Agricultural workers such as migrant and seasonal farmworkers are a population uniquely vulnerable to the negative effects of climate-related disasters. The primary aim of this study was to assess how counties in eastern North Carolina (NC) incorporated best practices related to agricultural workers in emergency preparedness planning.

The authors conducted a quantitative content analysis of 47 emergency preparedness plans from 41 eastern NC counties between November 2022 and March 2023. The research team developed a codebook based on recommended best practices from the Centers for Disease Control and Prevention, Farmworker Advocacy Network, Federal Emergency Management Agency, and National Center for Farmworker Health. Best practices included having materials in Spanish language, mapping vulnerable populations, and garnering input from agricultural workers.

Of the 47 plans evaluated, most lacked inclusion of agricultural workers in emergency preparedness planning. Furthermore, plans demonstrated few relevant best practices that address agricultural workers’ specific challenges in preparation for and recovery from climate-related disasters.

Public emergency preparedness plans in eastern NC rarely include mention of recommended best practices related to agricultural workers. Local emergency preparedness officials should consider collaboration with advocacy groups, community health workers, and federal emergency management agencies to build disaster resilience.

This study aims to outline Clostridioides difficile infection (CDI) trends and outcomes in Mexican healthcare facilities during the COVID-19 pandemic.

Observational study of case series.

Sixteen public hospitals and private academic healthcare institutions across eight states in Mexico from January 2016 to December 2022.

CDI patients.

Demographic, clinical, and laboratory data of CDI patients were obtained from clinical records. Cases were classified as community or healthcare-associated infections, with incidence rates calculated as cases per 10,000 patient days. Risk factors for 30-day all-cause mortality were analyzed by multivariate logistic regression.

We identified 2,356 CDI cases: 2,118 (90%) were healthcare-associated, and 232 (10%) were community-associated. Common comorbidities included hypertension, diabetes, and cancer. Previous high use of proton-pump inhibitors, steroids, and antibiotics was observed. Recurrent infection occurred in 112 (5%) patients, and 30-day mortality in 371 (16%). Risk factors associated with death were a high Charlson score, prior use of steroids, concomitant use of antibiotics, leukopenia, leukocytosis, elevated serum creatine, hypoalbuminemia, septic shock or abdominal sepsis, and SARS-CoV-2 coinfection. The healthcare-associated CDI incidence remained stable at 4.78 cases per 10,000 patient days during the pre-and pandemic periods. However, the incidence was higher in public hospitals.

Our study underscores the need for routine epidemiology surveillance and standardized CDI classification protocols in Mexican institutions. Though CDI rates in our country align with those in some European countries, disparities between public and private healthcare sectors emphasize the importance of targeted interventions.