Evaluation of the implementation of a community health worker-led COVID-19 contact tracing intervention in Chiapas, Mexico, from March 2020 to December 2021

• Published in: BMC health services research 2024-01, Vol.24 (1), p.97-97, Article 97
• Main Authors: Aranda, Zeus, Vázquez, Sandra, Gopaluni, Anuraag, Martínez, Laura, Ramírez, Mayra, Jiménez, Ariwame, Bernal, Daniel, Rodríguez, Ana L, Chacón, Selene, Vargas, Bruno, Fulcher, Isabel R, Barnhart, Dale A
• Format: Article
• Language: English
• Subjects: Chronic illnesses; Community; Community health aides; Community health workers; Contact tracing; COVID-19; COVID-19 diagnostic tests; Demographics; Disease prevention; Epidemics; Evaluation; Infections; Intervention; Medical personnel; Medical supplies; Methods; Mexico; Outpatient care facilities; Pandemics; Rural areas; Services; Severe acute respiratory syndrome coronavirus 2
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-024-10590-3

Mexico is one of the countries with the greatest excess death due to COVID-19. Chiapas, the poorest state in the country, has been particularly affected. Faced with an exacerbated shortage of health professionals, medical supplies, and infrastructure to respond to the pandemic, the non-governmental organization Compañeros En Salud (CES) implemented a COVID-19 infection prevention and control program to limit the impact of the pandemic in the region. We evaluated CES's implementation of a community health worker (CHW)-led contact tracing intervention in eight rural communities in Chiapas. Our retrospective observational study used operational data collected during the contract tracing intervention from March 2020 to December 2021. We evaluated three outcomes: contact tracing coverage, defined as the proportion of named contacts that were located by CHWs, successful completion of contact tracing, and incidence of suspected COVID-19 among contacts. We described how these outcomes changed over time as the intervention evolved. In addition, we assessed associations between these three main outcomes and demographic characteristics of contacts and intervention period (pre vs. post March 2021) using univariate and multivariate logistic regression. From a roster of 2,177 named contacts, 1,187 (54.5%) received at least one home visit by a CHW and 560 (25.7%) had successful completion of contact tracing according to intervention guidelines. Of 560 contacts with complete contact tracing, 93 (16.6%) became suspected COVID-19 cases. We observed significant associations between sex and coverage (p = 0.006), sex and complete contact tracing (p = 0.049), community of residence and both coverage and complete contact tracing (p