Impact of COVID-19 on tuberculosis detection and treatment in Baja California, México
In 2020, Mexico reported the lowest tuberculosis (TB) incidence on record, and it is unclear to what extent COVID-19 has impacted TB surveillance, diagnosis, and treatment. It is important to understand COVID-19's impact in Baja California (BC), which has the highest TB burden in Mexico. With t...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.921596/full |
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| author | Raquel Muñiz-Salazar Tina Le Jazmine Cuevas-Mota Jesús Eduardo González-Fagoaga Jesús Eduardo González-Fagoaga Rogelio Zapata-Garibay Rogelio Zapata-Garibay Paola Saritzia Ruiz-Tamayo Javier Robles-Flores Richard S. Garfein |
| author_facet | Raquel Muñiz-Salazar Tina Le Jazmine Cuevas-Mota Jesús Eduardo González-Fagoaga Jesús Eduardo González-Fagoaga Rogelio Zapata-Garibay Rogelio Zapata-Garibay Paola Saritzia Ruiz-Tamayo Javier Robles-Flores Richard S. Garfein |
| author_sort | Raquel Muñiz-Salazar |
| collection | DOAJ |
| description | In 2020, Mexico reported the lowest tuberculosis (TB) incidence on record, and it is unclear to what extent COVID-19 has impacted TB surveillance, diagnosis, and treatment. It is important to understand COVID-19's impact in Baja California (BC), which has the highest TB burden in Mexico. With the increasing number of migrants and asylum seekers arriving in BC, limited resources and crowded living conditions increase the risk of TB transmission. The purpose of this study was to assess the impact of COVID-19 on TB diagnosis and treatment in BC. We were also interested in health disparities experienced by migrants in BC. We conducted a mixed methods analysis using quantitative surveillance data obtained from the Mexico National TB Program (NTP) and qualitative data collected through in-depth interviews and focus group discussions with TB program directors and personnel in BC's four provincial health jurisdictions. Compared to the year prior, surveillance data from March 2020 - February 2021 revealed that TB incidence in BC declined by 30.9% and favorable TB outcomes (TB cure or treatment completion) declined by 49.8%. Elucidating differences by migrant status was complicated by the lack of standardized collection of migrant status by the NTP. Qualitative analysis revealed that TB diagnostic and treatment supplies and services became limited and disproportionately accessible across jurisdictions since the pandemic began; however, favorable adaptations were also reported, such as increased telemedicine use and streamlined care referral processes. Participants shared that migrant status is susceptible to misclassification and that TB care is difficult due to the transitory nature of migrants. This study did not identify major differences in TB service delivery or access between migrants and non-migrants in BC; however, migrant status was frequently missing. COVID-19 has overwhelmed health systems worldwide, disrupting timely TB diagnostic and treatment services, and potentially caused underdiagnosis of TB in BC. TB programs in BC should quickly restore essential services that were disrupted by COVID-19 while identifying and preserving beneficial program adaptations, such as telemedicine and streamlined care referral processes. Improved methods for documenting migrant status of TB cases are also needed. |
| first_indexed | 2024-12-10T09:38:02Z |
| format | Article |
| id | doaj.art-15e3c686477143cbaef150177631ea09 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-10T09:38:02Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-15e3c686477143cbaef150177631ea092022-12-22T01:54:06ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-07-011010.3389/fpubh.2022.921596921596Impact of COVID-19 on tuberculosis detection and treatment in Baja California, MéxicoRaquel Muñiz-Salazar0Tina Le1Jazmine Cuevas-Mota2Jesús Eduardo González-Fagoaga3Jesús Eduardo González-Fagoaga4Rogelio Zapata-Garibay5Rogelio Zapata-Garibay6Paola Saritzia Ruiz-Tamayo7Javier Robles-Flores8Richard S. Garfein9Escuela de Ciencias de la Salud, Universidad Autónoma de Baja California, Ensenada, MexicoHerbert Wertheim School of Public Health, University of California, San Diego, San Diego, CA, United StatesHerbert Wertheim School of Public Health, University of California, San Diego, San Diego, CA, United StatesHealthy Border Program, US-Mexico Border Heath Commission, Tijuana, MexicoFacultad de Humanidades y Ciencias Sociales, Universidad Autónoma de Baja California, Tijuana, MexicoHealthy Border Program, US-Mexico Border Heath Commission, Tijuana, MexicoFacultad de Humanidades y Ciencias Sociales, Universidad Autónoma de Baja California, Tijuana, MexicoEscuela de Ciencias de la Salud, Universidad Autónoma de Baja California, Ensenada, MexicoEscuela de Ciencias de la Salud, Universidad Autónoma de Baja California, Ensenada, MexicoHerbert Wertheim School of Public Health, University of California, San Diego, San Diego, CA, United StatesIn 2020, Mexico reported the lowest tuberculosis (TB) incidence on record, and it is unclear to what extent COVID-19 has impacted TB surveillance, diagnosis, and treatment. It is important to understand COVID-19's impact in Baja California (BC), which has the highest TB burden in Mexico. With the increasing number of migrants and asylum seekers arriving in BC, limited resources and crowded living conditions increase the risk of TB transmission. The purpose of this study was to assess the impact of COVID-19 on TB diagnosis and treatment in BC. We were also interested in health disparities experienced by migrants in BC. We conducted a mixed methods analysis using quantitative surveillance data obtained from the Mexico National TB Program (NTP) and qualitative data collected through in-depth interviews and focus group discussions with TB program directors and personnel in BC's four provincial health jurisdictions. Compared to the year prior, surveillance data from March 2020 - February 2021 revealed that TB incidence in BC declined by 30.9% and favorable TB outcomes (TB cure or treatment completion) declined by 49.8%. Elucidating differences by migrant status was complicated by the lack of standardized collection of migrant status by the NTP. Qualitative analysis revealed that TB diagnostic and treatment supplies and services became limited and disproportionately accessible across jurisdictions since the pandemic began; however, favorable adaptations were also reported, such as increased telemedicine use and streamlined care referral processes. Participants shared that migrant status is susceptible to misclassification and that TB care is difficult due to the transitory nature of migrants. This study did not identify major differences in TB service delivery or access between migrants and non-migrants in BC; however, migrant status was frequently missing. COVID-19 has overwhelmed health systems worldwide, disrupting timely TB diagnostic and treatment services, and potentially caused underdiagnosis of TB in BC. TB programs in BC should quickly restore essential services that were disrupted by COVID-19 while identifying and preserving beneficial program adaptations, such as telemedicine and streamlined care referral processes. Improved methods for documenting migrant status of TB cases are also needed.https://www.frontiersin.org/articles/10.3389/fpubh.2022.921596/fullSARS-CoV-2migrationMycobacterium tuberculosisqualitative analysisincidence |
| spellingShingle | Raquel Muñiz-Salazar Tina Le Jazmine Cuevas-Mota Jesús Eduardo González-Fagoaga Jesús Eduardo González-Fagoaga Rogelio Zapata-Garibay Rogelio Zapata-Garibay Paola Saritzia Ruiz-Tamayo Javier Robles-Flores Richard S. Garfein Impact of COVID-19 on tuberculosis detection and treatment in Baja California, México Frontiers in Public Health SARS-CoV-2 migration Mycobacterium tuberculosis qualitative analysis incidence |
| title | Impact of COVID-19 on tuberculosis detection and treatment in Baja California, México |
| title_full | Impact of COVID-19 on tuberculosis detection and treatment in Baja California, México |
| title_fullStr | Impact of COVID-19 on tuberculosis detection and treatment in Baja California, México |
| title_full_unstemmed | Impact of COVID-19 on tuberculosis detection and treatment in Baja California, México |
| title_short | Impact of COVID-19 on tuberculosis detection and treatment in Baja California, México |
| title_sort | impact of covid 19 on tuberculosis detection and treatment in baja california mexico |
| topic | SARS-CoV-2 migration Mycobacterium tuberculosis qualitative analysis incidence |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.921596/full |
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