Knowledge, attitudes, perceptions, and COVID-19 hesitancy in a large public university in Mexico city during the early vaccination rollout.

BACKGROUND: Vaccination against COVID-19 is a primary tool for controlling the pandemic. However, the spread of vaccine hesitancy constitutes a significant threat to reverse progress in preventing the disease. Studies conducted in Mexico have revealed that vaccination intention in Mexico among the general population ranges from 62 to 82%. OBJECTIVE: To know the prevalence of COVID-19 vaccine hesitancy and associated factors among academics, students, and administrative personnel of a public university in Mexico City. METHODS: We administered an online survey investigating sociodemographic aspects, knowledge, attitudes, practices, and acceptance/hesitancy regarding the COVID-19 vaccine. Using generalized linear Poisson models, we analyzed factors associated with vaccine hesitancy, defined as not intending to be vaccinated within the following six months or refusing vaccination. RESULTS: During May and June 2021, we studied 840 people, prevalence of vaccine hesitancy was 6%. Hesitancy was significantly associated with fear of adverse effects, distrust of physician's recommendations, lack of knowledge regarding handwashing, age younger than 40 years, refusal to use face masks, and not having received influenza vaccination during the two previous seasons. CONCLUSIONS: Vaccine hesitancy in this population is low. Furthermore, our results allowed us the identification of characteristics that can improve vaccine promotion.

Social determinants for overweight and obesity in a highly marginalized population from Comitán, Chiapas, Mexico.

OBJECTIVE: We assessed the prevalence of overweight and obesity and its association with some social determinants in a highly marginalized population in Mexico. MATERIALS AND METHODS: Cross-sectional study conducted in Comitán, Chiapas, from 2010 to 2012, comprising 1 858 subjects aged ≥20 years. We evaluated proximal, intermediate, and structuralsocial determinants. RESULTS: The prevalence of overweight and obesity was 37.9 and 16.5%, respectively. The probability of overweight and obesity was higher in participants with ≥primary school, self-reported non-indigenous origin, and medium level of marginalization compared with those with

OBJETIVO: Estimar la prevalencia de sobrepeso y obesidad y su asociación con determinantes sociales en población con alto grado de marginación. MATERIAL Y MÉTODOS: Estudio transversal realizado en Comitán, Chiapas, de 2010 a 2012, que incluyó 1 858 sujetos ≥20 años de edad. Se evaluaron determinantes sociales proximales, intermedios y estructurales. RESULTADOS: La prevalencia de sobrepeso y obesidad fue de 37.9 y 16.5%, respectivamente. La probabilidad de sobrepeso y obesidad fue mayor en sujetos con escolaridad ≥primaria, en sujetos que se autodefinieron como no indígenas y en sujetos con un grado de marginación medio comparado con individuos con escolaridad

Outbreak of Vibrio cholerae serogroup O1, serotype Ogawa, biotype El Tor strain--La Huasteca Region, Mexico, 2013.

On September 2 and 6, 2013, Mexico's National System of Epidemiological Surveillance identified two cases of cholera in Mexico City. Rectal swab cultures from both patients were confirmed as toxigenic Vibrio cholerae serogroup O1, serotype Ogawa, biotype El Tor. Pulsed-field gel electrophoresis and virulence gene amplification (ctxA, ctxB, zot, and ace) demonstrated that the strains were identical to one another but different from strains circulating in Mexico previously. The strains were indistinguishable from the strain that has caused outbreaks in Haiti, the Dominican Republic, and Cuba. The strain was susceptible to doxycycline, had intermediate susceptibility to ampicillin and chloramphenicol, was less than fully susceptible to ciprofloxacin, and was resistant to furazolidone and trimethoprim-sulfamethoxazole. An investigation failed to identify a common source of infection, additional cases, or any epidemiologic link between the cases. Both patients were treated with a single, 300-mg dose of doxycycline, and their symptoms resolved.

[Impact of self-reported periodontal status on oral health-related quality of life in adult population with Type 2 Diabetes from Mexico City]. / Impacto del estado periodontal autorreportado en la calidad de vida relacionada con la salud oral en población adulta con diabetes tipo 2 de la Ciudad de México.

OBJECTIVE: Periodontitis ranks sixth as a type 2 diabetes (T2D) complication. According to its severity, it may cause pain, discomfort and tooth loss. The aim of this study was to evaluate the impact of self-reported periodontal status on the Oral Health Related Quality of Life (OHRQoL) of people with T2D. METHODS: A cross-sectional study was conducted involving seventy-nine adults with T2D who visited the Metabolic Syndrome clinic at the Cosío Villegas National Institute of Respiratory Diseases in Mexico City between August and November 2010. The OHRQoL was evaluated with the shortened Oral Health Impact Profile (OHIP-EE14). Periodontitis was measured by self-report, probing depth (PD), and clinical attachment loss (CAL). The association between self-reported periodontal status and OHRQoL was evaluated with binomial regression models. RESULTS: Mean age of the participants was 60,4 years (SD=9,6); diabetes duration was 10,1 years (SD=6,6). The OHRQoL was associated with self-perception of bad breath (RR=1,58; p=0,025), self-perception of poor gum health (RR=1,66; p=0,016), dissatisfaction with chewing ability (RR=2,22; p≤0,001), tooth loss due to mobility (RR=1,74; p=0,019), and presence of 20 teeth or less (RR=1,57; p=0,045). CONCLUSIONS: OHRQoL is associated with self-report of bad breath, poor gum health and dissatisfaction with chewing ability in people with T2D, which suggests that self-perceived oral conditions represent signs and symptoms of functional and psychological impairment related to severe periodontitis.

OBJECTIVE: La periodontitis es la sexta complicación de la diabetes tipo 2 (DT2); dependiendo de su severidad puede causar dolor, incomodidad o hasta pérdida dental. El objetivo del estudio fue evaluar el impacto del estado periodontal autorreportado en la Calidad de Vida Relacionada con la Salud Oral (CVRSO) en personas con DT2. METHODS: Se realizó un estudio transversal que incluyó a setenta y nueve adultos con DT2 atendidos en la Clínica de Síndrome Metabólico del Instituto Nacional de Enfermedades Respiratorias Cosío Villegas en la Ciudad de México, entre agosto y noviembre de 2010. La CVRSO se evaluó con el cuestionario Perfil de Impacto en la Salud Bucal acortado (OHIP-EE14). La periodontitis se evaluó por autorreporte, profundidad al sondeo (PS) y pérdida de inserción clínica (PIC). La asociación entre estado periodontal autorreportado y CVRSO se evaluó con modelos de regresión binomial negativa. RESULTS: La edad promedio fue de 60,4 años (DE=9,6); la duración de diabetes de 10,1 años (DE=6,6). La CVRSO se asoció con la autopercepción de mal aliento (RR=1,58, p=0,025), autopercepción de mala salud de las encías (RR=1,66, p=0,016), insatisfacción de la habilidad para masticar (RR=2,22, p≤0,001), pérdida de algún diente con movilidad previa (RR=1,74, p=0,019) y 20 dientes presentes o menos (RR=1,57, p=0,045). CONCLUSIONS: La CVRSO se asocia con el autorreporte de mal aliento, mala salud de las encías e insatisfacción de la habilidad para masticar en personas con DT2; esto sugiere que las condiciones bucales autopercibidas representan signos y síntomas de deterioro funcional y psicológico relacionados con la periodontitis severa.

Association of diabetes and tuberculosis: impact on treatment and post-treatment outcomes.

OBJECTIVE: To determine the clinical consequences of pulmonary tuberculosis (TB) among patients with diabetes mellitus (DM). METHODS: We conducted a prospective study of patients with TB in Southern Mexico. From 1995 to 2010, patients with acid-fast bacilli or Mycobacterium tuberculosis in sputum samples underwent epidemiological, clinical and microbiological evaluation. Annual follow-ups were performed to ascertain treatment outcome, recurrence, relapse and reinfection. RESULTS: The prevalence of DM among 1262 patients with pulmonary TB was 29.63% (n=374). Patients with DM and pulmonary TB had more severe clinical manifestations (cavities of any size on the chest x-ray, adjusted OR (aOR) 1.80, 95% CI 1.35 to 2.41), delayed sputum conversion (aOR 1.51, 95% CI 1.09 to 2.10), a higher probability of treatment failure (aOR 2.93, 95% CI 1.18 to 7.23), recurrence (adjusted HR (aHR) 1.76, 95% CI 1.11 to 2.79) and relapse (aHR 1.83, 95% CI 1.04 to 3.23). Most of the second episodes among patients with DM were caused by bacteria with the same genotype but, in 5/26 instances (19.23%), reinfection with a different strain occurred. CONCLUSIONS: Given the growing epidemic of DM worldwide, it is necessary to add DM prevention and control strategies to TB control programmes and vice versa and to evaluate their effectiveness. The concurrence of both diseases potentially carries a risk of global spreading, with serious implications for TB control and the achievement of the United Nations Millennium Development Goals.

Low complexity regions (LCRs) contribute to the hypervariability of the HIV-1 gp120 protein.

Low complexity regions (LCRs) are sequences of nucleic acids or proteins defined by a compositional bias. Their occurrence has been confirmed in sequences of the three cellular lineages (Bacteria, Archaea and Eucarya), and has also been reported in viral genomes. We present here the results of a detailed computer analysis of the LCRs present in the HIV-1 glycoprotein 120 (gp120) encoded by the viral gene env. The analysis was performed using a sample of 3637 Env polyprotein sequences derived from 4117 completely sequenced and translated HIV-1 genomes available in public databases as of December 2012. We have identified 1229 LCRs located in four different regions of the gp120 protein that correspond to four of the five regions that have been identified as hypervariable (V1, V2, V4 and V5). The remaining 29 LCRs are found in the signal peptide and in the conserved regions C2, C3, C4 and C5. No LCR has been identified in the hypervariable region V3. The LCRs detected in the V1, V2, V4, and V5 hypervariable regions exhibit a high Asn content in their amino acid composition, which very likely correspond to glycosylation sites, which may contribute to the retroviral ability to avoid the immune system. In sharp contrast with what is observed in gp120 proteins lacking LCRs, the glycosylation sites present in LCRs tend to be clustered towards the center of the region forming well-defined islands. The results presented here suggest that LCRs represent a hitherto undescribed source of genomic variability in lentivirus, and that these repeats may represent an important source of antigenic variation in HIV-1 populations. The results reported here may exemplify the evolutionary processes that may have increased the size of primitive cellular RNA genomes and the role of LCRs as a source of raw material during the processes of evolutionary acquisition of new functions.

[Knowledge, attitudes and practices about influenza A(H1N1) 2009, and influenza vaccine in Mexico: results of a population survey]. / Conocimientos, actitudes y prácticas sobre la influenza A(H1N1) 2009 y la vacunación contra influenza pandémica: resultados de una encuesta poblacional.

OBJECTIVE: To assess knowledge, attitudes and practices regarding influenza pandemic, with special emphasis on issues related to influenza vaccine, seasonal and pandemic. MATERIALS AND METHODS: Cross-sectional study, probabilistic multistage sampling in patients over 18 years, residents of Mexico City (and metropolitan area), Monterrey, Guadalajara and Merida in December 2009. RESULTS: A total of 1.600 subjects (48.9% male) were interviewed, 34% had previously received seasonal flu vaccine, 90.6% were willing to be vaccinated against A(H1N1), 46.5% of those who would not receive the vaccine was because they did not trust A (H1N1), 68% considered influenza A (H1N1) as a risk for their family. Hand washing was the preventive measure most commonly reported (47.5%), secondly influenza vaccine (28%). Schooling (1.7, p=0.006) and age (1.02, p<0.001) influence rejection to get vaccine. 82.9% of respondents rate the federal government's management as good or very good. CONCLUSIONS: There was a high acceptance rate for the pandemic influenza vaccine in Mexico when compared to similar studies in other countries, the main reason for those who reject the vaccine was distrust in it.

Evaluating the impact of mobility in COVID-19 incidence and mortality: A case study from four states of Mexico.

Introduction: The COVID-19 pandemic in Mexico began at the end of February 2020. An essential component of control strategies was to reduce mobility. We aimed to evaluate the impact of mobility on COVID- incidence and mortality rates during the initial months of the pandemic in selected states. Methods: COVID-19 incidence data were obtained from the Open Data Epidemiology Resource provided by the Mexican government. Mobility data was obtained from the Observatory for COVID-19 in the Americas of the University of Miami. We selected four states according to their compliance with non-pharmaceutical interventions and mobility index. We constructed time series and analyzed change-points for mobility, incidence, and mortality rates. We correlated mobility with incidence and mortality rates for each time interval. Using mixed-effects Poisson models, we evaluated the impact of reductions in mobility on incidence and mortality rates, adjusting all models for medical services and the percentage of the population living in poverty. Results: After the initial decline in mobility experienced in early April, a sustained increase in mobility followed during the rest of the country-wide suspension of non-essential activities and the return to other activities throughout mid-April and May. We identified that a 1% increase in mobility yielded a 5.2 and a 2.9% increase in the risk of COVID-19 incidence and mortality, respectively. Mobility was estimated to contribute 8.5 and 3.8% to the variability in incidence and mortality, respectively. In fully adjusted models, the contribution of mobility to positive COVID-19 incidence and mortality was sustained. When assessing the impact of mobility in each state compared to the state of Baja California, increased mobility conferred an increased risk of incident positive COVID-19 cases in Mexico City, Jalisco, and Nuevo León. However, for COVID-19 mortality, a differential impact of mobility was only observed with Jalisco and Nuevo León compared to Baja California. Conclusion: Mobility had heterogeneous impacts on COVID-19 rates in different regions of Mexico, indicating that sociodemographic characteristics and regional-level pandemic dynamics modified the impact of reductions in mobility during the COVID-19 pandemic. The implementation of non-pharmaceutical interventions should be regionalized based on local epidemiology for timely response against future pandemics.

Two-year follow-up of the COVID-19 pandemic in Mexico.

Background: After the initial outbreak in China (December 2019), the World Health Organization declared COVID-19 a pandemic on March 11th, 2020. This paper aims to describe the first 2 years of the pandemic in Mexico. Design and methods: This is a population-based longitudinal study. We analyzed data from the national COVID-19 registry to describe the evolution of the pandemic in terms of the number of confirmed cases, hospitalizations, deaths and reported symptoms in relation to health policies and circulating variants. We also carried out logistic regression to investigate the major risk factors for disease severity. Results: From March 2020 to March 2022, the coronavirus disease 2019 (COVID-19) pandemic in Mexico underwent four epidemic waves. Out of 5,702,143 confirmed cases, 680,063 were hospitalized (11.9%), and 324,436 (5.7%) died. Even if there was no difference in susceptibility by gender, males had a higher risk of death (CFP: 7.3 vs. 4.2%) and hospital admission risk (HP: 14.4 vs. 9.5%). Severity increased with age. With respect to younger ages (0-17 years), the 60+ years or older group reached adjusted odds ratios of 9.63 in the case of admission and 53.05 (95% CI: 27.94-118.62) in the case of death. The presence of any comorbidity more than doubled the odds ratio, with hypertension-diabetes as the riskiest combination. While the wave peaks increased over time, the odds ratios for developing severe disease (waves 2, 3, and 4 to wave 1) decreased to 0.15 (95% CI: 0.12-0.18) in the fourth wave. Conclusion: The health policy promoted by the Mexican government decreased hospitalizations and deaths, particularly among older adults with the highest risk of admission and death. Comorbidities augment the risk of developing severe illness, which is shown to rise by double in the Mexican population, particularly for those reported with hypertension-diabetes. Factors such as the decrease in the severity of the SARS-CoV2 variants, changes in symptomatology, and advances in the management of patients, vaccination, and treatments influenced the decrease in mortality and hospitalizations.

Clinical and Virological Features of Patients Hospitalized with Different Types of COVID-19 Vaccination in Mexico City.

Coronavirus disease 2019 (COVID-19) vaccines effectively protect against severe disease and death. However, the impact of the vaccine used, viral variants, and host factors on disease severity remain poorly understood. This work aimed to compare COVID-19 clinical presentations and outcomes in vaccinated and unvaccinated patients in Mexico City. From March to September 2021, clinical, demographic characteristics, and viral variants were obtained from 1014 individuals with a documented SARS-CoV-2 infection. We compared unvaccinated, partially vaccinated, and fully vaccinated patients, stratifying by age groups. We also fitted multivariate statistical models to evaluate the impact of vaccination status, SARS-CoV-2 lineages, vaccine types, and clinical parameters. Most hospitalized patients were unvaccinated. In patients over 61 years old, mortality was significantly higher in unvaccinated compared to fully vaccinated individuals. In patients aged 31 to 60 years, vaccinated patients were more likely to be outpatients (46%) than unvaccinated individuals (6.1%). We found immune disease and age above 61 years old to be risk factors, while full vaccination was found to be the most protective factor against in-hospital death. This study suggests that vaccination is essential to reduce mortality in a comorbid population such as that of Mexico.