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DTBE in Mexico

map of Mexico

Capital City: Mexico City
Area*:1,972,550 sq. km. (751,600 sq. mi.)
Population (est.), 2011*: 113,724,226
Estimated TB Incidence, 2010**: 16/100,000
Estimated TB Prevalence, 2010**: 18/100,000
Adult HIV Prevalence Rate, 2009***: 0.3%
Number of people living with HIV (PLHIV), 2009***:220,000
Percent of tested TB patients who were HIV+, 2010**: 13%

*Source: www.state.gov
**Source: WHO Global TB Control Report 2011
***Source: UNAIDS, Report on the Global AIDS Epidemic, 2010

Background

Mexico has relatively low tuberculosis (TB) and HIV prevalence rates, but contributes to 23% of TB cases in the United States among foreign-born individuals.  The Mexico National Tuberculosis Program (NTP) and Centers for Disease Control and Prevention’s Division of Tuberculosis Elimination (CDC/DTBE) have been in close collaboration since 1995 to expand the WHO-recommended Directly Observed Therapy Short-course (DOTS) strategy in Mexico and improve TB control along the United States-Mexico border.  CDC/DTBE provides technical assistance in the following areas: trainings, operational research, and capacity building.  Since 2009, CDC/DTBE has had a regional TB technical advisor (Medical Officer) providing assistance to Latin America.  CDC/DTBE continues to collaborate and support the National TB Program, Epidemiology Office and Insituto Nacional de Enfermedades Respiratorias (INER). 

Recent Accomplishments & Ongoing Collaborations

Program Strengthening and Epidemiology

Expansion of Services: Grupos Sin Fronteras, Juntos, Los dos Laredos, and the Texas Department of Health Services collaborated with the Mexico Ministry of Health to provide the following services: physician consultation, second-line TB medications, diagnostic testing, patient interviews and contact tracing, equipment and supplies, and educational materials and TB staff training opportunities.

Greater Collaboration & Coordination between US and Mexico: A summit between the United States and Mexico held in 2010 with participants from the NTP, CDC, U.S. health state departments, and non-governmental organizations (NGOs) established a framework for a memorandum of understanding (MOU).  This MOU established regular communication between the United States and Mexico to improve TB program coordination and technical assistance.  Some of the terms of this MOU include working jointly to improve care for migrant TB patients, detection of TB in legal and undocumented migrants, referral and counter-referral systems between both countries and the elimination of barriers to continuation and completion of TB retreatment without regard to legal status.

Multidrug-Resistant TB (MDR TB), TB/HIV, and Other At-Risk Populations

Evaluation of Cure TB Program: In November 2009, CDC/DTBE conducted the first evaluation of the bi-national referral program for TB patients who cross the border between Mexico and the United States to assess program effectiveness and patient outcomes (called the Cure TB Program).  The Cure TB evaluation report was released in 2010. A follow-up second phase evaluation of Cure TB evaluation is currently underway.

Binational Multidrug-Resistant TB (MDR TB) Consultation Network: The Mexico National Government launched a demonstration project to link TB care providers with a network of TB experts from Mexico and the United States.  The consultants remotely reviewed and discussed TB treatment, prevention and management.  Cases discussed received ongoing consultation through the Heartland National TB Center (HNTC) in Texas.  The establishment of a Binational MDR TB Consultation Network through collaboration between the HNTC and Mexican TB physicians was helpful in ensuring patients were successfully treated in Mexico. Key discussions concerned availability and supply chains for first and second-line drugs; availability of second line drug susceptibility testing; and accuracy of MDR TB diagnosis.

National Drug-Resistance Survey: The Mycobacteriology Laboratory Branch (MLB) in CDC/DTBE and the Mexican Reference Laboratory successfully collaborated on the implementation of a national drug resistance Survey for first-line drug susceptibility testing (DST).  CDC/DTBE conducted an external quality assurance on a portion of the sample study isolates.  Data analysis is ongoing in Mexico.

 

Additional Information

 
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