Keywords
COVID-19 pandemic
Verbal autopsy
Mexico
Post-mortem examination
How to Cite
Abstract
Introduction: The COVID-19 pandemic has challenged societies, not only because of its magnitude and impact, but also because it has deepened health inequalities and inequities. Socially disadvantaged groups show a higher frequency of adverse health events due to COVID-19, particularly in Latin America. With that in mind, we describe the distribution of deaths in COVID-19 patients stratified by sociodemographic characteristics and medical comorbidities, and explore perceptions related to disease-care, in selected rural and urban localities from Sonora, Mexico. Methods: We conducted a cross-sectional study on 160 deaths attributed to COVID-19, from the period April 1st and July 31st 2020, using death certificates as a data source. Furthermore, to explore the variables of interest, a verbal autopsy was applied to a relative caregiver for the patient’s health. Data collected was analyzed by descriptive statistics and qualitative technique. Results: We did not find significant differences in sociodemographic conditions among the COVID-19 deaths. Interestingly, 85.6% of the deceased had a chronic medical condition and 74.4% of all deaths took place in an urban locality. Caregivers frequently consigned deficiencies from medical services over the disease-care process of COVID-19 deaths.
References
World Health Organization. “WHO Coronavirus (COVID-19) Dashboard” [updated February 28, 2023]. Geneva: WHO; 2023. Available from: https://covid19.who.int/
Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with Coronavirus Disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020; 180(7): 934-943. doi: 10.1001/jamainternmed.2020.0994
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. 2020. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395: 1054–1062. doi : https://doi.org/10.1016/S0140-6736(20)30566-3
Paremoer L, Nandi S, Serag H, Baum F. COVID-19 pandemic and the social determinants of health. BMJ. 2021; 372: n129. doi: https://doi.org/10.1136/bmj.n129
Abrams EM, Greenhawt M, Shaker M, Pinto AD, Sinha I, Singer A. The COVID-19 pandemic. Adverse effects on social determinants of health in children and families. Ann Allergy Asthma Immunol. 2022; 128(1): 19-25. https://doi.org/10.1016/j.anai.2021.10.022
Shamah-Levy T, Vielma-Orozco E, Heredia-Hernández O, Romero-Martínez M, Mojica-Cuevas J, Cuevas-Nasu L et al. Encuesta Nacional de Salud y Nutrición 2018-19: Resultados Nacionales. Cuernavaca, México: Instituto Nacional de Salud Pública; 2020. Disponible en: https://insp.mx/produccion-editorial/novedades-editoriales/ensanut-2018-nacionales
Carrillo-Vega MF, Salinas-Escudero G, García-Peña C, Gutiérrez-Robledo LM, Parra-Rodríguez L. Early estimation of the risk factors for hospitalization and mortality by COVID-19 in Mexico. PLoS One. 2020; 15(9): e0238905. doi: 10.1371/journal.pone.0238905
Hernández-Garduño E. 2020. Obesity is the comorbidity more strongly associated for Covid-19 in Mexico. A case-control study. Obesity Res Clin Pract. 2020; 14(4): 375-379. doi: 10.1016/j.orcp.2020.06.001
Gouda HN, Flaxman AD, Brolan CE, Joshi R, Riley ID, Zahr CA, et al. New challenges for verbal autopsy: considering the ethical and social implications of verbal autopsy methods in routine health information systems. Soc Sci Med. 2017; 184: 65-74. doi: 10.1016/j.socscimed.2017.05.002
Leitao J, Chandramohan D, Byass P, Jakob R, Bundhamcharoen K, Choprapawon C, et al. Revising the WHO verbal autopsy instrument to facilitate routine cause-of-death monitoring.” Global Health Action. 2013; 6: 21518. doi: 10.3402/gha.v6i0.21518
Byass P, Herbst K, Fottrell E, Ali MM, Odhiambo F, Amek N, et al. Comparing verbal autopsy cause of death findings as determined by physician coding and probabilistic modelling: a public health analysis of 54 000 deaths in Africa and Asia. J Global Health. 2015; 5(1): 010402. doi: 10.7189/jogh.05.010402
Biswas A, Halim A, Abdullah AS, Rahman F, Doraiswamy S. Factors associated with maternal deaths in a hard-to-reach marginalized rural community of Bangladesh: A cross-sectional study. Int J Environ Res Public Health. 2020; 17(4): 1184. doi: 10.3390/ijerph17041184
Karthika M, Philip S, Prathibha MT, Varghese A, Rakesh PS. Why are people dying due to tuberculosis? A study from Alappuzha District, Kerala, India. Indian J Tuberc. 2019; 66(4): 443-447. doi: https://doi.org/10.1016/j.ijtb.2018.05.001
Gobierno de México. Censo Nacional de Población y Vivienda 2020. Tabulados Sonora. [Internet] México: Instituto Nacional de Estadística y Geografía (INEGI); 2020. [Consultado: Sep 2, 2023]. Disponible en: https://www.inegi.org.mx/programas/ccpv/2020/default.html#Tabulados
World Health Organization. International Statistical Classification of Diseases and Related Health Problems, 10th Revision. 2010. [Internet] Geneve, Switzerland: WHO; 2010. [Consultado: Septiembre 1, 2023]. Disponible en: https://icd.who.int/browse10/2010/en
Gobierno de México. Catálogo, Sistema Urbano Nacional, 2012. [Internet] México: Secretaría de Desarrollo Social; 2012. Disponible en: https://www.gob.mx/cms/uploads/attachment/file/112772/Catalogo_Sistema_Urbano_Nacional_2012.pdf
Cotlear D, Gómez-Dantés O, Knaul F, Atun R, Barreto I, Cetrángolo OC, et al. 2015. Overcoming social segregation in health care in Latin America. Lancet. 2015; 385 (9974): 1248-1259. doi: 10.1016/S0140-6736(14)61647-0
Silva-Peñaherrera M, Lopez-Ruiz M, Merino-Salazar P, Gómez-García AR, Benavides FG. Health inequity in workers of Latin America and the Caribbean. Int J Equity Health. 2020; 19(1): 109. doi: 10.1186/s12939-020-01228-x
Callaghan T, Lueck JE, Lunz-Trujillo K, Ferdinand AO. Rural and urban differences in COVD-19 prevention behaviors. J Rural Health. 2021; 37(2): 287-295. doi: 10.1111/jrh.12556
Peters DJ. Community susceptibility and resiliency to COVID-19 across the rural-urban continuum in the United States. J Rural Health. 2020; 36(3): 446-456. doi: 10.1111/jrh.12477
Gobierno de México. Encuesta Nacional de Empleo y Ocupación, 2020. [Internet] México: Instituto Nacional de Estadística y Geografía (INEGI); 2020. Disponible en: https://www.inegi.org.mx/temas/empleo/
Gobierno de México. Características de los hogares, 2020. [Internet] México: Instituto Nacional de Estadística y Geografía (INEGI); 2020. Disponible en: https://www.inegi.org.mx/temas/hogares/
Gomez JM, Du-Fay-de-Lavallaz JM, Fugar S, Sarau A, Simmons JA, Clark B et al. Sex differences in COVID-19 hospitalization and mortality. J Womens Health (Larchmt). 2021; 30(5): 646-653. doi: 10.1089/jwh.2020.8948
Kharroubi SA, Diab-El-Harake M. Sex differences in COVID-19 diagnosis, risk factors and disease comorbidities: a large US-based cohort study. Front Public Health. 2022, 10: 1029190. doi: https://doi.org/10.3389/fpubh.2022.1029190
Patel JA, Nielsen FBH, Badiani AA, Assi VA, Unadkat B, Patel R. Poverty, inequality, and COVID-19: the forgotten vulnerable. Public Health. 2020; 183: 110-111. doi: 10.1016/j.puhe.2020.05.006
Sweeney S, Juhani-Capeding TP, Eggo R, Huda M, Jit M, Mudzengi D, et al. Exploring equity in health and poverty impacts of control measures for SARS-CoV-2 in six countries. BMJ Global Health. 2021; 6(5): e005521. doi: https://doi.org/10.1136/bmjgh-2021-005521
Larochelle MR. Is it safe for me to go to work? Risk stratification for workers during the COVID-19 pandemic. New Eng J Med. 2020; 383(5): e28. doi: 10.1056/NEJMp2013413
Galasso V, Pons V, Profeta P, Becher M, Brouard S, Foucault M. Gender differences in COVID-19 attitudes and behavior: panel evidence from eight countries. Proc Natl Acad Sci USA. 2020; 117(44): 27285-27291. doi: 10.1073/pnas.2012520117
Costa-Fernandes M. Health belief model for coronavirus infection risk determinants. Rev Saude Publica. 2020; 54: 47. doi: 10.11606/s1518-8787.2020054002494
Martínez-Martínez OA, Rodríguez-Brito A. Vulnerability in health and social capital: a qualitative analysis by levels of marginalization in Mexico. Int J Equity Health. 2020; 19(1): 24. doi: https://doi.org/10.1186/s12939-020-1138-4
Blendon RJ, Benson JM, Hero JO. Public trust in physicians--U.S. medicine in international perspective. New Eng J Med. 2014; 371(17):1570-1572. doi: https://doi:10.1056/NEJMp1407373
World Health Organization. The COVID-19 infodemic. [Internet] Geneve, Switzerland: 2023 [Consulted: Sep 2, 2023]. Available from: https://www.who.int/health-topics/infodemic/the-covid-19-infodemic#tab=tab_1
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2024 Diego Ivar Álvarez-Hernández, Gerardo Álvarez-Hernández , Mónica Paola Espinoza-Molina , Brenda Judith Millanes-Campa , Patricia Aranda-Gallegos , Maria del Carme Candia-Plata