Perfil clínico-epidemiológico de las defunciones por influenza con antecedente de vacunación oportuna, México 2010-2018.

INTRODUCTION: Influenza epidemics are of higher risk at the extremes of life and in people with comorbidities. Effective -vaccination prevents the occurrence of serious cases and decreases mortality. OBJECTIVE: To describe deaths from influenza with a history of timely vaccination, from the 2010 to the 2018 season in Mexico. METHOD: Cross-sectional, descriptive study where the Influenza Epidemiological Surveillance System database was used. RESULTS: From 2010 to 2018, 65 vaccinated individuals died from influenza, from which 55% of cases (n = 36) were due to type A (H1N1), 51% (n = 33) were females, median age was 57 years, 21 % (n = 14) did not meet the operational definition of influenza-like illness or severe acute respiratory infection, 83% (n = 54) had at least one comorbidity, with the most common being diabetes mellitus and hypertension (32% each); 55% (n = 36) of deaths received antiviral treatment and only 8% (n = 5) had no comorbidities and received treatment with oseltamivir. CONCLUSIONS: Deaths from influenza with timely vaccination represent a very low percentage of the totality. Vaccination against influenza has been a specific prevention strategy that decreases disease burden.

INTRODUCCIÓN: Las epidemias de influenza son de mayor riesgo en los extremos de la vida y en personas con comorbilidades. La vacunación efectiva previene la aparición de casos graves y disminuye la mortalidad. OBJETIVO: Describir las defunciones por influenza en México con antecedente de vacunación oportuna, de 2010 a 2018. MÉTODO: Estudio transversal descriptivo en el que se utilizó la base de datos del Sistema de Vigilancia Epidemiológica de Influenza. RESULTADOS: De 2010 a 2018 fallecieron por influenza 65 personas con vacunación, 55 % (n = 36) de las cuales por tipo A (H1N1), 51 % (n = 33) del sexo femenino, la mediana de edad fue de 57 años, 21 % (n = 14) no cumplía la definición operacional de enfermedad tipo influenza o infección respiratoria aguda grave, 83 % (n = 54) tenía al menos una comorbilidad; las comorbilidades más frecuentes fueron diabetes mellitus e hipertensión arterial (32 % cada una); 55 % (n = 36) recibió tratamiento antiviral y solo 8 % (n = 5) no presentaba comorbilidades y tenía tratamiento con oseltamivir. CONCLUSIONES: Las defunciones por influenza con vacunación oportuna representan un porcentaje muy bajo del total. La vacunación contra influenza ha sido una estrategia de prevención específica que disminuye la carga de la enfermedad.

Clinical-epidemiological profile of deaths from influenza with a history of timely vaccination, Mexico 2010-2018.

INTRODUCTION: Influenza epidemics are of higher risk at the extremes of life and in people with comorbidities. Effective vaccination prevents the occurrence of serious cases and decreases mortality. OBJECTIVE: To describe deaths from influenza with a history of timely vaccination, from the 2010 to the 2018 season in Mexico. METHOD: Cross-sectional, descriptive study where the Influenza Epidemiological Surveillance System database was used. RESULTS: From 2010 to 2018, 65 vaccinated individuals died from influenza, from which 55% of cases (n = 36) were due to type A (H1N1), 51% (n = 33) were females, median age was 57 years, 21 % (n = 14) did not meet the operational definition of influenza-like illness or severe acute respiratory infection, 83% (n = 54) had at least one comorbidity, with the most common being diabetes mellitus and hypertension (32% each); 55% (n = 36) of deaths received antiviral treatment and only 8% (n = 5) had no comorbidities and received treatment with oseltamivir. CONCLUSIONS: Deaths from influenza with timely vaccination represent a very low percentage of the totality. Vaccination against influenza has been a specific prevention strategy that decreases disease burden.

Challenges in the development and implementation of the National Comprehensive Cancer Control Program in Mexico.

Chronic noncommunicable diseases (NCDs), including cancer, have become the leading cause of human morbidity and mortality. In Mexico, cancer is the third leading cause of death, with a high incidence among the economically active population, a high proportion of advanced stages at diagnosis and limited care coverage for patients. However, no public policy aimed at managing this important public health problem has been developed and implemented to date. This manuscript describes the first interinstitutional proposal of a National Program for Cancer Control, considering the known risk factors, early detection, treatment, palliative care and patient rehabilitation. This manuscript also outlines a series of thoughts on the difficulties and needs that the Mexican health system faces in achieving the main objectives of the program: to decrease the incidence of cancer, to increase survival and to improve the quality of life for this group of patients.

[Emerging and reemerging diseases]. / Enfermedades emergentes y reemergentes.

Emerging and reemerging diseases are the result of the interaction of multiple factors, such as social determinants of health, climate change, and conditions that prevail and are identifiable in some populations. As a consequence, there may be situations that by their nature are defined as a health emergency, impacting directly on the health of a population, either because they are not known or due to their rapid spread, resulting in a health security problem. Examples of these diseases are described in this article, starting with their origin, their impact on the population, and the response necessary in order to contain or prevent damage of a greater magnitude. The presence of these agents and their consequent damage to the population should lead efforts towards comprehensive prevention and appropriate containment strategies to ensure the protection of public health. Endeavors should be directed not only to a specific agent, but rather to factors that determine their reemergence, such as Ebola, or their permanence, such as the binomial infection of tuberculosis-AIDS. In order to correctly implement strategies, training and availability of supplies play a crucial role in facing the challenges that lie ahead.

[Impact of health transition on services demand]. / La transición en salud y su impacto en la demanda de servicios.

Health transition is a process that determines the way a population dies and gets sick, there are several processes that contribute to the change in the health profile of a population that might be analyzed. The demographic transition, reflected in population aging and change of population structure; risk transition, which explains differential exposures to risk factors; technologic transition, as a major contributor to change in health and the epidemiologic transition that explains how the social, economic and demographic determinants impact the epidemiologic profile of a society. An analysis of the current health profile in Mexico is shown and its consequences on the health system and the need for change is discussed.

Analysis of spatial mobility in subjects from a Dengue endemic urban locality in Morelos State, Mexico.

INTRODUCTION: Mathematical models and field data suggest that human mobility is an important driver for Dengue virus transmission. Nonetheless little is known on this matter due the lack of instruments for precise mobility quantification and study design difficulties. MATERIALS AND METHODS: We carried out a cohort-nested, case-control study with 126 individuals (42 cases, 42 intradomestic controls and 42 population controls) with the goal of describing human mobility patterns of recently Dengue virus-infected subjects, and comparing them with those of non-infected subjects living in an urban endemic locality. Mobility was quantified using a GPS-data logger registering waypoints at 60-second intervals for a minimum of 15 natural days. RESULTS: Although absolute displacement was highly biased towards the intradomestic and peridomestic areas, occasional displacements exceeding a 100-Km radius from the center of the studied locality were recorded for all three study groups and individual displacements were recorded traveling across six states from central Mexico. Additionally, cases had a larger number of visits out of the municipality´s administrative limits when compared to intradomestic controls (cases: 10.4 versus intradomestic controls: 2.9, p = 0.0282). We were able to identify extradomestic places within and out of the locality that were independently visited by apparently non-related infected subjects, consistent with houses, working and leisure places. CONCLUSIONS: Results of this study show that human mobility in a small urban setting exceeded that considered by local health authority's administrative limits, and was different between recently infected and non-infected subjects living in the same household. These observations provide important insights about the role that human mobility may have in Dengue virus transmission and persistence across endemic geographic areas that need to be taken into account when planning preventive and control measures. Finally, these results are a valuable reference when setting the parameters for future mathematical modeling studies.

Detection of Zika virus in Aedes mosquitoes from Mexico.

Background: We report on the results of an entomovirological surveillance system of Aedes populations performed by the Ministry of Health of the central state of San Luis Potosí, Mexico. Methods: Indoor adult Aedes aegypti and Aedes albopictus pools collected at San Martín, Tamazunchale, Ciudad Valles, Metlapa, Ebano, Tamuin and Axtla during the dry season of 2016 were examined for the presence of dengue (DENV), chikungunya (CHIKV) and Zika (ZIKV) viruses using real-time PCR. Results: Both Ae. aegypti and Ae. albopictus were found to be infected with ZIKV in the absence of confirmed symptomatic human cases. Conclusions: The entomovirological surveillance system analysed here identified both Ae. aegypti and Ae. albopictus infected with ZIKV which triggered an immediate aggressive vector control campaign.

Clinical-epidemiological profile of deaths from influenza with a history of timely vaccination, Mexico 2010-2018

Introduction: Influenza epidemics are of higher risk at the extremes of life and in people with comorbidities. Effective vaccination prevents the occurrence of serious cases and decreases mortality. Objective: To describe deaths from influenza with a history of timely vaccination, from the 2010 to the 2018 season in Mexico. Method: Cross-sectional, descriptive study where the Influenza Epidemiological Surveillance System database was used. Results: From 2010 to 2018, 65 vaccinated individuals died from influenza, from which 55% of cases (n = 36) were due to type A (H1N1), 51% (n = 33) were females, median age was 57 years, 21 % (n = 14) did not meet the operational definition of influenza-like illness or severe acute respiratory infection, 83% (n = 54) had at least one comorbidity, with the most common being diabetes mellitus and hypertension (32% each); 55% (n = 36) of deaths received antiviral treatment and only 8% (n = 5) had no comorbidities and received treatment with oseltamivir. Conclusions: Deaths from influenza with timely vaccination represent a very low percentage of the totality. Vaccination against influenza has been a specific prevention strategy that decreases disease burden.

Challenges in the development and implementation of the National Comprehensive Cancer Control Program in Mexico / Retos del desarrollo e implementación del Programa Nacional de Control Integral del Cáncer en México

Abstract Chronic noncommunicable diseases (NCDs), including cancer, have become the leading cause of human morbidity and mortality. In Mexico, cancer is the third leading cause of death, with a high incidence among the economically active population, a high proportion of advanced stages at diagnosis and limited care coverage for patients. However, no public policy aimed at managing this important public health problem has been developed and implemented to date. This manuscript describes the first interinstitutional proposal of a National Program for Cancer Control, considering the known risk factors, early detection, treatment, palliative care and patient rehabilitation. This manuscript also outlines a series of thoughts on the difficulties and needs that the Mexican health system faces in achieving the main objectives of the program: to decrease the incidence of cancer, to increase survival and to improve the quality of life for this group of patients.

Resumen Las enfermedades crónicas no transmisibles (ECNT), incluido el cáncer, se han convertido en la principal causa de morbimortalidad de la humanidad. En México, el cáncer es la tercera causa de muerte, con una frecuencia elevada en población económicamente activa, una alta proporción de etapas avanzadas al momento del diagnóstico y una limitada cobertura de atención a quienes la padecen. No obstante, hasta el momento no se ha desarrollado e implementado una política pública dirigida al control de este importante problema de salud pública. Este manuscrito muestra la primera propuesta interinstitucional de un Programa Nacional para el Control del Cáncer, considerando los factores de riesgo conocidos, la detección temprana, el tratamiento y los cuidados paliativos y la rehabilitación del paciente. Asimismo se hacen una serie de reflexiones sobre las dificultades y necesidades a las que el sistema de salud mexicano se enfrenta para alcanzar los objetivos principales del programa: reducir la incidencia, incrementar la supervivencia y mejorar la calidad de vida de este grupo de pacientes.

[Epidemiology of tobacco use in Mexico]. / Epidemiología del tabaquismo en México.

Tobacco use is a worldwide public health problem. According to the World Health Organization (WHO), smoking is the second principal cause of death in the world, with almost five million deaths annually. Information about tobacco consumption is essential in order to improve the focus of prevention and control measures and thereby succeed in the struggle against tobacco use. This literature review, carried out in Mexico in 2006, presents a comparative analysis of information about smoking prevalence from the National Addictions Survey 2002, as it relates to results obtained in previous surveys. This review also presents information about youth and passive smoking, tobacco consumption in the medical profession and impact on mortality as aspects relevant to the analysis of this epidemic. Epidemiological information is viewed in the context of the tobacco use component of the Plan of Action on Addiction and the WHO Framework Convention on Tobacco Control.

[Policies, monitoring and minors access to cigarettes in Mexico City]. / Políticas, vigilancia y acceso de los menores de edad a los cigarros en la Ciudad de México.

In Mexico and other countries, the accessibility that minors have to products derived from tobacco -mainly cigarettes- is a primary contributing factor to smoking, and is currently one of the main public health challenges worldwide. In the fight against tobacco use, effective legislation for decreasing production, distribution and the sale of tobacco products is indispensable to the creation of conditions necessary for achieving a tobacco-free society. The sale of cigarettes to minors is an act that has unique characteristics according to the particular location, particularly in Mexico City, and the time in which it is evaluated. The lack of monitoring compliance with official regulations contributes to the fact that minors directly obtain cigarettes from most of the stores.

[Prevalence and risk factors related to sale of cigarettes to minors in stores in Mexico City]. / Prevalencia y factores asociados a la venta de cigarros a menores de edad en el Distrito Federal.

OBJECTIVE: To identify the prevalence of the sale of cigarette to minors in stores in Mexico City. MATERIAL AND METHODS: A cross-sectional study was done applying a questionnaire to salespersons in stores that sell cigarettes. The SCINCE 2000 from INEGI was used to select and sample two Basic Geostatistical Areas (AGEB) per Delegation and a census of stores was carried out. RESULTS: A total of 577 stores were visited, 73% sold cigarettes to minors, 58% sell loose cigarettes, only 2.6% asked the buyer's age, and 1.2% requested identification. Among the salespersons, 51% were men, 37% had secondary school studies, 57% were smokers, 42% had children underage, and 99% knew that the sale of cigarettes to minors is prohibited. The multivariate analysis established an explicative model and it was discovered that when the salesperson was male or if the cigarettes were sold individually the probability of sale was 2 and 5 times higher respectively. CONCLUSIONS: The sale of cigarettes to minors in Mexico City is not associated with the personal characteristics of the salespersons or with the stores.

Epidemiología del tabaquismo en México / Epidemiology of tobacco use in Mexico

El consumo de tabaco es un problema de salud pública mundial. De acuerdo con la Organización Mundial de la Salud, el tabaquismo es la segunda causa principal de muerte en el mundo, con casi cinco millones de defunciones anuales. Se requiere contar con información y análisis sobre el consumo de tabaco para tener éxito en la lucha contra el tabaquismo y así orientar de mejor manera las medidas de prevención y control. En este artículo de revisión, realizado en México en 2006, se presenta un análisis comparativo de la información de la prevalencia del tabaquismo de la Encuesta Nacional de Adicciones 2002, en relación con los resultados obtenidos en encuestas anteriores. También se presenta la información de los fumadores jóvenes y los pasivos, el consumo de tabaco en la profesión médica y el efecto sobre la mortalidad, así como aspectos relevantes de análisis de esta epidemia. Tal información epidemiológica se observa en el contexto del componente tabaquismo del Plan de Acción de Tabaquismo y el Convenio Marco para el Control del Tabaco.

Políticas, vigilancia y acceso de los menores de edad a los cigarros en la Ciudad de México / Policies, monitoring and minors access to cigarettes in Mexico City

En México y otros países, la accesibilidad que tienen los menores de edad a productos derivados del tabaco -sobre todo cigarros- es un factor primordial que contribuye al desarrollo del tabaquismo, que hoy día constituye uno de los principales desafíos de la salud pública en todo el mundo. En la lucha contra esta adicción, la existencia de una legislación eficaz para disminuir la producción, distribución y venta de productos derivados del tabaco es indispensable para crear las condiciones necesarias y lograr una sociedad libre de tabaco. La venta de cigarros a menores es un acto que posee características específicas en cada lugar y tiempo en que se evalúa. En particular, en el Distrito Federal la falta de vigilancia en el cumplimiento de las disposiciones oficiales contribuye a que los menores de edad consigan los cigarros en la mayoría de los comercios y los adquieran de forma directa.

Prevalencia y factores asociados a la venta de cigarros a menores de edad en el Distrito Federal / Prevalence and risk factors related to sale of cigarettes to minors in stores in Mexico City

OBJETIVO: Conocer la prevalencia y los factores asociados a la venta de cigarros a menores en el Distrito Federal. MATERIAL Y MÉTODOS: Estudio transversal realizado mediante una encuesta a expendedores de comercios que venden cigarros. Se generó un marco muestral mediante el SCINCE 2000 del INEGI, se seleccionaron probabilísticamente dos Areas Geoestadísticas Básicas (AGEB) por delegación y se realizó un censo de dichos comercios. RESULTADOS: Se visitaron 577 comercios de los cuales 73 por ciento vendió cigarros a menores, 58 por ciento vendía cigarros sueltos; 2.6 por ciento preguntó la edad y 1.2 por ciento solicitó una identificación. De los expendedores, 51 por ciento fueron hombres, 37 por ciento cursó la secundaria, 57 por ciento había fumado, 42 por ciento tenía hijos menores y 99 por ciento sabía que está prohibido vender cigarros a menores. El análisis multivariado permitió establecer un modelo explicativo, y se encontró que cuando el expendedor es hombre o se venden cigarros sueltos se incrementa entre 2 y 5 veces la posibilidad de venta, respectivamente. CONCLUSIONES: La venta de cigarros a menores en el Distrito Federal es independiente de las características del expendedor y del comercio.