Background Childhood asthma is a significant health issue with 8.3% prevalence in the U.S. Its prevalence is particularly higher among low-income communities in the Texas-Mexico border region, as they often lack access to clinical care and health insurance. This study examines the impact of a home-based education led by Community Health Workers (CHWs) on health outcomes for asthmatic, predominantly Hispanic children in these communities. Methods The study was a quasi-experimental design to learn the effectiveness of the asthma home-based education by comparing changes of health outcomes between baseline and follow-up of intervention and control groups. This study enrolled 290 participants, consisting of 130 in the intervention group and 160 in the control group. The educational intervention led by the CHWs referenced the Asthma and Healthy Homes curriculum and contents of the Seven Principles of Healthy Homes. The multiple linear regression analysis was conducted to estimate the associations between the intervention and each health outcome. Results When comparing the intervention group with the control group, the intervention group showed a significantly greater decrease in asthma attacks than the control group ( p = 0.049). Although all of the five Children’s Health Survey for Asthma (CHSA) scores showed significant improvements between baseline and follow-up in both groups, we found that increases of CHSA scores in the intervention group were higher than the control group except for emotional health of children (EC) score. The multiple linear regression models demonstrated that the mean changes in asthma attacks ( p = 0.036) and emotional health of families (EF) score ( p = 0.038) were significantly better in the intervention group than the control group, adjusting for children’s age of diagnosis, household income, use of steroids, family history of allergy, and type of insurance. Conclusions This study concluded that the home-based education by CHWs effectively improve health outcomes among children in communities lacking access to medical resources. The findings suggest the importance of the home-based education program in promoting emotional and medical care for children and their families in low-income communities like those in the Texas-Mexico border region.
Hidalgo County (HC), located along the Texas–Mexico border, was listed as a high-risk county for Zika virus (ZIKV) in 2017 by the Texas Department of State Health Services, based on its historical presence of Dengue. Due to its subtropical climate, active binational travel, and population of low socioeconomic status, Hidalgo County focused on disease detection activities for the prevention of further transmission. Therefore, Hidalgo County Health and Human Services enacted public health surveillance, reviewed laboratory results, and conducted epidemiological investigations from 2016 to 2018. In 2017, Hidalgo County experienced a locally-acquired outbreak of Zika virus disease, resulting in the highest local mosquito-borne acquisition case count for the year within the United States. This resulted in Hidalgo County reviewing epidemiological data for disease detection and risk areas. With the data review, key outcomes of testing were identified. This included the importance of both RT-PCR and IgM-ELISA/PRNT testing methods. In addition, increased antenatal testing and surveillance also recognized the need of improved disease identification and testing among the general population, especially during localized outbreaks.
From 2016 to 2018, Hidalgo County observed the emergence of Zika virus (ZIKV) infections along with sporadic cases of Dengue virus (DENV) and West Nile virus (WNV). Due to the emergence of ZIKV and the historical presence of other mosquito-borne illnesses, Hidalgo County obtained funding to enhance mosquito surveillance and educate residents on arboviruses and travel risks. During this time period, Hidalgo County mosquito surveillance efforts increased by 1.275%. This increase resulted in >8000 mosquitoes collected, and 28 mosquito species identified. Aedes aegypti, Ae albopictus and Culex quinquefasciatus made up approximately two-thirds of the mosquitoes collected in 2018 (4122/6171). Spatiotemporal shifts in vector species composition were observed as the collection period progressed. Significantly, temperature variations (p < 0.05) accounted for associated variations in vector abundance, whereas all other climate variables were not significant.
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