Leptospirosis prevalence in patients with initial diagnosis of dengue.

Objective. To determine the prevalence of leptospirosis in patients from Veracruz with initial diagnosis of dengue and its association with risk factors. Materials and Methods. Transversal study in patients who sought medical attention under the suspicion of dengue. Backgrounds were researched and blood samples were drawn to determine dengue (NS1, RT-PCR) and leptospirosis (IFI). Simple frequencies, central tendency and dispersion measures, and prevalence and trust intervals at 95% (IC95%) were obtained. Prevalence reasons (RP) and IC(95%) were obtained and a multivariate logistic model was applied, using SPSS V15. Results. 171 patients were included, 56% women (32 ± 14 years) and 44% men (32 ± 17 years). 48% of the cases (IC95% 40.5-55.4) was positive to dengue, with a cut point of 1 : 80, seroprevalence for leptospirosis was of 6% (IC(95%) 2.7-10); 12% (IC95% 7-16.5) was positive to both pathologies and 34% was negative to both tests. Although the largest number of isolations corresponded to serotype 2, the four dengue virus serotypes were identified. In the bivariate analysis, overcrowding RP = 1.33, (IC = 0.46-3.5), bathing in rivers (RP = 1.31, IC = 0.13-7.4), and walking barefoot (RP = 1.39, IC = 0.58-3.3) were the variables associated with leptospirosis, although the relation was not statistically significant. Conclusions. Leptospirosis prevalence in subjects under suspicion of dengue fever is high, as well as the coincidence of both infections. The results show the coexistence of overlapped outbreaks of several diseases sharing the side of transmission. It is necessary the intentional search of other pathologies, such as influenza, rickettsiosis, and brucella, among others.

[Lead blood levels in mothers and newborn infants covered by the Mexican Institute of Social Security]. / Niveles de plomo sanguíneo en madres y recién nacidos derechohabientes del Instituto Mexicano del Seguro Social.

OBJECTIVE: To establish the relation between maternal blood lead (MBL) and umbilical cord blood lead (CBL) levels during delivery, and to determine the major predictors for MBL in women covered by the Mexican Institute of Social Security (MISS), in Mexico City. MATERIAL AND METHODS: From 1991 to 1993, a cross-sectional study was conducted in four MISS hospitals, among normal pregnant women who volunteered to participate. Blood samples were taken from women and from the umbilical cord during delivery. Statistical analysis consisted of descriptive statistics and simple and multiple linear regression. RESULTS: A total of 1,404 mother-newborn pairs were studied. Mean maternal age was 25 years. MBL average was 10.7 +/- 6.5 micrograms/dl; no significant differences were found by hospital, age, or marital status. Mean CBL was 10.4 +/- 6.2 micrograms/dl. A log unit increase in MBL corresponded to a log increase of 0.62 in CBL (p < 0.01). Pearson's correlation was 0.61 (p < 0.01). The main predictors of MBL were: Use of lead-glazed ceramic (positively associated) and milk and orange juice intake (negatively associated). Forty-seven percent of mothers and 50 percent of the newborn babies had values higher than 10 micrograms/dl, and 578 of them had blood lead levels higher than their mothers. CONCLUSIONS: Further studies should be carried out in order to identify necessary interventions.