Public Policies and Programs for the Prevention and Control of Breast Cancer in Latin American Women: Scoping Review.

BACKGROUND: Breast cancer has positioned itself worldwide as one of the main public health problems, especially in Latin America. In some countries, several programs for the prevention and control of breast cancer in women have been developed and implemented on a permanent basis, but there are no public reports on the policies that originated such programs. OBJECTIVE: A scoping review of scientific publications that identify the type, extent, and scope of policies and programs for the prevention and control of breast cancer in Latin American women was performed, and the main results were presented in this paper. METHODS: This scoping review was carried out according to the method by Arksey and O'Malley based on 3 fundamental questions about breast cancer prevention and control policies in Latin America: their type, extent and scope, and reference framework. The search period was from 2000 to 2019, and the search was carried out in the following databases: MEDLINE (PubMed), MEDLINE (EbscoHost), CINAHL (EbscoHost), Academic Search Complete (EbscoHost), ISI Web of Science (Science Citation Index), and Scopus in English, Spanish, and Portuguese, and Scielo, Cochrane, and MEDES-MEDicina in Spanish and Portuguese. Of the 743 studies found, 20 (2.7%) were selected, which were analyzed using descriptive statistics and qualitative content analysis. RESULTS: The selected studies identified several Latin American countries that have generated policies and programs to prevent and control breast cancer in women, focusing mainly on risk communication, prevention and timely detection, effective access to health services, improvement of the screening process, and evaluation of screening programs. Evaluation criteria and greater participation of civil society in policy design and program execution are still lacking. This could undoubtedly help eliminate existing barriers to effective action. CONCLUSIONS: Although several Latin American countries have generated public policies and action programs for the prevention and control of breast cancer, a pending issue is the evaluation of the results to analyze the effectiveness and impact of their implementation given the magnitude of the public health problem it represents and because women and civil society play an important role in its prevention and control. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/12624.

The Moderating Effect of Resilience on Mental Health Deterioration among COVID-19 Survivors in a Mexican Sample.

Resilience has been reported to be a protective psychological variable of mental health; however, little is known about its role in COVID-19 survivors. Thus, in this study, we aimed to evaluate the levels of depression, anxiety, stress, traumatic impact, and resilience associated with COVID-19, as well as to investigate the role of resilience as a moderating variable. A sample of 253 participants responded to an online survey; all were previously diagnosed with COVID-19 by a nasopharyngeal swab RT-PCR test, were older than 18 years, and signed an informed consent form. Significant negative correlations were found between resilience and the mental health variables. Higher resilience was significantly related to a lower impact of the event, stress, anxiety, and depression when the number of symptoms was low. Only when the duration of COVID-19 was short and resilience levels were medium or high was psychological distress reduced. Moreover, resilience moderated the effects of COVID-19 on mental health, even if a relapse occurred. The results emphasize the need for interdisciplinary interventions aimed at providing COVID-19 patients with psychological and social resources to cope with the disease, as well as with probable relapses.

Prevalence of toxoplasma infection in Mexican newborns and children: a systematic review from 1954 to 2009.

Introduction. Recent studies in Mexico have shown that from 20/10,000 to 58/10,000 newborns with Toxoplasma infection could be undetected. The aim of this study was to determine the weighed prevalence of T. gondii infection and describe the epidemiological transition of infection in newborns. Methods. Research literature reporting Toxoplasma infection prevalence in Mexican newborns and children were searched in five international databases. Weighted prevalence was calculated by inverse variance-weighted method in asymptomatic and symptomatic study groups, and the epidemiological transition was estimated by a lineal regression analysis. Results. The weighed prevalence in 4833 asymptomatic newborns was 0.616%, CI95% (0.396%-0.835%) (P < 0.001), whereas, among 895 symptomatic newborns, the weighed prevalence was 3.02%, CI 95% (1.91%-4.1%) (P < 0.001). A downward trend of 0.25%/year represented an accumulated decrease of -13,75% in the prevalence in the symptomatic newborns throughout 55 years, whereas, in the asymptomatic children, the prevalence was similar over the course of the years. Conclusion. The high-weighted prevalence of congenital Toxoplasma infection in newborns justifies that Toxoplasma gondii testing be included in the screening programs for women during pregnancy and newborns in Mexico. A rapid diagnosis and treatment strategy could aid in limiting a potential damage to the newborns.

Factores geográficos en la epidemiología de la intoxicación por Karwinskia (tullidora) en México / Geographical factors in the epidemiology of intoxication by Karwinskia (tullidora) in Mexico

Las Parálisis Flácidas causadas por el consumo de los frutos de las plantas del género Karwinskia (tullidora) han emergido como un problema de salud pública en ciertas regiones de México. Investiga los factores geográficos asociados a esta patología, en 72 casos reportados en México de 1990 a 1994. La distribución geográfica de casos coincide con las 11 especies reportadas de Karwinskia en México. La mayoría se relacionaron con la K. humboldtiana y, en menor medida, con K. mollis, K. parvifolia, K. johnstonil y K. rzedowskii. La presencia de casos es mayor en regiones con climas secos (79,2 por cento), vegetación de Matorrales Aridos (41,7 por cento) y altitudes menores de mil metros (54,1 por cento). Se determinaron tres diferentes zonas de riesgo: la zona del río Balsas, la región norte del país, así como las zonas áridas y secas centrales de los estados de Puebla, Hidalgo, San Luis Potosí y Querétaro. Las comunidades menores de 2.500 habitantes y con niveles de bienestar y de educación bajos son las más afectadas.

Factores de riesgo para resistencia a drogas antifímicas en Chiapas, México / Risk factors for drug-resistant tuberculosis in Chiapas, Mexico

Objetivo. Determinar los factores de riesgo para resistencia antifímica en pacientes con tuberculosis pulmonar, en cuatro jurisdicciones sanitarias del estado de Chispas, México. Material y métodos. Se realizó un estudio de casos y controles en el cual se incluyeron pacientes con tuberculosis pulmonar diagnosticados por medio de baciloscopía, notificados durante 1992. Se aplicó una encuesta que incluía variables relacionadas con el diagnóstico, tratamiento y seguimiento de los pacientes con tuberculosis pulmonar y se recolectaron muestras de expectoración para su análisis. La pruebas de sensibilidad se realizaron con el método de las proporciones. Se consideró a un paciente con infección de M. tuberculosis resistente cuando existían colonias desarrolladas en la presencia de una o más drogas antifímicas. El grupo control estuvo constituido por pacientes con resultados negativos a baciloscopías y cultivos, y en caso de ser positivo este último, con informe de M. tuberculosis sensible a las drogas estudiadas. Resultados. Del total de 18 individuos con cultivos positivos y desarrollo de M. tuberculosis, 13 (72 por ciento) fueron resistentes a una o más drogas antifímicas y 10 a dos o más drogas, de los cuales tres fueron resistentes a cinco antifímicos. La resitencia más alta fue para la isoniacida con 77 por ciento. Los factores de riesgo detectados en la población estudiada fueron la monoterapia (RM=34.2), los abandonos del tratamiento (RM=6.86), el tiempo prolongado de evolución de la enfermedad (RM=6.40) y los multitratamientos (RM=28.3). Conclusiones. La proporción tan alta de pacientes resistentes a drogas antifímicas (72 por ciento), denota un grave problema de salud pública y es de clara consecuencia de los problemas originados por el manejo inadecuado del tratamiento antituberculoso

Objectives. To determine risk factors for antibiotic resistance in patients with pulmonary tuberculosis in four Health Jurisdictions of the state of Chiapas. Material and Methods. A case-control study was carried out in patients diagnosed by acid fast smear during 1992. A questionnaire was applied which included variables related to the diagnosis, treatment and follow-up of the patients. Sputum samples were collected for culture and sensitivity tests. A case of drug-resistant pulmonary tuberculosis was defined as the presence of culture colonies showing resistance to one or more drugs. The control group was patients with negative smears and cultures or positive cultures for M. tuberculosis sensitive to the specific drugs. Results. Of the total of 18 individuals reported to have positive cultures, 13 (72.2%) were resistant to one or more drugs. Resistance to two or more drugs was found in 10 of them of which three were resistant to five antituberculosis drugs. The most frequent resistance was to isoniazid (77%). Risk factors for resistance encountered in this patient population were monotherapy (OR= 34.2), abandonment of treatment (OR= 6.86), a prolonged period of illness (OR= 6.40), delay in diagnosis and a history of prior therapy (OR= 28.3). Conclusions. The high proportion of patients resistant to antituberculosis therapy poses a public health problem and is a clear consequence of the problems arising from inadequate treatment.