PM2.5 exposure as a risk factor for type 2 diabetes mellitus in the Mexico City metropolitan area.

BACKGROUND: Exposure to air pollution is the main risk factor for morbidity and mortality in the world. Exposure to particulate matter with aerodynamic diameter ≤ 2.5 µm (PM2.5) is associated with cardiovascular and respiratory conditions, as well as with lung cancer, and there is evidence to suggest that it is also associated with type II diabetes (DM). The Mexico City Metropolitan Area (MCMA) is home to more than 20 million people, where PM2.5 levels exceed national and international standards every day. Likewise, DM represents a growing public health problem with prevalence around 12%. In this study, the objective was to evaluate the association between exposure to PM2.5 and DM in adults living in the MCMA. METHODS: Data from the 2006 or 2012 National Health and Nutrition Surveys (ENSANUT) were used to identify subjects with DM and year of diagnosis. We estimated PM2.5 exposure at a residence level, based on information from the air quality monitoring system (monitors), as well as satellite measurements (satellite). We analyzed the relationship through a cross-sectional approach and as a case - control study. RESULTS: For every 10 µg/m3 increase of PM2.5 we found an OR = 3.09 (95% CI 1.17-8.15) in the 2012 sample. These results were not conclusive for the 2006 data or for the case - control approach. CONCLUSIONS: Our results add to the evidence linking PM2.5 exposure to DM in Mexican adults. Studies in low- and middle-income countries, where PM2.5 atmospheric concentrations exceed WHO standards, are required to strengthen the evidence.

[Correcting for misclassified HIV/aids deaths in Mexico: Retrospective analysis, 1983-2012]. / Corrección de la mala clasificación de las muertes por sida en México: Análisis retrospectivo de 1983 a 2012.

OBJECTIVE: To identify and reassign misclassified AIDS deaths in Mexico, reconstructing the time series of mortality from 1983 to 2012, by state, sex, age, and affiliation to social security. MATERIALS AND METHODS: 15.5 million deaths from 1979 to 2012 were analyzed. The HIV-AIDS mortality correction was done in three phases: a) those causes directly related to AIDS; b) by miscoded deaths, and c) AIDS deaths hidden in other underlying causes of death. Age-standardized rates of mortality (SMR) were calculated by sex, affiliation to social security, and state. RESULTS: 107 981 AIDS deaths from 1983 to 2012 were accumulated, representing 11% of total deaths observed for the period. The SMR in men for all age groups begins to decline since 1996, while for women the decline started in 2008. A similar picture is observed for the population with / without social security. Heterogeneity is a feature for SMR by state. CONCLUSION: An easily replicable methodology for the correction of mortality from AIDS, which generates relevant information for decision making based on the evidence is presented.

Corrección de la mala clasificación de las muertes por sida en México: Análisis retrospectivo de 1983 a 2012 / Correcting for misclassified HIV/aids deaths in Mexico: Retrospective analysis, 1983-2012

Objetivo. Identificar y reasignar defunciones mal clasificadas por sida en México, y reconstruir la mortalidad 1983-2012, por entidad federativa, sexo, edad y derechohabiencia a la seguridad social. Material y métodos. Se analizaron 15.5 millones de defunciones de 1979 a 2012. La corrección de la mortalidad por sida se hizo en tres fases: a) por causas directamente relacionadas con sida, y b) por muertes mal codificadas; c) muertes por sida ocultas en otras causas. Se calcularon tasas estandarizadas por edad de mortalidad (TEM) por sexo, derechohabiencia a la seguridad social y entidad federativa. Resultados. Se acumularon 107981 muertes por sida entre 1983 y 2012 (11% más del total de muertes observadas). La TEM en hombres, para todos los grupos de edad, empieza a descender desde 1996, mientras que para las mujeres la caída inicia en 2008. Un panorama similar se observa para la población con/sin seguridad social. La heterogeneidad caracteriza la TEM estatal. Conclusión. Se presenta una metodología fácilmente replicable para la corrección de la mortalidad de sida que genera información relevante para la toma de decisiones fundamentada en la evidencia.

Objective. To identify and reassign misclassified AIDS deaths in Mexico, reconstructing the time series of mortality from 1983 to 2012, by state, sex, age, and affiliation to social security. Materials and methods. 15.5 million deaths from 1979 to 2012 were analyzed. The HIV-AIDS mortality correction was done in three phases: a) those causes directly related to AIDS; b) by miscoded deaths, and c) AIDS deaths hidden in other underlying causes of death. Age-standardized rates of mortality (SMR) were calculated by sex, affiliation to social security, and state. Results. 107 981 AIDS deaths from 1983 to 2012 were accumulated, representing 11% of total deaths observed for the period. The SMR in men for all age groups begins to decline since 1996, while for women the decline started in 2008. A similar picture is observed for the population with / without social security. Heterogeneity is a feature for SMR by state. Conclusion. An easily replicable methodology for the correction of mortality from AIDS, which generates relevant information for decision making based on the evidence is presented.

[Acute respiratory infections among children and identification of alarm signs by parents and caregivers in Mexico]. / Infecciones respiratorias agudas en niños y signos de alarma identificados por padres y cuidadores en México.

OBJECTIVE: To estimate the prevalence of acute respiratory infection (ARI) during the two weeks previous to the interview among children <5 years of age and to describe the frequency of identification of alarm signs by parents or caregivers (PC). MATERIALS AND METHODS: Analysis of data from the National Health and Nutrition Surveys 2012 and 2006 and of National Health Survey 2000. RESULTS: ARI prevalence decreased from 2006 to 2012 (47.0-44.8%), particularly in the lower socioeconomic strata and children <1 year of age. 2012 Survey revealed highest prevalence for <1 year children. Fever was the main pneumonia-associated alarm sign (28.6%) in contrast to "breathes rapidly" (10.2%) or "unable to breathe" (20.9%). CONCLUSIONS: Results show that the magnitude of the problem has decreased in recent years, mainly among the more vulnerable groups, such as smaller children and those belonging to the lowest socioeconomic strata. However, training is required, particularly at the community level.

[Acute diarrheal diseases and feeding practices among children under five years in Mexico]. / Diarreas agudas y prácticas de alimentación en niños menores de cinco años en México.

OBJECTIVE: To estimate the prevalence of acute diarrheal diseases (ADD) during the two weeks previous to the interview among children <5 years of age and to describe alarm signs and feeding practices of parents and caregivers (PCG) during children's ADD. MATERIALS AND METHODS: Analysis of data from the National Health and Nutrition Surveys 2012 and 2006 and the National Health Survey 2000. RESULTS: ADD prevalence decreased significantly from 2006 (13.1%) to 2012 (11.0%), particularly in the lower socioeconomic status. "Frequent bowel movements" were the main warning sign identified by PCG (66.0%) in contrast to "crying without tears" (4.3%) and "blood in faeces" (0.5%); only 42% PCG reported administering oral rehydration therapy. Factors associated with ADD were child's age <1 year and mother's age <20 years. CONCLUSIONS: It is necessary to reinforce appropriate ADD preventive and treatment practices among PCG of children <5 years of age.

Infecciones respiratorias agudas en niños y signos de alarma identificados por padres y cuidadores en México / Acute respiratory infections among children and identification of alarm signs by parents and caregivers in Mexico

Objetivo. Estimar la prevalencia de las infecciones respiratorias agudas (IRA) en las dos semanas previas a la entrevista en niños menores de 5 años y describir signos de alarma identificados por padres o cuidadores (PC). Material y métodos. Análisis de las Encuestas Nacionales de Salud y Nutrición 2006 y 2012 y de la Encuesta Nacional de Salud 2000. Resultados. La prevalencia disminuyó entre 20062012 (47-44.9%); reducción significativa en los menores de un año y en los pertenecientes al nivel socioeconómico más bajo. En la ENSANUT 2012 la prevalencia fue mayor en los menores de un año. La fiebre fue el principal signo de alarma (28.6%) reconocido por PC en contraste con "respira rápido" (10.2%) y "no puede respirar" (20.9%). Conclusiones. La magnitud del problema ha disminuido, principalmente en los grupos más vulnerables como los niños más pequeños y los pertenecientes a los niveles socioeconómicos más bajos. Sin embargo, existen necesidades de capacitación, principalmente a nivel comunitario.

Objective. To estimate the prevalence of acute respiratory infection (ARI) during the two weeks previous to the interview among children <5 years of age and to describe the frequency of identification of alarm signs by parents or caregivers (PC). Materials and methods. Analysis of data from the National Health and Nutrition Surveys 2012 and 2006 and of National Health Survey 2000. Results. ARI prevalence decreased from 2006 to 2012 (47.0-44.8%), particularly in the lower socioeconomic strata and children <1 year of age. 2012 Survey revealed highest prevalence for <1 year children. Fever was the main pneumonia-associated alarm sign (28.6%) in contrast to "breathes rapidly" (10.2%) or "unable to breathe" (20.9%). Conclusions. Results show that the magnitude of the problem has decreased in recent years, mainly among the more vulnerable groups, such as smaller children and those belonging to the lowest socioeconomic strata. However, training is required, particularly at the community level.

Diarreas agudas y prácticas de alimentación en niños menores de cinco años en México / Acute diarrheal diseases and feeding practices among children under five years in Mexico

Objetivo. Estimar la prevalencia de las enfermedades diarreicas agudas (EDA) en las dos semanas previas a la entrevista en niños menores de 5 años y describir signos de alarma y prácticas de alimentación durante las mismas. Material y métodos. Análisis de datos de las Encuestas Nacionales de Salud y Nutrición 2006 y 2012 de la Encuesta Nacional de Salud 2000. Resultados. La prevalencia de EDA disminuyó significativamente de 2006 (13.1%) a 2012 (11.0%), particularmente en el nivel socioeconómico más bajo. Las "evacuaciones frecuentes" fueron el principal signo de alarma (66.0%), en contraste con "llanto sin lágrimas" (4.3%) y "sangre en las heces" (0.5%); solamente 42% de los padres o cuidadores refirió administrar sales de rehidratación oral. Los factores asociados con EDA fueron edad menor a un año y edad de la madre menor de 20 años. Conclusiones. Es necesario reforzar prácticas adecuadas de diagnóstico y tratamiento de las EDA en los padres o cuidadores.

Objective. To estimate the prevalence of acute diarrheal diseases (ADD) during the two weeks previous to the interview among children <5 years of age and to describe alarm signs and feeding practices of parents and caregivers (PCG) during children's ADD. Materials and methods. Analysis of data from the National Health and Nutrition Surveys 2012 and 2006 and the National Health Survey 2000. Results. ADD prevalence decreased significantly from 2006 (13.1%) to 2012 (11.0%), particularly in the lower socioeconomic status. "Frequent bowel movements" were the main warning sign identified by PCG (66.0%) in contrast to "crying without tears" (4.3%) and "blood in faeces" (0.5%); only 42% PCG reported administering oral rehydration therapy. Factors associated with ADD were child's age <1 year and mother's age <20 years. Conclusions. It is necessary to reinforce appropriate ADD preventive and treatment practices among PCG of children <5 years of age.