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Objetivo: Estimar la diversidad de garrapatas, la prevalencia de infestación y tasa de infección de Rickettsia spp. en ganado bovino en la costa del estado de Chiapas. Material y métodos. Se realizó un estudio transversal de octubre de 2021 a marzo de 2022, que incluyó la extracción de garrapatas de 297 vacas pertenecientes a 5 municipios. Se calcularon los índices de diversidad. El diagnóstico de Rickettsia spp en las garrapatas se realizó mediante PCR anida., Resultados: Se encontró una baja diversidad de especies. Las especies Rhipicephalus microplus, Amblyomma cajennense y Rhipicephalus sanguineus hembra adultas fueron positivas a Rickettsia spp. Los municipios de Pijijiapan y Tonalá presentaron la TMI más alta con 7.5 y 7.2%. Conclusión. Este es primer estudio México que reporta infección de Rickettsia spp, en garrapatas colectadas de ganado bovino, lo cual indica un riesgo de salud pública.

Objetivo: Sistematizar, evaluar y sintetizar la investigación original específica en México sobre la zoonosis por Trypano-soma cruzi, los vectores (Triatominae: Hemiptera: Reduviidae) y la enfermedad de Chagas (EC). Material y métodos. La investigación original fue identificada con PRISMA mediante cuatro sistemas de búsqueda, usando criterios de inclusión, se realizó la asignación a 14 áreas temáticas y fue evaluada mediante criterios técnicos., Resultados: De un total de 1 410 registros, fueron elegidos 659 (46.7%) para la valoración técnica, de los cuales, 221 (15.7%) fueron incluidos como las evidencias de mayor calidad. El buscador PubMed contribuyó con 95% de los registros, mientras que los buscadores BibTri, Lilacs y Scielo aportaron 5%. La tasa de publicación fue constante de 1950 a 1990, con un incremento exponencial de 1995 a 2020. La alta calidad de publicaciones incrementó de 5.3% en 1990 hasta 49.8% en 2020. Los temas de aspectos sistémicos, económicos, antropológicos y sociales de la EC en México fueron los menos representados (8%)., Conclusiones: En las dos últimas décadas en México ha incrementado la investigación científica. Sin embargo, son notables las caren- cias en las áreas para poder fundamentar la política pública sanitaria en cuanto a la atención, la prevención y el control de la EC en el país.

La creciente epidemia de obesidad ha sido uno de los retos más importantes de salud pública en México durante los últimos años. Con apoyo de la Federación Mundial de Obesidad, en 2021 formamos un grupo de profesionales para identificar y resumir las acciones prioritarias en las que puede enfocarse nuestro país para hacer frente a esta epidemia. Al proceso de desarrollo y discusión de este grupo se sumaron más de 1 000 profesionales de la salud para retomar recomendaciones de documentos y guías de alto nivel previamente publicados. En conmemoración del Día Mundial de la Obesidad, en este 2022 se presenta esta postura como insumo para el desarrollo de acciones en el ámbito profesional y de los diferentes sectores, en la que se incluyen 10 recomendaciones de acción, desde la perspectiva poblacional hasta la atención individualizada, y se enfatiza en la importancia de la participación social, de las intervenciones integrales con visión centrada en la persona y de la sostenibilidad planetaria, además de mejorar la educación y las campañas de difusión, propiciar un ambiente promotor de entornos activos y blindar de conflictos de interés los esfuerzos de prevención y control. La postura hace un llamado para abordar la obesidad de manera seria, con base en la evidencia científica, oportuna e integral, con enfoque de curso de vida, de forma ética y sensible, y sin perpetuar las barreras del estigma de peso en la sociedad.

Objective: We examined delays during the search for care and associations with mother, child, or health services characteristics, and with symptoms reported prior to death., Materials and Methods: Cross-sectional study compris-ing household interviews with 252 caregivers of children under-5 who died in the state of Yucatán, Mexico, during 2015-2016. We evaluated the three main delays: 1) time to identify symptoms and start search for care, 2) transport time to health facility, and 3) wait time at health facility., Results: Children faced important delays including a mean time to start the search for care of 4.1 days. The mean transport time to the first facility was longer for children enrolled in Seguro Popular and there were longer wait times at public facilities, especially among children who also experienced longer travel time., Conclusions: Providing resources to enable caregiv-ers to access health services in a timely manner may reduce delays in seeking care., Competing Interests: Abraham D Flaxman has had consultancies with Kaiser Permanente, Sanofi, Merck for Mothers, Agathos Ltd and NORC. The rest of the authors declare that they have no conflict of interest., (Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License)

Objective: To determine the presence of Rickettsia typhi in Rhipicephalus sanguineus s.l. and Amblyomma mixtum in southern Mexico., Materials and Methods: Ticks were collected in humans and domestic animals. The presence of Rickettsia was determined by PCR and sequencing., Results: 10/39 work vials amplified fragments of the gltA, htrA and ompB genes. On 7/10 from Rh. sanguineus s.l. collected from dogs and in 3/10 of A. mixtum collected from horse and human. Sequencing indicated R. typhi in Rh. sanguineus and A. mixtum with 100% homology (LS992663.1) for a region of the htrA gene and 99% (LS992663.1) with the regions of the gltA and OmpB genes. The minimum infection rate (TMI) for R. typhi was 3.88., Conclusions: Rhipicephalus sanguineus s.l. and Amblyomma mixtum are naturally infected with R. typhi in Southern Mexico., Competing Interests: Declaration of conflict of interests. The authors declare that they have no conflict of interests.

Objective: To know opinions of adolescents from Cholul, Yucatán, about Plato del Bien Comer Maya in order to improve it as health promotion tool., Materials and Methods: Qualitative study, formative research. Three focus groups were carried out, participating 28 adolescents: 12-16 years old. Criteria of inclusion: studying middle school; to have native family from the town. Analysis of the data made manually., Results: Comparatively with the national Plato del Bien Comer, the Plato Maya was better identified because have local food products easier to obtain and cheaper. The principal finding was to understand Fruto is a linguistic variation word which represents in Maya context both fruits and vegetables. This might be an important key to improve health promotion activities with that population., Conclusions: In order to have better results in nutritional interventions, it is necessary to design educational-communicative strategies in accordance with the local culture., Competing Interests: Declaration of conflict of interests. The authors declare that they have no conflict of interests.

Objectives: To determine the importance of Ae. aegypti breeding-sites in Merida;to evaluate the impact of Recicla por tu bienestar (RxB, a recycling program) on the reduction of breeding sites and the perception of participants., Materials and Methods: The relative importance for pupae production of the different types of breeding-sites was determined. Pre-and post-RxB entomological surveys were performed in participant neighborhoods to evaluate the impact on total containers and positive breeding-sites. A survey on the perception of participating people about dengue prevention and control and RxB was applied., Results: Buckets/pots and "small diverse items" were the most important breeding-sites. RxB had a significant impact in the reduction of total containers (IRR = 0.74), positive containers (IRR = 0.33) and the risk of a house being positive for Ae. aegypti (OR = 0.41). All the interviewed participants referred RxB as needed and most consider it useful., Conclusions: RxB should be considered as a good practice for the dengue vector control.

Food-borne diseases are among the major public health problems that currently exist. Microbiological risk assessment is a process used to evaluate the hidden hazards in food, the likelihood of exposure to these hazards and their impact on public health. Risk assessment is performed in four steps: hazard identification, hazard characterization, assessment of exposure and risk characterization. According to the process/response microbial risk assessment is classified in two categories, qualitative and quantitative. The aim of this review is to underline the importance of implementing assessments in seafood that is usually consumed raw, strengthening access to good quality and safe food for the consumer's benefit and to stress the necessity of microbiological risks assessments in Mexico.

Objective: CCR5-Δ32 allele frequency needs to be identified in HIV+ patients and exposed seronegative individuals in Yucatan, Mexico, to understand this mutation's relationship to infection and disease progression., Material and Methods: A total of 355 samples were analyzed: 62 from HIV+ patients, 51 from exposed seronegative individuals and 242 from general population. Infected patients were subdivided into a) normal progressors n= 49; b) slow progressors n= 10, and c) non-progressors n= 3., Results: Genotype wt/Δ32 was identified in 17.7% of HIV+, 13.7% of exposed seronegative individuals and 6.2% of general population. Genotype Δ32/Δ32 was identified in 3.9% of exposed seronegative individuals. In infected patients, wt/Δ32 was identified in 10.2% of normal progressors, 30% of slow progressors and 100% of non-progressors., Conclusion: Genotype wt/Δ32 was observed in all non-progressing HIV+ patients, supporting its role in this group's disease development and clinical evolution.

Objective: To determine the prevalence of secondary effects on lipid metabolism as a result of highly active antiretroviral therapy (HAART), as well as the impact of different types of antiretroviral regimens on lipids and glucose in a group of patients in Yucatan, Mexico., Material and Methods: A cross-sectional study was conducted. A questionnaire created for this study was administered to each patient and total cholesterol, triglycerides and fasting glucose values were determined. The presence of hyperlipidemia and alterations in glucose were determined as well as their relation to the epidemiological variables obtained from the questionnaire., Results: A total of 211 subjects were studied [36 (17%) of which were women and 175 (83%) men]. Ninety-two patients (44%) were found to have hyperlipidemia. Of these, 43 (20%) had hypercholesterolemia (HC) and 82 (39%) hypertriglyceridaemia (HT). The presence of combined HC and HT was observed in 30 (14%) patients. Nineteen (9%) patients had alterations in glucose, six (3%) diabetes mellitus and 13 (6%) impaired glucose tolerance. The variables associated with the presence of hyperlipidemia were: levels of lymphocytes CD4 >350 cells/microl (OR = 2.79 1.08-7.27, p = 0.03), male gender (OR = 3.6 1.4-9.12, p = 0.006) and the use of nucleoside-reverse transcriptase inhibitors (NRTI) (OR = 3.1 1.2-8.1, p = 0.01)., Conclusions: Patients with HIV infection who receive HAART have an increased risk of presenting hyperlipidemia. In this group of patients the presence of hyperlipidemia and impaired glucose tolerance was significant. Unlike what has been indicated in most published reports, the alterations of lipids were associated more frequently with INTR use, for which it is concluded that the pathogeny of these alterations is not unique, that it is probable that concurrent effects exist between different antiretroviral drug families and that other host factors are involved in the pathogenic mechanism of these alterations.

Objective: To report the prevalence of antibodies against the hepatitis C virus (anti-HCV) in a group of patients with hepatic cirrhosis (HC)., Material and Methods: A prospective transversal and descriptive study was carried out from March 1998 to May 1999. Study subjects were 153 patients; 117 (76%) male and 36 (24%) female, diagnosed with HC. They were attended at the General Hospital Agustin O'Horan and at Regional Research Center Doctor Hideyo Noguchi, in Merida, Yucatan, Mexico. A clinical-epidemiologic questionnaire completed by interview was used for data collection. Anti-HCV were detected using a 2nd generation enzyme-linked immunosorbent assay (ELISA-2). To confirm diagnosis, a second generation recombining immunoblot assay (RIBA-2) was used. Hepatitis B surface antigen (HbsAg) and antibodies against the hepatitis B core antigen (anti-HBc) were determined using ELISA. The presence of anti-HCV was related to the epidemiologic variables of study subjects. The prevalence of anti-HCV was obtained and the frequency of the characteristics obtained by interview were compared among the positive and negative patients through the chi 2 test and the Fisher's exact test, as needed., Results: Among patients with HC (35/117 (30%) male and 14/36 (39%) female), 32% were positive to anti-HCV. Alcoholism was present in all seroreactive males and absent in all positive females (p < 0.001). Data obtained through an interview were not associated with seropositivity. Anti-HBc was found in 16% of patients positive to anti-HCV and in 12% of seronegatives (p = 0.69)., Conclusions: The prevalence found was greater than previous reports in the general population in the Yucatan Peninsula (1.3%). The high prevalence of anti-HCV in these patients suggests that HC is more frequently associated with HCV in Yucatan, Mexico than hepatitis B. Alcoholism probably acts as a cofactor for the development of HC in males.

Objective: To determine the prevalence of Chlamydia trachomatis in women attending two family planning clinics in Merida, Yucatan, Mexico., Material and Methods: From January to December 1998, a cross-sectional study was conducted in 1,100 sexually active women between 15 and 45 years of age. Study subjects had not received antibiotic therapy for at least one month prior to their visit to the clinic. Endocervical samples were taken for bacterial detection with the enzymatic Wellcozyme immunoassay method. Data were analyzed using the Epi-Info program. Statistical analysis was conducted using the chi-squared test and prevalence ratios., Results: Seventy four women were positive to Chlamydia trachomatis (6.7%). Almost 50% of those women were asymptomatic. No statistically significant differences were found between the group with Chlamydia and the group without it who had vulvar-vaginal symptoms. Cervical changes were more frequent in infected women. More positive cases of Chlamydia infection were found in oral contraceptive users (8.3%) than among non users (5.4%)., Conclusions: Study results confirm the high prevalence of asymptomatic infections and emphasize the importance of timely diagnosis to avoid infection sequelae. The English version of this paper is available at:http://www.insp.mx/salud/index.html.

Chagas' disease, caused by the protozoan parasite Trypanosoma cruzi, represents a major public health problem in most of the American continent. As transmission of the parasite is being interrupted in most of South America, the disease remains endemic in various areas of Mexico. We review here some of the information gathered in recent years. Seroprevalence of T. cruzi infection in humans remains relatively high in some areas, and there has been a general increase in the number of chronic cases reported to health authorities in recent years. In fact, chronic chagasic cardiomyopathy appears to be affecting a large number of patients with heart disease, but many cases may be misreported because of the unspecific nature of the clinical symptoms. Epidemiological monitoring of vector and reservoir populations, as well as of human cases is helping focus on endemic areas, but a better coordination and development of these efforts is still needed. Recent studies of parasite biology are in agreement with previous work showing the great diversity of parasite characteristics, and support the need for a regional approach to this zoonosis. Strong and continuing support from health and academic authorities is thus still needed to further improve our understanding of Chagas' disease in Mexico and implement efficient control programs.

The contraceptive effects of breast-feeding still play an important role in child spacing in developing countries; however, its use as a method of family planning was untested until 1988, when an international group of researchers met in Bellagio and reached a consensus statement that reads "The maximum birth spacing effect of breast-feeding is achieved when mothers fully or nearly fully breast-feed and remain amenorrheic (and no menstrual bleeding has occurred before the 56th postpartum day). When these two conditions are present, breast-feeding provides more than 98% of protection in the first six months. That became the basis for a method of family planning called the lactational amenorrhea method (LAM). Which is a new introductory family planning method that simultaneously promotes child spacing and breast-feeding, with its optimal nutrition and disease preventive benefits for the infant. This method is based on the natural infertility caused by the hormonal suppression of ovulation.

With the aim of knowing the microbiological quality of drinking water in Merida, Yucatan, 383 paired samples of drinking water (two per house) were studied. Three hundred sixty four (95%) city water system samples and 283 (73.89%) tap water samples met the microbiological standards for drinking water. It was concluded that microbiological quality of drinking water from the city water system is satisfactory, except for the water system district Merida III, which has a significant aerobic plate count contamination level (21.7% of the samples). Domestic storage systems preserve water quality, with the exception of district Merida I, which has the highest level of contamination (4.8% of the samples) possibly from sewage water and fecal sources.

We report the prevalence of Vibrio parahaemolyticus and of antibodies against Vibrio parahaemolyticus in the feces and serum of fish and seafood handlers in the city of Mérida, Yucatán, Mexico. Between March 1 and August 31, 1989, we studied 81 feces samples and 81 serum samples from an equal number of handlers. Vibrio parahaemolyticus was not isolated in any of the feces studied. We found no statistically significant differences upon comparing our zero per cent isolation in feces samples with the highest percentages reported from available literature (3.85%): chi 2c = 0.36, p greater than 0.05. In two serum samples, we detected Vibrio parahaemolyticus antibodies to the degree of 2.47 per cent. We found no statistically significant differences upon comparing our 2.47 per cent prevalence of serum antibodies with the 10 per cent prevalence reported in a study done by Molina García, et al: chi 2c = 0.10, p greater than 0.05. The estimation interval with a confidence level of 95.00 per cent for the percentage in the population of fish and seafood handlers with Vibrio parahaemolyticus antibodies is 0.94% less than or equal to p less than or equal to 4.00%. We conclude that either the asymptomatic carrier stage does not exist, or that it is of a very short duration. On the other hand, based upon our 2.47 per cent serum-positive prevalence, we conclude that there exists both contact with, and infection from, Vibrio parahaemolyticus in fish and seafood handlers.

Between August/1987, and February/1988, 60 homosexual-men from Cancun, Q. Roo, Mexico, were studied to determine the prevalence of HIV antibodies (Elisa and Western Blot). Six subjects were seropositive. No relationship was found between HIV antibodies and age, socioeconomic level or sexual intercourse with foreign subjects. The number of sexual partners/month, and the number of sexual intercourse/month were associated with the presence of HIV antibodies. Bisexual practices were found in 43 percent of all the group. Two subjects with HIV antibodies were classified in the phase II of HIV infection, one in phase III, two in phase IV-A and one more in phase IV-c2.