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Espinoza B, Rangel-Flores H, Saucedo-Arteaga G, Martínez I, Aguilar-Salinas CA, Cabrera-Mendoza B, Ponce-Patiño D, Mendoza-Duarter J, Martínez-Rangel CE. First Report of Seropositivity to Trypanosoma cruzi in Mexican Afro-Descendants from Guerrero and Oaxaca States. J Parasitol Res 2024; 2024:2014142. [PMID: 38751402 PMCID: PMC11095991 DOI: 10.1155/2024/2014142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/03/2024] [Accepted: 04/12/2024] [Indexed: 05/18/2024] Open
Abstract
Mexican Afro-descendant is a population poorly studied in many aspects, between them the infectious diseases that they suffer. This population is mainly found in the country's Pacific (Oaxaca and Guerrero states) and Atlantic (Veracruz) coast. In these regions, a diversity of triatomine vectors of the Chagas disease is found. Also, all the genotypes of Trypanosoma cruzi DTUs have been reported. That is why the present study aimed to study the presence of antibodies against T. cruzi and cardiac pathology associated with the Chagas disease in the Mexican Afro-descendant population of Guerrero and Oaxaca. ELISA, Western blot, and recombinant antigen's ELISA were used to evaluate the seropositivity of these communities. Furthermore, an electrocardiographic study and evaluation of risk factors associated with T. cruzi infection in the Oaxaca and Guerrero populations were conducted. 26.77% of the analyzed population was positive for two serological tests. These percentages are higher than the previously reported for the mestizo population in similar studies. Electrocardiographic results showed cardiac disorder associated with the Chagas disease in the population. Also, risk factors were identified associated with the men's activities in the outdoor working areas.
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Affiliation(s)
- Bertha Espinoza
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, UNAM, Ciudad de México 04010, Mexico
| | - Hilda Rangel-Flores
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos 62100, Mexico
| | - Gabriel Saucedo-Arteaga
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Ciudad de México 14080, Mexico
| | - Ignacio Martínez
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, UNAM, Ciudad de México 04010, Mexico
| | - Carlos A. Aguilar-Salinas
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Ciudad de México 14080, Mexico
| | - Brenda Cabrera-Mendoza
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, UNAM, Ciudad de México 04010, Mexico
| | - David Ponce-Patiño
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, UNAM, Ciudad de México 04010, Mexico
| | - Javier Mendoza-Duarter
- Hospital Regional de Alta Especialidad, Centenario de la Revolución Emiliano Zapata, ISSSTE, Emiliano Zapata, Morelos 62765, Mexico
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Vásconez-González J, Izquierdo-Condoy JS, Fernandez-Naranjo R, Gamez-Rivera E, Tello-De-la-Torre A, Guerrero-Castillo GS, Ruiz-Sosa C, Ortiz-Prado E. Severe Chagas disease in Ecuador: a countrywide geodemographic epidemiological analysis from 2011 to 2021. Front Public Health 2023; 11:1172955. [PMID: 37143984 PMCID: PMC10151800 DOI: 10.3389/fpubh.2023.1172955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/04/2023] [Indexed: 05/06/2023] Open
Abstract
Background Chagas disease is a neglected and often forgotten tropical disease caused by the Trypanosoma cruzi. This parasite can be transmitted through the direct contact of human skin with feces and urine of the triatomine insect. According to the World Health Organization (WHO), an estimated 6-7 million people are infected worldwide, killing at least 14,000 every year. The disease has been reported in 20 of the 24 provinces of Ecuador, with El Oro, Guayas, and Loja being the most affected. Methodology We analyzed the morbidity and mortality rates of severe Chagas disease in Ecuador on a nationwide, population-based level. Hospitalization cases and deaths were also examined based on altitude, including low (< 2,500 m) and high (> 2,500 m) altitudes, according to the International Society. Data was retrieved from the National Institute of Statistics and Census hospital admissions and in-hospital mortality databases from 2011 to 2021. Results A total of 118 patients have been hospitalized in Ecuador since 2011 due to Chagas disease. The overall in-hospital mortality rate was 69.4% (N = 82). Men have a higher incidence rate (4.8/1,000,000) than women, although women have a significantly higher mortality rate than men (6.9/1,000,000). Conclusion Chagas disease is a severe parasitic condition that primarily affects rural and poorer areas of Ecuador. Men are more likely to be infected due to differences in work and sociocultural activities. Using average elevation data, we conducted a geodemographic analysis to assess incidence rates by altitude. Our findings indicate that the disease is more common at low and moderate altitudes, but recent increases in cases at higher altitudes suggest that environmental changes, such as global warming, could be driving the proliferation of disease-carrying vectors in previously unaffected areas.
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Affiliation(s)
- Jorge Vásconez-González
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Raul Fernandez-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Esteban Gamez-Rivera
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Andrea Tello-De-la-Torre
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | | | - Carlos Ruiz-Sosa
- Postgraduate in Gastroenterology and Digestive Endoscopy, Faculty of Medicine, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
- *Correspondence: Esteban Ortiz-Prado,
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González-Guzmán S, González-Cano P, Bagu ET, Vázquez-Vega S, Martínez-Salazar M, Juárez-Montiel M, Gutiérrez-Hoya A, Crescencio-Trujillo JA, Sánchez-Montes S, Fernández-Figueroa E, Contreras-López EA, Guerra-Márquez Á, Arroyo-Anduiza CI, Ángeles-Márquez LE, Rodríguez-Trejo E, Bekker-Méndez C, Guerra-Castillo FX, Regalado-Santiago C, Tesoro-Cruz E, Oviedo N, Victoria-Jardón AM, Bautista-Olvera J, García-Ramírez P, Vázquez-Meraz JE, Contreras-Lozano MC, Castillo-Flores VS, Guevara-Reyes R, Girón-Sánchez AR, Arenas-Luis HD, Pecero-Hidalgo MJ, Ríos-Antonio E, Ramírez-Pereda N, Martínez-Mora A, Paredes-Cervantes V. Seroprevalence of Trypanosoma cruzi in Eight Blood Banks in Mexico. Arch Med Res 2022; 53:625-633. [PMID: 36109203 DOI: 10.1016/j.arcmed.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/16/2022] [Accepted: 08/19/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND The true prevalence of Chagas disease in Mexico is unknown. However, it has been estimated that 1.1-4 million people are infected with Trypanosoma cruzi, which represents a potential risk for transmission of the disease via contaminated blood. AIM OF THE STUDY To determine the Chagas disease seroprevalence in donors from eight blood banks in the north of Mexico City, and the northeast of the State of Mexico. STUDY DESIGN AND METHODS Serum samples from blood donors (n = 515,038) were tested to detect the presence of anti-Trypanosoma cruzi antibodies in eight blood banks. The serologic screening test was performed in each of the blood banks. To confirm the seropositive blood donors, only two out of the eight blood banks used a test with a different principle with the aim of identifying anti-Trypanosoma cruzi antibodies. All tests were validated by the Mexican Institute for Epidemiological Diagnosis and Reference. RESULTS One thousand two hundred and ten blood donors were seropositive for Trypanosoma cruzi, which represents a 0.23% seroprevalence (95% CI 0.22-0.25%). Of the seropositive blood donors, 97.03 % resided in the northeast area of the State of Mexico, Mexico City, and southern part of the State of Hidalgo. CONCLUSIONS Active transmission of Chagas disease may be occurring in non-endemic regions in the northeast of the State of Mexico.
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Affiliation(s)
- Saúl González-Guzmán
- Banco Central de Sangre, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México; Hospital Regional de Alta Especialidad de Zumpango, Estado de México, México
| | - Patricia González-Cano
- Departamento de Farmacobiología, Universidad de La Cañada, Teotitlán de Flores Magón, Oaxaca, México
| | - Edward T Bagu
- Sanford School of Medicine School, University of South Dakota, Vermillion, South Dakota, USA
| | - Salvador Vázquez-Vega
- Unidad de Investigación Epidemiológica y Servicios de Salud, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Martha Martínez-Salazar
- División Atención Oncológica Pediátrica, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Margarita Juárez-Montiel
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México, México
| | - Adriana Gutiérrez-Hoya
- Cátedra-CONACyT. Unidad de Diferenciación Celular e Investigación del Cáncer, Facultad de Estudios Superiores, Zaragoza, Universidad Nacional Autónoma de México, Ciudad de México, México
| | | | - Sokani Sánchez-Montes
- Centro de Medicina Tropical, Universidad Nacional Autónoma de México, Ciudad de México, México; Facultad de Ciencias Biológicas y Agropecuarias, Universidad Veracruzana, Veracruz, México
| | - Edith Fernández-Figueroa
- Departamento de Genómica Poblacional, Genómica Computacional y Biología integrativa. Instituto Nacional De Medicina Genómica, Ciudad de México, México
| | - Erik A Contreras-López
- Hospital General de Zona #25, Instituto Mexicano del Seguro Social, Ciudad de México, México; Hospital General Tacuba, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Ciudad de México, México
| | - Ángel Guerra-Márquez
- Banco Central de Sangre, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Carla I Arroyo-Anduiza
- Banco Central de Sangre, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Laura E Ángeles-Márquez
- Banco Central de Sangre, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Eduardo Rodríguez-Trejo
- Banco Central de Sangre, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Carolina Bekker-Méndez
- Unidad de Investigación Médica en Inmunología e Infectología, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Francisco X Guerra-Castillo
- Unidad de Investigación Médica en Inmunología e Infectología, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | | | - Emiliano Tesoro-Cruz
- Unidad de Investigación Médica en Inmunología e Infectología, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Norma Oviedo
- Unidad de Investigación Médica en Inmunología e Infectología, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | | | | | | | - José E Vázquez-Meraz
- Banco de Sangre Regional Ecatepec Las Américas, Ecatepec Estado de México, México
| | | | | | | | | | - H D Arenas-Luis
- Hospital Regional de Alta Especialidad de Zumpango, Estado de México, México
| | | | - Emiliano Ríos-Antonio
- Departamento de Farmacobiología, Universidad de La Cañada, Teotitlán de Flores Magón, Oaxaca, México
| | - Natividad Ramírez-Pereda
- Departamento de Farmacobiología, Universidad de La Cañada, Teotitlán de Flores Magón, Oaxaca, México
| | - Adalberto Martínez-Mora
- Departamento de Farmacobiología, Universidad de La Cañada, Teotitlán de Flores Magón, Oaxaca, México
| | - Vladimir Paredes-Cervantes
- Unidad de Investigación Médica en Inmunología e Infectología, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México.
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Velázquez-Ramírez DD, Pérez de Léon AA, Ochoa-Díaz-López H. Review of American Trypanosomiasis in Southern Mexico Highlights Opportunity for Surveillance Research to Advance Control Through the One Health Approach. Front Public Health 2022; 10:838949. [PMID: 35372189 PMCID: PMC8964530 DOI: 10.3389/fpubh.2022.838949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/14/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Adalberto A Pérez de Léon
- USDA-ARS San Joaquin Valley Agricultural Sciences Center, Parlier, CA, United States.,Veterinary Pest Genomics Center, Kerrville, TX, United States
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Joselín DV, Ignacio M, Ángel RM, Gabriel GG, Rodrigo Isaias LV, Víctor SC, Jorge FN, Jose ÁC, Bertha E. Multiple Discrete Typing Units of Trypanosoma cruzi Infect Sylvatic Triatoma dimidiata and Panstrongylus rufotuberculatus in Southeast Mexico. Am J Trop Med Hyg 2021; 105:1042-1049. [PMID: 34398820 PMCID: PMC8592174 DOI: 10.4269/ajtmh.20-1574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/11/2021] [Indexed: 11/07/2022] Open
Abstract
Chagas disease or American trypanosomiasis is an infection caused by the parasite Trypanosoma cruzi. According to its genetic characteristics, this parasite is divided into six groups (TcI-TcVI) called discrete typing units (DTUs). Trypanosoma cruzi is transmitted to humans by insects of the Triatominae family. In Mexico, despite having a great variety of triatomine species, little is known about vector sylvatic populations and the DTUs associated with them. In this work, molecular markers such as minicircle, miniexon, 18S, and 24S ribosomal genes and restriction fragment length polymorphism (RFLP) analysis of the hsp70 gene were used to determine the DTUs present in vectors from rural communities and sylvatic areas inside the Biosphere Reserve Los Tuxtlas, Veracruz, in southeast Mexico. One hundred triatomines were collected and two species were identified: Triatoma dimidiata and Panstrongylus rufotuberculatus. The infection with T. cruzi was determined in 29% of analyzed vectors from the domestic area and TcI was the predominant DTU. Furthermore, 71% of vectors from the sylvatic environment were infected and TcI, TcII, TcIV, and TcVI were identified. One female and one male of P. rufotuberculatus were infected only with TcI. This is the first report of TcVI in T. dimidiata from the sylvatic area in México and the first report of P. rufotuberculatus infected with T. cruzi in Mexico.
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Affiliation(s)
- Díaz-Valdez Joselín
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Martínez Ignacio
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Rodríguez-Moreno Ángel
- Instituto de Biología, Universidad Nacional Autónoma de México, Ciudad de México, México
| | | | | | - Sánchez-Cordero Víctor
- Instituto de Biología, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Fraga-Nodarse Jorge
- Departamento de Parasitología, Instituto de Medicina Tropical Pedro Kouri, La Habana, Cuba
| | - Ángeles-Chimal Jose
- Facultad de Medicina, Universidad Autónoma del Estado de Morelos, Cuernavaca, Morelos, México
| | - Espinoza Bertha
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, México
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Tello-Cajiao ME, Agudelo-Rojas OL, Quintero M, Cardenas L, Rosso F. Trends of Seroprevalence of Chagas´s diseases in healthy blood donors, solid organ donors and heart transplant recipients: experience of a single health care center in Colombia. Epidemiol Infect 2020; 148:1-25. [PMID: 33153501 PMCID: PMC7770375 DOI: 10.1017/s0950268820002721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/13/2020] [Indexed: 11/07/2022] Open
Abstract
The prevalence of Chagas disease has decreased in the Americas region due to vector control measures. However, non-vectorial transmission through blood transfusions and organ transplantation has gained importance in recent years. Screening among blood and organ donors are essential to reduce Trypanosoma cruzi transmission and could provide information to estimate population prevalence. We conducted a cross-sectional study on the prevalence of immunoglobulin G (IgG) antibodies against T. cruzi in healthy blood donors, solid organ donors and heart transplant recipients from 2012 to 2019. We found a total of 99 357 IgG T. cruzi results during the study period. The cumulative seroprevalence in healthy blood donors was 0.13% (95% confidence interval (CI) 0.10–0.15), in organ donors was 0.53% (95% CI 0.06–1.92) and in heart transplant recipients was 3.03 (95% CI 0.07–15.75). Seroprevalence trend in healthy blood donors showed annual increase between 2012 and 2015, decreasing in the following years. No trend was seen in organ donors neither heart recipients. Adjusted rates did not show difference by sex and age among blood donors. No significant increases in seroprevalence T. cruzi were found during the study period. T. cruzi transmission remains low.
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Affiliation(s)
- María Elena Tello-Cajiao
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Olga Lucia Agudelo-Rojas
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Marcela Quintero
- Blood Bank, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Laura Cardenas
- Blood Bank, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Fernando Rosso
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
- Fundacion Valle del Lili, Internal Medicine Department, Infectious Disease Service, Cali, Valle del Cauca, Colombia
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7
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Bello-López JM, León-García G, Rojas-Bernabé A, Fernández-Sánchez V, García-Hernández O, Mancilla Rámirez J, Ibáñez-Cervantes G. Morbidity Trends and Risk of Tuberculosis: Mexico 2007-2017. Can Respir J 2019; 2019:8295261. [PMID: 31178943 PMCID: PMC6501252 DOI: 10.1155/2019/8295261] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 12/14/2018] [Accepted: 03/20/2019] [Indexed: 12/12/2022] Open
Abstract
Background To know the current status of the epidemiological and geographic distribution of tuberculosis and its complication meningeal tuberculosis in Mexico, this work analyzes national surveillance data (ten years) issued by the General Directorate of Epidemiology (GDE). Methods An observational and retrospective analysis of monthly and annual reports of pulmonary and meningeal tuberculosis cases from January 2007 to December 2017 was performed on the annual reports issued by the GDE in Mexico. The number of cases and incidence were classified by year, state, age group, gender, and seasons. Results A national case distribution map of pulmonary and meningeal tuberculosis incidence was generated. During this period, a total of 184,003 and 3,388 cases were reported with a median of 16,727.5 and 308 cases per year for pulmonary and meningeal tuberculosis diseases, respectively. The number of cases and incidence of pulmonary and meningeal tuberculosis per year showed that male gender presented a continuous increase in both parameters. The geographic analysis of the distribution of cases of tuberculosis showed that states like Guerrero, Tabasco, and Veracruz presented higher means of tuberculosis cases during this period. Northern states had the highest number of cases in the country compared to other states. In Mexico, pulmonary tuberculosis and meningeal tuberculosis are seasonal. Interestingly, cases of meningeal tuberculosis show an increase during October and November (autumn). Conclusions In Mexico, during the years 2007-2017, there has been an increase in the proportion of male TB patients. It remains necessary to implement strategies to detect TB in the adult population, especially among men, because tuberculosis could be difficult to recognize in an early stage in the population, and the appearance of resistant strains can cause an increase in the incidence of the disease.
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Affiliation(s)
- Juan Manuel Bello-López
- Unidad de Investigación en Microbiología y Toxicología, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Col. Magdalena de las Salinas, 07360 Mexico City, Mexico
| | - Gregorio León-García
- Hospital de la Mujer, SSA, Salvador Díaz Mirón 374, Col. Santo Tomas, 11340 Mexico City, Mexico
- Centro Médico y de Investigaciones Científicas Fundación CIAM ESPERAS, A.C., Felipe Carrillo Puerto 181, Col. Popotla, 11400 Mexico City, Mexico
- Escuela Superior de Medicina, Instituto Politécnico Nacional, Salvador Díaz Mirón, Col. Casco de Santo Tomas, 11340 Mexico City, Mexico
| | - Araceli Rojas-Bernabé
- Escuela Superior de Medicina, Instituto Politécnico Nacional, Salvador Díaz Mirón, Col. Casco de Santo Tomas, 11340 Mexico City, Mexico
| | | | - Omar García-Hernández
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Javier Mancilla Rámirez
- Hospital de la Mujer, SSA, Salvador Díaz Mirón 374, Col. Santo Tomas, 11340 Mexico City, Mexico
- Escuela Superior de Medicina, Instituto Politécnico Nacional, Salvador Díaz Mirón, Col. Casco de Santo Tomas, 11340 Mexico City, Mexico
| | - Gabriela Ibáñez-Cervantes
- Hospital de la Mujer, SSA, Salvador Díaz Mirón 374, Col. Santo Tomas, 11340 Mexico City, Mexico
- Escuela Superior de Medicina, Instituto Politécnico Nacional, Salvador Díaz Mirón, Col. Casco de Santo Tomas, 11340 Mexico City, Mexico
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