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OBJETIVO: Identificar factores asociados a la picadura de alacran durante la recoleccion de maiz, entre campesinos del estado de Guerrero. MATERIAL Y METODOS: Estudio transversal hecho en 2004, sobre picaduras de alacran durante el ciclo agricola 2003, con encuesta a hogares en 14 comunidades del estado de Guerrero, seleccionadas de forma aleatoria. Se obtuvieron frecuencias simples y analisis bivariado para identificar los factores asociados a la picadura de alacran durante la pizca de maiz. Se estimo razon de momios para valorar la magnitud del efecto. RESULTADOS: La incidencia de picadura de alacran fue de 15% (500/3 294) en 2003. El empleo de guantes se acompano de menor riesgo de picaduras de alacran en la mano (RM = 0.11; IC 95% 0.06-0.18). Usar solo un guante podria evitar 133 picaduras por cada 1 000 campesinos que ahora no los utilizan. Los costos implicados por la picadura de alacran sumaron 505.90 pesos (46 dolares estadounidenses). CONCLUSIONES: Es necesario promover el uso de guantes entre campesinos que viven en zonas con alta endemicidad de alacranes. Asimismo, extender la red de suministro de suero antialacran a toda el area rural donde predominan especies muy toxicas y orientar a los campesinos sobre la importancia de buscar atencion oportuna en las unidades de salud.

Background Community participation was a core tenet of Primary Health Care as articulated in the 1970s. How this could be generated and maintained was less clear. This historical article describes development of protocols for evidence-based community mobilisation in five local administrative units (municipios) in the Mexican state of Guerrero between 1992 and 1995. Methods A sample of five to eight sentinel sites represented each of the most impoverished municipalities of the poorest five of the state's seven regions. A 1992 baseline survey of diarrhoea and its actionable determinants provided the substrate for discussion with local planners and communities. Municipal planners used different strategies to promote participation. In one municipality, new health committees took control of water quality. In another, municipal authorities hired health promoters; a song promoted oral rehydration, and house-to-house interpersonal discussions promoted chlorination. In the poorest and most mountainous municipality, radio casera (home-made radio) soap operas used local "stars". In the largest and most disparate municipality, a child-to-family scheme relied on primary and secondary school teachers. The research team assessed outcomes at intervals and used the results to reinforce local planning and action. Results Diarrhoea rates declined in all five municipalities, and there were several positive intermediate outcomes from the communication strategies – changing knowledge, household practices and uptake of services. There was a strong link between specific contents of the communication package and the changing knowledge or practices. Conclusions Apart from these evidence-based interventions, other factors probably contributed to the decline of childhood diarrhoea. But, by monitoring implementation of planning decisions and the impact this has at community level, micro-regional planning can stimulate and reinforce actions likely to improve the health of communities. The process empowered municipalities to get access to more resources from the state government and international agencies.

Recurrence and reinfection of tuberculosis have quite different implications for prevention. We identified 267 spoligotypes ofMycobacterium tuberculosisfrom consecutive tuberculosis patients in Acapulco, Mexico, to assess the level of clustering and risk factors for clustered strains. Point cluster analysis examined spatial clustering. Risk analysis relied on the Mantel Haenszel procedure to examine bivariate associations, then to develop risk profiles of combinations of risk factors. Supplementary analysis of the spoligotyping data used SpolTools. Spoligotyping identified 85 types, 50 of them previously unreported. The five most common spoligotypes accounted for 55% of tuberculosis cases. One cluster of 70 patients (26% of the series) produced a single spoligotype from the Manila Family (Clade EAI2). The high proportion (78%) of patients infected with cluster strains is compatible with recent transmission of TB in Acapulco. Geomatic analysis showed no spatial clustering; clustering was associated with a risk profile of uneducated cases who lived in single-room dwellings. The Manila emerging strain accounted for one in every four cases, confirming that one strain can predominate in a hyperendemic area.

Mexico is a main importers of pesticides in Latin America.to describe pesticide symptoms prevalence, use, and management in a group of agricultural workers.we carried out a transversal study in 303 agricultural workers laboring in vegetables, grains and flowers fields. We investigated the work history, pesticide management, and pesticide use frequency, as well as exposure-associated symptoms.mean age was 46 years; 19.5 % of workers were illiterate, and mean pesticide use was 15 years. With regard to pesticide application, 17.2 % of laborers worked with pesticides from 11:00 a. m. to 3:00 p. m., and 36.4 % of them applied pesticides for2 h; 29.7 % applied pesticides against the wind, while 26.4 % applied these with the wind. After applying the pesticides, 37.4 % of them bathed after 3 h, 34.5 % changed clothes, and 18.8 % returned to cultivation some hours later; 23 % of workers presented some symptom, the most frequent being headache, itchiness, numbness, and perception of burning on skin; this latter proportion was greater in theor = 46 years old groupsymptom prevalence is in agreement with inappropriate pesticide management; nonetheless, we found no statistically significant association. Our results are lower than other studies, possibly due to lesser exposure, determined by toxicity, pesticide amount utilized, and use and management of chemicals.

To identify the factors associated with dyspareunia, during the 60-180 days following childbirth, in women with a history of one or two childbirths.A case study of 304 women, matched by age and parity who visited family planning services in a hospital in Acapulco, State of Guerrero, Mexico, 60-180 days after giving birth. A questionnaire was administered to assess socioeconomic status (age, level of education, partner's level of education, marital status, employment, social security, and homeownership), obstetric history (type of birth, parity, location of the birth, tearing, episiotomy, and complications), and gynecological status (constricted introitus, scar tissue at the episiotomy site, symptoms of vaginitis, vaginal dryness, contraceptive use, and breast feeding duration). Cases were defined as those women who related pain, burning, or bleeding following vaginal intercourse after childbirth. An unconditional logistic regression model was applied and odd ratios (OR) and 95% confidence interval were calculated.Of the 368 women who had reinitiated sexual relations, 152 (41.3%) mentioned dyspareunia. The factors associated with dyspareunia were: an infection with or without episiorrhaphy dehiscence (OR=34.09; CI95%: 10.59-109.78); symptoms of vaginitis (OR=7.43; CI95%: 3.68-14.99); tightness in the introitus of the vagina (OR=6.38; CI95%: 2.92-13.94), and breast feeding exclusively (OR=4.86; CI95%: 2.44- 9.69).Dyspareunia was related to complications with episiotomy and its possible sequelae, such as infection, episiorrhaphy dehiscence, and constricted introitus. More attention should be given to the episiotomy site during the postpartum period and greater selectivity is needed when deciding which women require an episiotomy.

OBJETIVO: Identificar los factores asociados con la dispareunia entre 60 y 180 dias despues del parto en mujeres con antecedentes de uno o dos partos. METODOS: Estudio de casos y controles, pareados por la edad y la paridad en 304 mujeres que acudieron al servicio de planificacion familiar de un hospital de Acapulco, Guerrero, Mexico, entre los 60 y 180 dias despues del parto. Se aplico un cuestionario con preguntas sobre su situacion socioeconomica (edad, escolaridad propia y de su pareja, estado civil, situacion laboral, de seguridad social y de tenencia de su casa) y sus antecedentes obstetricos (caracteristicas del parto, paridad, lugar de atencion, desgarros, episiotomia y complicaciones) y ginecologicos (sensacion de estrechez del introito, presencia de cicatriz queloide de la episiorrafia, sintomas de vaginitis, resequedad vaginal, metodos anticonceptivos empleados y tipo y duracion de la lactancia). Se consideraron como casos a las mujeres que refirieron dolor, ardor o sangrado al tener relaciones sexuales con penetracion vaginal despues del parto. Se aplico un modelo de regresion logistica no condicionada y se calcularon las razones de posibilidades (odds ratios, OR) y los intervalos de confianza de 95% (IC95%). RESULTADOS: De 368 mujeres que habian reiniciado relaciones sexuales, 152 (41,3%) refirieron dispareunia. Los factores asociados con dispareunia fueron haber tenido infeccion con o sin dehiscencia de la episiorrafia (OR = 34,09; IC95%: 10,59 a 109,78), presentar sintomas de vaginitis (OR = 7,43; IC95%: 3,68 a 14,99), tener sensacion de estrechez del introito vaginal (OR = 6,38; IC95%: 2,92 a 13,94) y practicar la lactancia exclusiva (OR = 4,86; IC95%: 2,44 a 9,69). CONCLUSIONES: La dispareunia estuvo relacionada con las complicaciones de la episiotomia y sus posibles secuelas, como la infeccion, la dehiscencia de la episiorrafia y la estrechez del introito vaginal. Se debe realizar una mejor vigilancia de la episiorrafia durante el puerperio y seleccionar mas apropiadamente las mujeres a quienes se les realiza la episiotomia.

"Introducción: México es uno de los princi- pales importadores de plaguicidas en Amé- rica Latina. Objetivo: describir la prevalencia de sínto- mas, el uso y manejo de plaguicidas, en un grupo de trabajadores agrícolas. Material y métodos: se realizó un estudio transversal en 303 agricultores de hortali- zas, granos y flores. Se investigó historia laboral, manejo y frecuencia de uso de plaguicidas, así como los síntomas asocia- dos con la exposición. Resultados: la mediana de edad fue de 46 años; 19.5 % era analfabeta. La mediana de exposición de plaguicidas fue de 15 años. Aplicó plaguicidas, 17.2 % de las 11:00 a 15:00 horas; 36.4 % por más de dos horas; 29.7 % en contra del viento, y 26 % a favor y en contra del viento. Des- pués de aplicarlos, 37.4 % se bañaba al cabo de tres horas, 34.5 % se cambiaba de ropa y 18.8 % reingresaba al cultivo horas después; 23 % presentó algún síntoma, los más fre- cuentes fueron cefalea, comezón, mareo, ardor de piel y hormigueo; la proporción fue mayor entre el grupo ≤ 46 años. Conclusiones: la prevalencia de síntomas es concordante con el inadecuado manejo de los plaguicidas, sin embargo, no encon- tramos asociación estadísticamente signi- ficativa. Nuestros resultados son menores a otros estudios, debido posiblemente a la menor intensidad de la exposición, deter- minada por la toxicidad, la cantidad utiliza- da y al uso y manejo de los químicos."

Identify factors associated with scorpion stings among farm workers who pick corn in the Mexican state of Guerrero.Cross-sectional survey in 14 randomly selected communities in the state of Guerrero.Simple frequencies were obtained and bivariate analysis was used to identify factors associated with scorpion stings while picking corn. Odds ratio was estimated to evaluate the magnitude of the effect.The incidence of scorpion stings was 15% (500/3 294) in 2003. Use of gloves was associated with a dramatic reduction in risk of scorpion stings to the hands (OR = 0.11; IC95% 0.06-0.18). Scorpion stings are a frequent occupational health issue for farm workers. If the results of this survey were reproduced in an unbiased trial, the implication would be that gloves could prevent 133 stings per 1,000 farm workers who currently do not use gloves. The cost of medical attention, transportation and time away from work due to a scorpion sting totaled 505.90 pesos (46 US dollars).The use of gloves by farmers who live in regions where scorpions are endemic should be promoted. The supply network for anti-scorpion serum should also be extended to all rural areas where very toxic species are predominant and farmers should be educated about the importance of seeking timely medical care at health clinics.

The occurrence of physical abuse during pregnancy, identifying associated factors and outcomes for women's health was estimated.A cross-sectional community-based study in Ometepec in the Mexican state of Guerrero identified women who reported at least one pregnancy in the three years prior to the survey. These completed a questionnaire administered by a female nurse.Out of 2389 women in Ometepec, 709 were eligible to complete the questionnaire. Among those interviewed without being present their partners/ husbands, 21% reported a history of physical abuse and 5.6% reported physical abuse during the last pregnancy. There was a strong association between physical abuse in pregnancy and the report of vaginal bleeding. This suggests that physical abuse might be linked to miscarriage (p = 0.06). We found little recognition of physical abuse as cause of obstetrical problems. There was also an association between physical violence during pregnancy and the admission of violent reactions against children, based on a hypothetical scenario of disobedience.This study identified important associations between obstetrical problems and physical violence.

Objective. T he occurrence of physical abuse during pregnancy, identifying associated factors and outcomes for women’s health was estimated. Material and Methods. A cross-sectional community-based study in Ometepec in the Mexican state of Guerrero identified women who reported at least one pregnancy in the three years prior to the survey. These completed a questionnaire administered by a female nurse. Results. Out of 2 389 women in Ometepec, 709 were eligible to complete the questionnaire. Among those interviewed without being present their partners/ husbands, 21% reported a history of physical abuse and 5.6% reported physical abuse during the last pregnancy. There was a strong association between physical abuse in pregnancy and the report of vaginal bleeding. This suggests that physical abuse might be linked to miscarriage (p=0.06). We found little recognition of physical abuse as cause of obstetrical problems. There was also an association between physical violence during pregnancy and the admission of violent reactions against children, based on a hypothetical scenario of disobedience. Conclusions. This study identified important associations between obstetrical problems and physical violence.