A spatial analysis of tuberculosis in Mexico, 1990-1996

Abstract

This study describes the spatial distributions of Tuberculosis (TB) incidence and mortality rates in Mexico over the period 1990-1996. As well, it establishes the strength of association between TB incidence and mortality rates and several potential etiological factors. First, the TB incidence and mortality rates are mapped by state and described. Stepwise multiple regression models are then used within the conceptual framework of the triangle of human ecology of disease to determine the strength of association between TB incidence and mortality rates and healthcare availability measures and sociodemographic characteristics. Mapping of the rates illustrates a resurgence in TB incidence rates and a tapering off of TB mortality rates in Mexico over the study period. The highest incidence rates are found in Baja California Norte, Guerrero, Tabasco, and Nayarit, while the states of Baja California Norte, Veracruz-Llave, Chiapas, and Oaxaca have the highest mortality rates. This study shows that sociodemographic characteristics such as percent indigenous population, the index of marginality, and percent rural population have an impact on the geographic distributions of TB incidence and mortality rates in the states of Mexico, while percent illiterate population is shown to have no impact. The healthcare indicators, population per treatment facility, population with no healthcare benefits, population with public healthcare benefits, and population with private healthcare benefits are shown to have practically no impact on the rates of either TB incidence or mortality.