Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

This issue of Salud Pública de México on Health Equity in the Americas focuses on research studies and in­terventions related to this broad topic that reaches across the diverse populations of the Americas. These papers have the particular purpose of disseminating evidence to promote and accelerate equity within the area of can­cer prevention and control; they are the result of national and international collaborations between researchers and government and community organizations of the United States and Latin America.

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Objective. To characterize medical care and self-care actions in a population with diabetes in locations smaller than 100 000 inhabitants. Materials and methods. With information from the Encuesta Nacional de Salud y Nutrición 100k (Ensanut 100k), two logistic regression models were obtained: not performing five basic actions in the last consultation and not taking priority self-care actions. Results. Having low schooling, belonging to the low economic stratum, and speaking indigenous language, increase the probability of not taking self-care actions. On the contrary, as age increases, the chances of self-care are reduced by 3%. Belonging to an indigenous household and the low tercile, increases the chances that health personnel will not perform the five basic actions during the consultation. Conclusion. It is essential that a diabetes control program be established that includes patient education and update courses for medical staff.

Objective. To compare the coverage of continuous ma- ternal healthcare and early childhood care in women with and without adolescent motherhood (AM) who live in under-100 000-inhabitants communities. Materials and methods. Cross-sectional analysis of Ensanut 100k 2018 of 767 women aged 12 to 49 years living in under-100 000-in- habitants communities who had their last birth two years before the survey. Results. Women with AM have lower continuous coverage of maternal care than those without AM (8.1 and 19.6%, respectively). Infant care coverage with adequate content was lower than 30%, and there were no differences between the groups. Conclusions. It is necessary to strengthen actions focused on this group of women in order to reduce the gaps in coverage and improve maternal and child health.

Objective. To briefly describe the process of establishment and preliminary results of the Mérida Population-based Can­cer Registry (Mérida-PBCR) Materials and methods. Mérida-PBCR started in 2016 as a research project in the IMSS, with a gradual increase in its information sources. It covers a population of 908 536 inhabitants. Data collection is active and passive, international standards are used; CanReg5 software enables data entry, storage and analysis. Results. Current data include 71.5% of sources. For the period 2015- 2016, a total of 2 623 new cancer cases were registered, the majority of these (60.1%) among females. 81.5% of the cases had morphological verification. Prostate (17.4%), colorectal (8.5%) and stomach (8.1%) cancers were the most common among males, and breast (31.6%), cervix (12%) and corpus uteri (7.6%) cancers, the most common among females. Age-adjusted cancer incidence rates (per 100 000) for all sites combined were 114.9 among males and 145.1 among females. Conclusion. The implementation of the Mérida-PBCR has followed particular parameters, with important efforts to include new information sources. Although the data are still preliminary and must be interpreted with great caution, the main cancers follow a similar pattern to that of the national and regional estimates.

Objective. To describe the methodological design of the National Health and Nutrition Survey in localities with less than 100 000 inhabitants (Ensanut 100k). Materials and methods. The Ensanut 100k is a probabilistic survey that over-represents households with less economic capabilities. This paper describes the scope of the survey, sampling procedures, measurement and inference and logistics organization. Results. 10 461 home interviews and 26 161 individual interviews were obtained. The household response rate was 89 and 92% from individuals. Conclusions. The probabilistic design of the Ensanut 100k allows to make valid statistical inferences about parameters of interest for public health in localities with less than 100 000 inhabitants, localities where 52% of the population lives according to the 2010 census. The comparability of the results with the Ensanut 2012 facilitates the assessment of the government’s support actions to populations with lower economic capacities in the period 2012-2018.

Objective. To estimate the prevalence of unintentional injuries (UI) in people residing in localities with <100 000 inhabitants and to analyze its association with different environmental, household and individual characteristics. Materials and methods. Cross-sectional design that analyses the UI component of Ensanut 100k, which is a probabilistic national survey that focused on households beneficiaries of the program Prospera and those with fewer economic capabilities. Prevalence of UI was estimated considering the complex design of the survey. Association with variables of interest was explored using logistic regression analysis. Results. Prevalence of UI was 5.15% (CI95%: 1.43-6.16); probability was higher in male, those living in the region CDMX-EdoMex, and those with hearing and motor disability. Conclusions. Policies directed to prevent UI need to be strengthened to promote health and quality of life amongst individuals, particularly those with social and economic vulnerability, and to reduce the burden that these conditions impose to public health in Mexico.

 Objective. To establish the current situation of antimicrobial resistance and antibiotic consumption in Mexican hospitals. Materials and methods. Antimicrobial susceptibility data from blood and urine isolates were collected. Defined daily dose (DDD) of antibiotic consumption/100 occupied beds (OBD) was calculated. Results. Study period: 2016 and 2017. Of 4 382 blood isolates, E. coli and K. pneumoniae were most frequently reported, with antimicrobial resistance >30% for most drugs tested, only for carbapenems and amikacin resistance were <20%. A. baumannii had antimicrobial resis­tance >20% to all drugs. Resistance to oxacillin in S. aureus was 20%. From 12 151 urine isolates, 90% corresponded to E. coli; resistance to ciprofloxacin, cephalosporins and trimetho­prim/sulfamethoxazole was >50%, with good susceptibility to nitrofurantoin, amikacin and carbapenems. Global median antimicrobial consumption was 57.2 DDD/100 OB. Con­clusions. This report shows a high antimicrobial resistance level in Gram-negative bacilli and provides an insight into the seriousness of the problem of antibiotic consumption.

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Objective. To analyze the association between supplements and Liconsa milk intake, with anemia, zinc (ZD) and iron (ID) deficiencies, and morbidity in Mexican children resident of less than 100 000 habitants’ localities. Materials and methods. A subsample of 1 516 children aged 1-4 participants of Ensanut 100k was analyzed, carried out in 2018. Anemia was considered if [Hb]<11 g/dL, ZD if [Zn]<65 µg/dL and ID if [ferritin]<12 µg/L. Supplements and Liconsa milk consumption were obtained from a semi-quantitative food frequency; morbidity by self-report of the mother. Multiple logistic regression models were used adjusted by confounders. Results. Medium and high consumption of Liconsa milk was associated to lower odds of ID (OR=0.02, [95%CI 0.002,0.24] and OR=0.07, [95%CI 0.01,0.52]) and anemia (OR=0.13, [95%CI 0.04,0.37] and OR=0.17, [95%CI 0.03,0.87]). A high intake of Liconsa milk (OR=0.09, [95%CI 0.01,0.44]) and Vitaniño (OR=0.05 [95%CI 0.005, 0.46]) were both associated to lower diarrhea risk. Conclusions. To assure the continuity of the consumption of nutritional supplements is necessary for improving the health and the micronutrients status in vulnerable Mexican children.