Influences of Cross-Border Mobility on Tuberculosis Diagnoses and Treatment Interruption Among Injection Drug Users in Tijuana, Mexico (original) (raw)
Related papers
American Journal of Public Health, 2013
Tuberculosis (TB) is an important health concern along the 1950-mile international border shared by Mexico and the United States. The neighboring states of Baja California, Mexico, and California, United States, have TB incidence rates that far exceed those of their respective countries. In 2008, the incidence rate for TB in Baja California was 50.9 per 100 000, versus 17.1 per 100 000 nationally in Mexico. 1 In California, the incidence of TB that same year was 7.4 per 100 000, compared with 4.2 cases per 100 000 persons in the United States. 2 Multidrug-resistant tuberculosis (MDR-TB) is TB disease associated with Mycobacterium tuberculosis strains that are resistant to isoniazid and rifampin, the 2 most effective TB medications available. 3 MDR-TB is found in Mexico and California, and significantly increases treatment and societal costs of TB, with case fatality rates ranging from 12% in HIVnegative to 90% in HIV coinfected persons. 3 Although TB control efforts worldwide are starting to decrease TB incidence and mortality, 4,5 the emergence of MDR-TB is "threatening to destabilize global TB control," 6(p261) and could rapidly turn TB into an untreatable disease, even in high-income countries. 7 California had an average of 41 MDR-TB cases per year from 1994 to 2003-the highest incidence of MDR-TB in the United States. 8 More than 85% of the incident MDR-TB cases in California from 1993 to 2006 were among foreign-born individuals, 28% of whom were born in Mexico. 7 In Mexico, although some studies of MDR-TB prevalence in specific populations have been conducted, 9-12 there is no routine surveillance data on MDR-TB for comparison. California and Baja California share a strong migratory dynamic. Translocation and contact between inhabitants of both sides of the border are frequent, and familial and other social relations extend across the border. 13 This
Tuberculosis in the San Diego-Tijuana Border Region: Time for Bi-National Community-Based Solutions
2009
The close geographical proximity of San Diego and Tijuana, the stark contrast between their distinct economies and levels of socio-economic development, and the ease and magnitude of cross-border exchange between these two metropolitan areas, demand our undivided attention. According to the San Diego Association of Governments (SANDAG), over 60 million persons cross into San Diego from Tijuana at the San Ysidro border crossing each year. In fact, many have come to agree that the San Diego-Tijuana border region does not identify with one particular country, but rather has a broader identity of its own. The blending of economic, social and cultural activities in this region charges us to find bi-national solutions to the unique bi-national issues facing the region. One such regional issue we must confront is that of tuberculosis (TB). Both California and Baja California have TB incidence rates that are much higher than the national rates of their respective countries. Furthermore, Tij...
Panorama of Tuberculosis in Mexico Focusing on the Northern Border
2015
Tuberculosis is one of humanity’s oldest diseases and the one that has caused the most death and suffering. It also continues to be a huge threat given the rise in resistance to medications, its link with the human immunodeficiency virus (hiv-aidS), and, particularly in Mexico and other countries, a closer and closer link to diabetes mellitus (dM), given the role of certain social determinants of health, such as poverty, marginalization, alcoholism, and migration. This is a generally chronic systemic or localized infectious disease caused by Mycobacterium tuberculosis (MTb), transmittable by air (from person to person), traveling through the droplets that accompany usually untreated patients’ coughs or sneezes. It manifests itself mainly in the form of a cough with phlegm, at times with blood, weight loss, afternoon fevers, heavy night sweats, fatigue, and loss of appetite.1 In Mexico, cases are found in all 31 states and Mexico City’s Federal District, but along the border it prese...
High prevalence of latent tuberculosis infection among injection drug users in Tijuana, Mexico
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2009
We studied prevalence and correlates of latent tuberculosis infection (LTBI) among injection drug users (IDUs) in Tijuana, Mexico, where tuberculosis (TB) is endemic. IDUs aged > or =18 years were recruited via respondent-driven sampling (RDS) and underwent standardized interviews, human immunodeficiency virus (HIV) antibody testing and LTBI screening using Quanti-FERON((R))-TB Gold In-Tube, a whole-blood interferon-gamma release assay (IGRA). LTBI prevalence was estimated and correlates were identified using RDS-weighted logistic regression. Of 1020 IDUs, 681 (67%) tested IGRA-positive and 44 (4%) tested HIV-positive. Mean age was 37 years, 88% were male and 98% were Mexican-born. IGRA positivity was associated with recruitment nearest the US border (aOR 1.64, 95%CI 1.09-2.48), increasing years of injection (aOR 1.20/5 years, 95%CI 1.07-1.34), and years lived in Tijuana (aOR 1.10/5 years, 95%CI 1.03-1.18). Speaking some English (aOR 0.38, 95%CI 0.25-0.57) and injecting most ofte...
Border Lookout: Enhancing Tuberculosis Control on the United States-Mexico Border
The American journal of tropical medicine and hygiene, 2015
We evaluated the use of federal public health intervention tools known as the Do Not Board and Border Lookout (BL) for detecting and referring infectious or potentially infectious land border travelers with tuberculosis (TB) back to treatment. We used data about the issuance of BL from April 2007 to September 2013 to examine demographics and TB laboratory results for persons on the list (N = 66) and time on the list before being located and achieving noninfectious status. The majority of case-patients were Hispanic and male, with a median age of 39 years. Most were citizens of the United States or Mexico, and 30.3% were undocumented migrants. One-fifth had multidrug-resistant TB. Nearly two-thirds of case-patients were located and treated as a result of being placed on the list. However, 25.8% of case patients, primarily undocumented migrants, remain lost to follow-up and remain on the list. For this highly mobile patient population, the use of this novel federal travel intervention...
Latent tuberculosis in migrants travelling through the northeast regions of Mexico
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Background: Latent tuberculosis infection (LTBI) affects nearly a quarter of the global population. Public health interventions aimed at interrupting tuberculosis transmission do not routinely include systematic screening of migrant populations for LTBI in Mexico, nor other high-income countries. However, early detection and treatment of LTBI in immigrant populations from high-burden countries are recommended by the World Health Organization. Objective: The objective of this study was to determine the proportion of migrants with LTBI in shelters in northeastern Mexico. Methods: In this cross-sectional study, blood samples were obtained from 455 migrants living in shelters in northeastern Mexico during January 2017 to October 2019. LTBI was diagnosed using the QuantiFERON®-TB Gold Plus test. Results: Most of the migrants evaluated in this study were from Honduras; ~86% were male; the average age was 29 ± 10 years. LTBI was identified in 18.4% of those from Central America. Migrants from El Salvador and Nicaragua were more likely to have LTBI than those from Honduras or Guatemala. Overweight or obese persons and older persons had a higher prevalence of LTBI. We detected no significant differences with respect to LTBI when the results were compared based on gender, education, or marital status. Conclusion: The LTBI rates amongst migrants from Central America recently screened in shelters in northeastern Mexico appears to be relatively low given recent estimates of LTBI prevalence in Mexico.
Tuberculosis in Mexico and the USA, Comparison of Trends Over Time 1990-2010
Tuberculosis and Respiratory Diseases, 2015
Background: The aim was to compare tuberculosis trends in Mexico and United States and to evaluate Mexican diagnostic methods and contact investigation. Methods: Retrospective comparative study of tuberculosis cases and incidence rates between both countries (1990-2010). Diagnostic methods and contact investigations were also evaluated for Mexico. Estimates were obtained from official websites. Results: In Mexico, no clear trend was found over time for cases. Pulmonary (PTB) and all forms of tuberculosis (AFTB) incidence decreased 2.0% annually. There was a negative correlation between the mean contacts examined per case and AFTB incidence (r 2 =-0.44, p=0.01) with a 33% reduction in AFTB incidence. In United States, PTB and AFTB cases have been decreasing 6.0% and 5.6% annually, respectively. The incidence decreased 7.3% and 6.8%, respectively. Conclusion: The incidence of tuberculosis in Mexico is decreasing slightly over time at 2% annually. In the United States, cases and incidence rates have been decreasing at a higher rate (5% to 7% annually). The inverse association between number of contacts examined per state and incidence rates in Mexico underscore the importance of reinforcing and improving contact investigations with the likely translation of a decrease of TB incidence at a higher rate.