Servicios de Salud de Yucatan

Mérida, Mexico

Servicios de Salud de Yucatan

Mérida, Mexico
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Manrique-Saide P.,Autonomous University of Yucatán | Che-Mendoza A.,Servicios de Salud de Yucatan | Barrera-Perez M.,Autonomous University of Yucatán | Guillermo-May G.,Autonomous University of Yucatán | And 7 more authors.
Emerging Infectious Diseases | Year: 2015

Dengue prevention efforts rely on control of virus vectors. We investigated use of insecticide-treated screens permanently affixed to windows and doors in Mexico and found that the screens significantly reduced infestations of Aedes aegypti mosquitoes in treated houses. Our findings demonstrate the value of this method for dengue virus vector control. © Centers for Disease Control and Prevention (CDC). All rights reserved.


PubMed | CINVESTAV and Servicios de Salud de Yucatan
Type: Journal Article | Journal: American journal of human biology : the official journal of the Human Biology Council | Year: 2016

The purpose of this study was to analyze the association between maternal Maya ancestry and the birth weight of infants born in Yucatan, Mexico, during 2013.A total of 30,435 singletons born at term (37 weeks) in Yucatan during 2013 were analyzed. Birth weights, gestational ages, and maternal socioeconomic data were provided by the Ministry of Health of Yucatan. Maternal Maya ancestry was defined by the presence of Maya surnames in: (1) non-Maya surnames (NM-NM), (2) one Maya surname (NM-M), and (3) two Maya surnames (M-M). Biological and socioeconomic parameters were compared between the categories of ancestry through one-way analysis of variance (ANOVA) and a multiple regression model was used to analyze the association between ancestry and infants birth weight controlling for influence of covariates.Mean birth weight was 3,114 g (SD=406) (NM-NM: 3,150 g [SD=404], NM-M: 3,106 g [SD=402], M-M: 3,088 g [SD=408]). With the biological and socioeconomic variables statistically adjusted for, the presence of one and two maternal Maya surnames was associated with decreases in birth weight of 42 g and 63 g, respectively. None of the interactions between ancestry and other predictors was statistically significant.The lower mean birth weights of Maya infants are consistent with studies reporting poor growth and nutritional status of Maya children from Yucatan. Historically adverse socioeconomic conditions experienced by the Maya population are probably linked to the relatively lower birth weights of their infants. Am. J. Hum. Biol. 28:436-439, 2016. 2015 Wiley Periodicals, Inc.


PubMed | Autonomous University of Yucatán, Servicios de Salud de Yucatan, Servicios de Salud del Estado de Guerrero, London School of Hygiene and Tropical Medicine and National Autonomous University of Mexico
Type: Evaluation Studies | Journal: Journal of the American Mosquito Control Association | Year: 2014

A recent innovation instrumented for the Dengue Prevention and Control program in Mexico is the use of the premises condition index (PCI) as an indicator of risk for the vector Aedes aegypti infestation in dengue-endemic localities of Mexico. This paper addresses whether further improvements for the dengue control program could be made if the prevalence and productivity of Ae. aegypti populations could be reliably predicted using PCI at the household level, as well as medium-sized neighborhoods. We evaluated the use of PCI to predict the infestation with Aedes aegypti (breeding sites and immature productivity) in Merida, Mexico. The study consisted of a cross-sectional survey based on a cluster-randomized sampling design. We analyzed the statistical association between Aedes infestation and PCI, the extent to which the 3 components of PCI (house maintenance, and tidiness and shading of the patio) contributed to the association between PCI and infestation and whether infestation in a given premises was also affected by the PCI of the surrounding ones. Premises with the lowest PCI had significantly lower Aedes infestation and productivity; and as PCI scores increased infestation levels also tended to increase. Household PCI was significantly associated with Ae. aegypti breeding, largely due to the effect of patio untidiness and patio shade. The mean PCI within the surroundings premises also had a significant and independent explanatory power to predict the risk for infestation, in addition to individual PCI. This is the 1st study in Mexico showing evidence that premises condition as measured by the PCI is related to Ae. aegypti breeding sites and immature productivity. Results suggest that PCI could be used to streamline surveys to inform control efforts at least where Ae. aegypti breeds outdoors, as in Merida. The effect of individual premises, neighborhood condition, and the risk of Aedes infestation imply that the risk for dengue vector infestation can only be minimized by the mass effect at the community level.


PubMed | Autonomous University of Yucatán, Centers for Disease Control and Prevention, Servicios de Salud de Yucatan and Emory University
Type: | Journal: Parasites & vectors | Year: 2016

Dengue is a major public health problem in Mexico, where the use of chemical insecticides to control the principal dengue vector, Aedes aegypti, is widespread. Resistance to insecticides has been reported in multiple sites, and the frequency of kdr mutations associated with pyrethroid resistance has increased rapidly in recent years. In the present study, we characterized patterns of insecticide resistance in Ae. aegypti populations in five small towns surrounding the city of Merida, Mexico.A cross-sectional, entomological survey was performed between June and August 2013 in 250 houses in each of the five towns. Indoor resting adult mosquitoes were collected in all houses and four ovitraps were placed in each study block. CDC bottle bioassays were conducted using F0-F2 individuals reared from the ovitraps and kdr allele (Ile1016 and Cys1534) frequencies were determined.High, but varying, levels of resistance to chorpyrifos-ethyl was detected in all study towns, complete susceptibility to bendiocarb in all except one town, and variations in resistance to deltamethrin between towns, ranging from 63-88% mortality. Significant associations were detected between deltamethrin resistance and the presence of both kdr alleles. Phenotypic resistance was highly predictive of the presence of both alleles, however, not all mosquitoes containing a mutant allele were phenotypically resistant. An analysis of genotypic differentiation (exact G test) between the five towns based on the adult female Ae. aegypti collected from inside houses showed highly significant differences (p<0.0001) between genotypes for both loci. When this was further analyzed to look for fine scale differences at the block level within towns, genotypic differentiation was significant for both loci in San Lorenzo (Ile1016, p=0.018 and Cys1534, p=0.007) and for Ile1016 in Acanceh (p=0.013) and Conkal (p=0.031).The results from this study suggest that 3 years after switching chemical groups, deltamethrin resistance and a high frequency of kdr alleles persisted in Ae. aegypti populations. The spatial variation that was detected in both resistance phenotypes and genotypes has practical implications, both for vector control operations as well as insecticide resistance management strategies.


PubMed | Servicios de Salud de Yucatan, West Health Institute and Instituto Carlos Slim Of La Salud
Type: | Journal: International journal of telemedicine and applications | Year: 2015

Background. Fetal and neonatal morbidity and mortality are significant problems in developing countries; remote maternal-fetal monitoring offers promise in addressing this challenge. The Gary and Mary West Health Institute and the Instituto Carlos Slim de la Salud conducted a demonstration project of wirelessly enabled antepartum maternal-fetal monitoring in the state of Yucatn, Mexico, to assess whether there were any fundamental barriers preventing deployment and use. Methods. Following informed consent, high-risk pregnant women at 27-29 weeks of gestation at the Chemax primary clinic participated in remote maternal-fetal monitoring. Study participants were randomized to receive either prototype wireless monitoring or standard-of-care. Feasibility was evaluated by assessing technical aspects of performance, adherence to monitoring appointments, and response to recommendations. Results. Data were collected from 153 high-risk pregnant indigenous Mayan women receiving either remote monitoring (n = 74) or usual standard-of-care (n = 79). Remote monitoring resulted in markedly increased adherence (94.3% versus 45.1%). Health outcomes were not statistically different in the two groups. Conclusions. Remote maternal-fetal monitoring is feasible in resource-constrained environments and can improve maternal compliance for monitoring sessions. Improvement in maternal-fetal health outcomes requires integration of such technology into sociocultural context and addressing logistical challenges of access to appropriate emergency services.


Lorono-Pino M.A.,Autonomous University of Yucatán | Garcia-Rejon J.E.,Autonomous University of Yucatán | Machain-Williams C.,Autonomous University of Yucatán | Gomez-Carro S.,Servicios de Salud de Yucatan | And 11 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2013

The home, or domicile, is the principal environment for transmission of dengue virus (DENV) between humans and mosquito vectors. Community-wide distribution of insecticide-treated curtains (ITCs), mimicking vector control program-driven interventions, has shown promise to reduce DENV infections. We conducted a Casa Segura consumer product intervention study in Mé rida, Mexico to determine the potential to reduce intradomicillary DENV transmission through ITC use in individual homes. Dengue virus infections in mosquitoes and in humans were reduced in homes with ITCs in one of two study subareas. Overall, ITCs reduced intradomicillary DENV transmission; ITC homes were significantly less likely to experience multiple DENV infections in humans than NTC homes. Dengue virus-infected Aedes aegypti females were reduced within the ITC homes where curtain use was highest. Some homes yielded up to nine infected Ae. aegypti females. This study provides insights regarding best practices for Casa Segura interventions to protect homes from intradomicillary DENV transmission. Copyright © 2013 by The American Society of Tropical Medicine and Hygiene.


Garcia-Rejon J.E.,Autonomous University of Yucatán | Lopez-Uribe M.P.,Autonomous University of Yucatán | Lorono-Pino M.A.,Autonomous University of Yucatán | Farfan-Ale J.A.,Autonomous University of Yucatán | And 4 more authors.
Journal of Medical Entomology | Year: 2011

During 2007-2010, we examined which container types in Mérida, México, are most productive for Aedes aegypti (L.) immatures. Surveys for mosquito immatures followed routine surveillance methodology and container type classifications used by Servicios de Salud de Yucatán. Our main findings were that 1) small and larger discarded containers that serve no particular purpose and therefore can be removed from the environment contribute strongly to larval and pupal production in Mérida, and 2) the importance of different container types can vary among sets of residential premises as well as between dry and wet periods. These results may help to guide future implementation in Mérida of control efforts that target the most productive container types for Ae. aegypti immatures. Furthermore, if the Patio Limpio cleanup campaign that currently is ongoing in Mérida proves successful in removing discarded containers as important immature development sites, then we should see dramatic changes in the most productive container types in the future as the mosquito is forced to switch to other container types, which perhaps also will be easier to include in highly targeted mosquito control interventions. © 2011 Entomological Society of America.


Garcia-Rejon J.E.,Autonomous University of Yucatán | Lorono-Pino M.A.,Autonomous University of Yucatán | Farfan-Ale J.A.,Autonomous University of Yucatán | Flores-Flores L.F.,Autonomous University of Yucatán | And 5 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2011

We determined abundance of Aedes aegypti mosquitoes and presence of dengue virus (DENV) in females collected from schools in Mérida, México, during 2008 and 2009. Backpack aspiration from 24 schools produced 468 females of Ae. aegypti and 1,676 females of another human biter, Culex quinquefasciatus. Ae. aegypti females were collected most commonly from classrooms followed by offices and bathrooms. Of these females, 24.7% were freshly fed. Examination of 118 pools of Ae. aegypti females (total of 415 females) for presence of DENV RNA produced 19 positive pools (16.1%). DENV-infected pools were detected from 11 (45.8%) of 24 schools and came from different room types, including classrooms, offices, and bathrooms. The overall rate of DENV infection per 100 Ae. aegypti females was 4.8. We conclude that schools in Mérida present a risk environment for students, teachers, and other personnel to be exposed to mosquitoes and bites of DENV-infected Ae. aegypti females. Copyright © 2011 by The American Society of Tropical Medicine and Hygiene.


Waleckx E.,Autonomous University of Yucatán | Camara-Mejia J.,Autonomous University of Yucatán | Ramirez-Sierra M.J.,Autonomous University of Yucatán | Cruz-Chan V.,Autonomous University of Yucatán | And 5 more authors.
Transactions of the Royal Society of Tropical Medicine and Hygiene | Year: 2014

Background: Non-domiciliated (intrusive) triatomine vectors remain a challenge for the sustainability of Chagas disease vector control as these triatomines are able to transiently (re-)infest houses. One of the bestcharacterized examples is Triatoma dimidiata from the Yucatan peninsula, Mexico, where adult insects seasonally infest houses between March and July. Methods: We focused our study on three rural villages in the state of Yucatan, Mexico, in which we performed a situation analysis as a first step before the implementation of an ecohealth (ecosystem approach to health) vector control intervention. Results: The identification of the key determinants affecting the transient invasion of human dwellings by T. dimidiata was performed by exploring associations between bug presence and qualitative and quantitative variables describing the ecological, biological and social context of the communities. We then used a participatory action research approach for implementation and evaluation of a control strategy based on window insect screens to reduce house infestation by T. dimidiata. Conclusions: This ecohealth approach may represent a valuable alternative to vertically-organized insecticide spraying. Further evaluation may confirm that it is sustainable and provides effective control (in the sense of limiting infestation of human dwellings and vector/human contacts) of intrusive triatomines in the region. © The author 2015.


Ferral J.,Autonomous University of Yucatán | Chavez-Nunez L.,Autonomous University of Yucatán | Euan-Garcia M.,Autonomous University of Yucatán | Ramirez-Sierra M.J.,Autonomous University of Yucatán | And 3 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2010

Chagas disease is a major vector-borne disease, and regional initiatives based on insecticide spraying have successfully controlled domiciliated vectors in many regions. Non-domiciliated vectors remain responsible for a significant transmission risk, and their control is a challenge. We performed a proof-of-concept field trial to test alternative strategies in rural Yucatan, Mexico. Follow-up of house infestation for two seasons following the interventions confirmed that insecticide spraying should be performed annually for the effective control of Triatoma dimidiata; however, it also confirmed that insect screens or long-lasting impregnated curtains may represent good alternative strategies for the sustained control of these vectors. Ecosystemic peridomicile management would be an excellent complementary strategy to improve the cost-effectiveness of interventions. Because these strategies would also be effective against other vector-borne diseases, such as malaria or dengue, they could be integrated within a multi-disease control program. Copyright © 2010 by The American Society of Tropical Medicine and Hygiene.

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