1
|
Campos-Nonato I, Oviedo-Solís C, Vargas-Meza J, Ramírez-Villalobos D, Medina-García C, Gómez-Álvarez E, Hernández-Barrera L, Barquera S. Prevalencia, tratamiento y control de la hipertensión arterial en adultos mexicanos: resultados de la Ensanut 2022. Salud Publica Mex 2023; 65:s169-s180. [PMID: 38060966 DOI: 10.21149/14779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/16/2023] [Indexed: 12/18/2023] Open
Abstract
OBJETIVO Describir la prevalencia de hipertensión arterial (HTA), las características del tratamiento y la proporción de adultos mexicanos que tiene tensión arterial (TA) controlada. Material y métodos. Se midió la TA a 8 647 adultos en la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022). Se consideró que un participante tenía HTA o TA controlada cuando cumplía los criterios de la American College of Cardiology y la American Heart Association (ACC/AHA) o la Eighth Joint National Committee (JNC-8). RESULTADOS La prevalencia de HTA en adultos fue 47.8% (según criterio del ACC/AHA). De éstos, 65.5% desconocía su diagnóstico. En adultos con diagnóstico previo de HTA, 33.7% tuvo TA controlada. Según la clasificación JNC-8, 29.4% de los adultos tenía HTA y 43.9% ignoraba su diagnóstico. Conclusión. En la Ensanut 2022 la mitad de los adultos tenía HTA y de ellos, tres de cada cinco no habían sido diagnosticados. El sistema de salud debe mejorar sus mecanismos de detección de HTA porque el subdiagnóstico y el mal control de la TA ocasiona discapacidad, mala calidad de vida y mortalidad prematura.
Collapse
Affiliation(s)
- Ismael Campos-Nonato
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, México..
| | - Cecilia Oviedo-Solís
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, México..
| | - Jorge Vargas-Meza
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, México..
| | - Dolores Ramírez-Villalobos
- Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, México..
| | - Catalina Medina-García
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, México..
| | - Enrique Gómez-Álvarez
- Jefatura de División de Cardiocirugía, Centro Médico Nacional 20 de Noviembre. Ciudad de México, México..
| | - Lucía Hernández-Barrera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, México..
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, México..
| |
Collapse
|
2
|
Campos-Nonato I, Hernández-Barrera L, Oviedo-Solís C, Ramírez-Villalobos D, Hernández-Prado B, Barquera S. Epidemiología de la hipertensión arterial en adultos mexicanos: diagnóstico, control y tendencias. Ensanut 2020. Salud Publica Mex 2021; 63:692-704. [DOI: 10.21149/12851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/25/2021] [Indexed: 11/06/2022] Open
Abstract
Objetivo. Describir la prevalencia de hipertensión arterial (HTA) en adultos mexicanos, la proporción que tiene tensión arterial (TA) controlada y la tendencia en el periodo 2018-2020. Material y métodos. Se midió la TA a 9 844 adultos en la Encuesta Nacional de Salud y Nutrición (Ensanut) 2020. Se consideró que tenían HTA o TA controlada cuando cumplían los criterios del Seventh Joint National Committee (JNC-7) o American Heart Association (AHA). Resultados. La prevalencia de HTA fue 49.4% (según JNC-7), de los cuales 70% desconocía su diagnóstico. Según la clasificación AHA, 30.2% de los adultos tenía HTA y 51.0% ignoraba su diagnóstico. Entre adultos con diagnóstico previo de HTA, 54.9% tuvo TA controlada. Entre el periodo 2018-2020 no se observaron cambios en las prevalencias. Conclusiones. Al menos un tercio de los adultos mexicanos tiene HTA y de ellos al menos la mitad no habían sido diagnosticados. Debe evaluarse la pertinencia de los actuales programas de diagnóstico de HTA porque el subdiagnóstico y mal control pueden ocasionar complicaciones y la muerte.
Collapse
|
3
|
Ramírez-Villalobos D, Monterubio-Flores EA, Gonzalez-Vazquez TT, Molina-Rodríguez JF, Ruelas-González MG, Alcalde-Rabanal JE. Delaying sexual onset: outcome of a comprehensive sexuality education initiative for adolescents in public schools. BMC Public Health 2021; 21:1439. [PMID: 34289834 PMCID: PMC8296525 DOI: 10.1186/s12889-021-11388-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A common risk behavior in adolescence is the early initiation of unprotected sex that exposes adolescents to an unplanned pregnancy or sexually transmitted infections. Schools are an ideal place to strengthen adolescents' sexual knowledge and modify their behavior, guiding them to exercise responsible sexuality. The purpose of this article was to evaluate the knowledge of public secondary school teachers who received training in comprehensive education in sexuality (CES) and estimate the counseling's effect on students' sexual behavior. METHODS Seventy-five public school teachers were trained in participatory and innovative techniques for CES. The change in teacher knowledge (n = 75) was assessed before and after the training using t-tests, Wilcoxon ranks tests and a Generalized Estimate Equation model. The students' sexual and reproductive behavior was evaluated in intervention (n = 650) and comparison schools (n = 555). We fit a logistic regression model using the students' sexual debut as a dependent variable. RESULTS Teachers increased their knowledge of sexuality after training from 5.3 to 6.1 (p < 0.01). 83.3% of students in the intervention school reported using a contraceptive method in their last sexual relation, while 58.3% did so in the comparison schools. The students in comparison schools were 4.7 (p < 0.01) times more likely to start sexual initiation than students in the intervention schools. CONCLUSION Training in CES improved teachers' knowledge about sexual and reproductive health. Students who received counseling from teachers who were trained in participatory and innovative techniques for CES used more contraceptive protection and delayed sexual debut.
Collapse
Affiliation(s)
- Dolores Ramírez-Villalobos
- Center for Health Systems Research, National Institute of Public Health, Avenida Universidad 655, Colonia Santa María de Ahuacatitlán, 62100 Cuernavaca, Morelos Mexico
| | - Eric Alejandro Monterubio-Flores
- Center for Health and Nutrition Research, National Institute of Public Health, Avenida Universidad 655, Colonia Santa María de Ahuacatitlán, 62100 Cuernavaca, Morelos Mexico
| | - Tonatiuh Tomás Gonzalez-Vazquez
- Center for Health Systems Research, National Institute of Public Health, Avenida Universidad 655, Colonia Santa María de Ahuacatitlán, 62100 Cuernavaca, Morelos Mexico
| | - Juan Francisco Molina-Rodríguez
- Center for Health Systems Research, National Institute of Public Health, Avenida Universidad 655, Colonia Santa María de Ahuacatitlán, 62100 Cuernavaca, Morelos Mexico
| | - Ma. Guadalupe Ruelas-González
- Center for Evaluation and Survey Research, National Institute of Public Health, Av. Universidad 655, Colonia Santa María, 62100 Cuernavaca, Morelos México
| | - Jacqueline Elizabeth Alcalde-Rabanal
- Center for Health Systems Research, National Institute of Public Health, Avenida Universidad 655, Colonia Santa María de Ahuacatitlán, 62100 Cuernavaca, Morelos Mexico
| |
Collapse
|
4
|
Treviño-Siller S, Ramírez-Villalobos D, Sanchez-Dominguez MS, Hernández Prado B. How to deal with the suffering: Utility of an emotional containment strategy to collect data for verbal autopsies in Mexico. Death Stud 2020; 46:1015-1020. [PMID: 32584164 DOI: 10.1080/07481187.2020.1784310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Verbal autopsies are often used to establish cause of death but can be emotionally taxing on the interviewers. We conducted focus groups with interviewers (N = 15) who collected data for verbal autopsies in Mexico in order to explore the utility of an emotional containment strategy designed to boost self-confidence and resilience. The interviewers reflected on broader cultural perspectives on illness and death and described the strategy as helpful in developing strategies to manage emotionally stressful situations and develop their confidence in their work performance. This type of intervention may be useful for field personnel who perform verbal autopsy interviews.KEY MESSAGESIn low- and middle-income countries with less reliable statistics systems, a significant proportion of deaths is not certified by a professional doctor. This complicates the registration of causes of death, which is a crucial issue for health systems. In the absence of reliable vital statistics systems, verbal autopsies (VA) offer an alternative for establishing cause of death.In response to emotional crises leading to resignations among the interviewers while testing an instrument for collecting VA, we designed an emotional containment strategy (ECS). It was specifically crafted to boost the self-confidence and resilience of participants in addition to enhancing their capacity for emotional recovery and to regain a functional state. In order to explore ECS results we conducted a qualitative cross-sectional study with four focus groups of interviewers who collected VA.The results obtained were positive, the interviewers were able to perform their work better by overcoming the emotional crisis that occurred both in them and in the people they interviewed.We recommend developing this type of intervention with all field staff performing verbal autopsy interviews, not only as a resource for emotional health, but also as a means of achieving better-quality data collection.
Collapse
Affiliation(s)
- Sandra Treviño-Siller
- Instituto Nacional de Salud Pública, Centro de Investigación en Sistemas de Salud, Cuernavaca, Mexico
| | | | | | | |
Collapse
|
5
|
James SL, Romero M, Ramírez-Villalobos D, Gómez S, Pierce K, Flaxman A, Serina P, Stewart A, Murray CJL, Gakidou E, Lozano R, Hernandez B. Validating estimates of prevalence of non-communicable diseases based on household surveys: the symptomatic diagnosis study. BMC Med 2015; 13:15. [PMID: 25620318 PMCID: PMC4306245 DOI: 10.1186/s12916-014-0245-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 12/08/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Easy-to-collect epidemiological information is critical for the more accurate estimation of the prevalence and burden of different non-communicable diseases around the world. Current measurement is restricted by limitations in existing measurement systems in the developing world and the lack of biometry tests for non-communicable diseases. Diagnosis based on self-reported signs and symptoms ("Symptomatic Diagnosis," or SD) analyzed with computer-based algorithms may be a promising method for collecting timely and reliable information on non-communicable disease prevalence. The objective of this study was to develop and assess the performance of a symptom-based questionnaire to estimate prevalence of non-communicable diseases in low-resource areas. METHODS As part of the Population Health Metrics Research Consortium study, we collected 1,379 questionnaires in Mexico from individuals who suffered from a non-communicable disease that had been diagnosed with gold standard diagnostic criteria or individuals who did not suffer from any of the 10 target conditions. To make the diagnosis of non-communicable diseases, we selected the Tariff method, a technique developed for verbal autopsy cause of death calculation. We assessed the performance of this instrument and analytical techniques at the individual and population levels. RESULTS The questionnaire revealed that the information on health care experience retrieved achieved 66.1% (95% uncertainty interval [UI], 65.6-66.5%) chance corrected concordance with true diagnosis of non-communicable diseases using health care experience and 0.826 (95% UI, 0.818-0.834) accuracy in its ability to calculate fractions of different causes. SD is also capable of outperforming the current estimation techniques for conditions estimated by questionnaire-based methods. CONCLUSIONS SD is a viable method for producing estimates of the prevalence of non-communicable diseases in areas with low health information infrastructure. This technology can provide higher-resolution prevalence data, more flexible data collection, and potentially individual diagnoses for certain conditions.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Bernardo Hernandez
- Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave,, Suite 600, Seattle 98121, WA, USA.
| |
Collapse
|
6
|
Torres LM, Rhenals AL, Jiménez A, Ramírez-Villalobos D, Urióstegui R, Piña M, Rocha H. [Intentional search and reclassification of maternal deaths in Mexico: The effect on the distribution of causes]. Salud Publica Mex 2014; 56:333-347. [PMID: 25604173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 04/29/2014] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVE To correct the misclassification and improve the quality of information on maternal mortality in Mexico. MATERIALS AND METHODS Using clinical records and verbal autopsies, we studied all deaths certified as maternal deaths as well as a selection of deaths of women of childbearing age whose causes were considered as suspected of hiding a maternal death, all of which occurred during 2011 within Mexico. RESULTS The deliberate search of maternal deaths and reclassification allowed the rescue of just over 100 deaths that were not originally registered or coded as maternal and confirmed or corrected the causes of death recorded on death certificates as confirmed maternal deaths. This procedure also allowed the reclassification of 297 maternal deaths of women in the groundwork of the National Institute of Statistics and Geography. CONCLUSIONS International Search and Reclassification of Maternal Deaths is a very useful procedure for improving the classification of cases that were not classified as maternal deaths and the effect was greater with the coding of indirect obstetric deaths.
Collapse
Affiliation(s)
- Luis Manuel Torres
- Dirección General de Información en Salud, Secretaría de Salud, México, DF, México, 06600,
| | - Ana Luisa Rhenals
- Dirección General de Información en Salud, Secretaría de Salud, México, DF, México, 06600,
| | - Aline Jiménez
- Dirección General de Información en Salud, Secretaría de Salud, México, DF, México, 06600,
| | - Dolores Ramírez-Villalobos
- Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Rocío Urióstegui
- Dirección General de Información en Salud, Secretaría de Salud, México, DF, México, 06600,
| | - Miriam Piña
- Dirección General de Información en Salud, Secretaría de Salud, México, DF, México, 06600,
| | - Humberto Rocha
- Dirección General de Información en Salud, Secretaría de Salud, México, DF, México, 06600,
| |
Collapse
|
7
|
Manuel Torres L, Luisa Rhenals A, Jiménez A, Ramírez-Villalobos D, Urióstegui R, Piña M, Rocha H. Búsqueda intencionada y reclasificación de muertes maternas en México: el efecto en la distribución de las causas. Salud Publica Mex 2014. [DOI: 10.21149/spm.v56i4.7353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objetivo. Corregir la mala clasificación y mejorar la calidad de la información sobre la mortalidad materna en México. Material y métodos. A través de los registros clínicos y autopsias verbales, se estudiaron todas las defunciones certificadas como maternas y una selección de defunciones de mujeres en edad fértil, cuyas causas fueron consideradas como sospechosas de encubrir una muerte materna; todas ocurridas durante 2011 en México. Resultados. La búsqueda intencionada y reclasificación de muertes maternas permitió rescatar más de 100 muertes que no habían sido registradas ni codificadas inicialmente como maternas y se ratificaron o rectificaron las causas anotadas en los certificados de defunción. Este procedimiento también permitió reclasificar como muertes maternas 297 defunciones de la base preliminar del Instituto Nacional de Estadística y Geografía. Conclusiones. La Búsqueda Intencionada y Reclasificación de Muertes Maternas es un procedimiento muy útil para mejorar la calidad de la información sobre la mortalidad materna.
Collapse
|
8
|
Murray CJL, Lozano R, Flaxman AD, Serina P, Phillips D, Stewart A, James SL, Vahdatpour A, Atkinson C, Freeman MK, Ohno SL, Black R, Ali SM, Baqui AH, Dandona L, Dantzer E, Darmstadt GL, Das V, Dhingra U, Dutta A, Fawzi W, Gómez S, Hernández B, Joshi R, Kalter HD, Kumar A, Kumar V, Lucero M, Mehta S, Neal B, Praveen D, Premji Z, Ramírez-Villalobos D, Remolador H, Riley I, Romero M, Said M, Sanvictores D, Sazawal S, Tallo V, Lopez AD. Using verbal autopsy to measure causes of death: the comparative performance of existing methods. BMC Med 2014; 12:5. [PMID: 24405531 PMCID: PMC3891983 DOI: 10.1186/1741-7015-12-5] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 12/10/2013] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Monitoring progress with disease and injury reduction in many populations will require widespread use of verbal autopsy (VA). Multiple methods have been developed for assigning cause of death from a VA but their application is restricted by uncertainty about their reliability. METHODS We investigated the validity of five automated VA methods for assigning cause of death: InterVA-4, Random Forest (RF), Simplified Symptom Pattern (SSP), Tariff method (Tariff), and King-Lu (KL), in addition to physician review of VA forms (PCVA), based on 12,535 cases from diverse populations for which the true cause of death had been reliably established. For adults, children, neonates and stillbirths, performance was assessed separately for individuals using sensitivity, specificity, Kappa, and chance-corrected concordance (CCC) and for populations using cause specific mortality fraction (CSMF) accuracy, with and without additional diagnostic information from prior contact with health services. A total of 500 train-test splits were used to ensure that results are robust to variation in the underlying cause of death distribution. RESULTS Three automated diagnostic methods, Tariff, SSP, and RF, but not InterVA-4, performed better than physician review in all age groups, study sites, and for the majority of causes of death studied. For adults, CSMF accuracy ranged from 0.764 to 0.770, compared with 0.680 for PCVA and 0.625 for InterVA; CCC varied from 49.2% to 54.1%, compared with 42.2% for PCVA, and 23.8% for InterVA. For children, CSMF accuracy was 0.783 for Tariff, 0.678 for PCVA, and 0.520 for InterVA; CCC was 52.5% for Tariff, 44.5% for PCVA, and 30.3% for InterVA. For neonates, CSMF accuracy was 0.817 for Tariff, 0.719 for PCVA, and 0.629 for InterVA; CCC varied from 47.3% to 50.3% for the three automated methods, 29.3% for PCVA, and 19.4% for InterVA. The method with the highest sensitivity for a specific cause varied by cause. CONCLUSIONS Physician review of verbal autopsy questionnaires is less accurate than automated methods in determining both individual and population causes of death. Overall, Tariff performs as well or better than other methods and should be widely applied in routine mortality surveillance systems with poor cause of death certification practices.
Collapse
Affiliation(s)
- Christopher JL Murray
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue Suite 600, Seattle, WA 98121, USA
| | - Rafael Lozano
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue Suite 600, Seattle, WA 98121, USA
- National Institute of Public Health, Universidad 655, 62100 Cuernavaca, Morelos, Mexico
| | - Abraham D Flaxman
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue Suite 600, Seattle, WA 98121, USA
| | - Peter Serina
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue Suite 600, Seattle, WA 98121, USA
| | - David Phillips
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue Suite 600, Seattle, WA 98121, USA
| | - Andrea Stewart
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue Suite 600, Seattle, WA 98121, USA
| | - Spencer L James
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue Suite 600, Seattle, WA 98121, USA
| | - Alireza Vahdatpour
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue Suite 600, Seattle, WA 98121, USA
| | - Charles Atkinson
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue Suite 600, Seattle, WA 98121, USA
| | - Michael K Freeman
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue Suite 600, Seattle, WA 98121, USA
| | - Summer Lockett Ohno
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue Suite 600, Seattle, WA 98121, USA
| | - Robert Black
- Johns Hopkins University, Bloomberg School of Public Health, 615 N Wolfe St #5041, Baltimore, MD 21205, USA
| | - Said Mohammed Ali
- Public Health Laboratory-IdC, P.O. BOX 122 Wawi Chake Chake Pemba, Zanzibar, Tanzania
| | - Abdullah H Baqui
- Johns Hopkins University, Bloomberg School of Public Health, 615 N Wolfe St #5041, Baltimore, MD 21205, USA
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue Suite 600, Seattle, WA 98121, USA
- Public Health Foundation of India, ISID Campus, 4 Institutional Area, Vasant Kunj, New Delhi 110070, India
| | - Emily Dantzer
- Brigham and Women's Hospital, 75 Francis St, Boston, MA 02215, USA
| | - Gary L Darmstadt
- Global Development, Bill and Melinda Gates Foundation, PO Box 23350, Seattle, WA 98012, USA
| | - Vinita Das
- CSM Medical University, Shah Mina Road, Chowk, Lucknow, Uttar Pradesh 226003, India
| | - Usha Dhingra
- Dept of International Health, Johns Hopkins Bloomberg School of Public Health, E5521, 615 N. Wolfe Street, Baltimore, MD 21205, USA
- Public Health Laboratory-Ivo de Carneri, Wawi, Chake-Chake, Pemba, Zanzibar, Tanzania
| | - Arup Dutta
- Johns Hopkins University, 214A Basement, Vinobapuri Lajpat Nagar-II, New Delhi 110024, India
| | - Wafaie Fawzi
- Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115-6018, USA
| | - Sara Gómez
- National Institute of Public Health, Universidad 655, 62100 Cuernavaca, Morelos, Mexico
| | - Bernardo Hernández
- Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue Suite 600, Seattle, WA 98121, USA
| | - Rohina Joshi
- The George Institute for Global Health, The University of Sydney, 83/117 Missenden Rd, Camperdown, NSW 2050, Australia
| | - Henry D Kalter
- Johns Hopkins University, Bloomberg School of Public Health, 615 N Wolfe St #5041, Baltimore, MD 21205, USA
| | | | | | - Marilla Lucero
- Research Institute for Tropical Medicine, Corporate Ave, Muntinlupa City 1781, Philippines
| | - Saurabh Mehta
- Division of Nutritional Sciences, Cornell University, 314 Savage Hall, Ithaca, NY 14853, USA
| | - Bruce Neal
- The George Institute for Global Health, The University of Sydney, 83/117 Missenden Rd, Camperdown, NSW 2050, Australia
| | - Devarsetty Praveen
- The George Institute for Global Health, 839C, Road No. 44A, Jubilee Hills, Hyderabad 500033, India
| | - Zul Premji
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | | | - Hazel Remolador
- Research Institute for Tropical Medicine, Corporate Ave, Muntinlupa City 1781, Philippines
| | - Ian Riley
- School of Population Health, University of Queensland, Level 2 Public Health Building School of Population Health, Herston Road, Herston, QLD 4006, Australia
| | - Minerva Romero
- National Institute of Public Health, Universidad 655, 62100 Cuernavaca, Morelos, Mexico
| | - Mwanaidi Said
- Muhimbili University of Health and Allied Sciences, United Nations Rd, Dar es Salaam, Tanzania
| | - Diozele Sanvictores
- Research Institute for Tropical Medicine, Corporate Ave, Muntinlupa City 1781, Philippines
| | - Sunil Sazawal
- Dept of International Health, Johns Hopkins Bloomberg School of Public Health, E5521, 615 N. Wolfe Street, Baltimore, MD 21205, USA
- Public Health Laboratory-Ivo de Carneri, Wawi, Chake-Chake, Pemba, Zanzibar, Tanzania
| | - Veronica Tallo
- Research Institute for Tropical Medicine, Corporate Ave, Muntinlupa City 1781, Philippines
| | - Alan D Lopez
- University of Melbourne School of Population and Global Health, Building 379, 207 Bouverie St., Parkville 3010, VIC, Australia
| |
Collapse
|
9
|
Hernández B, Ramírez-Villalobos D, Duarte MB, Corcho A, Villarreal G, Jiménez A, Torres LM. Subregistro de defunciones de menores y certificación de nacimiento en una muestra representativa de los 101 municipios con más bajo índice de desarrollo humano en México. Salud pública Méx 2012; 54:393-400. [DOI: 10.1590/s0036-36342012000400009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 12/15/2011] [Indexed: 11/21/2022] Open
|
10
|
Murray CJL, Lopez AD, Black R, Ahuja R, Ali SM, Baqui A, Dandona L, Dantzer E, Das V, Dhingra U, Dutta A, Fawzi W, Flaxman AD, Gómez S, Hernández B, Joshi R, Kalter H, Kumar A, Kumar V, Lozano R, Lucero M, Mehta S, Neal B, Ohno SL, Prasad R, Praveen D, Premji Z, Ramírez-Villalobos D, Remolador H, Riley I, Romero M, Said M, Sanvictores D, Sazawal S, Tallo V. Population Health Metrics Research Consortium gold standard verbal autopsy validation study: design, implementation, and development of analysis datasets. Popul Health Metr 2011; 9:27. [PMID: 21816095 PMCID: PMC3160920 DOI: 10.1186/1478-7954-9-27] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Accepted: 08/04/2011] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Verbal autopsy methods are critically important for evaluating the leading causes of death in populations without adequate vital registration systems. With a myriad of analytical and data collection approaches, it is essential to create a high quality validation dataset from different populations to evaluate comparative method performance and make recommendations for future verbal autopsy implementation. This study was undertaken to compile a set of strictly defined gold standard deaths for which verbal autopsies were collected to validate the accuracy of different methods of verbal autopsy cause of death assignment. METHODS Data collection was implemented in six sites in four countries: Andhra Pradesh, India; Bohol, Philippines; Dar es Salaam, Tanzania; Mexico City, Mexico; Pemba Island, Tanzania; and Uttar Pradesh, India. The Population Health Metrics Research Consortium (PHMRC) developed stringent diagnostic criteria including laboratory, pathology, and medical imaging findings to identify gold standard deaths in health facilities as well as an enhanced verbal autopsy instrument based on World Health Organization (WHO) standards. A cause list was constructed based on the WHO Global Burden of Disease estimates of the leading causes of death, potential to identify unique signs and symptoms, and the likely existence of sufficient medical technology to ascertain gold standard cases. Blinded verbal autopsies were collected on all gold standard deaths. RESULTS Over 12,000 verbal autopsies on deaths with gold standard diagnoses were collected (7,836 adults, 2,075 children, 1,629 neonates, and 1,002 stillbirths). Difficulties in finding sufficient cases to meet gold standard criteria as well as problems with misclassification for certain causes meant that the target list of causes for analysis was reduced to 34 for adults, 21 for children, and 10 for neonates, excluding stillbirths. To ensure strict independence for the validation of methods and assessment of comparative performance, 500 test-train datasets were created from the universe of cases, covering a range of cause-specific compositions. CONCLUSIONS This unique, robust validation dataset will allow scholars to evaluate the performance of different verbal autopsy analytic methods as well as instrument design. This dataset can be used to inform the implementation of verbal autopsies to more reliably ascertain cause of death in national health information systems.
Collapse
Affiliation(s)
- Christopher JL Murray
- Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave, Suite 600, Seattle, WA 98121, USA
| | - Alan D Lopez
- University of Queensland, School of Population Health, Brisbane, Australia
| | - Robert Black
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ramesh Ahuja
- Community Empowerment Lab, Shivgarh, India, and The INCLEN Trust International, New Delhi, India
| | | | - Abdullah Baqui
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave, Suite 600, Seattle, WA 98121, USA
- Public Health Foundation of India, New Delhi, India
| | | | | | - Usha Dhingra
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Arup Dutta
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Wafaie Fawzi
- Harvard University, School of Public Health, Boston, MA, USA
| | - Abraham D Flaxman
- Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave, Suite 600, Seattle, WA 98121, USA
| | - Sara Gómez
- National Institute of Public Health, Cuernavaca, Mexico
| | | | - Rohina Joshi
- The George Institute for Global Health, Camperdown, Australia
| | - Henry Kalter
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Aarti Kumar
- Community Empowerment Lab, Shivgarh, India, and The INCLEN Trust International, New Delhi, India
| | - Vishwajeet Kumar
- Community Empowerment Lab, Shivgarh, India, and The INCLEN Trust International, New Delhi, India
| | - Rafael Lozano
- Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave, Suite 600, Seattle, WA 98121, USA
| | - Marilla Lucero
- Research Institute for Tropical Medicine, Manila, Philippines
| | - Saurabh Mehta
- Cornell University, Division of Nutritional Sciences, Ithaca, NY, USA
| | - Bruce Neal
- The George Institute for Global Health, Camperdown, Australia
| | - Summer Lockett Ohno
- Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave, Suite 600, Seattle, WA 98121, USA
| | | | | | - Zul Premji
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Hazel Remolador
- Research Institute for Tropical Medicine, Manila, Philippines
| | - Ian Riley
- University of Queensland, School of Population Health, Brisbane, Australia
| | | | - Mwanaidi Said
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Sunil Sazawal
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Veronica Tallo
- Research Institute for Tropical Medicine, Manila, Philippines
| |
Collapse
|
11
|
Hernández B, Ramírez-Villalobos D, Romero M, Gómez S, Atkinson C, Lozano R. Assessing quality of medical death certification: Concordance between gold standard diagnosis and underlying cause of death in selected Mexican hospitals. Popul Health Metr 2011; 9:38. [PMID: 21816103 PMCID: PMC3160931 DOI: 10.1186/1478-7954-9-38] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Accepted: 08/04/2011] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND In Mexico, the vital registration system relies on information collected from death certificates to generate official mortality figures. Although the death certificate has high coverage across the country, there is little information regarding its validity. The objective of this study was to assess the concordance between the underlying cause of death in official statistics obtained from death certificates and a gold standard diagnosis of the same deaths derived from medical records of hospitals. METHODS The study sample consisted of 1,589 deaths that occurred in 34 public hospitals in the Federal District and the state of Morelos, Mexico in 2009. Neonatal, child, and adult cases were selected for causes of death that included infectious diseases, noncommunicable diseases, and injuries. We compared the underlying cause of death, obtained from medical death certificates, against a gold standard diagnosis derived from a review of medical records developed by the Population Health Metrics Research Consortium. We used chance-corrected concordance and accuracy as metrics to evaluate the quality of performance of the death certificate. RESULTS Analysis considering only the underlying cause of death resulted in a median chance-corrected concordance between the cause of death in medical death certificates versus the gold standard of 54.3% (95% uncertainty interval [UI]: 52.2, 55.6) for neonates, 38.5% (37.0, 40.0) for children, and 66.5% (65.9, 66.9) for adults. The accuracy resulting from the same analysis was 0.756 (0.747, 0.769) for neonates, 0.683 (0.663, 0.701) for children, and 0.780 (0.774, 0.785) for adults. Median chance-corrected concordance and accuracy increased when considering the mention of any cause of death in the death certificate, not just the underlying cause. Concordance varied substantially depending on cause of death, and accuracy varied depending on the true cause-specific mortality fraction composition. CONCLUSIONS Although we cannot generalize our conclusions to Mexico as a whole, the results demonstrate important problems with the quality of the main source of information for causes of death used by decision-makers in settings with highly technological vital registration systems. It is necessary to improve death certification procedures, especially in the case of child and neonatal deaths. This requires an important commitment from the health system and health institutions.
Collapse
Affiliation(s)
- Bernardo Hernández
- Institute for Health Metrics and Evaluation, University of Washington, USA, 2301 5th Ave, Suite 600, Seattle, WA 98121, USA.
| | | | | | | | | | | |
Collapse
|
12
|
Leyva-López A, Chávez-Ayala R, Atienzo EE, Allen-Leigh B, Ramírez-Villalobos D, Yunes-Díaz E, Rivera-Rivera L. [Emergency contraception in Mexican students]. Salud Publica Mex 2010; 52:156-64. [PMID: 20485873 DOI: 10.1590/s0036-36342010000200008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2009] [Accepted: 10/29/2009] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate emergency contraception (EC) knowledge and use as well as identify factors associated to correct EC knowledge among public schools students in Morelos, Mexico. MATERIAL AND METHODS Cross-sectional study conducted in 2003-2004 in a sample of 1,550 students (ages 14-24). Logistic regression was used to identify factors associated to EC correct knowledge. RESULTS Among all, 40% were men and 60% women with an average age of 19 years. Sixty percent have heard about EC, nevertheless, only 45% have correct knowledge about it; 3% of sexually active students (43%) reported its use. Factors associated to EC correct knowledge are: being a woman (OR=1.66; CI 1,33, 2,06), being sexually active (OR=1.77; CI 1,43, 2,18), middle income (OR=1.87; CI 1,04, 3,37), living in a semi-urban zone (OR=1.34; CI 1,02, 1,77), drinking alcohol (OR=1.78; CI 1,42, 2,22). CONCLUSIONS In Morelos, adolescents' knowledge of EC is scarce. Specific messages regarding its correct use are necessary.
Collapse
|
13
|
Ramírez-Villalobos D, Hernández-Garduño A, Salinas A, González D, Walker D, Rojo-Herrera G, Hernández-Prado B. Early hospital discharge and early puerperal complications. Salud Publica Mex 2009; 51:212-8. [PMID: 19967306 DOI: 10.1590/s0036-36342009000300011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2008] [Accepted: 01/26/2009] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the association between time of postpartum discharge and symptoms indicative of complications during the first postpartum week. MATERIALS AND METHODS Women with vaginal delivery at a Mexico City public hospital, without complications before the hospital discharge, were interviewed seven days after delivery. Time of postpartum discharge was classified as early (<24 hours) or late (>25 hours). The dependent variable was defined as the occurrence and severity of puerperal complication symptoms. RESULTS Out of 303 women, 208 (68%) were discharged early. However, women with early discharge and satisfactory prenatal care had lower odds of presenting symptoms in early puerperium than women without early discharge and inadequate prenatal care (OR 0.36; 95% confidence intervals = 0.17-0.76). CONCLUSIONS There was no association between early discharge and symptoms of complications during the first postpartum week; the odds of complications were lower for mothers with early discharge and satisfactory prenatal care.
Collapse
Affiliation(s)
- Dolores Ramírez-Villalobos
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, 62508 Cuernavaca, Morelos, México.
| | | | | | | | | | | | | |
Collapse
|