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Objective: To describe the availability of some essential drugs at the primary health care units of the Ministry of Health of Tamaulipas, Mexico., Material and Methods: Between September and October 1998, all first level healthcare units of Tamaulipas' three sanitary jurisdictions were surveyed. Drug availability was assessed. The measurement instrument was a checklist of 56 drugs and 10 different supplies. For each drug and input the absolute number and the proportion of units with this drug or input was calculated. In the units where the drugs were available, the medians were calculated. The median of the total number of drugs available in all units was used as a global indicator. This same exercise was developed for each unit. Comparisons between the availability of these inputs in the units and stockrooms were also done. Stata 5.0 was used for statistical analysis., Results: None of the inspected units had full availability of all checklist drugs. The highest percentage of drug availability was 84% and the lowest was 32%. There was limited availability of antibiotics, antihypertensive, hypoglycemic, and iron deficiency drugs. The availability of oral rehydration salts and contraceptive and vaccine agents was acceptable., Conclusions: Healthcare organizations must find alternative ways to improve access to drugs nationwide, in general, and availability of essential drugs in first level healthcare units, in particular. Two recent initiatives provide an optimistic outlook: decentralization of health services for the uninsured and the Generic Exchangeable Drugs Program, established nationwide in 1998.

This paper reports on the prevalence of lead poisoning in children between 1 and 5 years of age living in a marginal area to the north of Mexico City and also includes an evaluation of sources of exposure to this metal in the same area. The results show that 67.5% of the children studied have blood lead (PbB) levels > or = 10 micrograms/100 ml. Twenty-one percent of these children (1987) had PbB levels that required medical evaluation (> or = 20 micrograms/100 ml- < or = 40 micrograms/100 ml), and 112 children needed medical treatment (PbB > or = 40 micrograms/100 ml). In addition, the study found that the probability of higher blood lead levels (> or = 20 micrograms/dl) corresponds to children whose mothers use lead-glazed pottery dishes (OR = 2.80; CI 95%, 1.55-5.07) and to children who habitually bite colored pencils (OR = 2.05; CI 95%, 1.13-3.71) compared, respectively, with children whose mothers do not use that type of dishes and children who do not bite pencils. Our results provide baseline information for estimating the impact and costs of population-based interventions aimed at these populations and also confirm the need to strengthen health education programs to promote the reduction of lead exposure in the general population.

In 1988 the Mexican General Directorate of Epidemiology and the Mexican Institute of Psychiatry carried out the first National Addiction Survey that provided prevalence estimates at national and regional levels of alcohol consumption, tobacco smoking, and several other drugs use. In addition, a questionnaire included questions regarding alcohol consumption during pregnancy and adverse outcomes. According to the results of logistic regression, women classified as suffering from Alcohol Dependence Syndrome had a very high risk of low birth weight and/or preterm delivery: Odds ratio = 12.1 with a 95% confidence interval of (1.3, 108.9) and p = .026. After controlling for several confounding variables, the findings remained basically the same.

A case-control study of mortality from acute respiratory infections (ARI) among children under five years of age was conducted in Naucalpan, an urban-suburban area of Mexico City, and in rural localities of Tlaxcala, Mexico. The study found that ARI deaths tended to occur in the poorest neighborhoods; 78% of the deceased study subjects were infants under six months old; and 68% of the deaths occurred at home. Comparison of the data for cases (fatalities) and control children who had severe ARI but recovered showed that failure to receive antibiotics was associated with death (odds ratio 28.5, 95% confidence interval 2.1-393.4). This antibiotic effect was controlled for numerous potentially confounding factors. It is evident that antibiotics had a much greater effect in the early days of the illness than later on. In general, the findings strongly support PAHO/WHO primary health care strategies--including such strategies as standardized management of severe ARI cases--that seek to reduce childhood ARI mortality.

A matched case-control study was undertaken in Naucalpan de Juárez, Estado de México. The goal of this study was to identify the risk factors for diarrheal disease in children between seven days and one year of age. We identified 63 case and 188 controls. The most important risk factors were: mother's age greater than 36 years with an odds ratis (OR) 3.7, lack of breastfeeding (OR 11.3), breast and bottle feeding (OR 5.4), lack of intradomiciliary sewage (OR 8.3), repeated episoded of disease (OR 8.6) and father's consumption alcoholic beverages (OR 3.6). The main possible paths by which these factors influence mortality are discussed. Specific interventions for some of the factors are proposed.