Resumo Histórico: A diálise peritoneal (DP) vem ganhando terreno como terapia eficiente/acessível em ambientes pobres. Contudo, há poucos dados sobre diferenças na qualidade de vida (QV) dos cuidadores primários (CP) de pacientes em DP e hemodiálise (HD). Objetivo: Comparar QV dos CP de pacientes em DP e HD de uma cidade mexicana de renda média. Métodos: Estudo transversal com CP de pacientes em DP (n=42) e HD (n=95) de 4 hospitais (taxa resposta=70,2%). Aplicou-se o questionário QV-36 itens, entrevista de sobrecarga de Zarit e escala de ansiedade/depressão Goldberg. Escores médios normalizados para cada domínio de QV foram comparados por tipo de diálise. Probabilidades ajustadas foram calculadas usando regressão logística para determinar a probabilidade de baixa QV (<70% da pontuação máxima possível resultante das pontuações adicionadas das 8 dimensões). Resultados: O grupo DP apresentou escores médios mais altos para aspectos emocionais (+10,6; p=0,04), capacidade funcional (+9,2; p=0,002), dor (+9,2; p=0,07), aspectos sociais (+5,7; p=0,25), saúde mental (+1,3; p=0,71); o grupo HD teve pontuação maior para aspectos físicos (+7,9, p=0,14), estado geral de saúde (+6,1; p=0,05), vitalidade (+3,3; p=0,36). Uma probabilidade não significativa foi observada na regressão multivariada (OR=0,66; 95% IC 0,18-2,31). Os escores de Zarit foram semelhantes, mas os níveis da sobrecarga foram menores na DP (médio/alto: DP 7,2%, HD 14,8%). Ansiedade (50,5% vs 19%; p<0,01) e depressão (49,5% vs 16,7%; p<0,01) foram menores na DP. Conclusão: O risco de baixa QV entre grupos não foi diferente na análise ajustada. Estes achados fortalecem a importância da DP em ambientes com recursos limitados.

Abstract Background: Peritoneal dialysis (PD) is gaining track as an efficient/affordable therapy in poor settings. Yet, there is little data regarding differences in quality of life (QoL) of primary caregivers (PCG) of patients in PD and hemodialysis (HD). Aim: To compare the QoL of PCG of patients in PD and HD from an upper middle-income population in a Mexican city. Methods: Cross-sectional study was carried out with PCG of patients in PD (n=42) and HD (n=95) from 4 hospitals (response rate=70.2%). The SF 36-item QoL questionnaire, the Zarit burden interview, and the Goldberg anxiety/depression scale were used. Mean normalized scores for each QoL domain were compared by dialysis type. Adjusted odds were computed using logistic regression to determine the probability of low QoL (<70% of maximum possible score resulting from the added scores of the 8 dimensions). Results: The PD group had higher mean scores for emotional role functioning (+10.6; p=0.04), physical functioning (+9.2; p=0.002), bodily pain (+9.2; p=0.07), social functioning (+5.7; p=0.25), and mental health (+1.3; p=0.71); the HD group had higher scores for physical role functioning (+7.9, p=0.14), general health perception (+6.1; p=0.05), and vitality (+3.3; p=0.36). A non-significant OR was seen in multivariate regression (1.51; 95% CI 0.43-5.31). Zarit scores were similar, but workload levels were lower in the PD group (medium/high: PD 7.2%, HD 14.8%). Anxiety (HD 50.5%, PD 19%; p<0.01) and depression (HD 49.5%, PD 16.7%; p<0.01) were also lower in the PD group. Conclusion: Adjusted analysis showed no differences in the probability of low QoL between the groups. These findings add to the value of PD, and strengthen its importance in resource-limited settings.

RESUMEN Objetivo Identificar si la selección de parejas sexuales mixtas y la existencia de parejas concurrentes son predictores del uso de condón en trabajadores agrícolas migrantes indígenas de Colima, México. Métodos Estudio transversal analítico bajo un enfoque egocéntrico de redes de parejas sexuales. Entrevistadores comunitarios aplicaron un cuestionario estructurado a 192 trabajadores migrantes indígenas de un contexto agroindustrial cañero. Los datos se analizaron mediante regresión logística binaria; se calcularon razones de momios (RM) e intervalos de confianza (IC) de 95%. Resultados En el modelo de regresión de predictores del uso constante de condón, las RM ajustadas (RM; IC 95%) fueron: menores en las parejas sexuales de la misma etnicidad que en las otras parejas (0.30; 0.17-0.53), menores en las parejas concurrentes que en las no concurrentes (0.27; 0.15-0.50); y menores en las parejas usuarias de drogas ilegales que en las no usuarias (0.23; 0.11-0.49). El sentido predictor de estas variables se asoció a un mayor riesgo de sexo no protegido (algunas veces o nunca usaron condón). Conclusión Las parejas sexuales de la misma etnicidad, las parejas concurrentes y las parejas que usan drogas ilegales favorecen una baja frecuencia de uso constante del condón y con ello la vulnerabilidad a la transmisión de ITS y VIH en los trabajadores agrícolas migrantes indígenas.

ABSTRACT Objective To identify if the selection of mixed sexual partners and the existence of concurrent partners are predictors of condom use in indigenous migrant agricultural workers from Colima, Mexico. Methods Analytical cross-sectional study using an egocentric sexual network approach. Community interviewers applied a structured questionnaire to 192 indigenous migrant workers in a sugarcane agro-industrial context. Data were analyzed with binary logistic regression; odds ratios (OR) and 95% confidence intervals (CI 95%) were estimated. Results In the logistic regression model, adjusted odds (OR; 95% CI) of steady condom use were lower within partnerships of the same indigenous ethnicity compared to other partnerships (0.30; 0.17-0.53), partnerships that were concurrent to other partnerships (0.27; 0.15-0.50), and partnerships that used illegal drugs during sex to other partnerships (0.23; 0.11-0.49). Those variables were actually associated with increased risk of unprotected sex (occasionally or never using condoms), and therefore exposures were unprotected. Conclusion Sexual partners of the same ethnicity, concurrent partnerships and partnerships that use illegal drugs favor the low frequency of constant condom use and, in turn, the vulnerability to STIs and HIV transmission in indigenous migrant agricultural workers.

ABSTRACT Objective To identify if the selection of mixed sexual partners and the existence of concurrent partners are predictors of condom use in indigenous migrant agricultural workers from Colima, Mexico. Methods Analytical cross-sectional study using an egocentric sexual network approach. Community interviewers applied a structured questionnaire to 192 indigenous migrant workers in a sugarcane agro-industrial context. Data were analyzed with binary logistic regression; odds ratios (OR) and 95% confidence intervals (CI 95%) were estimated. Results In the logistic regression model, adjusted odds (OR; 95% CI) of steady condom use were lower within partnerships of the same indigenous ethnicity compared to other partnerships (0.30; 0.17-0.53), partnerships that were concurrent to other partnerships (0.27; 0.15-0.50), and partnerships that used illegal drugs during sex to other partnerships (0.23; 0.11-0.49). Those variables were actually associated with increased risk of unprotected sex (occasionally or never using condoms), and therefore exposures were unprotected. Conclusion Sexual partners of the same ethnicity, concurrent partnerships and partnerships that use illegal drugs favor the low frequency of constant condom use and, in turn, the vulnerability to STIs and HIV transmission in indigenous migrant agricultural workers.

RESUMEN Objetivo Identificar si la selección de parejas sexuales mixtas y la existencia de parejas concurrentes son predictores del uso de condón en trabajadores agrícolas migrantes indígenas de Colima, México. Métodos Estudio transversal analítico bajo un enfoque egocéntrico de redes de parejas sexuales. Entrevistadores comunitarios aplicaron un cuestionario estructurado a 192 trabajadores migrantes indígenas de un contexto agroindustrial cañero. Los datos se analizaron mediante regresión logística binaria; se calcularon razones de momios (RM) e intervalos de confianza (IC) de 95%. Resultados En el modelo de regresión de predictores del uso constante de condón, las RM ajustadas (RM; IC 95%) fueron: menores en las parejas sexuales de la misma etnicidad que en las otras parejas (0.30; 0.17-0.53), menores en las parejas concurrentes que en las no concurrentes (0.27; 0.15-0.50); y menores en las parejas usuarias de drogas ilegales que en las no usuarias (0.23; 0.11-0.49). El sentido predictor de estas variables se asoció a un mayor riesgo de sexo no protegido (algunas veces o nunca usaron condón). Conclusión Las parejas sexuales de la misma etnicidad, las parejas concurrentes y las parejas que usan drogas ilegales favorecen una baja frecuencia de uso constante del condón y con ello la vulnerabilidad a la transmisión de ITS y VIH en los trabajadores agrícolas migrantes indígenas.

We used a structured approach to assess whether active smokers presented with pictorial warnings on cigarette packages (PWCP) had a higher probability of quitting, reducing, and attempting to quit smoking than did unexposed smokers. We identified 21 articles from among nearly 2500 published between 1993 and 2013, prioritizing coverage over relevance or quality because we expected to find only a few studies with behavioral outcomes. We found very large heterogeneity across studies, poor or very poor methodological quality, and generally null or conflicting findings for any explored outcome. The evidence for or against the use of PWCP is insufficient, suggesting that any effect of PWCP on behavior would be modest. Determining the single impact of PWCP on behavior requires studies with strong methodological designs and longer follow-up periods.

Aplicamos un método estructurado para evaluar si los fumadores activos a los que se les mostraban advertencias gráficas en los paquetes de cigarrillos tenían una probabilidad mayor de abandonar el hábito, reducir el consumo de cigarrillos o intentar dejar de fumar por comparación con fumadores no expuestos. Seleccionamos 21 artículos de entre casi 2500 publicados entre 1993 y 2013, dando prioridad a la cobertura sobre la pertinencia o la calidad porque preveíamos encontrar muy pocos estudios con resultados comportamentales. Observamos una heterogeneidad muy grande entre los estudios, una calidad metodológica deficiente o muy deficiente y resultados por lo general nulos o contradictorios con respecto a cualquier desenlace explorado. Los datos científicos a favor o en contra del uso de las advertencias gráficas son insuficientes, lo cual hace sospechar que cualquier efecto de estas sobre el comportamiento sería moderado. La determinación del efecto individual de las advertencias gráficas sobre el comportamiento requiere de estudios con diseños metodológicos sólidos y períodos de seguimiento más largos.

Descrever as rotas seguidas para os cuidados de mulheres com câncer de mama filiadas ao Seguro Popular de Saúde em San Luís Potosí, no México. Pesquisa qualitativa realizada com abordagem etnográfica, envolvendo 12 mulheres que foram diagnosticadas. Foram conduzidas histórias narradas por duas participantes, seguidas de uma entrevista por telefone. As análises do conteúdo e diacrônica foram realizadas. Três opções foram identificadas em busca de atenção: (1) o processo de diagnóstico, (2) a partir do diagnóstico até o tratamento, e (3) controle e reincidência do câncer. Os resultados sugerem que os recursos de infraestrutura e humanos são escassos para a detecção adequada e diagnóstico oportuno. O adiamento da avaliação médica também está relacionado com a falta de informação sobre as consequências do câncer e o medo das mulheres em saber o resultado. O programa de rastreio atual precisa ser redesenhado para evitar atrasos no diagnóstico, que parecem explicar a alta frequência de estágios avançados relatados.

This study aims to describe the medical itineraries followed by breast cancer women affiliated to the People's Health Insurance in San Luis Potosí, central Mexico. We used an ethnographic approach based on oral histories of 12 women diagnosed with breast cancer in the year prior to the first meeting. Two face-to-face sessions per participant lasting 60 minutes each were conducted followed by a telephone interview. Content and diachronic analyses were used. Three main itineraries were identified: (1) diagnostic process, (2) final diagnosis to treatment, and (3) cancer control and relapse. Findings suggested that infrastructure and human resources to adequately screen and timely diagnose breast cancer were scant and insufficiently trained, respectively. Deferral of medical assessment was related with lack of information about breast cancer consequences, with women being afraid of a positive result, and with economic constraints. The current screening program needs to be redesigned to prevent diagnostic delays, as these seem to explain the high frequency of advanced stages reported at the time of diagnosis.

Describir los itinerarios de atención medicalizada seguidos por mujeres con cáncer de mama, afiliadas al Seguro Popular de Salud en San Luis Potosí, México. Se realizó un estudio cualitativo con enfoque etnográfico en el que participaron 12 mujeres. Se recolectaron historias orales, dos entrevistas cara a cara y una telefónica por participante. Se efectuó análisis de contenido y diacrónico. Tres itinerarios fueron identificados en la búsqueda de atención: (1) el proceso de diagnóstico, (2) del diagnóstico al tratamiento, y (3) el control del cáncer y la recaída. Los hallazgos sugieren que la infraestructura y los recursos humanos son escasos para obtener una detección adecuada y un diagnóstico oportuno. El aplazamiento de la valoración médica también se relaciona con la falta de información sobre las consecuencias del cáncer y el temor de las mujeres al resultado. El programa de cribado actual necesita ser rediseñado para evitar retrasos de diagnóstico, los cuales parecen explicar la alta frecuencia de estadios avanzados reportados.

Descrever as rotas seguidas para os cuidados de mulheres com câncer de mama filiadas ao Seguro Popular de Saúde em San Luís Potosí, no México. Pesquisa qualitativa realizada com abordagem etnográfica, envolvendo 12 mulheres que foram diagnosticadas. Foram conduzidas histórias narradas por duas participantes, seguidas de uma entrevista por telefone. As análises do conteúdo e diacrônica foram realizadas. Três opções foram identificadas em busca de atenção: (1) o processo de diagnóstico, (2) a partir do diagnóstico até o tratamento, e (3) controle e reincidência do câncer. Os resultados sugerem que os recursos de infraestrutura e humanos são escassos para a detecção adequada e diagnóstico oportuno. O adiamento da avaliação médica também está relacionado com a falta de informação sobre as consequências do câncer e o medo das mulheres em saber o resultado. O programa de rastreio atual precisa ser redesenhado para evitar atrasos no diagnóstico, que parecem explicar a alta frequência de estágios avançados relatados.

This study aims to describe the medical itineraries followed by breast cancer women affiliated to the People's Health Insurance in San Luis Potosí, central Mexico. We used an ethnographic approach based on oral histories of 12 women diagnosed with breast cancer in the year prior to the first meeting. Two face-to-face sessions per participant lasting 60 minutes each were conducted followed by a telephone interview. Content and diachronic analyses were used. Three main itineraries were identified: (1) diagnostic process, (2) final diagnosis to treatment, and (3) cancer control and relapse. Findings suggested that infrastructure and human resources to adequately screen and timely diagnose breast cancer were scant and insufficiently trained, respectively. Deferral of medical assessment was related with lack of information about breast cancer consequences, with women being afraid of a positive result, and with economic constraints. The current screening program needs to be redesigned to prevent diagnostic delays, as these seem to explain the high frequency of advanced stages reported at the time of diagnosis.

Describir los itinerarios de atención medicalizada seguidos por mujeres con cáncer de mama, afiliadas al Seguro Popular de Salud en San Luis Potosí, México. Se realizó un estudio cualitativo con enfoque etnográfico en el que participaron 12 mujeres. Se recolectaron historias orales, dos entrevistas cara a cara y una telefónica por participante. Se efectuó análisis de contenido y diacrónico. Tres itinerarios fueron identificados en la búsqueda de atención: (1) el proceso de diagnóstico, (2) del diagnóstico al tratamiento, y (3) el control del cáncer y la recaída. Los hallazgos sugieren que la infraestructura y los recursos humanos son escasos para obtener una detección adecuada y un diagnóstico oportuno. El aplazamiento de la valoración médica también se relaciona con la falta de información sobre las consecuencias del cáncer y el temor de las mujeres al resultado. El programa de cribado actual necesita ser rediseñado para evitar retrasos de diagnóstico, los cuales parecen explicar la alta frecuencia de estadios avanzados reportados.

A cohort of 123 adult contacts was followed for 18‐24 months (86 completed the follow-up) to compare conversion and reversion rates based on two serial measures of QuantiFERON (QFT) and tuberculin skin test (TST) (PPD from TUBERSOL, Aventis Pasteur, Canada) for diagnosing latent tuberculosis (TB) in household contacts of TB patients using conventional (C) and borderline zone (BZ) definitions. Questionnaires were used to obtain information regarding TB exposure, TB risk factors and socio-demographic data. QFT (IU/mL) conversion was defined as <0.35 to ≥0.35 (C) or <0.35 to >0.70 (BZ) and reversion was defined as ≥0.35 to <0.35 (C) or ≥0.35 to <0.20 (BZ); TST (mm) conversion was defined as <5 to ≥5 (C) or <5 to >10 (BZ) and reversion was defined as ≥5 to <5 (C). The QFT conversion and reversion rates were 10.5% and 7% with C and 8.1% and 4.7% with the BZ definitions, respectively. The TST rates were higher compared with QFT, especially with the C definitions (conversion 23.3%, reversion 9.3%). The QFT conversion and reversion rates were higher for TST ≥5; for TST, both rates were lower for QFT <0.35. No risk factors were associated with the probability of converting or reverting. The inconsistency and apparent randomness of serial testing is confusing and adds to the limitations of these tests and definitions to follow-up close TB contacts.

OBJETIVO: Evaluar la eficacia de una intervención amplia de 20 semanas de duración para prevenir la reinfección por Ascaris lumbricoides y Giardia lamblia en niños indígenas en edad escolar del norte de México. MÉTODOS: Estudio prospectivo, de comparación y ecológico. Se seleccionaron dos internados geográficamente aislados, cada uno de los cuales alberga entre 100 y 120 niños de 4 a 15 años de edad, según su infraestructura física: una escuela moderna en la que se llevó a cabo la intervención y otra, precaria, que se empleó como control. Tras el diagnóstico inicial, los niños con resultados positivos en los análisis de las muestras de heces recibieron tratamiento supervisado con nitazoxanida oral. El diagnóstico se hizo con al menos un resultado microscópico positivo en dos muestras sucesivas con la técnica de Faust, según lo informado por las observaciones independientes efectuadas por dos técnicos de laboratorio capacitados. Se tomaron muestras postratamiento y solo se hizo el seguimiento de los niños con resultados negativos. La intervención incluyó mejoras y mantenimiento de la infraestructura y un programa educativo de prevención para los niños, los padres y el personal de la escuela; en la escuela de control no se llevó a cabo ninguna actividad. RESULTADOS: La prevalencia inicial de la infección por A. lumbricoides fue de 37,5% en la escuela de la intervención frente a 16,6% en la escuela de control (P < 0,01); la de G. lamblia, de 51,7% frente a 37,8%, respectivamente. En la escuela de la intervención 35,7% no hablaba español, en comparación con 6,7% en la escuela de control (P < 0,01). Las tasas de curación fueron similares en ambas escuelas para A. lumbricoides (aproximadamente 98%) y para G. lamblia (aproximadamente 80%). La prevalencia final y las tasas de reinfección para G. lamblia fueron de 10,4% frente a 10,8% en la escuela de la intervención y de 17,2% frente a 21% en la escuela de control. No hubo nuevas infecciones o reinfecciones con A. lumbricoides en ninguna de las escuelas. Las tasas de seguimiento fueron de 80% a 83% en la escuela de control y de 90% a 95% en la escuela de la intervención. CONCLUSIONES: Las tasas de infección o reinfección fueron similares en las dos escuelas después de 20 semanas. El tratamiento supervisado cada semestre como única medida controló eficazmente las infecciones con A. lumbricoides o G. lamblia en este entorno indígena.

OBJECTIVE: To assess the effectiveness of a 20-week, broad intervention to prevent reinfection by Ascaris lumbricoides (AL) and Giardia lamblia (GL) among indigenous schoolchildren in northern Mexico. METHODS: A prospective, comparative, ecological study. Two isolated boarding schools, each hosting 100-120 children, 4-15 years of age, were selected based on physical infrastructure: intervention school (IS), modern; control school (CS), deprived. After initial diagnosis, children with positive stool samples received supervised treatment with oral nitazoxanide. Diagnoses were made with at least one positive microscopic result from two serial samples using the Faust technique, as reported by the independent observations of two trained, laboratory technicians. Post-treatment samples were taken, and only those with negative results were followed-up. The intervention included infrastructure improvements/maintenance and an educational preventive program for children, parents, and school personnel; no activities were undertaken in the CS. RESULTS: Baseline prevalence for AL was 37.5% at the IS versus 16.6% at the CS (P < 0.01); and for GL, 51.7% versus 37.8%, respectively. At the IS, 35.7% did not speak Spanish, compared to 6.7% in the CS (P < 0.01). Cure rates were similar in both schools for AL (~ 98%) and GL (~ 80%). Final prevalence and reinfection rates for GL were 10.4% versus 10.8%, and 17.2% versus 21% at the IS and CS, respectively. No children were infected/reinfected with AL in either school. Follow-up rates were 80%-83% at the CS and 90%-95% at the IS. CONCLUSIONS: Infection/reinfection rates were similar at the schools after 20 weeks. Supervised treatment alone every semester could effectively control AL/GL infections in this indigenous setting.

OBJECTIVE: To assess the adequacy and variability of the diet served to Tarahumara children in indigenous boarding schools. MATERIAL AND METHODS: Records of food and drinks served for meals, weighed daily, were obtained from Monday through Friday for 10 consecutive weeks in two selected boarding schools. Nutrient intake for Tuesdays, Wednesdays and Thursdays was calculated and analyzed for weeks 3, 5 and 7. RESULTS: The number of food items used per week ranged from 33 to 46. The most frequently utilized items were cooking oil, fortified corn tortilla, milk, onion, sugar and beans. Total energy served per day fluctuated between 1309 and 2919 Kcal; proteins comprised 10.5 to 21.2% (45 to 127 g/day), carbohydrates 40.7 to 61.9% (145 to 433 g/day), and lipids 22.5 to 48.1% (45 to 125 g/day) of the total. Daily micronutrient content ranges were: iron 15-33 mg, calcium 686-1795 mg, zinc 8-19 mg, vitamin A 118-756 mcg, vitamin B9 42-212 mcg, and vitamin B12 0.8-5 mcg. CONCLUSION: There was significant daily variability in the diet, which was hypercaloric due to the high lipid content, and yet insufficient in vitamins B9, B12 and A.

OBJETIVO: Evaluar la adecuación y variación de la dieta servida a escolares de albergues indigenistas. MATERIAL Y MÉTODOS: Durante diez semanas se evaluó la dieta servida en dos albergues documentando el tipo/cantidad de ingredientes empleados para preparar alimentos/bebidas y registrando la ración ofrecida mediante la técnica de pesos y medidas; se analizó la dieta servida los martes-miércoles-jueves de las semanas 3-5-7. RESULTADOS: Se utilizaron 33-46 ingredientes/semana; los más frecuentes fueron aceite, tortillas de harina de maíz fortificada, leche, cebolla, azúcar y frijol. La energía total en la ración diaria fluctuó entre 1309 y 2919 kcal; las proteínas constituyeron 10.5-21.2% (45-127 g/día), los hidratos de carbono 40.7-61.9% (145-433 g/día), y los lípidos 22.5-48.1% (45-125 g/día). El contenido diario de micronutrimentos fue el siguiente: hierro, 15-33 mg; calcio, 686-1795 mg; zinc, 8-19 mg; vitamina A, 118-756 mcg; vitamina B9, 42-212 mcg y vitamina B12, 0.8-5 mcg. CONCLUSIÓN: Existe una variación importante en la dieta servida que resulta relativamente hipercalórica por exceso de lípidos, pero con un contenido insuficiente de vitaminas B9, B12 y A.

OBJECTIVE: To assess the adequacy and variability of the diet served to Tarahumara children in indigenous boarding schools. MATERIAL AND METHODS: Records of food and drinks served for meals, weighed daily, were obtained from Monday through Friday for 10 consecutive weeks in two selected boarding schools. Nutrient intake for Tuesdays, Wednesdays and Thursdays was calculated and analyzed for weeks 3, 5 and 7. RESULTS: The number of food items used per week ranged from 33 to 46. The most frequently utilized items were cooking oil, fortified corn tortilla, milk, onion, sugar and beans. Total energy served per day fluctuated between 1309 and 2919 Kcal; proteins comprised 10.5 to 21.2% (45 to 127 g/day), carbohydrates 40.7 to 61.9% (145 to 433 g/day), and lipids 22.5 to 48.1% (45 to 125 g/day) of the total. Daily micronutrient content ranges were: iron 15-33 mg, calcium 686-1795 mg, zinc 8-19 mg, vitamin A 118-756 mcg, vitamin B9 42-212 mcg, and vitamin B12 0.8-5 mcg. CONCLUSION: There was significant daily variability in the diet, which was hypercaloric due to the high lipid content, and yet insufficient in vitamins B9, B12 and A.

OBJETIVO: Evaluar la adecuación y variación de la dieta servida a escolares de albergues indigenistas. MATERIAL Y MÉTODOS: Durante diez semanas se evaluó la dieta servida en dos albergues documentando el tipo/cantidad de ingredientes empleados para preparar alimentos/bebidas y registrando la ración ofrecida mediante la técnica de pesos y medidas; se analizó la dieta servida los martes-miércoles-jueves de las semanas 3-5-7. RESULTADOS: Se utilizaron 33-46 ingredientes/semana; los más frecuentes fueron aceite, tortillas de harina de maíz fortificada, leche, cebolla, azúcar y frijol. La energía total en la ración diaria fluctuó entre 1309 y 2919 kcal; las proteínas constituyeron 10.5-21.2% (45-127 g/día), los hidratos de carbono 40.7-61.9% (145-433 g/día), y los lípidos 22.5-48.1% (45-125 g/día). El contenido diario de micronutrimentos fue el siguiente: hierro, 15-33 mg; calcio, 686-1795 mg; zinc, 8-19 mg; vitamina A, 118-756 mcg; vitamina B9, 42-212 mcg y vitamina B12, 0.8-5 mcg. CONCLUSIÓN: Existe una variación importante en la dieta servida que resulta relativamente hipercalórica por exceso de lípidos, pero con un contenido insuficiente de vitaminas B9, B12 y A.

Objective. To determine the prevalence of iron deficiency anemia (IDA) among Tarahumara women of reproductive age. Material and Methods. A cross-sectional survey was conducted in a representative sample of 481 women aged 12-49 years, residents of Guachochi Municipality, Chihuahua, from June to September 1998. The hemoglobin (Hb) level was measured in capillary blood using the Hemocue technique, and the serum ferritin level in capillary serum spotted on filter paper, in a sub-sample of women. Central tendency and dispersion measures were estimated; the Chisquared test was used to test differences in proportions and ANOVA and Bonferroni's test for differences in means. Results. Prevalence of anemia (mean Hb±S.D.) was 16.1% (140±16 g/l) and 25.7% (129±12 g/l) for non-pregnant and pregnant women, respectively. Pregnant women in the 3rd trimester and those who were breast-feeding their children during the first 6 months after delivery had the highest prevalence of anemia (38.5% and 42.9%, respectively). Iron deficiency was responsible for most of the anemia found in this sample. Conclusions. This study provides relevant information for the development of intervention programs to treat and prevent IDA in this ethnic group. The English version of this paper is available too at: <a HREF="http://www.insp.mx/salud/index.html">http://www.insp.mx/salud/index.html</a>

Objetivo. Determinar la prevalencia de anemia ferropriva en mujeres tarahumaras de edad fértil. Material y métodos. Se realizó un estudio transversal en una muestra representativa de 481 mujeres, de edades entre 12 a 49 años, residentes del municipio de Guachochi, Chihuahua, de junio a septiembre de 1998. El nivel de hemoglobina (Hb) se midió en sangre capilar mediante la técnica del Hemocue, además, en un subgrupo se midió el nivel de ferritina en suero capilar sobre papel filtro. Se obtuvieron medidas de tendencia central y de dispersión, se hicieron pruebas de ji cuadrada para diferencias de proporciones, además de ANOVA y prueba de Bonferroni para diferencias de medias. Resultados. La prevalencia de anemia (<img src="/img/revistas/spm/v43n5/6717s1.gif" align="absmiddle"> Hb±DE) fue de 16.1% (140±16 g/l) y 25.7% (129±12 g/l) para no embarazadas y embarazadas, respectivamente. Las embarazadas en el tercer trimestre y las que estaban lactando durante los primeros seis meses del postparto mostraron las más altas prevalencias de anemia (38.5% y 42.9%, respectivamente). La deficiencia de hierro fue responsable de la mayoría de los casos de anemia encontrada en esta muestra. Conclusiones. Este estudio provee información relevante para desarrollar programas de intervención para tratar y prevenir la anemia ferropriva en este grupo étnico. El texto completo en inglés de este artículo está también disponible en: <a href="http://www.insp.mx/salud/index.html">http://www.insp.mx/salud/index.html</a>

Objective. To determine the prevalence of iron deficiency anemia (IDA) among Tarahumara women of reproductive age. Material and Methods. A cross-sectional survey was conducted in a representative sample of 481 women aged 12-49 years, residents of Guachochi Municipality, Chihuahua, from June to September 1998. The hemoglobin (Hb) level was measured in capillary blood using the Hemocue technique, and the serum ferritin level in capillary serum spotted on filter paper, in a sub-sample of women. Central tendency and dispersion measures were estimated; the Chisquared test was used to test differences in proportions and ANOVA and Bonferroni's test for differences in means. Results. Prevalence of anemia (mean Hb±S.D.) was 16.1% (140±16 g/l) and 25.7% (129±12 g/l) for non-pregnant and pregnant women, respectively. Pregnant women in the 3rd trimester and those who were breast-feeding their children during the first 6 months after delivery had the highest prevalence of anemia (38.5% and 42.9%, respectively). Iron deficiency was responsible for most of the anemia found in this sample. Conclusions. This study provides relevant information for the development of intervention programs to treat and prevent IDA in this ethnic group. The English version of this paper is available too at: <a HREF="http://www.insp.mx/salud/index.html">http://www.insp.mx/salud/index.html</a>

Objetivo. Determinar la prevalencia de anemia ferropriva en mujeres tarahumaras de edad fértil. Material y métodos. Se realizó un estudio transversal en una muestra representativa de 481 mujeres, de edades entre 12 a 49 años, residentes del municipio de Guachochi, Chihuahua, de junio a septiembre de 1998. El nivel de hemoglobina (Hb) se midió en sangre capilar mediante la técnica del Hemocue, además, en un subgrupo se midió el nivel de ferritina en suero capilar sobre papel filtro. Se obtuvieron medidas de tendencia central y de dispersión, se hicieron pruebas de ji cuadrada para diferencias de proporciones, además de ANOVA y prueba de Bonferroni para diferencias de medias. Resultados. La prevalencia de anemia (<img src="http:/img/fbpe/spm/v43n5/6717s1.gif" align="absmiddle"> Hb±DE) fue de 16.1% (140±16 g/l) y 25.7% (129±12 g/l) para no embarazadas y embarazadas, respectivamente. Las embarazadas en el tercer trimestre y las que estaban lactando durante los primeros seis meses del postparto mostraron las más altas prevalencias de anemia (38.5% y 42.9%, respectivamente). La deficiencia de hierro fue responsable de la mayoría de los casos de anemia encontrada en esta muestra. Conclusiones. Este estudio provee información relevante para desarrollar programas de intervención para tratar y prevenir la anemia ferropriva en este grupo étnico. El texto completo en inglés de este artículo está también disponible en: <a href="http://www.insp.mx/salud/index.html">http://www.insp.mx/salud/index.html</a>