Patricia Cravioto

Initial human transmission dynamics of the pandemic (H1N1) 2009 virus in North America.

Background  Between 5 and 25 April 2009, pandemic (H1N1) 2009 caused a substantial, severe outbreak in Mexico, and subsequently developed into the first global pandemic in 41 years. We determined the reproduction number of pandemic (H1N1) 2009 by analyzing the dynamics of the complete case series in Mexico City during this early period.

Consumo de drogas entre adolescentes: resultados de la Encuesta Nacional de Adicciones, 1998

OBJETIVO: Describir el consumo de drogas y los factores de riesgo en adolescentes de 12 a 17 anos. MATERIAL Y METODOS: Los datos provienen de la Encuesta Nacional de Adicciones 1998, realizada en hogares ubicados en zonas urbanas de la Republica Mexicana. El diseno de la muestra fue probabilistico, estratificado y por conglomerados en varias etapas de muestreo, donde la ultima unidad de seleccion fue un individuo en la vivienda. Los resultados se analizaron obteniendo los intervalos de confianza de las prevalencias del consumo de drogas, y se realizo un analisis de regresion logistica para evaluar los factores asociados con el consumo de drogas. RESULTADOS: El 3.57% de los varones y 0.6% de las mujeres habian usado una o mas drogas excluyendo al tabaco y al alcohol; 2.14 de hombres y 0.45% de mujeres lo habian hecho en los doce meses previos al estudio, y 1.4 de los hombres y 0.3% de las mujeres en los 30 dias anteriores a la encuesta. La mariguana es la droga mas usada (2.4 y 0.45%), seguida por los inhalables (1.08 y 0.20%) y la cocaina (0.99 y 0.22%) por hombres y mujeres, respectivamente. El riesgo de usar drogas se asocio con ser hombre, no estudiar, considerar facil conseguir drogas, no ver mal el uso de drogas por parte de los amigos, que estos las usaran, usarlas por parte de la familia y estar deprimido. CONCLUSIONES: El entorno que rodea a nuestros jovenes de 12 a 17 anos indica que el consumo de drogas esta cada vez mas presente. Los indices de consumo se han incrementado, especialmente en la region norte del pais y en las grandes metropolis (Tijuana, Ciudad de Mexico y Guadalajara, principalmente). Estos datos refuerzan la necesidad de desarrollar campanas que permitan detectar a los menores que tienen problemas emocionales y darles la atencion apropiada para evitar que consuman drogas como un mecanismo para enfrentar problemas de esta naturaleza. Asimismo, es necesario identificar a los menores con mayor probabilidad de desarrollar dependencia, quienes requieren de intervenciones preventivas mas intensas.

Del tabaco al uso de otras drogas: ¿el uso temprano de tabaco aumenta la probabilidad de usar otras drogas?

Objetivo. Analizar la probabilidad de abuso de sustancias en relacion con la edad de inicio del consumo de tabaco. Material y metodos. Los datos provienen de la Encuesta Nacional de Adicciones (1998) realizada en poblacion urbana. Resultados. La edad de mayor riesgo para experimentar con sustancias es entre los 15 y los 19 anos. Solamente en 5.6% de los usuarios de drogas y 13% de los que han consumido alcohol, el uso del tabaco no ocurrio primero. La probabilidad de beber en forma consuetudinaria y de presentar dependencia es mayor cuando la edad de inicio es temprana y disminuye en la medida en que se retrasa la edad de inicio. La experimentacion con drogas, el continuar usandolas y el poliuso son mas frecuentes entre quienes se iniciaron antes de los 15 anos. Conclusiones. El inicio temprano en el consumo de tabaco incrementa la probabilidad de uso y abuso de sustancias.

Drug use and risk of HIV/AIDS on the Mexico-USA border: a comparison of treatment admissions in both countries

This study analyzes trends in treatment admissions and summarizes HIV/AIDS risk factors along the US-Mexican border. Data are presented at the national level and at the state level for states along the border. Client data also are compared for treatment programs located in sister cities on the Texas-Mexico border. These data show that methamphetamine admissions are increasing nationally and methamphetamine use is a major problem in the western states on both sides of the border. Use of Ice (smoked methamphetamine) has increased significantly. Use of crack (smoked cocaine) is a growing problem on the border, and injection is the primary route for using black tar heroin in this area. Each of these drugs is a risk factor, either from drug-influenced risky sexual behaviors or from sharing injection equipment. In addition, the availability of drugs on the border and patterns of risky behaviors among migrants mean that drug users on the border are at risk of HIV/AIDS, and this risk is expected to increase with the spreading methamphetamine epidemic and smoking of crack cocaine. Comparable data on HIV/AIDS are needed for further studies of the relationship of drug use and HIV/AIDS on the border.

Cigarette smoking: knowledge and attitudes among Mexican physicians

OBJECTIVE To determine the prevalence of the smoking habit among Mexican physicians as well as some of their attitudes and information on specific issues concerning smoking. MATERIAL AND METHODS In 1993, a survey was carried out among 3,568 physicians of the three major official health care institutions in Mexico City. A questionnaire designed for The Mexican National Survey of Addictions (ENA 1993) was used. Prevalence of cigarette smoking, age of onset, number of cigarettes per day; also information and attitudes concerning smoking were assessed. RESULTS The mean age was 37, 66% were males. Of the 3,488 (98%) surveyed, 26.9% were smokers (62% daily), 20.6% were ex-smokers and 52.5% non-smokers. There were differences related to age and sex (p < 0.05). Of daily smokers, 36% smoked between 1 and 5 cigarettes. There was a significant trend among ex-smokers that linked the time they had ceased smoking with the fear to start smoking again. Physicians were well informed of the relationship between cigarette smoking and lung cancer. Over 80% considered tobacco an addictive drug but only 65% were in favor of banning smoking from their workplaces and over 10% were not aware that it is forbidden to smoke inside health care facilities. CONCLUSIONS These results differ from other studies that find the prevalence of smoking among physicians lower than in the general population. Our study revealed a greater prevalence of the smoking habit among female physicians and the number of cigarettes smoked per day was greater than in the general population regardless of sex.

Patrones de consumo de heroína en una cárcel de la frontera norte de México: barreras de acceso a tratamiento

Objective. To assess the prevalence of heroin use, patterns of initiation, intense use, and drug-dependency; also, to assess barriers to drug treatment access. Material and Methods. The study was conducted in the Ciudad Juarez, Chihuahua prison. Subjects were selected using simple random sampling from census of prison inmates. Barriers to drug treatment were identified and analyzed using a logistic regression model. Results. The prevalence of heroin use for the last six months was 26.4%; 25.3% were intense heroin users; and 95% showed dependence. The mean age of initiation was 21 years. A multivariate model showed that the significant barriers to drug treatment access were: low education, withdrawal, overdosing, presence of chronic diseases, and duration of heroin use. Conclusions. Study findings should serve to devise potential applications to establish treatment programs in prisons. The English version of this paper is available at: http://www.insp.mx/salud/ index.html

Mortalidad en México por influenza y neumonía (1990-2005)

Objective. To estimate the impact of influenza vaccine in infants less than two years of age and in elders more than sixty-five years of age, through the analysis of mortality due to influenza and pneumonia in Mexico, between 1990 and 2005. To determine the seasonal pattern of mortality, the tendency of mortality by volume of deaths per seasonal period, and the speed rate of mortality. Material and methods. Data were taken from the Epidemiological and Statistical Mortality System (SEED-SSA per its abbreviation in Spanish). Results and conclusions. The analysis showed there is a tendency of deaths decrease at a rate of 509 deaths less per year in the infants group and 29 deaths less in the elders group. Also, the ascending tendency of mortality was interrupted by vaccination. The vaccination intervention has a positive economic effect and also helps improve the quality of life. Therefore, its implementation is expected to lower hospital admissions and deaths.

Abortion, contraceptive use, and adolescent pregnancy among first-year medical students at a major public university in Mexico City

OBJECTIVE If properly trained, medical students could become future opinion leaders in health policy and could help the public to understand the consequences of unwanted pregnancies and of abortions. The objective of this study was to analyze the frequency of unwanted pregnancies and induced abortions that had occurred among women who were first-year medical students at a major public university in Mexico City and to compare the experiences of those women with the experiences of the general population of Mexican females aged 15 to 24. METHODS In 1998 we administered a cross-sectional survey to all the first-year medical students at the National Autonomous University of Mexico, which is the largest university in Latin America. For this study we analyzed 549 surveys completed by female students. RESULTS Out of the 549 women, 120 of them (22%) had been sexually active at some point. Among those 120 sexually active students, 100 of them (83%) had used a contraceptive method at some time, and 19 of the 120 (16%) had been pregnant. Of those 19 women who had been pregnant, 10 of them had had an illegal induced abortion (in Mexico, abortions are illegal except under a small number of extenuating circumstances). The reported abortion rate among the female medical students, 2%, was very low in comparison with the 11% rate for women of similar ages in the Mexican general population. CONCLUSIONS The lower incidence of abortion among the female medical students indicates that when young Mexican women have access to medical information and are highly motivated to avoid unintended pregnancy and abortion, they can do so.

Assessment of cigarette sales to minors in Mexico.

Editor,—In Mexico approximately 9% of smokers are aged between 12–17 years, and from 1988 to 1998 the prevalence of current smoking among minors increased from 7.7% to 11.6%.1-3 Data from the National Addictions Survey (NAS-98) indicate that 61.4% of adult smokers in Mexico became regular smokers before the age of 18.4 5 We sought to assess compliance with the law forbidding sale of tobacco products to minors in two Mexican cities (Mexico City and Ciudad Juarez).6 Compliance monitoring teams were formed, consisting of an adult and two minors. The minors were of both sexes, trained before the start of the study. The adult in each team served …

Varicela y herpes zóster: retos para la salud pública

Resumen: Objetivo: Evaluar el comportamiento epidemiologico de la varicela y el herpes zoster (HZ) para determinar politicas de salud y disminuir prevalencia y complicaciones. Material y metodos: La frecuencia de casos se estimo con datos del Sistema Unico de Informacion para la Vigilancia Epidemiologica (SUIVE), periodo 2000-2013; para los egresos hospitalarios de varicela y HZ, se utilizaron datos del Sistema Nacional de Informacion en Salud (Sinais). Resultados: El promedio de casos de varicela anual fue 296 733, 57% menores de 9 anos, la mayoria de marzo a mayo; de 2004 a 2012 los egresos hospitalarios de varicela fueron 17 398, de ellos 4.6% presento meningoecefalitis, 2.5% neumonia y 18% otras complicaciones. Por herpes zoster 7 042 egresos, mas afectados de 65 anos o mas, 1.3:1 la relacion mujer:hombre. Las complicaciones: neuralgia (11%), afeccion ocular (7%), meningoencefalitis (5.4%), enfermedad diseminada (2.8%) y otras (5.4%); estancia hospitalaria entre 6.4 a 13.3 dias. Conclusiones: Los datos coinciden con los de la literatura de otros paises. Se discute el papel de la vacunacion en la prevencion de la infeccion en ninos y adultos.