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

The evaluation of the program for enhancing health services showed advances in the building and provision of equipment for the health units, as well as development of additional operative capability until 1991. One of the main characteristics of the evaluation process, was the utilization of the local and state information systems, which allow the selective use of indicators in order to identify the advances of the program of expanded coverage and enhance of the quality of care and its direct relationship with the organization of health services. The present research constitutes a good example of the development of programmes funded by multilateral organizations. Key words: potential coverage, users coverage, health services productivity Solicitud de sobretiros: Dr. Miguel Angel Lezana Fernández, Director General de Estadística, Informática y Evaluación, Subsecretaría de Coordinación y Desarrollo, Secretaría de Salud. Liebnitz 20, 3er piso, colonia Anzures, 11590 México, D.F.

This paper is intended to offer a qualitative and quantitative diagnosis on publications concerned with human health impact of exposure to environmental chemical pollutants in Mexico. The review of these subjects included scientific papers on studies carried out in Mexico, published both in Mexican and international journals. The articles were analyzed according to the following criteria: chemical pollutants, type of study and institution that conducted it, study population, design, and analysis of data. The article concludes that publications in this field are scarce. Moreover, this review showed that there is little diversity, limited methodology and an unequal distribution of the human and material resources for research. All this indicates a rudimentary level of scientific knowledge in Mexico regarding public health implications of chemical pollutants.

The hospitals of the Ministry of Health in Mexico City, particularly psychiatric hospitals, have been confronting operational problems due to a scarce budget and lack of informational on their operation and costs. The present study intends to begin to solve some of those problems through an initial diagnosis. A form was designed for data harvesting, which enables to sort costs by class (direct and indirect). This information was projected in a worksheet and analyzed by service, day-bed and unity as a whole. The results show an inequitative distribution of the budget among hospitals.

Health services research is a basic tool for the development of the National Health System. This paper presents the results of a national survey on research projects carried out in Mexican health institutions, as well as in universities and research centers, from 1984 to 1991.

The Medical Service Management of Petróleos Mexicanos developed a situational diagnosis of 30 medical units in 1992. This evaluation covered 94 per cent of the institutional population. The basis for this evaluation was a formulary with more than 70 per cent closed questions and instructions with explicit explanations about them. The main points that the formulary investigated were: geography, demography, sociocultural and economics aspects, epidemiology, morbility, mortality, preventive medicine, service availability and others. With this situational diagnosis we have been able to identify the main problems with a possible solution, presented in terms of planning, organization and execution of actions.

HIV infection has had great impact on dental practice, mainly because public and professional perceptions about HIV- AIDS contagion are conflictive due to fear and ignorance. Since the practices of infection control have not been adequately studied in Mexico, the present survey explored some attitudes towards HIV infection, stated knowledge on HIV transmission and manifestations, and infection control procedures reportedly used by dental students. A questionnaire was administered to 262 final-year students (95% were 20 to 30 years old; 71% female) in Mexico City (July-August 1992), with emphasis on the clinical risk posed by HIV and hepatitis B (HBV) infections. Data were analyzed with Student's t-test and one-way ANOVA (Scheffé test). Results showed a mixed response as a general rule, with most respondents believing they had a moral (83%) and professional (78%) duty to treat HIV + patients but few having a sympathetic approach to them. Only a minority have had a direct experience with HIV + patients (5%) or high-risk groups (24%). Students seemed to use adequate infection control barriers as most wore gloves, gowns, masks and glasses while treating patients, but only 20 per cent had been vaccinated against hepatitis. Some contradictions in the use of disinfecting/sterilization equipment and agents were detected. The most important reasons given to refuse to treat HIV + patients were the lack of appropriate facilities and the risk of becoming infected. The sources of information on HIV most frequently resorted to were reported to be professional education and short courses of continuing education.

Over 85 000 hectares in the Mezquital Valley of central Mexico are irrigated with wastewater. The main crops are fodder and cereal crops. A two cross-sectional survey was carried out to test the impact of exposure to raw wastewater and from storage of that wastewater in reservoirs. The main outcomes were Diarrhoea disease and parasitic infections in farmworkers and their families. The total study population in the dry season included 2 049 households. The study population was classified in households where the farmworker is exposed to untreated wastewater (exposed group), households exposed to reservoir water (semi-exposed group), and households where the farmworker practices rainfed agriculture (control group). Preliminary analysis of the data has been carried out. Current information indicates that the risk of Ascaris lumbricoides infection is much higher in the exposed group than in the control group (95% CL= 4.0-67.3 and 4.7-78.8). According to the procedures employed, exposed children from exposed households were at higher risks of Diarrhoea disease than controls (95% CL= 1.03-2.03). The final results of this study are expected to aid decisions within the reuse programmes in developing countries.

The present study was carried out within the framework of the State Program for the Fluoridation of Table Salt in the State of Mexico. An estimate of the daily consumption of salt was carried out by home interviews in four communities within the state. Such communities covered a wide range of urban- rural population and socio-economic status, as well as several concentrations of fluoride in drinking water and sources of distribution of salt. Results showed that the daily consumption of salt for children 1-3 years old had a mean of 1.9 g/day, while children 4-6 years old consumed a mean of 3.4 g/day. Adult males (23-50 years old) consumed a mean of 6.9 g/day and adult females (23-50 years old) consumed 5.4 g/day. Although these estimates may overestimate the real intake of table salt, based on these data the additional intake of fluoride would be of 0.5, 0,8, 1.7 y 1.3 ppm/day for each of these groups.

This research was carried out in a sample of 96 adults from a rural community undergoing a socioeconomical transition with the aim of evaluating their risk of atherosclerosis. Total cholesterol, HDL, LDL and triglicerids levels were measured in blood and a simplified food intake questionnaire was applied. A sample of 116 middle class urban subjects of similar age and sex were studied to compare the data. Although food consumption in both groups was different, the intake saturated fat was very similar. No significant differences were found regarding blood cholesterol and its fractions. Data show that the socieconomical transition of the rural community is most unfavorable for their health, since besides all malnutrition-infection problems during infancy, adults present a chronic diseases risk similar to that of the urban population. It is possible that the poor population, due to their recent changes in food consumption habits, is in the border of a real chronic diseases epidemic, mainly of the atherosclerosis and tromboembolic type.

A serum search was performed at Centro municipality, Tabasco, Mexico. 393 samples were obtained with the aim of determining high density lipoproteins (HDL) values. A Framighan search was also done. 56.7 per cent of females showed values above 65 mg/dl; 15.7 per cent, between 45 and 65; and 27.6 per cent less than 45 mg/dl, with minor, medium and high risks for atherosclerosis, respectively. 56.9 per cent of males showed values above 55 mg/dl; 17.6 per cent between 35 and 55, and 25.5 per cent less than 35, with similar risk levels. In the Framighan search, 67.9 per cent of females showed 4.5 points and 32.1 per cent more than 4.6 for minor and major risk levels, respectively. 70.3 per cent of males obtained less than 5 points and 29.7 more than 5.1, for same risk.