Epidemiología de las enfermedades reumáticas en México. Un estudio de 5 regiones basado en la metodología COPCORD

To estimate the prevalence of musculoskeletal (MSK) disorders and to describe predicting variables associated with rheumatic diseases in 5 regions of México

ASOCIACIÓN GEOGRÁFICA ENTRE LA MORTALIDAD PORCRIPTOSPORIDIOSIS Y DEFICIENCIAS EN LA NUTRICIÓN EN EL ESTADO DE CHIHUAHUA (MÈXICO)

La mortalidad por Criptosporidiosis y por deficiencias en la nutrición representa dos problemas de Salud Pública que han sido poco estudiados. El objetivo del estudio fue explorar la relación entre la mortalidad por Criptosporidiosis y la mortalidad por deficiencias en la nutrición en el Estado de Chihuahua según grupos etarios y distribución geográfica. La metodología de abordaje de estos problemas epidemiológicos mediante sistemas de información geográfica es una importante aportación, demostrando la utilidad del trabajo colegiado en el análisis de bases de datos que ayuden a establecer la causalidad del fenómeno estudiado a un bajo costo. La distribución por grupos etarios permitió ver que los grupos mas afectados son las edades extremas, para el grupo de 1 a 4 años se encontró una tasa de mortalidad por Criptosporidiosis de 9.6 por 10,000 habitantes enel municipio de Creel y de 11.8 por deficiencias en la nutrición, en el grupo de 65 años y más, se encontraron tasas de 20.3 y 40.5 respectivamente. El mapa muestra de una manera práctica el daño mediante la distribución geográfica de las tasas de mortalidad tanto por Criptosporidiosis como por deficiencias en la nutrición y como estas coinciden en la mayor parte de los municipios abarcando diferentes regiones geográficas: de la sierra, zona desértica, y del Centro - Sur del Estado de Chihuahua (México), puede inferirse que el único común denominador es el ambiente social: la pobreza y el desamparo de los viejos y los niños. Se analiza el efecto del subregistro de criptosporidiosis.Palabras clave: Mortalidad, Criptosporidiosis, Deficiencias en la nutrición, Sistemas de Información GeográficaMortality, Cryptosporidiosis, Dietary deficiencies, Geographic Information System

Validez del Cuestionario Básico COPCORD como herramienta de clasificación de enfermedades reumáticas

Rheumatic diseases are vastly underdiagnosed and undertreated, particularly among minorities and those of low socioeconomic status. The WHO-ILAR Community Oriented Program in the Rheumatic Diseases (COPCORD) advocates screening of musculoskeletal complaints in the community. The objective of this study was to evaluate the performance of the COPCORD Core Questionnaire (CCQ) as a diagnostic tool for rheumatic diseases

DEFICIENCIAS EN LA NUTRICION ANÁLISIS POR CAUSA MULTIPLE DE MUERTE EN EL ESTADO DE CHIHUAHUA (MÉXICO)

El objetivo fue cuantificar la mortalidad asociada a deficiencias en la nutrición según edad, sexo y procedencia en el Estado de Chihuahua, obtener un índice para sensibilizar al personal de salud sobre la importancia del diagnóstico precoz de las deficiencias en la nutrición y evaluar indirectamente el impacto de las intervenciones realizadas. Se revisaron los certificados de defunción del año 2000, del Estado, considerando la causa múltiple y la básica, se calcularon las tasas de mortalidad por causa básica, múltiple y total, la mortalidad proporcional y el índice tasa total/tasa básica. El índice obtenido fue de 1.63, la mortalidad proporcional para el Estado fue de 3.5%, la más alta en Guachochi con 10.9%. La tasa total de mortalidad por deficiencias en la nutrición para el Estado fue de 1.8 por 10,000 habitantes. Los grupos de mayor riesgo fueron los menores de un año con unatasa total de 10.5 y los mayores de 65 años con 20.9. Las jurisdicciones mas afectadas, Guachochi con una tasa total de 5.32 y Creel con 4.24, todas por 10,000 habitantes, ambas ubicadas en la sierra, con población mayormente indígena. Disminuyeron las tasas y el índice, en relación a lo obtenido en 1990, por tanto las intervenciones han sido útiles, la metodología de causa múltiple, adecuada para dar seguimiento. Los extremos de la vida continúan siendo los grupos de riesgo (menores de 5 años y mayores de 65 años).Los datos brindan elementos para orientar las políticas de asistencia alimentaria en el Estado. Palabras clave: mortalidad, causa múltiple, deficiencias en la nutriciónmalnutrition, mortality, multiple causes

Prenatal Exposure to Nitrogen Oxides and its Association with Birth Weight in a Cohort of Mexican Newborns from Morelos, Mexico

Background: The Child-Mother binomial is potentially susceptible to the toxic effects of pollutants because some chemicals interfere with placental transfer of nutrients, thus affecting fetal development, and create an increased the risk of low birth weight, prematurity and intrauterine growth restriction. Objective: To evaluate the impact of prenatal exposure to nitrogen oxides (NOx) on birth weight in a cohort of Mexican newborns. Methodology: We included 745 mother-child pair participants of the POSGRAD cohort study. Information on socio-demographic characteristics, obstetric history, health history and environmental exposure during pregnancy were readily available and the newborns’ anthropometric measurements were obtained at delivery. Prenatal NOx exposure assessment was evaluated using a Land-Use Regression predictive models considering local monitoring from 60 sites on the State of Morelos. The association between prenatal exposure to NOx and birth weight was estimated using a multivariate linear regression models. Results: The average birth weight was 3217 ± 439 g and the mean of NOx concentration was 21 ppb (Interquartile range, IQR = 6.95 ppb). After adjusting for maternal age and other confounders, a significant birthweight reduction was observed for each IQR of NOx increase (ß = −39.61 g, 95% CI: −77.00; −2.21; p = 0.04). Conclusions: Our results provides evidence that prenatal NOx exposure has a negative effect on birth weight, which may influence the growth and future development of the newborn.<p

Reducing pesticide exposure and associated neurotoxic burden in an Ecuadorian small farm population

The contribution of community-based interventions, including farmer field schools (FFSs) in integrated pest management (IPM), to reducing pesticide exposures and associated neurotoxic burden among smallfarm families in Ecuador was assessed in three Andean farming communities in a co-design of targeted action–research. Baseline questionnaire surveys elicited pesticide-related knowledge, practices, and exposure and neurobehavioral assessments were done using an adapted WHO battery. Pesticide applications on plots farmed by FFS versus non-FFS participants were compared. A year later, repeated surveys of participating households (n = 29) and neurobehavioral testing of individuals (n = 63) permitted comparisons of pre- and post-intervention values. The FFS graduates applied pesticides on their plots less frequently (p = 0.171). FFS households had increased pesticiderelated knowledge of labels and exposure risk factors (both p < 0.004), better pesticide-handling practices (p < 0.01), and less skin exposure (p < 0.01). Neurobehavioural status had improved, particularly digit span and visuo-spatial function, resulting in overall zscore increases. Thus, community interventions reduced pesticide use, reported skin exposure, and neurotoxic burden among smallholder farm families

Regional differences in time to pregnancy among fertile women from five Colombian regions with different use of glyphosate

The objective of this study was to test whether there was an association between the use of glyphosate when applied by aerial spray for the eradication of illicit crops (cocaine and poppy) and time to pregnancy (TTP) among fertile women. A retrospective cohort study (with an ecological exposure index) of first pregnancies was undertaken in 2592 fertile Colombian women from 5 regions with different uses of glyphosate. Women were interviewed regarding potential reproductive, lifestyle, and work history predictors of TTP, which was measured in months. Fecundability odds ratios (fOR) were estimated using a discrete time analogue of Cox&apos;s proportional hazard model. There were differences in TTP between regions. In the final multivariate model, the main predictor was the region adjusted by irregular relationship with partner, maternal age at first pregnancy, and, marginally, coffee consumption and self-perception of water pollution. Boyacá, a region with traditional crops and. recently, illicit crops without glyphosate eradication spraying (manual eradication), displayed minimal risk and was the reference region. Other regions, including Sierra Nevada (control area, organic agriculture), Putumayo and Nariño (illicit crops and intensive eradication spray program), and Valle del Cauca, demonstrated greater risk of longer TTP, with the highest risk for Valle del Cauca (fOR 0.15, 95% CI 0.12, 0.18), a sugar-cane region with a history of use of glyphosate and others chemicals for more than 30 yr. The reduced fecundability in some regions was not associated with the use of glyphosate for eradication spraying. The observed ecological differences remain unexplained and may be produced by varying exposures to environmental factors, history of contraceptive programs in the region, or psychological distress. Future studies examining these or other possible causes are needed

Regional differences in time to pregnancy among fertile women from five Colombian regions with different use of glyphosate

The objective of this study was to test whether there was an association between the use of glyphosate when applied by aerial spray for the eradication of illicit crops (cocaine and poppy) and time to pregnancy (TTP) among fertile women. A retrospective cohort study (with an ecological exposure index) of first pregnancies was undertaken in 2592 fertile Colombian women from 5 regions with different uses of glyphosate. Women were interviewed regarding potential reproductive, lifestyle, and work history predictors of TTP, which was measured in months. Fecundability odds ratios (fOR) were estimated using a discrete time analogue of Cox&apos;s proportional hazard model. There were differences in TTP between regions. In the final multivariate model, the main predictor was the region adjusted by irregular relationship with partner, maternal age at first pregnancy, and, marginally, coffee consumption and self-perception of water pollution. Boyacá, a region with traditional crops and. recently, illicit crops without glyphosate eradication spraying (manual eradication), displayed minimal risk and was the reference region. Other regions, including Sierra Nevada (control area, organic agriculture), Putumayo and Nariño (illicit crops and intensive eradication spray program), and Valle del Cauca, demonstrated greater risk of longer TTP, with the highest risk for Valle del Cauca (fOR 0.15, 95% CI 0.12, 0.18), a sugar-cane region with a history of use of glyphosate and others chemicals for more than 30 yr. The reduced fecundability in some regions was not associated with the use of glyphosate for eradication spraying. The observed ecological differences remain unexplained and may be produced by varying exposures to environmental factors, history of contraceptive programs in the region, or psychological distress. Future studies examining these or other possible causes are needed