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BACKGROUND: Atherosclerotic ischaemic heart disease is the second leading cause of general mortality in Mexico due to the growing prevalence of atherosclerotic risk factors in our society. The data of the FRIMEX study (Factores de Riesgo en México, Risk Factors in Mexico), considered together with those of other contemporary epidemiological surveys, will aid in our comprehension of the current state of cardiovascular epidemics in Mexico. METHODS: Frequencies of obesity, hypertension and smoking, and total cholesterol and glucose in capillary blood were estimated in a non-probabilistic sample comprised of 140017 individuals (aged 44+/-13 years; 42% men and 58% women), from six Mexican cities (Mexico City, Guadalajara, Monterrey, Puebla, Leon and Tijuana). RESULTS: Obesity or overweight status was found in 71.9% of participants. Hypertension was found in 26.5%, and the proportions of awareness, treatment and control for this disease were 49.3, 73 and 36%, respectively. Prevalence of hypertension increased with age; while it was higher in men under 60 years of age, in the more aged individuals it was higher in women. Hypercholesterolaemia was found in 40% of the individuals and cholesterolaemia > or =240 mg/dl was significantly higher in women. Thirty-five and a half percent of men and 18.1% of women were smokers. Type 2 diabetes mellitus was found in 10.4% of participants. There was significant Pearson's correlation between body mass index and blood pressure, between hypertension and glucose levels, and between hypertension and total cholesterol concentrations. CONCLUSIONS: We conclude that this population has a high cardiovascular risk profile and a high probability of the occurrence of metabolic syndrome.

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OBJECTIVE: To elaborate Mexican growth charts based on international methodology. DESIGN: Data were obtained from the Mexican National Health Survey. The survey was stratified and probabilistic representative of all the country. SETTING: Nationwide open population living in urban and rural areas. SUBJECTS: Boys (8545) and girls (9983) from 10 to 18 years participating in the survey. METHODS: Age, weight and height were recorded. Empirical percentiles were calculated and smoothed. Smoothed curves were approximated using least-mean square estimation. RESULTS: Tables and figures for percentile values of weight, height and body mass index (BMI) for age, as well as percentile values of weight and BMI for height for both genders are presented. Regarding 50th BMI for age percentiles, Mexicans had higher levels than the Americans in the Centers for Disease Control and Prevention growth charts; Mexicans were lower but had similar weights than the Americans. Owing to the high BMI, the percentile corresponding to an overweight level (25 kg/m(2)) at 18 years was 74.5 in boys and 72.5 in girls, whereas obesity level (30 kg/m(2)) at 18 years was 97.3 and 97.4 in boys and girls, respectively. CONCLUSIONS: The present growth charts are snapshots of a Mexican population. Because of the high median BMI compared to US and World Health Organization standards, we must be cautious in establishing an upper normal cutoff for clinical normality, not merely selecting the 85th and 95th percentiles as equivalents of overweight and obesity, respectively. Therefore, we proposed percentiles 74.5 in boys and 72.5 in girls as the action points of overweight as they are the percentiles corresponding to BMI 25 kg/m(2) at 18 years. SPONSORSHIP: The survey was supported by the Mexican Minister of Health. Statistical analyses were sponsored by Dr Del-Rio-Navarro.

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OBJECTIVE: To assess the ability of the body mass index (BMI) to detect obesity-associated morbidity in subjects with a normal or short stature. METHODS: Information was obtained on 119 975 subjects from a cardiovascular risk factors detection program. Standardized questionnaires were used. Capillary glucose and cholesterol concentrations were measured. Diabetes, arterial hypertension and hypercholesterolemia were selected as end points. Sensitivity, specificity and the likelihood ratio for several BMI thresholds were calculated. ROC curves were constructed to identify the BMI cutoff points with best diagnostic performance. The area under the curve (AUC) was used to assess the proficiency of BMI. RESULTS: Short stature (height

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BACKGROUND: Drug resistance threatens global tuberculosis (TB) control efforts. Population-based estimates of drug resistance are needed to develop strategies for controlling drug-resistant TB in Mexico. OBJECTIVE: To obtain population-based data on Mycobacterium tuberculosis drug resistance in Mexico. METHODS: To obtain drug resistance data, we conducted a population-based study of TB cases in the states of Baja California, Sinaloa, and Oaxaca, Mexico. We performed cultures and drug susceptibility testing on M tuberculosis isolates from patients with newly diagnosed, smear-positive TB from April 1 to October 31, 1997. RESULTS: Mycobacterium tuberculosis was isolated from 460 (75%) of the 614 patients. Levels of resistance in new and retreatment TB cases to 1 or more of the 3 current first-line drugs used in Mexico (isoniazid, rifampin, and pyrazinamide) were 12.9% and 50.5%, respectively; the corresponding levels of multi-drug-resistant TB were 2.4% and 22.4%. Retreatment cases were significantly more likely than new cases to have isolates resistant to 1 or more of the 3 first-line drugs (relative risk [RR], 3.9; 95% confidence interval [CI], 2.8-5.5), to have isoniazid resistance (RR, 3.6; 95% CI, 2.5-5.2), and to have multi-drug-resistant TB (RR, 9.4; 95% CI, 4.3-20.2). CONCLUSIONS: This population-based study of M tuberculosis demonstrates moderately high levels of drug resistance. Important issues to consider in the national strategy to prevent M tuberculosis resistance in Mexico include consideration of the most appropriate initial therapy in patients with TB, the treatment of patients with multiple drug resistance, and surveillance or periodic surveys of resistance among new TB patients to monitor drug resistance trends.

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The mortality, incidence, morbidity, partial data and opportune detection, of the main cancer types were reviewed from de information register corresponding to 1987, to analyze the epidemiological panorama of cancer in Mexico. The main causes of death in women were cervix uterine, breast, stomach and lung carcinomas, leukemias and lymphomas; and in men were lung, gastric, prostate, leukemias and lymphomas. The most frequent localization of women's new cancer cases were cervix uterus, breast, ovary, lymphoma, thyroid gland and endometrium; and in men were prostate, lymphoma, stomach, leukemia and lung. In according to tendencies about the main death rates in Mexico, we estimate that 55.3 by 100.00 inhabitants will be the rate of cancer deaths in the year 2000, numerical character virtually bigger considering demographic variation like human life's hope and increase population with cancer risk.

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It has been recognized that due to immunization campaigns and specific treatment of medical complications, has resulted in a reduced measles mortality in México as in others countries. However, during the last few years the number of measles cases in México has shown an increasing trend over previous years due to two larges epidemics, in 1985 and 1989. As a vaccine preventable disease, the number of measles cases has shown an important decline in mortality as compared with mortality in the general population. From the total deaths in children under five years the measles deaths have been reduced from a level of 2.8% in 1969 to a level of 1.6% in 1985. The more recent mortality data available shows that 597 deaths caused by measles were registered in 1986, for a mortality rate of 0.75 per 100,000 inhabitants. At higher rate was observed in the age groups less than 1 year with a mortality rate of 5.9 per 100,000 inhabitants compared with 4.2 in the group from 1 to 4 years. The morbidity epidemiologic surveillance system among governmental health services reported a total of 20,076 cases in 1989, with an incidence rate of 23.8 cases per 100,000 inhabitants and a estimated mortality rate of 6.6%. This recent emergence of the measles activity in México is part of a pandemic that is affecting several countries around the world. The impact of these cases on an increased demand of medical care as well as its clinical complications, outcome and mortality, makes measles a high priority problem in México.

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