Prevalencia de Toxoplasma gondii en mujeres embarazadas asintomáticas en Quito, Ecuador 2020 / Prevalence of Toxoplasma gondii in asymptomatic pregnant women in Quito, Ecuador 2020

La toxoplasmosis es causada por un protozoo intracelular, Toxoplasma gondii, que tiene una amplia distribución geográfica. La forma congénita resulta en una forma gestacional que puede presentar una parasitemia temporal que infectará al feto. Es adquirido por consumo de carne cruda o poco cocida, alimentos o agua contaminada e infección congénita a través de la placenta. El objetivo de este estudio fue determinar la prevalencia de infección por toxoplasmosis y sus posibles factores de riesgo asociados con mujeres embarazadas que asistieron al servicio de control prenatal en el Hospital Gineco Obstétrico "Isidro Ayora", Ecuador. Las muestras de sangre se analizaron para detectar la presencia de anticuerpos IgG e IgM contra T. gondii utilizando una prueba de hemoaglutinación. Se probó la significación de los factores de riesgo mediante análisis bivariado. Se consideró un valor de p <0,05 como estadísticamente significativo. La prevalencia de anticuerpos IgG e IgM fue de 16,32%. Se observó una asociación significativa entre la seroprevalencia y antecedentes de aborto (p=0,00804), contacto con gatos domésticos (p<0,0001) y hábitos higiénicos incorrectos (p<0.0001). Los hallazgos demostraron que el contacto con gatos, antecedentes de abortos y hábitos higiénicos incorrectos se identificaron como factores de riesgo de infección por T. gondii(AU)

Toxoplasmosis is caused by an intracellular protozoan, Toxoplasma gondii, which has a wide geographical distribution. The congenital form results in a gestational form that can present a temporary parasiteamia that will infect the fetus. It is acquired by consumption of raw or undercooked meat, food or water contaminated and congenital infection through the placenta. Tthe objective of this study was to determine the prevalence of toxoplasmosis infection and its possible risk factors associated with pregnant women who attended the prenatal control service at the Gyneco-Obstetric Hospital "Isidro Ayora", Ecuador. Blood samples were tested for presence of IgG and IgM antibodies against T. gondii using a hemagglutination test. The risk factors were tested for significance using bivariate analysis. P-value <0.05 was considered statistically significant. The prevalence of IgG and IgM antibodies was 16.32%. A significant association was observed between seroprevalence and history of abortion (p=0,00804), contact with domestic cats (p<0,0001) and incorrect hygiene habits (p<0,0001). The findings demonstrated that contact with cats, a history of miscarriages, and poor hygiene habits were identified as risk factors for T. gondii infection(AU)

Prevalence and risk factors of toxoplasmosis among adults in a small Brazilian city

Abstract INTRODUCTION: The prevalence of Toxoplasma gondii infection varies markedly among different populations, especially depending on factors related to socioeconomic development and eating habits. Cássia dos Coqueiros is a small city in Brazil with rural characteristics and increased risk factors traditionally associated with T. gondii infection. METHODS: We carried out a cross-sectional study involving 970 inhabitants aged 18 years or more, selected from patients of the local health unit and home visits in urban and rural areas. Each participant completed a survey with questions regarding demographic, socioeconomic, and risk factors for toxoplasmosis. Blood samples from participants were tested for presence of IgG and IgM antibodies against T. gondii using a chemiluminescent microparticle immunoassay. RESULTS: The prevalence of IgG and IgM antibodies was 62.3% and 2.5%, respectively. Variables that proved to be independent predictors of infection were age, low levels of education, and previous diagnosis of toxoplasmosis. CONCLUSIONS: The high prevalence of toxoplasmosis serological markers in this adult population highlights the need to promote preventive practices, especially those directed toward women of childbearing age, in this part of Brazil.

Fatores associados e índice de adiposidade corporal (IAC) em adultos: estudo de base populacional / Factors associated with body adiposity index (BAI) in adults: population-based study

Resumo Objetivou-se analisar os fatores associados ao índice de adiposidade corporal. Um estudo transversal de base populacional foi conduzido com 964 adultos, de 20 e 59 anos, em Viçosa, MG, Brasil. Aplicou-se questionários domiciliares e medidas antropométricas para se obter os dados. A análise múltipla foi realizada por meio de regressão linear, ajustada pelo efeito do desenho amostral. A prevalência de excesso de adiposidade corporal foi 36,89 (IC 30,81-43,43), sendo mais elevada nos homens (48,18% - IC 39,09-57,34). Associou-se positivamente com o índice de adiposidade corporal o sexo feminino (p = 0,002), idade em anos (p < 0,001), aqueles que viveram com companheiro (p = 0,022) e com insatisfação com a imagem corporal (p < 0,001). A autoavaliação da saúde positiva (p = 0,048) esteve associada negativamente com o índice de adiposidade corporal. A prevalência de excesso de adiposidade corporal foi elevada, sendo o sexo, a faixa etária, o estado civil, a autoavaliação da saúde e a insatisfação com a imagem corporal fatores determinantes para o aumento da adiposidade corporal, nesta população, indicando um forte risco para doenças crônicas não transmissíveis decorrentes do excesso de adiposidade.

Abstract The objective of this study was to analyze factors associated with the body adiposity index. A population-based, cross-sectional study was conducted with 964 adults between 20 and 59 years of age, in Viçosa, State of Minas Gerais, Brazil. Household questionnaires and anthropometric measurements were applied to obtain data. Multiple analysis was performed using linear regression, adjusted for the sampling design effect. The prevalence of excess body adiposity was 36.89 (CI 30.81 to 43.43), being higher among men (48.18% - CI 39.09 to 57.34). Factors positively associated with body adiposity index were: female sex (p = 0.002); age in years (p < 0.001); those living with a partner (p = 0.022). Self-evaluation of positive health (p = 0.048) was negatively associated with the body adiposity index. The prevalence of excess body fat was high and the sex, age, marital status, health self-evaluation and dissatisfaction with body image were determinant factors to the increase in body adiposity in this population, indicating a marked risk for chronic diseases resulting from excess body fat.

Decliners of provider-initiated HIV testing and counselling: Characteristics of participants who refused HIV testing in a population survey in Zambia

Objective: To assess the prevalence of HIV infection, to highlight HIV-testing refusal rates among participants in a population-based tuberculosis survey and to assess the implication for programme implementation. Methods: This cross-sectional study on the characteristics of participants who refused HIV testing was conducted in a national survey in Zambia. All eligible participants were aged above 15 years and included in the analysis. Results: Out of the 44 791 tuberculosis survey participants, 14 164 (31.6%) refused to participate in HIV testing. The unemployed, rural dwellers, married, and those aged 15- 24 years were associated with higher refusal rates. Conclusions: Strategies to improve HIV testing acceptance are necessary. Qualitative research is recommended to understand the reasons for testing refusals so that remedial interventions can be implemented.

Tendencias del uso de drogas en la Ciudad de México: Encuesta de estudiantes, octubre 2012 / Drug use trends in Mexico City: 2012 students survey

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.

Population-based Estimates of Acute Gastrointestinal and Foodborne Illness in Barbados: A Retrospective Cross-sectional Study.

The aim of this study was to determine the burden and impact of acute gastroenteritis (AGE) and foodborne diseases (FBDs) in Barbados through a retrospective, cross-sectional population survey and laboratory study in August 2010–August 2011. Face-to-face interviews were conducted with one person from each of 1,710 randomly-selected households. Of these, 1,433 (84%) interviews were completed. A total of 70 respondents reported having experienced AGE in the 28 days prior to the interview, representing a prevalence of 4.9% and an annual incidence rate of 0.652 episodes per person-year. Age (p=0.01132), season (p=0.00343), and income (p<0.005) were statistically associated with the occurrence of AGE in the population. Norovirus was the leading foodborne pathogen causing AGE-related illness. An estimated 44,270 cases of AGE were found to occur during the period of the study and, for every case of AGE detected by surveillance, an additional 204 cases occurred in the community. Economic costs of AGE ranged from BD$ 9.5 million to 16.5 million (US$ 4.25-8.25) annually. This study demonstrated that the public-health burden and impact of AGE and FBD in Barbados were high and provided the necessary baseline information to guide targeted interventions.

Magnitude, Distribution, and Estimated Level of Underreporting of Acute Gastroenteritis in Jamaica.

Jamaica is the third largest island in the Caribbean. The epidemiology of acute gastroenteritis (AGE) is important to Jamaica, particularly in the areas of health, tourism, and because of the potential impact on the local workforce and the economy. Data collected by the National Surveillance Unit on the prevalence of AGE transmitted by food are not accurate. To determine the true magnitude, risk factors, and the extent of underreporting of AGE in Jamaica, we conducted a cross-sectional, population-based retrospective survey during the periods of 21 February–7 March and 14-27 June 2009, corresponding to high- and low-AGE season respectively. Of the total 1,920 persons selected randomly by a multistage cluster-sampling process, 1,264 responded (response rate 65.8%). Trained interviewers administered a standardized, validated questionnaire during face-to-face interviews. The overall prevalence of self-reported AGE was 4.0% (95% CI 2.9-5.1) at a rate of 0.5 episodes/per person-year. The highest monthly prevalence of AGE (14.6%) was found among the 1-4 year(s) age-group and the lowest (2.1%) among the 25-44 years age-group. Of the 18 cases (36%) who sought medical care, 11% were hospitalized, 33% were treated with antibiotics, and 66.7% received oral rehydration fluids. Only 2 cases who sought medical care reportedly submitted stool specimens. The mean duration of diarrhoea was 3.1 days, which resulted in a mean loss of 4 productive days, with over half of the cases requiring someone to care for them. The burden of syndromic AGE for 2009 was extrapolated to be 122,711 cases, showing an underreporting factor of 58.9. For every laboratory-confirmed AGE case, it was estimated that 383 more cases were occurring in the population. This research confirms that the prevalence of AGE is underreported in Jamaica and not being adequately detected by the current surveillance system. The components of the integrated surveillance system for AGE in Jamaica, particularly the laboratory aspect, need to be strengthened.

Burden and Impact of Acute Gastroenteritis and Foodborne Pathogens in Trinidad and Tobago.

Objectives of this study were to determine the burden and impact of acute gastroenteritis (AGE) and foodborne pathogens in Trinidad and Tobago. A retrospective, cross-sectional population survey, based on selfreported cases of AGE, was conducted in November-December 2008 and May-June 2009 (high- and low- AGE season respectively) by face-to-face interviews. From 2,145 households selected to be interviewed, the response rate was 99.9%. Of those interviewed, 5.1% (n=110; 95% CI 4.3-6.2) reported having AGE (3 or more loose watery stools in 24 hours) in the 28 days prior to the interview (0.67 episodes/person-year). Monthly prevalence of AGE was the highest among children aged <5 years (1.3 episodes/year). Eighteen (16%) persons with AGE sought medical care (4 treated with oral rehydration salts and 6 with antibiotics), and 66% reported restricted activity [range 1-16 day(s)]. The mean duration of diarrhoea was 2.3 days (range 2-10 days). One case submitted a stool sample, and another was hospitalized. Overall, 56 (10%) AGE specimens tested positive for foodborne pathogens. It was estimated that 135,820 AGE cases occurred in 2009 (84% underreporting), and for every 1 AGE case reported, an additional 6.17 cases occurred in the community. The estimated economic cost of AGE ranged from US$ 27,331 to 19,736,344. Acute gastroenteritis, thus, poses a huge health and economic burden on Trinidad and Tobago.

Estimating the Burden of Acute Gastrointestinal Illness in Grenada.

This is the first study conducted in Grenada, with a population of approximately 108,000, to quantify the magnitude, distribution, and burden of self-reported acute gastroenteritis (AGE). A retrospective population survey was conducted in October 2008 and April 2009 and a laboratory survey from October 2008 to September 2009. The estimated monthly prevalence of AGE was 10.7% (95% CI 9.0-12.6; 1.4 episodes/ person-year), with a median of 3 days of illness. Of those who reported AGE, 31% sought medical care (stool samples were requested from 12.5%); 10% took antibiotics; 45% took non-prescribed medication; and 81% reported restricted activity. Prevalence of AGE was significantly higher among children aged <5 years (23.5%, p<0.001). Of the AGE stool samples submitted to the laboratory for analysis, 12.1% were positive for a foodborne pathogen. Salmonella enteritidis was the most common foodborne pathogen associated with AGE-related illness. The estimated percentage of underreporting of syndromic AGE to the Ministry of Health was 69%. In addition, for every laboratory-confirmed foodborne/AGE pathogen, it was estimated that there were 316 additional cases occurring in the population. The minimum estimated cost associated with treatment for AGE was US$ 703,950 each year, showing that AGE has a potentially significant economic impact in Grenada.

Estimativa de consumo de sodio pela populacao brasileira, 2008-2009 / Estimativa de consumo de sodio por la poblacion brasilena, 2008-2009 / Estimated sodium intake for the Brazilian population, 2008-2009

OBJETIVO: Atualizar estimativas sobre consumo de sódio no Brasil. MÉTODOS: Foram utilizados dados da Pesquisa de Orçamentos Familiares 2008-2009. Realizou-se a conversão em nutrientes dos registros de aquisição de alimentos dos domicílios brasileiros por meio de tabelas de composição de alimentos. Foram calculadas a disponibilidade média de sódio/pessoa/dia e a disponibilidade média ajustada para um consumo energético diário de 2.000 kcal. Calculou-se a contribuição de grupos de alimentos selecionados para o total de sódio disponível para consumo no domicílio e comparou-se com aqueles da Pesquisa de Orçamentos Familiares 2002-2003. RESULTADOS: A quantidade diária de sódio disponível para consumo nos domicílios brasileiros foi de 4,7 g para ingestão diária de 2.000 kcal, mantendo-se mais de duas vezes superior ao limite recomendado de ingestão desse nutriente. A maior parte do sódio disponível para consumo provém do sal de cozinha e de condimentos à base de sal (74,4%), mas a fração proveniente de alimentos processados com adição de sal aumentou linear e intensamente com o poder aquisitivo domiciliar (12,3% do total de sódio no quinto inferior da distribuição da renda por pessoa e 27,0% no quinto superior). Observou-se redução na contribuição de sal e condimentos à base de sal (76,2% para 74,4%) e dos alimentos in natura ou processados sem adição de sal (6,6% para 4,8%) e aumento dos alimentos processados com adição de sal (15,8% para 18,9%) e dos pratos prontos (1,4% para 1,6%) na comparação com a Pesquisa de Orçamentos Familiares 2002-2003. CONCLUSÕES: O consumo de sódio no Brasil mantém-se em níveis acima da recomendação máxima para esse nutriente ...

OBJETIVO: Actualizar estimativas sobre consumo de sodio en Brasil. MÉTODOS: Se utilizaron datos de la Investigación de Presupuestos Familiares 2008-2009. Se realizó la conversión en nutrientes de los registros de adquisición de alimentos de los domicilios brasileños por medio de tablas de composición de alimentos. Se calcularon la disponibilidad promedio de sodio/persona/día y la disponibilidad promedio ajustada para un consumo energético diario de 2000 kcal. Se calculó la contribución de grupos de alimentos seleccionados para el total de sodio disponible para consumo en el domicilio y se comparó con los datos de la Investigación de Presupuestos Familiares 2002-2003. RESULTADOS: La cantidad diaria de sodio disponible para consumo en los domicilios brasileños fue de 4,7 g para ingestión diaria de 2000 kcal, manteniéndose más de dos veces mayor al límite recomendado de ingestión de dicho nutriente. La mayor parte del sodio disponible para consumo proviene de la sal de cocina y de condimentos a base de sal (74,4%), sin embargo, la fracción proveniente de alimentos procesados con adición de sal aumentó linear e intensamente con el poder adquisitivo domiciliar (12,3% del total de sodio en la quinta parte inferior de la distribución de renta por persona y 27,0% en la quinta parte superior). Se observó reducción en la contribución de sal y condimentos a base de sal (de 76,2% a 74,4%) y de los alimentos in natura o procesados sin adición de sal (de 6,6% a 4,8%) y aumento de los alimentos procesados con adición de sal (de 15,8% a 18,9%) y de las comidas listas (de 1,4% a 1,6%) en comparación con la Investigación de Presupuestos Familiares 2002-2003. CONCLUSIONES: El consumo de sodio en Brasil se mantiene en niveles por encima de la recomendación máxima para dicho nutriente ...

OBJECTIVE: To update estimates of sodium intake in Brazil. METHODS: We used data from the Brazilian Household Budget Survey of 2008-2009. Records of food purchases of households were converted into nutrients using food composition tables. Mean sodium availability per person per day and mean adjusted availability for a 2,000 kcal daily energy intake were calculated. The contribution of food groups to the total household sodium availability was calculated and compared to results estimated from the 2002-2003 Household Budget Survey. RESULTS: Mean daily sodium available for consumption in Brazilian households was 4.7 g per 2,000 kcal per day, thus still more than twice the recommended levels of intake for this nutrient. Although most of the sodium available for intake is derived from table salt or salt-based condiments (74.4%), the fraction derived from processed foods with added salt showed a strong linear increase with household income (12.3% of total sodium intake in the lower quintile of per capita income distribution and 27.0% in the upper quintile). There was a reduction in the contribution of salt and salt-based condiments (76.2% to 74.4%) and fresh or processed foods without added salt (6.6% to 4.8%) and an increase of processed foods with added salt (15.8% to 18.9%) and ready meals (1.4% to 1.6%), when compared to results estimated from the 2002-2003 Household Budget Survey. CONCLUSIONS: Sodium intake in Brazil remains at levels above the recommended maximum for this nutrient in all Brazilian macro regions and income strata. There was stability in the total household sodium availability, and an increase in the fraction from processed foods with addition of salt and ready meals, when comparing 2008-2009 with 2002-2003. .

Uso de contraceptivos orais entre mulheres de 18 a 49 anos: inquérito populacional telefônico / Oral contraceptive use among women 18-49 years: a population survey

As mulheres em idade reprodutiva representam cerca de 30% da população brasileira. A elas são direcionadas ações governamentais referentes ao planejamento familiar que visam garantir acesso amplo e integral às informações e aos métodos contraceptivos. O Ministérioda Saúde adota critérios de elegibilidade clínica (diretrizes clínicas baseadas em evidências científicas para orientar a prescrição e o uso desses métodos a fim de garantir sua eficácia e de evitar danos a saúde de quem os utiliza) desenvolvidos pela Organização Mundial de Saúde.Dentre os métodos para o planejamento familiar, o mais utilizado no mundo é o contraceptivo oral (ACO). OBJETIVOS: conhecer os padrões de utilização de métodos contraceptivos na população feminina brasileira e avaliar o uso adequado dos contraceptivos orais segundo oscritérios de elegibilidade clínica averiguando a ocorrência de iniquidades. METODOLOGIA: estudo epidemiológico de base populacional, transversal e descritivo que utilizou dados secundários provenientes do VIGITEL, que coleta informações sobre os fatores de risco e proteção para doenças crônicas da população brasileira por meio de entrevistas telefônicas. Refere-se à população feminina brasileira de 18 a 49 anos residente nas 26 capitais e no Distrito Federal e servida por linha de telefonia fixa para o ano de 2008 (n=21074). Asestimativas foram calculadas observando-se um intervalo de confiança de 95%. A escolaridade foi utilizada como proxy de condição socioeconômica para a análise de iniquidades. O uso inadequado de contraceptivos orais foi definido como o uso de ACO na presença de um ou mais dos seguintes fatores: hipertensão e/ou tabagismo em mulheres com mais de 35 anos e/ou doença cardiovascular. Por se tratar de amostra probabilística foram utilizados pesos para correção e inferências. Todas as informações são autorreferidas e oconsentimento livre e esclarecido foi substituído pelo consentimento verbal. RESULTADOS: cerca de 70% das mulheres...

Women in reproductive age represent about 30% of the Brazilian population. The government actions directed to them are related to family planning ensuring full and open access to information and contraceptive methods. The Ministry of Health adopts clinical eligibilitycriteria (clinical procedures based on scientific evidence to guide the prescription and use those methods to ensure their effectiveness and to avoid damaging the health of those who use them) developed by the World Health Organization. Among methods for family planning, theworld's most used is the oral contraceptive (OC). OBJECTIVES: To know the using patterns of contraceptives in Brazilian women and evaluate the appropriate appliance of oral contraceptives according to the clinical eligibility criteria that ascertains the occurrence of iniquities. METHODS: A population-based epidemiological study, which used cross-sectionaldescriptive secondary data from the VIGITEL, which collects information on risk factors for chronic diseases and protection of the population through telephone interviews. It considers the Brazilian female population 18-49 years, living in 26 state capitals and the Federal District, attended by fixed telephone line on the year 2008 (n = 21074). The estimations were calculated by observing an accuracy range of 95%. Educational level was used as proxy of socioeconomic status for the inequities analysis. The inappropriate use of oral contraceptives is defined with the presence of the following factors: hypertension and / or smoking in womenover 35 years and / or cardiovascular disease. Due to the probabilistic nature of the samples, weights were used for correction and inferences. All information is self reported and informed consent was replaced by verbal consent. RESULTS: Approximately 70% of women use somekind of family planning method, the OC is the most used (33.8%). Hypertension (15.5%) and smoking (12.2%) were the main risk factors for...

Violência familiar contra a criança e perspectivas de intervenção do Programa Saúde da Família: a experiência do PMF/Niterói (RJ, Brasil) / Domestic violence against children and prospects for intervention of the Family Health Program: the experience of the Family Doctor Program/Niterói (RJ, Brazil)

This study seeks to estimate the prevalence of psychological and physical violence practiced against children in the family environment among clients of the Family Medical Program in Niterói (RJ). It also discloses some potential opportunities for action in the prevention, early detection and monitoring of families experiencing violence. This population-based survey was conducted with face-to-face interviews with parents or legal sponsors of 278 children registered in 27 teams of the Family Health Program. The population studied was randomly selected among children up to ten years of age. The Brazilian version of Parent-Child Conflict Tactics Scales - CTSPC was employed to assess the occurrence of this type of violence. Psychological aggression occurred in 96.7 percent (CI 95 percent: 94.7-98.8) of the households, and corporal punishment occurred in 93.8 percent (CI 95 percent: 92.0-96.7). Minor physical violence was reported by 51.4 percent (CI 95 percent: 45.5-57.3) of the respondents, and severe physical maltreatment by 19.8 percent (CI 95 percent: 15.1-24.5) of them. Although the mother was the foremost perpetrator of all kinds of maltreatment, most of the children were abused by both parents. In view of these results, domestic violence against children should be seen as a main concern for the Family Health Program.

O objetivo do estudo é estimar a prevalência e caracterizar a Violência Familiar contra Crianças (VFC) adscritas ao Programa Médico de Família de Niterói/RJ, discutindo possibilidades de atuação das equipes visando à prevenção, detecção precoce e acompanhamento de famílias em situação de violência. Trata-se de um inquérito de base populacional, com amostra de 278 crianças, selecionadas através de amostragem sistemática, dentre aquelas adscritas a 27 equipes de Saúde da Família. A prevalência de VFC foi estimada utilizando-se a versão nacional da Conflict Tactics Scale Parent-Child (CTSPC). A agressão psicológica ocorreu em 96,7 por cento (IC 95 por cento: 94,7-98,8) dos domicílios. O castigo corporal foi referido por 93,8 por cento (IC 95 por cento: 92,0-96,7) dos respondentes. A violência física menor e a grave foram praticadas por 51,4 por cento (IC 95 por cento: 45,5-57,3) e 19,8 por cento (IC 95 por cento: 15,1-24,5) das famílias, respectivamente. A mãe foi a principal autora de todos os tipos de maus-tratos, embora a maioria das crianças sofra agressões psicológicas e punições corporais por parte de ambos os pais. Diante das altas prevalências e do envolvimento de toda a família nas situações de violência, preconiza-se que o problema seja considerado prioridade na Estratégia Saúde da Família.

Tendencias del uso de drogas en la Ciudad de México: Encuesta de Estudiantes del 2009 / Drug use trends in Mexico City: 2009 students survey

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 <

Prevalencia de enfermedad respiratoria en la población de la ciudad de Bahía Blanca / Prevalence of respiratory diseases in the population of the city of Bahia Blanca

Antecedentes. Se encuentran en el partido empresas químicas, petroquímicas y granarias. Están registrados 130.000 vehículos. Se realizaron estudios sobre prevalencia de enfermedades y factores de riesgo en distintas zonas . No se conoce la prevalencia de enfermedades respiratorias en la ciudad. Objetivos. Describir la frecuencia de asma, rinitis y factores de riesgo. Efectuar comparaciones. Metodología. Estudio de corte transversal por modalidad de encuesta de propósitos múltiples en hogares. Para la estimación del n se utilizó la prevalencia de asma ( 4 %), encontrada en estudios previos, un error absoluto de 0.8 % (ER=20 %) y un nivel de confianza del 95 %. Se efectuó un muestreo por conglomerados con submuestreo, con probabilidades proporcionales a su tamaño, aplicando el efecto de diseño (deff = 2). Se utilizó el cuestionario usado en otros estudios. Resultados. Se encuestaron 1447 viviendas, n = 4766 personas. El 18% refirió padecer algún tipo de enfermedad respiratoria. Rinitis 12,7% (607/4766), síntomas indicadores de asma (SIA) 3,4% (163/4766) y asma 2,6% (125/4766). El 19,8% padecía SIA con rinitis (OR = 3,57; IC95%: 2,30-5,54) y el 17,8% de los que referían asma padecían rinitis (OR = 3,04; IC95%: 1,83-5,07). La prevalencia de tabaquismo fue de 20%, encontrándose asociación entre inhalar humo y SIA. Se halló asociación entre obesidad y rinitis. Conclusiones. La prevalencia de asma y rinitis fue similar a la hallada en Argentina. La frecuencia de SIA fue notoriamente inferior. La prevalencia de asma en la ciudad sería del 6%. Se ratifica el subdiagnóstico de asma hecho que contribuye a los tratamientos inadecuados referidos. La comparación con los resultados de los estudios anteriores, ratificarán o no la existencia de áreas de mayor riesgo para padecer enfermedad respiratoria(AU)

Background. In the place there are chemical, petrochemical and granaries companies. There are registrered 130.000 vehicles. Studies were realized on prevalence of diseases and factors of risk in different zones. There is not known the prevalence of respiratory diseases in the city. Proposes. To describe the frequency of asthma, rinitis and factors of risk. To carry out comparisons. Methodology. Study of transverse cut for modality of survey of multiple proposes in homes. For the estimation of n there was in use the prevalence of asthma (4%), found in previous studies, a mean error of 0.8 % (ER = 20%) and a confidence level of 95%. A sampling was effected by conglomerates with subsampling, by proportional probabilities to its size, applying the effect of design (deff=2). The questionnaire applyed was used in other studies. Results. There were polled 1447 housings, n = 4766 persons. The 18% answered to suffer some kind of respiratory disease. Rhinitis: 12.7% (607/4766), Symptoms Indicators of Asthma (SIA): 3.4% (163/4766) and asthma: 2.6% (125/4766). The 19.8% was suffering SIA with rhinitis ­OR = 3.57 (95% CI: 2.30-5.54 )­ and 17.8% of those who were recounting asthma they were suffering rhinitis ­OR = 3.04 (95% CI: 1.83-5.07)­. The prevalence of smoking was 20%, being association between inhaling smoke and SIA. Association was situated among obesity and rhinitis. Conclusions. The prevalence of asthma and rhinitis was similar to found in Argentina. SIA's frequency was glaringly low. The prevalence of asthma in the city would be 6 %. There is corroborated the made subdiagnosis of asthma that its ratified to the inadequate above-mentioned treatments. The comparison with the results of the previous studies, they will corroborated or not the existence of areas of major risk to suffer respiratory disease. (AU)