José Luis Vázquez-Martínez

Clinical profile of dengue hemorrhagic fever cases in Mexico

OBJECTIVE Dengue hemorrhagic fever is a public health problem in Mexico since 1994. With four serotypes circulating the risk of epidemic dengue hemorrhagic fever is increasing. MATERIAL AND METHODS We describe the clinical features of confirmed cases in the social security health system (IMSS) from 1995 to 2003. Clinical picture and epidemiological features were compared and a multivariate model was fitted to evaluate associations. RESULTS Cases were divided into two groups: 438 patients with dengue fever, including 109 cases with hemorrhagic manifestations without thrombocytopenia, and 977 cases with dengue hemorrhagic fever, including 79 deaths. The main risk factors associated with mortality were hematemesis (RR 2.6; CI 95% 1.4-4.6) and melena (RR 2.2; Cl 95% 1.2-3.7). CONCLUSIONS Our results characterize the clinical profile of dengue hemorrhagic fever cases in Mexico and identify prognostic factors to alert clinician for the prevention of a fatal evolution.

Seroprevalence of hepatitis B in pregnant women in Mexico

OBJECTIVE To determine the seroprevalence of hepatitis B in pregnant women from several regions of Mexico, as well as the risk factors associated with its occurrence. MATERIAL AND METHODS A cross-sectional study was conducted between May and August 2000. It included 9,992 pregnant women attending the health services of the Mexican Institute of Social Security (Instituto Mexicano del Seguro Social-IMSS) in five cities: Tijuana, Ciudad Juarez, Acapulco, Cancun, and Mexico City (northeast and southeast regions). RESULTS The overall prevalence for confirmed cases was 1.65% (165/9,992). The prevalences for individual cities were as follows: Tijuana, 1.27%; Ciudad Juarez, 1.46%; Acapulco, 2.47%; Cancun, 0.93%; northeastern Mexico City, 1.20%, and southeastern Mexico City, 2.52%. The risk factors found to be associated with HBsAg were: age, age at first sexual intercourse, city (Acapulco and southeastern Mexico City), and marital status (single or divorced). CONCLUSIONS The prevalence of HBsAg in pregnant women (1.65%) was greater than that reported in previous studies and showed geographical differences. This high prevalence suggests that a considerable amount of cases of hepatitis B occurs perinatally and through contact with carriers in the general population. Vaccination of newborns of high-risk pregnant women should be considered.

Obesity and overweight in IMSS female workers in Mexico City

OBJECTIVE To estimate the prevalence and risk factors for overweight (OW) and obesity (OB) in women working at the Mexican Social Security Institute (IMSS, per its abbreviation in Spanish) in Mexico City, using two different classification criteria. MATERIAL AND METHODS A cross-sectional study was performed from July 1999 to September 2000. It included 588 women 20 to 65 years of age and who were working at the IMSS. The criteria used to estimate the prevalence of OW and OB were the WHO criteria and the Mexican Official Norm (NOM) for the integrated management of obesity in Mexico. RESULTS The frequency of OB, according to WHO criteria, was 27.6% (26% adjusted) and for OW 43.2% (40.2% adjusted). According to the NOM, the levels of OB in those with short height (< 1.50 m) increased to 75% and to 52.2% for those with height > 1.50 m. Comparison of BMI between the two height groups showed no differences. The risk factor associated with OB and OW was age. Education and exercise were protective factors. CONCLUSIONS The high prevalences detected in this particular working group highlight the importance of prevention and control of OB in health personnel because it can result in a high number of disability and premature retirement due to disease. The use of the NOM criteria for the identification of women at risk may be useful for early detection of high-risk groups.

La violencia en las mujeres usuarias de los servicios de salud en el IMSS y la SSA

Objective. To compare the prevalence of violence and determine its risk factors among women who use Mexican Social Services (IMSS) clinics and do not have access to social security services. Material and Methods. Sociodemographic data linked to domestic violence reported by women attending the Mexican Institute of Social Security (IMSS) health services was analyzed. Bivariate and multivariate analysis was performed using STATA V.7. Results. Psychological violence in IMSS women was 18% followed by physical violence (9.1%), sexual (6.7%) and economic (5%). Prevalence of violence in women with no social security care was psychological (21.4%), physical (10.5%), sexual (7.5%) and economical (5%). Women between 25 and 44 years of age with basic schooling and married and with family background of violence were the most affected. The daily consumption of alcohol by their partners was an important predictor of domestic violence. Conclusion. Violence in women with no social security is higher. Partner’s alcohol intake pattern is an important risk factor. Detection of domestic violence in the clinical setting is necessary to recognize its real magnitude as a social problem.