Metodología de la Encuesta Nacional de Salud y Nutrición 2020 sobre Covid-19.

Objetivo. Describir el diseño y los resultados de campo de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2020 so-bre Covid-19. Material y métodos. La Ensanut Covid-19 es una encuesta probabilística de hogares. En este artículo se describen los siguientes elementos del diseño: alcance, muestreo, medición, inferencia y logística. Resultados. Se obtuvieron 10 216 entrevistas de hogar completas y 9 464 resultados sobre seropositividad a SARS-CoV-2. La tasa de respuesta de hogar fue 80% y la de prueba de seropositividad de 44%. Conclusiones. El diseño probabilístico de la Ensa-nut Covid-19 permite hacer inferencias estadísticas válidas sobre parámetros de interés para la salud pública a nivel nacional y regional; en particular, permitirá hacer inferencias de utilidad práctica sobre la prevalencia de seropositividad a SARS-CoV-2 en México. Además, la Ensanut Covid-19 podrá ser comparada con Ensanut previas para identificar potenciales cambios en los estados de salud y nutrición de la población mexicana.

Prevalencia de diabetes y descontrol glucémico en México: resultados de la Ensanut 2016 / Prevalence of diabetes and poor glycemic control in Mexico: results from Ensanut 2016

Resumen: Objetivo: Estimar la prevalencia de diabetes (total, diagnosticada y no diagnosticada), de descontrol glucémico en México y sus factores asociados. Material y métodos: Se analizaron 3 700 adultos participantes en la Encuesta Nacional de Salud y Nutrición de 2016. Se estimaron las prevalencias con ponderadores poblacionales y los factores asociados con diabetes total y descontrol glucémico con modelos de regresión de Poisson. Resultados: La prevalencia total de diabetes fue de 13.7% (9.5% diagnosticada, 4.1% no diagnosticada); 68.2% de los diagnosticados presentó descontrol glucémico. Mayor tiempo de diagnóstico, vivir en el centro/sur del país y ser atendido en farmacias se asoció con descontrol glucémico, mientras que ser atendido en los servicios de seguridad social se asoció con mejor control glucémico. Conclusión: Se requieren esfuerzos multisectoriales para fortalecer el tamizaje, diagnóstico oportuno y control de la enfermedad, considerando las diferencias por región y tipo de servicio de salud.

Abstract: Objective: To estimate the prevalence of total, diagnosed and undiagnosed diabetes, and the prevalence of poor glycemic control in Mexico, and its associated factors. Materials and methods: Data from 3 700 adult participants were analysed in the 2016 National Health and Nutrition Survey. Diabetes prevalences were estimated with population weights, and the factors associated with total diabetes and poor glycemic control with Poisson regression models. Results: The total prevalence of diabetes was 13.7% (9.5% diagnosed, 4.1% undiagnosed); 68.2% of people with diagnosed diabetes presented poor glycemic control. Longer disease duration, living in the centre or south of the country and being treated in pharmacies were associated with poor glycemic control. Being treated in a social security system was associated with better glycemic control. Conclusion: Multisectoral efforts are needed to strengthen screening, timely diagnosis and disease control, considering differences by region and type of health service.

[Prevalence of diabetes and poor glycemic control in Mexico: results from Ensanut 2016.] / Prevalencia de diabetes y descontrol glucémico en México: resultados de la Ensanut 2016.

OBJECTIVE: To estimate the prevalence of total, diagnosed and undiagnosed diabetes, and the prevalence of poor glycemic control in Mexico, and its associated factors. MATERIALS AND METHODS: Data from 3 700 adult participants were analysed in the 2016 National Health and Nutrition Survey. Diabetes prevalences were estimated with population weights, and the factors associated with total diabetes and poor glycemic control with Poisson regression models. RESULTS: The total prevalence of diabetes was 13.7% (9.5% diagnosed, 4.1% undiagnosed); 68.2% of people with diagnosed diabetes presented poor glycemic control. Longer disease duration, living in the centre or south of the country and being treated in pharmacies were associated with poor glycemic control. Being treated in a social security system was associated with better glycemic control. CONCLUSIONS: Multisectoral efforts are needed to strengthen screening, timely diagnosis and disease control, considering differences by region and type of health service.

OBJETIVO: Estimar la prevalencia de diabetes (total, diagnosticada y no diagnosticada), de descontrol glucémico en México y sus factores asociados. MATERIAL Y MÉTODOS: Se analizaron 3 700 adultos participantes en la Encuesta Nacional de Salud y Nutrición de 2016. Se estimaron las prevalencias con ponderadores poblacionales y los factores asociados con diabetes total y descontrol glucémico con modelos de regresión de Poisson. RESULTADOS: La prevalencia total de diabetes fue de 13.7% (9.5% diagnosticada, 4.1% no diagnosticada); 68.2% de los diagnosticados presentó descontrol glucémico. Mayor tiempo de diagnóstico, vivir en el centro/sur del país y ser atendido en farmacias se asoció con descontrol glucémico, mientras que ser atendido en los servicios de seguridad social se asoció con mejor control glucémico. CONCLUSIONES: Se requieren esfuerzos multisectoriales para fortalecer el tamizaje, diagnóstico oportuno y control de la enfermedad, considerando las diferencias por región y tipo de servicio de salud.

[The health of Mexicans living in localities with less than 100 000 inhabitants]. / La salud de los mexicanos que habitan en localidades de menos de 100 000 habitantes.

OBJECTIVE: To describe the health and nutritional status of Mexican population living in localities under 100 000 inhabitants (100k) in year 2018 in comparison it with a sample of similar characteristics in 2012. MATERIALS AND METHODS: The more relevant results analyzed in 19 articles about health and nutrition of the population are presented. This included information on access and utilization of health services, health and nutrition status by age groups and households affected by food insecurity (FI). RESULTS: Information was obtained about the health and nutrition status of the population from <100k localities, which is characterized by its higher poverty levels. CONCLUSIONS: Great inequities prevails the health and nutrition conditions of the Mexican population. The findings are useful for the devel- opment of public policies capable of reducing health inequities conditions, in order to achieve social equity.

OBJETIVO: Describir la situación de salud y nutrición de la población mexicana que habita en localidades de menos de 100 000 habitantes (100k) para el año 2018 y compararla con una muestra con características similares en 2012. MATERIAL Y MÉTODOS: Se presentan los resultados sobre la salud y nutrición de la población, analizados en 19 artículos sobre el acceso y utilización de los servicios de salud, la situación de salud y nutrición por grupos de edad y sobre los hogares afectados por inseguridad alimentaria. RESULTADOS: Se obtuvo información de salud y nutrición a nivel nacional en población de localidades <100k, caracterizada por tener mayores con- diciones de pobreza. CONCLUSIONES: En México prevalecen desigualdades en las condiciones de salud y nutrición de la po- blación. Los hallazgos son de utilidad para desarrollar políticas públicas capaces de reducir las desigualdades en salud, con el objeto de lograr la equidad social.

[Medical care and self-care actions in people living with diabetes, according to socioeconomic level.] / Atención médica y acciones de autocuidado en personas que viven con diabetes, según nivel socioeconómico.

OBJECTIVE: To characterize medical care and self-care actions in a population with diabetes in locations smaller than 100 000 inhabitants. MATERIALS AND METHODS: With information from the Encuesta Nacional de Salud y Nutrición 100k (Ensanut 100k), two logistic regression models were obtained: not performing five basic actions in the last consultation and not taking priority self-care actions. RESULTS: Having low schooling, belonging to the low economic stratum, and speaking indigenous language, increase the probability of not taking self-care actions. On the contrary, as age increases, the chances of self-care are reduced by 3%. Belonging to an indigenous household and the low tercile, increases the chances that health personnel will not perform the five basic actions during the consultation. CONCLUSIONS: It is essential that a diabetes control program be established that includes patient education and update courses for medical staff.

OBJETIVO: Caracterizar la atención médica y las acciones de autocuidado en población con diabetes, en localidades de menos de 100 000 habitantes. MATERIAL Y MÉTODOS: Con información de la Encuesta Nacional de Salud y Nutrición 100k (Ensanut 100k), se obtuvieron dos modelos de regresión logística: no realizar las cinco acciones básicas en la última consulta médica y no realizar acciones prioritarias de autocuidado. RESULTADOS: Tener baja escolaridad, pertenecer al estrato económico bajo y hablar lengua indígena incrementan las posibilidades de no realizar acciones de autocuidado. Por el contrario, al incrementarse la edad, se disminuyen las posibilida- des de autocuidado en 3%. Pertenecer a un hogar indígena y al tercil bajo incrementan las posibilidades de que el personal de salud no realice las cinco acciones básicas durante la consulta. CONCLUSIONES: Es indispensable que se establezca un programa de control de diabetes que incluya educación a pacientes y cursos de actualización al personal médico.

La salud de los mexicanos que habitan en localidades de menos de 100 000 habitantes / The health of Mexicans living in localities with less than 100 000 inhabitants

Resumen: Objetivo: Describir la situación de salud y nutrición de la población mexicana que habita en localidades de menos de 100 000 habitantes (100k) para el año 2018 y compararla con una muestra con características similares en 2012. Material y métodos: Se presentan los resultados sobre la salud y nutrición de la población, analizados en 19 artículos sobre el acceso y utilización de los servicios de salud, la situación de salud y nutrición por grupos de edad y sobre los hogares afectados por inseguridad alimentaria. Resultados: Se obtuvo información de salud y nutrición a nivel nacional en población de localidades <100k, caracterizada por tener mayores condiciones de pobreza. Conclusiones: En México prevalecen desigualdades en las condiciones de salud y nutrición de la población. Los hallazgos son de utilidad para desarrollar políticas públicas capaces de reducir las desigualdades en salud, con el objeto de lograr la equidad social.

Abstract: Objective: To describe the health and nutritional status of Mexican population living in localities under 100 000 inhabitants (100k) in year 2018 in comparison it with a sample of similar characteristics in 2012. Materials and methods: The more relevant results analyzed in 19 articles about health and nutrition of the population are presented. This included information on access and utilization of health services, health and nutrition status by age groups and households affected by food insecurity (FI). Results: Information was obtained about the health and nutrition status of the population from <100k localities, which is characterized by its higher poverty levels. Conclusions: Great inequities prevails the health and nutrition conditions of the Mexican population. The findings are useful for the development of public policies capable of reducing health inequities conditions, in order to achieve social equity.

Atención médica y acciones de autocuidado en personas que viven con diabetes, según nivel socioeconómico / Medical care and self-care actions in people living with diabetes, according to socioeconomic level

Resumen: Objetivo: Caracterizar la atención médica y las acciones de autocuidado en población con diabetes, en localidades de menos de 100 000 habitantes. Material y métodos: Con información de la Encuesta Nacional de Salud y Nutrición 100k (Ensanut 100k), se obtuvieron dos modelos de regresión logística: no realizar las cinco acciones básicas en la última consulta médica y no realizar acciones prioritarias de autocuidado. Resultados: Tener baja escolaridad, pertenecer al estrato económico bajo y hablar lengua indígena incrementan las posibilidades de no realizar acciones de autocuidado. Por el contrario, al incrementarse la edad, se disminuyen las posibilidades de autocuidado en 3%. Pertenecer a un hogar indígena y al tercil bajo incrementan las posibilidades de que el personal de salud no realice las cinco acciones básicas durante la consulta. Conclusión: Es indispensable que se establezca un programa de control de diabetes que incluya educación a pacientes y cursos de actualización al personal médico.

Abstract: Objective: To characterize medical care and self-care actions in a population with diabetes in locations smaller than 100 000 inhabitants Materials and methods: With information from the Encuesta Nacional de Salud y Nutrición 100k (Ensanut 100k), two logistic regression models were obtained: not performing five basic actions in the last consultation and not taking priority self-care actions. Results: Having low schooling, belonging to the low economic stratum, and speaking indigenous language, increase the probability of not taking self-care actions. On the contrary, as age increases, the chances of self-care are reduced by 3%. Belonging to an indigenous household and the low tercile, increases the chances that health personnel will not perform the five basic actions during the consultation. Conclusions: It is essential that a diabetes control program be established that includes patient education and update courses for medical staff

The Mexican National Health and Nutrition Survey as a Basis for Public Policy Planning: Overweight and Obesity.

Mexico has one of the highest overweight and obesity rates in the world. Our objective is to describe the tendency of overweight and obesity by sex, health service affiliation, and socioeconomic tertile (T1,2,3), and to give examples of public policies derived from the results of the Mexican National Health and Nutrition Surveys (ENSANUT). Data come from the 2006, 2012, and 2016 ENSANUTs, which are probabilistic surveys that allow us to make inferences at the national level, on urban and rural strata and regions; their coverage includes all the population age groups. We assessed overweight and obesity (OW + O) in all population groups. The prevalence of OW + O in preschool children was lower in T1 in all the surveys, and shows an increase by year of survey, according to the health service affiliation. In school-age women, prevalence increased over the 10 years of evaluation, in spite of the high prevalence in both genders in T3. Adolescent behavior is similar and, in adults, the prevalence of OW + O shows an increase by year of survey, gender, and affiliation, with the differences not explained by socioeconomic tertile. In conclusion, the ENSANUT series represents a surveillance system that allow us to observe the changes in overweight and obesity prevalence over the time, showing a high prevalence of OW + O in the population, and has contributed to public policy enhancement.

Move on Bikes Program: A Community-Based Physical Activity Strategy in Mexico City.

Open streets programs are free and multisectoral programs in which streets are temporally closed allowing access to walkers, runners, rollerbladers, and cyclists. The Move on Bikes program (by its name in Spanish Muévete en Bici) (MEB) consists of 55 km of interconnected streets in middle-high income areas of Mexico City. There is scarce evidence on the evaluation of this program in Mexico. The purposes of this study were to estimate the participation, physical activity levels among the MEB participants, and the association of the frequency of participation with sociodemographic, physical, and program characteristics. METHODS: From October 2017 to July 2018, six hundred seventy-nine MEB participants were surveyed using a questionnaire that contains sociodemographic, physical, and program characteristics. A wide-angle video camera was used to estimate the average speed of each activity per event per participant. Based on the information collected by the program authorities and survey interviews, we estimated the number of participants per event. RESULTS: On a typical MEB program day, 21,812 people participated. MEB program users accumulated an average of 221 min of moderate-to-vigorous physical activity (MVPA) per typical Sunday and 88.4% accumulated at least 150 min of MVPA. In total, 29.6% of users attended the program every Sunday. Those who were more likely to attend the program frequently included: men, those aged 41 to 64 years old, users classified as very and sufficiently active, those that used active transportation to travel to the program, and participants that came alone. CONCLUSIONS: This study provides evidence that the MEB program adds an extra 71 min/week of MVPA to more than 20,000 users.

Work status, retirement, and depression in older adults: An analysis of six countries based on the Study on Global Ageing and Adult Health (SAGE).

The aim of the present study was to analyse the association between the occurrence of a major depressive episode among older adults and work status in low- and medium-income countries. A cross-sectional study was conducted with people 60 years of age and older from the six countries (Mexico, India, China, Russian Federation, Ghana and South Africa) included in the Study on Global Ageing and Adult Health (SAGE) and who participated in its first wave (2009-2010). The occurrence of a major depressive episode (MDE) over the previous 12 months was determined based on an adaptation of the ICD-10 diagnostic criteria. The association between current work status and the presence of an MDE was estimated using binary logistic regression models with country-level fixed effects, and interaction terms between the country and work status. Results showed the odds of presenting an MDE were lower for older adults who were retired with a pension than for those who were currently working, although this protective association was observed only for men in China (OR=0.23; CI 95%:0.08-0.70) and Ghana (OR=0.25; CI 95%:0.07-0.95) and for women in India (OR=0.05; CI 95%:0.01-0.51) and South Africa (OR=0.19; CI 95%:0.04-0.97). For women, being a homemaker also showed a protective association in South Africa (OR=0.09; CI95%:0.01-0.66) and Mexico (OR=0.32; CI95%:0.14-0.76). In the case of being retired without a pension, no significant association was found in any country. The previous indicates that retirement with pension has a protective association with MDE only for men in China and Ghana and women in India and South Africa. The heterogeneity of this association reflects cultural and socioeconomic differences between the analysed countries.

Evolución de los programas de ayuda alimentaria en México a través de información de la Ensanut MC 2016 / Evolution of social food assistance programs in Mexico through Ensanut MC 2016 data

Resumen: Objetivo: Describir la cobertura y focalización de los Programas de Ayuda Alimentaria (PAA) en México. Material y métodos: Se obtuvo información de 9137 hogares de la Encuesta Nacional de Salud y Nutrición Medio Camino (Ensanut MC) 2016 sobre los PAA que reciben. Se analizó la distribución de los PAA por lugar de residencia, índice de nivel socioeconómico y pertinencia los PAA. Resultados: El 44% de los hogares recibe algún PAA, con mayor concentración en hogares indígenas (70%), de muy bajo nivel socioeconómico (70%) y en inseguridad alimentaria moderada y severa. Los PAA con mayor cobertura fueron Prospera (21%), Liconsa (9%), Programa de Desayunos Escolares (17%) y el Programa de Adultos Mayores; de éstos, el programa mejor focalizado fue Prospera. Conclusiones: Es necesario revisar los recursos de los programas y dirigirlos a la población con mayores carencias y mayor vulnerabilidad nutricional.

Abstract: Objective: To describe the coverage and targeting of Social Food Assistance Programs (SFAP) in Mexico. Materials and methods: Data were obtained from 9137 households of the Halfway National Health and Nutrition Survey 2016 (Ensanut MC 2016) who receive SFAP. The distribution of the SFAP by place of residence, index of socioeconomic status and SFAP relevance were analyzed. Results: 44% of households receive some SFAP, with a higher concentration in indigenous households (70%), a very low socioeconomic level (70%), and moderate and severe food insecurity. The SFAP with the greatest coverage were Prospera (21%), Liconsa (9%), School Breakfasts Program (17%) and the Support Program for Older Adults; of these the best-focused program was Prospera. Conclusions: It is necessary to review the resources of the programs and direct them to the population with greater deficiencies and greater nutritional vulnerability.

[Evolution of social food assistance programs in Mexico through Ensanut MC 2016 data]. / Evolución de los Programas de Ayuda Alimentaria en México a través de información de Ensanut MC 2016.

OBJECTIVE: To describe the coverage and targeting of Social Food Assistance Programs (SFAP) in Mexico. MATERIALS AND METHODS: Data were obtained from 9 137 households of the Halfway National Health and Nutrition Survey 2016 (Ensanut MC 2016) who receive SFAP. The distribution of the SFAP by place of residence, index of socioeconomic status and SFAP relevance were analyzed. RESULTS: 44% of households receive some SFAP, with a higher concentration in indigenous households (70%), a very low socioeconomic level (70%), and moderate and severe food insecurity. The SFAP with the greatest coverage were Prospera (21%), Liconsa (9%), School Breakfasts Program (17%) and the Support Program for Older Adults; of these the best-focused program was Prospera. CONCLUSIONS: It is necessary to review the resources of the programs and direct them to the population with greater deficiencies and greater nutritional vulnerability.

OBJETIVO: Describir la cobertura y focalización de los Programas de Ayuda Alimentaria (PAA) en México. MATERIAL Y MÉTODOS: Se obtuvo información de 9 137 hogares de la Encuesta Nacional de Salud y Nutrición Medio Camino (Ensanut MC) 2016 sobre los PAA que reciben. Se analizó la distribución de los PAA por lugar de residencia, índice de nivel socioeconómico y pertinencia los PAA. RESULTADOS: El 44% de los hogares recibe algún PAA, con mayor concentración en hogares indígenas (70%), de muy bajo nivel socioeconómic (70%) y en inseguridad alimentaria moderada y severa. Los PAA con mayor cobertura fueron Prospera (21%), Liconsa (9%), Programa de Desayunos Escolares (17%) y el Programa de Adultos Mayores; de éstos, el programa mejor focalizado fue Prospera. CONCLUSIONES: Es necesario revisar los recursos de los programas y dirigirlos a la población con mayores carencias y mayor vulnerabilidad nutricional.

Impact and economic evaluations of a combination prevention programme for men who have sex with men in Mexico.

BACKGROUND: Despite the high-profile support for combination prevention programmes (CPPs) since 2008, there is little rigorous evidence on their impact and cost-effectiveness. In 2010, Mexico received funds from the Global Fund to implement a series of behavioural, biomedical, and structural interventions over 3 years targeted to men who have sex with men. The aims of the study were to estimate the impact of the programme across a range of outcomes and cost-effectiveness. METHODS: A quasi-experiment was designed before the implementation of the CPP, in which 24 cities were randomly selected for impact evaluation and 12 pairs of cities were matched. In practice, though, implementation of the programme was staggered over 1 year. Therefore, we used two different approaches to estimate impact: a difference-in-difference estimation comparing both groups and a dose-response approach using time exposure to the programme at the city level. FINDINGS: Results from the difference-in-difference estimation showed modest impact on condom use. However, the dose­response findings revealed a 7.5% increase in HIV testing per additional year exposed to the programme, relative to baseline coverage; an increase in awareness of HIV status among HIV-positive individuals of 6.3%; a 6.7% increase in HIV-positive individuals on treatment; and a 7% reduction in the perception of stigma/discrimination from healthcare personnel. The cost per person not exposed to an untreated HIV-positive individual was gauged to be US$400. CONCLUSIONS: The study provides evidence of the effectiveness and cost of a CPP along the HIV treatment cascade: access to HIV tests, awareness of HIV status, and antiretroviral therapy initiation.

[The role of supply-side characteristics of services in AIDS mortality in Mexico]. / Exploración del rol de la oferta de servicios para explicar la variación de la mortalidad por sida en México.

OBJECTIVE: To document the association between supply-side determinants and AIDS mortality in Mexico between 2008 and 2013. MATERIALS AND METHODS: We analyzed the SALVAR database (system for antiretroviral management, logistics and surveillance) as well as data collected through a nationally representative survey in health facilities. We used multivariate logit regression models to estimate the association between supply-side characteristics, namely management, training and experience of health care providers, and AIDS mortality, distinguishing early and non-early mortality and controlling for clinical indicators of the patients. RESULTS: Clinic status of the patients (initial CD4 and viral load) explain 44.4% of the variability of early mortality across clinics and 13.8% of the variability in non-early mortality. Supply-side characteristics increase explanatory power of the models by 16% in the case of early mortality, and 96% in the case of non-early mortality. CONCLUSIONS: Aspects of management and implementation of services contribute significantly to explain AIDS mortality in Mexico. Improving these aspects of the national program, can similarly improve its results.

Exploración del rol de la oferta de servicios para explicar la variación de la mortalidad por sida en México / The role of supply-side characteristics of services in AIDS mortality in Mexico

Objetivo. Documentar la asociación entre factores de la oferta de servicios de atención de VIH sobre la mortalidad por sida en México en el periodo 2008-2013. Material y métodos. Se analizaron datos del sistema de administración, logística y vigilancia de antirretrovirales (SALVAR) y de una encuesta aplicada en unidades de atención. Se utilizaron modelos de regresión logit multivariados para estimar la asociación entre características de la oferta de servicios -en particular, de la gerencia de servicios y de la capacitación y experiencia de los prestadores- y la mortalidad por sida, distinguiendo entre mortalidad temprana y no temprana, y controlando por características clínicas de los pacientes. Resultados. Las características clínicas de los pacientes (CD4 inicial y carga viral) explican 44.4% de la variabilidad en la mortalidad temprana entre clínicas y 13.8% de la variabilidad de mortalidad no temprana. Las características de la oferta aumentan 16% del poder explicativo en el caso de la mortalidad temprana y 96% en el de la mortalidad no temprana. Conclusiones. Los aspectos de gerencia e implementación de los servicios de atención de VIH contribuyen significativamente a explicar la mortalidad por sida en México. Mejorar estos aspectos del programa nacional puede mejorar sus resultados.

Objective. To document the association between supply-side determinants and AIDS mortality in Mexico between 2008 and 2013. Materials and methods. We analyzed the SALVAR database (system for antiretroviral management, logistics and surveillance) as well as data collected through a nationally representative survey in health facilities. We used multivariate logit regression models to estimate the association between supply-side characteristics, namely management, training and experience of health care providers, and AIDS mortality, distinguishing early and non-early mortality and controlling for clinical indicators of the patients. Results. Clinic status of the patients (initial CD4 and viral load) explain 44.4% of the variability of early mortality across clinics and 13.8% of the variability in non-early mortality. Supply-side characteristics increase explanatory power of the models by 16% in the case of early mortality, and 96% in the case of non-early mortality. Conclusions. Aspects of management and implementation of services contribute significantly to explain AIDS mortality in Mexico. Improving these aspects of the national program, can similarly improve its results.

Seroprevalencia de VIH en población mexicana de entre 15 y 49 años: resultados de la Ensanut 2012 / HIV seroprevalence among Mexicans age 15 to 49: results from the National Health & Nutrition Survey 2012

Objetivo. Estimar la seroprevalencia de VIH en población mexicana no institucionalizada de 15 a 49 años, y aspectos selectos del perfil de la población serorreactiva. Material y métodos. Estudio transversal con una muestra probabilística de la población del país de 15 a 49 años, con información sobre comportamientos obtenida por entrevista directa en los hogares y determinación de anticuerpos para VIH en sangre capilar. Resultados. Se identificó una seroprevalencia de 0.15% (IC95% 0.09-0.21) en la población de 15 a 49 años; de 0.07% (IC95% 0.03-0.11) en mujeres, y de 0.24% (IC95% 0.11-0.36) en hombres. La población serorreactiva a VIH son hombres jóvenes, de mayor nivel socioeconómico en relación con la población general y con información que sugiere una mayor cobertura por la seguridad social (49.9% en serorreactivos contra 34.5% en no serorreactivos). El 49.4% de los serorreactivos contra 18.5% de los no serorreactivos se había realizado al menos una prueba de detección de VIH. Conclusiones. La seroprevalencia de VIH estimada en la Encuesta Nacional de Salud y Nutrición (Ensanut) 2012 sugiere que ésta se ha mantenido relativamente estable desde 2000. La estimación representa alrededor de 104000 personas (rango de entre 53000 y 126000) de 15 a 49 años que viven con VIH en México (75% de los cuales son hombres), de los que 50.6% desconocería su estatus serológico. Implementando un modelo de corrección de sesgo y agregando a los estimados en hogar, los casos estimados entre población de hombres que tienen sexo con hombres (tanto homosexual como bisexual), la estimación de la seroprevalencia alcanzaría 0.23%, con un total de 140000 personas de 15 a 49 años viviendo con VIH (con un intervalo estimado de entre 92000 y 201000 personas).

Objective. To estimate the HIV seroprevalence among Mexicans aged 15 to 49 years old and living in households, and to describe the profile of serorreactive individuals. Materials and methods. Cross-sectional study with a national probabilistic sample of individuals aged 15 to 49 years with behavioral data from direct interview (face-to-face) at households and HIV screening using capillary blood collected from the same individuals. Results. A seroprevalence of 0.15% (95%CI 0.09-0.21) was estimated for Mexicans aged 15 to 49; seroprevalence among women was 0.07% (95%CI 0.03-0.11) and 0.24% (95%CI 0.11-0.36) for men. HIV serorreactive population is composed of younger men, with a higher socioeconomic level compared to the general population, and with a higher insurance coverage-social protection on health in general and social security in particular. Only 50% of the serorreactive individuals may be aware of their status as living with HIV. Conclusions. The estimated HIV seroprevalence in the NHNS 2012 suggests a stable pattern since 2000. The estimated prevalence among individuals 15 to 49 years was adjusted both for selection bias correction and to include MSM estimations (under the assumption that MSM is a population hard to reach in a household survey), resulting in a total seroprevalence of 0.23% and an estimated number of people with HIV of 140000.

[HIV seroprevalence among Mexicans age 15 to 49: results from the National Health & Nutrition Survey 2012]. / Seroprevalencia de VIH en población mexicana de entre 15 y 49 años: resultados de la Ensanut 2012.

OBJECTIVE: To estimate the HIV seroprevalence among Mexicans aged 15 to 49 years old and living in households, and to describe the profile of serorreactive individuals. MATERIALS AND METHODS: Cross-sectional study with a national probabilistic sample of individuals aged 15 to 49 years with behavioral data from direct interview (face-to-face) at households and HIV screening using capillary blood collected from the same individuals. RESULTS: A seroprevalence of 0.15% (95%CI 0.09-0.21) was estimated for Mexicans aged 15 to 49; seroprevalence among women was 0.07% (95%CI 0.03-0.11) and 0.24% (95%CI 0.11-0.36) for men. HIV serorreactive population is composed of younger men, with a higher socioeconomic level compared to the general population, and with a higher insurance coverage-social protection on health in general and social security in particular. Only 50% of the serorreactive individuals may be aware of their status as living with HIV. CONCLUSIONS: The estimated HIV seroprevalence in the NHNS 2012 suggests a stable pattern since 2000. The estimated prevalence among individuals 15 to 49 years was adjusted both for selection bias correction and to include MSM estimations (under the assumption that MSM is a population hard to reach in a household survey), resulting in a total seroprevalence of 0.23% and an estimated number of people with HIV of 140,000.

[Food assistance programs in Mexico, coverage and targeting]. / Programas de ayuda alimentaria en México, cobertura y focalización.

OBJECTIVE: To describe the distribution of social food assistance programs in Mexico. MATERIALS AND METHODS: Information about 36 150 households from the National Health and Nutrition Survey (ENSANUT 2012) was included. The distribution of the social assistance food programs by characteristics as rural/urban locality, country region, ethnicity, socioeconomic level and nutritional status was observed. RESULTS: At the national level, food assistance programs with the greater coverage are Oportunidades (reaching 18.8% of the population), Liconsa (milk distribution, 9.7%) and School Breakfasts (12.2%). The program that assists in the best way the target population is Oportunidades, where 75% of its beneficiaries belong to the "low" and "lower" socioeconomic levels, in contrast to Liconsa and School Breakfasts programs, where only 42% and 55% of the beneficiaries are in such levels, respectively. CONCLUSION: Current focus and application of the food assistance programs must be adjusted under the perspective of wellness, health and nutrition of the children population.

Programas de ayuda alimentaria en México, cobertura y focalización / Food assistance programs in Mexico, coverage and targeting

Objetivo. Describir la distribución de los programas de ayuda alimentaria en México. Material y métodos. Se incluyó información de 36 150 hogares de la Encuesta Nacional de Salud y Nutrición 2012. Se observó la distribución de los programas en los hogares de acuerdo con características como tipo de localidad, región, etnicidad, nivel socioeconómico y estado de nutrición. Resultados. A nivel nacional, los programas de ayuda alimentaria con mayor cobertura son Oportunidades (18.8%), Liconsa (9.7%) y Desayunos Escolares (12.2%). El programa con mejor focalización es Oportunidades ya que 75% de sus beneficiarios se concentra en los niveles socioeconómicos bajo y muy bajo, situación que no ocurre para Liconsa (42%) y Desayunos Escolares (55%). Conclusión. La focalización y pertinencia de los programas de ayuda alimentaria deben de ser revisados bajo la perspectiva de bienestar, salud y nutrición de la población infantil.

Objective. To describe the distribution of social food assistance programs in Mexico. Materials and methods. Information about 36 150 households from the National Health and Nutrition Survey (ENSANUT 2012) was included. The distribution of the social assistance food programs by characteristics as rural/urban locality, country region, ethnicity, socioeconomic level and nutritional status was observed. Results. At the national level, food assistance programs with the greater coverage are Oportunidades (reaching 18.8% of the population), Liconsa (milk distribution, 9.7%) and School Breakfasts (12.2%). The program that assists in the best way the target population is Oportunidades, where 75% of its beneficiaries belong to the "low" and "lower" socioeconomic levels, in contrast to Liconsa and School Breakfasts programs, where only 42% and 55% of the beneficiaries are in such levels, respectively. Conclusion. Current focus and application of the food assistance programs must be adjusted under the perspective of wellness, health and nutrition of the children population.