Regional disparities of prostate cancer mortality in Ecuador: an examination of trends and correlates from 2004 to 2019.

BACKGROUND: Prostate cancer is the leading cause of cancer death in Ecuadorian men. However, there is a lack of information regarding the evolution of prostate cancer mortality rates in Ecuador and its regions in the last few decades. OBJECTIVE: The aim of this study was to report prostate cancer mortality rates in Ecuador and its geographical areas and observe the evolution of these rates between 2004 and 2019. METHODS: An observational ecological study was conducted, analysing data for prostate cancer deaths from 2004 to 2019 in Ecuador. Age standardized mortality rates (ASMR) were calculated per 100,000 men using the world standard population with the direct method proposed by SEGI. Joinpoint regression analysis was performed to examine mortality trends. We used a Cluster Map to explore relationships among regions between 2015 and 2019. RESULTS: Ecuador reported 13,419 deaths by prostate cancer between 2004 and 2019, with the Coastal region accounting for 49.8% of the total deaths. The mean age at death was 79 years (± 10 years), 91.7% were elderly (more than 65 years old) and had primary education (53%). Deaths by prostate cancer were more frequently reported among mestizos (81.4%). There were no significant variations in these percentages in Ecuador and its regions during the study period. Carchi province had the highest mortality rate in 2005 and 2019 (> 13 deaths per 100,000). Heterogeneity in the evolution of mortality rates was reported among the provinces of Ecuador. Azuay decreased in the first few years, and then increased from 2010 to 2019, whereas Guayas and Pichincha decreased throughout the whole period. CONCLUSION: Although prostate cancer mortality rates in Ecuador have remained stable over the past few decades, there are significant disparities among the different regions. These findings suggest the need for the development of national and provincial registration measures, integrated healthcare actions, and targeted interventions to reduce the burden of prostate cancer in the Ecuadorian population.

Uso de micronutrientes y grado de anemia en niños menores de 3 años atendidos en un centro de salud Ica 2017 / Use of micronutrients and degree of anemia in children under 3 years old attended at a center health Ica 2017

Objetivo: Determinar el uso de los micronutrientes y grado de anemia en niños menores de 3 años atendidos en un Centro de Salud de Ica 2017. Materiales y métodos: El estudio fue cuantitativo, de tipo descriptivo, y transversal, la muestra estuvo conformada por 40 niños menores de tres años con sus respectivas madres, la técnica que se utilizó fue la observación y el análisis documental. Resultados: En relación a los datos generales de la madre, el 47.5% (19) tienen 19 a 34 años, el 50% (20) tienen instrucción superior, el 40% (16) son solteras y el 57.5% (23) trabaja fuera de casa; sobre los datos del niño, el 55% (22) tienen de 6 a 12 meses, el 72.5% (29) recibió solo lactancia materna hasta los seis meses y el 100% (40) inició la alimentación complementaria a los 6 meses. El uso de micronutrientes es adecuado en el 82.5% (33) de las madres y es inadecuado en el 17.5% (07). Según valores de hemoglobina, el 62.5% (25) de los niños no presentan anemia, el 37.5% (15) presentan anemia leve, no encontrando niños con anemia moderada ni anemia severa. Conclusiones: El uso de micronutrientes que administran las madres a sus niños es adecuado y los niños no presentan anemia en su mayoría, existiendo porcentajes menores de niños con anemia leve por lo que se sugiere que se continúe con el abastecimiento continuo de los micronutrientes realizando campañas educativas a fin de comprometer a las madres en la administración correcta de los micronutrientes en sus menores hijos aprovechando los momentos de contacto con las madres para la educación respectiva en las sala de espera, durante sus controles de inmunizaciones, controles CRED, y realizar un monitoreo periódico del control de hemoglobina. (AU)

Objective: To determine the use of micronutrients and the degree of anemia in children under 3 years of age served in an Ica Health Center 2017. Materials and methods: The study was quantitative, descriptive, and cross-sectional, the sample consisted of 40 children under three years with their respective mothers, the technique used was observation and documentary analysis. Results: In relation to the general data of the mother, 47.5% (19) are 19 to 34 years old, 50% (20) have higher education, 40% (16) are single and 57.5% (23) work ; On the data of the child, 55% (22) have from 6 to 12 months, 72.5% (29) received only breastfeeding until six months and 100% (40) started complementary feeding at 6 months. The use of micronutrients is adequate in 82.5% (33) of mothers and is inadequate in 17.5% (07). According to hemoglobin values, 62.5% (25) of the children do not have anemia, 37.5% (15) have mild anemia, and there are no children with moderate anemia or severe anemia. Conclusions: The use of micronutrients administered by mothers to their children is mostly adequate and children do not have anemia in their majority. There are smaller percentages of children with mild anemia, so it is suggested that continuous supply of the micronutrients conducting educational campaigns in order to engage mothers in the correct administration of micronutrients in their younger children, taking advantage of the moments of contact with mothers for the respective education in the waiting room, during their immunization controls, CRED controls, and perform periodic monitoring of hemoglobin control. (AU)