COVID-19 Pneumonia in Fully Vaccinated Adults during the Dominance of the Omicron Sublineages BA.1.1 and BA.2 in Mexico

Background and Objectives: A nationwide retrospective cohort study was conducted to evaluate the factors associated with the risk of laboratory-confirmed coronavirus disease 2019 (COVID-19)-related pneumonia in fully vaccinated adults during the dominance of the Omicron sublineages in Mexico. Materials and Methods: Fully COVID-19-vaccinated adults with laboratory-positive illness and symptom onset from April to mid-June 2022 were eligible. We computed the eta-squared (η2) to evaluate the effect size of the study sample. The characteristics predicting pneumonia were evaluated through risk ratios (RRs), and the 95% confidence intervals (CIs) were computed through generalized linear models. Results: The data from 35,561 participants were evaluated, and the overall risk of pneumonia was 0.5%. In multiple analyses, patients aged ≥ 60 years old were at increased risk of developing pneumonia (vs. 20–39 years old: RR = 1.031, 95% CI = 1.027–1.034). Chronic pulmonary obstructive disease, type 2 diabetes mellitus, arterial hypertension, chronic kidney disease (any stage), and immunosuppression (any cause) were also associated with a higher pneumonia risk. The η2 of all the variables included in the multiple models was Conclusions: Our study suggests that, even when fully COVID-19-vaccinated, older adults and those with chronic conditions were at increased risk of pneumonia during the dominance of the Omicron sublineages BA.1.1 and BA.2

Disability-Adjusted Life Years for Cancer in 2010–2014: A Regional Approach in Mexico

The disability-adjusted life years (DALYs) were used to estimate the regional (state of Colima, Mexico) cancer burden in 2010–2014. The years of life lost (YLL) were estimated with mortality data and years lived with disability (YLD) using incidence data. The DALYs were calculated as the arithmetic addition of YLL and YLD. Sex and cancer site-specific estimations were made and DALY rates were used to identify the leading causes of disease burden. Data from 2532 deaths were analyzed and, for all malignant tumors combined, 18,712.9 DALYs and 20,243.3 DALYs were estimated in males and females respectively. The overall contribution of YLL in DALY estimates was higher among females (93.7% vs. 87.4%). Age-standardized DALY rates (and 95% confidence intervals, CI) per 100,000 inhabitants were used to rank the leading causes of disease burden and, among males, malignant tumors from the prostate, lower respiratory tract, and colon and rectum accounted the highest rates (45.7, 95% CI 32.7–59.3; 37.6, 95% CI 25.7–49.9; and 25.9, 95% CI 16.0–36.1 DALYs). Breast, cervix uteri, and lower respiratory tract cancer showed the highest burden in females (66.0, 95% CI 50.3–82.4; 44.4, 95% CI 31.5–57.7; and 20.9, 95% CI 12.0–30.0 DALYs). The present study provides an indication of the burden of cancer at the regional level, underscoring the need to expand cancer prevention, screening, and awareness programs, as well as to improve early diagnosis and medical treatment

Expected years of life lost through road traffic injuries in Mexico

Background: Road traffic injuries (RTIs) are a leading cause of premature mortality, mainly in low- and middle-income countries Objective: To estimate the 2014 burden of RTIs in Mexico calculating years of life lost (YLL) and age-standardized YLL rates (ASYLL), and to evaluate sex, age, and region-related differences in premature mortality. Methods: Mortality data were obtained from the National Institute of Statistics and Geography and 14,637 deaths of individuals 15 years of age and older were analyzed. The YLL and ASYLL were computed. Results: The overall burden of RTIs was 332,922 YLL and 82.4% of the deaths occurred in males. Males from 25 to 34 years of age and females from 15 to 24 years of age showed the highest age-adjusted YLL rates (933 and 158 YLL per 100,000 inhabitants, respectively). The national ASYLL rate was 416 per 100,000 inhabitants and the highest state-stratified mortality rates were observed in Tabasco (851), Sinaloa (709), Durango (656), Zacatecas (642), and Baja California Sur (570). Conclusions: RTIs contributed to the premature mortality rate in the study population. Our findings may be useful from a health policy perspective for designing and prioritizing interventions focused on the prevention of premature loss of life

Cost-Effectiveness of the Strategies to Reduce the Incidence of Dengue in Colima, México

Dengue fever is considered to be one of the most important arboviral diseases globally. Unsuccessful vector-control strategies might be due to the lack of sustainable community participation. The state of Colima, located in the Western region of Mexico, is a dengue-endemic area despite vector-control activities implemented, which may be due to an insufficient health economic analysis of these interventions. A randomized controlled community trial took place in five urban municipalities where 24 clusters were included. The study groups (n = 4) included an intervention to improve the community participation in vector control (A), ultra-low volume (ULV) spraying (B), both interventions (AB), and a control group. The main outcomes investigated were dengue cumulative incidence, disability-adjusted life years (DALYs), and the direct costs per intervention. The cumulative incidence of dengue was 17.4%, A; 14.3%, B; 14.4%, AB; and 30.2% in the control group. The highest efficiency and effectiveness were observed in group B (0.526 and 6.97, respectively) and intervention A was more likely to be cost-effective ($3952.84 per DALY avoided) followed by intervention B ($4472.09 per DALY avoided). Our findings suggest that efforts to improve community participation in vector control and ULV-spraying alone are cost-effective and may be useful to reduce the vector density and dengue incidence

Screening for Depressive Mood During Acute Chikungunya Infection in Primary Healthcare Settings

Background: We aimed to screen for depressive mood experienced during acute chikungunya (CHIKV) infection, and to evaluate the association of several exposures with the risk of depressive symptoms. Methods: A cross-sectional analysis of a multicenter cohort study took place and data from 354 adult individuals with confirmed CHIKV infection were analyzed. Participants were recruited in primary health care settings and the Patient Health Questionnaire-2 (PHQ-2) was used. Prevalence odds ratios (OR) and 95% confidence intervals (CIs) estimated by means of logistic models were used. Results: Depressive mood (PHQ-2 score 3 or higher) was reported by 44.1% of individuals. Subjects with articular effusion (OR = 3.37, 95% CI 1.77⁻8.11), gastrointestinal manifestations (diarrhea, vomiting or abdominal pain, OR = 1.97, 95 CI 1.21⁻3.19), and higher length of severe arthralgia (reference ≤ 14 days: 15⁻30 days, OR = 3.38, 95% CI 1.78⁻6.41; ≥ 30 days, OR = 1.69, 95% CI 0.95⁻3.01) were more likely to self-report depressive mood. Increasing age (≥ 40 years old, OR = 0.55, 95% CI 0.31⁻0.95) and rash (OR = 0.54, 95% CI 0.30⁻0.98) were associated with a decreased risk of depressive mood. Conclusions: Depressive mood seemed to be a frequent event among analyzed individuals, and markers associated with its risk were identified

Empirical Antibiotic Prescribing in Adult COVID-19 Inpatients over Two Years in Mexico

Background and Objectives: Empirical antibiotic prescribing in patients with coronavirus disease 2019 (COVID-19) has been common even though bacterial coinfections are infrequent. The overuse of antibacterial agents may accelerate the antibiotic resistance crisis. We aimed to evaluate factors predicting empirical antibiotic prescribing to adult COVID-19 inpatients over 2 years (March 2020–February 2021) in Mexico. Materials and Methods: A cross-sectional analysis of a nationwide cohort study was conducted. Hospitalized adults due to laboratory-confirmed COVID-19 were included (n = 214,171). Odds ratios (OR) and 95% confidence intervals (CI), computed by using logistic regression models, were used to evaluate factors predicting empirical antibiotic prescribing. Results: The overall frequency of antibiotic usage was 25.3%. In multiple analysis, the highest risk of antibiotic prescription was documented among patients with pneumonia at hospital admission (OR = 2.20, 95% CI 2.16–2.25). Male patients, those with chronic comorbidities (namely obesity and chronic kidney disease) and longer interval days from symptoms onset to healthcare seeking, were also more likely to receive these drugs. We also documented that, per each elapsed week during the study period, the odds of receiving antibiotic therapy decreased by about 2% (OR = 0.98, 95% CI 0.97–0.99). Conclusion: Our study identified COVID-19 populations at increased risk of receiving empirical antibiotic therapy during the first two years of the pandemic

Assessing the relationship between energy-related methane emissions and the burden of cardiovascular diseases: a cross-sectional study of 73 countries

Abstract The energy industry significantly contributes to anthropogenic methane emissions, which add to global warming and have been linked to an increased risk of cardiovascular diseases (CVD). This study aims to evaluate the relationship between energy-related methane emissions and the burden of CVD, measured in disability-adjusted life years (DALYs), in 2019. We conducted a cross-sectional analysis of datasets from 73 countries across all continents. The analyzed datasets included information from 2019 on environmental energy-related methane emissions, burden of DALYs due to CVD. The age-standardized prevalence of obesity in adults and life expectancy at birth were retrieved. The relationship between the variables of interest was evaluated using multiple linear regression models. In the multiple model, we observed a positive linear association between methane emissions and the log-transformed count of DALYs related to CVD. Specifically, for each unit increase in energy-related methane emissions, the burden of CVD increased by 0.06% (95% CI 0.03–0.09%, p < 0.001). The study suggests that reducing methane emissions from the energy industry could improve public health for those at risk of CVD. Policymakers can use these findings to develop strategies to reduce methane emissions and protect public health

Survival Analysis and Contributing Factors among PCR-Confirmed Adult Inpatients during the Endemic Phase of COVID-19

In May 2023, the global health emergency status of COVID-19 concluded, marking the onset of an endemic era. This study assessed survival rates among PCR-confirmed adult inpatients during this phase and determined contributing factors. Employing a survival analysis approach, this investigation utilized a nationwide Mexican cohort encompassing 152 adult inpatients. Survival rates were computed using the Kaplan–Meier method, and a proportional Cox model identified mortality risk factors. Survival rates remained above 65% on day 14 after admission. Vaccination status, including the number of doses administered, was not significantly associated with fatal outcomes. Chronic kidney disease or a history of immunosuppression (due to any cause) increased mortality risk. Our findings underscore the persistent severity of COVID-19 beyond the global health emergency, emphasizing the necessity for tailored interventions for vulnerable patients

Assessing the Influence of COVID-19 Vaccination Coverage on Excess Mortality across 178 Countries: A Cross-Sectional Study

The COVID-19 pandemic has had a devastating impact on global health, necessitating urgent and effective strategies to mitigate its consequences. Vaccination programs have been implemented worldwide to combat virus transmission and reduce the disease burden. This study aimed to investigate the relationship between COVID-19 vaccination coverage and all-cause excess mortality in 178 nations during the first two years of the pandemic. Multiple regression analysis, after adjusting for life expectancy at birth, confirmed a significant association between higher vaccination coverage and lower all-cause mortality rates (β = −106.8, 95% CI −175.4 to −38.2, p = 0.002). These findings underscore the importance of vaccination campaigns in reducing overall mortality during the COVID-19 pandemic. Evidence-based decision making and resource allocation can benefit from this information, facilitating the optimization of vaccination strategies for maximal impact on mortality reduction. Further research and continuous monitoring are crucial to understanding the long-term effects of vaccination coverage on population health in the ongoing pandemic