[Burden of disease in the aged, Mexico, 1994]. / El peso de la enfermedad en adultos mayores, México 1994.

OBJECTIVE: To estimate the disability adjusted life years lost (DALYs) in population over 60 years of age in Mexico during 1994. MATERIAL AND METHODS: Years of life lost due to premature mortality (YLL) and years lived with disability (YLD) were estimated for 108 diseases, both sexes, and 32 states of the Mexican Republic divided in rural and urban areas in the population over 60 years of age, using the methodology originally proposed by Murray and López adapted to specific local characteristics. The inputs used were: mortality statistics for 1994 (after corrections of under-registration and misclassification), statistics on incidence and prevalence from local epidemiological studies, national health surveys and estimates by the authors. RESULTS: During 1994 the Mexican population over 60 years of age lost 1.8 million DALYs, 59% of which were YLL while 41% were YLD. Most of the burden of disease is due to noncommunicable diseases. The principal health needs of the elderly in Mexico can be divided in two groups: a) those that traditionally are frequent in this age group, such as ischaemic heart disease, diabetes, stroke and b) disabling diseases such as dementia, falls and arthritis as the most important. CONCLUSIONS: The use of composite indicators such as DALYs to assess health needs in older adult can help decision-makers and planners to incorporate disabling and lethal diseases within the list of priority needs, thereby achieving greater equity in the assignment of resources to different health care, prevention and rehabilitation programs.

Mortality from cervical carcinoma in Mexico: impact of screening, 1980-1990.

OBJECTIVE: To determine the temporal mortality trends of uterine cervical cancer in Mexico for the period 1980-1990. STUDY DESIGN: In Mexico, data from death certificates are collected in a national repository at the National Institute of Statistics, Geography and Informatics. These data were analyzed to obtain mortality trends, and regional variations were obtained for the same period using a Poisson regression model. RESULTS: The official mortality figure for cervical cancer for the study period was 37,982 cases. Subregistration due to misclassification was evident, particularly in the first five years of the study period; however, poor quality of information was proportionally distributed across the different age groups. A standardized analysis by quinquennia showed a steady mortality trend during the last 10 years, with slightly upward significant trends within some age groups (beta=0, P<.05). High regional variations in cervical cancer mortality risks were found using a Poisson regression model. Twenty-four states in Mexico showed an increased mortality risk when compared with Mexico City; seven states showed a steady or downward trend. CONCLUSION: The results show the ineffectiveness of the cancer screening program, underscoring the need to ensure access to and the quality of the cervical cancer screening program in order to decrease mortality rates.

[Mother's work and severity of accidental injuries in children]. / El trabajo materno y la gravedad de lesiones accidentales en niños.

A study was conducted in children under five years old, in order to establish the association between the mother's work and the severity of unintentional injuries. The study was carried out at the emergency room of six pediatric hospitals in Mexico City. Cases were children with major injuries that required hospitalization, intensive care, surgery, or who died as a result of the injury. Controls were children of similar age, with minor injuries resolved at the emergency room. Sample size was 350 cases and 350 controls. Variables were grouped according to: mother's occupation; characteristics of the child, socioeconomic status, child care, and those related with home risk factors. Results showed a protective effect on severity of injuries when the mother worked outside home in comparison to mothers who do not work, (or 0.79, 95%CI 0.57-1.07). No differences were found with respect to sex and age of children. Mother age under 24 years old and low schooling (< 3 years of elementary school) were statistically significant with a risk of major injuries (or 2.30, 95%CI 1.5-3.4). Delay of demand of medical care after 60 minutes of injury occurrence is related with a risk of major injury (or 1.68, 95% CI 1.2-2.3). No differences related with household risk factors were found. Results provide valuable information about risk factors related with injury severity and the association with mother's work.

[The risk factors for home accidents in children. A case-control study]. / Factores de riesgo de accidentes en el hogar en niños. Estudio de casos y controles.

INTRODUCTION: The main objective was to determine the risk factors involved in unintentional injuries in children under 10 years old occurring at home. MATERIAL AND METHODS: A Case Control study was conducted in the emergency room of three pediatrics hospitals in Mexico City. The sample size was 160 cases and 320 controls. RESULTS: Boys were more affected than girls (OR) 1.7, C.I. (95%) 1.2-2.5. The age group more affected was two-three years old (OR) 1.6, C.I.1.1-2.2. When children play outside home (roof, stairs, patio) the risk was OR 2.48, C.I. 1.63-3.76. If mother is not encharged of children care (OR) 2.9, C.I. 1.8-4.8. The age > 40 years old of the person encharged of children care (OR) 2.2, C.I. 1.4-3.5. CONCLUSIONS: The results showed us how necessary is to develop injury prevention programs especially to implement passive measures, with target populations people encharged of children care.

[Home accidents in children less than 10 years of age: causes and consequences]. / Acccidentes en el hogar en niños menores de 10 años. Causas y consecuencias.

A case-control study was carried out, aimed at identifying and defining the individual, family, household and childcare social support network characteristics, more likely to be associated with the occurrence of accidental home injuries in 0-9 year-old children. This study was carried out in the emergency units of three pediatric hospitals in the Federal District. In this article we report the results of the descriptive analysis only of the cases. The results were as follows: male children (62%) and the one and two year-old children group (37%) were the most affected. Contusions, head injuries and fractures occupied the first three places, the main three causes being falls from one level to another (mainly in stairways and off the bed) falls on the same level (sliding, tripping or stumbling) and burns with boiling liquids (most frequently boiling water for bathing). A history of injuries was documented in only 15% of cases. Thirty nine percent of cases requested medical attention after one hour of the accident; 51% of these were hospitalized. In 25% of cases, the mother worked outside the home, being absent from 6 to 12 hours. Risk factors occurring most frequently were: unprotected electricity inlets (40%); products within reach of children: cleaning products (38%), makeup products (34%), plastic bags (30%) and tools (30%); lack of protection rails for cradles (30%) and for staircases (48%), and free access to roofs (44%). In 62 percent of cases some care was provided in the house of the injured child; twenty six percent counted on a support network, and 3 percent were by themselves. We present some proposals for epidemiologic and health services research, and stress the necessity to implement health education, social security and health services policies to favorably influence the solution of these problems.

[Trends in mortality from ischemic cardiopathy in Mexico, from 1950 to 1985]. / Tendencia de la mortalidad por cardiopatía isquémica en México, de 1950 a 1985.

This paper presents the results of an ecologic study of the trends of ischemic heart diseases (IHD) (ICD 9th 410-414) from 1950 to 1985 in Mexico. The mortality rates area strongly related with age and sex. Among those aged 30 to 59 years old, the male-female ratio (MFR) was 2.5 whereas in those aged 60 or more the ratio was 1.2. The mortality rates for IHD increase over time, particularly when converted in logarithms (r = 0.89). There were important differences in the regional mortality patterns by age and gender. Among males the northern region showed a mortality risk 2.5 times higher than the southern region; this risk increases (3.0) in those older than 60 years old. The increasing risk modifiable risk factors such as smoking, cholesterol and hypertension.