Ethnicity and other COVID-19 death risk factors in Mexico.

Introduction: Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may develop coronavirus disease 2019 (COVID-19). Risk factors associated with death vary among countries with different ethnic backgrounds. We aimed to describe the factors associated with death in Mexicans with confirmed COVID-19. Material and methods: We analysed the Mexican Ministry of Health's official database on people tested for SARS-CoV-2 infection by real-time reverse transcriptase-polymerase chain reaction (rtRT-PCR) of nasopharyngeal fluids. Bivariate analyses were performed to select characteristics potentially associated with death, to integrate a Cox-proportional hazards model. Results: As of May 18, 2020, a total of 177,133 persons (90,586 men and 86,551 women) in Mexico received rtRT-PCR testing for SARS-CoV-2. There were 5332 deaths among the 51,633 rtRT-PCR-confirmed cases (10.33%, 95% CI: 10.07-10.59%). The median time (interquartile range, IQR) from symptoms onset to death was 9 days (5-13 days), and from hospital admission to death 4 days (2-8 days). The analysis by age groups revealed that the significant risk of death started gradually at the age of 40 years. Independent death risk factors were obesity, hypertension, male sex, indigenous ethnicity, diabetes, chronic kidney disease, immunosuppression, chronic obstructive pulmonary disease, age > 40 years, and the need for invasive mechanical ventilation (IMV). Only 1959 (3.8%) cases received IMV, of whom 1893 were admitted to the intensive care unit (96.6% of those who received IMV). Conclusions: In Mexico, highly prevalent chronic diseases are risk factors for death among persons with COVID-19. Indigenous ethnicity is a poorly studied factor that needs more investigation.

Diseño y validación de un cuestionario de hábitos de vida de alimentación y actividad física para escolares de 8-12 años / Design and validation of a questionnaire to assess healthhabits of school children aged 8-12

Introducción: El sobrepeso y la obesidad son actualmente un serio problema de salud pública en México, principalmente en la etapa infantil, según la Encuesta Nacional de Salud y Nutrición (ENSANUT, 2012). La obesidad es una enfermedad multifactorial, en la cual se involucran aspectos genéticos, ambientales y de estilo de vida. Para prevenir y tratarla deben modificarse los hábitos de vida, mediante promoción y educación para la salud. Para cambiar los hábitos de la población primero se debe conocer cuáles son, posteriormente crear estrategias para modificarlos. No existen cuestionarios para identificar los hábitos de vida saludables en niños escolares en nuestro medio. Objetivo: Diseñar y evaluar la fiabilidad y validez del cuestionario. Métodos: Se aplicó en 417 escolares. Se usaron medidas de tendencia central y dispersión para los dominios y grupos; consistencia interna mediante alpha de Cronbach y correlación interescalar. Resultados: Se encontró que los 27 ítems en los dos dominios superaron el estándar propuesto de fiabilidad (α de Cronbach) mayor a 0.50. Se encontró correlación aceptable, en las diferentes dimensiones del cuestionario (total vs. dominios). La estabilidad test-retest es superior a 0.75 en las dos dimensiones; en los análisis de validez efectuados (de contenido y constructo) los resultados son satisfactorios. Conclusiones: La versión del cuestionario reúne los criterios de consistencia interna y validez de contenido y constructo. Dichos resultados ponen de manifiesto que el cuestionario propuesto pueda ser utilizado como una herramienta para valorar los hábitos de vida en escolares.

Introduction: Being over weight and obesity are currently serious public health problems in Mexico, particularly in childhood. According to the National Health and Nutrition Examination Survey (ENSANUT, 2012), obesity is a multifactorial disease in which genetic, environmental and lifestyle issues are involved. To prevent and treat obesity lifestyle should be altered through health promotion and education. To change the habits of the population, first they need to be recognised, then strategies to modify them developed. Presently, there are no questionnaires to identify healthy habits in school children in our area. Objective: To design and evaluate the reliability and validity of a questionnaire that assesses health habits in children. Methods: 417 schoolchildren undertook the questionnaire. Measures of central tendency and dispersion for domains and groups were used; internal consistency using Cronbach's alpha and interscalar correlation. Results: It was found that the 27 items in the 2 domains exceeded the suggested standard of reliability (Cronbach α) greater than 0.50. Acceptable correlation was found in the different dimensions of the questionnaire (total vs. domains). The test-retest stability was higher than 0.75 in both dimensions; in analyses performed on validity (content and construct) the results were satisfactory. Conclusions: The version of the questionnaire met the criteria of internal consistency and content validity and construct. These results show that the proposed questionnaire can be used as a tool to assess lifestyle in school children.

Paragonimiasis en la Provincia de Cotopaxi, Ecuador

Para determinar la situación real de la paragonimiasis en la provincia de Cotopaxi, se realizó una revisión estadistica retrospectiva a partir del año 1976 hasta 1993. en paralelo, un estudio prospectivo de búsqueda de casos fue realizado durante los años 1992 y 1993 en los cantones de la Maná, Pangua y Sigchos, zonas subtropicales que representan el 20 por ciento del área territorial de la provincia. En total, se identificaron 287 casos, esta parasitosis se presentó desde 500 a 2000 m sobre el nivel del mar. Por lo tanto, la paragonimiasis es endemica en dichos cantones, con los mayores índices de prevalencia en las parroquias de quindigua, Pucayacu, Guasaganda y La Maná. Además, se demostró transmisión activa en la zona, por la presencia de cangrejos Zilchiopsis ecuadoriensis infestados con metacercarias de paragonimus mexicanus.