Dengue fever incidence and its geographical distribution are increasing throughout the world. Quality and timely information is essential for its prevention and control. A web based, geographically enabled, dengue integral surveillance system (Dengue-GIS) was developed for the nation-wide collection, integration, analysis and reporting of geo-referenced epidemiologic, entomologic, and control interventions data. Consensus in the design and practical operation of the system was a key factor for its acceptance. Working with information systems already implemented as a starting point facilitated its acceptance by officials and operative personnel. Dengue-GIS provides the geographical detail needed to plan, asses and evaluate the impact of control activities. The system is beginning to be adopted as a knowledge base by vector control programs. It is used to generate evidence on impact and cost-effectiveness of control activities, promoting the use of information for decision making at all levels of the vector control program. Dengue-GIS has also been used as a hypothesis generator for the academic community. This GIS-based model system for dengue surveillance and the experience gathered during its development and implementation could be useful in other dengue endemic countries and extended to other infectious or chronic diseases.

Background: Vector control programs, which have focused mainly on the patient house and peridomestic areas around dengue cases, have not produced the expected impact on transmission. This project will evaluate the assumption that the endemic/epidemic transmission of dengue begins around peridomestic vicinities of the primary cases. Its objective is to assess the relationship between symptomatic dengue case exposure and peridomestic infection incidence.Methods/Design: A prospective cohort study will be conducted (in Tepalcingo and Axochiapan, in the state of Morelos, Mexico), using the state surveillance system for the detection of incident cases. Paired blood specimens will be collected from both the individuals who live with the incident cases and a sample of subjects residing within a 25-meter radius of such cases (exposed cohort), in order to measure dengue-specific antibodies. Other subjects will be selected from areas which have not presented any incident cases within 200 meters, during the two months preceding the sampling (non-exposed cohort). Symptomatic/asymptomatic incident infection will be considered as the dependent variable, exposure to confirmed dengue cases, as the principal variable, and the socio-demographic, environmental and socio-cultural conditions of the subjects, as additional explanatory variables.Discussion: Results indicating a high infection rate among the exposed subjects would justify the application of peridomestic control measures and call for an evaluation of alternate causes for insufficient program impact. On the other hand, a low incidence of peridomestic-infected subjects would support the hypothesis that infection occurs outside the domicile, and would thus explain why the vector control measures applied in the past have exerted such a limited impact on cases incidence rates. The results of the present study may therefore serve to reassess site selection for interventions of this type.

Exposure to inorganic arsenic (iAs) via drinking water is a serious global health threat. Various factors influence susceptibility to iAs-associated health outcomes, including differences in iAs metabolism. Previous studies have shown that obesity is associated with iAs metabolism. It has been hypothesized that this association can be explained by confounding from nutritional factors involved in one-carbon metabolism, such as folate or other B vitamins, whose intake may differ across BMI categories and is known be associated with iAs metabolism. However, no studies have explored whether this association is confounded by nutritional factors. We investigated the relationship between body mass index (BMI) and the distribution of urinary arsenic species in a cross-sectional cohort of 1166 adults living in Chihuahua, Mexico from 2008 to 2013. Nutrient intake related to one-carbon metabolism, including folate, vitamin B2, and vitamin B12, was assessed using a food frequency questionnaire developed for Mexican populations. Multivariable linear regression was used to estimate the association between BMI and the distribution of urinary arsenic metabolites. Effect modification by drinking water iAs level and sex was also examined. After adjusting for potential confounders, including age, educational attainment, smoking, alcohol consumption, seafood consumption, water iAs, and sex, BMI was negatively associated with the proportion of urinary inorganic arsenic (%U-iAs) and urinary monomethylated arsenic (%U-MMAs) and positively associated with urinary dimethylated arsenic (%U-DMAs). This relationship was not influenced by additional adjustment for folate, vitamin B2, or vitamin B12 intake. Additionally, there was significant effect modification by both drinking water iAs level and sex. This study provides further evidence for an association between BMI and arsenic metabolism. However, contrary to previous hypotheses, these results suggest that this association is not confounded by the intake of micronutrients involved in one-carbon metabolism.

Dengue is a public health problem in more than 100 countries around the world and in virtually the entire region of the Americas, including Mexico. Mosquitoes of the genus Aedes aegypti transmit dengue; its reproduction requires certain geographical, epidemiological, demographic and socioeconomic conditions. Detailed information on socioeconomic, epidemiological and entomological data is available, but detailed meteorological information is not. The objective of this study was to identify the areas of risk of dengue transmission for each month of the year based on environmental, social, entomological and epidemiological information from 2010 to 2020, in Culiacan, Mexico. LST, NDVI and NDMI were calculated from Landsat 8 satellite images with remote sensing techniques. Additional variables were human population density and overcrowding; mosquito egg density from positive ovitraps; and probable cases of dengue. A descriptive analysis of the study variables and a multiple linear regression analysis were performed to determine the significant variables. In addition, a multicriteria spatial analysis was applied through the AHP technique to identify areas at risk of dengue transmission. The results revealed that the variables NDVI, NDMI and overcrowding were not significant; however, the LST, population density, egg density per positive ovitrap and probable cases were. The highest population in the transmission risk areas was in November, and the highest transmission area was identified in October. In conclusion, it was possible to identify which of the study variables were significant; in addition, monthly maps of risk areas of dengue transmission for Culiacan were obtained. Each geographical area had its own characteristics that influenced, in one way or another, the incidence of dengue, highlighting that the strategies for control of dengue must be specific to each region.

Malaria is currently an endemic disease in Mexico. The country joined the WHO’s E-25 initiative for the elimination of Plasmodium vivax to achieve elimination and certification within the established period. Having a Web-based information system was, therefore, deemed necessary to assist in the detection, investigation, and elimination of transmission in the foci, as well as for the timely treatment of malaria-positive cases. The “Information System for the Elimination of Malaria in Mexico” was designed, developed, and implemented with a geographic vision, which includes a Web tool to georeference homes and aquatic systems, a dashboard and an indicator evaluation card for monitoring activities, notification of probable cases, and vector control among other indicators. The implementation of the system was gradual in the seven states that are currently in the malaria elimination phase; subsequently, the system was implemented in non-transmission states. In 2020, the system implementation stage began; first, the basic data of more than 96,000 homes throughout the country were georeferenced, and then the primary data capture tools of 17 formats, 32 reports, and 2 geographic viewers were enabled for information queries. A total of 56 active foci have been identified in 406 localities as well as 71 residual foci in 320 localities. Recently, the Foci Manager was developed, which is a specific tool for the study, evaluation, and monitoring of active foci through a GIS, a dashboard, and a systematized evaluation certificate. Georeferencing tools decreased the cost of spatial data collection.

Recent evidence has linked air pollution with frailty, yet little is known about the role of NO₂ in this association. Our aim was to assess the association between frailty and NO₂ air concentrations in Mexican older adults. We used georeferenced data from the population-based Nutrition and Health Survey in Mexico (NHNS) 2021, representative of national and subnational regions, to measure a frailty index based on 31 health deficits in adults aged 50 and over. Air pollution due to NO₂ concentrations was estimated from satellite images validated with data from surface-level stations. Maps were produced using Jensen’s Natural break method. The association of frailty and NO₂ concentrations was measured using the frailty index (multivariate fractional response logit regression) and a frailty binary variable (FI ≥ 0.36, multivariate logit regression). There was a positive and significant association of the frailty index with the NO₂ concentrations, adjusting for age, sex, urban/ rural area, years of education, socio-economic status, living arrangement, particulate matter smaller than 2.5 microns, and indoor pollution. For each standard deviation increase of NO₂ concentrations measured ten years before the survey, the odds of being frail were 15% higher, and the frailty index was 14.5% higher. The fraction of frailty attributable to NO2 exposure ranged from 1.8 to 23.5% according to different scenarios. Frailty was positively associated with exposure to NO₂ concentrations. Mapping frailty and its associated factors like NO₂ air concentrations can contribute to the design of targeted pro-healthy aging policies.