Factors Associated With Extrapulmonary Tuberculosis in Southeastern Mexico: A Case-Control Study.

INTRODUCTION: Extrapulmonary tuberculosis (EPTB) is a disease that can affect any organ or tissue. Due to its potential to cause more dangerous sequelae and the barriers to its timely diagnosis, greater clinical awareness of this disease is crucial. This study aimed to identify the factors associated with EPTB in the population of Oaxaca, Mexico. METHODS: This is an unpaired case-control study. The cases were patients with EPTB+ while the controls were patients with pulmonary tuberculosis (PTB+) registered in the Tuberculosis Epidemiological Surveillance System. Sociodemographic, clinical, and microbiological variables were recovered. Bivariate analyses were performed and logistic regression analyses were performed to calculate the odds ratio (OR). RESULTS: A total of 75 EPTB+ cases and 300 PTB+ controls were included. Of the total sample, 57.1% were men and 60.3% indigenous. The most frequent clinical presentations of EPTB+ were nodal (21.3%), miliary (21.3%), and breast (20.0%). According to logistic regression analysis, age <40 years (OR: 2.25 (95% CI: 1.13-4.49), female sex (OR: 1.92 (95% CI: 1.03-3.56)], urban residence (OR: 2.25 (95% CI: 1.11-4.55)), comorbidity with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (OR: 3.46 (95% CI: 1.31-9.10)), dyspnea (OR: 2.67 (1.22-5.82)), and adenopathy (OR: 3.38 (95% CI: 1.42-8.06)) were positively associated with EPTB+. CONCLUSION: These results can serve as a basis for screening EPTB+, thus improving the preventive and diagnostic capacity of local health services, taking as a starting point women under 40 years of age and patients with HIV/AIDS in urban areas, as well as the presence of adenopathy and dyspnea as clinical characteristics of the disease.

Estado nutricional y medidas antropométricas en escolares Zapotecas y no Zapotecas de Oaxaca, México / Nutritional status and anthropometric measurements in Zapotec and non-Zapoteca schoolchildren from Oaxaca, Mexico

Introducción: Los grupos indígenas se enfrentan a la discriminación y exclusión, lo que genera inequidades en el ámbito de la salud. Además, son nutricionalmente vulnerables, lo que afecta su potencial de crecimiento y desarrollo en comparación con población no indígena. Objetivo: comparar el estado nutricional y medidas antropométricas entre escolares zapotecas y no zapotecas de una región de Oaxaca, México. Material y métodos: estudio descriptivo trasversal en una muestra representativa de 477 escolares de 8 a 11 años de un municipio de Oaxaca. Se dividió a la población en zapoteco (Zap+) y no zapoteco (Zap-). Se obtuvo el peso, talla, circunferencia de cintura, circunferencia de brazo y el pliegue tricipital. Se calculó el IMC para la edad, el índice cintura-talla e indicadores del componente graso y muscular del brazo. Se utilizó la prueba chi cuadrada y exacta de Fisher para diferencias proporcionales Resultados: El 51,5% de escolares fue Zap+ y se reportó una alta prevalencia de sobrepeso y obesidad de 33,7%. Las niñas Zap+ presentaron mayor prevalencia de desmedro (p=0,032) y los niños Zap+ presentaron menor % área grasa de brazo (0,004). Entre niños y niñas Zap-, los niños presentaron bajo peso (p=0,040) y musculatura reducida (p=0,003), mientras que las niñas presentaron mayor proporción grasa arriba del promedio (p=<0,001). Los niños Zap- presentaron mayor prevalencia de desmedro en comparación con los Zap+ (p=0,022). Esta diferencia se mantuvo hasta los 11 años (p=0,007). Se observó que las niñas Zap+ de 11 años presentaron una menor musculatura (p=0.001) y mayor riesgo cardiovascular (p=0,032) en comparación con las Zap-. Conclusiones: Se observaron cambios seculares positivos en niños Zap+ reflejados en una mayor talla que las niñas Zap+ y niños Zap-, y una tendencia al aumento del IMC y riesgo cardiovascular en las niñas Zap+ lo cual podría reflejar una posible transición nutricional.(AU)

Introduction: Indigenous groups face discrimination andexclusion, which generates inequities in the field of health. Inaddition, they are nutritionally vulnerable, which affects theirgrowth and development potential compared to the non-in-digenous population. Objective: to compare the nutritional status and anthro-pometric measurements between Zapotec and non-Zapotecschoolchildren from a region of Oaxaca, Mexico. Material and methods: cross-sectional descriptive studyin a sample of 477 schoolchildren aged 8 to 11 from a mu-nicipality in Oaxaca. The population was divided into Zapotec(Zap+) and non-Zapotec (Zap-). Weight, height, waist cir-cumference, arm circumference and triceps fold were meas-ured. Anthropometric indicators and the fatty and muscularcomponent of the arm were calculated. A comparative analy-sis of nutritional status and body composition was performedbetween Zap+ and Zap- using chi square and Fisher’s exacttest. A p value <0.05 was considered significant. Results: 51.5% of schoolchildren were Zap+ and a highprevalence of overweight and obesity of 33.7% was reported.Zap+ girls had a higher prevalence of wasting (p=0.032) andZap+ boys had a lower % arm fat area (0.004). Among Zap-boys and girls, boys had low weight (p=0.040) and reducedmusculature (p=0.003), while girls had a higher proportion offat above average (p=<0.001). Zap- children had a higherprevalence of stunting compared to Zap+ children (p=0.022).It was observed that 11-year-old Zap+ girls had less muscle(p=0.001) and a higher cardiovascular risk (p=0.032) com-pared to Zap- girls. Conclusions: Positive secular changes were observed inZap+ boys, reflected in greater height than Zap- boys, and atrend in increasing BMI and cardiovascular risk in Zap+ girls,which could reflect a possible nutritional transition.(AU)

Dietary patterns associated with physical activity and sedentary behavior in university students in Mexico

Dietary patterns (DPs) are conditioned by a large number of factors, including physical activity and sedentary lifestyle, however, there is limited information on their interaction. This study aimed to identify DPs and their associations with physical activity and sedentary behavior among university students from Mexico. We conducted a cross-sectional, observational and analytical study. The participants were university students from Southwest Mexico. A total of 419 participants who did not suffer from any disease that affects oral nutrition or that prevented them from performing physical activity were included. DPs were generated from a principal component analysis and associations were analyzed using a logistic regression model. Three DPs were identified: "western", "prudent" and "traditional". The traditional pattern was significantly associated with high physical activity (OR: 2.78; 95% CI: 1.34-5.75) and was a protective factor against sedentary lifestyle (OR: 0.35; 95% CI: 0.13-0.93). The results show that a high physical activity and a lower sedentary lifestyle were associated with a healthier dietary pattern in the study population. It is important to implement interventions towards nutrition, physical activity and sedentary behavior for the population being studied.

Los patrones dietéticos están condicionados por una gran cantidad de factores, entre ellos la actividad física y el sedentarismo, sin embargo, existe poca información sobre su interacción. Este estudio tuvo como objetivo identificar patrones dietéticos y sus asociaciones con la actividad física y el comportamiento sedentario entre estudiantes universitarios del suroeste de México. Se trata de un estudio transversal, observacional y analítico. Los participantes fueron estudiantes universitarios del suroeste de México. Se incluyeron un total de 419 participantes que no padecían alguna enfermedad que condicionara su nutrición oral, ni condición que les impidiera realizar actividad física. Se realizó un análisis de componentes principales para determinar los patrones dietéticos, mientras que se utilizó un modelo de regresión logística para verificar las asociaciones. Se identificaron tres patrones dietéticos: "occidental", "prudente" y "tradicional". El patrón tradicional se asoció significativamente con actividad física elevada (OR: 2,78; IC 95%: 1,34-5,75) y fue un factor protector contra el sedentarismo (OR: 0,35; IC 95%: 0,13-0,93). Los resultados muestran que una alta actividad física y un menor sedentarismo se asociaron con un patrón dietético más saludable en la población de estudio. Es importante implementar intervenciones hacia la nutrición, la actividad física y el sedentarismo para la población en estudio.

Asociación entre la actividad física y el porcentaje de grasa en estudiantes universitarios de México / Association between physical activity and the percentage of fat in university students in Mexico

Fundamentos: El exceso de grasa se asocia con enfermedades metabólicas, siendo la actividad física (AF) y elsedentarismo los factores modificables más asociados. En universitarios existen cambios importantes en elestilo de vida que impactan en la composición corporal. El objetivo de esta investigación fue asociar la AF enMETs con el porcentaje de grasa (PG) en universitarios de México.Métodos: Estudio transversal, que incluyó 176 estudiantes universitarios del Istmo de Tehuantepec, México.Se evaluó el PG mediante bioimpedancia y la AF a través del Cuestionario Internacional de Actividad Física(IPAQ). Para asociar la AF con el PG se realizó una regresión lineal múltiple ajustado por edad, IMC ysedentarismo.Resultados: Se encontró una prevalencia conjunta de sobrepeso (SP) y obesidad (OB) de 47,2%, mostrandomayor IMC en hombres (p=0,010), el 36,9% tenía un exceso de PG, siendo mayor en mujeres (p<0,001), en lacategoría más alta de PG se mostró mayor proporción en hombres (p<0,001). Se observó una asociación inversaentre mayor cantidad de METs y menor PG (p=0,003).Conclusiones: La presente investigación revela la asociación inversa entre la AF y el PG en estudiantesuniversitarios; así como cifras elevadas de SP, OB y PG. Es importante generar intervenciones integrales de AFen universitarios. (AU)

Background: Excess fat is associated with metabolic diseases. The most associated modifiable factors arephysical activity (PA) and sedentary lifestyle. In university students there are important changes in lifestyle thatimpact body composition. The objective of this research was to associate PA in MET with the percentage ofbody fat (%BF) in university students from Mexico.Methods: Cross-sectional study, 176 university students from the Isthmus of Tehuantepec, Mexico, wereincluded, the %BF was evaluated through bioimpedance and the AF through the IPAQ. To associate PA with%BF, a multiple linear regression adjusted for age, BMI and sedentary lifestyle was performed.Results: we found a joint prevalence of overweight (OW) and obesity (OB) of 47.2%, showing a higher BMI inmen (p=0.010), 36.9% had an excess of %BF, being higher in women (<0.001), in the highest category of %BF itwas shown higher proportion in men (<0.001). An inverse association was observed between a higher amountof METs and a lower PG (p=0.003).Conclusions: The present investigation reveals the inverse association between PA and %BF in universitystudents; as well as high numbers of OW, OB and %BF. It is important to generate comprehensive PAinterventions in university students. (AU)

Factors associated with tuberculosis-diabetes mellitus type 2 binomial in rural population of Oaxaca, Mexico.

INTRODUCTION: Type 2 diabetes mellitus (T2DM) is a growing condition that hinders the treatment and control of tuberculosis (TB). Several factors promote this comorbidity showing variations according to characteristics of the population affected. The objective was to identify the factors associated with the comorbidity of TB-T2DM in a rural population of Oaxaca, Mexico. METHODOLOGY: This was an unpaired case-control study. Descriptive statistics was performed for clinical and sociodemographic variables. Logistic regression was used to calculate odds ratio (OR) to identify associated factors with TB-T2DM binomial. RESULTS: 126 controls (TB+ T2DM-) and 69 cases (TB+ T2DM+) were included. 43% were considered as indigenous population. Significant differences were found according to the groups. Treatment failure was higher in individuals with binomial (p = 0.015), as well as a higher bacillary load (two crosses) and presence of pulmonary TB (p ≤ 0.001). Association analysis showed that the risk factors of binomial were: female sex (OR = 2.47; 95% CI 1.24-4.92), age ≥ 45 years (OR = 2.90; 95% CI 1.42-5.92), body mass index ≥ 25 kg/m2 (OR = 2.69; 95% CI 1.25-5.77) and presenting > 6 symptoms (OR = 2.71; 95% CI 1.19-6.14). CONCLUSIONS: This is the first report of this comorbidity in a rural Mexican population. The results highlight the growing problem of TB-T2DM, and the need to address the issue from an integral and gender perspective. Furthermore, mandatory screening is necessary in patients with T2DM to improve early diagnosis of TB and T2DM. This would promote better management of both conditions.

Predictores antropométricos asociados a hiperglucemia en mujeres adultas zapotecas del Istmo de Tehuantepec, Oaxaca: un estudio transversal / Anthropometric predictors associated with hyperglycemia in adult Zapotec women from the Isthmus of Tehuantepec, Oaxaca: a cross-sectional study

Fundamentos: Las disparidades sociales en México han afectado a los grupos indígenas dejándolos en estadode vulnerabilidad ante las enfermedades crónicas, reflejando la necesidad de herramientas para undiagnóstico precoz de hiperglucemia. El objetivo de este estudio fue evaluar la capacidad predictiva demediciones antropométricas para identificar hiperglucemia en mujeres adultas zapotecas.Métodos: Estudio transversal analítico realizado en 130 mujeres zapotecas. Se efectuaron pruebasestadísticas como, t de student, U-mann-whitney y X2para variables sociodemográficas, antropométricas yclínicas. Se obtuvieron puntos de corte del IMC, CC y el ICT utilizando curvas ROC y se obtuvieron razones deprevalencia (RP) mediante regresión de Poisson con varianza robusta para su asociación conhiperglucemia. Un valor p<0.05 se consideró estadísticamente significativo.Resultados: Se encontró una elevada proporción conjunta de sobrepeso y obesidad de 90,6% ehiperglucemia (prediabetes y diabetes) de 43,1%. La CC y el ICT se asociaron significativamente (RP=1,75; IC:1,14-2,69) y (RP=1,75; IC: 1,12-2,75) aumentando 75% la probabilidad de hiperglucemia con puntos de cortede 97.5cm y 0.65 respectivamente.Conclusiones: La CC y el ICT son buenos predictores de hiperglucemia en la población estudiada, además detener la bondad de ser herramientas accesibles que se adaptan a las necesidades de grupos vulnerables. (AU)

Background: Social disparities in Mexico have affected indigenous groups leaving them in a state ofvulnerability to chronic diseases, reflecting the need for tools for early diagnosis. The objective of this studywas to evaluate the predictive capacity of anthropometric measurements to identify hyperglycemia in adultZapotec women.Methods: Cross-sectional analytical study conducted in 130 Zapotec women. Statistical tests such asStudent's t, Mann-Whitney U and X2 were performed for sociodemographic, anthropometric and clinicalvariables. Cut-off points for BMI, CC and CTI were obtained using ROC curves and prevalence ratios (PR) wereobtained by Poisson regression with robust variance for their association with hyperglycemia. A p-value <0,05was considered statistically significant.Results: We found a high combined proportion of overweight and obesity of 90,6% and hyperglycemia(prediabetes and diabetes) of 43,1%. CC and CTI were significantly associated (PR=1,75; CI:1,14-2,69) and(PR=1,75; CI: 1,12-2,75) increasing 75% the probability of hyperglycemia with cut-off points of 97,5 cm and0,65 respectively.Conclusions: CC and ICT are good predictors of hyperglycemia in the population studied, in addition to havingthe goodness of being accessible tools that adapt to the needs of vulnerable groups. (AU)

Association of Family History and Life Habits in the Development of Colorectal Cancer: A Matched Case-Control Study in Mexico.

Colorectal cancer (CRC) is one of the most frequently diagnosed cancers and, as such, is important for public health. The increased incidence of this neoplasm is attributed to non-modifiable controls such as family history and modifiable variable behavioral risk factors involved in lifestyle like diets in Mexico. The presence of these factors is unknown. Therefore, the aim of this study was to evaluate family history and lifestyle factors associated with developing colorectal cancer in a Mexican population. Descriptive statistics and multivariate logistic regression were used to estimate the adjusted odds ratios (OR), as well as the 95% confidence intervals (CI). In this paper, significant differences were demonstrated between cases and controls. A family history of cancer (FHC) increased the probability of CRC [OR = 3.19 (95% CI: 1.81-5.60)]. The area of urban residence was found to be a protective factor compared to the rural area. This was also the case for frequent consumption of fruits [OR = 0.49 (95% CI: 0.28-0.88)], the frequent consumption of beef [OR = 2.95 (95% CI: 1.05-8.26)], pork [OR = 3.26 (95% CI: 1.34-7.90)], and region-typical fried food [OR = 2.79 (95% CI (1.32-5.89)]. These results provide additional evidence supporting the association of some CRC risk factors with family history of cancer, low fruit consumption, high consumption of red meat, and fried foods typical of the region of México. It is important to establish intervention methods, as well as genetic counseling to relatives of patients with CRC.