SARS-CoV-2 seroprevalence in the city of Puerto Madryn: Underdiagnosis and relevance of children in the pandemic.

BACKGROUND: Reported cases of COVID-19 may be underestimated due to mild or asymptomatic cases and a low testing rate in the general population. RESEARCH QUESTION: What is the seroprevalence of SARS-CoV-2 infection in the general population and how it compares with the data on SARS-CoV-2 cases reported by a national health surveillance system (SNVS 2.0). STUDY DESIGN AND METHODS: This was a population-based, seroepidemiological, cross-sectional study in the city of Puerto Madryn, a middle size city in the Province of Chubut, Argentina. The study period was between March 3 and April 17, 2021. The sample size was calculated using the technique of calculation of confidence intervals for a proportion. Participants were selected using stratified and cluster probability sampling. A total of 1405 subjects were invited to participate in the study. Participants were divided into the following four age groups: 1) 0 to 14, 2) 15 to 39, 3) 40 to 64, and 4) 65 or older. After informed consent was obtained, a blood sample was taken by puncture of the fingertip, and a structured questionnaire was administered to evaluate demographics, socioeconomic status, level of education, comorbidities and symptoms suggestive of COVID-19. COVID-19 seroprevalence was documented using an immunoenzymatic test for the in vitro detection of IgG antibodies specific to the spike protein of SARS-CoV-2. RESULTS: A total of 987 participants completed the survey. Seropositivity in the full study population was 39,2% and in those under 15 years of age, 47.1%. Cases reported by the SNSV 2.0 amounted to 9.35% of the total population and 1.4% of those under 15 years of age. INTERPRETATION: The prevalence of COVID-19 infection in the general population is four times higher than the number of cases reported by the SNVS 2.0 in the city of Puerto Madryn. For each child under the age of 15 identified by the SNVS 2.0 with COVID-19, there are more than 30 unrecognized infections. Seroepidemiological studies are important to define the real extent of SARS-CoV-2 infection in a particular community. Children may play a significant role in the progression of the current pandemic.

Acceso y adherencia a la atención en patologías crónicas, atenciones pediátricas y embarazos, en Aislamiento Social Preventivo y Obligatorio / Access and adherence to care in chronic pathologies, pediatric care and pregnancies, in Preventive and Compulsory Social Isolation

La pandemia por el virus COVID-19 motivó a Argentina a adoptar medidas preventivas, enmarcadas en el Aislamiento Preventivo, Social y Obligatorio. El primer nivel de atención de salud se vio obligado a readaptarse para evitar la propagación de la enfermedad y proteger a grupos de riesgo como embarazadas, niños y pacientes con enfermedades crónicas, pero el impacto de esta medida de prevención en la atención primaria de la salud es aún desconocido en nuestro medio. El presente estudio pretende evaluar el acceso y adherencia a la atención adecuada de embarazadas, menores de 5 años y personas con Diabetes, Tuberculosis o Hipertensión en contexto de Aislamiento Social Preventivo y Obligatorio y sus factores asociados, en las ciudades de Santa Fe, Reconquista y Villa María. Se llevó a cabo un estudio transversal de una muestra proporcional de Centros de Atención Primaria de cada ciudad incluida en el estudio. Se utilizó fuentes secundarias de información de sistemas de vigilancia online y los registros digitales o papel de cada centro de atención. Variables seleccionadas referentes al acceso y adherencia a la atención fueron evaluadas en dos periodos; antes y durante el Aislamiento Preventivo Social y Obligatorio. Se realizó un análisis inferencial, comparando la media a través del test de las permutaciones y proporciones a través del test de Fisher. Finalmente se realizó un análisis multivariado de reducción de dimensiones mediante el método de componentes principales para variables cuantitativas y se agruparon los centros de salud con características similares