Migrants in Transit and Asylum Seekers in Mexico: An Epidemiological Analysis of the Covid-19 Pandemic

Abstract

BACKGROUND: Migrants could be disproportionately affected by the COVID-19 pandemic, yet little is known so far of the epidemiology of the disease among them, especially in low- and middle-income countries. OBJECTIVE: To describe the epidemiology of suspect cases of COVID-19 in migrants in transit and asylum seekers in Mexico, and to compare their characteristics with those of non-migrants. METHODS: This was a secondary analysis of information from the surveillance system of Mexico from January 1 to May 3 2020, identifying persons from the main sending countries of mixed migrant flows in Mexico (Central America, the Caribbean, Venezuela and African countries), in northern and southern Mexican border states. We compared the demographic and clinical characteristics, risk conditions, and epidemic curves for migrants and non-migrants. Also, we estimated the cumulative incidence for non-migrants, and for migrants in two scenarios defined by different estimations of their population size. RESULTS: Migrants were on average younger, had less accompanying risk conditions, and a lower percentage of suspect cases tested positive for COVID-19. The odds of hospitalization were lower among migrants, but the difference disappeared after adjusting by age, gender and underlying risk conditions. The cumulative incidence ratios comparing migrants with non-migrants were 6.12 (CI95% 4.75,7.77) for the first scenario, and 1.49 (CI95% 1.15,1.89) for the second scenario. CONCLUSION: Migrants and asylum seekers in Mexico are at increased risk for infectious respiratory diseases, and could be disproportionately affected by COVID-19. It is important to continue monitoring the situation, with more detailed information about migration status, living conditions and other determinants of migrants health.

SARS-CoV-2 among migrants and forcibly displaced populations: a rapid systematic review

“…[16] Risk conditions in this specific study population seemed to be less among migrants except for the case of pregnant women. [16] 3. Impact on social and socio-psychological wellbeing was assessed among international students in central China's Hubei province, showing that almost a quarter of the study population talked about the virus in regular conversations and almost half of the study population was unhappy due to the current lockdown condition.…”

“…The incidence risk among the observational studies varied from 0·12% to 2·08% in non-outbreak settings [16, 17], and from 5·64% to 21·15% in outbreak settings [18, 19], showing a high heterogeneity across the studies. Modelling studies also showed a high heterogeneity, which is due to different scenarios and timeframes.…”

“…[17] A high risk of bias study among migrants in transit in Mexico reports low incidence risks in two scenarios with 0·12% or 0·51% respectively. [16] The estimated cumulative incidence in two scenarios (with different sources for the population size of asylum seekers in the US) showed a higher number of suspected cases per 100 000 in the migrant group compared to non-migrants. [17] An ecological study investigating migrants in transit in Mexico found a higher Incidence Risk Ratio (IRR: 6·43, 95%CI, 4·41-9·39) for SARS-CoV-2 in state cluster populations with a higher proportion of migrants.…”

“…[23] Among the observational studies Bojorquez et al found a tendency of lower odds to be hospitalised in migrants in transit and asylum seekers in Mexico (adjusted OR for confirmed cases: 0·18 (CI95%, 0·2-1·53) compared to the Mexican population. [16] In contrast, the odds of interstate migrants was 1·36 (95%CI, 1·19-1·54) times the odds of hospitalisation than the reference (Mexican) population. [25] About 6·49% of all hospitalised SARS-CoV-2 cases in Mexico from 28th February until 21st April 2020 were interstate migrants.…”

“…[16] Risk conditions in this specific study population seemed to be less among migrants except for the case of pregnant women. [16]…”