Salud Pública de México (Jun 2000)
Neumonitis por hipersensibilidad en la ciudad de México Hypersensitivity pneumonitis in Mexico City
Abstract
OBJETIVO: Determinar la asociación entre la zona urbana de origen del paciente en la ciudad de México y la prevalencia de neumonitis por hipersensibilidad inducida por antígeno aviario. MATERIAL Y MÉTODOS: Se trata de un estudio de casos y controles realizado en el Instituto Nacional de Enfermedades Respiratorias, en la ciudad de México, en el año de 1999. Se estudiaron 109 casos con neumonitis por hipersensibilidad y 184 controles: de éstos, 39, con fibrosis pulmonar idiopática; 63, con tuberculosis pulmonar, y 82, con asma. La ciudad de México y las zonas conurbadas se dividieron en cinco zonas geográficas: centro, noreste, sureste, noroeste y el suroeste. Se calcularon las prevalencias de las diferentes enfermedades por zona urbana de los pacientes que participaron en el estudio; como medida de asociación, se estimó la razón de momios, con un intervalo de confianza al 95%. Asimismo, se realizó regresión logística múltiple ajustando por edad, sexo y estrato socioeconómico. RESULTADOS: Ochenta casos de neumonitis por hipersensibilidad se concentraron en el sur del noreste de las zonas conurbadas y la parte norte del sureste de la ciudad de México, 48 y 32, respectivamente (RM= 3.86, IC 95% 2.17-6.96). Treinta y seis controles de asma se localizaron en el suroeste de la ciudad de México, zona donde se ubica el Intituto Nacional de Enfermedades Respiratorias (pOBJECTIVE: To investigate the association between the urban area of origin of patients and the prevalence of hypersensitivity pneumonitis (HP), induced by avian antigens. MATERIAL AND METHODS: A case-control study was conducted in 1999 at the National Institute of Respiratory Diseases (NIRD). Cases were 109 consecutive HP patients and controls were 184 patients: 39 with idiopathic pulmonary fibrosis (IPF), 63 with pulmonary tuberculosis (PTB), and 82 with asthma. Mexico City and surrounding counties (SC) were divided into 5 geographical areas: 1) Downtown; 2) North-East (NE); 3) South-East (SE); 4) North-West (NW) and 5) South-West (SW). Statistical analysis consisted of calculation of disease prevalence by urban area; associations were assessed with odds ratios and 95% confidence intervals. Multivariate analysis with multiple logistic regression was performed to adjust for age, gender and socioeconomic level. RESULTS: Eighty HP cases were located in the NE southernmost and SE northernmost areas of Mexico City (48 and 32, respectively) (OR= 3.86; 95% CI 2.17-6.96). Thirty-six controls with asthma came from the SW area, (where NIRD is located) (p<0.05), and four from SC. Controls with PTB and IPF were scattered throughout the study area. CONCLUSIONS: The NE southernmost and SE northernmost areas were associated with HP. The cause of HP may not be geographical; a garbage dump used to be located in this area, suggesting that exposure to organic particles might contribute to the development of HP in susceptible individuals.
