Metodología de la Encuesta Nacional de Salud y Nutrición 2022 y Planeación y diseño de la Ensanut Continua 2020-2024.

OBJETIVO: Presentar el diseño de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2022 y cuantificar el avance de la Ensanut Continua 2020-2024. Material y métodos. La Ensanut 2022 es la tercera encuesta de la serie de en-cuestas denominada Ensanut Continua 2020-2024. En este documento se describe el alcance de la Ensanut 2022 y sus procedimientos de muestreo, medición y organización logís-tica. Además, se presenta el avance esperado de la Ensanut Continua 2020-2024 al concluir la Ensanut 2022. Resulta-dos. La Ensanut 2022 obtendrá, a nivel nacional, al menos 10 160 entrevistas completas de hogar y 9 441 resultados de seropositividad a SARS-CoV-2. CONCLUSIONES: La Ensanut 2022 estimará la prevalencia de seropositividad a SARS-CoV-2 a nivel nacional y regional y avanzará en la acumulación de información para alcanzar los objetivos de la Ensanut Con-tinua 2020-2024.

Incorporating respondent-driven sampling into web-based discrete choice experiments: preferences for COVID-19 mitigation measures.

To slow the spread of COVID-19, most countries implemented stay-at-home orders, social distancing, and other nonpharmaceutical mitigation strategies. To understand individual preferences for mitigation strategies, we piloted a web-based Respondent Driven Sampling (RDS) approach to recruit participants from four universities in three countries to complete a computer-based Discrete Choice Experiment (DCE). Use of these methods, in combination, can serve to increase the external validity of a study by enabling recruitment of populations underrepresented in sampling frames, thus allowing preference results to be more generalizable to targeted subpopulations. A total of 99 students or staff members were invited to complete the survey, of which 72% started the survey (n = 71). Sixty-three participants (89% of starters) completed all tasks in the DCE. A rank-ordered mixed logit model was used to estimate preferences for COVID-19 nonpharmaceutical mitigation strategies. The model estimates indicated that participants preferred mitigation strategies that resulted in lower COVID-19 risk (i.e. sheltering-in-place more days a week), financial compensation from the government, fewer health (mental and physical) problems, and fewer financial problems. The high response rate and survey engagement provide proof of concept that RDS and DCE can be implemented as web-based applications, with the potential for scale up to produce nationally-representative preference estimates.

Nationally representative SARS-CoV-2 antibody prevalence estimates after the first epidemic wave in Mexico.

Seroprevalence surveys provide estimates of the extent of SARS-CoV-2 infections in the population, regardless of disease severity and test availability. In Mexico in 2020, COVID-19 cases reached a maximum in July and December. We aimed to estimate the national and regional seroprevalence of SARS-CoV-2 antibodies across demographic and socioeconomic groups in Mexico after the first wave, from August to November 2020. We used nationally representative survey data including 9,640 blood samples. Seroprevalence was estimated by socioeconomic and demographic characteristics, adjusting by the sensitivity and specificity of the immunoassay test. The national seroprevalence of SARS-CoV-2 antibodies was 24.9% (95%CI 22.2, 26.7), being lower for adults 60 years and older. We found higher seroprevalence among urban and metropolitan areas, low socioeconomic status, low education and workers. Among seropositive people, 67.3% were asymptomatic. Social distancing, lockdown measures and vaccination programs need to consider that vulnerable groups are more exposed to the virus and unable to comply with lockdown measures.

Inseguridad alimentaria y percepción de cambios en la alimentación en hogares mexicanos durante el confinamiento por la pandemia de Covid-19.

Objetivo. Estudiar la asociación de la inseguridad alimentaria con los cambios percibidos en la alimentación durante el confinamiento por Covid-19 en México. Material y métodos. El nivel de inseguridad alimentaria se obtuvo utilizando la Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA) en 9 933 hogares de la Encuesta Nacional de Salud y Nutrición Continua 2020 Covid-19 (Ensanut -Continua- 2020 Covid-19). Los cambios en el consumo de grupos de alimentos durante el confinamiento se clasificaron en negativos, positivos o sin cambios durante el confinamiento. La asociación entre cambios en la alimentación e inseguridad alimentaria se analizó con modelos multinomiales ajustados por características sociodemográficas del hogar. Resulta-dos. Los hogares con reducción en el gasto en alimentos e inseguridad alimentaria severa mostraron mayor probabilidad de tener cambios negativos en su alimentación (0.43, IC95%: 0.40-0.46). Conclusiones. La inseguridad alimentaria severa se asocia con cambios negativos en la alimentación durante el confinamiento por Covid-19, en hogares con reducción del gasto en alimentos.

Metodología de la Encuesta Nacional de Salud y Nutrición 2021.

Objetivo. Describir el diseño de la Encuesta Nacional de Salud y Nutrición 2021 (Ensanut 2021). Material y métodos. La Ensanut 2021 es una encuesta probabilística de hogares que forma parte de la serie de Ensanut Continua 2020-2024. En esta ocasión se describen el alcance, el muestreo, la medición y la organización logística. Resultados. Se planea obtener al menos 12 060 entrevistas de hogar completas a nivel nacional y 9 837 muestras para determinar seropositividad a SARS-CoV-2 a nivel nacional. Conclusiones. La Ensanut 2021 permitirá realizar inferencias regionales sobre la prevalencia de seropositividad a SARS-CoV-2 y también acumular información para realizar inferencias estatales en el año 2024.

Prevalence of diabetes and glycemic control in Mexico: national results from 2018 and 2020.

OBJECTIVE: To estimate the prevalence of diabetes (diagnosed and undiagnosed), glycemic control in Mexico, and its associated factors. MATERIALS AND METHODS: We used data from Ensanut 2018 (n=12 648) and 2020 (n=2 309). We defined diabetes as fasting glucose ≥126 mg/dl or HbA1c≥6.5% or previously diagnosed; glycemic control was defined as HbA1c<7%. We fitted Poisson regression models to assess the association between diabetes, glycemic control, and potential associated factors. RESULTS: The total prevalence of diabetes was 16.8% in 2018 and 15.7% in 2020. In 2018, 38% of adults with diabetes were unaware of their disease, while in 2020 this figure was 29%. Glycemic control was observed in 42% of participants in 2018 and 39% in 2020. Longer disease duration was associated with lower glycemic control, while older age, having a diet, and being affiliated to IMSS, Pemex, Sedena, or private healthcare were associated with better control. CONCLUSION: Mexico is among the countries with the highest diabetes prevalence. A high proportion of adults with diabetes did not have a previous diagnosis, and the proportion with glycemic control is low. Strengthening screening to achieve a timely diagnosis, and improving glycemic control, should be key actions in the management of diabetes.

Factors associated with changes in movement behaviors in toddlers and preschoolers during the COVID-19 pandemic: A national cross-sectional study in Mexico.

Little is known about physical activity, screen time and sleep among Mexican toddlers and preschoolers. The COVID-19 pandemic led to the closure of childcare education centers and restrictions to spend time outdoors. This study aimed to investigate the correlates of changes in movement behaviors from before to during the early stages of the COVID-19 lockdown in a national sample of toddlers and preschoolers in Mexico. A cross-sectional study was conducted using an open online survey completed by caretakers of children aged 1-5 years from April to July 2020. The questionnaire enquired about the time spent in each movement behavior during a regular week before and during lockdown, and family and household characteristics. Factors associated with changes in movement behaviors were explored using adjusted linear regression models. A total of 631 children (3.3y, 95% CI: 3.1, 3.4) were included in the study. During lockdown, physical activity decreased by 25%, screen time doubled, and sleep quality declined in 17% (p < 0.001). Toddlers and preschoolers of older age, attending a childcare education center before the lockdown, with a screen in their bedroom, higher access to electronic devices, and lower socioeconomic level experienced greater changes during this period. Those with limits on the use of electronic devices, who had someone available to play with them, and availability of toys experienced less pronounced changes. Pandemic restrictions have impacted movement behaviors of toddlers and preschoolers, with disproportionate effects among lower socioeconomic levels. Interventions with a multi-level equity-oriented approach are urgently needed to mitigate these effects.

Metodología de la Encuesta Nacional de Salud y Nutrición 2020 sobre Covid-19.

Objetivo. Describir el diseño y los resultados de campo de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2020 so-bre Covid-19. Material y métodos. La Ensanut Covid-19 es una encuesta probabilística de hogares. En este artículo se describen los siguientes elementos del diseño: alcance, muestreo, medición, inferencia y logística. Resultados. Se obtuvieron 10 216 entrevistas de hogar completas y 9 464 resultados sobre seropositividad a SARS-CoV-2. La tasa de respuesta de hogar fue 80% y la de prueba de seropositividad de 44%. Conclusiones. El diseño probabilístico de la Ensa-nut Covid-19 permite hacer inferencias estadísticas válidas sobre parámetros de interés para la salud pública a nivel nacional y regional; en particular, permitirá hacer inferencias de utilidad práctica sobre la prevalencia de seropositividad a SARS-CoV-2 en México. Además, la Ensanut Covid-19 podrá ser comparada con Ensanut previas para identificar potenciales cambios en los estados de salud y nutrición de la población mexicana.