Clinical diagnosis delays and epidemiology of dengue fever during the 2002 outbreak in Colima, Mexico.

Dengue fever is a re-emergent and challenging public health problem in the world. Here, we assess retrospectively the epidemiological and clinical characteristics of the 2002 dengue epidemic in the state of Colima, Mexico. This study is carried out by analysing a database containing demographic, epidemiological and clinical information. Of the 4040 clinical dengue cases diagnosed in the hospitals of the Mexican Institute of Public Health in the state of Colima, 548 cases were confirmed by laboratory tests, and 495 cases presented at least one haemorrhagic manifestation. Of the total clinically diagnosed cases, the most common symptoms observed were: fever (99.6%), headache (92.4%), myalgia (89.4%) and arthralgia (88.6%). The most common haemorrhagic manifestations were: petechiae (7.1%), gingivitis (3.4%) and epistaxis (3.6%). The median time between the onset of illness and visit to the health care clinic (diagnostic delay) was 1 day (interquartile range [IQR]: 0-3). For cases presenting haemorrhagic manifestations, the diagnostic delay was higher (median: 2 days, IQR: 0-4) than for non-haemorrhagic cases (median: 1 day, IQR: 0-3). The proportion of males presenting haemorrhagic manifestations was higher than females (Fisher Exact test; p

The dynamics of pulmonary tuberculosis in Colima, Mexico (1999-2002).

Tuberculosis is a public health problem in Mexico. From 1999 to 2002, we assessed retrospectively the epidemiological, clinical, and treatment characteristics of pulmonary tuberculosis in the hospitals of the Mexican Institute of Public Health in the state of Colima (Mexico). We included 184 cases diagnosed with pulmonary tuberculosis. A database containing demographic, epidemiological, and clinical information was constructed and analyzed. We estimate a median patient delay of 83 d and a mean treatment delay of 2.3 d. Of 14 cases suspected for multiresistance and microbiologically assayed, 5 were found to carry a multi-drug-resistant strain. We also found a significant association between a short patient delay and the presence of hemoptysis (p = 0.002) or dyspnea (p<0.001). 86 patients (46.8%) were sputum smear microscopy negative at the end of treatment and 40 (21.7%) completed treatment giving an overall success rate of 68.5%, which compares unfavorably with the World Health Organization target success rate of 85%. Five (2.7%) patients failed treatment, 10 (5.4%) died, 39 (21.2%) interrupted treatment, and 4 (2.2%) transferred to another reporting unit. A 2002 strategic change in drug distribution seemed to prove successful.

Alacranismo en Colima: aspectos epidemiológicos / Scorpion sting in the state of Colima, Mexico: epidemiological aspects

Objetivo: describir el comportamiento epidemiológico de los casos con picadura de alacrán, informados en la Delegación Regional del Instituto Mexicano del Seguro Social (IMSS) en Colima, considerada zona epidémica.Material y métodos: se realizó estudio descriptivo de 4502 casos registrados durante 1998 en el Sistema de Información Médico-Operativo y el Sistema de Vigilancia Epidemiológica del IMSS. Se determinaron tasas y frecuencias absolutas y relativas. Resultados: la tasa de incidencia de picadura de alacrán fue de 218.3 por cada 10 mil usuarios derechohabientes; 26 por ciento de los casos ocurrió en menores de 15 años de edad, 68 por ciento en el grupo, de 15 a 64, y 6 por ciento en mayores de 64. En 40 por ciento de los casos (n = 1858) se administró suero antialacránico. La incidencia fue similar durante el año [febrero, 302 casos (6 por ciento); septiembre, 483 (10 por ciento); octubre, 440 (10 por ciento), respectivamente]. No se indicaron muertes. Conclusiones: La picadura de alacrán es un problema de salud en Colima, con una incidencia similar a lo largo del año, por lo cual se justifican acciones para prevenir, controlar y tratar dicha entidad clínica.