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.

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.

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.

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.

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.

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

Resumen: 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%.

Abstract: 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.

[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 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.

Evaluation of HIV, STI and CD4 results among voluntary attendees at the HIV/AIDS program of Mexico City / Evaluación de resultados de VIH, ETS y CD4 en asistentes al programa de VIH/SIDA de la Ciudad de México

Abstract: 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.

Resumen: Objetivo: Describir resultados del programa VIH/SIDA de la Clínica Especializada Condesa (CC). Material y métodos: Se identificaron anticuerpos contra VIH, sífilis y hepatitis C, así como HBsAg del virus de la hepatitis B. Se hizo un conteo de CD4 y carga viral en los positivos a VIH asistentes a la CC. El conteo CD4 menor a 200 células/μL definió el diagnóstico tardío de la infección por VIH. Resultados: La prevalencia de VIH, sífilis, HBsAg y virus de la hepatitis (HCV) fue de 20.1, 6, 1 y 1, respectivamente. Los hombres mostraron prevalencias mayores de infección que las mujeres y en ellos la infección por VIH estuvo relacionada con la edad y con los marcadores de ITS. El diagnóstico tardío de VIH fue de 31.8% y su riesgo fue mayor en las mujeres y se incrementó conforme la edad. Conclusión: Se encontraron diferencias de género en las prevalencias de VIH e ITS, en los riesgos de infección por VIH y en el diagnóstico tardío de esta infección.

[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.

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

Objetivo. Identificar el grupo poblacional en el que se concentra el incremento de sífilis ocurrido durante los últimos años. Material y métodos. A partir de información obtenida de los Anuarios de Morbilidad de la Secretaría de Salud, se conformaron diversas bases de datos con información desagregada por sexo, grupo de edad y entidad federativa durante el periodo de 2003 a 2013. Mediante análisis de regresión lineal, se estimó el incremento con intervalos de confianza a 95%; se evaluaron los cambios a través del tiempo en los diversos grupos poblacionales analizados. Resultados. A partir de 2010 hay un incremento de 0.67 casos por 100000 habitantes (IC95% 0.30-1.04) entre los hombres, que se concentra en individuos de 20 a 24 y de 25 a 44 años. Las mayores incidencias de sífilis adquirida se reportaron en los dos últimos años: 2012 y 2013; este último año registró una incidencia 1.85 veces mayor a la reportada en el año 2003. Entidades como Aguascalientes, Distrito Federal, Durango, México, Oaxaca, Puebla, Quintana Roo, Yucatán y Zacatecas reportaron incrementos de sífilis adquirida durante el periodo de estudio. Conclusión. La sífilis adquirida aparentemente está reemergiendo en México entre hombres jóvenes, incremento que no es homogéneo en el país, por lo que es necesario focalizar medidas de intervención para esta infección de transmisión sexual.

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 100000 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.

HPV infection, risk factors and viral load among Mexican male college students

Objectives: To determine the prevalence of HPV and the risky sexual behaviors associated to it in a sample of male college students, taking into account genotype and viral load. Methods: From 2002 to 2003, male students from the Autonomous University of Morelos State completed a questionnaire and provided self-collected genital samples to detect and quantify HPV. We performed a bivariate and a multivariate logistic regression analysis to identify correlates associated with the infection and to assess the viral load as a function of the viral infecting type. The fragments of β-globin gene and L1 of HPV, were amplified, purified and cloned, to evaluate viral load. Results: Among 253 subjects, HPV prevalence was 19.4%, and HPV16 was the most common subtype. History of STIs (OR = 4.8; 95% CI 1.2–18.9), contraceptive pill use by female partner (OR = 2.6; 95% CI 1.1–6.3) and exchanging sex for money (OR = 4.9; 95% CI 1.2–20) were associated to the HPV infection. HPV16 viral load was 7.8 copies (HPV/beta-globin) compared to 0.9 copies for other HPV types. Discussion: HPV16 displayed the highest viral load, and it was the most prevalent. It was found that using contraceptive pills by female partners was associated with HPV infection. .

HPV infection, risk factors and viral load among Mexican male college students.

OBJECTIVES: To determine the prevalence of HPV and the risky sexual behaviors associated to it in a sample of male college students, taking into account genotype and viral load. METHODS: From 2002 to 2003, male students from the Autonomous University of Morelos State completed a questionnaire and provided self-collected genital samples to detect and quantify HPV. We performed a bivariate and a multivariate logistic regression analysis to identify correlates associated with the infection and to assess the viral load as a function of the viral infecting type. The fragments of ß-globin gene and L1 of HPV, were amplified, purified and cloned, to evaluate viral load. RESULTS: Among 253 subjects, HPV prevalence was 19.4%, and HPV16 was the most common subtype. History of STIs (OR=4.8; 95% CI 1.2-18.9), contraceptive pill use by female partner (OR=2.6; 95% CI 1.1-6.3) and exchanging sex for money (OR=4.9; 95% CI 1.2-20) were associated to the HPV infection. HPV16 viral load was 7.8 copies (HPV/beta-globin) compared to 0.9 copies for other HPV types. DISCUSSION: HPV16 displayed the highest viral load, and it was the most prevalent. It was found that using contraceptive pills by female partners was associated with HPV infection.

Molecular epidemiology of Escherichia coli O25b-ST131 isolates causing community-acquired UTIs in Mexico.

Escherichia coli is a common uropathogen causing community-acquired urinary tract infections (UTIs). Out of 4735 E. coli community-acquired UTIs, 10.2% were extended spectrum ß-lactamases (ESBL)-producing. The identified ESBL types were CTX-M-15 (96.4%), SHV-2a (3%), and TLA-1 (1%). Of the isolates, 94.6% tested positive for plasmid-mediated quinolone resistance (PMQR) genes (aac(6')-lb-cr [92.1%] and qepA1 [7%] and for qnr-determinants [3.5%]). E. coli O25b-ST131 was identified in 25% of the isolates that harbor a non-conjugative 160-kb plasmid (IncFIA) containing the CTX-M-15, and all of these isolates were found to contain PMQR genes. This work can be useful in modeling the potential impact that may have on community-acquired UTIs in Mexico.

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.

Maternal/child seroprevalence of antibodies against Treponema pallidum at four general hospitals in the state of Morelos, Mexico.

BACKGROUND AND AIMS: Treponema pallidum can cause syphilis in pregnant women and congenital syphilis in the newborn. In Latin America, 330,000 pregnant women are diagnosed with syphilis every year. Adequate prenatal care to detect syphilis reduces maternal morbidity and fetal and neonatal mortality and morbidity. We undertook this study to determine T. pallidum seroprevalence among pregnant and puerperal women from Morelos, Mexico, as well as to evaluate the sexual behavior, demographic and clinical variables associated with the infection. METHODS: A cross-sectional study was carried out among pregnant and puerperal women from four general hospitals from Morelos, Mexico during 2005-2009. Women answered a questionnaire and provided a blood sample to detect antibodies against T. pallidum. RESULTS: A total of 2331 women were analyzed with 0.26% of T. pallidum seroprevalence. There were four cases with active syphilis and two cases with latent syphilis, as well as two cases of congenital syphilis. Illiterate women had 6.7 times higher risk of being infected. Women who did not undergo a urine test had a 5.3 times higher risk for infection and women who do not have piped water inside their household had a 5.0-fold higher risk of having anti-T. pallidum antibodies. All seropositive cases were from the same hospital (Cuautla General Hospital) with demographic, sexual behavior and medical care characteristics different from the other three hospitals. CONCLUSIONS: Syphilis during pregnancy and congenital syphilis are still present in Mexico. It may be that the more urban a population the higher the chance of the prevalence of maternal syphilis. It would be beneficial to reinforce the observance of the Official Mexican Norm and to implement rapid diagnostics tests to contend with this public health problem.

Seroprevalence and national distribution of human toxoplasmosis in Mexico: analysis of the 2000 and 2006 National Health Surveys.

Global warming has had serious implications on dispersion of infectious diseases like toxoplasmosis. Since the frequency of Toxoplasma gondii largely depends on climatic conditions, we studied its prevalence by means of 3599 samples of the National Health Survey 2000 (NHS-2000) and 2916 of the National Health and Nutrition Survey 2006 (NHNS-2006) serum banks, obtained from 1-98 year old subjects of both genders and all states of Mexico. Anti-T.gondii IgG antibodies were determined by ELISA and confirmed by western blot. Crude, epidemiologically weighted and diagnosis-performance-adjusted prevalence values were calculated. Seroprevalence changes were compared between both surveys and among regions (north, center and coast). Also, correlations between changes in temperature or humidity and those in prevalence were measured. National crude prevalence was 60.1% and 62.6% for NHS-2000 and NHNS-2006, respectively. Weighted and adjusted values were 62.5% and 40.0% for NHS-2000, and 63.7 and 43.1% for NHNS-2006. Coastal states and children presented the largest increases between surveys, while the center of the country showed a decrease. An apparently higher prevalence of T. gondii infection was observed in both surveys compared to that performed in 1987, while a geographical re-distribution was found from 2000 to 2006, with a positive correlation between temperature and frequency deltas in 21 states where prevalence increased.

HIV risk behaviors differ by workplace stability among Mexican female sex workers with truck driver clientele.

BACKGROUND: In a study of female sex workers (FSW) servicing truck driver clients in Mexican border cities, we evaluated differences in HIV/STI risk behaviors by workplace. DESIGN AND METHODS: Our study was cross-sectional and its population comprised 100 FSWs from Nuevo Laredo (US border) and 100 FSWs from Ciudad Hidalgo (Guatemalan border). The main outcome was primary place of sex work defined as unstable (street, vehicle, gas station, etc.) vs stable (bar, brothel, and hotel). Logistic regression was used to identify correlates associated with trading sex at unstable workplaces in the last month. RESULTS: Of the FSW surveyed, 18% reported an unstable workplace. The majority of FSW surveyed were young (<30), single, had <9th grade education, and had worked in the sex trade for a median of 4.9 years. After controlling for study site, FSW with unstable vs. stable workplaces were more likely to have a majority/all truck driver clientele, but were less likely to have visited a gynecologist in the last year (OR 0.1, 95%CI 0.03-0.4) or ever had an HIV test (OR 0.1, 95%CI 0.06-0.3), and there was a trend towards lower condom use self-efficacy scores (OR 0.8 per unit increase, 95%CI 0.7-1.0). On multivariate regression, unstable workplace was associated with having majority/all truck driver clientele, being surveyed in Nuevo Laredo, and decreased odds of ever having an HIV test. CONCLUSIONS: Among Mexican FSW with truck driver clients, providing safe indoor spaces for sex work may help facilitate public health interventions that improve HIV/STI and reproductive health outcomes.