School of Public Health, Georgia State University, Atlanta, USA.
Centre for Research on Pandemics & Society, Oslo Metropolitan University, Oslo, Norway.
Int J Infect Dis. 2022 Sep;122:910-920. doi: 10.1016/j.ijid.2022.07.052. Epub 2022 Jul 26.
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.
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 (R).
The mortality rate among indigenous populations of Mexico was 68% higher than that of non-indigenous 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 R among the two groups was comparable.
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.
在大流行期间，土著人口受到的影响不成比例。我们在国家和次国家层面调查了墨西哥土著和非土著人群中的 COVID-19 死亡率估计。
我们从墨西哥卫生部获得了关于 2173036 例实验室确诊的 RT-PCR 阳性 COVID-19 病例和 238803 例死亡的信息。我们估计了每 1000 人周的死亡率、土著与非土著群体之间的死亡率比值（RR）以及 COVID-19 死亡在 2020 年 2 月至 2022 年 3 月的四次大流行浪潮中的风险比（HR）。我们还评估了繁殖数（R）的差异。
墨西哥土著人口的死亡率比非土著群体高 68%。在 32 个联邦实体中，有 23 个实体的土著群体死亡率更高（在 13 个实体中 P < 0.05）。第四波的 RR 最高（2.40）。未调整的 HR 为 1.67（95%CI：1.62，1.72），在控制了其他协变量后，HR 降至 1.08（95%CI：1.04，1.11）。在强烈的第四波中，两组之间的 R 相当。
在墨西哥，土著身份是 COVID-19 死亡率的一个重要危险因素。我们的研究结果可能反映了墨西哥土著和非土著人群在非药物（例如洗手和戴口罩）和 COVID-19 疫苗接种干预措施方面的差异。
