Stress, anxiety, and depression are associated with low adherence to antiretroviral therapy (ART) in HIV patients, but there are no reports of this association in southeastern Mexico. To describe the frequency of adherence to ART and its association with depression, anxiety, and stress. A cross-sectional study was conducted. 442 HIV-positive outpatients treated at General Hospital Number 1 in Tapachula, Chiapas, in the period August-December 2022 were analyzed. Adherence to ART was assessed with the Simplified Medication Adherence Questionnaire (SMAQ) and the Depression, Anxiety, and Stress Scale-21 (DASS-21) was applied. To assess the association between variables, adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated using a multivariate logistic regression model. Cases with ART adherence between 95% and 100% were compared with those with ART adherence below 95%. Of the total 442 HIV-positive subjects, 344 had ART adherence between 95% and 100%, and 98 had ART adherence below 95%. The frequencies of depression, anxiety, and stress were 33%, 13.3%, and 8.8%, respectively. Associations were observed between ART adherence below 95% and anxiety, depression, and stress. Since low ART adherence was associated with depression, anxiety, and stress among HIV-positive patients, early mental health interventions may help improve therapeutic adherence.

Background: The clinical expression and severity of COVID-19 have shifted substantially throughout the pandemic owing to viral evolution, rising population immunity, and the expansion of vaccination. However, in Mexico, few studies have compared these changes across successive waves using primary clinical data from first- and second-level healthcare units. We aimed to characterize temporal changes in symptoms, clinical severity, and outcomes across six COVID-19 waves in a southern border city of Mexico, and to examine their correspondence with national patterns of variant predominance and vaccination coverage. Methods: We conducted a descriptive time-series study of confirmed COVID-19 cases treated in first- and second-level units of the Mexican Institute of Social Security in Tapachula, Chiapas, Mexico, from March 2020 to January 2023. Clinical, demographic, and epidemiological data were extracted from medical records and the SINOLAVE. Cases were classified into six epidemic waves. Clinical characteristics and severity indicators were compared across waves using chi-square or Fisher’s exact tests with Bonferroni correction. Predominant variants were inferred through temporal alignment with national genomic surveillance. Results: Among 18,319 suspected cases, 6,145 (47.1%) were confirmed. Severe disease, oxygen requirement, intubation, and mortality were concentrated in the first three waves, accounting for 88% of all intubations and 72% of deaths, coinciding with the circulation of unspecified lineages (waves 1–2) and the Delta variant (wave 3). Subsequent waves showed marked reductions in dyspnea, tachypnea, cyanosis, and chest pain, and a relative increase in upper-respiratory symptoms. Beginning with the fourth wave, corresponding to Omicron predominance and increasing vaccination coverage, hospitalizations, intubations, and mortality declined substantially. Conclusions: COVID-19 severity and symptom patterns changed markedly across the six waves in Tapachula, reflecting variant replacement and population immunity. These findings provide actionable evidence for health system planning and policy design in resource-limited border settings.

Antecedentes: La transfusión de sangre o de sus derivados es una acción terapéutica esencial en los distintos servicios hospitalarios. A pesar de la estricta hemovigilancia que se lleva a cabo en los bancos de sangre, sigue existiendo un riesgo residual de contraer enfermedades infecciosas a través de una transfusión. Objetivo: Determinar la seroprevalencia de agentes infecciosos en donantes de sangre. Material y métodos: Estudio retrospectivo y observacional. Las detecciones fueron realizadas en donantes sanguíneos que acudieron al banco de sangre del Hospital General de Zona No. 1 de Tapachula, Chiapas, México, durante el periodo de agosto de 2020 a diciembre de 2023. Resultados: La seroprevalencia general fue del 3.94%, encontrando con mayor frecuencia sífilis (1.37%), seguida de brucelosis (1.17%), virus de la inmunodeficiencia humana (0.55%), hepatitis C (0.34%), hepatitis B (0.19%) y enfermedad de Chagas (0.19%), con un 0.10% de casos de coinfección. Conclusiones: La seroprevalencia de agentes infecciosos en donantes de sangre en el estudio permite conocer un panorama epidemiológico de lo ocurrido en una ciudad de la frontera sur de México, reafirmando a la sífilis como una enfermedad reemergente en la zona y con altas prevalencias de brucelosis y virus de la inmunodeficiencia humana.

Background There is substantial variation in COVID-19 lethality across countries. In addition, in countries with populations with extreme economic inequalities, such as Mexico, there are regional and local differences in risk factors for COVID-19 death. The goal of this study was to test the hypothesis that the risk of death in Mexican COVID-19 patients was associated with the time between symptom onset and hospitalization and/or with the healthcare site. Also, death prognostic models were developed. Methods The study included two COVID-19 inpatient cohorts, one prospective and one retrospective from Chiapas, Mexico. Demographic, clinical and laboratory variables were collected, and the diagnosis of SARS-CoV-2 infection was performed using RT-qPCR in samples collected seven days since symptom onset. The 30-day mortality, since symptom onset, was the outcome, and clinical variables at the first 48 hours of hospitalization were independent factors. Multivariate logistic regression analyses were conducted. Results Of the 392 patients included, 233 died (59.4%). The time between symptom onset and hospitalization, the healthcare site and sex were not related to the 30-day mortality. Three death prognostic models were developed (AUC between 0.726 and 0.807). Age, LDH, AST, and lymphocyte count were included in all models, OSI-WHO Classification (Non-invasive ventilation or high-flow oxygen, and mechanical ventilation with or without organ support/ECMO) and leukocyte count in two models, and diabetes and diarrhea in one model. Conclusion The population evaluated had underlying deteriorated health before COVID-19 compared with regional and country population. The factors that determine the COVID-19 mortality risk in a relatively healthy population are sex, age and comorbidities. However, as this study shows, when populations have underlying poor health, some of these factors lose their associations with mortality risk, and others become more important.