Staying Well Connecteds

Staying Well. Connected.

Texas Wintertime Rabies Vaccine Bait Distribution Begins January 6th

According to the Texas Department of State Health Services, distribution of the rabies vaccine bait for coyotes and gray foxes will begin on January 6th, 2008. The rabies bait distribution is part of a 12 year project to create zones of vaccinated coyotes and gray foxes to contain and then eliminate rabies in the areas.

The overall goal is to reduce the threat of the disease to domestic animals and humans. More information about rabies eradication efforts is available from the Oral Rabies Vaccinations Program.

The number of canine rabies cases in South Texas has declined from a high of 142 cases when the program began in 1995 to none in 2002 and 2003, 1 reported in 2004, and none in 2005, 2006 and through November 2007. Gray fox cases are down overall from an all-time high of 265 cases in 1994 to 61 in 2007 through November. The fewest number of cases, eight, was reported in 2005. (Statistics from Texas DSHS)

South Texas counties included in the bait drop: Cameron, Dimmit, Hidalgo, Jim Hogg, La Salle, Maverick, Starr, Webb, Willacy, Zapata and Zavala

US-Mexico Border 2012 Program

Border 2012 is a binational initiative with the goal of “protecting the environment and public health in the U.S.-Mexico border region, consistent with the principles of sustainable development.” The Border 2012 Web site, hosted by EPA, provides information about several regional and local projects. The list of projects in the Mexico-South Texas region highlights several sponsored by EPA.

Study on sex tourism along the border, and its consequences

A recent study by researchers at the University of California San Diego, in cooperation with partners on both sides of the border, reveals some of the serious health consequences of sex tourism in Mexican border cities, and urges binational prevention efforts — focused on both the sex workers and their customers — in an effort to prevent the very real possibility of a generalized HIV/STI epidemic.

The paper, “Characteristics of Female Sex Workers With US Clients in Two Mexico-US Border Cities,” currently appears online and will appear in a forthcoming issue of the journal Sexually Transmitted Diseases. The paper reports on the initial stage of a behavioral-intervention study to promote safer sex, involving 474 female sex workers (FSW) in Tijuana, BC (across the border from San Diego CA) and 450 in Ciudad Juárez, Chih (across from El Paso TX), who had reported unprotected sex encounters in the previous 2 months and who had not previously tested positive for HIV. The subjects were interviewed on working and social conditions, financial need, risk behaviors, sociodemographic characteristics, and physical & psychiatric health, and they provided samples for HIV and STI testing.

The paper found that in comparison to the overall group of sex workers studied in Tijuana and Cd. Juárez, the subset who said they had US clients were younger on average than the group as a whole, and more likely to:

  • speak English,
  • engage in unprotected sex,
  • report risky behavior involving injecting drugs,
  • have syphilis titers (16% vs. 10% overall),
  • have gonorrhea (8% vs. 2%), and
  • test positive for HIV (30% vs. 20%).

In addition, the paper indicates that “FSWs reporting US clients also had greater numbers of male clients and were more likely to report earning more money for having sex without a condom… The practice of offering more money for unprotected sex is not unique to our settings, as it has been reported elsewhere. Since FSWs in Mexico are primarily engaged in sex work due to economic need, this practice threatens to undermine HIV and STI prevention efforts and should be actively discouraged.”

Although this paper specifically studied Tijuana and Cd. Juárez, the conditions and regulations surrounding the sex trade in those cities have been described as similar to those present in the “Zonas Rojas” or “Boystowns” in Matamoros, Reynosa, and Nuevo Laredo — so the study’s findings deserve attention in the South Texas health community as well. The paper is summarized in this article from the San Diego Union-Tribune, which also includes this link to the full text of the paper; it was also recently covered in this segment from PRI’s “The World”. Here’s the full citation:

Strathdee SA, Lozada R, Semple SJ, Orozovich P, Pu M, Staines-Orozco H, Fraga-Vallejo M, Amaro H, Delatorre A, Magis-Rodríguez C, Patterson TL. Characteristics of Female Sex Workers With US Clients in Two Mexico-US Border Cities. Sex Transm Dis [forthcoming]. doi:10.1097/OLQ.0b013e31815b0 OVID JumpStart link

Need Health Related Statistics?

Good statistics are often important for grants and other reporting. One good place to find reports or request statistics is the Texas Department of State Health Services Center for Health Statistics. The Center for Health Statistics calls itself the Portal for Comprehensive Health Data in Texas. Data may be used to support research, grant applications and policy development, and provide rapid needs response to health emergencies.

Cancer Gene Identified in Minority Women

A multracial study conducted by researchers from the Northern California Cancer Institute at Stanford University has discovered that a genetic mutation in the BRCA1 gene, known to increase the risk of cancer in certain Jewish women of Eastern European ancestry, is found in significant numbers in Hispanic women who develop the disease. It is estimated that 3.5 percent of Hispanic women with breast cancer also have a mutation of this gene. In women diagnosed with breast cancer before age 35, the prevalence of the mutation is 8.9 percent. Since minority women are less likely to be tested for the BRCA1 mutation, the chance of detecting any possible cancer at an early stage is lower.

The BRCA1 gene makes a protein that helps cells repair DNA, but a mutation of this gene makes them less able to fix DNA and the accumulated mutations can lead to cancer.

Genetic Link to Spina Bifida Discovered

Spina Bifida is a neural tube birth defect that occurs when the spine of the baby fails to close during the first months of pregnancy. It is the most common permanently disabling birth defect in the United States, occurring in seven out of 10,000 births. However, it is more prevalent in the Hispanic population, with a Hispanic woman twice as likely to have a child with this condition. In Texas, nearly two out of every 1,000 babies is born with Spina Bifida.

Epidemiological studies have always recognized a link between high glucose levels and having a child with spina bifida, but now an association between three variants in glucose metabolism genes and spina bifida has been identified through research conducted at the UT Medical School at Houston.

According to Dr. Manju Monda, M.D., professor at the Universty of Texas Medical School at Houston … “This is important from a practical standpoint because neural tube defects are more common in pregnancies complicated by maternal diabetes and maternal obesity, and our study suggests a mechanism for this association. In the United States, Mexican-American women have the highest rates of neural tube defects and they are also at increased risk for obesity and adult-onset diabetes, so this study may be especially relevant to pregnant women in Texas.”

The study, titled “Genes in Glucose Metabolism and Association with Spina Bifida”, is being published in the January 2008 issue of the journal Reproductive Services.

New Online Database of Vitamins, Minerals, and Herbs

Learning about supplements is often a challenge. A new free online database, the Dietary Supplements Labels Database from the National Library of Medicine seeks to help patients and healthcare professionals learn more about many common supplements. It includes vitamins, minerals, herbs or other botanicals, amino acids, and specialty supplements. Information is included about ingredients in brand-name products, including name, form, active and inactive ingredients, amount of active ingredient/unit, manufacturer/distributor information, suggested dose, label claims, warnings, and percentage of daily value.

Latino Health Access

Latino Health Access http://www.latinohealthaccess.org/index.shtml is an award winning, non-profit, 501c3 organization established in 1993. America Bracho founded Latino Health Access with the vision to promote healthy living and disease prevention. LHA uses participatory approaches to community health education. They train promotoras to be leaders of wellness and change. Programs offered arise from the needs of the community. Latino Health Access was featured in a PBS special entitled: FAT: What no one is telling you. http://www.pbs.org/wgbh/takeonestep/fat/video-ch_10.html.

Think Cultural Health

Sponsored by the US Dept. of Health & Human Services, Office of Minority Health(OMH), the Think Cultural Health website offers cultural competency e-training for health providers. Part of the OMH mission is to “improve the health of racial and ethnic minority populations through the development of effective health policies and programs that help to eliminate disparities in health”.

Along with free online courses which are accredited for continuing education credit, other resources and tools are available to promote awareness of cultural awareness in the patient population. Resources are available for physicians, physicians’ assistants, nurse practitioners, nurses, pharmacists, social workers and other health professionals. The website is advertising a soon to be curriculum for emergency responders also. Another added resource is the Health Care Services Language Implementation Guide which has been developed to assist healthcare organizations implement language access services to meet the needs of patients who have limited English proficiency.

Think Cultural Health: Bridging the Health Care Gap through Cultural Competency Continuing Education Programs.

Immigrants less likely to report family history of cancer

A new study indicates that immigrants are less likely to report family histories of cancer, and therefore might be missed by screening and prevention efforts that could otherwise benefit them. The study will appear in the 15 January issue of Cancer but is now online (see citation below). It is based on analysis of data from over 5000 respondents to the 2005 Health Information Trends Survey (HINTS). The analysis found that foreign-born respondents were two-thirds less likely to report a family history of cancer than US-born respondents — and that rate was consistent among immigrants regardless of the amount of time they had lived in the US or their degree of acculturation. Possible contributing factors discussed included:

  • Lower incidence of cancer in countries of origin: “Lower incidence rates of cancer outside of the United States are thought to be attributable to younger age structures in these countries, behavioral and environmental exposures, and a pattern of underdiagnosing and under-reporting cancers in under-resourced countries.”
  • Immigrants may have fewer opportunities to learn about family histories of cancer; distance from relatives, and some cultural beliefs (i.e. stigma) may inhibit exchange of information about cancer history.
  • Immigrants may be less likely to have experienced medical care that emphasized knowing and reporting family history of illnesses — not just cancer, but other family history as well.

Here’s a summary of the study from HealthDay/MedlinePlus — and here’s the same summary in Spanish. The full citation is as follows:

Orom H, Coté ML, González H, Underwood W, Schwartz AG. Family History of Cancer: Is it an Accurate Indicator of Cancer Risk in the Immigrant Population? Cancer [forthcoming 2008-01-15]. doi:10.1002/cncr.23173. http://dx.doi.org/10.1002/cncr.23173