Effects of public health measures during the SARS-CoV-2 pandemic on the winter respiratory syncytial virus epidemic: An interrupted time series analysis.

BACKGROUND: Public health measures (PHM) designed to contain the spread of COVID-19 pandemic have influenced the epidemiological characteristics of other viral infections. Its impact on acute RSV bronchiolitis in infants of ≤24 months old has not been systematically studied in our setting. OBJECTIVES: To describe the monthly pattern of visits to the Paediatric Emergency Department (PED) of patients 0 to 14 years of age, the rate of patients diagnosed with RSV acute bronchiolitis per thousand inhabitants of 0 to 24 months, and the rate of them requiring hospital admission during the winter 2020-2021, in the context of local and national COVID-19 restrictions and compare them to the four previous seasons. METHODS: Interrupted time series analysis of patients assisted in the PED and diagnosed with or admitted for RSV acute bronchiolitis in a tertiary University Hospital from January 2016 to February 2020 (pre-intervention period) and from March 2020 to June 2021 (post-intervention period). INTERVENTION: Preventive PHM implemented by the Spanish government weighted by the Containment and Health Index of the Oxford COVID-19 Government Response Tracker. RESULTS: The intervention was followed by an immediate reduction of the rate of visits to the PED of -19.5 (95% confidence interval [CI] -24.0, -14.9) per thousand, and the rate of diagnoses and admissions for RSV acute bronchiolitis of -44.3 (95% CI -73.8, -14.8) and -1.4 (95% CI -2.7, -0.1) per thousand, respectively, with a delayed rebound. CONCLUSIONS: After the implementation of PHM to prevent the spread of SARS-CoV-2 infection, an immediate and important decline in the visits to the PED was observed, with an upward change thereafter. There was also an initial reduction in the diagnoses of and admissions by RSV acute bronchiolitis. An upward trend was observed six to nine months after the usual time of the winter RSV epidemic, coinciding with the relaxation of the preventive PHM.

Public policy guidelines for a comprehensive, territorial and sustainable development to improve productivity and competitiveness. Case Tungurahua province-Ecuador.

In this work we elaborate a proposal for policy guidelines for the improvement of productivity and competitiveness of the province of Tungurahua -Ecuador-, such proposal is based on the theoretical foundations about the concept of a comprehensive, territorial and sustainable development applied to the territorial diagnosis. Herein three analysis techniques were used as a methodological strategy: The Rasmussen Method, which consists of a multisector model based on the Input-Output Tables-; the technique of focus groups for the analysis of perception on the prioritization of key sectors by the population and by the productive sectors; and the Shift-Share Analysis, to determine the level of growth of some sectors with respect to others. The results have allowed the identification of the strengths and weaknesses, as well as, the opportunities and threats associated with the levels of productivity and competitiveness of the province of Tungurahua. Therefore, strategies have been formulated aimed at the comprehensive, territorial and sustainable development of the province, which are built on the strengthening of endogenous capacities in science, technology and innovation, the encouragement of a coordination and articulation between the actors, the strengthening of the local business web and the internationalization of the territory.

[Etiology of acute viral respiratory tract infections in children from Gran Canaria, the Canary Islands (Spain)]. / Diagnóstico etiológico de las infecciones respiratorias agudas de origen vírico en un hospital pediátrico de Gran Canaria.

OBJECTIVE: Acute respiratory tract infections (ARTI) of viral origin are a frequent cause of pediatric consultations and hospital admissions. The aim of this study was to investigate the etiology of these infections in Gran Canaria, the Canary Islands, (Spain). METHODS: From May 2002 through May 2005, 1957 nasopharyngeal washings were collected from 1729 children presenting with ARTI to the Pediatric Emergency Unit. A rapid antigen detection method was performed in every sample to identify respiratory syncytial virus (RSV). An immunofluorescence assay (IFA) and cell culture (CC) was used in RSV-negative samples. RESULTS: Median age was 2 months (range, 0.03-119). A viral agent was identified in 1032 children (59.7%). RSV was detected in 769 children (74.5%). Other viruses identified, in order of frequency, were parainfluenza viruses, rhinoviruses, adenoviruses, influenza viruses, enteroviruses, and coronaviruses. Statistical differences were found between age and the type of virus detected: Adenoviruses caused respiratory infections in older children (median age: 6 months; range: 1-74). There were 6 mixed infections. Sensitivity of IFA as compared to CC was 55.8%, and specificity was 99.2%. CONCLUSIONS: Respiratory viruses are responsible for a large number of ARTI cases in children from Gran Canaria, RSV being the major cause. Viral identification is determinant for managing these patients and making a proper use of antibacterial and antiviral drugs.