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Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains one of the leading infectious causes of death globally, with drug resistance presenting a significant challenge to control efforts. The interplay between type 2 diabetes mellitus (T2DM) and TB introduces additional complexity, as T2DM triples the risk of active TB and exacerbates drug resistance development. This review explores how T2DM-induced metabolic and immune dysregulation fosters the survival of Mtb, promoting persistence and the emergence of multidrug-resistant strains. Mechanisms such as efflux pump activation and the subtherapeutic levels of isoniazid and rifampicin in T2DM patients are highlighted as key contributors to resistance. We discuss the dual syndemics of T2DM–TB, emphasizing the role of glycemic control and innovative therapeutic strategies, including efflux pump inhibitors and host-directed therapies like metformin. This review underscores the need for integrated diagnostic, treatment, and management approaches to address the global impact of T2DM–TB comorbidity and drug resistance.

Objetivo. Adaptar y validar el instrumento EMPODERA-TB para medir el empoderamiento en pacientes con tuberculosis pulmonar. Métodos. Se adaptó y validó un instrumento, diseñado inicialmente para medir el empoderamiento en pacientes con enfermedades crónicas, para medir el empoderamiento en pacientes con tuberculosis. Para ello, se seleccionaron y adaptaron los ítems aplicables a los pacientes con tuberculosis. La validación se realizó mediante análisis factorial exploratorio y confirmatorio, y la consistencia interna mediante el coeficiente alfa de Cronbach, con base en los datos de una muestra de 49 pacientes de origen mexicano con diagnóstico de tuberculosis pulmonar. Resultados. El instrumento se integró por 19 ítems agrupados en tres dimensiones: adquisición de conocimientos, habilidades para compartir información y para la toma de decisiones. Se observó un ajuste aceptable (SRMR: 0,124; CD: 0,999), mientras que la consistencia interna para las dimensiones fue de 0,878; 0,879 y 0,808, respectivamente, y para el instrumento completo fue de 0,885. Conclusiones. El instrumento mostró índices de ajuste de bondad aceptables y consistencia interna adecuada, por lo que permite medir el empoderamiento en pacientes con tuberculosis pulmonar. Este instrumento será de utilidad en la práctica clínica y epidemiología de tuberculosis en países latinoamericanos d habla hispana, y permitirá implementar estrategias que mejoren el conocimiento y el apego al tratamiento, así como la interacción con pacientes o individuos en riesgo de contagio y, con ello, establecer estrategias de prevención.

Abstract Background Skin-to-skin contact and breastfeeding initiation within the first hour after birth are key recommendations to promote breastfeeding. In Mexico, the National Survey of Demographic Dynamics 2018, known by its Spanish acronym ENADID, collected information about breastfeeding practices. The ENADID survey is probabilistic and allows results to be generalized to the entire population in Mexico. Methods Information from a public database featuring 26,587 mother-baby pairs was analyzed by proportions, means and associations, as well as machine learning methods, to conduct a comparison among the pairs according to immediate skin-to-skin contact after delivery status. Results Skin-to-skin contact was described by 78.7% of the mothers and was associated with receiving an explanation regarding how to give breastmilk or the breast to the baby immediately following birth [Odds ratio (OR) 6.46; 95% Confidence Interval (CI) 6.02, 6.97], initiating breastfeeding in the first hour of life (OR 2.01; 95% CI (1.84, 2.18) and a breastfeeding duration of ≥ 6 months (OR 1.16; 95% CI 1.08, 1.25). The breastfeeding duration, in days, was greater in the group with skin-to-skin contact than in the group without skin contact. Conclusions In Mexico, immediate and uninterrupted skin-to-skin contact between newborns and their mothers should be facilitated. Support should be provided to mothers to favor skin-to-skin contact and breasting initiation during the first hour of life, ideally through an empathic explanation by trained health personnel. Future research should focus on the evaluation of strategies to modify maternity services to facilitate immediate skin-to-skin contact after delivery and develop training programs for health personnel to support the initiation of breastfeeding during the first hour of life.

Abstract Background Type 2 diabetes mellitus (T2DM) has been associated with treatment failure, and the development of drug resistance in tuberculosis (TB). Also, whole-genome sequencing has provided a better understanding and allowed the growth of knowledge about polymorphisms in genes associated with drug resistance. Considering the above, this study analyzes genome sequences to evaluate the influence of type 2 diabetes mellitus in the development of mutations related to tuberculosis drug resistance. M. tuberculosis isolates from individuals with (n = 74), and without (n = 74) type 2 diabetes mellitus was recovered from online repositories, and further analyzed. Results The results showed the presence of 431 SNPs with similar proportions between diabetics, and non-diabetics individuals (48% vs. 52%), but with no significant relationship. A greater number of mutations associated with rifampicin resistance was observed in the T2DM-TB individuals (23.2% vs. 16%), and the exclusive presence of rpoBQ432L, rpoBQ432P, rpoBS441L, and rpoBH445L variants. While these variants are not private to T2DM-TB cases they are globally rare highlighting a potential role of T2DM. The phylogenetic analysis showed 12 sublineages, being 4.1.1.3, and 4.1.2.1 the most prevalent in T2DM-TB individuals but not differing from those most prevalent in their geographic location. Four clonal complexes were found, however, no significant relationship with T2DM was observed. Samples size and potential sampling biases prevented us to look for significant associations. Conclusions The occurrence of globally rare rifampicin variants identified only in isolates from individuals with T2DM could be due to the hyperglycemic environment within the host. Therefore, further studies about the dynamics of SNPs’ generation associated with antibiotic resistance in patients with diabetes mellitus are necessary.

Genetic variation in tuberculosis is influenced by the host environment, patients with comorbidity, and tuberculosis–type 2 diabetes mellitus (TB-T2DM) and implies a higher risk of treatment failure and development of drug resistance. Considering the above, this study aimed to evaluate the influence of T2DM on the dynamic of polymorphisms related to antibiotic resistance in TB. Fifty individuals with TB-T2DM and TB were initially characterized, and serial isolates of 29 of these individuals were recovered on day 0 (diagnosis), 30, and 60. Genomes were sequenced, variants related to phylogeny and drug resistance analyzed, and mutation rates calculated and compared between groups. Lineage X was predominant. At day 0 (collection), almost all isolates from the TB group were sensitive, apart from four isolates from the TB-T2DM group showing the mutation katG S315T, from which one isolate had the mutations rpoB S450L, gyrA A90G, and gyrA D94G. This pattern was observed in a second isolate at day 30. The results provide a first overview of the dynamics of mutations in resistance genes from individuals with TB-T2DM, describing an early development of resistance to isoniazid and a rapid evolution of resistance to other drugs. Although preliminary, these results help to explain the increased risk of drug resistance in individuals with TB and T2DM.

Genomics has significantly revolutionized pathogen surveillance, particularly in epidemiological studies, the detection of drug-resistant strains, and disease control. Despite its potential, the representation of Latin American countries in the genomic catalogues of Mycobacterium tuberculosis (Mtb), the bacteria responsible for Tuberculosis (TB), remains limited. In this study, we present a whole genome sequencing (WGS)-based analysis of 85 Mtb clinical strains from 17 Mexican states, providing insights into local adaptations and drug resistance signatures in the region. Our results reveal that the Euro-American lineage (L4) accounts for 94% of our dataset, showing 4.1.2.1 (Haarlem, n = 32), and 4.1.1.3 (X-type, n = 34) sublineages as the most prevalent. We report the presence of the 4.1.1.3 sublineage, which is endemic to Mexico, in six additional locations beyond previous reports. Phenotypic drug resistance tests showed that 34 out of 85 Mtb samples were resistant, exhibiting a variety of resistance profiles to the first-line antibiotics tested. We observed high levels of discrepancy between phenotype and genotype associated with drug resistance in our dataset, including pyrazinamide-monoresistant Mtb strains lacking canonical variants of drug resistance. Expanding the Latin American Mtb genome databases will enhance our understanding of TB epidemiology and potentially provide new avenues for controlling the disease in the region.

Abstract Background Mexico is on the top five countries with the highest number of TB cases in America continent, nevertheless, information about genotypes circulating is practically unknown. Considering the above this study aims to characterize the genetic diversity of TB in the city of Veracruz, México. Methods A cross-sectional study was conducted among positive smear samples from patients living in Veracruz City, samples were cultured, and first-line drug profiles determined. Genotyping was made by spoligotyping and MIRU-VNTR 24 loci. Associations of lineages, clusters, and variables were also analyzed. Results Among the 202 isolates analyzed resistance to at least one drug was observed in 60 (30%) isolates and 41(20%) were multidrug-resistant. Three major lineages were identified: L4/Euro-American (88%), L1/Indo-Oceanic (9%), and L2/East Asian (3%). The Euro-American lineage included more than six sublineages, the most abundant were: H (32%), T (23%), LAM (18%), and X (12%). 140 isolates (70%) were placed in 42 SITs patterns. Conclusions These results provide the first baseline data on the genetic structure of TB in the city of Veracruz. Sublineages H, X and LAM were predominant; however, it was founded an important diversity of genotypes that could contribute to the dispersion of TB and explain the high prevalence. This information might be useful for the development of further interventions to reduce impact of TB.

The World Health Organization (WHO) places Tuberculosis (TB) as one of the most important health problems today. According to the WHO, this disease requires novel actions to control its expansion and, in this way, achieve one of the goals established in the sustainable development goals: to reduce TB morbidity and incidence by 2030 and regain control. To achieve this goal, the tools currently used for diagnosis and treatment are no longer adequate. In this sense, it is necessary to develop new drugs and vaccines, as well as novel drug administration procedures that generate a better response, reduce times, and optimize treatments. Nanotechnology has incorporated in recent years a considerable number of new tools that significantly increase the diversity of mechanisms for the administration of anti-tuberculosis drugs. Therefore, the present review briefly describes the current state of drug resistance in tuberculosis, as well as the general characteristics of nanoparticles being evaluated as tools to transport new antibiotics against tuberculosis.

Abstract Whole genome sequencing (WGS) has been shown to be superior to traditional procedures of genotyping in tuberculosis (TB), nevertheless, reports of its use in drug resistant TB (DR-TB) isolates circulating in Mexico, are practically unknown. Considering the above the main of this work was to identify and characterize the lineages and genomic transmission clusters present in 67 DR-TB isolates circulating in southeastern Mexico. The results show the presence of three major lineages: L1 (3%), L2 (3%) and L4 (94%), the last one included 16 sublineages. Sublineage 4.1.1.3 (X3) was predominant in 18 (27%) of the isolates, including one genomic cluster, formed by eleven multidrug resistant isolates and sharing the SIT 3278, which seems to be restricted to Mexico. By the use of WGS, it was possible to identify the high prevalence of L4 and a high number of sublineages circulating in the region, also was recognized the presence of a novel X3 sublineage, formed exclusively by multidrug resistant isolates and with restrictive circulation in Mexico for at least the past 17 years.

The purpose of this work was to perform by Whole Genomic Sequencing (WGS) a characterization of tuberculosis isolates circulating in the central region of Veracruz, Mexico, and to determine its geographical distribution. The genome of 25 clinical isolates of tuberculosis patients, recovered from central zone of Veracruz, Mexico, were sequenced and the information obtained was used to characterize lineage, prediction of drug resistance, identification of clonal complexes, and finally correlated with the geolocalization data. Isolates analyzed were included into seven L4 sublineages, most frequent was X3; X1 (4.1.1.3) in 35%. rpoBSer450Leu polymorphism was the most frequently found variant. Sublineage Haarlem (4.1.2) had the widest distribution, found in five municipalities. Of the of two clonal complexes found, the most abundant included eight isolates, with X3/X1 lineage, placed in two municipalities. Combination of WGS and geographic information system was very useful for the identification of sublineages, clonal complexes, and their geographical dispersion with important implications in the epidemiological surveillance and clinical control of TB.

Despite the global efforts tuberculosis (TB) remains as one of the most important infectious disease and with the greatest impact on global public health, this situation has been aggravated in recent decades by the growing problem of drug resistance (DR). Such is the impact of the drug resistant in tuberculosis that would threaten the Millennium Development Goals. In addition to polymorphisms in genes associated with drug resistance in tuberculosis, new mechanisms have being described in recent years. Considering the above, the aim of this mini-review is to give a brief description of the traditional mechanisms related with drug resistance and to describe two of the new mechanisms that will have an important impact in the next future; efflux pumps and DNA damage repair mechanisms.

Zika virus (ZIKV) infection in pregnancy is associated with birth and developmental alterations in infants. In this study, clinical records of 47 infants whose mothers had Zika during pregnancy or clinical manifestations compatible with Zika were reviewed. A description of the infants’ anomalies was established, and a neurodevelopmental assessment was performed on 18 infants, using the Evaluation of Infant Development (EDI for its initialism in Spanish) and DDST-II (Denver Developmental Screening Test II) tests. From his sample, 74.5% of the infants evaluated had major anomalies and 51.9% had minor anomalies. The incidence of major anomalies, related to trimester of pregnancy, was 84.2% for the first trimester, 77.8% for the second trimester, and 37.5% in the third trimester. A similar trend was observed in the frequency of infants without anomalies and was less evident in the incidence of minor anomalies (p = 0.016). Through neurodevelopmental assessments, EDI identified 27.8% of infants as having normal development, while 55.5% of affected infants had developmental delay, and 16.7% were at risk for developmental delay. The DDSST-II showed that 77.7% infants had delay in the gross motor and language area, 88.8% in the fine-adaptative motor area, and 72.2% in the personal–social area. In this work, children of mothers with ZIKV infection during pregnancy may have major or minor anomalies regardless of the trimester of pregnancy in which the infection occurred. The neurodevelopmental assessment shows that ZIKV can cause a developmental delay in infants with the fine-adaptative motor area being the most affected.

Abstract Background The host, microbial, and environmental factors that contribute to variation in tuberculosis (TB) disease are incompletely understood. Accumulating evidence suggests that one driver of geographic variation in TB disease is the local ecology of mycobacterial genotypes or strains, and there is a need for a comprehensive and systematic synthesis of these data. The objectives of this study were to (1) map the global distribution of genotypes that cause TB disease and (2) examine whether any epidemiologically relevant clinical characteristics were associated with those genotypes. Methods We performed a systematic review of PubMed and Scopus to create a comprehensive dataset of human TB molecular epidemiology studies that used representative sampling techniques. The methods were developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We extracted and synthesized data from studies that reported prevalence of bacterial genotypes and from studies that reported clinical characteristics associated with those genotypes. Results The results of this study are twofold. First, we identified 206 studies for inclusion in the study, representing over 200,000 bacterial isolates collected over 27 years in 85 countries. We mapped the genotypes and found that, consistent with previously published maps, Euro-American lineage 4 and East Asian lineage 2 strains are widespread, and West African lineages 5 and 6 strains are geographically restricted. Second, 30 studies also reported transmission chains and 4 reported treatment failure associated with genotypes. We performed a meta-analysis and found substantial heterogeneity across studies. However, based on the data available, we found that lineage 2 strains may be associated with increased risk of transmission chains, while lineages 5 and 6 strains may be associated with reduced risk, compared with lineage 4 strains. Conclusions This study provides the most comprehensive systematic analysis of the evidence for diversity in bacterial strains that cause TB disease. The results show both geographic and epidemiological differences between strains, which could inform our understanding of the global burden of TB. Our findings also highlight the challenges of collecting the clinical data required to inform TB diagnosis and treatment. We urge future national TB programs and research efforts to prioritize and reinforce clinical data collection in study designs and results dissemination.

SARS-CoV-2 has rapidly generated a pandemic. Vaccines are currently being rolled out to control the viral spread and prevent deaths. Emergency vaccines, using new platforms, have been approved. Their effectiveness, safety and immunogenicity in different populations are not fully known. This study aimed to discover the immunogenicity of the messenger ribonucleic acid (mRNA) BNT162b2 and adenovirus vector Ad5-nCoV vaccines through IgG antibody generation against subunit 1 of protein S (S1 IgG) and assess the side effects of the vaccines. A total of 115 vaccinated people were included, 61 of whom received the BNT162b2 vaccine, while 54 received Ad5-nCoV. Measurements of S1 IgG antibodies were carried out using the enzyme-linked immunosorbent assay (ELISA) technique. The BNT162b2 vaccine generated S1 IgG antibodies in 80.3% of the participants after the first dose. The number of seropositive participants increased to 98.36% with the administration of the second dose. The Ad5-nCoV vaccine generated S1 IgG antibodies in 88.89% of those vaccinated. Women generated more antibodies when administered either vaccine. There were no serious adverse effects from vaccination. In conclusion, not all participants had detectable S1 IgG antibodies. The Ad5-nCoV vaccine presented the most seronegative cases. The studied vaccines were shown to be safe.

Objectives: To determine genetic diversity by comparing the whole genome sequences of cattle and human Mycobacterium bovis isolates from Baja California. Methods: A whole genome sequencing strategy was used to obtain the molecular fingerprints of 172 isolates of M. bovis obtained from Baja California, Mexico; 155 isolates were from cattle and 17 isolates were from humans. Spoligotypes were characterized in silico and single nucleotide polymorphism (SNP) differences between the isolates were evaluated. Results: A total of 12 M. bovis spoligotype patterns were identified in cattle and humans. Two predominant spoligotypes patterns were seen in both cattle and humans: SB0145 and SB1040. The SB0145 spoligotype represented 59% of cattle isolates (n = 91) and 65% of human isolates (n = 11), while the SB1040 spoligotype represented 30% of cattle isolates (n = 47) and 30% of human isolates (n = 5). When evaluating SNP differences, the human isolates were intimately intertwined with the cattle isolates. Conclusions: All isolates from humans had spoligotype patterns that matched those observed in the cattle isolates, and all human isolates shared common ancestors with cattle in Baja California based on SNP analysis. This suggests that most human tuberculosis caused by M. bovis in Baja California is derived from M. bovis circulating in Baja California cattle. These results reinforce the importance of bovine tuberculosis surveillance and control in this region.

Objective/Background: Tuberculosis (TB) remains one of the most important infectious diseases. Although Mexico is one of the Latin American countries with the largest contribution to these statistics, there are few reports that describe the genotypic characteristics of TB. The aim of this study was to use the MIRU-VNTR-24 loci to analyze the genetic diversity of M. tuberculosis circulating in the state of Veracruz, Mexico. Methods: Here, we analyze by MIRU-VNTR-24 loci 80 clinical isolates from individuals with confirmed TB from Veracruz México, also clinical and epidemiological variables were recovered and analyzed. Results: Of the individuals included in the analyses 65% were from men with an average age of 42 (± 17) years, 17% and 6% were drug and multi-drug resistant. 88% of the isolates were included in 20 clusters, of which 52% were classified into twelve orphan clusters and the remaining 37% were distributed among eight lineages: LAM (10%), EAI (9%), Haarlem (8%), H37Rv (4%), S (4%) and TUR (2%). Conclusion: An important diversity of lineages and unknown genotypes was identified; however, more studies are necessary in order to understand the characteristics of the genotypes displayed in the region. There is no doubt regarding the need for a molecular epidemiological surveillance system that can help to evaluate the dynamics of genotypes circulating in the country and support strategies for the prevention and management of populations affected by TB.

BackgroundWhole genome sequencing (WGS) has been proposed as a tool for diagnosing drug resistance in tuberculosis. However, reports of its effectiveness in endemic countries with important numbers of drug resistance are scarce. The goal of this study was to evaluate the effectiveness of this procedure in isolates from a tuberculosis endemic region in Mexico.MethodsWGS analysis was performed in 81 tuberculosis positive clinical isolates with a known phenotypic profile of resistance against first-line drugs (isoniazid, rifampin, ethambutol, pyrazinamide and streptomycin). Mutations related to drug resistance were identified for each isolate; drug resistant genotypes were predicted and compared with the phenotypic profile. Genotypes and transmission clusters based on genetic distances were also characterized.FindingsPrediction by WGS analysis of resistance against isoniazid, rifampicin, ethambutol, pyrazinamide and streptomycin showed sensitivity values of 84%, 96%, 71%, 75% and 29%, while specificity values were 100%, 94%, 90%, 90% and 98%, respectively. Prediction of multidrug resistance showed a sensitivity of 89% and specificity of 97%. Moreover, WGS analysis revealed polymorphisms related to second-line drug resistance, enabling classification of eight and two clinical isolates as pre- and extreme drug-resistant cases, respectively. Lastly, four lineages were identified in the population (L1, L2, L3 and L4). The most frequent of these was L4, which included 90% (77) of the isolates. Six transmission clusters were identified; the most frequent was TC6, which included 13 isolates with a L4.1.1 and a predominantly multidrug-resistant condition.ConclusionsThe results illustrate the utility of WGS for establishing the potential for prediction of resistance against first and second line drugs in isolates of tuberculosis from the region. They also demonstrate the feasibility of this procedure for use as a tool to support the epidemiological surveillance of drug- and multidrug-resistant tuberculosis.

BACKGROUND:Mexico is one of the most important contributors of drug and multidrug-resistant tuberculosis in Latin America; however, knowledge of the genetic diversity of drug-resistant tuberculosis isolates is limited. METHODS:In this study, the genetic structure of 112 Mycobacterium tuberculosis strains from the southeastern Mexico was determined by spoligotyping and 24-loci MIRU-VNTRs. FINDINGS:The results show eight major lineages, the most of which was T1 (24%), followed by LAM (16%) and H (15%). A total of 29 (25%) isolates were identified as orphan. The most abundant SITs were SIT53/T1 and SIT42/LAM9 with 10 isolates each and SIT50/H3 with eight isolates. Fifty-two spoligotype patterns, twenty-seven clusters and ten clonal complexes were observed, demonstrating an important genetic diversity of drug and multidrug-resistant tuberculosis isolates in circulation and transmission level of these aggravated forms of tuberculosis. Being defined as orphan or as part of an orphan cluster, was a risk factor for multidrug resistant-tuberculosis (OR 2.5, IC 1.05-5.86 and OR 3.3, IC 1-11.03, respectively). Multiple correspondence analyses showed association of some clusters and SITs with specific geographical locations. CONCLUSIONS:Our study provides one of the most detailed description of the genetic structure of drug and multidrug-resistant tuberculosis strains in southeast Mexico, establishing for the first time a baseline of the genotypes observed in resistant isolates circulating, however further studies are required to better elucidate the genetic structure of tuberculosis in region and the factors that could be participating in their dispersion.

Tuberculosis (TB) is an infectocontagious respiratory disease caused by members of the Mycobacterium tuberculosis complex. A 7 base pair (bp) deletion in the locus polyketide synthase (pks)15/1 is described as polymorphic among members of the M. tuberculosis complex, enabling the identification of Euro-American, Indo-Oceanic and Asian lineages. The aim of this study was to characterise this locus in TB isolates from Mexico. One hundred twenty clinical isolates were recovered from the states of Veracruz and Estado de Mexico. We determined the nucleotide sequence of a ± 400 bp fragment of the locus pks15/1, while genotypic characterisation was performed by spoligotyping. One hundred and fifty isolates contained the 7 bp deletion, while five had the wild type locus. Lineages X (22%), LAM (18%) and T (17%) were the most frequent; only three (2%) of the isolates were identified as Beijing and two (1%) EAI-Manila. The wild type pks15/1 locus was observed in all Asian lineage isolates tested. Our results confirm the utility of locus pks15/1 as a molecular marker for identifying Asian lineages of the M. tuberculosis complex. This marker could be of great value in the epidemiological surveillance of TB, especially in countries like Mexico, where the prevalence of such lineages is unknown.

INTRODUCTION: The situation of tuberculosis (TB) is being modified by the human immunodeficiency virus (HIV), which is increasing the occurrence of new cases and the generation of drug resistant strains, affecting not only the people infected with HIV, but also their close contacts and the general population, conforming a serious public health concern. However, the magnitudes of the factors associated to this co-infection differ considerably in relation to the population groups and geographical areas. METHODS: In order to evaluate the prevalence and risk factors for the co-infection of tuberculosis (TB) in a population with human immunodeficiency virus (HIV+) in the Southeast of Mexico, we made the analysis of clinical and epidemiological variables and the diagnosis of tuberculosis by isolation of mycobacteria from respiratory samples. RESULTS: From the 147 HIV+ individuals analyzed, 12 were culture positive; this shows a prevalence of 8% for the co-infection. The only variable found with statistical significance for the co-infection was the number of CD4-T < 200 cells/mm³, OR 13 (95%, CI 2-106 vs 12-109). CONCLUSIONS: To our knowledge this is the first report describing the factors associated with tuberculosis co -infection with HIV in a population from Southern Mexico. The low number of CD4 T-cells was the only variable associated with the TB co-infection and the rest of the variables provide scenarios that require specific and particular interventions for this population group.

Antecedentes: La tuberculosis (TB) es una enfermedad infecciosa responsable de 8 millones de casos y tres millones de muertos cada año. De acuerdo a la Organización Mundial de la Salud, el conocimiento y la actitud del personal médico sobre la enfermedad se ubica como un elemento importante para el correcto desarrollo de los programas de lucha contra la TB, con especial énfasis en países de economías emergentes. Es por lo anterior que el objetivo del este trabajo es evaluar los conocimientos y actitudes en personal medico de Veracruz, México. Metodología: Se encuestó a una muestra representativa de médicos que laboran en una institución pública, identificando edad, género, especialidad médica y antigüedad. El conocimiento de TB se considero en 5 apartados (enfermedad, diagnóstico, tratamiento, prevención y normativo), que integrados mostraron el conocimiento global; se compararon las variables del medico y el conocimiento mediante pruebas t y χ2. Resultados: De los 220 médicos encuestados, solo 38 (17%) obtuvieron una evaluación global adecuada; por apartados, 142 (65%) mostraron conocimiento adecuado en prevención y 40 (18%) en enfermedad. No se observaron diferencias entre los niveles de conocimiento y las variables analizadas. El 70% de los médicos refieren a la TB como un tema poco importante en el total de sus actividades, e identificamos que el enfoque que se da a la enfermedad esta orientado hacia la prevención. Conclusión: Se observó un bajo conocimiento global; sin embargo, se ubicaron los apartados que deberían ser reforzados para generar un mejor entendimiento y en consecuencia un cambio de actitud hacia la enfermedad.

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Hemagglutinin–neuraminidase (HN) from porcine rubulavirus La Piedad Michoacan (RvpLPM) is one of the most antigenic proteins known, and is responsible for virus–host cell interaction. We analyzed the amino acid sequence of HN, using computer-assisted techniques to identify B cell epitopes. From a pool of 18 possible antigenic peptides, we evaluated the antigenicity of the 2 peptides with the highest scores and the 1 with lowest score. Antibodies from RvpLPM-infected pigs recognized the synthesized HN-A, HN-B, and HN-R peptides (optical density [OD] 0.33 ± 0.02 for HN-A, 0.20 ± 0.02 for HN-B, and 0.07 ± 0.01 for HN-R); bovine serum albumin-coupled HN-A and HN-B induced rabbit anti-RvpLPM antibodies (OD 0.39 ± 0.01 for HN-A and 0.35 ± 0.02 for HN-B). Loop 5 from the outer membrane protein, OmpC, from Salmonella typhiwas replaced with HN-B; this protein was then expressed in Escherichia coliUH302. BALBc mice were challenged intraperitoneally or orogastrically with the fusion protein expressed in E. coliand murine antibodies obtained from both types of administration inhibited virus-hemagglutinating activity, as did the antibodies from RvpLPM-infected swine. These results suggest that HN-A and HN-B are peptides involved in RvpLPM cell carbohydrate recognition, and could therefore be considered potential targets for vaccine and diagnostic procedures development. [ABSTRACT FROM AUTHOR]