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Abstract Introduction Research findings about intimate-partner violence (IPV) have focused mostly on women as victims of violence. Recent studies show the importance of violence inflicted by women towards men or between same-sex couples. Objective To estimate the prevalence of intimate-partner violence and its association with alcohol and drug consumption in a representative sample of men and women in Mexico through secondary data analysis. Method The data come from a representative sample who filled out the section on intimate-partner violence in the Mexican 2011 Encuesta Nacional de Adicciones (National Survey on Addictions). Results The prevalence of intimate-partner violence in the last year was 17.6% against women and 13.4% against men. If one of the two partners consumed substances, the risk that men and women would experience violence increased, and that risk was even greater if both consumed. Discussion and conclusion This is the first time violence against men was reported in a Mexican national study. The findings show that gender-based violence should also be considered a result of social and cultural violence.
Resumen Introducción Los hallazgos de investigación sobre la violencia de pareja se han centrado principalmente en las mujeres como víctimas de la violencia. Estudios recientes destacan también la importancia de la violencia infligida por las mujeres hacia los hombres o entre parejas del mismo sexo. Objetivo Estimar la prevalencia de la violencia de pareja y su asociación con el consumo de alcohol y drogas en una muestra representativa de hombres y mujeres en México mediante un análisis secundario de datos. Método Los datos provienen de la Encuesta Nacional de Adicciones de México 2011, específicamente de una muestra representativa que contestó la sección sobre violencia de pareja. Resultados La prevalencia de violencia de pareja en el último año fue de 17.6% hacia las mujeres y de 13.4% hacia los hombres. Si uno de los dos integrantes de la pareja consumía sustancias, aumentaba el riesgo de que hombres o mujeres experimentaran violencia y ese riesgo era aún mayor si ambos consumían. Discusión y conclusión Esta es la primera vez que se reporta la violencia hacia los hombres en un estudio nacional mexicano. Los resultados muestran que la violencia de género también debe considerarse como resultado de la violencia social y cultural.
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Abstract Introduction Mexico northern border has high levels of heroin use. For more than 10 years, the country has implemented several harm reduction interventions to reduce the risks associated with drug use. New strategies such as Safe Consumption Sites (SCS) must be considered as a next step to service vulnerable populations and increase their health outcomes. Objective This report seeks to measure and compare attitudes on a potential SCS intervention in Tijuana among police and people with lived experience (PLE) in heroin use in the city. Method Two parallel studies on police practices and everyday experiences of heroin users in Tijuana were able to ask similar questions about attitudes toward SCS and its implementation in the city. They conducted quantitative interviews with 771 active police officers and 200 PLE while in rehabilitation services. Results Both groups showed a high personal support for SCS of nearly 82% and a perceived implementation success around 80%. Officers reported 58.9% peer support for SCS while PLE 79%. Around 76% of both groups agreed that a SCS would help to improve their personal health. Finally, 86.2% of the officers would refer people to a SCS while 62.5% of PLE would use the service. Discussion and conclusions The strong positive attitudes from police officers and PLE towards SCS in the city of Tijuana reported in both studies indicate the possibility of a successful implementation of a SCS. This intervention would represent an innovative way to protect PLE from police harassment and victimization, helping reduce HIV and HCV risk behaviors while improving community health.
Resumen Introducción En la frontera norte de México hay niveles altos de consumo de heroína. Durante más de 10 años, el país ha implementado diversas intervenciones de reducción de daños para minimizar los riesgos asociados con el uso de sustancias. Los sitios de consumo seguro (SCS) se deben considerar como una opción que brinde servicios a poblaciones vulnerables para mejorar su salud. Objetivo Este reporte mide y compara actitudes entre policías y personas con experiencia vivida (PEV) en uso de heroína en Tijuana, relacionadas con una posible implementación de SCS en la ciudad. Método Dos estudios paralelos sobre prácticas policiales y experiencias cotidianas de usuarios de heroína en Tijuana incluyeron preguntas similares sobre actitudes hacia los SCS y su implementación en la ciudad. Se realizaron 771 entrevistas cuantitativas con oficiales de policía y 200 con PEV internadas en centros de rehabilitación. Resultados Ambos grupos mostraron un alto apoyo hacia los SCS cercano al 82% y un éxito percibido en implementación del 80%. Los oficiales reportaron 58.9% de apoyo entre pares a las SCS y del 79% entre PEV. Un 76% en ambos grupos coincidieron que un SCS ayudaría a mejorar su salud personal. Finalmente, el 86.2% de los oficiales referirían hacia un SCS, mientras que 62.5% de PEV las usarían. Discusión y conclusiones Las actitudes hacia los SCS indican una posible implementación exitosa de SCS en la ciudad. Esta intervención representaría una forma innovadora de disminuir el acoso y victimización policial hacia las PEV, reduciendo los factores de riesgo de VIH y VHC, mejorando la salud comunitaria.
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Abstract: Introduction: Gambling disorder is characterized by an uncontrollable need to gamble, lack of control over gambling, prioritizing gambling over other activities, and continuing to gamble despite the negative consequences this entails. Worldwide, between .1% and 5% of people show signs of problem gambling and between .1% and 2.2% present a positive result in gambling disorder criteria. Objective: To determine the extent of the problem of gambling disorder in Mexico and to identify and analyze the demographic groups in which it occurs. Method: ENCODAT 2016-2017 is a probabilistic, multi-stage survey with national and state representativeness. The sample comprises 56 877 people who answered a standardized questionnaire that collects information on addictive substance use and other areas such as gambling disorder. Results: A total of 24.5% of the population aged 12 to 65 have played a betting game at lifetime. Men have higher statistically significant prevalences than women in nearly all types of gambling and in six of the nine symptoms of gambling disorder. In Mexico, .3% of the target population meet the criteria for gambling disorder, with adolescents showing the highest percentage (.4%). Discussion and conclusion: It is necessary to reinforce public policies for this issue that include the development of preventive actions targeting the adolescent and youth population in Mexico, and to ensure the adequate monitoring of authorized centers.
Resumen: Introducción: El juego patológico se caracteriza por la necesidad incontrolable de jugar, la falta de control sobre el juego, la prioridad de jugar sobre otras actividades y de continuar jugando a pesar de las consecuencias negativas. A nivel mundial, entre .1% y el 5% de las personas muestra señales de juego problemático y del .1% al 2.2% presenta un resultado positivo en los criterios de juego patológico. Objetivo: Conocer la extensión del problema del juego patológico en México e identificar y analizar los grupos demográficos en los que se presenta. Método: La ENCODAT 2016-2017 es una encuesta probabilística y polietápica con representatividad nacional y estatal. La muestra fue de 56 877 personas, las cuales contestaron un cuestionario estandarizado que recaba información sobre consumo de sustancias adictivas y otras áreas como el juego patológico o ludopatía. Resultados: El 24.5% de la población de 12 a 65 años ha jugado algún juego de azar alguna vez en la vida. Los hombres presentan prevalencias estadísticamente significativas más altas que las mujeres en casi todos los tipos de juegos y en 6 de los 9 síntomas de juego patológico. En el país, el .3% de la población objetivo cumple con los criterios para juego patológico, y los adolescentes muestran el mayor porcentaje (.4%). Discusión y conclusión: Es necesario reforzar políticas públicas sobre el tema que incluyan el desarrollo de acciones preventivas dirigidas a la población adolescente y joven del país, así como incidir en el monitoreo adecuado de los centros autorizados.
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Abstract: Introduction: Worldwide, binge drinking of alcohol has increased, especially among young people. In Mexico, various epidemiological sources allow us to account for the growth this pattern of consumption has had. Given this context, the Encuesta Nacional de Consumo de Drogas 2016-2017 (ENCODAT) shows the evolution in alcohol consumption. Objective: To determine the prevalence and national and regional trends, as well as state variations of alcohol consumption in the population aged 12 to 65. Method: The ENCODAT 2016-2017 is a random, probabilistic, and multi-stage study with national and state representation. The sample consisted of 56 877 people who answered a standardized questionnaire through ACASI (self-administered computer interviews) that collects information about the use of tobacco, alcohol, and medical and illegal drugs. Results: Binge drinking past month increased from 12.3% to 19.8% from 2011 to 2016. A similar situation occurs in daily use (from .8% to 2.9%) and weekly binge drinking (from 5.4% to 8.5%). The age of onset has remained stable since 2011 (16.6 years for men, 19.2 years for women in 2016). Meanwhile, 2.2% reported alcohol dependence. The states with the highest prevalence of binge drinking are Nuevo León (30.3%), Jalisco (27.7%) and, Coahuila (27.5%). Discussion and conclusion: The results show that alcohol use increased with respect to 2011, especially in women; data on treatment seeking indicate that women who use alcohol are also the least likely to seek help. Given this context, it is necessary to have specialized spaces that provide treatment in keeping with use-based needs and gender condition.
Resumen: Introducción: A nivel internacional, el consumo excesivo de alcohol ha aumentado, principalmente entre la población joven. En México, diversas fuentes epidemiológicas dan cuenta del crecimiento de este patrón de consumo. Dado este contexto, la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016-2017 (ENCODAT) muestra la evolución en el consumo de alcohol. Objetivo: Conocer las prevalencias y tendencias nacionales y regionales, así como las variaciones estatales del consumo de alcohol en la población de 12 a 65 años. Método: La ENCODAT 2016-2017 es un estudio aleatorio, probabilístico y polietápico con representatividad nacional y estatal. En la muestra participaron 56 877 personas que contestaron un cuestionario estandarizado mediante ACASI (entrevistas auto-administradas por computadoras), que recaba información sobre consumo de tabaco, alcohol y drogas médicas e ilegales. Resultados: El consumo excesivo en el último mes se incrementó de 12.3% a 19.8% de 2011 a 2016. Una situación similar ocurre en el consumo diario (de .8% a 2.9%) y consuetudinario (de 5.4% a 8.5%). La edad de inicio se ha mantenido estable desde 2011 (16.6 años hombres; 19.2 años mujeres en 2016). En tanto, el 2.2% reportó dependencia al consumo de alcohol. Las entidades con las prevalencias más altas en consumo excesivo son Nuevo León (30.3%), Jalisco (27.7%) y Coahuila (27.5%). Discusión y conclusión: Los resultados muestran que el consumo de alcohol creció con respecto a 2011, especialmente en mujeres. Datos sobre la asistencia a tratamiento, indican que éstas son también quienes menos acuden. Dado este contexto, es necesario contar con espacios especializados que brinden atención conforme a las necesidades de consumo y de condición de género.
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Abstract Introduction Marijuana use among the student population has increased in Mexico and Latin America. There are social, interpersonal and individual factors associated with the onset and continuation of marijuana use. These include the availability of drugs in the community, opportunity for use, low perceived risk of harm from marijuana use and social tolerance by family and close friends. Moreover, these factors increase the probability of experimenting with other drugs, polysubstance use and dependence. Objective To identify the relationship between the level of urbanization, drug availability, exposure to opportunity for use, risk perception and social tolerance of the level of marijuana use among Mexican middle and high school students. Method The results are drawn from various surveys conducted in Mexico City and the National Survey of Drug Use among Students 2014. A total of 114 364 middle and high school students participated (49.8% boys and 50.2% girls). Results Of the respondent 10.6% had used marijuana at least once (12.9% boys and 8.4% girls). The variables that predicted higher marijuana use were drug use approval by family and best friend,, the level of urbanization and low risk perception. Discussion and conclusion Action must be taken on the factors mentioned to decrease the availability and use of drugs in the environment, and raise awareness of their consequences. These elements must be introduced systematically and creatively into preventive programs in this area.
Resumen Introducción El consumo de mariguana en población estudiantil se ha incrementado en México y América Latina. Existen factores sociales, interpersonales e individuales asociados con el inicio y la continuación de su consumo. Entre ellos encontramos la disponibilidad de drogas en la comunidad, la oportunidad de consumo, la baja percepción de riesgo por consumir mariguana, la tolerancia social de la familia y la de los amigos cercanos. Además, estos factores aumentan la probabilidad de experimentar con otras drogas, ser policonsumidor y producir dependencia. Objetivo Conocer la relación entre el nivel de urbanización, la disponibilidad de drogas, la exposición a la oportunidad de consumo, la percepción de riesgo y la tolerancia social con el nivel de consumo de mariguana en los estudiantes mexicanos de secundaria y bachillerato. Método Los resultados parten de diversas encuestas realizadas en la Ciudad de México y de la Encuesta Nacional de Consumo de Drogas en Estudiantes 2014. Participaron 114 364 alumnos de secundaria y bachillerato (49.8% hombres y 50.2% mujeres). Resultados El 10.6% consumieron mariguana alguna vez (12.9% hombres y 8.4% mujeres). Las variables predictoras de un mayor consumo de mariguana fueron la tolerancia ante el consumo de drogas de la familia y del mejor amigo, el nivel de urbanización y una baja percepción de riesgo. Discusión y conclusión Es necesario incidir en los factores señalados con objeto de disminuir la disponibilidad y el consumo de drogas en el entorno, así como en el conocimiento real de sus consecuencias. Estos elementos deben introducirse sistemática y creativamente en los programas preventivos del área.
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RESUMEN Introducción: El consumo de drogas y sus consecuencias sociales y de salud son del interés de múltiples sectores. Las encuestas en estudiantes son estrategias epidemiológicas para monitorear el problema, las cuales se complementan con encuestas de hogares y en grupos especiales de la población, lo que permite ver anticipadamente fenómenos que posteriormente son evidentes en la población general. Además de las tendencias y del patrón de consumo de drogas, estos estudios muestran la influencia de otros factores que incrementan el uso y sus consecuencias. Objetivo: Conocer las prevalencias de uso de drogas, alcohol y tabaco en estudiantes de primaria (5° y 6°) y secundaría-bachillerato de México y sus Estados. Método: Es una encuesta probabilística en población escolar 5° y 6° de primaria, secundaria y bachillerato con representatividad nacional y de cada Estado del país. La muestra fue de 52 171 alumnos en primaria y 114 364 en secundaria-bachillerato. La información se obtuvo mediante un cuestionario estandarizado y validado en encuestas anteriores. Resultados: El consumo de tabaco alguna vez fue de 30.4% y la edad promedio de inicio de esta sustancia fue 13.4 años. El 53.2% ha bebido alcohol y 14.5% ha bebido en exceso. La prevalencia de consumo de drogas alguna vez fue de 17.2%. Las drogas de preferencia son la mariguana (10.6%), seguida de inhalables (5.8%) y cocaína (3.3%). Discusión y conclusión: El crecimiento del consumo de sustancias, principalmente mariguana y alcohol, resalta la importancia de la creación de nuevas estrategias de prevención para disminuir los índices de consumo entre los estudiantes.
ABSTRACT Introduction: Drug use and its social and health consequences are subject of interest. Students' surveys are epidemiological strategies to monitor this problem, and they are complemented with household and specific population surveys. All this can show in advance some phenomenon that later is visible in general population. Besides drug use trends and patterns, these studies show the influence of other factors that may increase the drugs use and their consequences. Objective: To know the drugs, alcohol and tobacco use prevalences in elementary (5th and 6th grade), middle and high school students (7th-12th grades) of Mexico and its States. Material and methods: This survey is a probabilistic elementary-high school students' survey with national and statal representativity. The study sample had 52 171 elementary students and 114 364 middle and high school students. The information was obtained with a previously standardized and validated questionnaire. Results: The lifetime tobacco use was 30.4% and the average onset age was 13.4 years old. 53.2% has drunk alcohol and 14.5% has binge drinking. Any drug use lifetime prevalence is 17.2%. The preferred drugs are marihuana (10.6%), followed by inhalants (5.8%) and cocaine (3.3%). Discussion and conclusion: The increase in drugs use, specially of marihuana and alcohol, highlights the importance of creating new prevention strategies focused to decrease their use rate among students.
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Introducción Los estudios epidemiológicos en nuestro país muestran un incremento en el consumo de drogas ilegales y de alcohol. La edad de inicio también ha disminuido, especialmente en el consumo de alcohol. Por su parte, el consumo de inhalables se ha incrementado en forma importante, especialmente entre las mujeres jóvenes. Son diversos los factores asociados al consumo de drogas, pero de manera importante destacan el desarrollo de estrategias de resistencia, junto con sus habilidades sociales subyacentes, así como los estilos parentales de crianza. Método La presente es una encuesta probabilística en población escolar de secundarias y bachilleratos de la Ciudad de México que se levantó en noviembre del 2012, con representación a nivel de cada Delegación. La muestra fue de 26 503 alumnos. La información se obtuvo mediante un cuestionario estandarizado y validado en encuestas anteriores. Resultados El consumo de tabaco disminuyó significativamente (de 44.3% a 41.0%), el 32.9% de los adolescentes comenzó a utilizar tabaco antes de los 13 años. El 68.2% consumió alcohol alguna vez; en tanto que la edad de inicio promedio de consumo de esta sustancia se mantuvo en los 12.6 años. La prevalencia de consumo de drogas alguna vez aumentó de 21.5% a 24.4%. La mariguana es la droga de preferencia en la población estudiantil (15.9%). También se encontraron incrementos en la presencia de abuso sexual, mientras que el intento suicida disminuyó. Discusión Los resultados muestran el continuo crecimiento que tiene esta problemática, aunque los inhalables se mantuvieron constantes y el tabaco disminuyó de manera importante. Dado estos resultados, es una tarea preponderante dedicar más esfuerzos a la prevención con estudios e intervenciones evaluadas para preescolar y primaria, así como para los padres de familia y los maestros.
Introduction Epidemiological studies in our country show increases in the consumption of illegal drugs and alcohol. The age of onset has decreased, especially regarding alcohol use. Meanwhile, consumption of inhalants has increased significantly, especially among young women. There are several factors associated with drug use, but the development of resistance strategies, along with its underlying social skills and parenting styles, stand out in a significant way. Method Data comes from a probabilistic survey carried out in November 2012, with students from 7th to 12th school grades, in Mexico City, which was representative for each of its districts. The sample was 26 503 students. Information was obtained through a questionnaire standardized and validated in previous surveys. Results Tobacco consumption decreased significantly (44.3% to 41.0%); 32.9% of the adolescents began its use before age 13. Lifetime consumption of alcohol was 68.2%, while the average age of onset of cannabis use remained at 12.6 years. Lifetime prevalence of any drug use increased from 21.5% to 24.4%. Marijuana was the first drug of choice among students (15.9%). Increases were also found in sexual abuse rate, while suicide attempt decreased. Discussion Although inhalants use remained stable and tobacco use decreased significantly, results show the continued growth of drug use. Given this context, concentrating more efforts in prevention with studies and evaluated interventions for pre-school and elementary school students, as well as for parents and teachers, is a preponderant task.
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Human Development Index is currently considered a reference indicator to account for the social and economic situation experienced by countries. Method This study was conducted using the database from the study "Guiding Elements for Public Policies on Drugs in the Subregion -First Comparative Study on Drug Use and Associated Factors in Population of 15 to 64 years", held in Uruguay, Bolivia, Chile, Perú, Ecuador and Argentina. Target was urban population, from both sexes and of 12 to 65 years. Samples were stratified, three-staged and probabilistic. Sample sizes were theoretical with the inclusion of a non-response rate. Results Prevalence of drug consumption during last year and last month prior to the survey is higher in countries with high HDI compared with medium HDI countries. Lifetime prevalence of alcohol consumption is higher in countries with medium HDI compared with those with high HDI. There is less consumption in lifetime prevalence of legal drugs of countries with higher human development index and an equal rate of cigarette consumption. Discussion High development index implies that the inhabitants of a country have a long and healthy life, more access to knowledge and a decent standard of living. Population with a favorable view on these indicators are not only exposed, but they are also active drug users. The higher the index of human development is, the higher the drug consumption rates are, which indicate that although the human development index can reflect material or economic improvements, it is not necessarily traduced in the human value of the people or society and does not assure quality of life or well-being.
El Índice de Desarrollo Humano (IDH) es un indicador de referencia para explicar la situación social y económica de un país. Método Este estudio se realizó con la base de datos del estudio "Elementos Orientadores para las Políticas Públicas sobre Drogas en la Subregión - Primer Estudio Comparativo sobre Consumo de Drogas y Factores Asociados en Población de 15 a 64 Años". La población objetivo fue urbana, de ambos sexos y de entre 12 y 65 años. Las muestras fueron estratificadas, trietápicas y probabilísticas. Se estimaron tamaños de muestras teóricos, incluyendo una tasa de no respuesta. Resultados La prevalencia de consumo de drogas en el último año y en el mes previo al estudio es mayor en los países con IDH alto en comparación con los países con IDH medio. La prevalencia de consumo de alcohol alguna vez en la vida es mayor en los países con IDH medio comparados con aquellos que tienen un IDH alto. En cuanto a las drogas legales, los países con un IDH alto presentan menores prevalencias alguna vez en la vida, situación similar cuando se considera el consumo de tabaco. Discusión Un IDH alto implica que los habitantes de un país tienen una vida larga y saludable, mayor acceso a la educación y un estándar de vida satisfactorio. La población con una puntuación favorable en estos indicadores no sólo está expuesta al consumo de drogas, sino que también es usuaria activa de éstas. Cuanto mayor Índice de Desarrollo Humano, mayor es la prevalencia de consumo de drogas, lo que indica que si bien el índice de desarrollo humano refleja mejoras en la economía o bienes materiales, no necesariamente se traduce en valores humanos para la persona o la sociedad y no garantizan una buena calidad de vida o el bienestar.
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OBJECTIVE: To describe the prevalence of depressive symptoms in the Mexican population, aged 12 to 65 years, by identifying the main related socio-demographic and personal factors. METHODS: Data are drawn from the National Survey on Addictions 2008 (ENA 2008), a random, probabilistic, multistage study. A randomly selected sub-sample of 22,962 persons answered the section on depressive symptomatology, measured with the Center for Epidemiologic Studies Depression Scale (CES-D). RESULTS: The total prevalence for depressive symptomatology was 5.1%; the prevalence was 7.5% for women and 2.5% for men. For women, more evidence of depressive symptoms was seen in the central region, whereas for men, symptoms were homogeneous across the country. Factors related to the presence of depressive symptoms include being divorced (in women) or widowed (in men), having lower educational attainment, perceiving one's place of residence as unsafe, displaying alcohol abuse or dependence, being a regular drug consumer (in men) and having been sexually abused (males and females). CONCLUSIONS: The regional distribution of depressive symptomatology in women indicates the need for region-specific prevention programs that take into account the different social problems that affect women's emotional well-being. More research is also needed to support the early identification and intervention of men suffering from depression.
OBJETIVO: Conhecer a prevalência de sintomas depressivos a nível nacional na população de 12 a 65 anos e identificar os principais fatores sociodemográficos e pessoais associados. MÉTODO: Os dados foram obtidos da Pesquisa Nacional de Adições (ENA 2008), um estudo aleatório e probabilístico. Uma sub-amostra de 22.962 indivíduos responderam a seção de sintomas depressivos medida com a Escala de Depressão do Centro de Estudos Epidemiológicos (CES-D). RESULTADOS: A prevalência de sintomas depressivos foi de 5,2%; 7,5% em mulheres e 2,5% em homens. Entre as mulheres, os sintomas se apresentaram mais na região central do país e, entre os homens, a distribuição geográfica foi homogênea. Os fatores que se associaram aos sintomas depressivos foram estar divorciado (mulheres) ou viúvo (homens), ter nível educacional inferior, sentir sua residência como um local não seguro, apresentar dependência de álcool, ser usuário regular de drogas (homens) e abuso sexual. CONCLUSÕES: A distribuição regional de sintomatologia depresiva em mulheres indica a necessidade regional de orientação para prevenção, levando em conta que as distintas problemáticas sociais podem afetar seu bem-estar emocional. Entre os homens, mais estudos são necessários para identificação precoce da depressão.
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Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Depressão/epidemiologia , Distribuição por Idade , Depressão/etiologia , Métodos Epidemiológicos , México/epidemiologia , Distribuição por Sexo , Fatores SocioeconômicosRESUMO
Rickettsia typhi is an intracellular bacteria who causes murine typhus. His importance is reflected in the high frequency founding specific antibodies against R. typhi in several worldwide seroepidemiological studies, the seroprevalence ranging between 3-36%. Natural reservoirs of Rickettsia typhi are rats (some species belonging the Rattus Genus) and fleas (Xenopsylla cheopis) are his vector. This infection is associated with overcrowding, pollution and poor hygiene. Typically presents fever, headache, rash on trunk and extremities, in some cases may occur organspecific complications, affecting liver, kidney, lung or brain. Initially the disease is very similar to other diseases, is very common to confuse the murine typhus with Dengue fever, therefore, ignorance of the disease is a factor related to complications or non-specific treatments for the resolution of this infection. This paper presents the most relevant information to consider about the rickettsiosis caused by Rickettsia typhi
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Rickettsia , Rickettsia typhi , Infecções , RatosRESUMO
OBJECTIVE: To study the prevalence of, severity of, and risk factors for depressive symptoms in a probabilistic sample of Mexican adolescent mothers. METHODS: A sample of adolescents aged 13-19 years, drawn from a national survey, was interviewed in relation to severity of depressive symptoms [Center for Epidemiological Studies Depression Scale (CES-D) 16-23 and CES-D > 24] and pregnancy or parenting status. RESULTS: Depressive symptoms (CES-D 16-23) ranged from 2.3 percent in the first postpartum semester to 32.5 percent in the second trimester of pregnancy; high depressive symptoms (CES-D > 24) ranged from 3.0 percent in the second postpartum semester to 24.7 percent in mothers of an infant more than 1 year old. Significant differences between groups were in mothers in the second gestation trimester, who had significantly more symptoms than those who had never been pregnant and those in the first postpartum semester. In those with high symptomatology, no significant differences were observed between groups. A multinomial logistic regression model used to estimate the likelihood of depression found increased risk of depressive symptoms (CES-D 16-23) in those without a partner in the first, second, or third trimester of pregnancy; in the second postpartum semester; and with a child over the age of 1 year. Increased risk of high symptomatology (CES-D > 24) was found in those not in school or with a child over the age of 1 year. CONCLUSIONS: Depressive symptoms entail an enormous burden of disease for the mother and mental health risks to the infant; mothers should therefore be targeted in prevention and intervention actions.
OBJETIVO: Estudiar la prevalencia, la gravedad y los factores de riesgo de los síntomas depresivos en una muestra probabilística de madres adolescentes de México. MÉTODOS: En una muestra de adolescentes de 13 a 19 años de edad tomadas de una encuesta nacional se efectuaron entrevistas relacionadas con la gravedad de los síntomas depresivos (Center for Epidemiological Studies Depression Scale [CES-D] 16 a 23 y CES-D > 24) y la situación de embarazo o de crianza. RESULTADOS: Los síntomas depresivos (CES-D de 16 a 23) variaron de 2,3 por ciento en el primer semestre después del parto a 32,5 por ciento en el segundo trimestre del embarazo; los síntomas depresivos graves (CES-D > 24) fueron desde 3,0 por ciento en el segundo semestre posparto hasta 24,7 por ciento en las madres de un niño mayor de 1 año de edad. Se observaron diferencias significativas entre los grupos en las madres que se encontra-ban en el segundo trimestre de la gestación, que presentaron significativamente más síntomas que las mujeres que nunca habían estado embarazadas y que las que estaban en el primer semestre posparto. En las mujeres con síntomas graves, no se observaron diferencias significativas entre los grupos. Mediante un modelo de regresión logística polinómico usado para calcular la probabilidad de depresión se detectó un mayor riesgo de padecer síntomas depresivos (CES-D 16 a 23) en las mujeres sin una pareja que se encontraban en el primer, segundo o tercer trimestre del embarazo; en el segundo semestre después del parto; y en las mujeres con un niño mayor de 1 año. En las mujeres que no concurrían a la escuela y en aquellas con un niño mayor de 1 año se encontró un mayor riesgo de presentar síntomas graves (CES-D > 24). CONCLUSIONES: Los síntomas depresivos implican una carga de morbilidad impor-tante para la madre y riesgos para la salud mental del lactante; por lo tanto, las acciones de prevención y de intervención deben dirigirse a las madres.
Assuntos
Adolescente , Feminino , Humanos , Gravidez , Adulto Jovem , Depressão/epidemiologia , Mães , Complicações na Gravidez/epidemiologia , México , Prevalência , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
In the course of the last three years, a wide range of epidemiological studies related to drug use has been conducted, both at a national and international level. Talking about national studies in the field of school population, surveys have been conducted in the states of Colima, Nuevo León and Jalisco, as well as surveys in university population, among others. Regarding tobacco use, several studies were made and they covered many cities of the country. About household surveys, the fifth National Addictions Survey (ENA) was carried out in 2008 and it provided data at a national and state level. The Global Survey of Smoking in Adults (GATS) was also made having nationwide coverage. In relation to tobacco use, the trend shows a decrease in the prevalence of consumption. This is shown in ENA 2008 and GATS, as well as school population studies in different states. For alcohol consumption, the situation is different; both for the prevalence and for the proportion of people who start its early consumption, significant increases have been reported throughout the country. Alcohol abuse remains constant and is similar between men and women. When considering the use of illegal drugs, there is an overall increase. As for marijuana, data indicates that its consumption has increased and that it remains as the primary drug of use. However, the main increase is for inhalants, particularly among school population and especially in women. For cocaine, data from United Nations shows a significant decrease in the supply of this substance due to the increase of seizures. Data from ENA 2008 shows that the use of this drug has doubled between 2002 and 2008. The United Nations report indicates that the increase in our country is apparent until 2005 and since then it has been decreasing. Methamphetamine use remains low and it does not increase. Only in the case of the population that goes to service centers for drug users, a high rate of consumption is found. Finally, the consumption of heroin and hallucinogens is low. Chihuahua remains as the state with the most problems in the use of heroine. Most recent surveys have allowed us to see, in general, some of the trajectories in adolescent mental health, where sexual abuse is presented first in women, followed by ADDH, then the consumption of legal drugs, antisocial behavior, use of inhalants and suicide attempt. Then drug consumption, marijuana and cocaine. In men, the sequence is similar, although they face ADDH first and then sexual abuse. In this context, the objective of this study is to assess the prevalence of drug, alcohol and tobacco use, as well as consumption trends in school population from 7th to 12th grade from Mexico City and its political delegations. Method To ensure the comparability with similar studies carried out in Mexico in school population, the methodology used in this study maintains the basic aspects of the previous measurements that have been made in students from 7th to 1 2th grade from Mexico City and other states. The project had the approval of the ethics committee from the National Institute of Psychiatry Ramón de la Fuente Muñiz, and was approved by the educational authorities of Mexico City to be applied in school population. The unit of analysis from which the information was obtained were the students enrolled in 7th to 12th grade in 2008-2009 from public and private schools in Mexico City. The sampling frame was developed based on the official records of the 2008-2009 school year. A non-response rate of 20%, a confidence level of 95% and an average absolute error of 0.004 were considered. The sample design was stratified by level of education (7th to 9th grades and 10th to 12th grades) and political delegations, which gave 32 different strata. It was also clustered by scholar group which was the primary unit of selection. The sample of groups and students were weighted considering the group, educational level and the delegation. A final sample of 22 980 subjects was obtained: 49.8% were female and 50.2% were men. 56.3% of the sample attended to 7th to 9th grades and 43.7% attended to 10th to 12th grades. In addition, most of the male and female adolescents were full-time students during the year prior to the study and only 7% of men and 5.1% of women were not students. 23.3% of men and 11.9% of women worked part or full time, and additionally, most of them had both parents. The information was obtained through a standardized questionnaire, which has been applied in previous surveys and has been previously validated. Due to the extension of the instrument, four forms were used to include various sections, the main part of questionnaire was administered to all subjects and the last two pages corresponded to forms, so each form was applied to one quarter of the sample. Alcohol consumption indicators used are comparable with WHO indicators, international observatories from Europe and the ones used in <
Introducción En los últimos tres años, se ha realizado una amplia gama de estudios epidemiológicos, a nivel nacional e internacional, sobre el consumo de drogas. En cuanto a tabaco, la Encuesta Nacional de Adicciones 2008, la encuesta de GATS y los estudios estatales en población escolar muestran una tendencia importante a la disminución del consumo de la sustancia. Para el consumo de alcohol, tanto en la prevalencia como en la proporción de personas que inicia su consumo temprano, se han reportado incrementos. El abuso de alcohol se mantiene constante y similar entre hombres y mujeres. Al considerar el uso de drogas ilegales hay incrementos importantes. El incremento más pronunciado es el de los inhalables, especialmente en mujeres. En cuanto a la cocaína, la ENA 2008 señala que se ha duplicado el consumo y el informe de la ONU indica que al parecer el incremento se da hasta 2005 y a partir de ahí ha disminuido. Las metanfetaminas mantienen una prevalencia baja. Sólo entre quienes acuden a los centros de servicio para usuarios de drogas se encuentra un alto consumo. En este contexto, el objetivo de este trabajo es evaluar las prevalencias del uso de drogas, alcohol y tabaco, así como las tendencias de consumo en la población de estudiantes de enseñanza media y media superior de la Ciudad de México. Método El marco muestral se elaboró con base en los registros oficiales del ciclo escolar 2008-2009 de la Secretaría de Educación Pública (SEP). Se consideró una tasa de no respuesta de 20%, un nivel de confianza de 95%, con un error absoluto promedio de 0.004. El diseño de la muestra fue estratificado y por conglomerados; la unidad de selección fue el grupo escolar. Se obtuvo una muestra final de 22 980 sujetos y quedó conformada por 49.8% de mujeres y 50.2% de hombres. La información se obtuvo mediante un cuestionario estandarizado, que ha sido aplicado y validado en las anteriores encuestas. Los indicadores de consumo de alcohol, drogas y tabaco empleados son comparables con los indicadores de la OMS, de los observatorios internacionales de Europa y de los usados en <
RESUMO
Drug use in Mexico has been on the rise since the 1970s. Nonetheless, this problem has exhibited important variations in the different regions of Mexico. To document these trends, the National Institute of Psychiatry Ramón de la Fuente (INP) has performed household surveys on addictions in different Mexican cities. In the 1970s and early 1980s surveys were conducted in the following cities: Mexico City, La Paz, Baja California Sur; Mexicali, Baja California Norte; Monterrey, Nuevo León; San Luis Potosí, San Luis Potosí; and Puebla, Puebla, among others. The first national survey in urban population was carried out in 1 988, and was repeated in 1993 and 1998, while the first national survey to included rural population was conducted in 2002, which is being followed by another study currently in the field. The student population has also been extensively studied, and has been included in three national drug surveys and studies performed in different entities. Antecedents Results from these surveys show that drug use has not increased in a uniform fashion throughout the Mexican Republic and both student and household surveys have demonstrated higher rates in the northwestern region of the country comprising the states of Baja California, Sonora and Chihuahua, which have exhibited above-average drug use on comparison with the remaining regions of the country. The most frequently consumed drug by the population is marihuana. The 1988 national household survey registered a rising prevalence in use of 2.9% in Mexican population aged 12-65 years of individuals who had used drugs at some time during their lifetime; in 1993 this prevalence increased to 3.32% and in 1998 to 4.70%; while in 2002 the percentage demonstrated a slight decrease to 3.48%. In 1988, the second place in drug preferences of the population was inhalants with a prevalence of drug use at some time during their lifetime of 0.76%; by 1993, the second place was occupied by cocaine. Prevalence of use of the latter was 0.33% in 1988; by 1993, cocaine increased to 0.56% and to 1.45% in 1998, presenting a slight decrease in use in 2002 (1.23%). From 1988-2002 non-prescribed medical drugs consumed were found in the third place in population preference. Objective This article compared drug use rates observed in three cities on or near Mexico's northern border with the U. S.: Ciudad Juarez, Chihuahua; Tijuana, Baja California Norte, and Monterrey, Nuevo León, were studied as part of the 1 998 national survey on addictions by selecting independent representative samples of these localities and with a new survey of these entities in 2005. Method The 1998 national survey of addictions was carried out in a representative sample of Mexican urban population (in localities of 2500 inhabitants). Independent samples were drawn from inhabitants living in several cities throughout Mexico. In this article we report the drug-use trends for three of these cities (Ciudad Juarez, Monterrey and Tijuana) by comparing the rates observed in 1998 with the results of a new wave of household surveys conducted in 2005 in the same cities using comparable methodology. Samples in both periods included population 12-65 years of age residing in households. Sample design was stratified by means of the following: several stages with localities (Áreas Geoestadísticas Básicas, AGEBS, its acronym in Spanish, census tracts); blocks of houses within the selected localities; segments of houses within sample blocks, and one individual per household as the selection unit in each stage. Sample size in Tijuana was 466 and 553 in 1998 and 2005, respectively, while sample sizes for Ciudad Juarez were 472 in 1998 and 606 in 2005, and for Monterrey this was 637 in 1998 and 675 in 2005, and the non-response rate was 23% in 1 998 and 20.3% in 2005. Instruments for obtaining information employed in both time frames considered were similar. Two types of questionnaires were administered: a household questionnaire that included sociodemographic information on all household inhabitants in the sample and their housing conditions and an standardized individual questionnaire administered in a face-to-face interview that collected information on the following: prevalence and use patterns of tobacco, alcohol, five types of illegal drugs (marihuana, cocaine, heroin, hallucinogens, amphetamine-type stimulants and other drugs); four types of medical pharmaceuticals utilized without a prescription (narcotics, stimulants, tranquilizers and sedatives), determining consequences and services utilization. In this article tobacco and alcohol use is not reported. This questionnaire has been extensively tested and used in previous surveys. Interviewers were persons academically prepared in the Social Sciences and trained in the logistics of the several survey stages and extensively supervised during field work. Results Highest rates of use were observed in Tijuana and Ciudad Juarez in contrast with Monterrey, which had lower rates. When use of any drug was considered, an increase in lifetime use from 1998-2005 was observed in all three cities; when use during the past year was contemplated, an increase was observed from 1998-2005 from 2.8-4.8% in the case of Ciudad Juarez and in Monterrey from 1.3%-2.0%, while these rates for Tijuana decreased from 5.4%-4.01%. Reports of use during the previous month fell in Tijuana from 4.4%-2.81 % and in Monterrey this decreased from 1.1 %-0.71 %, while in Ciudad Juarez drug use rates during the previous month increased from 2.4%-3.24%. It is important to mention that there was no statistical significance in any of the different prevalences types. Lifetime use of medical drugs without prescription increased in Tijuana and in Monterrey, while in Ciudad Juarez this remained stable from 1998-2005. In 2005, use of medical drugs decreased in Ciudad Juarez from 1.2%-0.88% and in Tijuana from 1.3%-1 .28%, while in Monterrey no use was detected in 1998, but 0.48% of interviewees did reported drug use in 2005. Previous-month use increased in Tijuana from 0.7%-1 .28% and in Monterrey this ranged from no use in 1998 to 0.48% by contrast in Ciudad Juarez previous-month drug use fell from 1.2-0.88%. In referring only to use of any illegal drug (excluding medical pharmaceutical), lifetime use increased in all three cities from 1998-2005; lifetime use doubled in Monterrey and Ciudad Juarez, while use during the previous year decreased in Tijuana from 4.4%-3.25% and increased in Ciudad Juarez from 1.6%-3.98% and in Monterrey from 1.3%-1 .52%. Prior-month increased in Ciudad Juarez from 1.2%-2.42%, while this exhibited a decrease in Tijuana from 3.9%-2.05% and in Monterrey from 1.1%-0.23%. Data also indicate that a high proportion of individuals in Monterrey have used only one drug; these percentages rose in the 1998-2005 period from 3.7%-8.96% numbers of the poly-drug users doubled in Tijuana from 4%-8.44% and in Ciudad Juarez from 3.2%-7.43%; in Tijuana this was due to an increase among males, and in Ciudad Juarez the number of poly-drug users increased in both genders.
El consumo de drogas en México ha ido en aumento. En la década de 1970, el Instituto Nacional de Psiquiatría realizó las primeras encuestas de hogares sobre el tema de las adicciones en población de distintas ciudades del país: la Ciudad de México, La Paz, B.C.S.; Mexicali, B.C.; Monterrey, N.L.; San Luis Potosí, S.L.P., y Puebla, Pue, entre otras y ha documentado las tendencias del problema y sus variaciones regionales. A nivel nacional se han realizado en hogares cuatro encuestas en 1988, en 1993, en 1998 y en 2002, denominadas <
RESUMO
Three leptospirosis cases with lung involvement are reported from the Yucatan Peninsula, Mexico. All three patients were admitted to the intensive care unit due to acute respiratory failure. Treatment with antibiotics resulted in favorable evolution despite the negative prognosis. Leptospirosis should be included in the differential diagnosis of patients with fever and lung involvement.
Analisamos três casos de leptospirose com envolvimento pulmonar na Península Yucatán, México. Os três pacientes com seqüelas pulmonares entraram na unidade de cuidados intensivos devido à insuficiência respiratória grave. Todos os casos evoluíram favoravelmente ao tratamento com antibióticos, apesar do prognóstico negativo. Leptospirose deve ser incluída no diagnóstico diferencial de pacientes com febre e comprometimento pulmonar.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Hemorragia/microbiologia , Leptospirose/diagnóstico , Pneumopatias/microbiologia , Ensaio de Imunoadsorção Enzimática , Hemorragia/diagnóstico , Hemorragia/tratamento farmacológico , Imunoglobulina G/sangue , Leptospira interrogans/imunologia , Leptospirose/tratamento farmacológico , Pneumopatias/diagnóstico , Pneumopatias/tratamento farmacológico , Índice de Gravidade de Doença , Adulto JovemRESUMO
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Summary: Antisocial behavior emerges as the result of different factors such as scholar problems, drug consumption, alcoholism, antisocial peer relationships, emotional problems, etc., which may in turn predispose to the individual to develop a pattern of antisocial behavior. The present work aims to determine the association of antisocial behavior between the factors of a bad family environment and mistreatment, and to determine if they can predict the presence of antisocial behaviors in adolescents. Family plays a primary role in the development of a person, especially in adolescent. In recent times, several problems of family disintegration and inadequate parent-child relationships are observed, and it has been described that antisocial personalities may arise from environments with child abuse, economical problems, humiliation, physical punishment and family disintegration. The experience of such emotions during childhood may lead to a severe impairment in the conformation of an emotionally-adapted personality, and may promote a tendency for the commitment of delictive behaviors in the future. It is necessary to close the vicious cycle where mistreated parents mistreat their own children and avoid that the parents who lived unpleasant experiences of hostility, rejection, lack of communication, inestability, etc., repeat these patterns with their children. It is important to revalorize the role of family, its functions and characteristics and the most important, its determinant influence on young people that have behavior problems as antisocial behavior. It is vital to create conscience about the harm that some children, adolescents and even adults have from their negative familial experiences of hostility, aggression, and mistreatment, because these experiences increase the possibilities of delictive behavior in these individuals. Objective. In this context, the present research has its main interest in showing the relationship between past experiences of mistreatment or inadequate familial environments and the presence of antisocial behaviors in adolescents. Method. The present research is supported on results of the Mexico City Survey on drug consumption in 7 th to 12 th grade population carried on October 2003. The total sample of the survey comprised 10659 students. For this research we used 3603 students, that corresponds to the number of students that completed the Form A of the questionnaire, that contained the areas of interest of the study. The questionnaire was previously validated an its main indicators have shown adequate stability in different surveys. This instrument was applied in three different times due to its extension. Total time for its application was of 75 minutes. Raters were trained for the application of the questionnaire. The course lasted 12 hours and included all the theoretical aspects related to addictions, objectives of the study, management of the questionnaire and the instructions for its application in the groups. Results. First of all, a comparative analysis by gender was performed. It was observed that antisocial behaviors were more frequent in men than in women. It is important to mention that men committed this acts in a double frequency than women, specially in terms of severe acts, where 10% of men committed them in contrast to the 3.3% observed in women. Additionally, two factor ANOVA was performed (gender and antisocial behaviors) with the variables of this study, mistreatment and family environment, to determine if there were differences between groups (p<0.05) and significant differences were observed in all the areas of family environment. The interaction analysis of the two factors: gender, act-non acts with family environment showed that for the area of hostility and rejection there were significant differences where women that committed antisocial acts were the ones that reported higher levels of hostility and rejection. In terms of communication of the son/daughter, women that committed antisocial acts were also the ones that reported a lower level of communication. In the area of parent support, women that committed antisocial acts were also the ones that reported the lower levels. In the areas of parent communication and support to the son/daughter, men and women that committed antisocial acts reported less communication and support, respectively. For the area of mistreatment, women reported higher levels of prosocial discipline and negative discipline when compared to men. No significant differences emerged between men an women in the area of severe negative discipline. Also, no significant differences emerged between adolescents that committed antisocial acts and adolescents than do not committed these acts, in terms of prosocial discipline. Nevertheless, adolescents that committed antisocial acts reported higher levels of severe negative discipline. For the analysis of the interaction of the factors gender, acts-non acts in the area of mistreatment, no differences emerged in the area of negative discipline. Significant differences emerge for prosocial discipline, where men that do not committed antisocial acts reported the lowest levels of prosocial discipline. For severe negative discipline, both men and women that committed antisocial acts reported the highest levels. Finally, using logistic regression, we find that the main predictors of antisocial behavior were the presence of high hostility, low level of communication from the children, less child support and the presence of higher negative discipline and negative severe discipline. Communication, parent support and prosocial discipline were not predictive variables for antisocial behavior. Our results support what is described in other studies where family is the main agent of socialization as family teaches the ways of social interaction, values, habit, etc. Furthermore, several studies that evaluated the relationship of the family and antisocial behavior were performed by analyzing the role of the family as a mediator of behavior and society, on the basis that family teaches children rules, abilities and motivations that in some way constitute their cultural and social patterns. We conclude that family environment and mistreatment are factors associated to the presence of antisocial behavior. We must prevent this problem by improving familial relationships and providing a positive family environment to adolescents. In this way, our adolescents may have an adequate development throughout their lives. If an adequate and positive environment is provided during childhood and is maintained through adolescence, with positive affective family relationships, the adolescent may see his/her parents as a guide; a reasonable not arbitrary discipline allows the adolescent to develop a social behavior that leads to an adequate self-control and self-directedness. On the contrary, if the relationships between parents and children are not favorable, the social behavior of the adolescent may be easily impaired and it is very common that these adolescents exhibit severe difficulties for social adaptation.
RESUMO
Objective. The main purpose of this study was to identify the trends of risky eating behaviors among student population in Mexico City in the period 1997-2003 and its relationship with sex age and family head educational level. Methods. Data from the 1997 (N = 9,755), 2000 (N = 3,286) and 2003 (N = 3,062) Drug and Alcohol Prevalence in Student Population of Mexico City Survey's were analyzed. These are representative data of students of junior high, high school and technical schools in Mexico City, with a mean age of 14.5 years (SD - 1.9). Eating behaviors were assessed with a brief questionnaire developed following DSM-FV diagnostic criteria. Risky eating behaviors and the number of risk indicators were compared by sex, age and family head educational level. Results. The results showed an overall increase in the percentage of males (from 1.3% in 1997 to 3.8% in 2003), and females (3.4% in 1997 to 9.6% in 2003) who showed 3 or more risky eating behaviors. The analysis by age groups showed an increase in all but 16-17 year old males, and in all females, being 12-13 year old males and 18-19 year old females the most affected. Regarding the type of risk indicators in both sexes and across all age groups, an increase in preoccupation towards gaining weight and the use of purging and restrictive methods to loose weight was observed. Body weight over estimation decreased in males, while in females showed an increase along with binges in the 2000 survey but showed a decrease after that (2003 survey). The relationship between the family head educational level and risky eating behaviors did not show a regular pattern among males, while a positive relationship between both variables was found among females. Conclusions. A first overall view of the situation of risky eating behaviors among adolescent students in Mexico City and the changes observed in the period studied. An increase of these behaviors was observed along the period of study, being younger males and older females the most affected, as well as women whose family head showed higher educational level.
Objetivo. Identificar las tendencias de las conductas alimentarias de riesgo en estudiantes del Distrito Federal en el periodo 1997-2003 y su relación con el sexo, la edad y el nivel de escolaridad del jefe de familia. Material y métodos. Se analizaron los datos de las encuestas sobre la Prevalencia del Consumo de Drogas y Alcohol en la Población Estudiantil del Distrito Federal 1997 (N = 9,755), 2000 (N = 3,286) y 2003 (N = 3,062). Se trata de muestras representativas de estudiantes de nivel secundaria, preparatoria y técnico en la ciudad de México, con una edad promedio de 14.5 años (DE = 1.9). La información acerca de conductas alimentarias de riesgo se obtuvo mediante un cuestionario breve desarrollado con base en los criterios diagnósticos del DSM-IV. Se hicieron comparaciones por sexo, edad y escolaridad del jefe de familia acerca del tipo, cantidad y frecuencia de conductas alimentarias de riesgo. Resultados. Los resultados mostraron un incremento general en la proporción de estudiantes que reportaron tres o más conductas alimentarias de riesgo (hombres, 1.3% en 1997 a 3.8% en 2003; mujeres 3.4% en 1997 a 9.6% en 2003). Por grupos de edad, se observó incremento en la frecuencia de estas conductas en varones de todas las edades excepto los de 16 y 17 años, y en las mujeres de todas las edades, siendo los más importantes en los varones de 12-13 años y en las mujeres de 18-19 años. En cuanto a los tipos de conducta, se incrementaron la preocupación por engordar y el uso de métodos purgativos y restrictivos para bajar de peso, la sobrestimación del peso corporal disminuyó de forma general en los varones, mientras que en las mujeres se incrementó junto con la práctica de atracones en la medición 2000, pero disminuyó en la medición 2003. La relación con la escolaridad del jefe de familia no mostró un patrón regular en los varones, pero en las mujeres se encontró una relación positiva entre estas variables. Conclusiones. Se muestra un primer panorama acerca de la situación que guardan las conductas alimentarias de riesgo en los adolescentes escolarizados de la ciudad de México y los cambios observados en el periodo estudiado. Se observa un incremento de dichas conductas a lo largo del periodo de estudio, siendo los varones más jóvenes y las mujeres de mayor edad los má-s afectados, así como las mujeres cuyo jefe de familia refirió mayor nivel de escolaridad.
Assuntos
Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Comportamento Perigoso , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Comportamento Alimentar , Desnutrição/epidemiologia , Estudantes/estatística & dados numéricos , Anorexia Nervosa/epidemiologia , Imagem Corporal , Peso Corporal , Bulimia/epidemiologia , Dieta Redutora/estatística & dados numéricos , Escolaridade , Características da Família , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Comportamento Alimentar , Desnutrição/etiologia , México/epidemiologia , Obesidade/epidemiologia , Obesidade/prevenção & controle , Obesidade/psicologia , Risco , Inquéritos e Questionários , População Urbana , Vômito , Redução de PesoRESUMO
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Abstract: Introduction: Research focused on drug consumption in schools has been developed in México since 1976 and has allowed for a constant monitoring of this behavior in the population. The National Institute of Psychiatry Ramón de la Fuente (INP) and the Public Education Administration (SEP) have been the pionering institutions in these efforts, where other interested institutions and states add their contributions to the assessment of the problem in this social sector. Due to the need of developing local preventive programs to reduce drug consumption, several regions of the country have carried out, in a first stage, situational diagnoses of drug consumption. These data, in addition to other community information sources, have helped to enhance efforts in terms of prevention. To date, the main investigations related to students are the Fourth National Survey on Addictions, the National Survey from the National System for the Integral Family Development, regional surveys with young students from 7th to 91 grades (Queretaro; Ríoverde, San Luis Potosí; Sinaloa; Tamaulipas and Ciudad Guzmán, Jalisco.), from 101 to 12th grade (same states, except for Ciudad Guzman and the study done in Guanajuato whose results have not been published yet) and college (Ríoverde). The main findings for adolescents and youths obtained from these studies show an increase in drug consumption, specially for alcohol, cannabis and metamphetamines, although the general index of consumption remains steady since 2001, specially in the case of cocaine. There have also been changes in men and female contributions to the consumption index, giving similar prevalences for alcohol and tobacco in both. Regional variations have been observed, where drug consumption is higher in more urbanized cities. However, new generations are more affected by this phenomenon regardless of the level of urbanization of the place where they live. Also, as it has been previously established, being in a scholastic environment is a protective factor against drug consumption, beacause consumption is higher among adolescents who do not study, and it is a differential factor that protects men more than women. As a consequence, these sources and different students' surveys point out that the probability of drug consumption increases when a minor is working. Additionally, studies report that an early consumption onset for tobacco and alcohol, mainly before 13 years old, increases the possibility of consuming other drugs. This fact is important because several reports on the literature show that age of onset for consuming these drugs is becoming earlier. It is relevant to consider that drug consumption is not an isolated factor. It is known that some precursors for drug consumption are the same for other behaviors, such as sexual intercourses without protection, antisocial, delinquent behaviors or suicide attempt. In behalf of this, prevention programs must be designed in an integral way considering the global environment of adolescents, and not just focused on drug consumption. From this point of view, results from the survey on drug use carried out among students in Mexico City in autumn, 2003, are presented. This survey is the most recent diagnosis about this problem in Mexican adolescents, and keeps the methodological standards of previous surveys. Objective: The aim of the present work is to give a recent and complete view about this problem and prevention opportunities for adolescents of Mexico City and the whole country. Materials and method: The study comprised a randomized sample of 10,659 students from Mexico City, with a two-stage design (school-group), and stratified (from 71 to 9 grades, and from 10 to 123 grades, technical and normal), where the last selection unit was the scholar group. Data is representative for delegation and educational level, and the design is similar to those previously applied in schools by the INP and SEP. The reviewed sample frame was obtained from the registrations to the 2001-2002 school period of SEP A randomized sample was obtained for each county and educational level. Regarding estimations precision, calculated non-response index was 15%, with an absolute error average of 0.004, and a design effect equaling 2. The confidence intervals obtained were generated by the STATA program, version 7.0. The mean-age of the subjects was 14.6 years (12-22 years), 50.5% of the sample were men and 49.5% were women. The indicators of drug consumption included in the questionnaire are the same used in similar studies and are the same used by the WHO. In addition to drug consumption and related problems, several behaviors were assessed among adolescents, such as suicide attempt, level of depression, eating risk behaviors and some features of their sexual behavior. Interviewers were trained to obtain the most reliable information from the adolescents and to keep confidentiality. A total of 23 interviewers and five supervisors participated in the study. Results: First of all, a slightly increase in drug consumption was found in the last three years, from 14.7% to 15.2%, which is not significative. Nevertheless, there are significant changes in the consumption of specific drugs. There is a significant increase in cannabis consumption, while inhalants and tranquilizers remain steady and cocaine use showed a slightly decrease. By sex, it was observed that drug consumption in women has increased, while in men it remains steady or has even decreased a little. In this context, drug preferences remain very similar to those reported three years ago, where cannabis occupied the first place, followed by inhalants, tranquilizers and cocaine (with similar levels of consumption between the last three ones). The drugs of preference among women are tranquilizers. With respect to legal drugs, alcohol consumption has increased, while tobacco consumption remains similar to the reported in the survey of 2000. A significant change in these drugs, as mentioned above, is that their consumption is almost the same among men and women. Talking about alcohol abuse, a 2% increase was observed, which indicates 23.8% of the adolescents had consumed at least five drinks per occasion during the month previous to the study. In regional terms, there were also changes. The most affected delegations are Azcapotzalco, Venustiano Carranza, Miguel Hidalgo and Cuauhtemoc. In the last survey, the most affected delegations were Gustavo A. Madero and Coyoacan. This is very important information, because the SEP implemented several prevention strategies in these two delegations in order to reduce drug consumption. Considering the results of the present study, it can be concluded these efforts were successful. Even though results will be presented in a specific publication, according to the adolescents' evaluation of the brochure given to each student at the end of the application, we can say they were very positive, as 15% of the adolescents indicated they had quitted smoking and a similar percentage reported a decrease in their tobacco consumption. Another 15% mentioned they had used help telephone lines, and more than 60% shared the content of the brochure with their families. Most of them have kept the brochure for future occasions and have also lent it to friends. Discussion: The data about drug consumption is similar to the data of other national studies reporting that consumption of medical and illegal drugs and tobacco, is steadier on the whole, although there are changes in specific drugs consumption and by sex. Meanwhile, the prevalence of alcohol consumption has been increasing, even when its abuse remains stable. For prevention, it is important to consider the new location of the problem (most affected delegations), and to use crime indicators and other delinquent behaviors, to share prevention efforts in the most affected areas of the city. Another interesting result is the low level of risk perception for tobacco and alcohol consumption, which are important precursors for the consumption of other drugs, especially if there is an early consumption onset for these substances. In the context of drug consumption associated with other adolescents' problems, suicide attempt is the most frequent situation reported by the participants (16%) and it is even more frequent than drug consumption. Although this situation seems to be quite problematic, adolescent population in scholastic environments is the least affected in comparison to those that quit or stop studying. On the other hand, the information obtained about the brochure "What's up with your life?" is encouraging for prevention practices, and the presence and growth of these problems makes it important to consider that the process of obtaining information as an integral part of the diagnosis may also be used as an opportunity to reach adolescents with information or materials created for them. Finally, it is important to point out that prevention must be applied during childhood and not only during adolescence. To reach this goal, it is important to include all possible human resources. The point is simple: the possibilities to obtain better results under this conception are greater, because the interaction with children and their complete integration at home facilitate this prevention task. During childhood, the human being is more receptive to this kind of interventions and it is simpler to work with the families. So, when children grow up, it will be easier to communicate with them as adolescents and to give them all the support they require in their identity formation. Even when the work is focused on the longer term, the results will be better and we will be able to offer better options to the new generations from the construction of an adequate prevention culture.
RESUMO
Depois da descoberta e caracterização inicial da Rickettsia felis em 1992 por Azad e cols, e à descrição subseqüente do primeiro caso de infecção humana em 1994, houveram duas comunicações de rickettsioses causadas por Rickettsia felis na América Latina. A primeira foi feita por Zavala-Velazquez e cols em 2000 no México. Em 2001, Raoult e cols descreveram a ocorrência de dois casos humanos de rickettsiose por Rickettsia felis no Brasil. Na presente discussão, esses dois artigos foram comparados, e depois da descrição dos principais sinais e sintomas, conclui-se que outros estudos são necessários, com a participação de um maior número de pacientes, para se estabelecer a verdadeira freqüência dos sinais clínicos e sintomas presentes nas rickettsioses por Rickettsia felis.
Assuntos
Humanos , Rickettsia , Infecções por Rickettsia , Brasil , DNA Bacteriano , México , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Índice de Gravidade de DoençaRESUMO
A leptospirosis clinical-epidemiological study was made in humans and reservoirs in the state of Yucatßn, MÚxico. Interviews and serological analyses were made on 400 persons from an open population, 439 probable cases of leptospirosis and 1060 animal reservoirs (cows, pigs, dogs, rats and opossums). IgM Leptospira DipstickTM and Microscopic Agglutination Test (MAT) was used to detect human antibodies to leptospiras and serovar respectively. Leptospirosis incidence in humans was 2.2/100,000 inhab. in 1998, 0.7/100,000 in 1999 and 0.9/100,000 in 2000. Overall seroprevalence was 14.2 percent, relatively unchanged from seroprevalences observed 20 years ago. Highest seropositivity was found in people over 56 years of age, predominating males over females. Predominant serovars in the open population were tarassovi, hardjo, pomona and panama. Leptospirosis cases were most frequent in rural areas, and the anicteric course predominated over the icteric. The panama, icterohaemorrhagiae and pomona serovars predominated in both anicteric and icteric courses. Dogs, pigs and rodents had the highest seropositivity among the reservoirs. Contact with rodents and natural water sources were significant factors (p ú 0.05). Human cases (74 percent) occurred during the rainy season. It is concluded that leptospirosis is still a serious illness with important clinical and epidemiological implications in the state of Yucatßn, Mexico
Assuntos
Animais , Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Reservatórios de Doenças , Leptospirose , Incidência , Leptospirose , México , Estudos SoroepidemiológicosRESUMO
OBJECTIVE: To determine the neonatal mortality risk according to gestational age and birth weight. MATERIAL AND METHODS: The cohort consisted of 19,668 newborns of Centro MÚdico Nacional (National Medical Center) Ignacio GarcÝa TÚllez, a tertiary level healthcare institution of the Instituto Mexicano del Seguro Social (Mexican Institute of Social Security, IMSS) of the Yucatan Peninsula. All newborns discharged from the hospital between January 1st, 1995 and October 31st, 1999 were included in the study. Birth weight, gestational age, and conditions upon discharge were recorded. Absolute risk (AR) of mortality was calculated for each week-of-gestation- and birth group. RESULTS: Observed AR in newborns 34 to 44 weeks of gestational age and weighing at least 2,250 g was 0.4, while that for those 26 to 32 weeks of gestational age and weighing between 1000 g was 15. CONCLUSIONS: AR of neonatal mortality increased inversely proportional to gestational age and birth weight. These data can be used as reference values for our hospital and for comparison with other hospitals.