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After introducing guidelines for breast cancer screening in 2003, Mexico began to prioritize the implementation of mammography screening nationally. Since then, there have been no studies assessing changes in mammography in Mexico using the two-year prevalence interval that corresponds to national guidelines for screening frequency. The present study analyzes the Mexican Health and Aging Study (MHAS), a national population-based panel study of adults aged 50 and older, to evaluate changes in 2-year mammography prevalence among women aged 50 to 69 across five survey waves from 2001 to 2018 (n = 11,773). We calculated unadjusted and adjusted mammography prevalence by survey year and health insurance type. Overall prevalence increased substantially from 2003 to 2012 and leveled off in the period from 2012 to 2018 (2001: 20.2 % [95 % CI 18.3, 22.1]; 2003: 22.7 % [20.4, 25.0]; 2012: 56.5 % [53.2, 59.7]; 2015: 62.0 % [58.8, 65.2]; 2018: 59.4 % [56.7,62.1]; unadjusted prevalence). Prevalence was higher among respondents with social security insurance, who are more likely to work in the formal economy, than among respondents without social security, who are more likely to work in the informal economy or be unemployed. The overall prevalence estimates observed were higher than previously published estimates of mammography prevalence in Mexico. More research is needed to confirm findings regarding two-year mammography prevalence in Mexico and to better understand the causes of observed disparities.

While the debate on the national care system is gaining momentum in the academic and political spheres, it's important to note that the issues of gender and child care often overshadow the component concerning the elderly, which needs a more thorough analysis. This article aims to support constructing a care agenda that prioritizes older people. It presents arguments in favor of care, understood as a right, and discusses the burden of disease as being responsible for dependency and a consequence of long periods of need for care. The concept of care is analyzed, along with its distinction between long-term care and palliative care. A different perspective is proposed to calculate dependency beyond the number of affected activities of daily living (ADL). In addition, the national and intergenerational situation of the care systems is presented, specifically long-term, which in Mexico is non-existent, and critical points to integrate the system are reviewed, such as legislation and regulations for residences, training and certification of older people, and incorporation of the community approach. Given the context of inequality, social backwardness, increasing health needs, and a rapidly aging population, it is imperative to reform the care system by integrating the health system with the social care system. [ABSTRACT FROM AUTHOR]

AimWe conducted a cost-effectiveness analysis of seven hepatitis C virus (HCV) testing strategies in blood donors.MethodsThree of the seven strategies were based on HCV diagnosis and reporting guidelines in Mexico and four were from previous and current recommendations outlined by the CDC. The strategies that were evaluated determine antibody levels according to the signal-to-cut-off (S/CO) ratio and use reflex Immunoblot (IMB) or HCV RNA tests to confirm true positive (TP) cases of chronic HCV infection. Costs were calculated from the perspective of the Mexican Institute of Social Security (IMSS). A decision tree model was developed to estimate the expected number of true positive cases and costs for the base-case scenarios and for the sensitivity analyses.ResultsBase-case findings indicate an extended dominance of the CDC-USA2 and CDC-USA4 options by the IMSS Mexico3 and IMSS-Mexico1 alternatives. The probabilistic sensitivity analyses results suggest that for a willingness-to-pay (WTP) range of $0-9,000 USD the IMSS-Mexico1 strategy is the most cost-effective of all strategies ($5,000 USD per TP). The IMSS-Mexico3, IMSS-Mexico2, and CDC-USA3 strategies are also cost-effective strategies that cost between $7,800 and $8,800 USD per TP case detected. The CDC-USA1 strategy was very expensive and not cost-effective.ConclusionsHCV antibody testing strategies based on the classification of two or three levels of the S/CO are cost-effective procedures to identify patients who require reflex IMB or HCV RNA testing to confirm chronic HCV infection.

This research delves into the need to use granular analyses at the neighborhood level to study the preexisting conditions of vulnerability that best explain the waves of COVID-19 incidence and mortality. It seems most appropriate to use the comprehensive approach of the sustainable development with variables that analyze the economic, social, environmental, and governance dimensions, given the extensive literature that identifies each as a determining factor for the impact of disease. The work utilizes a composite vulnerability index that allows the city of Malaga to be divided into 434 census sections; waves of incidence and mortality for each section are constructed for the period of March 2020 to March 2021. Cluster analysis reveals that there are five different cluster incidence patterns, whereas the lethality waves are found to behave as a hot-spot phenomenon. The results reveal that neighborhoods that are the most vulnerable in terms of their demographic conditions (large proportion over 65 years of age and dependent) and socioeconomic conditions (severe material deprivation), have been the most affected by COVID-19 infection and mortality. [ABSTRACT FROM AUTHOR]

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