Between tradition and change: condom use with primary sexual partners among Mexican migrants.

The frequency of male Mexico-US migration has been associated with increased HIV risk for sexual partners awaiting their return in Mexico. This study examined the association between sexual partner characteristics and condom use among a sample of 354 male migrants from two Mexican municipalities. Migrants were interviewed about their past year's sex practices. Results indicated that migrants were more likely to use condoms with their non-spousal partners, partners with less education than the migrant, and partners with higher employment status. Condom use was greater among younger migrants and residents of the more densely populated municipality. Findings suggest the coexistence of a traditional cultural orientation that does not support condom use and another one that does provided the sex partner is formally employed. Prevention programs must strengthen the structural conditions fostering greater equality between the sexes and adapt their approaches for different population density, age and partner types.

Iodine deficiency and its association with intelligence quotient in schoolchildren from Colima, Mexico.

OBJECTIVE: To determine the prevalence of iodine deficiency, its causes and its association with intelligence quotient (IQ) in Mexican schoolchildren. DESIGN: Cross-sectional analytical study, in which determinations of thyroid gland size, urinary iodine excretion, IQ, iron nutritional status, physical anthropometry, family consumption of goitrogenic foods, type/origin and iodine saturation of salt consumed at home and coliform organisms in drinking water were performed, and the association of each variable with IQ scores was evaluated by multiple regression analyses. SETTING: Municipality of Cuauhtémoc, in Colima, Mexico (altitude: 600-2700 m above sea level). Sea salt is extracted manually nearby and often used for human consumption. Goitre remains present in the region despite over half a century of mandatory salt iodination in the country. SUBJECTS: Three hundred and three children, similar proportions of boys and girls, mean age 9.3 years, randomly selected from 19 public elementary schools. RESULTS: Overall goitre rate was 21.4%; low urinary iodine excretion was found in 19.5% of the children, high urinary iodine excretion in 32.0%. IQ scores were transformed into percentile values, with the following categorisation: < or = P5 (low IQ), 48.5%; > P5 to < or = P25 (below average), 24.2%; > P25 to < P75 (average), 18.8%; > or = P75 to < P95 (above average), 3.6%; > or = P95 (high IQ), 4.9%. Ninety-two per cent of the population used iodinated salt, but deficient iodine saturation (<50 ppm) was found in 86.8% of salt samples. The main goitrogenic foods consumed were peanuts (by 31.5% of the sample), cabbage (30.1%), broccoli (27.7%) and cauliflower (25.7%). Median counts of coliform organisms (colony-forming units/100 ml of drinking water) were: 207.5 (well water), 151 (cisterns), 52 (private homes), 25 (elementary schools) and 12 (kindergartens). Moderate iodine deficiency was associated (P < 0.05) with a 4.26 times higher risk of low IQ. CONCLUSIONS: There is a perturbing negative impact of these findings on human capital acquisition for the region and the country. More attention is needed to ensure effective salt iodination processes, particularly in regions where goitrogens may contribute to the negative effects of iodine deficiency on the intellectual development of children.

[Frequency of intestinal helminthiasis and its association with iron deficiency and malnutrition in children from western Mexico]. / Frecuencia de helmintiasis intestinal y su asociación con deficiencia de hierro y desnutrición en niños de la región occidente de México.

OBJECTIVE: To determine intestinal helminthiasis frequency and its association with malnutrition and iron deficiency. MATERIAL AND METHODS: An analytical cross-over study was carried out on children in the municipality of Comala, Colima, Mexico. Coproparasitoscopic exams in series of three using the Kato-Katz technique were performed in all children. To evaluate the degree ofmalnutrition, the following anthropometric indices were determined: means and z-scores for weight/height, height/age, weight/age. Severe, moderate and minimal iron deficiency was considered when ferritin was: < or = 12 ng/ml, 12 to 18 ng/mL and 19 to 24 ng/mL, respectively. RESULTS: 243 children were studied with an average age of 65.3+/-8.7 months. 60.9% (n = 148) of the children showed a decrease in ferritin levels and 2.5% (n = 6) had anemia. 16% (n = 39) had trichuriasis, 6.9% (n = 17) ascariasis and 5.3% (n = 13) had both parasites. Trichiura infection was associated with declining health (OR 11.0, CI 3.9-30.8; p<0.001) and with iron deficiency, with cut-off points of <24 ng (OR 2.0, CI 1.0-3.9, p = 0.02) and <18 ng/ dL (OR 2.2, CI 1.2-4.2, p= 0.009). Ascaris infection was not associated with malnutrition or iron deficiency. CONCLUSIONS: Trichiura infection was associated with declining health and slight and moderate degrees of iron deficiency.

Frecuencia de helmintiasis intestinal y su asociación con deficiencia de hierro y desnutrición en niños de la región occidente de México / Frequency of intestinal helminthiasis and its association with iron deficiency and malnutrition in children from western Mexico

Objetivo: Determinar la frecuencia de helmintiasis intestinal y su asociación con desnutrición y deficiencia de hierro. Material y métodos: Se realizó un estudio transversal analítico en el municipio de Comala, Colima, México. A todos los niños, se les determinó coproparasitoscópico seriado de tres días con la técnica de Kato-Katz. Para evaluar el grado de desnutrición; se establecieron los siguientes índices antropométricos: mediana y puntajes Z para peso/ talla, talla/edad y peso/edad. Se consideró que había deficiencia de hierro severa, moderada o leve con ferritina ≤ 12 ng/ ml, de 12 a 18 ng/mL y de 19 a 24 ng/mL respectivamente. Resultados: Se estudiaron 243 niños con una edad promedio de 65.3 ± 8.7 meses. El 60.9 % (n = 148) y el 2.5 % (n = 6) de los niños presentaron disminución de la ferritina y anemia respectivamente. El 16 % (n = 39) mostró trichuriasis, el 6.9 % (n = 17) ascariasis y el 5.3 % (n = 13) ambas. La infección por Trichuris trichiura se asoció a desmedro (OR 11.0, IC 3.9-30.8; p < 0.001) y a deficiencia de hierro con puntos de corte de < 24 ng (OR 2.0, IC 1.0-3.9, p = 0.02) y < 18 ng/dL (OR 2.2, IC 1.2-4.2, p = 0.009). La infección por ascaris no se asoció con desnutrición o deficiencia de hierro. Conclusiones: La infección de T. trichiura se asoció con desmedro y deficiencia de hierro grado leve y moderado.

OBJECTIVE: To determine intestinal helminthiasis frequency and its association with malnutrition and iron deficiency. Material and METHODS: An analytical cross-over study was carried out on children in the municipality of Comala, Colima, Mexico. Coproparasitoscopic exams in series of three using the Kato-Katz technique were performed in all children. To evaluate the degree ofmalnutrition, the following anthropometric indices were determined: means and z-scores for weight/height, height/age, weight/age. Severe, moderate and minimal iron deficiency was considered when ferritin was: < or = 12 ng/ml, 12 to 18 ng/mL and 19 to 24 ng/mL, respectively. RESULTS: 243 children were studied with an average age of 65.3+/-8.7 months. 60.9% (n = 148) of the children showed a decrease in ferritin levels and 2.5% (n = 6) had anemia. 16% (n = 39) had trichuriasis, 6.9% (n = 17) ascariasis and 5.3% (n = 13) had both parasites. Trichiura infection was associated with declining health (OR 11.0, CI 3.9-30.8; p<0.001) and with iron deficiency, with cut-off points of <24 ng (OR 2.0, CI 1.0-3.9, p = 0.02) and <18 ng/ dL (OR 2.2, CI 1.2-4.2, p= 0.009). Ascaris infection was not associated with malnutrition or iron deficiency. CONCLUSIONS: Trichiura infection was associated with declining health and slight and moderate degrees of iron deficiency.

Concepciones culturales sobre el dengue en contextos urbanos de México / Cultural conceptions on dengue in urban contexts in Mexico

OBJETIVO: Explorar las dimensiones conceptuales del dengue en contexto urbano, a fin de generar hipótesis sobre actitudes comunitarias relacionadas a campañas preventivas. MÉTODOS: Estudio transversal exploratorio realizado entre marzo y abril de 2003 con 130 personas seleccionadas por muestreo propositivo en tres municipios con distintas prevalencias de dengue en México. Se aplicaron entrevistas semiestructuradas mediante técnicas de listados libres, sorteo de montones y triadas. Se indagaron términos asociados al dengue y grupos de dimensiones conceptuales. Se aplicó análisis de consenso mediante factorización de componentes principales y análisis dimensional mediante conglomerados jerárquicos y escalas multidimensionales. RESULTADOS: El modelo de consenso mostró alta homogeneidad en las concepciones del dengue (valores de 14.5 y 13.5 en los contextos de más prevalencia y de 5.4 en el de menor prevalencia). Las dimensiones comunes en las concepciones fueron: medidas de prevención, síntomas, causas y reservorios de Aedes aegypti (valor de verosimilitud: stress<0.28). En los tres contextos, predominó una concepción de la prevención basada en acciones públicas de autoridades sanitarias, mientras que las acciones individuales y comunitarias casi no se mencionaron. En la concepción también apareció una dimensión moral basada en una noción de higiene como mecanismo diferenciador de la comunidad cercana (limpia) frente a personas y comunidades externas (sucias y enfermas). CONCLUSIONES: Las concepciones culturales del dengue desfavorecen la participación comunitaria autogestiva en las campañas preventivas verticales y generan barreras para la modificación de prácticas comunitarias e individuales de prevención y control.

[Cultural conceptions on dengue in urban contexts in Mexico]. / Concepciones culturales sobre el dengue en contextos urbanos de México.

OBJECTIVE: To explore the conceptual dimensions of dengue in the urban context, aiming at creating hypotheses about community attitudes toward prevention campaigns. METHODS: An exploratory cross-sectional study was carried out between March and April 2003 comprising 130 people selected by proposition sampling in three municipalities with different dengue prevalences in Mexico. Semi-structured interviews were applied using free lists, pile sorts and triads. Dengue-related terms and groups of conceptual dimensions were investigated. A consensual analysis was performed by factorizing the major components as well as a dimensional analysis with hierarchical clustering and multidimensional scales. RESULTS: The consensual model showed high homogeneity in dengue conceptions (values of 14.5 and 13.5 in the most prevalent contexts, and 5.4 in the least prevalent one). The common dimensions of conceptions were: preventive measures, symptoms, causes and reservoirs of Aedes aegypti (goodness of fit test values: <0.28). In the three contexts studied, a conception of basic prevention based on public actions by health officials predominated while individual and community actions were almost never mentioned. A moral dimension also appeared in the conception based on a notion of hygiene as a differentiating mechanism between the nearby community (clean) and outside people and communities (dirty and sick). CONCLUSIONS: The cultural conceptions of dengue do not favor self-managed community involvement in vertical prevention campaigns, and create obstacles to modifying community and individual prevention and control practices.

[Knowledge about HIV/AIDS in young people from indigenous migrant day laborer families in Colima and Nayarit]. / Conocimientos sobre el VIH/sida en jóvenes de familias jornaleras migrantes indígenas en Colima y Nayarit.

Objective: to explore the pattern of knowledge about HIV/AIDS among young native migrant farm workers. Methods: analytical crosscut study. Sample: 135 young people selected by propositive sampling. A questionnaire about knowledge of HIV/AIDS and socio-demographics was applied. A descriptive analysis was made and a knowledge pattern was estimated by means of factorial analysis. Results: average age 19.9 ± 5.8, men 54.8 %, bilingual 79.4 %, elementary or no education, 78.7 %, single 60.4 %, Catholic 67.6 %, two or more work trips 61.8 %; 80.7 % had heard about HIV/AIDS, especially from informal information sources (72 %). Knowledge pattern was homogenous (greater consensus in Nayarit than in Colima: 6.2 versus 3.8) and directed towards building risk identities based on personage (prostitutes 88.1%, men having sex with other men 45 %) and urban setting (78 %). It includes uncertainty about the effectiveness of condoms, the mosquito as a vector, and dentists as transmitters. The pattern showed significant differences according to sex, education and migrant experience. Conclusions: the knowledge of young people does not favor safe sex practices, and the low risk perception could favor their vulnerability to HIV/AIDS.

Objetivo: explorar el patrón de conocimientos sobre VIH/sida en jóvenes indígenas jornaleros migrantes. Métodos: : estudio transversal analítico de 135 jóvenes seleccionados por muestreo propositivo. Se aplicó cuestionario sociodemográfico y de conocimientos de VIH/sida. Se realizó análisis descriptivo y se estimó un patrón de conocimientos mediante análisis factorial. Resultados: : edad 19.9 ± 5.8 años, hombres 54.8 %, bilingües 79.4 %, escolaridad primaria o ninguna 78.7 %, solteros 60.4 %, católicos 67.6 %, dos o más viajes laborales 61.8 %. El 80.7 % escuchó hablar de VIH/sida. El patrón de conocimientos fue homogéneo (consenso mayor en Nayarit que en Colima: 6.2 versus 3.8) y orientado a construir identidades de riesgo basadas en personajes (trabajadoras sexuales 88.1 %, hombres que tienen sexo con hombres 45 %) y contexto urbano (78 %). Incluye incertidumbre sobre la eficacia del condón al mosquito como vector (45 %) y a los dentistas como transmisores. Patrón con diferencias significativas por sexo, escolaridad y experiencia migratoria. Conclusiones: el conocimiento de los jóvenes desfavorece el uso de protección y una baja percepción del riesgo, que podrían propiciar la vulnerabilidad al riesgo de transmisión del VIH/sida.

[Migraine. Review of physiopathogeny and future alternative therapy]. / Migraña. Una revisión de la fisiopatogenia y alternativa terepéutica futura.

This work examines recent discoveries in physiopathogenesis, focusing on the combination of sequential events involved in migraine origin. Recent facts concerning active intestinal peptide, substance P, histamine, HI and H3 receptors, and H3-receptor agonists, all neuromodulators having an intimate relations ship with migraine were examined. Present-day recommended treatment, with an efficacy of barely 70%, and reasons for its poor performance were described. The authors state that the future of migraine treatment should be directed toward the search for drugs that directly interact with the above-mentioned neuromodulators, thus offering patients a more efficacious treatment and fewer undesirable side-effects.

Nalpha-methylhistamine safety and efficacy in migraine prophylaxis: phase I and phase II studies.

OBJECTIVE: To study the therapeutic potential of the subcutaneous administration of Nalpha-methylhistamine in migraine prophylaxis. BACKGROUND: The histamine catabolite, Nalpha-methylhistamine, possesses a selective affinity for H3 receptors. We consequently considered it viable to conduct a clinical pharmacological study to evaluate the safety and efficacy of this histaminergic H3 agonist in migraine prophylactic treatment, which specifically may inhibit the neurogenic edema response involved in migraine pathophysiology. METHODS: Phase I.-In a clinical trial of 30 healthy volunteers, the effects of the subcutaneous administration of Nalpha-methylhistamine and placebo were studied to assess undesirable symptomatic effects. Phase II.-In a clinical open study, we evaluated the efficacy of Nalpha-methylhistamine in reducing headache intensity, frequency, and duration; and in decreasing analgesic intake in 18 patients with migraine. RESULTS: Phase I.-None of the variables studied showed significant differences (P>.05), and no secondary effects were observed at doses below 10 ng. Phase II.-Nalpha-methylhistamine, at doses of 1 to 3 ng, significantly reduced (P<.0001) the frequency, intensity, and duration of migraine attacks, as well as the need for rescue analgesics. However, at doses greater than 3 ng, patients experienced intense headache. CONCLUSIONS: The present study provides evidence of the safety and efficacy of Nalpha-methylhistamine applied subcutaneously at doses of 1 to 3 ng twice a week.