Beyond translation: Transcreation of a clinicians' guide to structure discussions about health-related values with Latinx patients throughout cancer.

OBJECTIVE: This study aimed to ensure accurate translation and cultural appropriateness of a guide designed to help oncology clinicians provide person-centered care to Spanish-speaking Latinx patients with cancer. METHODS: Initial translation of a clinician-patient values discussion guide in open-ended question format ("Guide") was pretested in interviews with 27 Spanish-speaking individuals, followed by national expert panel review. At three sites, semi-structured, in-depth, audio-recorded interviews in the participant's preferred language (Spanish/English) were then conducted with Latinx patients receiving systemic treatment for a solid tumor malignancy and family joining them at clinic. RESULTS: Interviews of 43 patient/family participants representing diverse Latinx communities addressed the Guide's understandability, acceptability, relevance and responsiveness. Rapid analysis of interviews contributed to cultural adaptation/transcreation of the Guide for a pilot interventional trial. CONCLUSION: Moving beyond translation to transcreation can help promote inclusion, equity, and cultural sensitivity in oncologic care/communication. PRACTICE IMPLICATIONS: Clinicians now have a linguistically- and culturally-adapted guide including questions and prompts to help structure discussions in Spanish or English of health-related values with Latinx patients receiving oncologic care.

Multi-component Reliability Inference in Modified Weibull Extension Distribution and Progressive Censoring Scheme.

The statistical inference of multi-component reliability stress-strength system with nonidentical-component strengths is considered for the modified Weibull extension distribution in the presence of progressive censoring samples. For this aim, we study the estimation of multi-component reliability parameter in classical and Bayesian inference. So we derive some point and interval estimates such as maximum likelihood estimation, asymptotic confidence intervals, uniformly minimum variance unbiased estimation, approximate and exact Bayes estimation and highest posterior density intervals. Comparing of different estimates is provided by employing the Monte Carlo simulation, the mean squared error and coverage probabilities. Finally, one real data is utilized to illustrate the applicability of this new model.

Cultural adaptation process of cancer-related interventions: A step-by-step guide.

INTRODUCTION: To contribute to the reduction and elimination of cancer-related local and global health disparities, interventions must be culturally adapted to reach diverse cultural groups and demonstrate success in improving clinical and psychosocial outcomes. We provide step-by-step information on the conceptual and methodological challenges involved in culturally adapting interventions and provide guidelines, suggestions, tools, and concrete steps for implementing the process. METHODS: This article provides information, guidelines, suggestions, tools, and concrete steps, based on three rigorous models of cultural adaptations, for implementing this process, followed with examples from the field, to illustrate the conceptual and methodological challenges involved in culturally adapting interventions. CONCLUSION: Our systematic step-by-step approach recommends (1) the guidance of well-established research models; (2) use of multiple data sources and input from various stakeholders (i.e., from patients and providers); (3) qualitative and quantitative data usage and integration; (4) a steering committee with multiple perspectives, stakeholders assessments, and qualitative analyses; (5) consensus meetings; and (6) diverse representation on the steering committee and/or research team.

High-resolution characterization of intertidal areas and lowest astronomical tidal surface by use of Sentinel-2 multispectral imagery and hydrodynamic modeling: Case-study in Cadiz Bay (Spain).

In intertidal areas, the zonation is determined by factors such as sea-level and topography. For this reason, a mixed methodology for the characterization (topography, extension, and zonation) of maximum intertidal areas is presented, based upon multispectral satellite imagery, hydrodynamic modeling, and in situ measurements. The methodology is applied and validated in the inner Cadiz Bay (SW Spain) as a case study. Satellite-derived waterlines were vertically referenced by tide-gauge measurements of sea-level; the resulting partial topography of intertidal areas was integrated into available hydrographic/topographic data to elaborate a high-resolution (10 m) model grid from which hydrodynamic simulations were conducted. Model results for lowest and highest tidal level situations were used to characterize the maximum intertidal areas within the inner Cadiz Bay, as well as the lowest astronomical tidal surface (LAT). The obtained LAT, referenced with respect the chosen geoid and/or ellipsoid, was identified with the vertical reference surface for Hydrography (VRSH) in this environment, complementing and improving the official VRSH presently being developed for Spanish waters. Obtained results show errors of the order of 1 cm for sea-level amplitudes and <1 min for the main tidal lags when comparing with tide-gauge data. Further applications of this exportable, relatively fast, low-cost, and accurate methodology are outlined.

Airborne Bacterial Community Composition According to Their Origin in Tenerife, Canary Islands.

Microorganisms are ubiquitous in the environment, and the atmosphere is no exception. However, airborne bacterial communities are some of the least studied. Increasing our knowledge about these communities and how environmental factors shape them is key to understanding disease outbreaks and transmission routes. We describe airborne bacterial communities at two different sites in Tenerife, La Laguna (urban, 600 m.a.s.l.) and Izaña (high mountain, 2,400 m.a.s.l.), and how they change throughout the year. Illumina MiSeq sequencing was used to target 16S rRNA genes in 293 samples. Results indicated a predominance of Proteobacteria at both sites (>65%), followed by Bacteroidetes, Actinobacteria, and Firmicutes. Gammaproteobacteria were the most frequent within the Proteobacteria phylum during spring and winter, while Alphaproteobacteria dominated in the fall and summer. Within the 519 genera identified, Cellvibrio was the most frequent during spring (35.75%) and winter (30.73%); Limnobacter (24.49%) and Blastomonas (19.88%) dominated in the summer; and Sediminibacterium represented 10.26 and 12.41% of fall and winter samples, respectively. Sphingomonas was also identified in 17.15% of the fall samples. These five genera were more abundant at the high mountain site, while other common airborne bacteria were more frequent at the urban site (Kocuria, Delftia, Mesorhizobium, and Methylobacterium). Diversity values showed different patterns for both sites, with higher values during the cooler seasons in Izaña, whereas the opposite was observed in La Laguna. Regarding wind back trajectories, Tropical air masses were significantly different from African ones at both sites, showing the highest diversity and characterized by genera regularly associated with humans (Pseudomonas, Sphingomonas, and Cloacibacterium), as well as others related to extreme conditions (Alicyclobacillus) or typically associated with animals (Lachnospiraceae). Marine and African air masses were consistent and very similar in their microbial composition. By contrast, European trajectories were dominated by Cellvibrio, Pseudomonas, Pseudoxanthomonas, and Sediminibacterium. These data contribute to our current state of knowledge in the field of atmospheric microbiology. However, future studies are needed to increase our understanding of the influence of different environmental factors on atmospheric microbial dispersion and the potential impact of airborne microorganisms on ecosystems and public health.

The fate of Guadalquivir River discharges in the coastal strip of the Gulf of Cádiz. A study based on the linking of watershed catchment and hydrodynamic models.

A catchment model for river basins and a hydrodynamic model were combined in order to simulate the spreading of the turbidity plume produced by sediment discharges from the Guadalquivir River basin within the Gulf of Cádiz under different meteorological conditions. The current fields provided by the hydrodynamic model and a transport-diffusion scheme based on tracking virtual particles tracking released at the river mouth have enabled us to simulate turbidity plumes that show great similarity with the plumes observed in satellite images. The most relevant results of the study show that in the absence of winds, the plume tends to spread very slowly, gradually progressing northwards; this is because of the symmetry between the filling and draining flows at the mouth of the Guadalquivir and low intensity of the tidal currents beyond the mouth. In addition, the transport of the plume towards the Strait of Gibraltar requires wind conditions with a northerly, north-westerly or westerly component. Westwards transport, however, requires winds with an easterly, southerly, or south-easterly component. The periods of heaviest rainfall in the Guadalquivir River basin coincide with winds mainly from the west; therefore, the times of maximum discharge at the mouth of the river occur when there are wind conditions that favour the transport of the matter suspended in the plume, southwards along the coast, towards the Strait of Gibraltar and the Alboran Sea. Linking the watershed catchment and hydrodynamic models has proved its suitability to predict the evolution and reaching of the sediment plumes from the Guadalquivir River discharges and the experience encourages the use of that methodology to be applied in a future prediction system for the creation and evolution of those sediment plumes.

The influence of natural vs anthropogenic factors on trace metal(loid) levels in the Mussel Watch programme: Two decades of monitoring in the Spanish Mediterranean sea.

The spatial distribution and temporal trends of trace metals (i.e. Cd, Cu, Hg, Pb and Zn) and a metalloid (i.e. As) along the Spanish Mediterranean coast from 1993 to 2013 are presented with a new estimation of their background levels monitored using wild mussels. Over a 20 years period, yearly mussel monitoring was undertaken with a rigorous field sampling protocol using 3 pooled samples strategy (3 x n = 80, with 8 mussels in the 3.0 to 3.9 size categories at each site), obtained in the pre-spawning period (May-June) to minimize biological factors and seasonal variability, which is a fundamental element of the international programme. Spatial distribution was characterized every 5 years and temporal trends were determined in 11 locations. The main aims of the present long term study are to evaluate the environmental status of different coastal locations regarding trace metal levels and follow the evolution of these levels over time after the implementation of regulatory measures. Regarding spatial distribution, the highest values for Cd, Cu, Hg and Pb were found close to known highly anthopogenic cities or shipyard areas. However, As and Zn did not strictly follow this pattern, showing natural increased concentrations in the Levantine Balearic and Strait of Gibraltar-Alboran Sea demarcations respectively. These distributions are associated with the conjunction of two geological formation inputs (Massif Central in France and Iberian Pyritic Belt in Spain) and the oceanographic conditions in the adjacent coastal area. In the case of temporal trends, metal concentrations decreased significantly over time in most stations, confirming the effectiveness of the regulatory measures and prohibitions established under European legislation. Concentrations of Pb were above the established thresholds for human consumption in only 12-14% of the sampling areas. With the information obtained for this study, we estimate background concentrations and propose new Background Assesment Criteria (BAC) for the Spanish Mediterranean coast as a threshold criterion: 1.62 mg/kg d.w. for Cd, 8.75 mg/kg d.w. for Cu, 0.202 mg/kg d.w. for Hg and 2.83 mg/kg d.w. for Pb. Exceptions should exist for As and Zn, for which there should be different levels in each demarcation, due to the geological, hydrological and oceanographic peculiarities of the Spanish coast. For the Levantine-Balearic demarcation, the proposed background concentrations are 117 mg/kg d.w. for As and 200 mg/kg d.w. for Zn., whereas in the Strait of Gibraltar-Alboran Sea demarcation, they are 27.5 mg/kg d.w. for As, and 471 mg/kg d.w. for Zn. This work demonstrates the vital importance of defining the background levels of metal(loid)s at a regional or subregional level because, for areas not affected by anthropogenic causes which have high values as the result of natural processes, this would avoid the risk of constantly surpassing the levels proposed in directives.

Working memory deficits in schizophrenia are associated with the rs34884856 variant and expression levels of the NR4A2 gene in a sample Mexican population: a case control study.

BACKGROUND: Cognitive functions represent useful endophenotypes to identify the association between genetic variants and schizophrenia. In this sense, the NR4A2 gene has been implicated in schizophrenia and cognition in different animal models and clinical trials. We hypothesized that the NR4A2 gene is associated with working memory performance in schizophrenia. This study aimed to analyze two variants and the expression levels of the NR4A2 gene with susceptibility to schizophrenia, as well as to evaluate whether possession of NR4A2 variants influence the possible correlation between gene expression and working memory performance in schizophrenia. METHODS: The current study included 187 schizophrenia patients and 227 controls genotyped for two of the most studied NR4A2 genetic variants in neurological and neuropsychiatric diseases. Genotyping was performed using High Resolution Melt and sequencing techniques. In addition, mRNA expression of NR4A2 was performed in peripheral mononuclear cells of 112 patients and 118 controls. A group of these participants, 54 patients and 87 controls, performed the working memory index of the WAIS III test. RESULTS: Both genotypic frequencies of the two variants and expression levels of the NR4A2 gene showed no significant difference when in patients versus controls. However, patients homozygous for the rs34884856 promoter variant showed a positive correlation between expression levels and auditory working memory. CONCLUSIONS: Our finding suggested that changes in expression levels of the NR4A2 gene could be associated with working memory in schizophrenia depending on patients' genotype in a sample from a Mexican population.

Deep-diving beaked whales dive together but forage apart.

Echolocating animals that forage in social groups can potentially benefit from eavesdropping on other group members, cooperative foraging or social defence, but may also face problems of acoustic interference and intra-group competition for prey. Here, we investigate these potential trade-offs of sociality for extreme deep-diving Blainville's and Cuvier's beaked whales. These species perform highly synchronous group dives as a presumed predator-avoidance behaviour, but the benefits and costs of this on foraging have not been investigated. We show that group members could hear their companions for a median of at least 91% of the vocal foraging phase of their dives. This enables whales to coordinate their mean travel direction despite differing individual headings as they pursue prey on a minute-by-minute basis. While beaked whales coordinate their echolocation-based foraging periods tightly, individual click and buzz rates are both independent of the number of whales in the group. Thus, their foraging performance is not affected by intra-group competition or interference from group members, and they do not seem to capitalize directly on eavesdropping on the echoes produced by the echolocation clicks of their companions. We conclude that the close diving and vocal synchronization of beaked whale groups that quantitatively reduces predation risk has little impact on foraging performance.

Effect of Agave Fructans as Carrier on the Encapsulation of Blue Corn Anthocyanins by Spray Drying.

Effects of agave fructans as carrier agents on the encapsulation of blue corn anthocyanins using spray-drying were evaluated. Blue corn extract was mixed with 6%, 8%, 10%, and 12% (w/v) of agave fructans in duplicate and dried at 150 °C. The extract showed good contents of anthocyanins, polyphenols, and antioxidant activity. The increase of agave fructans in the encapsulated powders caused a significant increase (p < 0.05) in the humidity, water activity (aw), pH, bulk density, water solubility index (WSI), and color L* values. On the contrary, the agave fructan addition decreased the hygroscopicity, water absorption index (WAI), antioxidant activity, total anthocyanin, total polyphenol, and individual anthocyanin contents. The encapsulation of blue corn extract with 6% agave fructans (w/v) resulted in good physical, thermal, morphological, and high antioxidant properties. The results suggest that the use of agave fructans as wall material represents advantages in the conservation of anthocyanins and other bioactive compounds from blue corn extract during their encapsulation. The application of blue corn anthocyanin encapsulated powders as a food ingredient is promising for food pigmentation, representing additional advantages for their contribution as a soluble fiber that can benefit the health of consumers.

NanoDJ: a Dockerized Jupyter notebook for interactive Oxford Nanopore MinION sequence manipulation and genome assembly.

BACKGROUND: The Oxford Nanopore Technologies (ONT) MinION portable sequencer makes it possible to use cutting-edge genomic technologies in the field and the academic classroom. RESULTS: We present NanoDJ, a Jupyter notebook integration of tools for simplified manipulation and assembly of DNA sequences produced by ONT devices. It integrates basecalling, read trimming and quality control, simulation and plotting routines with a variety of widely used aligners and assemblers, including procedures for hybrid assembly. CONCLUSIONS: With the use of Jupyter-facilitated access to self-explanatory contents of applications and the interactive visualization of results, as well as by its distribution into a Docker software container, NanoDJ is aimed to simplify and make more reproducible ONT DNA sequence analysis. The NanoDJ package code, documentation and installation instructions are freely available at https://github.com/genomicsITER/NanoDJ .

[Decrease of HCV seroprevalence in Mexico: Results from the National Health and Nutrition Survey 2012]. / Disminución de la seroprevalencia de hepatitis C en México: resultados de la Ensanut 2012.

OBJECTIVE: To estimate seroprevalence of hepatitis C virus (HCV) among 15-49 years old Mexicans living in households and to describe the profile of seroreactive individuals. MATERIALS AND METHODS: Cross-sectional study implemented in 2012 using a national probabilistic sample with behavioral data from face-to-face interviews at households and HCV antibodies screening using capillary blood from same individuals. RESULTS: HCV seroprevalence in Mexico was estimated at 0.27% (IC95% 0.12-0.60), representing 161 000 persons. Seroprevalence was significantly higher among males (0.45% CI95% 0.01-0.89) than females (0.10% CI95% 0.00-0.22). Multivariate analysis suggests a higher possibility of HCV reactivity among men, increasing with age and higher among those sexually active, and lower for higher socioeconomic level. CONCLUSION: HCV seroprevalence in Mexico by 2012 seems significantly lower than the estimation from 2000 of 1.2% for the same age-group. Evidence of infection among individuals 15-19 years old suggests the need to strength preventive actions, particularly in subjects with risky behaviors.

Disminución de la seroprevalencia de hepatitis C en México: resultados de la Ensanut 2012 / Decrease of HCV seroprevalence in Mexico: Results from the National Health and Nutrition Survey 2012

Objetivo. Estimar la seroprevalencia del virus de la hepatitis C (VHC) en población mexicana en viviendas particulares y explorar aspectos del perfil poblacional de serorreactividad. Material y métodos. Estudio transversal con una muestra probabilística de la población del país entre 15 y 49 años en el año 2012, con información sociodemográfica obtenida por entrevista en los hogares y determinación de anticuerpos al VHC por inmunoensayo de micropartículas en sangre capilar. Resultados. La seroprevalencia de VHC en México se estimó en 0.27% (IC95% 0.12-0.60), equivalente a 161 000 personas en el país, y fue mayor entre hombres (0.45% IC95% 0.01-0.89) en comparación con mujeres (0.10% IC95% 0.00-0.22). El análisis multivariado señala que la posibilidad de un resultado positivo a VHC es mayor entre hombres, aumenta con la edad y entre los sexualmente activos, y es menor en la población de mayor nivel socioeconómico. Conclusiones. La seroprevalencia observada de VHC resulta significativamente menor que la estimada en el año 2000 (1.2%) para el mismo grupo de edad. La evidencia de casos entre individuos de 15 a 19 años sugiere la necesidad de fortalecer acciones preventivas recomendadas internacionalmente, con énfasis en la población expuesta al VHC por prácticas de riesgo.

Objective. To estimate seroprevalence of hepatitis C virus (HCV) among 15-49 years old Mexicans living in households and to describe the profile of seroreactive individuals. Materials and methods. Cross-sectional study implemented in 2012 using a national probabilistic sample with behavioral data from face-to-face interviews at households and HCV antibodies screening using capillary blood from same individuals. Results. HCV seroprevalence in Mexico was estimated at 0.27% (IC95% 0.12-0.60), representing 161 000 persons. Seroprevalence was significantly higher among males (0.45% CI95% 0.01-0.89) than females (0.10% CI95% 0.00-0.22). Multivariate analysis suggests a higher possibility of HCV reactivity among men, increasing with age and higher among those sexually active, and lower for higher socioeconomic level. Conclusion. HCV seroprevalence in Mexico by 2012 seems significantly lower than the estimation from 2000 of 1.2% for the same age-group. Evidence of infection among individuals 15-19 years old suggests the need to strength preventive actions, particularly in subjects with risky behaviors.

Seroprevalencia de VIH en población mexicana de entre 15 y 49 años: resultados de la Ensanut 2012 / HIV seroprevalence among Mexicans age 15 to 49: results from the National Health & Nutrition Survey 2012

Objetivo. Estimar la seroprevalencia de VIH en población mexicana no institucionalizada de 15 a 49 años, y aspectos selectos del perfil de la población serorreactiva. Material y métodos. Estudio transversal con una muestra probabilística de la población del país de 15 a 49 años, con información sobre comportamientos obtenida por entrevista directa en los hogares y determinación de anticuerpos para VIH en sangre capilar. Resultados. Se identificó una seroprevalencia de 0.15% (IC95% 0.09-0.21) en la población de 15 a 49 años; de 0.07% (IC95% 0.03-0.11) en mujeres, y de 0.24% (IC95% 0.11-0.36) en hombres. La población serorreactiva a VIH son hombres jóvenes, de mayor nivel socioeconómico en relación con la población general y con información que sugiere una mayor cobertura por la seguridad social (49.9% en serorreactivos contra 34.5% en no serorreactivos). El 49.4% de los serorreactivos contra 18.5% de los no serorreactivos se había realizado al menos una prueba de detección de VIH. Conclusiones. La seroprevalencia de VIH estimada en la Encuesta Nacional de Salud y Nutrición (Ensanut) 2012 sugiere que ésta se ha mantenido relativamente estable desde 2000. La estimación representa alrededor de 104000 personas (rango de entre 53000 y 126000) de 15 a 49 años que viven con VIH en México (75% de los cuales son hombres), de los que 50.6% desconocería su estatus serológico. Implementando un modelo de corrección de sesgo y agregando a los estimados en hogar, los casos estimados entre población de hombres que tienen sexo con hombres (tanto homosexual como bisexual), la estimación de la seroprevalencia alcanzaría 0.23%, con un total de 140000 personas de 15 a 49 años viviendo con VIH (con un intervalo estimado de entre 92000 y 201000 personas).

Objective. To estimate the HIV seroprevalence among Mexicans aged 15 to 49 years old and living in households, and to describe the profile of serorreactive individuals. Materials and methods. Cross-sectional study with a national probabilistic sample of individuals aged 15 to 49 years with behavioral data from direct interview (face-to-face) at households and HIV screening using capillary blood collected from the same individuals. Results. A seroprevalence of 0.15% (95%CI 0.09-0.21) was estimated for Mexicans aged 15 to 49; seroprevalence among women was 0.07% (95%CI 0.03-0.11) and 0.24% (95%CI 0.11-0.36) for men. HIV serorreactive population is composed of younger men, with a higher socioeconomic level compared to the general population, and with a higher insurance coverage-social protection on health in general and social security in particular. Only 50% of the serorreactive individuals may be aware of their status as living with HIV. Conclusions. The estimated HIV seroprevalence in the NHNS 2012 suggests a stable pattern since 2000. The estimated prevalence among individuals 15 to 49 years was adjusted both for selection bias correction and to include MSM estimations (under the assumption that MSM is a population hard to reach in a household survey), resulting in a total seroprevalence of 0.23% and an estimated number of people with HIV of 140000.

[HIV seroprevalence among Mexicans age 15 to 49: results from the National Health & Nutrition Survey 2012]. / Seroprevalencia de VIH en población mexicana de entre 15 y 49 años: resultados de la Ensanut 2012.

OBJECTIVE: To estimate the HIV seroprevalence among Mexicans aged 15 to 49 years old and living in households, and to describe the profile of serorreactive individuals. MATERIALS AND METHODS: Cross-sectional study with a national probabilistic sample of individuals aged 15 to 49 years with behavioral data from direct interview (face-to-face) at households and HIV screening using capillary blood collected from the same individuals. RESULTS: A seroprevalence of 0.15% (95%CI 0.09-0.21) was estimated for Mexicans aged 15 to 49; seroprevalence among women was 0.07% (95%CI 0.03-0.11) and 0.24% (95%CI 0.11-0.36) for men. HIV serorreactive population is composed of younger men, with a higher socioeconomic level compared to the general population, and with a higher insurance coverage-social protection on health in general and social security in particular. Only 50% of the serorreactive individuals may be aware of their status as living with HIV. CONCLUSIONS: The estimated HIV seroprevalence in the NHNS 2012 suggests a stable pattern since 2000. The estimated prevalence among individuals 15 to 49 years was adjusted both for selection bias correction and to include MSM estimations (under the assumption that MSM is a population hard to reach in a household survey), resulting in a total seroprevalence of 0.23% and an estimated number of people with HIV of 140,000.

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.

[Guideline for interpretation and report of the antibody to hepatitis C virus. Grupo de Desarrollo de la Guía ]. / Guía de interpretación y reporte del anticuerpo a hepatitis C.

Patients with hepatitis C virus (HCV) infection are detected by testing for the presence of antibodies to HCV (Anti-HCV). A positive Anti-HCV test represents a true positive result only in a variable proportion of subjects (35 to 95%). The qualitative interpretation as positive or negative Anti-HCV report is associated with a general lack of understanding regarding the interpretation of results, when more specific testing should be performed, and which tests should be considered for this purpose. Therefore, a substantial variation in supplemental testing practices exists among laboratories and physicians. This guideline was developed on the basis of the best available evidence to classify positive antibody in two (low and high) or three levels (very low, low and high) according to the signal to cutoff (S/CO) ratio: the very low level of the Anti-HCV identifies false-positive results and further diagnostic testing is not necessary. The low antibody level is frequently related with false-positive results and testing with Immunoblot is recommended; only Immunoblot-positive subjects require HCV RNA testing because of a low possibility of being viremic. The high Anti-HCV level is an accurate serological marker for predicting viremia and denotes the need of routine HCV RNA testing in order to efficiently confirm hepatitis C. Cost-effectiveness analysis, based on the Anti-HCV level, recommends the use of the two or three-levels to choose the confirmatory test of positive antibody. This approach can be implemented without increasing test costs because the S/CO ratio is automatically generated in most laboratory analyzers and would provide health care professionals with useful information for counseling and evaluating patients, to eliminate unwarranted notifications in cases of false antibody reactivity, and correctly identifying those Anti-HCV-positive patients who are infected and need antiviral treatment. The written report should include the antibody level (S/CO ratio), the type of the immunoassay applied and interpretation guideline. Anti-HCV testing is performed in multiple settings including blood banks or health department facilities; adoption of this Guideline for interpretation and report of the antibody to hepatitis C virus by laboratories and its implementation by clinicians will improve the accuracy for interpreting antibody result to determine the next step on hepatitis C diagnosis.

Hepatitis C seroprevalence and correlation between viral load and viral genotype among primary care clients in Mexico.

OBJECTIVE: To measure hepatitis C virus (HCV) sero-prevalence, prevalence, hepatitis risk characteristics frequency, and genotype correlation with viral load among clients attending health care clinics. MATERIAL AND METHODS: Venous blood samples from l12 226 consecutive consenting adults were collected from January 2006 through December 2009. HCV antibodies were detected by immunoassay. HCV RNA was detected by qRT-PCR and viral genotype was performed by PCR and LIPA test. RESULTS: The HCV seroprevalence observed was l.5 % (C.I. 95% l.3-l.7), from seropositive individuals 60.9 % reported previous blood transfusion, 28.3% declared to have relatives with cirrhosis, 25.2% had tattoos or piercings, and 6.9% referred to have used drugs. Male gender and transfusion (p<0.001) were the most frequent hepatitis risk characteristics in the HCV seropositive group. Among seropositive subjects 48.3% presented HCV RNA.The most frequent genotype detected in all geographic areas of Mexico was l (subtype lA, 33%; subtype lB, 21.4%) followed by genotype 2 (subtype 2A, 8.50%). Subjects with genotype 1 had a significant correlation with the highest viral load. CONCLUSIONS: Our results show that nearly half of seropositive individuals are chronically infected. HCV infection has been shown in this study to be an emerging health problem in Mexico.