Effect of COVID-19 mortality on life expectancy in municipalities of Mexico. Comparison between 2019 and 2020.

BACKGROUND: Life expectancy (LE) is an indicator related to medical, demographic, social and geographic conditions. OBJECTIVES: To analyze the effect of the COVID-19 pandemic on LE and of its distribution according to sociodemographic variables in municipalities of Mexico. METHODS: Information on mortality was collected from data published by the Ministry of Health, and demographic information, from the 2020 Population and Housing Census. LE was calculated according to the standard actuarial method. A risk analysis was carried out between expected years of life lost and the size of the economically active population, years of education and indigenous-speaking population. RESULTS: In 2020, there was a nation-wide average drop of 4.7 years in LE, but its distribution was heterogeneous at the municipal level, with extreme values of -2.8 years and 12.6 years. The risk analysis showed an inverse relationship between sociodemographic variables and expected years of life lost, except for the indigenous-speaking population. CONCLUSIONS: The impact of the COVID-19 pandemic on LE in Mexico was significant and was influenced by the analyzed sociodemographic variables, particularly by the municipalities' population size.

ANTECEDENTES: La esperanza de vida es un indicador relacionado con condiciones médicas, demográficas, sociales y geográficas. OBJETIVOS: Analizar el efecto de la pandemia de COVID-19 en la esperanza de vida y de su distribución según variables sociodemográficas en municipios de México. MATERIAL Y MÉTODOS: Se recabó información sobre mortalidad de la Secretaría de Salud, así como información demográfica del Censo de Población y Vivienda de 2020. La esperanza de vida se calculó conforme el método actuarial estándar. Se realizó análisis de riesgo entre la pérdida de la esperanza de vida en años y el tamaño de la población, población económicamente activa, años de escolaridad y población de habla indígena. RESULTADOS: En 2020 se registró una caída promedio de 4.7 años en la esperanza de vida a nivel nacional, pero su distribución fue heterogénea en los municipios, con valores extremos de −2.8 años y 12.6 años. El análisis de riesgo mostró una relación inversa entre las variables sociodemográficas y la pérdida de años de esperanza de vida, con excepción de la población de habla indígena. CONCLUSIONES: El impacto de la pandemia de COVID-19 en la esperanza de vida en México fue significativo, matizado por las variables sociodemográficas analizadas, particularmente por el tamaño de la población de los municipios.

Syphilis Infection Markers Among HIV Positive Individuals In The Mexico City HIV/AIDS Program.

OBJECTIVE: The aim of this study is to evaluate the prevalence of T. pallidum infection markers in HIV-positive individuals receiving highly active antiretroviral therapy (ART) in the Mexico City HIV/AIDS Program, as well as predictive characteristics. METHODS: The reverse serologic algorithm method was used for the T. pallidum diagnosis, and applied to 2,383 HIV-positive individuals. Socio-demographic characteristics, sexual practices, previous syphilis diagnosis, and length of antiretroviral treatment, were evaluated. Variables significantly associated with syphilis markers were analyzed using a logistic regression model. RESULTS: Prevalence of "active or resolved" and "probable active" infection markers were 44.2% and 28.8%, respectively. Predictive factors were: Clinic Specialized Condesa Iztapalapa (CECI), previous syphilis diagnosis, MSM, and receptive sex practices. CONCLUSIONS: The prevalence of T. pallidum infection markers was the highest ever reported in Mexico, and was related to specific sexual practices as well as previous syphilis diagnosis, elements which require preventive measures in the Mexico City HIV/AIDS Program.

Association between life-style behaviors and health outcomes in Adventist and non-Adventist adolescents in Mexico: a pilot study.

BACKGROUND: Identifying lifestyle-related health predictors affecting adolescent behaviors is a matter of interest and study for diverse audiences, including the religious sphere. The Adventist religion recommends their followers to adopt a healthy diet, adequate rest, physical activity, sufficient water intake, and non-use of addictive substances such as alcohol, tobacco, and drugs, as well as fostering faith and hope to give meaning to life. METHODS: A cross-sectional and observational study was conducted among adolescent students aged 13 to 19 years old in Montemorelos City, Nuevo León, Northern Mexico, between September 14, 2017 and February 13, 2018. This study included 363 Mexican adolescents, consisting of 202 Adventists and 161 non-Adventists. The binomial logistic regression analysis was performed to examine the relationships between religious affiliation and life-style behaviors and evaluate the effect of life-style behaviors on health outcomes by religious affiliation. Age, gender, type of residence, and place of birth were controlled. RESULTS: We found that Adventist adolescents were more likely to be watching TV for 2 h or less per day (p < 0.001), have enough sleeping time for 7 h or more (p < 0.001), go to bed early at 11 o'clock or before (p < 0.001), and have breakfast (p = 0.006) than non-Adventist adolescents significantly. It indicates that Adventist students are more likely to have healthier life-style behaviors than non-Adventist students. The multiple binomial regression models showed that in the group of Adventist adolescents sporting activity and hours watching TV were significantly associated with obesity risk (p = 0.001) and risky eating patterns (p = 0.044), respectively, controlling for age, gender, type of residence, and place of birth. No relationship was found between life-style behaviors and health outcomes in non-Adventist adolescents. CONCLUSIONS: Religious affiliation could serve as a predictor of healthy behaviors among adolescents. This study concluded that Adventist adolescents are more likely to have a healthier lifestyle behavior than non-Adventist adolescents and various health-related behaviors were specifically identified among Adventist participants.

Evaluation of HIV, STI and CD4 results among voluntary attendees at the HIV/AIDS program of Mexico City.

OBJECTIVE:: To describe results of HIV, sexually transmitted diseases (STI) and CD4 counts at the HIV-specialized Condesa Clinic (CC) in Mexico City. MATERIALS AND METHODS:: Individuals who requested voluntary counseling and testing at CC were studied. We identified antibodies against HIV, syphilis, hepatitis C, and hepatitis B HBsAg. CD4 cell counts and viral load of HIV positive individuals were also obtained. Late HIV infection diagnosis was established if CD4 counts were lower than 200 cells/µL. RESULTS:: Global seroprevalence of HIV, syphilis, HBsAg, and anti HCV markers was of 20.1, 6, 1 and 1, respectively. Men displayed higher seroprevalence of infection markers than women. Among men, HIV infection was related to age and with all STI markers. Late HIV diagnosis was 31.8%. The risk of late HIV diagnosis was higher among women and it increased as age increased. CONCLUSIONS:: Differences between genders regarding HIV and STIs prevalence as well as risk factors for HIV infection and late HIV diagnosis were observed.

[Trend analysis of acquired syphilis in Mexico from 2003 to 2013]. / Análisis de la tendencia de sífilis adquirida en México durante el periodo 2003-2013.

OBJECTIVE: To identify the population group in which syphilis increase was concentrated. MATERIALS AND METHODS: The information was collected from the Mexico health statistical yearbooks. The information disaggregated by sex, age group and state during the period 2003 to 2013 was used to form different databases. Linear regression analysis with confidence interval at 95% was used to evaluate changes over time in different population groups. RESULTS: An increase of 0.67 cases per 100,000 population (95%CI 0.30-1.04) in men was detected from 2010. The increase was concentrated in each group of 20-24 and 25-44. The highest incidence of acquired syphilis was reported in the last two years: 2012 and 2013. The last year reported a 1.85 times higher incidence than reported in 2003. Aguascalientes, Distrito Federal, Durango, Mexico, Oaxaca, Puebla, Quintana Roo, Yucatan and Zacatecas reported that syphilis increased during the study period. CONCLUSION: Acquired syphilis may be reemerging in our country among young men; this increase is not uniform across the country, it is necessary to focus intervention measures for this sexually transmitted infection.

Correlates of STI symptoms among female sex workers with truck driver clients in two Mexican border towns.

BACKGROUND: Female sex workers (FSW) are at increased risk for HIV and other STI due to occupation-related risks and exposures. Long-distance truck drivers have been implicated in the spread of HIV, but less is known about HIV/STI risks of FSW servicing truck drivers, especially in North America. As part of an international collaborative pilot study, we interviewed FSWs servicing truck driver clients along two major transportation corridors to explore factors associated with recent STI symptoms. METHODS: A cross-sectional study of 200 FSW was conducted in Mexico: 100 from Nuevo Laredo (U.S. border); 100 from Ciudad Hidalgo (Guatemalan border). Eligibility criteria included age ≥18 years, speaking English or Spanish, and having ≥1 truck driver client in the past month. The main outcome was reporting any recent STI symptoms, defined as experiencing genital/anal warts, genital ulcers/sores, genital itching, or abnormal vaginal discharge in the past 6 months. Logistic regression was used to identify correlates of recent STI symptoms. RESULTS: Median age of FSW was 29 years, 74% were single, 87% had <9th grade education, and median income was 4000 pesos/month ($300 USD). Sex work occurred at a bar/cantina for 70%. One-quarter had never been tested for HIV, 53% reported lifetime drug use, 22% reported drinking alcohol before/during transactional sex and 17% reported recent STI symptoms. After controlling for age and study site, factors associated with STI symptoms were lifetime drug use (AOR 2.9, 95% CI 1.2-6.9), drug use before/during sex (AOR 2.8, 95% CI 1.1-7.1), alcohol use before/during sex (AOR 5.2, 95% CI 2.2, 12.6), forced sex ever (AOR 2.6, 95% CI 1.1-6.1), lifetime history of arrest (AOR 2.3, 95% CI 1.0-5.0), and being surveyed in Nuevo Laredo rather than Ciudad Hidalgo (AOR 4.8, 95% CI 2.0-10.0). CONCLUSIONS: The associations we observed between recent STI symptoms and drug and alcohol use suggest that interventions are needed that promote consistent and effective safer sex practices, especially while under the influence of alcohol or other substances.

Human papillomavirus incidence and risk factors among Mexican female college students.

OBJECTIVE: To determine the factors associated with high-risk human papillomavirus (HR-HPV) and its incidence in a cohort of female college students, with particular emphasis on the use of condoms. METHODS: A cohort was created during 2001 to 2005. The students signed informed consent, answered a questionnaire, and provided a vaginal scrape to detect HR-HPV. Incidences were estimated and risk factors were evaluated using Cox proportional risk model. The variable condom use was constructed based on the following 3 measurements: relative frequency throughout one's lifetime, use during the first sexual relationship, and use during the last sexual relationship. RESULTS: A total of 237 women participated, providing 395.6 person-years of follow-up. An incidence of 15.9 HR-HPV infection per 100 person-years was estimated and the factors associated with HR-HPV infection were found to be self-reported sexually transmitted infections (RR = 2.7), use of emergency contraception pill (ECP) (RR = 2.0), and having 2 or more sexual partners (RR = 1.9). University students using the ECP demonstrated more risky sexual behavior than nonusers. Women with 2 or more sexual partners who reported inconsistent condom use had 3.8 times the rate of HR-HPV infection. CONCLUSIONS: The incidence for HR-HPV in this cohort of Mexican female college students is comparable to that found in the United States and Canada. The results suggest that the consistent use of condoms is a protective factor against HR-HPV, especially for women with multiple sexual partners and/or those who use the ECP.

Heterogeneous distribution of hepatitis B serological markers in rural areas of Mexico.

OBJECTIVE: To study the distribution of the hepatitis B antibody (anti-HBc) based on a national serosurvey from 10 Mexican states showing a mean HBV prevalence higher than the national one. MATERIALS AND METHODS: This was a cross-sectional study. During 2003, anti-HBc was analyzed at INSP in 19 907 sera, and the related sociodemographic factors were determined. RESULTS: Anti-HBc prevalence was greater among men, but it was also associated to age, residence in a rural area, low socio-economic status, and illiteracy. Clusters of very high anti-HBc prevalence were found in several rural communities where the prevalence of anti-HBc in adults is 3 to 20 times the national average. CONCLUSIONS: Besides a low endemicity of HBV in Mexico, distribution is heterogeneous as was shown in several of the states studied, where there are rural towns with very high prevalence of HBV markers. National serosurveys are useful tools for identifying communities with hepatitis B hyperendemicity, where focused research and control measures are needed.

[Serological markers of hepatitis B and C, and HIV in La Calera and Cuambio, Guerrero, México]. / Marcadores serológicos de hepatitis B y C, y VIH en La Calera y Cuambio, Guerrero, México.

OBJECTIVE: To perform a hepatitis B, C, and HIV survey in an enhanced sample from two rural communities with the highest anti-HBc prevalence found in ENSA 2000. MATERIALS AND METHODS: This was a cross-sectional study.We studied the communities of La Calera and Cuambio, two adjacent rural towns of the district of Zirándaro, Guerrero, targeted because of the high prevalence of anti-HBc shown in ENSA 2000.We assessed the prevalence of hepatitis B and C, and HIV serological markers and associated factors among inhabitants older than 10 years. RESULTS: A very high prevalence of hepatitis B markers associated with socioeconomic factors was confirmed, while hepatitis C prevalence was low and HIV absent in the two communities addressed. CONCLUSIONS: National serosurveys are an accurate tool for identifying communities with hepatitis B high endemicity where focused research and control measures are needed.

Cross-sectional study to measure household water insecurity and its health outcomes in urban Mexico.

OBJECTIVE: To assess the links between structural and household determinants of household water insecurity and test three water insecurity measures against self-reported diarrhoea, dengue fever and perceived stress in the middle-income and low-income urban areas of Torreón, Mexico. DESIGN: Cross-sectional household survey conducted in two waves (rainy and dry seasons). PARTICIPANTS: 500 households selected via multistage cluster sample in selected communities. Socioeconomic status determined the selection of participant neighbourhoods; five were identified in low socioeconomic status neighbourhoods and five in low-medium socioeconomic status neighbourhoods. We examine how the context of urban water provision is related to a new cross-culturally valid Household Water Insecurity Experiences (HWISE) Scale. PRIMARY OUTCOME MEASURES: The HWISE Scale, self-reported diarrhoea, dengue fever and the Perceived Stress Scale. RESULTS: Water system intermittency (adjusted OR (AOR) 3.96, 95% CI 2.40 to 6.54, p<0.001), unpredictability (AOR 2.24, 95% CI 1.34 to 3.74, p=0.002) and the dry season (AOR 3.47, 95% CI 2.18 to 5.52, p<0.001) were structural correlates of the HWISE Scale. This study also found that the HWISE Scale was associated with two health outcomes, self-reported diarrhoea (AOR 1.09, 95% CI 1.03 to 1.15, p=0.002) and perceived stress (ß=0.28, SE=0.07, t=4.30, p<0.001), but not self-reported dengue fever (AOR 1.02, 95% CI 0.98 to 1.06). A 3-item hygiene subscore and a 3-item water worry subscore were also both positively associated with self-reported diarrhoea and perceived stress. CONCLUSION: Short-form screeners of water insecurity may be useful for assessing certain health risks by lay survey workers in settings with limited healthcare resources, particularly in lieu of more expensive microbiological tests that require specialised training and facilities.

HSV-2 seroincidence among Mexican college students: the delay of sexual debut is not enough to avoid risky sexual behaviours and virus transmission.

OBJECTIVES: Early sexual debut is a behaviour that has been associated with acquiring sexually transmitted infections. Higher schooling may delay sexual debut, thus the university population is categorised with low-risk sexual behaviours. The rate ratio of herpes simplex virus type 2 (HSV-2) seroincidence according to demographic characteristics and sexual behaviour was estimated for a cohort of university students. METHODS: A dynamic cohort of university students was followed at the Autonomous University of Morelos, in central Mexico, during the years 2001-5. After obtaining informed consent, information was gathered annually regarding demographic characteristics and sexual behaviour and blood samples were obtained to determine HSV-2 antibodies. Seroincidence was estimated and the incidence rate ratio was evaluated using the Poisson regression model. RESULTS: A total of 404 students participated, with 669.2 person-years of follow-up. An incidence of 4.2 cases per 100 person-years was estimated. The variables delayed sexual debut (≥18 years) and multiple sexual partners (two or more sexual partners during the past year) had a rate ratio of 4.1 (95% CI 1.2 to 14.3) and 2.5 (95% CI 1.1 to 5.6), respectively. Incidence for students with delayed sexual debut and multiple partners is estimated to be 10.3 cases per 100 person-years. CONCLUSIONS: Delayed sexual debut was a risk factor for acquiring HSV-2, due to a subgroup with sexual debut at 18 years of age or older that had multiple sexual partners; therefore, in the university population that tends to delay sexual debut, it is necessary to implement prevention programmes to promote the decrease of other risky sexual behaviours, as well as the promotion of the consistent use of condoms.

Distribution of HCV genotypes and HCV RNA viral load in different regions of Mexico.

BACKGROUND AND AIM: To identify the geographic distribution of hepatitis C virus (HCV) genotypes and HCV RNA viral load in a large number of HCV-infected carriers in Mexico. METHODS: Patients with chronic hepatitis C (n = 8,802) were studied to identify HCV genotype using an immune line probe assay in samples shown previously to be positive for viral RNA by an RT-PCR test. Baseline HCV RNA was also evaluated. RESULTS: Genotype 1 accounted for 70.3%, genotype 2 for 21.8%, genotype 3 for 7.2%, genotype 4 for 0.3%, and genotype 5 for 0.1% of all cases; coinfection was present in 0.3%. Overall, Genotype 1 was the most prevalent Genotype. Regionally, genotype 1 occurred more frequently in the North-East, North, and Center- East regions of Mexico; genotype 2 was more prevalent in the South, East, and Peninsula regions; and genotype 3 was more prevalent in the North and North-West regions. Only 22.4% of patients with genotype 1 were classified in the low HCV RNA viral load category, and the distribution of this genotype did not differ significantly between regions. CONCLUSION: The prevalence of HCV genotypes and viral load in Mexico was 70.3% for genotype 1, but only 22.4% of these patients had a low HCV viral load. Distribution was not uniform in Mexico, with greater frequency of genotype 2 in South, East and Peninsula Regions and Genotype 3 in North and North-West Regions.

CD3zeta expression and T cell proliferation are inhibited by TGF-beta1 and IL-10 in cervical cancer patients.

INTRODUCTION: Cervical cancer development from a squamous intraepithelial lesion is thought to be favored by an impaired T cell immunity. We evaluated parameters of T cell alterations such as proliferation, cytokine, and CD3zeta expression in peripheral blood and tumor-infiltrating T lymphocytes from women with squamous intraepithelial lesions (SIL) or cervical cancer (CC). RESULTS AND DISCUSSION: T cell proliferation and cytokine messenger RNA (mRNA) expression were similar in women with SIL and healthy donors, whereas low T cell proliferation and lower mRNA expression of IL-2, IL-10 and IFN-gamma were observed in women with CC. Moreover, infiltrating cells showed marginal responses. We also found that CD3zeta mRNA expression, whose protein is required for T cell activation, correlated with a decreased proliferation in advanced stages of the disease. CONCLUSION: Experiments with T cells from healthy donors in the presence TGF-beta1 or IL-10 suggest that these cytokines have a relevant role in T cell responses during CC progression.

Core group approach to identify college students at risk for sexually transmitted infections.

OBJECTIVE: To analyze the core group for sexually transmitted infections (STI) among college students. METHODS: Cross-sectional study carried out in a convenience sample comprising 711 college students of the public university of Morelos, Mexico, between 2001 and 2003. Sociodemographic and sexual behavior information were collected using self-applied questionnaires. Herpes simplex 2 (HSV-2) infection was tested in the blood. The number of sexual partners in the last year and cocaine consumption were used as indicators to construct the dependent variable "level of STI risk" in three categories: low, medium and high risk (core group). A multinomial analysis was conducted to evaluate whether different sex behaviors were associated with the variable "level of STI risk". RESULTS: There was significant association between HSV-2 seroprevalence and the variable "level of STI risk": 13%, 5.6% and 3.8% were found in high (core group), medium and low categories, respectively. There were gender differences regarding the core group. Men started having sexual intercourse earlier, had more sex partners, higher alcohol and drug consumption, higher frequency of sex intercourse with sex workers, exchanging sex for money, occasional and concurrent partners compared to women. CONCLUSIONS: The study findings suggest existing contextual characteristics in the study population that affect their sex behavior. In Mexico, the cultural conception of sexuality is determined mainly by gender differences where men engage in higher risky sexual behavior than women.

Impacto del COVID-19 en la esperanza de vida en los municipios de los estados del noreste de México / COVID-19 impact on life expectancy among municipalities of Northeastern states of Mexico

RESUMEN La mortalidad causada por COVID-19 en México se ha situado entre las más altas del mundo, por lo que es de interés epidemiológico estudiar su impacto respecto a la esperanza de vida (EV). El objetivo del presente trabajo fue analizar el impacto de la pandemia por COVID-19 en la esperanza de vida, comparando datos de 2019 y 2020, y evaluando su efecto por densidad poblacional de los municipios de los estados del noreste de México. La información sobre mortalidad para 2019 y 2020 se obtuvo de la Secretaría de Salud, y la demográfica del Consejo Nacional de Población. Se construyeron tablas de vida mediante el método actuarial estándar; se calcularon percentiles ≤ 25 y ≥ 75 de la diferencia en la EV; se evaluó la relación entre el tamaño de la población de los municipios y la magnitud de la diferencia en la pérdida de años en la EV. La pandemia por COVID-19 impactó en la EV en los estados del noreste de México, con gran heterogeneidad al interior en cada uno de ellos. La pérdida en años en promedio fue, para Coahuila de 5.4, Nuevo León 4.1 y Tamaulipas 4.9. Los municipios del percentil ≥ 75 mostraron una pérdida promedio de 9.2 años y los del percentil ≤ 25 de -0.35 años. La diferencia en la pérdida en años de EV, entre 2019 y 2020, se vio influenciada por el tamaño de la población, tendiendo a ser mayor en aquellos con mayor densidad demográfica, sin ser el único factor determinante.

ABSTRACT COVID-19 mortality in Mexico is among the highest in the world. Therefore, it is of epidemiologic interest to study its impact on life expectancy. The aim of the present paper was to analyze the impact of the COVID-19 pandemic on life expectancy through a comparison of data from 2019 and 2020. Specifically, the effect of population density in municipalities of Northeastern Mexican states. Information regarding 2019 and 2020 mortality rates for was obtained from the Ministry of Health, and demographics from the National Population Council. Life tables were constructed using the standard actuarial method. Percentiles ≤ 25 and ≥ 75 of the difference in life expectancy in the period were calculated. The relationship between the size of the population of the municipalities and the magnitude of the difference in life expectancy loss of years was evaluated. COVID-19 pandemic impacted on life expectancy with great heterogeneity in each of the northeastern states of Mexico. The loss in years in average life expectancy was 5.4 for Coahuila, 4.1 for Nuevo Leon and 4.9 for Tamaulipas. Municipalities above the ≥ 75th percentile showed an average loss of 9.2 years. Those in the lower than ≤ 25th percentile showed a decrease, of -0.35 years. The difference in the loss of life expectancy during 2019 and 2020 was influenced by population size, tending to be greater in those municipalities with higher population density, but was not the only determining factor.

Efecto de la mortalidad por COVID-19 en la esperanza de vida en los municipios de México. Comparación 2019 y 2020 / Effect of COVID-19 mortality on life expectancy in municipalities of Mexico. Comparison between 2019 and 2020

Resumen Antecedentes: La esperanza de vida es un indicador relacionado con condiciones médicas, demográficas, sociales y geográficas. Objetivos: Analizar el efecto de la pandemia de COVID-19 en la esperanza de vida y de su distribución según variables sociodemográficas en municipios de México. Material y métodos: Se recabó información sobre mortalidad de la Secretaría de Salud, así como información demográfica del Censo de Población y Vivienda de 2020. La esperanza de vida se calculó conforme el método actuarial estándar. Se realizó análisis de riesgo entre la pérdida de la esperanza de vida en años y el tamaño de la población, población económicamente activa, años de escolaridad y población de habla indígena. Resultados: En 2020 se registró una caída promedio de 4.7 años en la esperanza de vida a nivel nacional, pero su distribución fue heterogénea en los municipios, con valores extremos de −2.8 años y 12.6 años. El análisis de riesgo mostró una relación inversa entre las variables sociodemográficas y la pérdida de años de esperanza de vida, con excepción de la población de habla indígena. Conclusiones: El impacto de la pandemia de COVID-19 en la esperanza de vida en México fue significativo, matizado por las variables sociodemográficas analizadas, particularmente por el tamaño de la población de los municipios.

Abstract Background: Life expectancy (LE) is an indicator related to medical, demographic, social and geographic conditions. Objectives: To analyze the effect of the COVID-19 pandemic on LE and of its distribution according to sociodemographic variables in municipalities of Mexico. Methods: Information on mortality was collected from data published by the Ministry of Health, and demographic information from the 2020 Population and Housing Census. LE was calculated according to the standard actuarial method. A risk analysis was carried out between expected years of life lost and the size of the population, economically active population, years of education and indigenous-speaking population. Results: In 2020, there was a nation-wide average drop of 4.7 years in LE, but its distribution was heterogeneous at the municipal level, with extreme values of -2.8 years and 12.6 years. The risk analysis showed an inverse relationship between sociodemographic variables and expected years of life lost, except for the indigenous-speaking population. Conclusions: The impact of the COVID-19 pandemic on LE in Mexico was significant, and was influenced by the analyzed sociodemographic variables, particularly by the municipalities' population size.

[Autopercepción del peso a través de figuras corporales en niños en edad escolar de Piedras Negras, Coahuila, México]. / Self-perception of weight in school-age children from Piedras Negras, Coahuila, Mexico.

Background: The prevalence of overweight and obesity has increased worldwide. In this context, the lack of awareness of excess weight among overweight and obese children is a public health concern that needs to be explored in the Northern border of Mexico. Methods: Body mass index (BMI) was calculated from children from third to sixth grades of basic education. The Children's Body Image Scale was applied to evaluate perceived and ideal BMI comparing against calculated BMI. We also analyzed the frequency of accurate perceivers of actual weight and discrepancy of ideal weight against calculated BMI. Results: We studied 155 children (43.8% were female) with a mean age of 10.2 years. Accuracy prevalence of BMI perceived respect to calculated BMI was 59.4%. Discrepancy prevalence of ideal BMI respect to calculated BMI was 44.4%. Comparison of perceived BMI respect to calculated BMI showed an overestimation on low weight category (33%) and subestimations in categories of normal weight (12.4%), overweight (85%) and obesity (81.6%). Comparison of ideal BMI respect to calculated BMI showed an absolute overestimation of low weight and underestimations in categories of normal weight, overweight and obesity of 5.6%, 100%, and 97.4%, respectively. Conclusions: The results of this work showed a consistent underestimation of children's body weight, particularly among those classified in categories of overweight and obesity in a demographic context in which the prevalence of both categories was of 38% in this study.

Introducción: Ante la tendencia mundial en el incremento del índice de masa corporal (IMC) en todos los grupos de edad, se han buscado estrategias de control. La baja percepción en el exceso de peso en niños escolares es un tema pendiente de explorar en la frontera norte de México. Métodos: Se obtuvo el IMC de alumnos de tercero a sexto grado de educación básica. Se compararon los IMC, percibido e ideal, con el IMC medido, evaluando subestimaciones y sobrestimaciones con respecto a este último. Se calcularon las prevalencias de la exactitud en el IMC percibido y la discrepancia de la imagen ideal respecto al IMC. Resultados: Se estudiaron 155 niños (43.8% del sexo femenino) con una edad promedio de 10.2 años. La prevalencia de la exactitud del IMC percibido respecto al medido fue del 59.4%. La prevalencia de discrepancia entre el IMC ideal y el medido fue del 44.4%. La comparación del IMC percibido con el medido mostró una sobrestimación en la categoría de peso bajo (33%) y subestimaciones en las categorías de peso normal (12.4%), sobrepeso (85%) y obesidad (81.6%). Al comparar el IMC ideal con el medido, se mostró una sobrestimación absoluta en la categoría de peso bajo y subestimaciones en las categorías de peso normal, sobrepeso y obesidad, del 5.6%, 100% y 97.4%, respectivamente. Conclusiones: El presente trabajo muestra en forma consistente la subestimación que los escolares hacen de su peso, particularmente los clasificados en las categorías de sobrepeso y obesidad. en un contexto demográfico donde la prevalencia de ambas categorías en este estudio fue alta, del 38%.

Evaluation of a rapid strip and a particle agglutination tests for syphilis diagnosis.

The availability of new diagnostic approaches, which are easier and faster to perform than conventional tests, offers the opportunity to improve the attention given to public health problems as syphilis. This study aimed to evaluate a rapid immunochromatographic strip test (Determine TP; Abbott Laboratories, Chicago, IL) and a nonequipment demanding particle microagglutination test (Serodia TP-PA; Fujirebio, Japan) for qualitative detection of treponemic antibodies. Sera from 548 women belonging to 3 population groups were tested; one of them showing low syphilis seroprevalence (1.5%) and the other 2 showing higher seroprevalences (>15%). By comparison with the gold standard (Venereal Disease Research Laboratories plus fluorescent treponemal antibody absorption), sensitivity and specificity values for both diagnostic tests were calculated. Sensitivity values of both tests evaluated were higher than 95% for 2 groups of 3 addressed; in one of the high syphilis prevalence groups, Serodia TP-PA showed 88.6% sensitivity. Specificity values were above 95% for all 3 groups. The use of simple/rapid treponemic tests as those included here may prove to be a suitable replacement for the traditional syphilis serology diagnosis approach, particularly at primary care settings.

[Maternal and congenital syphilis in two Mexican hospitals: evaluation of a rapid diagnostic test]. / Sífilis matema y congénita en dos hospitales mexicanos: evaluación de una prueba diagnóstica rápida.

OBJECTIVE: To estimate the prevalence of maternal and neonatal syphilis, to assess the usefulness of a rapid treponemic diagnostic test, and to evaluate the frequency of screening for syphilis during prenatal care in Mexican women. MATERIAL AND METHODS: This was a cross-sectional study that included 1,322 women interviewed in two hospitals (Hospital General in Cuernavaca, Morelos, and Hospital de la Mujer in Mexico City). Women answered a questionnaire on reproductive background, exposure to sexually transmitted infections and prenatal care. In order to diagnose syphilis, a rapid Determine TP test and a latex-VDRL test were used among all participating women. Positive cases were confirmed using FTA-ABS test. RESULTS: Prevalence of serologically active syphilis was 0.3% (4/1322). Using as comparison standard a combination of VDRL and FTA-ABS tests, the Determine TP test had a sensitivity and specificity of 100%. Two newborns with positive FTA-ABS IgM, one negative with FTA-ABS IgM and one first-trimester abortion were found from seropositive women. Prenatal serum screening for syphilis was conducted in only 6.9% of women included in the study. CONCLUSIONS: Although the prevalence of maternal syphilis is relatively low, results show that if the situation found in the hospitals studied is shared by other hospitals in Mexico, a systematic screening for maternal syphilis would help to diagnose more cases of this infection than the number reported in official figures. Screening of syphilis in pregnant women using rapid tests may help in the prevention of congenital syphilis.

Syphilis infection markers among HIV positive individuals in the Mexico City HIV/AIDS Program / Marcadores de infección por sífilis de individuos VIH positivos en el Programa de VIH/SIDA de la Ciudad de México

Abstract: Objective: The aim of this study is to evaluate the prevalence of T. pallidum infection markers in HIV-positive individuals receiving highly active antiretroviral therapy (ART) in the Mexico City HIV/AIDS Program, as well as predictive characteristics. Materials and methods: The reverse serologic algorithm method was used for the T. pallidum diagnosis, and applied to 2 383 HIV-positive individuals. Sociodemographic characteristics, sexual practices, previous syphilis diagnosis, and length of antiretroviral treatment, were evaluated. Variables significantly associated with syphilis markers were analyzed using a logistic regression model. Results: Prevalence of "active or resolved" and "probable active" infection markers were 44.2 and 28.8%, respectively. Predictive factors were: Clínica Especializada Condesa Iztapalapa (CECI), previous syphilis diagnosis, men in who have sex with men (MSM), and receptive sex practices. Conclusions: The prevalence of T. pallidum infection markers was the highest ever reported in Mexico, and was related to specific sexual practices as well as previous syphilis diagnosis, elements which require preventive measures in the Mexico City HIV/AIDS Program.

Resumen: Objetivo: Evaluar las prevalencias de marcadores de infección por T. pallidum en personas que viven con VIH y reciben tratamiento antirretroviral en el Programa de VIH/SIDA de la Ciudad de México, así como sus características asociadas. Material y métodos: Se siguió el método del algoritmo reverso para el diagnóstico de T. pallidum aplicado a 2 383 individuos VIH positivos, quienes contestaron un cuestionario sobre características sociodemográficas, prácticas sexuales, diagnóstico previo de sífilis y tiempo de tratamiento antirretroviral. Las variables significativamente asociadas con los marcadores de sífilis se analizaron mediante un modelo de regresión logística. Resultados: Las prevalencias de marcadores de infección "activa o resuelta" y "probablemente activa" fueron 44.2 y 28.8%, respectivamente. Las características asociadas con los marcadores fueron Clínica Especializada Condesa Iztapalapa (CECI), diagnóstico previo de infección por sífilis, hombres que tienen sexo con hombres (HSH) y prácticas sexuales receptivas. Conclusiones: Las prevalencias de marcadores de infección por T. pallidum fueron altas y estuvieron relacionadas con prácticas sexuales específicas y con el diagnóstico previo de sífilis, características que requieren medidas preventivas dentro del programa.