[Deficient prevention and late treatment of diabetic retinopathy in Mexico]. / Prevención deficiente y tratamiento tardío de las complicaciones retinianas de la diabetes en México.

INTRODUCTION: Retinopathy is a frequent complication of diabetes, causing visual impairment in 10% and blindness in 2% of diabetic patients. The aim of this study is to describe the clinical profile of diabetic patients in an ophthalmologic unit in Tijuana, México. METHODS: Retrospective study of a random sample of 500 clinical charts of patients with diabetes who attended the Retina Service of "Fundación CODET para la Prevención de la Ceguera IBP" Ophthalmologic Center between 2006 and 2010. RESULTS: The main complaint of 58% of patients was decreased visual acuity in first evaluation. Only 6.2% of patients were referred by a health professional. Forty-six percent of the patients had a history of diabetes of at least 15 years. Thirty percent had clinically significant visual impairment at first visit, which was associated with a long history of diabetes and previous eye surgery. Twenty-five percent of these patients who were treated at our clinic experienced visual deterioration due to advanced retinopathy. CONCLUSION: Patients with diabetic retinopathy are referred to ophthalmological service tardily, when visual loss is usually severe and irreversible.

Profiles, perceptions and motivations of Community Health Workers of NGOs in a border city of US-Mexico.

To analyze the profile, perceptions and motivations of Community Health Workers (CHWs) from non-governmental organizations (NGOs) in the border city of US-Mexico and to describe the type of community interventions they perform. we surveyed 121 CHWs from 9 NGOs participating in a monthly meeting between May and July of 2009. Each participating CHW answered a structured questionnaire. Furthermore, two focus groups were held, in which 10 and 8 CHWs participated, respectively. Qualitative and quantitative analyses were carried out on the data obtained. 70% of the CHWs had 9 years or less of formal education. With respect to community work, 61% volunteered between 1 and 5 h weekly; only 40% received some form of economic support. The most commonly reported activities were distribution of informational materials (59.5%) and promotion of health fairs (52.9%). Analysis of focus group discussions lead to the development of four conceptual categories: personal development, motivation, perception of their community participation and institutional relationship, some of the testimonies are "…just because the people do not respond does not mean we give up. No, we must work, persist, promote and raise awareness of the people…", "…when they compensate us, it is not really a payment. We are there because we get results, we do it happily… It is voluntary…" CHWs are an important human resource for communities. Institutions focusing on primary care should view these community players as social capital, which could improve the effectiveness of prevention strategies and achieve greater coverage of health services.