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.