Barriers to Treatment Access for Chagas Disease in Mexico

Background: According to World Health Organization (WHO) prevalence estimates, 1.1 million people in Mexico are infected with Trypanosoma cruzi, the etiologic agent of Chagas disease (CD). However, limited information is available about access to antitrypanosomal treatment. This study assesses the extent of access in Mexico, analyzes the barriers to access, and suggests strategies to overcome them. Methods and Findings: Semi-structured in-depth interviews were conducted with 18 key informants and policymakers at the national level in Mexico. Data on CD cases, relevant policy documents and interview data were analyzed using the Flagship Framework for Pharmaceutical Policy Reform policy interventions: regulation, financing, payment, organization, and persuasion. Data showed that 3,013 cases were registered nationally from 2007–2011, representing 0.41% of total expected cases based on Mexico's national prevalence estimate. In four of five years, new registered cases were below national targets by 11–36%. Of 1,329 cases registered nationally in 2010–2011, 834 received treatment, 120 were pending treatment as of January 2012, and the treatment status of 375 was unknown. The analysis revealed that the national program mainly coordinated donation of nifurtimox and that important obstacles to access include the exclusion of antitrypanosomal medicines from the national formulary (regulation), historical exclusion of CD from the social insurance package (organization), absence of national clinical guidelines (organization), and limited provider awareness (persuasion). Conclusions: Efforts to treat CD in Mexico indicate an increased commitment to addressing this disease. Access to treatment could be advanced by improving the importation process for antitrypanosomal medicines and adding them to the national formulary, increasing education for healthcare providers, and strengthening clinical guidelines. These recommendations have important implications for other countries in the region with similar problems in access to treatment for CD

Nuclear effects on the transverse momentum spectra of charged particles in pPb collisions at √SNN = 5.02 TeV

Transverse momentum spectra of charged particles are measured by the CMS experiment at the CERN LHC in pPb collisions at [Formula: see text][Formula: see text], in the range [Formula: see text][Formula: see text] and pseudorapidity [Formula: see text] in the proton-nucleon center-of-mass frame. For [Formula: see text][Formula: see text], the charged-particle production is asymmetric about [Formula: see text], with smaller yield observed in the direction of the proton beam, qualitatively consistent with expectations from shadowing in nuclear parton distribution functions (nPDF). A pp reference spectrum at [Formula: see text][Formula: see text] is obtained by interpolation from previous measurements at higher and lower center-of-mass energies. The [Formula: see text] distribution measured in pPb collisions shows an enhancement of charged particles with [Formula: see text][Formula: see text] compared to expectations from the pp reference. The enhancement is larger than predicted by perturbative quantum chromodynamics calculations that include antishadowing modifications of nPDFs

Flagship Framework for Pharmaceutical Policy Reform [7].

<p>Flagship Framework for Pharmaceutical Policy Reform <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0002488#pntd.0002488-Roberts1" target="_blank">[7]</a>.</p

Data on access to treatment for Chagas disease in Mexico, 2007–2011.

<p><i>Note on </i><a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0002488#pntd-0002488-g003" target="_blank"><i>Figure 3</i></a><i>: It was assumed that an additional 166 registered cases that the Secretary of Health reported in 2013 had been diagnosed and registered in 2011 but had not yet been confirmed at the time of the initial data provision in January 2012</i>.</p

Variabilidad genética de la chinche (Triatoma pallidipennis): principal vector de la enfermedad de Chagas

La enfermedad de Chagas es una zoonosis reconocida por su elevado impacto sanitario, económico y social. A nivel mundial se reportan casi 8 millones de personas infectadas, la mayoría en Latinoamérica, y 25 millones en riesgo, para México se estiman 1.1. millones de personas. El parásito Trypanosoma cruzi es el responsable de dicha enfermedad, la cual se transmite por vectores específicamente insectos de la subfamilia Triatominae, conocidos comúnmente en México como chinches besuconas. Triatoma pallidipennis es una especie endémica en México, con una distribución que cubre potencialmente más del 18% del País. Su capacidad vectorial y de infestación a domicilios la hacen uno de los principales vectores de T. cruzi en el centro del país. En el estado de Morelos se ha registrado su presencia en la que se reportan que al menos el 77% de las comunidades urbanas y suburbanas están infestadas con T. pallidipennis. Por tal motivo, el objetivo del estudio fue analizar la variabilidad genética intra e inter poblacional de T. pallidipennis desde 25 localidades del estado de Morelos usando el gen ND4. De las 104 muestras analizadas, se obtuvo un total de 34 haplotipos con una diversidad haplotípica alta para el estado de Morelos. El análisis de distancia genética sugiere la presencia de grupos o linajes divergentes, sin embargo para confirmarlo son necesarias un mayor número de ejemplares.Fil: Arellano Arenas, Elizabeth. Instituto Nacional de Salud Publica; MéxicoFil: Mayares Salvador, Dayana Inés. Instituto Nacional de Salud Publica; MéxicoFil: Ramsey Willoquet, Janine Madeleine. Instituto Nacional de Salud Pública/crisp; MéxicoFil: Alcalá Martínez, Raúl Ernesto. Instituto Nacional de Salud Publica; MéxicoFil: Ibarra Cerdena, Carlos Napoleón. Instituto Politécnico Nacional/centro de Biotecnología; MéxicoFil: Tun Ku, Ezequiel. Instituto Nacional de Salud Pública/crisp; MéxicoFil: Pech May, Angélica del Rosario. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; ArgentinaFil: De La Cruz Félix, Himmler Keynes. Instituto Nacional de Salud Pública/crisp; MéxicoFil: Rosales Barrera, Rebeca. Instituto Nacional de Salud Publica; MéxicoFil: Ocampo Salgado, Marco Antonio. Instituto Nacional de Salud Publica; Méxic

Diseño de un sistema de información geográfica para un desarrollo sustentable.

A través del desarrollo de este proyecto se busca aplicar y alcanzar las premisas básicas que giran en torno al desarrollo sustentable, con base en la aplicación de eco-tecnologías que permiten la disminución del impacto ambiental generado por los usuarios (huéspedes) sobre el ecosistema aledaño a la zona donde se localizan las villas eco-turísticas "La Joya"