The city of Mexicali, Mexico and Imperial County, California, lie adjacent to each other along the US-Mexico border. Here, the border is highly fluid, with thousands of residents from Mexicali crossing each day in order to work within Imperial County. The geopolitics of this region produce unique challenges in terms of poverty, citizenship, and healthcare delivery. This is highlighted by the current rates of tuberculosis transmission on both sides of the border. Imperial County has seen an incidence of 38 cases per 100,000 population, nearly ten times higher than the national average in the United States, while Mexicali has seen an incidence of 100 cases per 100,000 population, one of the highest rates in the North American continent. With more robust detection efforts, it’s likely that these rates would be much higher.
Between the Center for Global Health Delivery, Advance Access & Delivery, and other Zero TB Initiative partners, we are working with state and local health officials to drive down TB rates within the region through the implementation of a comprehensive TB program. This includes active case finding for TB disease, rather than waiting for patients to show up to clinics; treatment of all forms of tuberculosis, not just active disease; and improved access to preventive care. By addressing the state of TB in both Mexicali and Imperial county along with the social determinants of health and noncommunicable diseases that often coinside with TB disease, our program has the capacity to greatly improve the quality of life of individuals not only here, but in other regions along the border as well.
Through the use of innovative and community-based tools, we will expand access to screening and diagnosis and improve linkages to care, especially for those in more rural portions of the region who would otherwise have to commute far distances to access screening. Mobile X-ray vans and X-ray backpacks are used to cast a highly sensitive net to catch as many individuals with TB as possible. In addition, our program strives to make TB infection treatment accessible for all people, regardless of citizenship or insurance status, and pledges to maintain the confidentiality of patients who may face serious penalization if their TB status is uncovered. We will be working with app developers to create a patient management system that maintains the confidentiality of the patients and facilitates the secure sharing of data for disease surveillance. These tools all fit within the Search, Treat, Prevent paradigm that is the cornerstone of our work.
The call to action by local stakeholders has mobilized us to coordinate conversations on how to best eliminate tuberculosis along the US-Mexico border. Our synergy with multiple groups will fill the gaps in programmatic care delivery and the lack of resources that have led to this entrenched epidemic. Learn more.