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Diabetes, undernutrition, migration and indigenous communities: tuberculosis in Chiapas, Mexico.

ABSTRACT: We investigated the distribution of comorbidities among adult tuberculosis (TB) patients in Chiapas, the poorest Mexican state, with a high presence of indigenous population, and a corridor for migrants from Latin America. Secondary analysis on 5508 new adult TB patients diagnosed between 2010 and 2014 revealed that the most prevalent comorbidities were diabetes mellitus (DM; 19.1%) and undernutrition (14.4%). The prevalence of DM in these TB patients was significantly higher among middle aged (41-64 years) compared with older adults (⩾65 years) (38.6% vs. 23.2%; P < 0.0001). The prevalence of undernutrition was lower among those with DM, and higher in communities with high indigenous presence. Immigrants only comprised 2% of all TB cases, but were more likely to have unfavourable TB treatment outcomes (treatment failure, death and default) when compared with those born in Chiapas (29.5% vs. 11.1%; P < 0.05). Unfavourable TB outcomes were also more prevalent among the TB patients with undernutrition, HIV or older age, but not DM (P < 0.05). Our study in Chiapas illustrates the challenges of other regions worldwide where social (e.g. indigenous origin, poverty, migration) and host factors (DM, undernutrition, HIV, older age) are associated with TB. Further understanding of these critical factors will guide local policy makers and health providers to improve TB management.

SUBMITTER: Rashak HA

PROVIDER: S-EPMC6518577 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Diabetes, undernutrition, migration and indigenous communities: tuberculosis in Chiapas, Mexico.

Rashak H A HA Sánchez-Pérez H J HJ Abdelbary B E BE Bencomo-Alerm A A Enriquez-Ríos N N Gómez-Velasco A A Colorado A A Castellanos-Joya M M Rahbar M H MH Restrepo B I BI

Epidemiology and infection 20190101

We investigated the distribution of comorbidities among adult tuberculosis (TB) patients in Chiapas, the poorest Mexican state, with a high presence of indigenous population, and a corridor for migrants from Latin America. Secondary analysis on 5508 new adult TB patients diagnosed between 2010 and 2014 revealed that the most prevalent comorbidities were diabetes mellitus (DM; 19.1%) and undernutrition (14.4%). The prevalence of DM in these TB patients was significantly higher among middle aged ( ...[more]

PMID: 30869023

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Project description:Background Indigenous populations globally face significant health disparities compared to non-Indigenous groups, primarily due to marginalization and limited access to healthcare. In Mexico, which is home to the largest Indigenous population in the Americas, these disparities were further exacerbated by the COVID-19 pandemic, with impacts intensified by factors such as marginalization, discrimination, and inadequate access to essential services.MethodsThis study aimed to investigate the COVID-19 pandemic's impact on mortality, vaccination access and uptake, and official birth registration among a predominantly Indigenous population in San Juan Chamula, Chiapas. We conducted an online survey among high school students at the Colegio de Bachilleres del Estado de Chiapas, supplemented with epidemiological and socio-demographic data (N = 107).ResultsThe survey revealed that 14% of respondents reported being infected with COVID-19, while national dashboard data indicated only 212 confirmed cases and one death in Chamula between April 2021 and June 2023. Additionally, 79.4% of respondents were unvaccinated, with significant communication barriers and a lack of information in Indigenous languages contributing to low vaccination rates. Additionally, 5.6% of surveyed family members and 4.7% of community residents lacked official birth certificates, significantly impeding their ability to access essential services such as education, healthcare, and vaccinations.ConclusionOur findings highlight significant underreporting of COVID-19 cases and deaths in Indigenous communities, likely due to inadequate diagnostic resources and medical evaluation. The study underscores the urgent need for tailored public health strategies that integrate local Indigenous languages, cultures, and knowledge systems supported by trusted Indigenous leaders. Investing in education in Indigenous languages is crucial for improving vaccination adherence and overall public health outcomes. These strategies can inform national preparedness and response plans to address the unique challenges faced by Indigenous populations during pandemics and other public health crises.

Project description:BackgroundLandrace farmers are the keepers of crops locally adapted to the environments where they are cultivated. Patterns of diversity across the genome can provide signals of past evolution in the face of abiotic and biotic change. Understanding this rich genetic resource is imperative especially since diversity can provide agricultural security as climate continues to shift.ResultsHere we employ RNA sequencing (RNA-seq) to understand the role that conditions that vary across a landscape may have played in shaping genetic diversity in the maize landraces of Chiapas, Mexico. We collected landraces from three distinct elevational zones and planted them in a midland common garden. Early season leaf tissue was collected for RNA-seq and we performed weighted gene co-expression network analysis (WGCNA). We then used association analysis between landrace co-expression module expression values and environmental parameters of landrace origin to elucidate genes and gene networks potentially shaped by environmental factors along our study gradient. Elevation of landrace origin affected the transcriptome profiles. Two co-expression modules were highly correlated with temperature parameters of landrace origin and queries into their 'hub' genes suggested that temperature may have led to differentiation among landraces in hormone biosynthesis/signaling and abiotic and biotic stress responses. We identified several 'hub' transcription factors and kinases as candidates for the regulation of these responses.ConclusionsThese findings indicate that natural selection may influence the transcriptomes of crop landraces along an elevational gradient in a major diversity center, and provide a foundation for exploring the genetic basis of local adaptation. While we cannot rule out the role of neutral evolutionary forces in the patterns we have identified, combining whole transcriptome sequencing technologies, established bioinformatics techniques, and common garden experimentation can powerfully elucidate structure of adaptive diversity across a varied landscape. Ultimately, gaining such understanding can facilitate the conservation and strategic utilization of crop genetic diversity in a time of climate change.

Dataset Information

Diabetes, undernutrition, migration and indigenous communities: tuberculosis in Chiapas, Mexico.

Publications

Diabetes, undernutrition, migration and indigenous communities: tuberculosis in Chiapas, Mexico.

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