipalities in the state of Queretaro, Mexico were analyzed. Sampling was done randomly and results were compared with those for the same sera with three conventional serologic methods: an enzyme-linked immunosorbent assay (ELISA), indirect hemagglutination (IHA), and an indirect immunofluorescence assay (IFA) to detect antibodies to T. cruzi SODe. Samples that were positive by these three techniques were also positive by the Western blot method. The seroprevalence values for SODe (8.16% by ELISA and Western blot) in Queretaro were considerably higher than those reported in regions of Mexico considered to be endemic for Chagas disease. These results support the use of SODe in the serodiagnosis of Chagas disease.

Animals↗
PubMed2005

[Acceptability of a test for antibodies against HIV in a group of pregnant women in Yucatan, Mexico].

OBJECTIVE: To evaluate the acceptability of a test for antibodies against HIV (Ab-HIV) in a group of pregnant women in Yucatan, Mexico. PATIENTS AND METHODS: A clinical and epidemiological study was carried out on 310 pregnant women at different health centers in Yucatan Mexico, from January 2000 to March 2001. A questionnaire was applied to determine information in relation to HIV infection and acceptability of the test. Prior counselling was given to all those who accepted being tested. RESULTS: The median age was 24 (range 14 to 42). A 64.5% had a basic education, 91.6% were homemakers; 38% of the sexual partners worked away from home; 15% said they had more than one sexual partner; 31% had leukorrhea at the time of testing and 69% at some time in the past. Ninety percent of the women accepted being tested for HIV and all of them showed negative results. CONCLUSION: The acceptability of the test was similar to that reported in the international literature. The cost benefits of such a test must be considered, but always within the values of prevailing normative and respect of human rights of women. Despite zero prevalence, we found factors favourable for HIV infection.

AIDS Serodiagnosis↗
PubMed2005

[Frequency of cesarean sections in four hospitals of Mexico City: 20 years later].

BACKGROUND: This article is an update of a similar study published in 1984 in which the frequency of cesarean sections practiced in four Mexico City hospitals from 1976 to 1983 was analyzed. OBJECTIVE: To assess the frequency of cesarean sections practiced in four Mexico City hospitals from 1995 to 2002. MATERIAL AND METHOD: Data from these same hospitals corresponding to the 1995-2002 period was again collected. RESULTS: The frequency of cesarean sections in those four health care centers exceeded by far the internationally accepted standards; this frequency shows an increase, and it now accounts for twice as many operations as the number of interventions originally recorded. In 1976, 10 out of every 68 pregnancies came to end vaginally. By 2002, the same ratio was 10 out of 27. CONCLUSIONS: It is urgent to reduce the frequency of such a practice, as well as to reorganize the obstetric services; furthermore, the corresponding modifications in the training of such medical specialists must be done.

Cesarean Section↗
PubMedDate not supplied

[Seroepidemiology of Chagas disease in Mexico].

The lack of information about Chagas disease in Mexico, as well as the controversy concerning its importance, was the basis for the seroprevalence study of Trypanosoma cruzi in the National Seroepidemiology Survey (NSS). This information was representative of the national situation with regard to disease prevalences and other factors related to the nation's health. Unfortunately the NSS was not a very good information source for the study of trypanosomiasis americana, because its coverage in the disperse rural areas was poor. Nevertheless, the results of the NSS indicated that Chagas disease has an irregular distribution in Mexico with seroprevalences of 1.6, 0.5 and 0.2 for the different dilution levels used in the evaluation. The survey data showed Chagas disease to be less important than that mentioned by other authors. The NSS data confirmed the areas of disease transmission already reported and identified some new ones in Hidalgo, Chiapas and Veracruz. The survey also detected migratory workers with Chagas antibodies in Baja California border cities, a situation which indicates a risk for blood transfusion in areas of the country presumed to be free of the disease. Three quarters (74.5%) of the seropositive population were less than 39 years old. Moreover, the fact that children of less than four years were infected suggests that natural transmission is still very important in some areas. Although the seroprevalences were greater in the lower socio-economic groups, some persons of the higher socio-economic level were also affected. This situation may be explained by the fact that many of these persons own vacation homes in tropical areas.

Adolescent↗
PubMedDate not supplied

[Determining factors of rubella in the 10 to 14 year-old population in Mexico].

The clinical and epidemiological importance of rubella relates to its teratogenic effects. When this disease occurs in children, adolescents and adults, it is usually benign. On the other hand, these age groups are source of disease transmission to pregnant women. The serology studies on rubella carried in Mexico prior to 1974, detected seropositivity levels from 87.1 to 97.7 percent in children younger than 14 years of age. In contrast, the National Seroepidemiology Survey (NSS) (1988) reported a much lower seropositivity (69.3%) in children of the same age group, and a rate of 80 percent in women of reproductive age. This situation is a particular problem for Mexico where a high proportion of the pregnancies occur during adolescence. While previous research has commented on descriptive measures of seroprevalences in women, this study, which is based on a logistic regression model, has the purpose of identifying the factors associated with the immunological status of girls between 10 and 14 years of age. The variable which showed the most evident relation to the antibody levels for rubella was years of schooling. The odds ratios (OR) for seropositivity among those who finished secondary schooling was 2.05 times (CI 1.28-2.56) that of the illiterate group. Other statistically significant variables were related to residence, urban vs rural (OR = 1.69; CI 1.48-2.12) and age, 10 vs 14 years (OR = 1.93; CL 1.69-2.42). Based on the multivariate model, it was observed that the girls with a greater risk of seropositivity were those who live in urban areas, attend secondary school, and are 14 years of age, with an OR = 4.05 (G = 6,756.4 and 5,580 gl; p less than .001). The study concludes with the following considerations: the immunological levels of girls from 10 to 14 years of age are low, and the results of the NSS suggest that Mexican public health authorities should evaluate the policy of vaccination against rubeola in the population potentially at risk, and that the factors associated with the disease, in descending order, are: years of schooling, age, and place of residence. It is also necessary to carry out analytic studies which will identify the risks and the etiology of congenital malformations which are likely to have been associated with the occurrence of rubeola virus during pregnancy.

Adolescent↗
PubMedDate not supplied

[Seroepidemiology of toxoplasmosis in Mexico].

This article presents to the results of the National Seroepidemiology Survey with regard to the prevalence of toxoplasmosis in Mexico. Some theoretical aspects of the disease are discussed, and the prevalences found in earlier reports are presented. The study measured 29,279 blood samples from persons in all 32 states of Mexico, for both sexes, all ages, and socio-economic groups. The samples were processed by indirect immunofluorescence for antibody titers of 1:16 and 1:128. Positivity levels were stratified by age, sex, socioeconomic level, place of residence, education level, number of persons in the family, state, and with or without rights to care in the social security medical institutions. The results pointed to greater prevalences in the costal areas, in lower socioeconomic levels, and a high incidence in women of reproductive age. Also included are a discussion of socio-economic aspects and the potential role of the domestic cat.

Adolescent↗
PubMedDate not supplied

[Detection of Coccidioides immitis infection in Coahuila, Mexico].

Coccidioidomycosis is a mycosis firstly pulmonar caused by Coccidioides immitis; it can be disseminated to central nervous system, bones and skin, principaly. In Mexico, the real frequency of the disease is unknown. The aim of this work was to determine, by skin test and by serology, the infection cases by C. immitis in twelve communities (10 rural and two urban), attended in the Hospital Rural No 79 at the Instituto Mexicano del Seguro Social (IMSS) from the Coahuila State, Mexico. Six hundred and sixty eight adult individuals of both sexes were studied, to whom 0.1 ml of coccidioidin by intradermal route was applied; 72 h after, the induration diameter was measured. One hundred eighty individuals were selected and seric anti-C. immitis immunoglobulins levels were determined by ELISA. Six hundred twenty one individuals (93%) were positive to coccidioidin, the frequency was much higher than that previously reported in Coahuila. From 180 sera studied, the means of optical density (OD) were: IgG1, 1.55; IgG2, 0.94; total IgG, 0.33; IgG3, 0.29; IgG4, 0.27; IgM, 0.08. The values of IgG1, IgG2 and IgM compared with the other immunoglobulins were statistically significant. The high values of IgG1 and IgG2 suggest frequent contact with the antigen, and probable cases of undiagnosed disease.

Adult↗
PubMedDate not supplied

[Teaching and including HIV/AIDS in the curricula of a medical school sample in Mexico].

BACKGROUND: The HIV/AIDS epidemic is apublic health problem that has had an impact on all health systems around the world. Mexico is no exception. Although it has been acknowledged that we have a concentrated epidemic, the problem continues to grow. OBJECTIVE: The objective of this study was to evaluate if the medical school curricula in Mexico included the topic of HIV/AIDS and to assess the level of knowledge medical students have about this disease. MATERIAL AND METHODS: Descriptive study of eight medical schools interviewing pre-graduate medical students. RESULTS: Only 15% of the curricula of private medical schools and 21.7% of public schools included the subject of HIV/AIDS. Although it is difficult to standardize this finding, an average of 8.8 hours was assigned to the study of HIV/AIDS. 90% of the professors involved in teaching the topic of HIV/AlDS hadno clinical experience in thefield CONCLUSION: HIV/AIDS is a low priority subject in our medical school curricula. Efforts must be placed to standardize and reinforce this highly important topic.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Control and eradication strategies of avian influenza in Mexico.

In December 1994, a highly pathogenic (HP) avian influenza (AI) outbreak occurred in Mexico, caused by the subtype H5N2, affecting two main regions of egg and poultry-meat production. At that time, governmental actions included immediate stamping out of the affected flocks, disinfection of affected premises, quarantine measures in the region, strict movement controls on poultry and their products and vaccination. With these policies, the disease was eradicated in a relatively short time. The last case of HPAI was detected in June 1995 and the country was declared as free of HPAI virus in January 1996 to the World Animal Health Organisation (OIE). Since then, Mexico has maintained a control programme against low pathogenic (LP) AI virus that is based on a zoning classification, movement controls and other strategies.

Animals↗
PubMedDate not supplied

[Scorpion stings: a public health problem in Morelos (Mexico)].

Scorpion stings represent a major public health problem in Mexico. Their annual incidence is estimated at 150,000 cases; 800-1,000 people die from them each year, 72.5% of whom are children younger than 5 years old. The states most affected are Aguascalientes, Colima, Durango, Guanajuato, Guerrero, Jalisco, Michoacán, Morelos, Oaxaca, Puebla, Sinaloa, and Zacatecas. Morelos is an endemic zone, and scorpion stings are relatively frequent, but the indigenous population underestimates the risks. In this locality, scorpion stings lead to high morbidity, with an average of 10,219 cases each year, and a prevalence varying from 584.86 per 100,000 inhabitants in 1994 to 2043.3 per 100,000 inhabitants in 2003. Because of this upsurge, systematic medical supervision and serum therapy are necessary if scorpion poisoning is suspected in a child. The indigenous community as well as tourists visiting Mexico must be informed about the substantial risk of scorpion poisoning.

Adolescent↗
PubMedDate not supplied

Rapid assessment procedures in environmental sanitation research: a case study from the northern border of Mexico.

BACKGROUND: There is a need to enhance the quality and sustainability of environmental health programs in Mexico. What socio-cultural factors influenced the adoption or rejection of Clean Water in Homes programs in this population? We applied rapid appraisal procedures (RAP) to evaluate these community-based programs. METHOD: Qualitative study conducted in communities along Mexico's northern border. We conducted informal dialogues, semi-structured interviews, field notes and observations. Home visits used a checklist to observe: sources of water, handwashing, as well as human waste and garbage disposal patterns. Data analysis was conducted using ATLAS.ti, which facilitated comparison and illustration of discrepancies, the elaboration of emerging issues and relationships between them. RESULTS: Community members perceived that the Clean Water program was a top-down intervention. Water is perceived as a political issue and a matter of corruption. Inequity also limits solidarity activities involved in environmental sanitation. Migration to the United States of America (US) contributes to community fragmentation, which in turn dilutes communal efforts to improve water and sanitation infrastructure. While targeting women as program "recipients", the Clean Water program did not take gendered spheres of decision-making into account. Community members and authorities discussed the main results in "assemblies", particularly addressing the needs of excluded groups. CONCLUSION: The oversight of not exploring community members' needs and priorities prior to program implementation resulted in interventions that did not address the structural (economic, infrastructure) and socio-cultural barriers faced by community members to undertake the health-promoting behaviour change, and provoked resentment.

Adolescent↗
PubMed2005

[Overuse of colposcopy service in Mexico].

BACKGROUND: Cervicouterine cancer is one of the main public health problems in Mexico. Several problems related to the low effectiveness of the Program of Opportune Detection of Cervicouterine Cancer have been identified, among them: low cover of the disease detection and absence of quality control in the detection, diagnosis and treatment of it. In Mexico the quality control problem in cytology has been taken with success, but the opposite occurs with colposcopy practice. For that reason this service is overused by patients with low risk cancer and is not accessible for the high risk population. OBJECTIVE: To evaluate the association between cervicouterine cancer knowledge and satisfaction with the service regarding the use and intention of adherence to it for the follow-up and treatment, as well as analyze the resources used for this attention. PATIENTS AND METHODS: A transversal study was done from May to December, 2002. It included all the patients who went to the Colposcopy Service in three hospitals. 1,606 patients were interviewed, from them 443 cases were first-time visits and 1,163 were subsequent ones. RESULTS: In a multivariate model we observed that the real utility knowledge of cervicovaginal cytology increases the probability that women come back to the Colposcopy Service (OR 2.0, Cl 95%: 1.57, 2.54). Patients who know their diagnosis when it is dysplasia or cancer are more likely to become attached to their follow-up than those who do not know it. 91% of the users (1,463) had two or more cervicovaginal cytolgies done, and 49% (787) had eight or more. Patients who know the purpose and utility of the biopsy had a 4.4 fold probability of become subsequent than those that do not know such information (Cl 95%: 1.72 to 11.35). CONCLUSIONS: Nowadays colposcopy clinics treat 70% of the patients who are subsequent and that have normal reports of cytology. This shows us an overuse of the service, with the consequent service, monetary and opportunity costs for women. More studies should be done to reformulate the rule that controls the treatment of these patients, and incorporate follow-up guidelines according to the natural history of the disease in Mexican women.

Adult↗
PubMed2006

Racial and ethnic differences in premature heart disease deaths in New Mexico: what is the role of diabetes?

Multiple-cause mortality files from 1999-2001 were obtained to describe premature heart disease (PHD) deaths and the role of diabetes as a contributing cause in heart disease (HD) mortality in American Indians, Hispanics, and non-Hispanic Whites in New Mexico. The proportion and rate of PHD and diabetes-related HD death were calculated and reported by race/ethnicity and gender. Results indicate that from 1999 to 2001, 24% of all deaths in New Mexico reported HD as the leading cause of death. Of these, 16.6% occurred in persons <65 years of age and were therefore classified as premature. The proportion of premature HD deaths was substantially higher in the American-Indian (29.2%) and Hispanic (20.8%) populations compared to Whites (13.7%). Furthermore, diabetes contributed to almost 18% of premature HD deaths in American Indians and Hispanics and to 10% of premature HD among Whites. These findings suggest that American Indians and Hispanics are disproportionately affected by premature HD death and that diabetes as a contributing cause is greater among these populations compared to non-Hispanic Whites.

Adult↗
PubMed2006

Large-scale entomologic assessment of Onchocerca volvulus transmission by poolscreen PCR in Mexico.

To study the impact of mass Mectizan treatment on Onchocerca volvulus transmission in Mexico, entomological surveys were carried out in the endemic foci of Oaxaca, Southern Chiapas, and Northern Chiapas. Collected flies were screened by polymerase chain reaction (PCR) for O. volvulus parasites. The prevalence of infected and infective flies was estimated using the PoolScreen algorithm and with a novel probability-based method. O. volvulus infective larvae were not detected in flies from 6/13 communities. In 7/13 communities, infective flies were detected, with prevalences ranging from 1.6/10,000 to 29.0/10,000 and seasonal transmission potentials ranging from 0.4 to 3.3. Infected and infective flies were found in a community in Northern Chiapas, suggesting that, according to World Health Organization criteria, autochthonous transmission exists in this focus. These data suggest that O. volvulus transmission in Mexico has been suppressed or brought to a level that may be insufficient to sustain the parasite population.

Algorithms↗
PubMedDate not supplied

[Risk factors associated with neurocysticercosis in a public hospital in Mexico].

OBJECTIVE: A case-control study was carried out to determine risk factors associated with neurocysticercosis in a public hospital in Mexico. METHODS: The following factors were analyzed: Socioeconomic, sociodemographic, hygiene, eating habits, and family history of neurocysticercosis in 85 cases and 170 controls. Cases were patients with cranial computed tomography images compatible with neurocysticercosis. The densitometric analysis (Hounsfield units) allowed us to distinguish normal tissue from physiological and pathological calcifications, and other types of lesions. Controls were admitted for neurocysticercosis but findings were not compatible with initial diagnosis. Statistical analysis was done using SPSS and Epi-info 2002. RESULTS: The most common clinical manifestation in patients was epileptic seizures OR=4.2 (IC 95% 2.40-9.67). With regards to risk factors, consumption of street food OR=2.33 (IC 95% 1.25-4.38), and family history of neurocysticercosis OR= 2.37 (IC 95% 1.11-5.04) were found to be associated with neurocysticercosis. In the north central region of Mexico where this study was performed, the disease was more frequent among urban populations.

Case-Control Studies↗
PubMedDate not supplied

[Changes in factors associated with the nutrition transition in Mexico].

OBJECTIVES: To describe the demographic and socioeconomic changes, food availability and food expense in Mexico during 1980-2000. METHODS: From official statistics (Population Census, FAO Food Balance Sheets, Family Income and Expense National Survey and Economic Census) we estimated the evolution of population distribution according to locality size, occupational structure, woman participation in the wage-earning labor force, minimum wage, availability of food establishments and expense in food. RESULTS: The percentage of the population that lives in urban areas has increased, they are employed in the tertiary sector, womens participation in the labor market has increased but real minimum wages have decreased. Vegetables, oleaginous, oils, fish and seafood availability have decreased whereas animal fat, vegetables, fruits, softdrinks, meats and egg availability have increased. The number of inexpensive restaurants (cocinas económicas and fondas) has also increased. Food expenses have decreased while amount of money spent in food consumed away from home has increased. CONCLUSIONS: In Mexico, the growth in urban areas and the tertiary job sector shows a parallel growth in the availability of high fat and protein food, a greater diet variety and more opportunities to consume food not prepared in the home. On the other hand, the sale of equipment and places designed for recreational physical activity have increased. By reducing employment in the primary sector it is foreseeable that labor intensive physical activity will become less important overtime.

Female↗