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 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

Mortalidad por VIH/SIDA en la frontera norte de México: niveles y tendencias recientes

En México, el VIH/SIDA se ha posicionado como una de las principales causas de muerte en ciertos grupos poblacionales y regiones del país, en particular la frontera norte. El objetivo de este artículo es revisar de manera general los niveles y tendencias recientes de la mortalidad por VIH/SIDA en los estados fronterizos del norte mexicano. Para medir la mortalidad se utilizaron los registros de defunciones ocurridas en México en el periodo 2000-2010. En ese periodo, las entidades de la frontera norte del país concentraron alrededor de una quinta parte de las defunciones relacionadas con VIH/SIDA, con una tendencia ascendente y con un comportamiento diferencial al del resto del país en cuanto a la estructura por edad y sexo, similar a la situación registrada en el caso de las infecciones

The Leaders across Borders Certification Program—A Systemic Multiple Level Observation of Groups Analysis Approach to Measure Effective Leadership: A Case Study

Leadership measurement, feedback, and development have grown in importance for the field of management. The Mexico–US Border defined as the area of land within 100 km (62.5 miles) north and south of the international boundary, shares common challenges, and requires the development of multicultural change agents who conduct binational actions toward the improvement of public health and quality of life of the population in the region. Leaders across Borders (LaB) was established in 2010 as an advanced certified binational leadership development program aimed at building the capacity of public health, health care, and other community sector leaders working to improve the health of the communities in the Mexico–US Border region. Leadership as a social interaction process requires leader skills development to achieve goals promoting unity and reducing polarization to optimize interactions between all resources, thus improving teamwork. Therefore, measurement and feedback model of general values and beliefs that guide effective behavior, not only individual personality assessments need to drive a proactive learning and action plan development to improve interactions in a team, thus optimizing leadership. Starting 2014, we administered a new model named Systemic Multiple Level Observation of Groups (SYMLOG) to measure the values and beliefs that guide the behavior of learners and team facilitators. We also evaluated the effectiveness of each team of the program and established benchmarks and action plans to optimize interactions and communication between all the learners during the 8-month program. This leads to a stronger systemic network upon graduation from the program. The SYMLOG approach measured initial and improved situations of individual leadership and team performance effectiveness because of the LaB Program training and skills development sessions. The SYMLOG also provided positive feedback to each participant, which had a direct impact on the optimization of members’ interactions of all teams, as well as developing effective leadership values and behaviors of participants. This study presents a case study of this application, the challenges in the design and implementation of the SYMLOG measurement model, and the results obtained for last three cohorts 2014–2016 of LaB Program

Virtual Seminar on Coronavirus 2019 for the US-Mexico Border Region: Building Opportunities for Communication and Collaboration

While the US-Mexico border region has had increasing restrictions due to coronavirus 2019 (COVID-19), the economically and socially integrated region continues to facilitate necessary movement between the two countries. Binational partners representing universities, government, and health delivery worked together to develop a COVID-19 Virtual Seminar for the US-Mexico Border Region, which consisted of weekly sessions in Spanish designed to better facilitate communication and collaborative systems between border states. In total 835 participants registered for the virtual seminar with attendance ranging from 394 in Session 1 to 269 in Session 6. From evaluation surveys (n = 297), organizers observed a large plurality of healthcare professionals, followed by students, researchers, and government employees. The seminar’s contribution to increasing collaborative and communication systems identified major needs in the region surrounding surveillance and monitoring; increased resources for migrant shelters to control outbreaks; an increase in personal protective equipment; tracking binational cases. © 2021, The Author(s).Open access articleThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Virtual Seminar on Coronavirus 2019 for the US-Mexico Border Region: Building Opportunities for Communication and Collaboration.

While the US-Mexico border region has had increasing restrictions due to coronavirus 2019 (COVID-19), the economically and socially integrated region continues to facilitate necessary movement between the two countries. Binational partners representing universities, government, and health delivery worked together to develop a COVID-19 Virtual Seminar for the US-Mexico Border Region, which consisted of weekly sessions in Spanish designed to better facilitate communication and collaborative systems between border states. In total 835 participants registered for the virtual seminar with attendance ranging from 394 in Session 1 to 269 in Session 6. From evaluation surveys (n = 297), organizers observed a large plurality of healthcare professionals, followed by students, researchers, and government employees. The seminar's contribution to increasing collaborative and communication systems identified major needs in the region surrounding surveillance and monitoring; increased resources for migrant shelters to control outbreaks; an increase in personal protective equipment; tracking binational cases

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 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

The Border Health Consortium of the Californias—Forming a Binational (California–Baja California) Entity to Address the Health of a Border Region: A Case Study

The California–Baja California border region is one of the most frequently traversed areas in the world with a shared population, environment, and health concerns. The Border Health Consortium of the Californias (the “Consortium”) was formed in 2013 to bring together leadership working in the areas of public health, health care, academia, government, and the non-profit sector, with the goal of aligning efforts to improve health outcomes in the region. The Consortium utilizes a Collective Impact framework which supports a shared vision for a healthy border region, mutually reinforcing activities among member organizations and work groups, and a binational executive committee that ensures continuous communication and progress toward meeting its goals. The Consortium is comprised of four binational work groups which address human immunodeficiency virus, tuberculosis, obesity, and mental health, all mutual priorities in the border region. The Consortium holds two general binational meetings each year alternating between California and Baja California. The work groups meet regularly to share information, resources and provide binational training opportunities. Since inception, the Consortium has been successful in strengthening binational communication, coordination, and collaboration by providing an opportunity for individuals to meet one another, learn about each other systems, and foster meaningful relationships. With binational leadership support and commitment, the Consortium could certainly be replicated in other border jurisdictions both nationally and internationally. The present article describes the background, methodology, accomplishments, challenges, and lessons learned in forming the Consortium