RESUMEN
BACKGROUND: Initial publications of COVID-19 (2019 coronavirus disease) focused on the adult population until March 2020, when the first series in children was reported. Our objective was to analyze the spatiotemporal behavior of the pediatric population with COVID-19 in the state of Jalisco. METHODS: We conducted a cross-sectional study including subjects < 18 years of age with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection confirmed by reverse transcription-polymerase chain reaction, registered in the RADAR platform. We investigated the prevalence, incidence rate, age, sex, outpatient or inpatient status, distribution of cases by time, municipality of residence, and geographical region. Descriptive statistics were used for data analysis. RESULTS: Of 58,231 subjects studied, 1,515 were children (3%): 768 males (51%) and 747 females (49%). The mean age was 12 ± 5 years; outpatients predominated (94%). The Central region concentrated the largest cases with 1,257 (82%) and was the second-highest incidence rate, behind the Occidental Coastal-Mountain region. The most affected municipality was Guadalajara. The distribution of new cases increased proportionally to mobility: after the holiday weekend in May, it rose from 28 to 161 cases; after the opening of beaches and recreational sites in June and July, to 539; and after the opening of movie theaters in August, to 673 cases. CONCLUSIONS: Although with a lower incidence, the pediatric population is not exempt from SARS-CoV-2 infection. We observed an increase in cases as restrictions on social activities diminished.
INTRODUCCIÓN: Las publicaciones iniciales de COVID-19 (enfermedad por coronavirus de 2019) se enfocaron en población adulta, hasta marzo de 2020, cuando se informó la primera serie en niños. Nuestro objetivo fue analizar el comportamiento espacio-temporal de la población pediátrica con COVID-19 en el estado de Jalisco. MÉTODOS: Se llevó a cabo un estudio transversal en el que se incluyeron sujetos < 18 años con infección por SARS-CoV-2 (coronavirus tipo 2 del síndrome respiratorio agudo grave) confirmada por reacción en cadena de la polimerasa con retrotranscriptasa, registrados en la plataforma RADAR. Se investigó la prevalencia, tasa de incidencia, edad, sexo, paciente ambulatorio u hospitalizado, distribución de casos por tiempo, municipio de residencia y región geográfica. Se utilizó estadística descriptiva para el análisis de los datos. RESULTADOS: De 58,231 sujetos estudiados, se encontraron 1,515 pacientes pediátricos (3%): 768 de sexo masculino (51%) y 747 de sexo femenino (49%). La media de edad fue de 12 ± 5 años; predominaron los pacientes ambulatorios (94%). La región Centro concentró la mayor cantidad de casos con 1,257 (82%) y fue la segunda con mayor tasa de incidencia, detrás de la región Costa-Sierra Occidental. El municipio más afectado fue Guadalajara. La distribución de nuevos casos incrementó al aumentar la movilidad: después del puente vacacional de mayo subió de 28 a 161 casos; tras la apertura de playas y sitios de recreación en junio y julio, a 539 casos, y posterior a la apertura de cines en agosto, a 673 casos. CONCLUSIONES: Aunque con una incidencia menor, la población pediátrica no está exenta de la infección por SARS-CoV-2. Se observó un incremento de los casos a medida que disminuyeron las restricciones para las actividades sociales.
Asunto(s)
COVID-19 , Adolescente , Adulto , COVID-19/epidemiología , Niño , Estudios Transversales , Femenino , Humanos , Incidencia , Masculino , SARS-CoV-2 , Análisis Espacio-TemporalRESUMEN
BACKGROUND: Acute leukemia is the most common cancer in childhood. Analyzing the spatial distribution of acute leukemia may generate the identification of risk factors. OBJECTIVE: To study the incidence rate of acute leukemia, its geographic distribution, and cluster detection in the metropolitan area of Guadalajara, Mexico. METHODS: We included children under 15 years of age diagnosed with acute leukemia during the period 2010-2014 in the metropolitan area of Guadalajara. Each case was geo-referenced to street level to latitude and longitude coordinates using Quantum Geographic Information System (QGIS). Spatial clusters were found in the location of the acute leukemia cases applying the Density-Based Spatial Clustering of Applications with Noise (DBSCAN) algorithm with R statistical software. RESULTS: A total of 269 cases of leukemia were registered, 227 (84%) were acute lymphoblastic leukemia and 42 (16%) acute myeloblastic leukemia. The mean age was 6 ± 4 years. The mean incidence of acute leukemia was 6.44 cases/100,000 inhabitants: El Salto 10.12/100,000, Guadalajara 7.55/100,000, and Tlaquepaque 6.74/100,000. The DBSCAN found three clusters, all located within the municipality of Guadalajara. CONCLUSIONS: The incidence of acute leukemia in our population is higher than that in Canada and the USA. We found three spatial clusters of childhood acute lymphoblastic leukemia in the municipality of Guadalajara, suggesting the presence of local predisposing factors.
