In 2007, the 5-year survival rate for children with acute leukemia in Baja California, Mexico was estimated at 10% (vs. 88% in the United States). In response, stakeholders at St. Jude Children’s Research Hospital, Rady Children’s Hospital San Diego, and the Hospital General de Tijuana (HGT) implemented a transcultural partnership to establish a pediatric oncology program. The aim was to improve clinical outcomes and overall survival for children in Baja California. An initial needs assessment evaluation was performed and a culturally sensitive, comprehensive, 5-year plan was designed and implemented. After six years, healthcare system accomplishments include the establishment of a fully functional pediatric oncology unit with 60 new healthcare providers (vs. five in 2007). Patient outcome improvements include a rise in 5-year survival for leukemia from 10 to 43%, a rise in new cases diagnosed per year from 21 to 70, a reduction in the treatment abandonment rate from 10% to 2%, and a 45% decrease in the infection rate. More than 600 patients have benefited from this program. Knowledge sharing has taken place between teams at the HGT and Rady Children’s Hospital San Diego. Further, one of the most significant outcomes is that the HGT has transitioned into a regional referral center and now mentors other hospitals in Mexico. Our results show that collaborative initiatives that implement long-term partnerships along the United States–Mexico border can effectively build local capacity and reduce the survival gap between children with cancer in the two nations. Long-term collaborative partnerships should be encouraged across other disciplines in medicine to further reduce health disparities across the United States–Mexico border.
This paper explores the relative effects of employment and family responsibility on the perceived health status of Latino women. The data source analyzed for this study was the 1990 Panel Study of Income Dynamics/Latino National Political Survey (PSID/LNPS) Early-Release File (n = 1,502). Regression analyses were used to investigate the contributions of variables associated with perceived health status, including sociodemographics, Latino ethnicity, language, employment, and family responsibility. The results suggest that annual employment hours, occupation, and family responsibilities, such as child care and weekly housework, significantly affect self-reported health status of employed Latinas. Both social causation and social selection may be underlying the associations found. The results suggest that there is need for the development of public policies that seek to increase Latinas' labor force participation rate since any expansion has the potential to have a positive impact on their health status.
Background In Honduras, thirteen percent of patients with tuberculosis are coinfected with HIV, but the prevalence of latent tuberculosis infection among people with HIV infection is unknown. The goal of this study is to determine the prevalence and characteristics of latent tuberculosis infection among HIV diagnosed patients. Methods A cross-sectional study was conducted from June 2015 to December 2015 in two major clinical centers in Tegucigalpa, Honduras. This study used an adapted questionnaire-based clinical algorithm from the World Health Organization, procedures described by the Pan American Health Organization, and the Honduran National Norms for Tuberculosis Control included in the supplement material. There were two hundred ten individuals interviewed. Laboratory testing included tuberculin skin testing with absolute CD4 counts. Results There was a statistically significant higher risk of latent tuberculosis infection with HIV disease in the subgroups with a lower level of education (p = 0.002) and prior history of tuberculosis (p < 0.001). Conclusion The prevalence of latent tuberculosis infection is lower than in high-prevalence regions in different countries. The tuberculin skin test continues to identify patients with latent tuberculosis with HIV disease and intervene with concurrent antiretroviral therapy and tuberculosis chemoprophylaxis. A low education level is probably related to low socioeconomic status and access to healthcare. The findings of this study represent an opportunity to reach underserved areas, test the HIV population with the tuberculin skin test, and administer chemoprophylaxis.
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