The association of gout with an increased risk of hypertension and diabetes mellitus among stroke survivors in New Zealand: A cross-sectional study using routinely collected electronic health data

Background There is a paucity of data relating to the association of gout with the occurrence of hypertension and diabetes mellitus in patients with stroke. This study aimed to determine the association of gout with the risk of hypertension and diabetes mellitus in a cohort of stroke patients from Auckland, Aotearoa New Zealand. Methods A cross-sectional study was conducted among stroke survivors in South and East Auckland, New Zealand from the years 2010 to 2014. Electronic health record data were collected and analysed using Statistical Package for Social Science version 23. Multivariate logistic regression modelling adjusted for age, gender, and ethnicity was conducted to determine the association of gout with the risk of hypertension and diabetes mellitus in patients discharged with a diagnosis of stroke. Results The age-, gender-, and ethnicity-adjusted odds ratio for having hypertension and diabetes mellitus among stroke survivors with gout history were 3.25 (95% confidence interval 1.32–8.03) and 1.94 (95% confidence interval 1.12–3.36), respectively. Māori stroke survivors with gout history had the highest risk of having diabetes mellitus with age- and gender-adjusted odds ratio of 5.10 (95% confidence interval 1.90–18.93). Conclusion The findings from this study suggest gout may be independently associated with an increased risk of hypertension and diabetes mellitus in patients with stroke. Māori who are the indigenous population of New Zealand show a greater risk of diabetes mellitus associated with a gout diagnosis compared to other populations. This finding highlights the importance of the need for further research with Māori stroke survivors and other indigenous populations.

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Association of cleft lip and palate on mother-to-infant bonding: a cross-sectional study in the Japan Environment and Children’s Study (JECS)

BMC Pediatrics ◽

10.1186/s12887-019-1877-9 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Shinobu Tsuchiya ◽

◽

Masahiro Tsuchiya ◽

Haruki Momma ◽

Takeyoshi Koseki ◽

...

Keyword(s):

Confidence Interval ◽

Maternal Depression ◽

Odds Ratio ◽

Maternal Age ◽

Cleft Lip ◽

Cross Sectional Study ◽

Advanced Age ◽

Sectional Study ◽

Cross Sectional ◽

Increased Risk

Abstract Background Cleft lip and/or palate is among the most prevalent congenital birth defects, and negatively affects maternal psychological status and may consequently result in higher prevalence of child maltreatment. However, the association of childbirths of infants with cleft lip and/or palate with maternal emotional involvement still remains unclear. We examined the association between childbirths of infants with cleft lip and/or palate and mother-to-infant bonding, using data from the Japan Environment and Children’s Study, a nationwide birth cohort study. Methods A cross-sectional study using the jecs-an-20,180,131 dataset was performed. A total 104,065 fetuses in 15 regional centres in Japan were enrolled after obtaining informed written consent. The Mother-to-Infant Bonding Scale, a self-report scale consisting of 10 items, was used to evaluate maternal bonding at one year after childbirth. Finally, the participants consisted of 79,140 mother-infant pairs, of which 211 mothers of infants with cleft lip and/or palate were included in our analyses. Multivariable logistic regression analysis using multiple imputation for missing data was performed to calculate the odds ratio and 95% confidence interval in the estimation of the association between bonding disorders and childbirths with cleft lip and/or palate. Results No increased risk of bonding disorders was observed among all the mothers of infants with cleft lip and/or palate (odds ratio [95% confidence interval]; 0.97 [0.63–1.48], p = 0.880), however, advanced maternal age or multiple parity may adversely affect the associations between bonding disorders and cleft lip and/or palate, respectively. After stratification with a combination of maternal age and parity, a significant association of cleft lip and/or palate with bonding disorders was found only among advanced-age multiparae (odds ratio [95% confidence interval] = 2.51 [1.17–5.37], p = 0.018), but it was weakened after additional adjustment for maternal depression. Conclusions Childbirths of infants with cleft lip and/or palate may increase the risk of bonding disorders among advanced-age multiparae, possibly through maternal depression. This finding provides valuable information for the provision of multidisciplinary cleft care.

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Association of Cleft Lip and Palate on Mother-to-Infant Bonding: a Cross-Sectional Study in the Japan Environment and Children's Study (JECS).

10.21203/rs.2.13306/v4 ◽

2019 ◽

Author(s):

Shinobu Tsuchiya ◽

Masahiro Tsuchiya ◽

Haruki Momma ◽

Takeyoshi Koseki ◽

Kaoru Igarashi ◽

...

Keyword(s):

Confidence Interval ◽

Maternal Depression ◽

Odds Ratio ◽

Maternal Age ◽

Cleft Lip ◽

Cross Sectional Study ◽

Advanced Age ◽

Sectional Study ◽

Cross Sectional ◽

Increased Risk

Abstract Background: Cleft lip and/or palate is among the most prevalent congenital birth defects, and negatively affects maternal psychological status and may consequently result in higher prevalence of child maltreatment. However, the association of childbirths of infants with cleft lip and/or palate with maternal emotional involvement still remains unclear. We examined the association between childbirths of infants with cleft lip and/or palate and mother-to-infant bonding, using data from the Japan Environment and Children's Study, a nationwide birth cohort study. Methods: A cross-sectional study using the jecs-an-20180131 dataset was performed. A total 104,065 fetuses in 15 regional centres in Japan were enrolled after obtaining informed written consent. The Mother-to-Infant Bonding Scale, a self-report scale consisting of 10 items, was used to evaluate maternal bonding at one year after childbirth. Finally, the participants consisted of 79,140 mother-infant pairs, of which 211 mothers of infants with cleft lip and/or palate were included in our analyses. Multivariable logistic regression analysis using multiple imputation for missing data was performed to calculate the odds ratio and 95% confidence interval in the estimation of the association between bonding disorders and childbirths with cleft lip and/or palate. Results: No increased risk of bonding disorders was observed among all the mothers of infants with cleft lip and/or palate (odds ratio [95% confidence interval]; 0.97 [0.63-1.48], p = 0.880), however, advanced maternal age or multiple parity may adversely affect the associations between bonding disorders and cleft lip and/or palate, respectively. After stratification with a combination of maternal age and parity, a significant association of cleft lip and/or palate with bonding disorders was found only among advanced-age multiparae (odds ratio [95% confidence interval] = 2.51 [1.17-5.37], p = 0.018), but it was weakened after additional adjustment for maternal depression. Conclusions: Childbirths of infants with cleft lip and/or palate may increase the risk of bonding disorders among advanced-age multiparae, possibly through maternal depression. This finding provides valuable information for the provision of multidisciplinary cleft care.

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Inappropriate use of antibiotics, its reasons and contributing factors among communities of Yirgalem town, Sidama regional state, Ethiopia: A cross-sectional study

SAGE Open Medicine ◽

10.1177/20503121211042461 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110424

Author(s):

Azmach Dache ◽

Aregahegn Dona ◽

Amanuel Ejeso

Keyword(s):

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Community Education ◽

Cross Sectional Study ◽

Sectional Study ◽

Contributing Factors ◽

Cross Sectional ◽

Inappropriate Use ◽

Regional State

Objectives: The aim of this study was to assess the inappropriate use of antibiotics, its reasons and contributing factors among communities of Yirgalem town, Sidama regional state, Ethiopia. Methods: The study was conducted in Yirgalem town from 1 March to 30 March 2019. A cross-sectional study with interviewer administered structured and pretested questionnaire was used. A multistage sampling procedure was employed involving a total of 568 participants who used antibiotics in the past 1 year prior to the study period. Data were entered into Epi data version 3.1, and then exported to statistical package for social science version 20 for analysis. Descriptive statistics, bivariate and multivariate logistic regression analysis were done. p-value < 0.05 was used to consider significant variables. Results: The magnitude of inappropriate use of antibiotics was 37.9% (95% confidence interval (34.0, 41.5)). Main reason(s) for inappropriate use were long delays in health facility, cost-cutting and busy day’s program. Being employed (adjusted odds ratio = 3.45, 95% confidence interval (1.98, 6.02)), age 25–34 years (adjusted odds ratio = 2.89, 95% confidence interval (1.43, 5.84)), being male (adjusted odds ratio = 1.90, 95% confidence interval (1.20, 3.02)), seeking modern healthcare in private clinic (adjusted odds ratio = 2.54, 95% confidence interval (1.20, 5.36)), delayed waiting time in healthcare facilities (adjusted odds ratio = 4.87, 95% confidence interval (2.17, 10.91)), experienced with similar symptom/disease (adjusted odds ratio = 3.02, 95% confidence interval (1.89, 4.83)) and family size above five (adjusted odds ratio = 8.92, 95% confidence interval (3.56, 22.38)) were predictors positively associated with inappropriate use of antibiotics. Conclusion: The magnitude of inappropriate antibiotics use was high. Attention should be given to community education through involvement of the private health sector and healthcare providers about rational use of antibiotics.

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Prevalence and associated factors of depression among diabetic outpatients attending diabetic clinic at public hospitals in Eastern Ethiopia: A cross-sectional study

SAGE Open Medicine ◽

10.1177/20503121211066244 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110662

Author(s):

Mohamed Ebrahim ◽

Dawit Tamiru ◽

Behailu Hawulte ◽

Tadesse Misgana

Keyword(s):

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Sectional Study ◽

Cross Sectional ◽

Eastern Ethiopia ◽

Factors Associated ◽

Prevalence Of Depression

Introduction: Depression is one of the most common comorbid psychiatric disorders among diabetic patients. Depression among diabetic people has led to poor treatment adherence, defective treatment outcomes, and consequently worsened quality of life. However, there is a limited study conducted to assess the magnitude and factors associated with depression among diabetic patients in Ethiopia including this study area. Objective: This study aimed to assess the prevalence and factors associated with depression among adult diabetic outpatients attending diabetic clinic in Eastern Ethiopia. Methods: An institution-based cross-sectional study was conducted among 407 adult diabetic outpatients on treatment in Ethiopia in 2020. Patient Health Questionnaire-9 was used to assess depression among randomly selected samples. Bivariate and multivariate logistic regression was fitted to identify factors associated with depression among diabetic outpatients. A p value less than 0.05 with a 95% confidence interval was considered statistically significant. Results: The overall prevalence of depression among diabetic outpatients was found to be 48.9% (95% confidence interval: 44.2%, 53.4%). Being female (adjusted odds ratio = 1.50, 95% confidence interval: 1.39, 2.73), Khat chewing (adjusted odds ratio = 1.88, 95% confidence interval: 1.22, 2.93), having poor and moderate social support (adjusted odds ratio = 1.79, 95% confidence interval: 1.07, 2.98 and adjusted odds ratio = 1.90, 95% confidence interval: 1.14, 3.17, respectively), taking both oral hypoglycemic agents and insulin medication (adjusted odds ratio = 1.33, 95% confidence interval: 1.13, 2.80) and duration of diabetes mellitus for more than 6 years (adjusted odds ratio = 5.40, 95% confidence interval: 3.42, 8.14) were significantly associated with depression. Conclusion: This study revealed a relatively high prevalence of depression in diabetic outpatients. A lesser level of social support, taking oral and insulin treatment regimes, longer duration of illness, using Khat, and being female were associated with depression among diabetic outpatients. Therefore, early screening and identification of such factors could help ameliorate some of the deleterious effects of depression in diabetic outpatients.

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Predictors of pregnant women’s intention to vaccinate against coronavirus disease 2019: A facility-based cross-sectional study in southwest Ethiopia

SAGE Open Medicine ◽

10.1177/20503121211038454 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110384

Author(s):

Shewangizaw Hailemariam ◽

Besufekad Mekonnen ◽

Nigusie Shifera ◽

Biruk Endalkachew ◽

Molla Asnake ◽

...

Keyword(s):

Public Health ◽

Confidence Interval ◽

Pregnant Women ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Public Health Intervention ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Southwest Ethiopia

Objective: Ethiopia is planning to vaccinate 20% of its population against the coronavirus disease 2019 pandemic by the end of 2021—however, there is no single piece of evidence regarding pregnant women’s intention to be vaccinated against coronavirus disease 2019; hence, the objective of this study was to investigate predicting factors of intention to be vaccinated against coronavirus disease 2019 among pregnant women in Bench-Sheko Zone, southwest Ethiopia. Methods: Facility-based cross-sectional study was undertaken from 1 February to 1 March 2021 in southwest Ethiopia. The study was carried out among pregnant women who came for antenatal care service in the selected public health facilities. Interviewer-administered structured tool was used to collect the data. Data were entered into EpiData (version 3.1) and then analyzed using SPSS (version 20). Results: The study revealed that only 31.3% (95% confidence interval: 26.7–35.2) of the participants had an intention to be vaccinated against coronavirus disease 2019 when the vaccine will be made available in Ethiopia. Participants’ intention to be vaccinated against coronavirus disease 2019 was significantly associated with attaining secondary school and above (adjusted odds ratio = 4.24, 95% confidence interval: 2.23–9.32), residing in urban areas (adjusted odds ratio = 2.57, 95% confidence interval: 1.22–5.40), being compliant with coronavirus disease 2019 guidelines (adjusted odds ratio = 5.86, 95% confidence interval: 3.40–10.09), and having good perception toward coronavirus disease 2019 vaccine (adjusted odds ratio = 3.04, 95% confidence interval: 1.64–5.62). Conclusion: Above all, in this study, pregnant women’s intention to vaccinate against coronavirus disease 2019 was very low when compared with previous studies. Hence, before commencing the coronavirus disease 2019 vaccination program in Ethiopia, it is essential to launch a widespread public health education campaign that could improve people’s perception of the vaccine. Besides, the upcoming public health intervention programs better put special emphasis on community members with lower educational attainment backgrounds and rural residents.

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Predictors of self-care activities of outpatient diabetic residents in Harar and Dire Dawa: A hospital-based cross-sectional study

SAGE Open Medicine ◽

10.1177/2050312119865646 ◽

2019 ◽

Vol 7 ◽

pp. 205031211986564 ◽

Cited By ~ 1

Author(s):

Behailu Hawulte Ayele ◽

Melkamu Merid Mengesha ◽

Tewodros Tesfa

Keyword(s):

Diabetes Mellitus ◽

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Self Care ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Cross Sectional ◽

Dire Dawa

Objectives: Diabetes mellitus is a metabolic disorder of major public health importance due to its prevalence and potential health complication. The success of long-term maintenance therapy of diabetes patients depends largely on their ability to adherence to self-care practices. Africa’s most populous country, Ethiopia, has the highest burden of diabetes mellitus. However, studies on self-care activities of diabetic patients are limited. Therefore, this study measures the level of self-care activities of diabetic patients in a follow-up clinic of public hospitals in Harar and Dire Dawa, Eastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted on 320 randomly selected diabetic patients in Harar and Dire Dawa. A standard diabetic self-care activity interview tool was used to collect the data. Data were entered into Epi-data v 3.1 and STATA v 14.2 was used for analysis. Our outcome variable, self-care activities, has three ordered categories and a robust Ordinal logistic regression was used to identify predictors. All statistical tests with p-value <0.05 were considered as statistically significant. Results: The self-care activities of study participants were rated good for 38.1% (95% confidence interval: 32.94, 43.60). Being rural residents (adjusted odds ratio = 0.38, 95% confidence interval: 0.17, 0.82), attended secondary education (adjusted odds ratio = 2.96, 95% confidence interval: 1.51, 5.78), uncontrolled blood glucose (adjusted odds ratio = 1.68, 95% confidence interval: 1.02, 2.79), and had diabetic complications (one, adjusted odds ratio = 1.91, 95% confidence interval: 1.08, 3.38; two or more, adjusted odds ratio = 4.71, 95% confidence interval: 1.81, 12.25) were significantly associated with the better diabetes mellitus self-care activities. Conclusion: Significant number of diabetes mellitus patients living in rural areas did not adhere to diabetic self-care activities. This is more evident among participants who have limited or no formal education and patients with controlled blood glucose level. Therefore, individualized diabetic lifestyle education programs in follow-up clinics should target these population groups to improve self-care.

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Epidemiology of occupational injuries in Ethiopian hotel industry in Ethiopia: A cross-sectional study

SAGE Open Medicine ◽

10.1177/2050312120985273 ◽

2020 ◽

Vol 8 ◽

pp. 205031212098527

Author(s):

Roza Abune ◽

Hailu Merga ◽

Embialle Mengiste

Keyword(s):

Confidence Interval ◽

Work Experience ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Occupational Injury ◽

Occupational Injuries ◽

Educational Background ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

Introduction: An occupational injury is a global health issue, and in hotel industries, little is known about it. The aim of this study was therefore to assess the epidemiology of occupational injuries in international brand hotels. Method: An institutional cross-sectional study was conducted among 330 workers using a systematic random sampling method. Using EpiData and SPSS, respectively, data were entered and analyzed. The final results were explained and presented with the adjusted odds ratio and the 95% confidence interval, and the results of the qualitative data were triangulated with quantitative data. Results: Of the 330 study participants, 125 (37.9%; 95% confidence interval (32.7%, 43.8%)) reported having sustained an occupational injury. The study showed those who had four or less family members (adjusted odds ratio: 0.484, 95% confidence interval (0.286, 0.818)), those who had low educational background (adjusted odds ratio: 1.466, 95% confidence interval (1.098, 1.959)), those who had 2 years or less work experience (adjusted odds ratio: 1.065, 95% confidence interval (1.023, 1.108)), those who were working in shifts (adjusted odds ratio: 2.559, 95% confidence interval (1.197, 5.474)), and those who had sleep disturbance (adjusted odds ratio: 1.797, 95% confidence interval (1.025, 3.151)) were factors significantly associated with occupational injury. Conclusion: The study found that the prevalence rate was very high. Among the variables included in the analysis, having four or less family sizes, low educational background, having work experience of 2 years or less, working in shifts, and having sleep disorders/problems were statistically significant. It is therefore recommended that health and safety training and reinforcement be provided to increase awareness and understand the risk factors at the workplace.

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Association of Cleft Lip and Palate on Mother-to-Infant Bonding: a Cross-Sectional Study in the Japan Environment and Children's Study (JECS).

10.21203/rs.2.13306/v2 ◽

2019 ◽

Author(s):

Shinobu Tsuchiya ◽

Masahiro Tsuchiya ◽

Haruki Momma ◽

Takeyoshi Koseki ◽

Kaoru Igarashi ◽

...

Keyword(s):

Confidence Interval ◽

Maternal Depression ◽

Odds Ratio ◽

Maternal Age ◽

Cleft Lip ◽

Cross Sectional Study ◽

Advanced Age ◽

Sectional Study ◽

Cross Sectional ◽

Increased Risk

Abstract Background: Cleft lip and/or palate is among the most prevalent congenital birth defects, and negatively affects maternal psychological status and may consequently result in higher prevalence of child maltreatment. However, the association of cleft lip and/or palate childbirths with bonding disorders still remains unclear. We examined the association between cleft lip and/or palate childbirth and mother-to-infant bonding, using data from the Japan Environment and Children's Study, a nationwide birth cohort study. Methods: A cross-sectional study using the jecs-an-20180131 dataset was performed. A total of 104,065 foetuses in 15 regional centres in Japan were enrolled after obtaining informed written consent. The Mother-to-Infant Bonding Scale, a self-report scale consisting of 10 items, was used to evaluate maternal bonding at 1 year after childbirth. Finally, the participants consisted of 79,140 mother-infant pairs, of which 211 mothers with cleft lip and/or palate infants were included in our analyses. Multivariable logistic regression analysis using multiple imputation for missing data was performed to calculate the odds ratio and 95% confidence interval in the estimation of the association between bonding disorders and childbirth with cleft lip and/or palate. Results: No increased risk of bonding disorders was observed among all the mothers with cleft lip and/or palate childbirths (odds ratio [95% confidence interval]; 0.97 [0.63-1.48], p = 0.880), and advanced maternal age or multiple parity may adversely affect the associations between bonding disorders and cleft lip and/or palate childbirths, respectively. After stratification with a combination of maternal age and parity, a significant association of cleft lip and/or palate childbirth with bonding disorders was found only among advanced-age multiparae (odds ratio [95% confidence interval] = 2.51 [1.17-5.37], p = 0.018), but it was weakened after additional adjustment for maternal depression. Conclusions: Cleft lip and/or palate childbirth may increase the risk of bonding disorders among advanced-age multiparae, possibly through maternal depression. This finding provides valuable information for the provision of multidisciplinary cleft care.

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Fear of infertility limits contraceptive usage among first-time mothers in Ghana: A cross-sectional study

SAGE Open Medicine ◽

10.1177/20503121211021256 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110212

Author(s):

Emmanuel Adofo ◽

Elvis J Dun-Dery ◽

Agnes M Kotoh ◽

Frederick Dun-Dery ◽

James Atampiiga Avoka ◽

...

Keyword(s):

Child Welfare ◽

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Contraceptive Use ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Modern Contraceptives ◽

First Time

Objectives: This study aimed to determine postpartum modern contraceptive use among first-time young mothers attending child welfare clinics in the Eastern Region of Ghana and explore factors that influence family planning uptake after the first delivery, including fear of infertility. Methods: This facility-based, cross-sectional study used interviewer-administered structured questionnaires. The study recruited 422 first-time young mothers aged 15–24 years, with 6- to 18-month-old babies attending child welfare clinics. Results: Overall, less than half (44%) of first-time mothers used modern contraceptives within 18 months after delivery. Fear of infertility after contraceptive use (56%) is the main barrier reported as the reason for women’s non-use of modern contraceptives. Mothers with tertiary education have higher odds of using postpartum contraceptives (adjusted odds ratio =1.6, 95% confidence interval: 0.4–2.0). Compared to mothers with younger children, those with children older than 6 months have higher odds of postpartum contraceptive use (adjusted odds ratio = 1.3, 95% confidence interval: 0.3–1.7). Nonspousal communication (adjusted odds ratio = 0.1, 95% confidence interval: 0.1–0.3) as compared to communication among partners about contraception and those in formal employment (adjusted odds ratio = 0.3, 95% confidence interval: 0.1–0.7), were less likely to use postpartum contraceptives. Conclusion: Considering that there is low postpartum contraceptive utilization, mostly due to concerns about fear of infertility after use, it is paramount to intensify education on actual side effects and reformulate policies that address specific concerns of infertility among mothers and contraceptive use.

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Ethnic disparities in COVID-19 mortality in Mexico: a cross-sectional study based on national data

10.1101/2020.08.26.20182543 ◽

2020 ◽

Author(s):

Ismael Ibarra-Nava ◽

Kathia G. Flores-Rodriguez ◽

Violeta Ruiz-Herrera ◽

Hilda C. Ochoa-Bayona ◽

Alfonso Salinas-Zertuche ◽

...

Keyword(s):

Confidence Interval ◽

Indigenous People ◽

Indigenous Peoples ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Large Sample ◽

The Impact

Objectives: To analyze the mortality associated with ethnicity, particularly of Indigenous peoples, in a large sample of patients with COVID-19 in Mexico. Design: National, cross-sectional study. Setting: Mexico. Participants: 416546 adult patients; 4178 Indigenous peoples with COVID-19 were the primary population under study. Main outcome measures: The primary outcome was mortality from COVID-19 up to August 3rd, 2020. Logistic regression was used to calculate odds ratios while adjusting for confounders. Results: Among all patients with COVID-19, whether hospitalized or not, a higher proportion of Indigenous peoples died compared to non-Indigenous people (16.5% vs 11.1%, respectively). Among hospitalized patients, a higher proportion of Indigenous peoples died (37.1%) compared to non-Indigenous peoples (36.3%). Deaths outside the hospital were also higher among Indigenous peoples (3.7% vs 1.7%). A higher proportion of Indigenous peoples died in both the private and public health care sectors. The adjusted odds ratio for COVID-19 mortality among Indigenous peoples with COVID-19 was 1.13 (95% confidence interval 1.03 to 1.24). The adjusted odds ratio for COVID-19 mortality among Indigenous peoples with COVID-19 was higher among those who received only ambulatory care (1.55, 95% confidence interval 1.24 to 1.92). Conclusions: In the large sample of patients with COVID-19, the findings suggest that Indigenous peoples in Mexico have a higher risk of death from COVID-19, especially outside the hospital. These findings suggest Indigenous peoples lack access to care more so than non-Indigenous people during the COVID-19 pandemic in Mexico. More research is needed regarding the impact of the COVID-19 among racial and ethnic minorities in Mexico.

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