Association between living in municipalities with high crowding conditions and poverty and mortality from COVID-19 in Mexico

Ríos, Viridiana; Denova‐Gutiérrez, Edgar; Barquera, Sı́món

doi:10.1371/journal.pone.0264137

Cited by 21 publications

(21 citation statements)

References 41 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most patients started treatment after eight weeks, and the relative numbers of this group have continued to increase during the pandemic. Evaluation of this indicator is important in Mexico, as the population most affected by COVID-19-related mortality lives in overpopulated and poor areas ( 50 ) and is also the most affected by CC ( 51 ).…”

Section: Discussionmentioning

confidence: 99%

Cervical cancer prevention program in Mexico disrupted due to COVID-19 pandemic: Challenges and opportunities

Cruz-Valdéz

Palacio-Mejía²,

Quezada-Sánchez³

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

IntroductionThe COVID-19 pandemic disrupted the preventive services for cervical cancer (CC) control programs in Mexico, which will result in increased mortality. This study aims to assess the impact of the pandemic on the interruption of three preventive actions in the CC prevention program in Mexico.MethodsThis study is a retrospective time series analysis based on administrative records for the uninsured population served by the Mexican Ministry of Health. Patient data were retrieved from the outpatient service information system and the hospital discharge database for the period 2017–2021. Data were aggregated by month, distinguishing a pre-pandemic and a pandemic period, considering April 2020 as the start date of the pandemic. A Poisson time series analysis was used to model seasonal and secular trends. Five process indicators were selected to assess the disruption of the CC program, these were analyzed as monthly data (N=39 pre-pandemic, N=21 during the pandemic). HPV vaccination indicators (number of doses and coverage) and diagnostic characteristics of CC cases were analyzed descriptively. The time elapsed between diagnosis and treatment initiation in CC cases was modeled using restricted cubic splines from robust regression.ResultsAnnual HPV vaccination coverage declined dramatically after 2019 and was almost null in 2021. The number of positive Papanicolaou smears decreased by 67.8% (90%CI: -72.3, -61.7) in April–December 2020, compared to their expected values without the pandemic. The immediate pandemic shock (April 2020) in the number of first-time and recurrent colposcopies was -80.5% (95%CI:−83.5, −77.0) and -77.9% (95%CI: −81.0, −74.4), respectively. An increasing trend was observed in the proportion of advanced stage and metastatic CC cases. The fraction of CC cases that did not receive medical treatment or surgery increased, as well as CC cases that received late treatment after diagnosis.ConclusionsOur analyses show significant impact of the COVID-19 pandemic with declines at all levels of CC prevention and increasing inequalities. The restarting of the preventive programs against CC in Mexico offers an opportunity to put in place actions to reduce the disparities in the burden of disease between socioeconomic levels.

show abstract

Section: Discussionmentioning

confidence: 99%

Cervical cancer prevention program in Mexico disrupted due to COVID-19 pandemic: Challenges and opportunities

Cruz-Valdéz

Palacio-Mejía²,

Quezada-Sánchez³

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…The lack of access to high-complexity healthcare centers and tests that allow prioritization of high-risk cases cause patients to quickly lead to serious conditions or death. Also, the population with a lack of access to public services and with suboptimal housing conditions will be more exposed not only to COVID-19 but also to other infectious diseases, and indeed, to a greater risk of death ( 14 , 31 , 33 – 35 ). Finally, we observed a gradual reduction in the risk of mortality from COVID-19 from the first wave to the fifth wave, in the highest poverty levels of the CMPI, similar than in the studies by Hussey et al, Leveau et al, and Bastos et al This may be explained by some increase in herd immunity and vaccination efforts in the population ( 32 , 36 ).…”

Section: Discussionmentioning

confidence: 99%

“…Inequities in social determinants of health may lead to different unfavorable health outcomes in COVID-19 patients ( 10 – 14 ). Current scientific evidence indicated that the development of severe complications, including death, in COVID-19 patients have been associated with biological, social, and economic factors ( 12 , 15 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Socioeconomic disparities associated with mortality in patients hospitalized for COVID-19 in Colombia

Cardozo

Bedoya

Galvis

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

Socioeconomic disparities play an important role in the development of severe clinical outcomes including deaths from COVID-19. However, the current scientific evidence in regard the association between measures of poverty and COVID-19 mortality in hospitalized patients is scant. The objective of this study was to investigate whether there is an association between the Colombian Multidimensional Poverty Index (CMPI) and mortality from COVID-19 in hospitalized patients in Colombia from May 1, 2020 to August 15, 2021. This was an ecological study using individual data on hospitalized patients from the National Institute of Health of Colombia (INS), and municipal level data from the High-Cost Account and the National Administrative Department of Statistics. The main outcome variable was mortality due to COVID-19. The main exposure variable was the CMPI that ranges from 0 to 100% and was categorized into five levels: (i) level I (0%−20%), (ii) level II (20%−40%), (iii) level III (40%−60%), (iv) level IV (60%−80%); and (v) level V (80%−100%). The higher the level, the higher the level of multidimensional poverty. A Bayesian multilevel logistic regression model was applied to estimate Odds Ratio (OR) and their corresponding 95% credible intervals (CI). In addition, a subgroup analysis was performed according to the epidemiological COVID-19 waves using the same model. The odds for dying from COVID-19 was 1.46 (95% CI 1.4–1.53) for level II, 1.41 (95% CI 1.33–1.49) for level III and 1.70 (95% CI 1.54–1.89) for level IV hospitalized COVID-19 patients compared with the least poor patients (CMPI level I). In addition, age and male sex also increased mortality in COVID-19 hospitalized patients. Patients between 26 and 50 years-of-age had 4.17-fold increased odds (95% CI 4.07–4.3) of death compared with younger than 26-years-old patients. The corresponding for 51–75 years-old patients and those above the age of 75 years were 9.17 (95% CI 8.93–9.41) and 17.1 (95% CI 16.63–17.56), respectively. Finally, the odds of death from COVID-19 in hospitalized patients gradually decreased as the pandemic evolved. In conclusion, socioeconomic disparities were a major risk factor for mortality in patients hospitalized for COVID-19 in Colombia.

show abstract

“…Socioeconomic vulnerabilities affect the number of COVID-19 cases, mortality, and access to healthcare services or testing32 in distinct places such as Geneva,33 San Francisco34 or Mexico City,35 among others. In Brazil, socioeconomic inequalities disproportionately affected the evolution of the pandemic and the outcome for more vulnerable populations 36.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a multicomponent intervention to face the COVID-19 pandemic in Rio de Janeiro’s favelas: difference-in-differences analysis

Batista-da-Silva

Moraes²,

Bozza

et al. 2023

BMJ Glob Health

View full text Add to dashboard Cite

IntroductionFew community-based interventions addressing the transmission control and clinical management of COVID-19 cases have been reported, especially in poor urban communities from low-income and middle-income countries. Here, we analyse the impact of a multicomponent intervention that combines community engagement, mobile surveillance, massive testing and telehealth on COVID-19 cases detection and mortality rates in a large vulnerable community (Complexo da Maré) in Rio de Janeiro, Brazil.MethodsWe performed a difference-in-differences (DID) analysis to estimate the impact of the multicomponent intervention inMaré,before (March–August 2020) and after the intervention (September 2020 to April 2021), compared with equivalent local vulnerable communities. We applied a negative binomial regression model to estimate the intervention effect in weekly cases and mortality rates inMaré.ResultsBefore the intervention,Marépresented lower rates of reported COVID-19 cases compared with the control group (1373 vs 1579 cases/100 000 population), comparable mortality rates (309 vs 287 deaths/100 000 population) and higher case fatality rates (13.7% vs 12.2%). After the intervention,Marédisplayed a 154% (95% CI 138.6% to 170.4%) relative increase in reported case rates. Relative changes in reported death rates were −60% (95% CI −69.0% to −47.9%) in Maré and −28% (95% CI −42.0% to −9.8%) in the control group. The case fatality rate was reduced by 77% (95% CI −93.1% to −21.1%) inMaréand 52% (95% CI −81.8% to −29.4%) in the control group. The DID showed a reduction of 46% (95% CI 17% to 65%) of weekly reported deaths and an increased 23% (95% CI 5% to 44%) of reported cases inMaréafter intervention onset.ConclusionAn integrated intervention combining communication, surveillance and telehealth, with a strong community engagement component, could reduce COVID-19 mortality and increase case detection in a large vulnerable community in Rio de Janeiro. These findings show that investment in community-based interventions may reduce mortality and improve pandemic control in poor communities from low-income and middle-income countries.

show abstract

Association between living in municipalities with high crowding conditions and poverty and mortality from COVID-19 in Mexico

Cited by 21 publications

References 41 publications

Cervical cancer prevention program in Mexico disrupted due to COVID-19 pandemic: Challenges and opportunities

Cervical cancer prevention program in Mexico disrupted due to COVID-19 pandemic: Challenges and opportunities

Socioeconomic disparities associated with mortality in patients hospitalized for COVID-19 in Colombia

Effectiveness of a multicomponent intervention to face the COVID-19 pandemic in Rio de Janeiro’s favelas: difference-in-differences analysis

Contact Info

Product

Resources

About