Mpox: Fifty-Nine Consecutive Cases from a Mexican Public Hospital; Just the Tip of the STIs Iceberg.

Monkeypox (Mpox) is a zoonotic viral infection endemic to Africa, which has caused a global outbreak since April 2022. The global Mpox outbreak is related to Clade IIb. The disease has primarily affected men who have sex with men. Skin lesions are concentrated in the genital area, with lymphadenopathy as well as concurrent sexually transmitted infections (STIs). This is an observational study of adult patients with a recent development of skin lesions and systemic symptoms, which could not be explained by other diseases present. Fifty-nine PCR-positive patients with prominent skin lesions in the genital area (77.9%), inguinal lymphadenopathy (49.1%), and fever (83.0%) were included. Twenty-five (42.3%) were known to be living with human immunodeficiency virus (HIV), and 14 of the HIV-naïve subjects (51.9%) were found to be positive during workup, totaling 39 (66.1%) patients with HIV. Eighteen patients (30.5%) had concurrent syphilis infections. It is worrisome that Mpox is present in large metropolitan areas of Mexico, but the underlying growth of cases of HIV infection and other STIs has not been well studied and should be evaluated in all at-risk adults and their contacts.

A Local Health Situation Room for COVID-19: Recommendations for Decision-Making From a Higher Education Institution in Mexico.

Introduction: The Situation Room is a physical or virtual space where experts systematically analyze information to characterize a health situation, especially during emergencies. Decision-making processes are made toward solving health needs and promoting collaboration among institutions and social sectors. This paper presents the context and circumstances that led the University of Guadalajara (UdeG) to install a local health situation room (HSR) to address the COVID-19 pandemic at this institution based in the state of Jalisco, Mexico, a narrative is also made of its working processes and some of its results. Methods: The design of this situation room for COVID-19 was based on the methodology established by the Pan American Health Organization (PAHO)/WHO. This local-type situation room was installed on February 12, 2020. The health problem was characterized, and strategic lines, objectives, and goals were established; the first analysis was derived from an action plan deployed at the UdeG. The strategic lines were situational diagnosis, preventive actions, and containment strategies. Results: The situation room influenced the activities of the UdeG before the epidemic cases started in the state. One of the actions with the greatest impact was developing a mathematical model for predicting COVID-19 cases. Subsequently, new models have been developed according to the epidemiological evolution of the disease, helping manage the epidemic in the state. Another important result was the early closing of face-to-face university activities, reducing contagion risks and the mobility of more than 310,000 students, faculty, and administrative personnel throughout Jalisco. Conclusions: A consequence of the closure was that the confinement generated by the pandemic was the change to virtual meetings from April 2020 to date; but at the same time, this working format was a strength, since it influenced the decision of the university board to change all the academic activities to virtual format before other educational, economic, and social activities in the state did. By April 2020, the situation room transcended its institutional boundaries and was invited to participate at the Jalisco State's Health Committee. Its recommendations have helped to maintain the state with one of Mexico's lowest COVID-19 incidence and mortality rates.

[Clinical competence measurement in Mexican resident physicians for diagnosis and treatment of Chagas disease]. / Evaluación de la competencia clínica en médicos residentes mexicanos para el diagnóstico y tratamiento de la enfermedad de Chagas.

OBJECTIVE: Evaluate clinical competence of a mexican resident physicians sample for diagnosis and treatment of Chagas disease. MATERIAL AND METHODS: Cross-sectional and analytic study in 122 resident physicians of epidemiology, family medicine and internal medicine specialty, assigned to a third level medical unit from Guadalajara, Jalisco, Mexico, taking a sample for convenience. An instrument was designed and validated for to evaluate clinical competence in five dimensions: risk factors identification, clinical data identification, diagnostic test interpretation, diagnostic integration and therapeutic resources utilization; that classified competence level in four strata: random defined, low, medium and high, with 89% of reliability accord to Kunder-Richardson test. Descriptive and no parametric inferential statistics were obtained. RESULTS: A total of 122 physicians, 55.7% males (n = 68) and 44.3% females (n = 54). Random defined clinical competence 4.9% (n = 6), low 49.2% (n = 60), medium 44.3% (n = 54) and high 1.6% (n = 2). Median significantly higher in epidemiologists (p = 0.03). CONCLUSIONS: Improve clinical competence level of resident physicians for diagnosis and treatment of Chagas disease is necessary. Intervention studies are required.

Community participation and domiciliary occurrence of infected Meccus longipennis in two Mexican villages in Jalisco state.

The entomological features of Chagas disease in two western Mexican villages were analyzed through triatomines collection by the inhabitants and active research in the peridomicile. The inhabitant collections have the following comparable characteristics: 1) Meccus longipennis was the dominant species (> 91%), 2) around 43% of the insects were collected indoors, 3) about 70% of triatomines were adults, 4) cumulated rates of infestation of the dwellings reached 40-50%, 5) the triatomine infection rate by Trypanosoma cruzi was > 50%, and 6) the indoor triatomines frequently feed on humans (range 38.5-56.2%). However, the collection was twice as abundant in the first village and the peridomicile infestation, evaluated by the active collection, reached up to 60% and only 4.9% in the other village. Furthermore, females predominated in the first village, whereas males in the other. The current results allow discussing the course of action to prevent Chagas disease in this region.

Conocimiento epidemiológico y situación actual de la enfermedad de Chagas en el estado de Jalisco, México / Epidemiologic knowledge and current situation of Chagas disease in the state of Jalisco, Mexico

La enfermedad de Chagas en el estado de Jalisco, México, apareció por primera vez en 1967, aunque su conocimiento ha seguido un proceso lento. Entre los años de 1967 y 2006 se describió la enfermedad en sus formas agudas y crónicas; se identificaron las especies de vectores y se aisló el parásito Trypanosoma cruzi, que luego se caracterizó en el plano genético. La magnitud de la infección en el hombre se determinó con estudios serológicos en diversas poblaciones, así como en donadores de sangre. En la actualización presente del conocimiento de la enfermedad en el estado de Jalisco se mostró la necesidad de incrementar las investigaciones sobre la epidemiología de la enfermedad de Chagas, así como los estudios clínicos para determinar la salud de los individuos y las poblaciones.

Chagas disease in the state of Jalisco, Mexico was described for the first time in 1967; however, knowledge on the disease remains in a slow process. Between 1967 and 2006, the disease was described in its acute and chronic forms. The vector species have been identified, and the parasite Trypanosoma cruzi has been isolated and genetically characterized. Also, the magnitude of the infection in humans has been determined through serological studies of different populations as well as of blood donors. The up-to-dateness of knowledge of the disease in the state of Jalisco, unveils a necessity of increased research on the epidemiology of Chagas disease as well as on clinical studies to assess the health of individuals and the populations.

[Epidemiologic knowledge and current situation of Chagas disease in the state of Jalisco, Mexico]. / Conocimiento epidemiológico y situación actual de la enfermedad de Chagas en el estado de Jalisco, México.

Chagas disease in the state of Jalisco, Mexico was described for the first time in 1967; however, knowledge on the disease remains in a slow process. Between 1967 and 2006, the disease was described in its acute and chronic forms. The vector species have been identified, and the parasite Trypanosoma cruzi has been isolated and genetically characterized. Also, the magnitude of the infection in humans has been determined through serological studies of different populations as well as of blood donors. The up-to-dateness of knowledge of the disease in the state of Jalisco, unveils a necessity of increased research on the epidemiology of Chagas disease as well as on clinical studies to assess the health of individuals and the populations.

Manifestaciones digestivas en la fase crónica de la enfermedad de Chagas / Digestive manifestation in chronic phase of Chaga's disease

Se describen dos casos de enfermedad de Chagas en fase crónica, con mega deformaciones del tubo digestivo, ambos casos residentes del municipio de San Martín de Hidalgo, Jalisco. Con una evolución de 12 y 8 años respectivamente; el diagnóstico en ambos fue de acalasia de etiología desconocida. El primer paciente presenta megaesófago, megaduodeno y megaíleon (manifestaciones asociadas poco frecuentes). Los signos y síntomas digestivos fueron: disfagia, dolor retroesternal, regurgitación, sensación de plenitud gástrica, dolor epigástrico, vómito, sialorrea y pérdida de peso. El segundo paciente presenta disfagia, vómito regurgitación, tos de predominio nocturno, sialorrea, hipertrofia de parótidas y pérdida de peso. Los signos y síntomas comunes observadas en ambos casos son: disfagia, vómitos, regurgitación, sialorrea y pérdida de peso. Los signos y síntomas no comunes y asociados al padecimiento son: tos de predominio nocturno, hipertrofia de parótidas, dolor retroesternal, sensación de plenitud gástrica y dolor epigástrico.