[Results of surveys to users of IMSS children daycare centers during the COVID-19 pandemic]. / Resultados de encuestas a usuarios de guarderías IMSS durante la pandemia por COVID-19.

Background: Studies carried out in Mexico show that the COVID-19 pandemic has negatively impacted families in every field. Confinement has generated problems and economic, social and health instability in a large sector of the population, especially in the most vulnerable, to which children and adolescents are part of. Objective: To identify the impact of the confinement and closure of children daycare centers from the Instituto Mexicano del Seguro Social (IMSS) derived from the COVID-19 pandemic. Material and methods: Three questionnaire-type surveys were implemented via email for workers who were users of IMSS children daycare centers from September to November 2020. The surveys had a perception design, one- and two-stage, simple random and with results by segments. Results were obtained for independent proportions. The z-test was applied at 95% confidence. Results: Effects on workers and child users of the service derived from the closure of children daycare centers were observed, and it was greater in entities with closed children daycare centers than with those ones in operation (p < 0.0001). Conclusions: The negative impact derived from the closure of children daycare centers due to the confinement by COVID-19 in workers who use the service and their children was identified. The spheres with the greatest impact were the economic, the working environment, as well as the children's health (and their families).

Introducción: : estudios realizados en México muestran que la pandemia por COVID-19 ha impactado de forma negativa a las familias en todos los ámbitos. El confinamiento ha generado problemas e inestabilidad económica, social y en la salud en un gran sector de la población, especialmente en el más vulnerable, donde se encuentran los niños y adolescentes. Objetivo: identificar el impacto del confinamiento y el cierre de guarderías del Instituto Mexicano del Seguro Social (IMSS) derivado de la pandemia por COVID-19. Material y métodos: se aplicaron vía correo electrónico tres encuestas tipo cuestionario a trabajadores usuarios del servicio de guardería del IMSS de septiembre a noviembre de 2020. Las encuestas tenían diseño de percepción uni y bietápico, aleatorio simple y con resultados por segmentos. Se obtuvieron resultados para proporciones independientes. Se aplicó el z-test con un 95% de confianza. Resultados: se observó afectación en los trabajadores y en los niños usuarios del servicio derivado del cierre de las guarderías del IMSS, la cual fue mayor en las entidades con guarderías cerradas que en aquellas en operación (p < 0.0001). Conclusiones: se identificó el impacto negativo derivado del cierre de guarderías IMSS por el confinamiento por COVID-19 en trabajadores usuarios del servicio y sus hijos. Los ámbitos con más afectación fueron el económico, el laboral, así como la salud de los niños (y sus familias).

[Social determinants of infant mortality in socioeconomic deprived rural areas in Mexico]. / Determinantes sociales de la mortalidad infantil en municipios de bajo índice de desarrollo humano en México.

BACKGROUND: The aim of this study was to identify determinants of infant mortality in rural areas in Mexico and recommend strategies for its decrease. METHODS: A study was conducted in a sample of 16 municipalities among those with the lowest index of human development. Infant deaths were identified through official data, records and through interviews with civil authorities, health workers and community leaders. Mothers of children who died were also interviewed. RESULTS: In most cases, deaths were related with intermediate social determinants (living conditions and health services converged). The most important critical factors were the prevention programs and delays in receiving healthcare. Deficiencies in intersectorial policies to guarantee effective access to health services were found. CONCLUSIONS: To decrease infant mortality in rural areas of Mexico, geographic access has to be improved as well as investment in resources and training health personnel in intercultural competence and primary health care skills.

Congenital syphilis, a reemergent disease in Mexico: its epidemiology during the last 2 decades.

OBJECTIVE: To describe the epidemiologic profile of congenital syphilis in Mexico between 1990 and 2009. METHODS: The database of the General Direction of Epidemiology at the Ministry of Health in Mexico about congenital syphilis was reviewed. Data corresponding to the period between 1990 and 2009 were analyzed in every state of the Mexican republic. RESULTS: A total of 1717 cases of congenital syphilis were reported during the study period. A 16.6% increase was observed between 2005 and 2009 and the quinquennium between 2000 and 2004. A trend toward increase in the incidence of congenital syphilis was observed with 2.9 new cases for each 100,000 babies born alive. The states that displayed significant positive trends were as follows: Baja California, Colima, Chihuahua, Jalisco, Nayarit, Sinaloa, and Zacatecas. CONCLUSIONS: An increase in the number of cases of congenital syphilis is observed; the northern states are the ones that contribute the most to the statistics. There is a real need to refine the epidemiologic operations to detect and treat the cases of maternal and congenital syphilis in the country.

[Analysis of the mortality due to diarrhea in younger children, before and after the introduction of rotavirus vaccine]. / Mortalidad por enfermedad diarreica en menores, antes y después de la introducción de la vacuna contra el rotavirus.

OBJECTIVE: To analyze the mortality due to acute diarrhea in children younger than five years old, before and after the introduction of rotavirus vaccine in Mexico. MATERIAL AND METHODS: Number of deaths and mortality rates due to acute diarrhea were compared by children's age and states' vaccine status using annual percentage differences before (2000-2005) and after (2006-2007) the introduction of the HRV. RESULTS: From 2000-2007, deaths due to acute diarrhea in children under five years of age dropped 42%. In those states that received the HRV early in 2006, diarrhea mortality decreased between 2006-2007 15.8% in children younger than one year old and 22.7% in children 1-4 years old. DISCUSSION: The observed reduction in mortality due to acute diarrhea in children under five years of age after 2005 can be, in part, attributed to the HRV.

Mortalidad por enfermedad diarreica en menores, antes y después de la introducción de la vacuna contra el rotavirus / Analysis of the mortality due to diarrhea in younger children, before and after the introduction of rotavirus vaccine

Objetivo. Analizar la mortalidad por diarrea en menores de cinco años en México, antes y después de la vacunación contra el rotavirus. Material y métodos. Se compararon defunciones y mortalidad por diarrea mediante diferencias porcentuales anuales por grupo etario, antes (2000-2005) y después (2006-2007) de la vacunación. Resultados. Entre 2000 y 2007 la mortalidad por diarrea disminuyó 42%. En los estados con vacunación, la mortalidad se redujo 15.8 y 27.7% en menores de uno y de uno a cuatro años, respectivamente, en el periodo de 2006 a 2007. Discusión. La reducción observada en la mortalidad por diarrea en menores de cinco años después de 2005 puede atribuirse en parte a la vacunación contra el rotavirus.

Objective. To analyze the mortality due to acute diarrhea in children younger than five years old, before and after the introduction of rotavirus vaccine in Mexico. Material and Methods. Number of deaths and mortality rates due to acute diarrhea were compared by children’s age and states’ vaccine status using annual percentage differences before (2000-2005) and after (2006-2007) the introduction of the HRV. Results. From 2000-2007, deaths due to acute diarrhea in children under five years of age dropped 42%. In those states that received the HRV early in 2006, diarrhea mortality decreased between 2006-2007 15.8% in children younger than one year old and 22.7% in children 1-4 years old. Discussion. The observed reduction in mortality due to acute diarrhea in children under five years of age after 2005 can be, in part, attributed to the HRV.