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OBJETIVO: El estrato socioeconómico juega un rol importante en las desigualdades en salud. En México, la prevalencia más alta de casos de SIDA se encuentra en población de estratos más bajos. El propósito de lo estudio fue describir el estrato socioeconómico (ajustado por variables psicosociales, situacionales y demográficas) como un factor predictor del uso consistente del condón, en adolescentes. MÉTODOS: Se incluyó en el estudio una muestra de una encuesta previa aplicada a 1.410 adolescentes de 15 a 19 años y estratificada por edad, género y estrato socioeconómico de Guadalajara, México. El análisis fue aplicado sobre los 251 adolescentes que reportaron actividad sexual. El análisis estadístico se realizó mediante Ji Cuadrada, t-test, ANOVA y regresión logística. RESULTADOS: La frecuencia de uso consistente de condón fue 30,7% y hubo una prevalencia de uso irregular. El estrato socioeconómico alto fue el principal predictor (OR= 11,1, CI95%= 2,6-47,6). Otros predictores significativos fueron el género masculino, el soporte de los pares y el nivel alto de conocimientos sobre VIH/SIDA. CONCLUSIÓN: El estrato socioeconómico es un importante factor predictor del uso consistente del condón.

INTRODUCCIÓN: En México 2,1% de casos con SIDA son adolescentes. Los casos de 20 a 29 años alcanzan a 30,5% y una proporción importante pudo infectarse VIH en la adolescencia. El nivel de conocimientos de los adolescentes sobre VIH/SIDA es variable. En contextos urbanos poseen conceptos errados y mitos que podrían orientarlos a prácticas riesgosas. Los medios masivos e interpersonales son fuentes importantes de información en la construcción social del VIH/SIDA en los adolescentes. El objetivo es relacionar el grado de conocimientos sobre VIH/SIDA con la exposición a fuentes informativas masivas e interpersonales en los adolescentes de Guadalajara, México. MATERIAL Y MÉTODO: Encuesta a 1.410 adolescentes, varones y mujeres de 15 a 19 años, en diferentes estratos socio-económicos. Se aplicaron pruebas de significación Ji Cuadrada y BTukey, Intervalos de Confianza del 95% para proporciones y medias y ANOVA factorial simple. RESULTADO: Hay un nivel regular de conocimientos con medias favorables a los estratos alto y medio. La información de periódicos y profesores tuvo relación directa con el nivel de conocimientos controlada por la exposición a la televisión y variables socio-demográficas. CONCLUSIONES: Hay desigualdades por estratos socio-económicos en la relación de las fuentes informativas y los niveles de conocimientos sobre VIH/SIDA. Es necesario fortalecer y desarrollar acciones educativas por fuentes masivas e interpersonales, con énfasis en estratos bajo y marginado.

OBJETIVO: Describir conocimientos sobre VIH/SIDA en adolescentes de distintos estratos socioeconómicos, mediante un análisis de consenso cultural. MATERIAL Y MÉTODOS: Estudio transversal muestral descriptivo y correlacional. Cuestionario aplicado a 758 adolescentes de Guadalajara, Jalisco, México, entre julio de 1995 y marzo de 1996. Análisis: a) consenso por estratos y género con análisis factorial, b) estimación de patrón cultural de respuestas correctas y de concordancia de respuestas individuo/grupo por correlaciones r de Pearson. RESULTADOS: Hubo altos grados de consenso en todos los estratos. La concordancia de conocimientos individuo/grupo fue mayor en estratos superiores. El patrón de respuestas correctas mostró: a) conocimientos similares sobre formas de transmisión casual, características del SIDA y alto riesgo en trabajadoras del sexo comercial, y b) diferencias basadas en dudas e incertidumbres sobre la protección del condón, la distinción VIH/SIDA y la transmisión en clínicas. CONCLUSIONES: Los conocimientos son homogéneos en todos los estratos y se orientan hacia un modelo biomédico. Sin embargo, contienen elementos de duda e incertidumbre que precisan de intervenciones informativas segmentadas.

OBJETIVO: Evaluar la asociación de conocimientos objetivo y subjetivo sobre VIH/SIDA con el uso del condón. MATERIAL Y MÉTODOS: Se analizó la base de datos de una encuesta aleatoria, anónima y autoaplicada en 1 410 adolescentes de cuatro estratos socioeconómicos de Guadalajara, Jalisco, México, entre 1995 y 1996. El conocimiento objetivo se evaluó mediante 24 preguntas sobre VIH/SIDA y el "subjetivo" con la pregunta: "?(spanish)qué tanto crees conocer sobre el SIDA?" Las variables predictoras del uso del condón se identificaron mediante regresión logística y cálculo de la razón de momios con IC 95%. RESULTADOS: El nivel de conocimiento objetivo fue regular y tuvo diferencias por estratos (p< 0.001) favoreciendo al medio y superior (p= 0.008). Del conocimiento subjetivo, los de estratos alto, medio y bajo percibieron saber "algo", y los del marginado "poco". Los varones dijeron usar más el condón (35.4%) que las mujeres (15.3%) (p< 0.001), y los de estratos superiores (p< 0.005). Aunque conocimiento objetivo y subjetivo se correlacionaron (r= 0.37, p< 0.001), un mayor conocimiento subjetivo se asoció con el uso del condón (p< 0.001). CONCLUSIONES: Conocimiento subjetivo, pertenecer al estrato alto o medio y ser varón, predijeron el uso constante del condón. Su uso fue diferencial por género y estrato socioeconómico.

Background: The aim of this study was to determine the prevalence, SCC mec types, presence of the Panton-Valentine leukocidin (PVL) gene, and susceptibility to antibiotics of methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from hospitalized children. Methods: From August 2009 to September 2011, 291 S. aureus strains were isolated from normally sterile body sites, of which 190 (65%) were MRSA. One hundred and two of the MRSA strains were genetically evaluated. SCC mec genotypes were identified by M-PCR and the PVL gene ( pvl) by end-point PCR. Resistance to erythromycin, rifampicin, clindamycin, and trimethoprim-sulfamethoxazole (SXT) was assessed by Kirby-Bauer disk diffusion method in accordance with the Clinical and Laboratory Standards Institute guidelines of 2012. Results: Of the 102 strains evaluated, 97 (95%) were SCC mec type II, 5 (5%) were SCC mec type IVa, and all (100%) were pvl-negative. Resistance to erythromycin, clindamycin, rifampicin, and SXT was 97%, 95%, 0%, and 0%, respectively. Conclusions: The prevalence of hospital-acquired MRSA was high. SCC mec type II was predominant and the pvl gene appeared not to play any role in the virulence of the MRSA strains from hospitalized children. [ABSTRACT FROM AUTHOR]

Objective: to evaluate the prevalence of nasopharyngeal S. pyogenes (SP) carriers among children attending a day care center (DCC) and the spread of specific clones (SC) among caretakers and relatives. Methods: nasopharyngeal cultures were performed in children with SP positive culture (306), family members (51) and caretakers (73) at time-0, four and seven months later. Differences among SP strains were determined. Descriptive statistics and Fisher exact test were performed. Results: SP prevalence in carrier children, caretakers and relatives was 10, 0 and 4 %. Three pairs of children, from two different classrooms, shared SP strains SC I, II and III. A clone VII was isolated from a relative. In the second survey, the SP prevalence was 4, 0 and 0 %. Two classmates shared clone I and other two from a different classroom shared clone V. In the third, the prevalence was 2, 4 and 14 %. Strains of clones II and VII were isolated from children. A sister of one child, who did not attend to DCC, was a carrier of clone II found in her brother. Clone III was isolated in one caretaker. Conclusions: the SP carrier prevalence was similar to other reports. The sharing of identical clones of SP was found among children in close physical contact. [ABSTRACT FROM AUTHOR]

Objective: to develop a multivariate model to predict the Streptococcus pyogenes isolation in patients with acute tonsillitis. Methods: cross-sectional analytic study on patients with acute tonsillitis without a recent history of antimicrobial consumption. We evaluated 14 signs and 18 symptoms. A pharyngeal culture was realized on 5 % sheep blood agar. Group A streptococci was identified by standard methods. Statistical analysis: sensitivity, specificity, predictive values, Χ², Fisher's exact test, crude and adjusted odds ratio (OR) with 95 % CI using dichotomical logistic regression with direct method and Hosmer and Lemeshow-goodness- fit test. Results: there were 213 participants, 37 % were males; a mean age of 14.9 years. We isolated Streptococcus pyogenes in 15 %, and 84 % of them had received antimicrobials. We identified signs and symptoms associated with Streptococcus pyogenes isolation: painful swallowing (OR = 4.45, 95 % CI = 1.13-17.53); tonsils with exudates (OR = 3.20, 95 % CI = 1.22-8.43); smelly breath (OR = 2.78, 95 % CI = 1.09-7.10); painful neck nodes (OR = 2.70, 95 % CI = 1.05-6.96). The presence of nasal symptoms was a protective factor (OR = 0.25, 95 % CI = 0.09-0.71). Conclusions: the prevalence of Streptococcus pyogenes tonsillitis was similar to other reports. We found signs and symptoms associated to Streptococcus pyogenes isolation that allowed us to elaborate a decision algorithm. [ABSTRACT FROM AUTHOR]

Objective: Identifying factors associated with respiratory tract infection in indigenous migrant day-laborer families'children living in the sugarcane sector in Colima, Mexico., Methods: This was a cross-sectional study. Having given their informed consent, 71 mothers were interviewed for compiling pertinent sociodemographic data and a history of respiratory tract infection in their children during the harvest period 2010-2011. Anthropometry for 176 children aged 0-14 years was recorded and they were clinically examined for upper and lower respiratory tract infection. Frequencies, percentages, Chi-square, odds ratio (crude and adjusted) and 95 % confidence intervals were calculated for the resulting data., Results: 52.3 % of the children in the sample had a history of respiratory infection occurring during the last six months. Respiratory infection rates were statistically significant regarding temporary residence in shelters/hostels. The factors associated with a background of infection were being aged less than four years (AOR 4.06 (2.03-8.09) 95 % CI) and having been involved in temporary residence in a shelter,thereby leading to more overcrowding and an increased use of wood stoves for cooking (AOR 1.92 (1.01-3.63) 95 % CI)., Conclusion: Indigenous migrant day-laboring families'children are vulnerable to respiratory infection. Prevention programs should target their activities by age-group, emphasizing younger children, and promote improved sanitary conditions in the shelters.

Pertussis continues to be responsible for a significant disease burden worldwide. Although immunization practices have reduced the occurrence of the disease among children, waning vaccine- and infection-induced immunity still allows the disease to affect adolescents and adults who, in turn, can transmit the disease to non-immunized or partially immunized infants. This document is the result of a meeting in Mexico City of international experts who analyzed recent medical information in order to establish the current status of the epidemiology, diagnosis and surveillance of pertussis and, especially, the value of the dTpa booster dose in adolescents and adults as a pertussis prevention strategy in Mexico.

Background: Late-onset sepsis (occurring after 3 days of age) either cross-infection (CI) or perinatal is the first cause of morbidity and mortality in neonatal intensive care units (NICU) around the world. Our objective was to determine the current incidence of CI risk factors in neonates admitted to the NICU of the Hospital Civil de Guadalajara during a 9-month period., Methods: A case-control study with 114 newborns; 38 with CI and 76 controls. Odds ratio with 95 % confidence interval were calculated., Results: Associated risk factors were total parenteral nutrition (OR = 16.54, CI = 6.30-43.39, p < 0.001); weight < 1000 g (OR = 7.33, CI = 2.15-25.01, p < 0.001); intravascular catheter (OR = 6.79, CI = 2.68-17.00, p < 0.001); gestational age < 30 weeks (OR = 4.54, CI = 1.61-12.81, p < 0.003); intratracheal intubation and mechanical ventilation with (OR = 6.98, CI = 2.94-16.5, p < 0.001)., Conclusions: Total parenteral nutrition and weight < 1000 g showed the greatest association with cross-infection; in this study, male gender was not a risk factor.

Objective: to evaluate the prevalence of nasopharyngeal S. pyogenes (SP) carriers among children attending a day care center (DCC) and the spread of specific clones (SC) among caretakers and relatives., Methods: nasopharyngeal cultures were performed in children with SP positive culture (306), family members (51) and caretakers (73) at time 0, and four and seven months later. Differences among SP strains were determined. Descriptive statistics and Fisher exact test were performed., Results: SP prevalence in carrier children, caretakers and relatives was 10, 0 and 4 %. Three pairs of children, from two different classrooms, shared SP strains SC I, II and III. A clone VII was isolated from a relative. In the second survey, the SP prevalence was 4, 0 and 0 %. Two classmates shared clone I and other two from a different classroom shared clone V. In the third, the prevalence was 2, 4 and 14 %. Strains of clones II and VII were isolated from children. A sister of one child, who did not attend to DCC, was a carrier of clone II found in her brother. Clone III was isolated in one caretaker., Conclusions: the SP carrier prevalence was similar to other reports. The sharing of identical clones of SP was found among children in close physical contact.

Objective: to develop a multivariate model to predict the Streptococcus pyogenes isolation in patients with acute tonsillitis., Methods: cross-sectional analytic study on patients with acute tonsillitis without a recent history of antimicrobial consumption. We evaluated 14 signs and 18 symptoms. A pharyngeal culture was realized on 5% sheep blood agar. Group A streptococci was identified by standard methods., Statistical Analysis: sensitivity, specificity, predictive values, chi2, Fisher's exact test, crude and adjusted odds ratio (OR) with 95% CI using dichotomical logistic regression with direct method and Hosmer and Lemeshow-goodness-fit test., Results: there were 213 participants, 37% were males; a mean age of 14.9 years. We isolated Streptococcus pyogenes in 15%, and 84 % of them had received antimicrobials. We identified signs and symptoms associated with Streptococcus pyogenes isolation: painful swallowing (OR=4.45, 95% CI = 1.13-17.53); tonsils with exudates (OR=3.20, 95% CI = 1.22-8.43); smelly breath (OR=2.78, 95% CI = 1.09-7.10); painful neck nodes (OR=2.70, 95% CI = 1.05-6.96). The presence of nasal symptoms was a protective factor (OR=0.25, 95% CI = 0.09-0.71)., Conclusions: the prevalence of Streptococcus pyogenes tonsillitis was similar to other reports. We found signs and symptoms associated to Streptococcus pyogenes isolation that allowed us to elaborate a decision algorithm.

Objective: To evaluate the degree of identification of main signs and symptoms of streptococcal pharyngitis by resident doctors, general practitioners, family physicians and pediatricians., Materials and Methods: A prospective, cross-sectional and comparative study was done. A validated questionnaire was applied including the following topics: social demographic, main signs and symptoms, clinical cases; and clinical pictures. We interviewed resident doctors (n = 40), general physicians (n = 21), family physicians (n = 35) and pediatricians (n = 19) from different institutions (SSa, ISSSTE, IMSS) in Guadalajara, Mexico, from March to August 2005. Scores were interpreted as very good, good, regular and poor, and these scores were related with the specialty and clinical years of experience., Statistical Analysis: chi2, student t test and linear regression., Results: This study included 115 physicians between 22 to 60 years old (mean = 39) and with 0 to 31 (mean = 10) clinical years of experience. Regarding the conceptual identification of main signs and symptoms, tonsil exudates were recognized by 33 to 61% of physicians, and a clinical case of streptococcal tonsillitis was recognized by 50 to 70%. A clinical picture of tonsil caseum was misinterpreted as streptococcal tonsillitis by 13 to 35% of the physicians. There was no association between years of clinical experience and the scores obtained in clinical cases (r = 0.20) or clinical pictures (r = 0.09)., Conclusions: The clinical identification of streptococcal tonsillitis was regular to poor among all the interviewed physicians, and there had no correlation with the years of clinical experience. The reinforcement in teaching to recognize the key signs and symptoms of streptococcal tonsillitis at medical school would result in better recognition, more rational use of antimicrobials and reduction in health institutions costs.

Objective: to explore the pattern of knowledge about HIV/AIDS among young native migrant farm workers., Methods: analytical crosscut study. Sample: 135 young people selected by propositive sampling. A questionnaire about knowledge of HIV/AIDS and socio-demographics was applied. A descriptive analysis was made and a knowledge pattern was estimated by means of factorial analysis., Results: average age 19.9 ± 5.8, men 54.8 %, bilingual 79.4 %, elementary or no education, 78.7 %, single 60.4 %, Catholic 67.6 %, two or more work trips 61.8 %; 80.7 % had heard about HIV/AIDS, especially from informal information sources (72 %). Knowledge pattern was homogenous (greater consensus in Nayarit than in Colima: 6.2 versus 3.8) and directed towards building risk identities based on personage (prostitutes 88.1%, men having sex with other men 45 %) and urban setting (78 %). It includes uncertainty about the effectiveness of condoms, the mosquito as a vector, and dentists as transmitters. The pattern showed significant differences according to sex, education and migrant experience., Conclusions: the knowledge of young people does not favor safe sex practices, and the low risk perception could favor their vulnerability to HIV/AIDS.

Objective: To evaluate the seroprevalence, seroconversion, anamnesic response and events temporally associated with immune status pre and post immunization with measles and rubella vaccine in health personnel from a public University in Guadalajara, Mexico., Material and Methods: We carried out a prospective, longitudinal and comparative study from May to June 2000 among 120 healthy volunteers. Informed consent was obtained from all participants. We administered measles (Schwarz) and rubella (RA 27/3) vaccines. Weekly phone calls during six weeks were recorded from each volunteer to assess local and systemic events temporally associated with immunization non attributable to any other disease. Serum samples were obtained before and after vaccination in 75 volunteers. Antibodies against measles and rubella were measured by an enzyme immunoassay kit (Behring) with cut-off points of 300mUI/mL 8UI/mL respectively. Statistical analysis included mean, standard deviation and paired Student's t-test (P < 0.05)., Results: 105/120 participants (87.5%) were followed during 6 weeks. 87.4% were health personnel and 44.6% were males. The age range was 17-71 years (median = 21). We found a prior history of measles in 57.1%. Local events included pain, heat, redness and induration and were reported by 4/105. Systemic events such as fever, exanthema, pain in joints and arthritis was reported by 9/105. The proportion of study subjects with protective antibodies against measles and rubella prior to vaccination was 90.7 and 94.7% respectively. Both groups reached 100% after vaccination., Conclusions: The proportion of non-immune health personnel was low and similar to other reports. However, the potential spread of measles and rubella virus from a non-immunized infected health care provider could be amplified by the number of patients seen daily during the peak period of 3-5 days. The vaccination of health personnel should be encouraged.

Background: Group B streptococcus, or Streptococcus agalactiae, is a grampositive coccus related to infections in the mother and the newborn during peri and postnatal period., Objective: To describe the prevalence of S. agalactiae serotype III and the susceptibility to antimicrobials in strains isolated from pregnant women., Material and Methods: Cultures from vagina, rectum, and urine were taken from 123 high risk pregnant women, who attended to a Gynecology and obstetrics hospital from June 1st to August 30, 2000. Samples were cultured on 5% sheep blood agar and selective broth. For comparison purposes, we also studied 25 S. agalactiae strains from non-pregnant women isolated from January 2000 to August 2001. Serotyping was performed by latex agglutination and susceptibility testing by Kirby Bauer method., Results: The prevalence of S. agalactiae carriers in pregnant women was 13% and the serotypes were: I (58.8%), II (29.4%), III (5.9%) and non typeable (5.9%). Serotypes from non-pregnant women were: I (68%), II (4%), and III (28%). In both groups, the intermediate resistance to penicillin was 17.6 and 12%, whereas for ceftriaxione was 17.6 and 20% respectively. Resistance to both clindamycin and erythromycin was lower than 4%., Conclusions: The prevalence of S. agalactiae in pregnant women was low and similar to other studies reported in Mexico. Serotype I was the most frequently isolated. Resistance to clindamycin and erythromycin was low, whereas intermediate resistance to penicillin and ceftriaxone was high. The low prevalence of both Streptococcus agalactiae and associated infections in Mexico could be related to racial factors or immunity due to early exposure to that bacterium.

Objective: To evaluate the association between objective and subjective knowledge on HIV/AIDS and condom use., Material and Methods: Analysis of a database from an anonymous, self-applied, randomized survey conducted between 1995 and 1996. Study subjects were 1,410 adolescents of four socioeconomic strata from Guadalajara, Mexico. Objective knowledge was assessed with 24 questions regarding HIV/AIDS, and subjective knowledge with the question "how much do you think you know about HIV/AIDS?" The variables associated with condom use were identified using logistic regression analysis and by calculating odds ratios with a 95% confidence interval., Results: The degree of objective knowledge was "average", differentiated by socioeconomic strata (p < 0.001), and was higher in adolescents from medium and high socioeconomic strata (p < 0.008). Regarding subjective knowledge, adolescents from the low, medium, and high socioeconomic strata claimed to know "a little", and the ones from the lowest stratum claimed to know "very little". Condom use was higher in males (35.4%), and in adolescents from high socioeconomic strata (p < 0.005), than in females (15.3%) (p < 0.001). Although there was a correlation between objective and subjective knowledge (r = 0.37, p < 0.001), a higher degree of subjective knowledge was associated with condom use (p < 0.001)., Conclusions: Subjective knowledge, belonging to medium and high socioeconomic strata and being male, were predictors of condom use.

Objective: To describe the knowledge of HIV/AIDS among adolescents from different socioeconomic strata (SS), using cultural consensus analysis., Material and Methods: A cross-sectional descriptive and analytic study was conducted from July 1995 to March 1996, among 758 adolescents from Guadalajara, México. Data were collected using a questionnaire, and analyzed by means of: a) consensus by SS and gender using factorial analysis; and b) identification of the cultural pattern of correct answers, and concordance of individual/group answers using Pearson's r correlation coefficients., Results: There was a high degree of consensus across SS. The individual/group knowledge concordance was greater in higher SS. The pattern of correct responses showed: a) similar knowledge on casual transmission, AIDS characteristics, and higher risk in sex workers; and b) discrepancies regarding doubts and uncertainties about condom protection, distinction between HIV and AIDS, and HIV transmission in health clinics., Conclusions: Knowledge was homogeneous and mainly medically oriented across all SS. Nevertheless, there were elements of doubt and uncertainty that require differentiated informative interventions.