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1.
Artículo en Inglés | MEDLINE | ID: mdl-34064780

RESUMEN

Due to the COVID-19 global pandemic, guidelines for people's confinement have been implemented to prevent the disease's spread. As a result of this, companies have implemented teleworking as an emerging way to work from home using information technology. This cross-sectional study was conducted in Ecuador, with a sample of 204 teleworkers in the city of Quito. The results show that the teleworkers rearranged their bedrooms to carry out their activities. The respondents in each age group stated they did not perceive more significant ailments than those experienced before beginning teleworking. The relationships between the variables were analyzed utilizing the Chi-Square test and Fisher's exact test, finding a relationship between neck ailments and age of p = 0.031 * and between arm/forearm ailments of p = 0.032 *. This study contributes to a greater understanding of the ergonomic situation of the teleworkers and provides us with information to mitigate the ergonomic risks to which they are exposed.


Asunto(s)
COVID-19 , Teletrabajo , Estudios Transversales , Ecuador/epidemiología , Ergonomía , Humanos , Pandemias , Factores de Riesgo , SARS-CoV-2
2.
Artículo en Inglés | MEDLINE | ID: mdl-34067018

RESUMEN

Increased consumption of energy-dense, nutrient-poor foods can lead to inadequate intakes of shortfall nutrients, including vitamin A, D, C, and E, dietary folate, calcium, iron, magnesium, potassium, and fiber. The objective was to examine the prevalence of inadequate intake of shortfall nutrients and identify food sources of shortfall nutrients in eight Latin American countries. Data from ELANS, a multi-country, population-based study of 9218 adolescents and adults were used. Dietary intake was collected through two 24 h Recalls from participants living in urban areas of Argentina, Brazil, Chile, Colombia, Ecuador, Peru, and Venezuela. Foods and beverages were classified using the adapted version of the NHANES "What We Eat in America" system. Nutrients inadequacy was estimated using the Institute of Medicine recommendations and descriptive statistics were calculated. Prevalence of inadequacy was above 50% for most of the nutrients, which the exception of vitamin C with a prevalence of inadequacy of 39%. Milk, cheese, seafoods, breads, and fruit juices/drinks were among the top 5 sources for each of the 10 shortfall nutrients examined. Many food categories were top contributors to more than one dietary component examined. Understanding the nutrient intake and food sources can help inform dietary guidance and intervention approaches.


Asunto(s)
Dieta , Estado Nutricional , Adolescente , Adulto , Argentina/epidemiología , Brasil , Chile , Colombia , Ecuador/epidemiología , Ingestión de Energía , Humanos , América Latina/epidemiología , Encuestas Nutricionales , Perú , Venezuela , Vitaminas
3.
Vasc Health Risk Manag ; 17: 195-202, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33976550

RESUMEN

Background: This study aimed to determine the prevalence and correlates of self-reported cardiovascular diseases (SRCVDs) among adults in Ecuador. Methods: National cross-sectional survey data of 4638 persons aged 18-69 years in Ecuador were analysed. Research data were collected with an interview-administered questionnaire, physical and biochemical measurements. Results: The prevalence of SRCVDs was 8.7%, 8.5% among men and 8.9% among women. In adjusted logistic regression analysis, being Montubio (adjusted odds ratio-AOR: 1.66, 95% confidence interval-CI: 1.10-2.50), family alcohol problems (AOR: 1.78, 95% CI: 1.19-2.65), past smoking tobacco (AOR: 1.36, 95% CI: 1.02-1.81), and poor oral health status (AOR: 1.74, 95% CI: 1.19-2.54) were associated with SRCVD. In addition, in unadjusted analysis, older age, alcohol dependence, obesity, and having hypertension were associated with SRCVD. Conclusion: Almost one in ten persons aged 18-69 years had SRCVD in Ecuador. Several associated factors, including Montubio by ethnicity, family alcohol problems, past smoking, and poor oral health status, were identified, which can be targeted in public health interventions.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Estilo de Vida , Autoinforme , Adolescente , Adulto , Anciano , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Enfermedades Cardiovasculares/diagnóstico , Estudios Transversales , Ecuador/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Salud Bucal , Prevalencia , Medición de Riesgo , Factores de Riesgo , Fumar/efectos adversos , Fumar/epidemiología , Factores de Tiempo , Adulto Joven
4.
PLoS One ; 16(5): e0251295, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33999930

RESUMEN

The World Health Organization (WHO) declared coronavirus disease-2019 (COVID-19) a global pandemic on 11 March 2020. In Ecuador, the first case of COVID-19 was recorded on 29 February 2020. Despite efforts to control its spread, SARS-CoV-2 overran the Ecuadorian public health system, which became one of the most affected in Latin America on 24 April 2020. The Hospital General del Sur de Quito (HGSQ) had to transition from a general to a specific COVID-19 health center in a short period of time to fulfill the health demand from patients with respiratory afflictions. Here, we summarized the implementations applied in the HGSQ to become a COVID-19 exclusive hospital, including the rearrangement of hospital rooms and a triage strategy based on a severity score calculated through an artificial intelligence (AI)-assisted chest computed tomography (CT). Moreover, we present clinical, epidemiological, and laboratory data from 75 laboratory tested COVID-19 patients, which represent the first outbreak of Quito city. The majority of patients were male with a median age of 50 years. We found differences in laboratory parameters between intensive care unit (ICU) and non-ICU cases considering C-reactive protein, lactate dehydrogenase, and lymphocytes. Sensitivity and specificity of the AI-assisted chest CT were 21.4% and 66.7%, respectively, when considering a score >70%; regardless, this system became a cornerstone of hospital triage due to the lack of RT-PCR testing and timely results. If health workers act as vectors of SARS-CoV-2 at their domiciles, they can seed outbreaks that might put 1,879,047 people at risk of infection within 15 km around the hospital. Despite our limited sample size, the information presented can be used as a local example that might aid future responses in low and middle-income countries facing respiratory transmitted epidemics.


Asunto(s)
COVID-19/diagnóstico por imagen , COVID-19/epidemiología , Hospitales Especializados/organización & administración , Hospitales Especializados/tendencias , Pandemias/prevención & control , SARS-CoV-2/genética , Triaje/métodos , Adulto , Anciano , Inteligencia Artificial , COVID-19/prevención & control , COVID-19/virología , Prueba de Ácido Nucleico para COVID-19 , Ecuador/epidemiología , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Radiografías Pulmonares Masivas/métodos , Persona de Mediana Edad , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Factores de Riesgo , Tomografía Computarizada por Rayos X/métodos
5.
J Stroke Cerebrovasc Dis ; 30(6): 105778, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33836465

RESUMEN

BACKGROUND: Oily fish is a major dietary source of omega-3 polyunsaturated fatty acids and other nutrients that may reduce the expression of cerebral small vessel disease (cSVD) biomarkers, including white matter hyperintensities (WMH) of presumed vascular origin. However, information on this relationship is limited. We aimed to assess the association between oily fish intake and WMH severity in a population of frequent fish consumers. METHODS: The study included 572 individuals aged ≥60 years living in three neighboring rural villages of coastal Ecuador. Dietary oily fish intake was calculated and all participants received a brain MRI. Logistic regression models, adjusted for demographics, level of education, cardiovascular risk factors and other cSVD biomarkers, were fitted to assess the independent association between amounts of oily fish intake and WMH severity. RESULTS: Overall, the mean intake of oily fish was 8.5 ± 4.7 servings per week, and 164 individuals (29%) had moderate-to-severe WMH (according to the modified Fazekas scale). A multivariate logistic regression model disclosed a significant inverse association between the amount of oily fish intake and the presence of moderate-to-severe WMH (OR: 0.89; 95% C.I.: 0.85-0.94; p < 0.001). Predictive margins revealed an almost linear inverse relationship between quartiles of oily fish intake and probabilities of WMH severity, which became significant when the 1st quartile was compared with the 3rd and 4th quartiles. CONCLUSIONS: Increased amounts of oily fish intake are inversely associated with WMH severity. Further studies are warranted to determine whether oily fish intake reduces the risk of cSVD-related cerebrovascular complications.


Asunto(s)
Dieta Saludable/etnología , Aceites de Pescado/administración & dosificación , Indios Sudamericanos , Leucoencefalopatías/prevención & control , Valor Nutritivo , Alimentos Marinos , Anciano , Anciano de 80 o más Años , Estudios Transversales , Ecuador/epidemiología , Femenino , Humanos , Leucoencefalopatías/diagnóstico por imagen , Leucoencefalopatías/etnología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Factores Protectores , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad
6.
PLoS One ; 16(4): e0250171, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33857226

RESUMEN

Effective and rapid decision making during a pandemic requires data not only about infections, but also about human behavior. Mobile phone surveys (MPS) offer the opportunity to collect real-time data on behavior, exposure, knowledge, and perception, as well as care and treatment to inform decision making. The surveys aimed to collect coronavirus disease 2019 (COVID-19) related information in Ecuador and Sri Lanka using mobile phones. In Ecuador, a Knowledge, Attitudes and Practices (KAP) survey was conducted. In Sri Lanka, an evaluation of a novel medicine delivery system was conducted. Using the established mobile network operator channels and technical assistance provided through The Bloomberg Philanthropies Data for Health Initiative (D4H), Ministries of Health fielded a population-based COVID-19-specific MPS using Surveda, the open source data collection tool developed as part of the initiative. A total of 1,185 adults in Ecuador completed the MPS in 14 days. A total of 5,001 adults over the age of 35 in Sri Lanka completed the MPS in 44 days. Both samples were adjusted to the 2019 United Nations Population Estimates to produce population-based estimates by age and sex. The Ecuador COVID-19 MPS found that there was compliance with the mitigation strategies implemented in that country. Overall, 96.5% of Ecuadorians reported wearing a face mask or face covering when leaving home. Overall, 3.8% of Sri Lankans used the service to receive medicines from a government clinic. Among those who used the medicine delivery service in Sri Lanka, 95.8% of those who used a private pharmacy received their medications within one week, and 69.9% of those using a government clinic reported the same. These studies demonstrate that MPS can be conducted quickly and gather essential data. MPS can help monitor the impact of interventions and programs, and rapidly identify what works in mitigating the impact of COVID-19.


Asunto(s)
COVID-19/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Adolescente , Adulto , Teléfono Celular , Ecuador/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , SARS-CoV-2/aislamiento & purificación , Sri Lanka/epidemiología , Encuestas y Cuestionarios , Adulto Joven
7.
BMC Psychiatry ; 21(1): 212, 2021 04 28.
Artículo en Inglés | MEDLINE | ID: mdl-33910550

RESUMEN

BACKGROUND: Coronavirus disease 2019 (COVID-19) has become a global pandemic with serious consequences that have led to the implementation of unprecedented social isolation measures. At the early stages of the pandemic, Ecuador was one of the most affected countries in Latin America. The objective of this study was to assess the levels of depression, anxiety and stress in the Ecuadorian general population during the social isolation period due to COVID-19. METHODS: A web-based survey consisting of 31 short-answer and multiple-choice questions was administered to the general population from April 22-May 3, 2020. Mental health status was assessed through the Depression, Anxiety and Stress Scale-21 Items (DASS-21) questionnaire. Ordinal logistic analyses were used to identify potential risk factors associated with the severity of mental health issues. RESULTS: A total of 626 individuals were included. Most of them were females (60.5%), and their mean age was 29.6 ± 11.7 years. Approximately 17.7% of the respondents had moderate to very severe levels of depression, 30.7% had similar levels of anxiety, and 14.2% experienced stress. Female sex, younger age, student status, and having a relative diagnosed with COVID-19 were associated with significantly higher levels of depression, anxiety and stress. Ordinal regression models showed that being a student was a risk factor for having more severe levels of depression (OR = 3.67; 95% CI = 2.56-5.26, p: 0.0001), anxiety (OR= 1.86; 95% CI= 1.35-2.55, p: 0.0001), and stress (OR = 2.17; 95% CI= 1.47-3.19, p: 0.0001). Having a relative with COVID-19 was also found to be a risk factor only for depression (OR= 1.70; 95% CI= 1.03-2.80, p: 0.036) and anxiety (OR = 2.17; 95% CI= 1.35-3.47, p: 0.001). Additionally, male sex,  older age, and having more children were found to be protective factors for the three conditions. CONCLUSIONS: Our findings suggest that social isolation due to the COVID-19 outbreak has impacted the mental health of the general population in Ecuador. We identified potential risk and protective factors that could serve as a foundation from which to develop psychological strategies to safeguard the mental health of our population during the current pandemic.


Asunto(s)
COVID-19 , Depresión , Adolescente , Adulto , Anciano , Ansiedad/epidemiología , Niño , Estudios Transversales , Depresión/epidemiología , Brotes de Enfermedades , Ecuador/epidemiología , Femenino , Humanos , Masculino , SARS-CoV-2 , Aislamiento Social , Estrés Psicológico/epidemiología , Encuestas y Cuestionarios , Adulto Joven
8.
Artículo en Inglés | MEDLINE | ID: mdl-33925680

RESUMEN

A door-to-door survey was organised in Cuenca, Ecuador, to determine the prevalence of COVID-19 infection and adherence of the population to COVID-19 preventive measures. A total of 2457 persons participated in the study; 584 (23.7%) reported having experienced at least one flu-like symptom since the onset of the pandemic. The maximum SARS-CoV-2 seroprevalence in Cuenca was 13.2% (CI: 12-14.6%) (IgM or IgG positive). Considering PCR confirmed infections, the prevalence was 11% (CI: 10-12.4%). There was no significant difference in seroprevalence between rural and urban areas. Participants aged 35-49 years old, living with a COVID-19 positive person, at least six people in a household, physical contact with someone outside the household, a contact with a person outside the home with flu-like symptoms, using public transport, and not having enough resources for living, significantly increased the odds for SARS-CoV-2 seropositivity. Overall, there was good adherence to COVID-19 preventive measures. Having known someone who tested positive for COVID-19, having a primary or secondary level of education, and having enough resources for living, significantly increased the odds for higher adherence. In conclusion, despite good overall adherence of the population of Cuenca with COVID-19 preventive measures, our study suggests high ongoing COVID-19 transmission in Cuenca, particularly in certain parishes. Prevention should not only focus on behavioural change, but on intensified testing strategies in demographical risk groups.


Asunto(s)
COVID-19 , SARS-CoV-2 , Adulto , Estudios Transversales , Ecuador/epidemiología , Humanos , Persona de Mediana Edad , Estudios Seroepidemiológicos
9.
Aten Primaria ; 53(5): 102021, 2021 May.
Artículo en Español | MEDLINE | ID: mdl-33887602

RESUMEN

OBJECTIVE: The present study seeks to analyse sociodemographic determinants related to severe acute respiratory infections (SARI) and calculate the priorization index in the cantons of Ecuador to identify areas probably most vulnerable to COVID-19 transmission. DESIGN: This descriptive ecological observational study. SETTING: 224 cantons (geographical area) of Ecuador with secondary data sources of hospital information. PARTICIPANTS: The unit of measurement was 224 cantons of Ecuador, in which analysed morbidity and lethality rates for SARI using hospital release data (2016-2018). MAIN MEASUREMENTS: Eight sociodemographic indicators were structuralized, and correlation tests applied for a multiple regression model. The priorization index was created with criteria of efficiency, efficacy, effect size (IRR) and equity. Using the sum of the index for each indicator, the priorization score was calculated and localized in a territorial map. RESULTS: Morbidity associated factors where: school attendance years, urbanization and population density; for mortality resulted: school attendance and ethnics (indigenous) IRR: 1.09 (IC95%:1.06-1.15) and IRR: 1.024 (IC95%:102-1.03) respectively. With lethality where related cantons, with population older than 60 years, IRR: 1.049 (IC95%: 1.03-1.07); 87 cantons had high priority mostly localized in the mountain region and the Morona Santiago Province. CONCLUSIONS: Morbidity and mortality of SARI in Ecuador are associated to social and demographic factors. Priorization exercises considering these factors permit the identification of vulnerable territories facing respiratory disease propagation. The social determinants characteristic for each territory should be added to known individual factors to analyse the risk and vulnerability for COVID in the population.


Asunto(s)
COVID-19/etiología , COVID-19/prevención & control , Determinantes Sociales de la Salud , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/epidemiología , COVID-19/transmisión , Niño , Preescolar , Ecuador/epidemiología , Ambiente , Femenino , Mapeo Geográfico , Humanos , Lactante , Recién Nacido , Gripe Humana/epidemiología , Gripe Humana/etiología , Gripe Humana/prevención & control , Gripe Humana/transmisión , Masculino , Persona de Mediana Edad , Pandemias , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores Socioeconómicos , Poblaciones Vulnerables , Adulto Joven
10.
Artículo en Inglés | MEDLINE | ID: mdl-33807140

RESUMEN

Confinement due to COVID-19 has brought important changes in people's lives as well as in their eating and resting habits. In this study we aimed at exploring the eating habits and sleep quality of the adult population of Ecuador during the mandatory confinement due to the COVID-19 pandemic. This is a cross-sectional study, which used an online survey that included questions about eating habits and sleeping habits in adults (n = 9522) between 18-69 years old. The Pittsburg sleep quality questionnaire validated for the Hispanic population was used, and questions about dietary habits. The statistical test Chi-square statistical test was used to analyze the data. The results show that sleep quality differs according to sex, being worse in women, both in all components of sleep quality and in the total score (p < 0.001). Women had greater changes in the habitual consumption of food compared to men (24.24% vs. 22.53%), and people between 18 and 40 years of age decreased their food consumption in relation to people >40 years (24.06% vs. 17.73%). Our results indicate that mandatory confinement due to the COVID-19 pandemic in Ecuador has generated changes in the eating habits and sleep quality in the adult population sampled, and these changes are more noticeable in women and young adults. These changes offer an important alert for the health system and further, advice for the implementation of future public health policies.


Asunto(s)
COVID-19 , Pandemias , Adolescente , Adulto , Anciano , Estudios Transversales , Ecuador/epidemiología , Conducta Alimentaria , Femenino , Humanos , Masculino , Persona de Mediana Edad , SARS-CoV-2 , Sueño , Encuestas y Cuestionarios , Adulto Joven
11.
BMC Public Health ; 21(1): 637, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33794837

RESUMEN

BACKGROUND: Testing is crucial for COVID-19 response and management, however, WHO's preparedness index omits estimations of actual testing capabilities, which influence the ability to contain, mitigate and clinically manage infectious diseases. With one of the highest excess death rates globally, Ecuador had a comparatively low number of confirmed COVID-19 cases, which may have been influenced by limited availability of data for decision-making due to low laboratory capacity. METHODS: We examine de-identified data on 55,063 individuals with suspected COVID-19 between February 27 and April 30, 2020 included in the RT-PCR testing database collected by the Ministry of Health. Processing times and rates per province, and the number of pending tests, were tallied cumulatively. We assessed the relationship between sample shipping, laboratory capacity and case completion using a negative binomial generalized linear model. RESULTS: The national average time for case completion was 3 days; 12.1% of samples took ≥10 days to complete; the national average daily backlog was 29.1 tests per 100,000 people. Only 8 out of 24 provinces had authorized COVID-19 processing laboratories but not all processed samples. There was an association between samples coming from outside the processing laboratory province, the number of other samples present at the laboratory during processing, and the amount of time needed to process a sample. Samples from another province took 1.29 times as long to process, on average. The percentage of pending results on April 30 was 67.1%. CONCLUSION: A centralized RT-PCR testing system contributes to critical delays in processing, which may mask a case burden higher than reported, impeding timely awareness, and adequate clinical care and vaccination strategies and subsequent monitoring. Although Ecuador adapted or authorized existing facilities to address limitations in laboratory capacity for COVID-19, this study highlights the need to estimate and augment laboratory capabilities for improved decision making and policies on diagnostic guidelines and availability. Support is needed to procure the necessary human and physical resources at all phases of diagnostic testing, including transportation of samples and supplies, and information management. Strengthening emergency preparedness enables a clear understanding of COVID-19 disparities within and across the country.


Asunto(s)
Prueba de Ácido Nucleico para COVID-19 , COVID-19/diagnóstico , ARN Viral/aislamiento & purificación , SARS-CoV-2/aislamiento & purificación , COVID-19/genética , Ecuador/epidemiología , Política de Salud , Humanos , ARN Viral/genética , SARS-CoV-2/genética
12.
Artículo en Inglés | MEDLINE | ID: mdl-33668717

RESUMEN

The aim of the present cross-sectional study was to analyze the differential impact of the first COVID-19 lockdown (3 April 2020) on stress, health practices, and self-care activities across different Hispanic countries, age range, and gender groups. One thousand and eighty-two participants from Spain, Chile, Colombia, and Ecuador took part in this study. Irrespective of the country, and controlling for income level, young people, especially females, suffered a greater level of stress, perceived the situation as more severe, showed less adherence to health guidelines, and reported lower levels of health consciousness, in comparison to their male peers and older groups. However, in the case of self-care, it seems that older and female groups are generally more involved in self-care activities and adopt more healthy daily routines. These results are mostly similar between Colombia, Ecuador, and Spain. However, Chile showed some different tendencies, as males reported higher levels of healthy daily routines and better adherence to health guidelines compared to females and people over the age of 60. Differences between countries, genders, and age ranges should be considered in order to improve health recommendations and adherence to guidelines. Moreover, developing community action and intersectoral strategies with a gender-based approach could help to reduce health inequalities and increase the success of people's adherence to health guidelines and self-care-promoting interventions. Future studies should be addressed to explore the possible causations of such differences in more cultural-distant samples and at later stages of the current outbreak.


Asunto(s)
COVID-19/psicología , Conductas Relacionadas con la Salud , Autocuidado , Estrés Psicológico/epidemiología , Chile/epidemiología , Colombia/epidemiología , Control de Enfermedades Transmisibles , Estudios Transversales , Ecuador/epidemiología , Femenino , Humanos , Masculino , España/epidemiología
13.
BMC Med Educ ; 21(1): 128, 2021 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-33627116

RESUMEN

BACKGROUND: As the disease caused by the novel coronavirus has spread globally, there has been significant economic instability in the healthcare systems. This reality was especially accentuated in Ecuador where, the shortage of healthcare workers combined with cultural and macroeconomic factors has led Ecuador to face the most aggressive outbreak in Latin America. In this context, the participation of final-year medical students on the front line is indispensable. Appropriate training on COVID-19 is an urgent requirement that universities and health systems must guarantee. We aimed to describe the knowledge, attitudes, and practices of Ecuadorian final-year medical students that could potentially guide the design of better medical education curricula regarding COVID-19. METHODS: This was a cross-sectional 33-item online survey conducted between April 6 to April 2020 assessing the knowledge, attitudes, and practices toward the diagnosis, treatment, prevention, and prognosis toward COVID-19 in Ecuadorian final-year medical students. It was sent by email, Facebook, and WhatsApp. RESULTS: A total of 309 students responded to the survey. Out of which 88% of students scored high (≥ 70% correct) for knowledge of the disease. The majority of students were pessimistic about possible government actions, which is reflected in the negative attitude towards the control of COVID-19 and volunteering during the outbreak in Ecuador (77%, and 58% of the students, respectively). Moreover, 91% of students said they did not have adequate protective equipment. The latter finding was significantly associated with negative attitudes. CONCLUSIONS: Although a large number of students displayed negative attitudes, the non-depreciable percentage of students who were willing to volunteer and the coexisting high level of knowledge displayed by students, suggests that Ecuador has a capable upcoming workforce that could benefit from an opportunity to strengthen, improve and advance their training in preparation for COVID-19. Not having personal protective equipment was significantly associated to negative attitudes. Providing the necessary tools and creating a national curriculum may be one of the most effective ways to ensure all students are trained, whilst simultaneously focusing on the students' most pressing concerns. With this additional training, negative attitudes will improve and students will be better qualified.


Asunto(s)
COVID-19/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Pandemias , SARS-CoV-2 , Estudiantes de Medicina/psicología , Adulto , Actitud del Personal de Salud , COVID-19/diagnóstico , COVID-19/terapia , Estudios Transversales , Ecuador/epidemiología , Femenino , Encuestas de Atención de la Salud/estadística & datos numéricos , Humanos , Masculino , Equipo de Protección Personal/estadística & datos numéricos , Pronóstico , Estudiantes de Medicina/estadística & datos numéricos , Voluntarios/estadística & datos numéricos , Adulto Joven
14.
Washington; Organización Panamericana de la Salud; feb. 24, 2021. 32 p.
No convencional en Español | LILACS | ID: biblio-1151147

RESUMEN

El 11 de marzo de 2020, el Director General de la Organización Mundial de la Salud (OMS) declaró al COVID-19 como pandemia. En este contexto, la o¬cina de la OPS en Ecuador coordinó sus actividades con el Ministerio de Salud Pública (MSP) a ¬n de desarrollar el plan estratégico de preparación y respuesta al COVID-19 a nivel nacional, basado en los 9 pilares propuestos por la OMS. El plan tuvo un gran énfasis en la intervención en aquellas zonas de difícil acceso geográ¬co, como lo es la Amazonía ecuatoriana y que además se conforman de población indígena y montubia, ya que estos grupos/pueblos son considerados vulnerables y han sido priorizados por el gobierno nacional, respaldando con ello la promesa de "no dejar a nadie atrás". Es importante tomar en cuenta que el Ecuador es un país con una amplia diversidad cultural, conformada por 14 nacionalidades y 18 pueblos, los cuales se encuentran distribuidos en diferentes áreas geográ¬cas del país. En la región amazónica, estas comunidades se ubican en las provincias de Sucumbíos, Orellana, Pastaza, Napo, Morona Santiago, Zamora Chinchipe; y en el norte y en la región andina central del altiplano, en las provincias de Imbabura, Cotopaxi, Tungurahua, Bolívar, Chimborazo y Cañar. En muchos casos el ingreso a estas comunidades debe realizarse por vía uvial o aérea, lo que, entre otras realidades socioeconómicas, di¬culta la posibilidad de recibir atención primaria de salud, hecho que representó un mayor desafío para la ejecución de actividades de respuesta a emergencias. Adicionalmente, muchas de las comunidades indígenas decidieron realizar un aislamiento comunitario, prohibiendo la salida de sus ciudadanos y la entrada de personas ajenas a la comunidad, para evitar la propagación del COVID-19 en sus territorios. Una estrategia de respuesta con la mirada en los más vulnerables A la par de esta situación, como acción ante la emergencia, el gobierno ecuatoriano declaró un estado de excepción que restringió la movilidad humana y -si bien dentro del plan de respuesta al COVID-19 se encuentran acciones clave en los 9 pilares- las primeras actividades se enfocaron en el objetivo de salvar vidas, especialmente en las áreas urbanas donde hubo los picos más altos de contagio. Esto llevó a la concentración de recursos humanos, ¬nancieros y físicos a nivel hospitalario en las grandes ciudades, al inicio de la pandemia. Además, las medidas implementadas por el gobierno, contribuyeron de manera colateral a la interrupción de los servicios de salud esenciales en la mayor parte del territorio nacional. A pesar de ser este problema de índole nacional, los desafíos en las provincias con mayor concentración de población indígena fueron más importantes. Estas realidades requirieron la promoción de un trabajo coordinado con la participación activa de los líderes de estas comunidades a ¬n de de-nir acciones que pudieran ser efectivas para prevenir la enfermedad y el cuidado de las personas infectadas al mismo tiempo, respetando el contexto cultural y la cosmovisión indígena. Este boletín resume las actividades más importantes ejecutadas de agosto a diciembre del 2020 en cada una de las provincias priorizadas y enmarcadas en las recomendaciones del "Plan estratégico de preparación y respuesta para la enfermedad por coronavirus 2019 (COVID-19)", de acuerdo con los pilares 1, 2, 3, 5, 6, 7, y 9. Y comprende, principalmente, el apoyo en el análisis de la data en el contexto de la pandemia, la gestión de apoyo técnico para la revisión de estrategias de respuesta, la identi¬cación de necesidades para dotación de insumos y dispositivos médicos, el acompañamiento en el uso de herramientas OPS/OMS y la capacitación a equipos técnicos y operativos, entre otras


Asunto(s)
Humanos , Neumonía Viral/prevención & control , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Monitoreo Epidemiológico , Pueblos Indígenas , Ecuador/epidemiología
15.
Nat Commun ; 12(1): 1233, 2021 02 23.
Artículo en Inglés | MEDLINE | ID: mdl-33623008

RESUMEN

Climate drives population dynamics through multiple mechanisms, which can lead to seemingly context-dependent effects of climate on natural populations. For climate-sensitive diseases, such as dengue, chikungunya, and Zika, climate appears to have opposing effects in different contexts. Here we show that a model, parameterized with laboratory measured climate-driven mosquito physiology, captures three key epidemic characteristics across ecologically and culturally distinct settings in Ecuador and Kenya: the number, timing, and duration of outbreaks. The model generates a range of disease dynamics consistent with observed Aedes aegypti abundances and laboratory-confirmed arboviral incidence with variable accuracy (28-85% for vectors, 44-88% for incidence). The model predicted vector dynamics better in sites with a smaller proportion of young children in the population, lower mean temperature, and homes with piped water and made of cement. Models with limited calibration that robustly capture climate-virus relationships can help guide intervention efforts and climate change disease projections.


Asunto(s)
Cambio Climático , Geografía , Enfermedades Transmitidas por Vectores/epidemiología , Enfermedades Transmitidas por Vectores/transmisión , Animales , Número Básico de Reproducción , Culicidae/fisiología , Brotes de Enfermedades , Ecuador/epidemiología , Humanos , Kenia/epidemiología , Modelos Biológicos , Dinámicas no Lineales , Factores Socioeconómicos , Análisis Espacio-Temporal , Factores de Tiempo
16.
Artículo en Inglés | MEDLINE | ID: mdl-33578745

RESUMEN

Several public health measures have been implemented to contain the SARS-CoV-2 outbreak. The adherence to control measures is known to be influenced by people's knowledge, attitudes and practices with regard to the disease. This study aimed at assessing COVID-19 knowledge in individuals who were tested for the virus. An online cross-sectional survey of 32 items, adapted to the national context, was conducted among 1656 Ecuadorians. The mean knowledge score was 22.5 ± 3 out of 28, with significant differences being observed with regard to educational attainment. People with postgraduate training scored higher than those with college, secondary and elementary instruction. Indeed, multiple linear regression revealed that lower scores were associated significantly with the latter three levels of education. Interviewees were knowledgeable about the symptoms, detection, transmission and prevention of the disease. However, they were less assertive regarding the characteristics of the virus as well as the usefulness of traditional and unproven treatments. These outcomes indicated a lack of knowledge in fundamental aspects of virus biology, which may limit the effectiveness of further prevention campaigns. Conclusively, educational and communicational programs must place emphasis on explaining the basic molecular characteristics of SARS-CoV-2; such information will certainly contribute to improve the public's adherence to control measures.


Asunto(s)
COVID-19 , Conocimientos, Actitudes y Práctica en Salud , Pandemias , Estudios Transversales , Ecuador/epidemiología , Humanos , Encuestas y Cuestionarios
17.
Int J Infect Dis ; 105: 234-235, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33592341

RESUMEN

Voluntary collective isolation has been proposed to be the best response to COVID-19 for indigenous populations. While the potential value of voluntary collective isolation is appealing, the feasibility of this approach needs empirical evidence to support it as the best response to protect indigenous communities from COVID-19. This paper describes our experience during SARS-CoV-2 surveillance among Waorani communities in the Ecuadorian Amazonian region, from June to September 2020. We found that self-isolation strategies failed to contain the spread of SARS-CoV-2 from main urban areas to remote and isolated comunities.


Asunto(s)
COVID-19/prevención & control , SARS-CoV-2 , Aislamiento Social , COVID-19/diagnóstico , COVID-19/epidemiología , Ecuador/epidemiología , Humanos , Grupos de Población
18.
BMC Pregnancy Childbirth ; 21(1): 116, 2021 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-33563238

RESUMEN

BACKGROUND: In Ecuador eclampsia and preeclampsia were identified as the third cause of maternal death. Like other Latin-American countries, Ecuador has human settlements living from 0 to more than 4000 m of altitude and comprising a wide ethnic-diversity across all these altitude changes. These characteristics offer the possibility to study a wide variety of possible risk factors for preeclampsia and eclampsia. METHODS: We conducted a population-based retrospective study of all deliveries in Ecuador from 2015 through 2017. The main variables analyzed were: altitude, ethnic self-identification, geographic location, and maternal age. The data comes from the Ecuadorian National Institute of Statistics and Census (INEC) and the Ecuadorian Ministry of Health. Data information regarding maternal parity and socioeconomic status was not available from official records. Logistic regression analysis was used to study the relationship between preeclampsia and eclampsia with the variable of interest. Geospatial statistical analysis was done to identify statistically significant spatial clusters of preeclampsia and eclampsia cases. RESULTS: The incidence of preeclampsia was estimated between 5.11 (5.05-5.18) and 6.23 (6.16-6.30), and 0.25 (0.23-0.26) for eclampsia. Native American have a lower incidence regarding preeclampsia compared to other ethnic groups. High altitude has a significant odds ratio (OR = 2.31, 1.93-2.78) of preeclampsia. Montubio residing in middle altitude (1500-3500 m) have the highest risk of preeclampsia (OR = 18.13, 9.53-34.50). Afro-Ecuadorians also have an increased risk of preeclampsia associated with altitude (OR = 2.36, 1.78-3.14). Ethnicity was not identified as a risk factor for eclampsia. Early and older maternal age was associated with an increased risk of preeclampsia and eclampsia. Women living more than 20 km from the obstetric unit have an OR = 2.61 (2.32-2.95, p-value< 0.01) and OR = 1.87 (1.82-1.92, p-value< 0.01) of developing eclampsia and preeclampsia respectively. CONCLUSIONS: Preeclampsia is widespread across low and high-altitude areas, while eclampsia is mostly located at lower altitudes. Montubios living at middle or high altitudes represents the ethnic group with a higher risk of preeclampsia. No ethnic effect was identified as a potential risk factor for eclampsia. Moreover, in eclampsia the associated risk of young women seems to be higher than in preeclampsia.


Asunto(s)
Eclampsia/epidemiología , Preeclampsia/epidemiología , Adolescente , Adulto , Altitud , Niño , Ecuador/epidemiología , Grupos Étnicos , Femenino , Humanos , Incidencia , Edad Materna , Persona de Mediana Edad , Embarazo , Sistema de Registros , Estudios Retrospectivos , Adulto Joven
19.
PLoS Negl Trop Dis ; 15(1): e0008958, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33395425

RESUMEN

The SARS-CoV-2 virus has spread rapidly around the globe. Nevertheless, there is limited information describing the characteristics and outcomes of COVID-19 patients in Latin America. We conducted a cross-sectional analysis of 9,468 confirmed COVID-19 cases reported in Ecuador. We calculated overall incidence, mortality, case fatality rates, disability adjusted life years, attack and crude mortality rates, as well as relative risk and relative odds of death, adjusted for age, sex and presence of comorbidities. A total of 9,468 positive COVID-19 cases and 474 deaths were included in the analysis. Men accounted for 55.4% (n = 5, 247) of cases and women for 44.6% (n = 4, 221). We found the presence of comorbidities, being male and older than 65 years were important determinants of mortality. Coastal regions were most affected by COVID-19, with higher mortality rates than the highlands. Fatigue was reported in 53.2% of the patients, followed by headache (43%), dry cough (41.7%), ageusia (37.1%) and anosmia (36.1%). We present an analysis of the burden of COVID-19 in Ecuador. Our findings show that men are at higher risk of dying from COVID-19 than women, and risk increases with age and the presence of comorbidities. We also found that blue-collar workers and the unemployed are at greater risk of dying. These early observations offer clinical insights for the medical community to help improve patient care and for public health officials to strengthen Ecuador's response to the outbreak.


Asunto(s)
COVID-19/mortalidad , Brotes de Enfermedades , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Costo de Enfermedad , Estudios Transversales , Ecuador/epidemiología , Femenino , Geografía , Humanos , Lactante , Recién Nacido , Modelos Logísticos , Masculino , Persona de Mediana Edad , Ocupaciones , Factores de Riesgo , Distribución por Sexo , Clase Social , Evaluación de Síntomas , Desempleo , Adulto Joven
20.
BMC Cancer ; 21(1): 42, 2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33419403

RESUMEN

BACKGROUND: In contrast to the rapid increase in thyroid cancer incidence, the mortality has remained low and stable over the last decades. In Ecuador, however, thyroid cancer mortality has increased. The objective of this study is to determine possible drivers of high rates of thyroid cancer mortality, through a cross-sectional analysis of all patients attending a thyroid cancer referral center in Ecuador. METHODS: From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo, a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. RESULTS: Among 452 patients, 74.8% were young adults and 94.2% (426) were female. 13.7% had a family history of thyroid cancer, and patients' median tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15-5.95) with 76.2% of the thyroid cancer patients having MACIS score less than or equal to 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma, 86% (375) received radioactive iodine. CONCLUSION: Thyroid cancer histological characteristics and method of diagnosis are like those described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.


Asunto(s)
Adenocarcinoma Folicular/terapia , Carcinoma Papilar/terapia , Radioisótopos de Yodo/uso terapéutico , Uso Excesivo de los Servicios de Salud/estadística & datos numéricos , Neoplasias de la Tiroides/terapia , Tiroidectomía/métodos , Adenocarcinoma Folicular/diagnóstico , Adenocarcinoma Folicular/epidemiología , Adulto , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/epidemiología , Terapia Combinada , Estudios Transversales , Ecuador/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Pronóstico , Derivación y Consulta , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/epidemiología , Adulto Joven
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