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

Pertussis continues to be responsible for a significant disease burden worldwide. Although immunization practices have reduced the occurrence of the disease among children, waning vaccine- and infection-induced immunity still allows the disease to affect adolescents and adults who, in turn, can transmit the disease to non-immunized or partially immunized infants. This document is the result of a meeting in Mexico City of international experts who analyzed recent medical information in order to establish the current status of the epidemiology, diagnosis and surveillance of pertussis and, especially, the value of the dTpa booster dose in adolescents and adults as a pertussis prevention strategy in Mexico.

Objective. Determine the influence of nutritional counseling, exercise, access to social healthcare and drugs, and the quality of medical care on the control of diabetics. Material and Methods. The information and blood samples were obtained in 2005. Glycemic control was defined as good if HbA1c was ≤7.0%, poor from 7.01% - 9.50% and very poor if HbA1c mayor que 9.5%. Binary logistic regression models were used to determine the association of these factors with HbA1c mayor que 9.5%. Results. Thirty percent of the patients with a medical diagnosis of diabetes had adequate metabolic control. Conclusions. Nutritional guidance was associated with an increase in the degree of control. A majority of diabetics have poor or very poor glycemic control. Strengthening the quality of and access to medical care for these patients is urgently needed.

Objective. To analyze the characteristics of problems in the health system that present barriers to maternal care, according to their representation and rating by officials in different positions and social contexts. Material and Methods. Workshops were held with state health system officials from Mexican states with high maternal mortality (Mexico, Guerrero, Oaxaca and Veracruz) as well as with federal officials. A total of 99 health system problems were identified. Using concept mapping, 94 officials rated problems according to importance and feasibility; they were grouped into issues. Data was analyzed according to state/federal levels and the responsibilities of participants. The association was measured between responsibility profile/social context and priority issues. Results. The issues of highest priority for maternal health care are infrastructure, personnel hiring and financial resources. The importance of certain issues depends on context and, to an extent, on the actors’ responsibilities. Conclusions. There is consensus among actors to address the principal maternal health problems in Mexico. Important differences correspond to context. The usefulness of concept mapping to analyze problems was demonstrated.

Objective. To determine the prevalence of functional dependency (FD) on Mexican elderly living in extreme poverty conditions and to estimate the association between falls and FD. Material and Methods. A survey was conducted with three stages for selection, stratified by type of locality (rural or urban) and nationally representative of the 2006 Oportunidades Program. The target population was composed of individuals 70 years of age and older who were beneficiaries of the Oportunidades Program. Results. A total of 30.9% of the elderly presented FD. The gender stratified logistic regression model resulted in an odds ratio (OR) for women of 1.25 (I.C:1.13-1.39) for the association between the increase in the number of falls and FD and OR=1.12 (I.C:0.97-1.29) for men. Conclusions. Given the vulnerable conditions in which these older adults live, specific interventions need to be implemented to prevent falls in order to reduce the risk of functional dependency.

Objective. We present a model for the 2009 influenza epidemic in Mexico to describe the observed pattern of the epidemic from March through the end of August (before the onset of the expected winter epidemic) in terms of the reproduction number and social isolation measures. Material and Methods. The model uses a system of ordinary differential equations. Computer simulations are performed to optimize trajectories as a function of parameters. Results. We report on the theoretical consequences of social isolation using published estimates of the basic reproduction number. The comparison with actual data provides a reasonable good fit. Conclusions. The pattern of the epidemic outbreak in Mexico is characterized by two peaks resulting from the application of very drastic social isolation measures and other prophylactic measures that lasted for about two weeks. Our model is capable of reproducing the observed pattern.

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