Métodos y técnicas de monitoreo y predicción temprana en los escenarios de riesgos socionaturales

Esta obra concentra los métodos y las técnicas fundamentales para el seguimiento y monitoreo de las dinámicas de los escenarios de riesgos socionaturales (geológicos e hidrometeorológicos) y tiene como objetivo general orientar, apoyar y acompañar a los directivos y operativos de protección civil en aterrizar las acciones y políticas públicas enfocadas a la gestión del riesgo local de desastre

Persistent arthralgia and related risks factors in laboratory-confirmed cases of Chikungunya virus infection in Mexico

ABSTRACT Objective To estimate the cumulative incidence of persistent arthralgia at 6 months from acute Chikungunya virus (CHIKV) infection and to evaluate the association of clinical markers with the risk of long-term arthralgia. Methods This multicenter retrospective cohort study was conducted in the Mexican state of Colima. A total of 136 individuals aged 15 years and older with serologically confirmed CHIKV infection were enrolled. Participants were interviewed at 6 months from the onset of symptoms, and self-reported persistent arthralgia (PA) was the main binary outcome. A self-report numeric rating scale (NRS) ranging from 0 to 10 was used to estimate the severity of articular pain. Results The cumulative incidence of PA was 41.9%. Severe pain (NRS ≥ 7) presented in 36.8% of participants with PA. In multiple analysis, individuals aged 40 years and older (risk ratio (RR) = 1.60; 95% confidence interval (CI), 1.03–2.48) and those with articular pain at 3 months post-infection (RR = 3.95; 95% CI, 1.95–8.01) had a significantly increased risk of PA at 6 months from CHIKV infection. Conclusions To the best of our knowledge, this is first report of a CHIKV-associated long-term outcome in Mexico, where the incidence of the infection has been high. This is also the first study in Latin America evaluating several factors associated with the risk of PA. Our findings may be useful in health care settings to stratify the risk of chronic arthralgia secondary to CHIKV infection and to identify patients who would benefit clinically from early medical intervention

Riesgos potenciales de salud por consumo de agua con arsénico en Colima, México

Objetivo. Estimar los riesgos potenciales de salud debidos a la ingestión crónica de arsénico (As) en agua en Colima, México. Material y métodos. Se muestrearon aleatoriamente 36 pozos en 10 acuíferos locales. El análisis se hizo mediante ICP-OES siguiendo estándares internacionales. Se realizó una interpolación geoestadística con ArcGIS, implementando un modelo de ponderación del inverso de la distancia, para estimar la ruta de exposición de consumo en cada localidad. Se calcularon los coeficientes de peligro (HQ)y riesgo carcinogénico (R). Resultados. El HQ promedio ponderado de As para Colima es 2.41. Existen valores de HQ>1 para As que indican efectos adversos no carcinogénicos para la salud por ingestión continua y prolongada de agua; esto podría afectar a 183 832 individuos en el estado. El riesgo calculado de desarrollar cáncer debido a las concentraciones de arsénico en aguas subterráneas (R) es de 1.089E-3; estadísticamente esto podría ocasionar 446 casos de cáncer. Conclusiones. Los niveles actuales de arsénico en el agua de pozo incrementan los riesgos carcinogénicos y no carcinogénicos de salud humana en Colima

Health Impacts from Corn Production Pre-and Post-NAFTA Trade Agreement (1986–2013)

Life cycle assessment (LCA) is a powerful methodology for the study of health impacts and public policies. We performed this study to quantitatively explain the potential health impacts on disability-adjusted life years (DALYs) of corn produced in Mexico and imported from the United States of America (U.S.) from 1984 until 2014. The processes are hybrid and organic corn production. The functional unit was defined as 1 ton of corn production. Results indicate a total value of 178,431, 244,175, and 283,426 DALYs of three decades: 1984–1993, 1994–2003, and 2004–2013, of Mexican production; the U.S. production and transport were also calculated, showing values of 29,815, 65,837, and 107,729 for the same three decades. Additionally, DALYs were obtained for the category of human health and climate change by functional unit: 802.31 (1984–1993), 802.67 (1994–2003), and 803.92 (2004–2013), and for imported corn transported to Mexico from the U.S., 859.12 (1984–2013). DALYs on human toxicity were obtained: 99.05 (1984–1993), 99.05 (1994–2003), and 99.04 (2004–2013), and for the corn imported and transported to Mexico from the U.S., 116.25 (1984–2013). Conclusions: Environmental and health impacts in terms of DALYs are higher when corn is imported versus the corn produced in Mexico. Environmental health and nominal corn cultivation and transport impacts have increased as a result of the North American Free Trade Agreement (NAFTA). Mexico needs to redefine its public policies to suffer less of an environmental burden from corn to ensure global environmental health and food security

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