Francisco Espinoza-Gómez

Educational campaign versus malathion spraying for the control of Aedes aegypti in Colima, Mexico

Objective: To evaluate the effect of an educational campaign for reducing the breeding places of Aedes aegypti, the principal vector of dengue; and to compare its effects with the ones obtained by spraying of malathion at ultralow volume. Design: Randomised community trial. Setting: Colima city, in the State of Colima, Mexico. Participants: Householders of 187 houses, randomly selected from the west sector of the city. Data: In each house, an entomological survey was done, as well as one for knowledge, attitude and practices (KAP), before the intervention and six months after. The intervention consisted of educational campaign alone (47 houses); malathion spraying at ultra low volume alone (46 houses); both treatments simultaneously (49 houses) and no intervention, or control group (45 houses). Main results: The global average of the positive containers by house (C+/C) was reduced from 0.97 to 0.77. A two way analysis of variance showed that this reduction was more apparent in the houses that received educational campaign (F=8.4, p<0.005) with relation to the ones that received malathion spraying (F=0.38, p>0.5), while the combination of both treatments demonstrated a discrete negative interaction (F=6.52, p<0.05). These effects were independent of climatic changes and level of knowledge about dengue, as the KAP indicator did not show any significant changes in any group (F=1.14, p>0.1). Conclusion: The results indicated that the educational campaign reduced the A aegypti breeding places more effectively than the use of chemicals spraying, and that the combination of both treatments can reduce its efficiency, possibly because of the false expectancy of protection that spraying creates. The KAP surveys seemed to have very limited value in evaluating quantitatively the programmes of eradication of the dengue vector.

Matrix Metalloproteinase-2 Promoter Polymorphism Is Associated with Breast Cancer in a Mexican Population

Background:Matrix metalloproteinase-2 (MMP-2) is an enzyme with proteolytic activity on matrix proteins, particularly basement membrane constituents. A single nucleotide polymorphism C>T transition at –1306 displayed a strong association with several cancers. Our study investigated whether or not the MMP-2 –1306C>T polymorphism contributed to the development of breast cancer (BC) in a Mexican population. Methods: 90 patients with BC and 96 control subjects were analyzed to detect MMP-2 –1306C>T polymorphism. Results: The frequency of MMP-2 CC genotype was significantly higher in BC patients when compared with the control group (OR 2.15; 95% CI 1.1–4.1). MMP-2 CC genotype frequency was more pronounced in younger subjects (≤50 years) at diagnosis (OR 2.66; 95% CI 1.04–6.96). Conclusion: The data suggest that MMP-2 –1306C>T polymorphism strongly contributes to the development of BC in the population studied, especially among women 50 years old and younger.

Presence of Triatominae (Hemiptera, Reduviidae) and Risk of Transmission of Chagas Disease in Colima, México

With the purpose of evaluating the risk of transmission of the Chagas disease in the State of Colima, México, an entomological survey was performed to obtain triatominae and the rate of infection by Trypanosoma cruzi determined by examination of its dejections. Two hundred eighteen houses located in 16 villages were sampled. In each house the intradomestic and peridomestic habitats were examined by the man-hour-house method, sensor boxes and mouse-baited traps. Also, 12 silvatic places were explored around the same areas using the same techniques as the ones sampled. In total, 456 specimens were captured, of which 139 correspond to Triatoma phyllosoma pallidipennis; 80 to T.p. longipennis; one specimen of T. dimidiata and 236 nymphs of Triatoma sp. Two hundred ninety seven insects were captured in the intradomestic habitat, 132 in the peridomestic and 26 in the silvatic. The index of positive houses was 27%, located in the central area of the state. The rate of natural infection with T. cruzi showed 25.6%. This results confirmed the presence of two important vectors of the Chagas disease in Colima. Its preference for the domestic habitat and its high levels of natural infection with T. cruzi suggested the existence of a significant risk for its transmission in this area of the country.

Violencia doméstica y riesgo de conducta suicida en universitarios adolescentes

OBJECTIVE: To estimate the degree of association between domestic violence -physical, verbal or sexual- with suicidal behavior among university students. MATERIAL AND METHODS: A matched case-control study was done with students attending the University of Colima, Mexico. The cases were 235 teenagers who presented both suicidal ideation and suicide attempt; the controls were 470 individuals of the same age and sex. RESULTS: Sexual abuse showed the highest degree of association with suicidal behavior (OR= 27.4), followed by verbal violence (OR= 9.28), drug use (OR= 8.6), physical violence (OR= 5.5) and smoking (OR= 3.6). Multivariate logistic regression showed that verbal violence was associated with suicidal behavior independently of the other variables, while physical violence, sexual abuse, smoking and drug use seem to depend on verbal violence. CONCLUSIONS: Domestic violence, particularly verbal or sexual, is strongly associated with suicidal behavior in adolescents and should be considered in suicide prevention programs.

Transmisión interepidémica del dengue en la ciudad de Colima, México

OBJETIVO: Determinar la presencia de dengue interepidemico en una comunidad infestada por Aedes aegypti, y analizar sus caracteristicas epidemiologicas. MATERIAL Y METODOS: Entre 2001 y 2002 se realizo un estudio probabilistico longitudinal en 245 habitantes de la ciudad de Colima, Mexico. En cada caso se registraron: edad, sexo, nivel socioeconomico, cuadro clinico sugestivo de dengue, y se busco la presencia de IgG e IgM antidengue por inmunocromatografia rapida y por ELISA, en un seguimiento de siete meses. Los datos se analizaron mediante tablas de contingencia y regresion de Poisson univariada. RESULTADOS: Doce individuos resultaron con infeccion reciente (incidencia de 1.77%; IC 95%: 0.9-3.1%), ocho de ellos refirieron cuadro clinico reciente (ji2=19.6; p=0.0001, RM: 19.6). La regresion de Poisson no revelo correlacion de la infeccion reciente con edad, sexo, ni con nivel socioeconomico. CONCLUSIONES: En comunidades infestadas por A aegypti, como Colima, pueden ocurrir infecciones continuas por dengue sin epidemia aparente. Dichas infecciones no parecen asociarse con la edad, el sexo, ni con el nivel socioeconomico, pero si con el cuadro clinico, el cual podria considerarse como indicador precoz de posible transmision interepidemica.

Active transmission of human chagas disease in Colima Mexico

Despite efforts to eradicate American trypanosomiasis (AT) and Chagas disease from the Americas, there are still areas of active transmission that can eventually become a source of reinfection in previously controlled regions. Mexico could be one of those areas, where there are no formal preventive control programs despite the presence of communities infested by Triatominae bugs infected with Trypanosoma cruzi. This study explored the prevalence of T. cruzi infection in 405 habitants of 17 communities in the state of Colima, on the Pacific Mexican coast, through a seroepidemiological probabilistic survey. The results revealed a point seroprevalence of 2.4% positive for anti-T. cruzi. In addition, 2 clinical cases of chronic and 2 of acute Chagas disease were detected in the explored communities. These findings confirm the risk of active transmission of AT in Western Mexico, especially in rural and suburban communities infested with intra-domestic triatominae, where control programs should be implemented.

Detection of sequences from a potentially novel strain of cell fusing agent virus in Mexican Stegomyia ( Aedes ) aegypti mosquitoes

Flaviviruses (FVs) are a very heterogeneous group of viruses that includes viruses capable of infecting insects and/or vertebrates. Different human-disease-causing FVs are disseminated by mosquitoes, and therefore, the search for FV in these insects has recently been proposed in order to evaluate their potential transmission in a given community. An entomological survey was carried out in Colima (the hyperendemic dengue fever transmission zone in Mexico) to collect culicidae in urban and wild areas. No human-pathogenic FVs were found, but sequences related to a potentially novel strain of cell fusing agent virus (CFAV) were detected in Stegomyia (Aedes) aegypti mosquitoes.

Análisis de los factores de riesgo de la hipertensión arterial en Colima, México

OBJECTIVE To evaluate the possible association that age, sex, excess weight, family history of hypertension, alcoholism, and sedentary lifestyle have with hypertension in the adult population of the city of Colima, Mexico. METHODS This was a population-based analytic cross-sectional study. A structured survey was used with 280 adults older than 30 years of age who were living in the city of Colima in 2001 and 2002. The variables studied were sex, age, weight, height, family history of hypertension, engaging in physical exercise, smoking, and consuming alcohol. Blood pressure (BP) was measured with the auscultatory method. Borderline or doubtful measurements were checked again four or five days later. Hypertension was defined as systolic BP > or = 140 mm Hg and diastolic blood pressure > or = 90 mm Hg, or as the person being under antihypertensive treatment. The odds ratios (ORs) of the variables studied were calculated, along with their 95% confidence intervals (95% CIs). The association between the variables and hypertension was estimated through logistic regression, and their interaction through the coefficient of the interaction products. RESULTS The overall prevalence of hypertension was 28.6%. The prevalence was higher in men than in women (42.1% vs. 19.2%; OR = 3.04, 95% CI: 1.8 to 5.2) and in people older than 49 years than in people 30 to 49 years old (36.8% vs. 21.9%; OR = 2.07, 95% CI: 1.22 to 3.50). A family history of hypertension and excess weight were associated with hypertension, while physical exercise had a protective effect (OR = 0.45; 95% CI: 0.23 to 0.86). There was interaction between hypertension and age > or = 50 years, a family history of hypertension, overweight, and physical exercise, especially among women. CONCLUSIONS The prevalence of hypertension in Colima is very similar to that for Mexico as a whole. The strong association that hypertension had with male gender, regardless of the other variables, emphasizes the need for promoting prevention campaigns that focus more on men.

Meningitis caused by Alcaligenes xylosoxidans in a patient with HIV/AIDS

The purpose of the present work was to inform about the first case of meningitis associated to the bacteria Alcaligenes xylosoxidans in a patient with HIV/AIDS. The patient was a 46-year-old male, with the antecedent of have been diagnosed for HIV/ AIDS, who attended in the Hospital Universitario de Colima, Mexico, with fever, shock and meningismus. The study of the cerebrospinal fluid showed pleocytosis, elevated protein levels and hypoglycorrhachia. The culture yielded the presence of Alcaligenes xylosoxidans with sensitivity to ciprofloxacin. After 14 days of treatment with this antibiotic, the patient showed neurologic improvement and was able to continue with his outpatient antiretroviral treatment. The present case shows the importance of the inclusion of this bacterium in the differential diagnosis of the neurological infections in HIV/AIDS patients and emphasizes the importance of considering the bacterial meningitis in this population.

The Protective Effect of Peanut, Walnut, and Almond Consumption on the Development of Breast Cancer

Background/Aims: Breast cancer is the most common gynecologic malignancy known worldwide. The consumption of certain foods may modify the risk for its development. Peanuts and other seeds have shown anticarcinogenic effects in vitro, but there are a few studies that evaluate the effect of their consumption on the development of breast cancer. The aim of the present study was to determine whether there is an association between the consumption of peanuts, walnuts, and almonds and the development of breast cancer. Methods: We analyzed 97 patients presenting with breast cancer and 104 control subjects that did not have the pathology (BIRADS 1-2). An analysis of the main clinical characteristics and lifelong seed consumption was carried out. The association between the consumption of these foods and the risk for breast cancer was estimated by odds ratios and 95% confidence intervals, controlling other risk factors, using the Mantel-Haenszel analysis. Results: The high consumption of peanuts, walnuts, or almonds significantly reduced the risk for breast cancer by 2-3 times. This protective effect was not found with low or moderate seed consumption when compared with null consumption. Conclusions: High consumption of peanuts, walnuts, and almonds appears to be a protective factor for the development of breast cancer.