Investigating COVID-19 transmission and mortality differences among Indigenous and non-Indigenous populations in Mexico
Sushma, Dahal; Mamelund, Svenn-Erik; Luo, Ruiyan; Sattenspiel, Lisa; Self-Brown, Shannon; Chowell, Gerardo
Peer reviewed, Journal article
Published version
Permanent lenke
https://hdl.handle.net/11250/3023582Utgivelsesdato
2022-08-07Metadata
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Originalversjon
International Journal of Infectious Diseases. 2022, 122 910-920. https://doi.org/10.1016/j.ijid.2022.07.052Sammendrag
Objectives: Indigenous populations have been disproportionately affected during pandemics. We investigated COVID-19 mortality estimates among indigenous and non-indigenous populations at national and sub-national levels in Mexico.
Methods: We obtained data from the Ministry of Health, Mexico, on 2,173,036 laboratory-confirmed RT-PCR positive COVID-19 cases and 238,803 deaths. We estimated mortality per 1000 person-weeks, mortality rate ratio (RR) among indigenous vs. non-indigenous groups, and hazard ratio (HR) for COVID-19 deaths across four waves of the pandemic, from February 2020 to March 2022. We also assessed differences in the reproduction number (Rt).
Results: The mortality rate among indigenous populations of Mexico was 68% higher than that of nonindigenous groups. Out of 32 federal entities, 23 exhibited higher mortality rates among indigenous groups (P < 0.05 in 13 entities). The fourth wave showed the highest RR (2.40). The crude HR was 1.67 (95% CI: 1.62, 1.72), which decreased to 1.08 (95% CI: 1.04, 1.11) after controlling for other covariates. During the intense fourth wave, the Rt among the two groups was comparable.
Conclusion: Indigenous status is a significant risk factor for COVID-19 mortality in Mexico. Our findings may reflect disparities in non-pharmaceutical (e.g., handwashing and using facemasks), and COVID-19 vaccination interventions among indigenous and non-indigenous populations in Mexico.