Social Determinants of Pulmonary Tuberculosis in Families of Migrants participating in Mexico-Canada Seasonal Agricultural Workers Program: A Study in Guadalupe Zaragoza

Abstract

Objective: To analyze the social determinants of pulmonary tuberculosis in the families of migrant laborers registered in the Seasonal Agricultural Workers Program (SAWP) and residing in Guadalupe Zaragoza Tlahuapan, Puebla, México. Methods: An exploratory cross-sectional study of the interaction between migration, social determinants, and pulmonary tuberculosis. Results: In this poor and patriarchal community, the SAWP offers financial opportunities for the men of Guadalupe Zaragoza. The remittances of these migrant workers have enabled their families to live in adequate housing, but their health situation is still vulnerable. Only half of the families have access to public health services or the special health programs for migrant worker families. 13% of migrant family members were infected with pulmonary tuberculosis as measured by the Quantiferon-TB test. The female partners of migrants typically do not study past elementary school, become housewives with no pay, are forced to take on added work in the household, and experience subjective symptoms of stress and fatigue. The children of Guadalupe Zaragoza are also vulnerable; the number of children in this community who can regularly attend school is below the national average because many children have to work. These families end up paying more for education, housing, and health services than the average Mexican family. Conclusions: In the families of SAWP migrant workers, the prevalence of latent pulmonary tuberculosis was found to be lower than the national average based on studies using the tuberculin test; this may be due to the greater specificity of the Quantiferon-TB Gold test. There is a significant risk of reactivation tuberculosis in these families due to the inequity in the social determinants of health.