Impacto de brote por Covid-19 en las causas de egresos hospitalarios a nivel nacional por enfermedades del sistema nervioso central en población pediátrica durante el primer año de pandemia en Chile / Impact of Covid-19 outbreak in the causes of hospital discharges at national level due to central nervous system diseases in pediatric population during the first year of pandemic in Chile

INTRODUCCIÓN: La pandemia por Covid-19 ha generado cambios en la atención de salud nacional, observándose en este período cambios en las causas de egresos hospitalarios (EH). OBJETIVO: Analizar el impacto del brote de Covid-19 en las causas de EH por enfermedades del Sistema Nervioso Central (ESNC) en población pediátrica durante el primer año de pandemia. MÉTODO: Estudio transversal. Análisis de base de datos del Departamento de Estadística e Información en Salud en pacientes de 0 a 18 años, comparando años 2019 y 2020. RESULTADOS: En 2020 se redujeron EH por ESNC en un 39% comparado con 2019. Disminuyeron principalmente los EH por secuelas de enfermedades inflamatorias SNC, parálisis cerebral, migraña y paraplejia/cuadriplejia, aumentando los EH por isquemia cerebral transitoria, enfermedades desmielinizantes SNC y polineuropatía inflamatoria. El número EH por ESNC mensual se correlacionó con el número de casos Covid-19 (rho -0.774, p0.003) y con la movilidad mensual del país (rho 0.928, p 0.001). CONCLUSIONES: El impacto del brote Covid-19 se asoció con reducción de EH por ESNC, disminuyeron EH por patologías crónicas y aumentaron causas agudas.

INTRODUCTION: The Covid-19 pandemic has been associated with modifications in national health care, with changes in causes of hospital discharges (HD) in this period. OBJECTIVE: To analyze the impact of the Covid-19 outbreak on causes of HD due to Central Nervous System Diseases (CNSD) in pediatric population during the first year of pandemic. METHOD: Cross-sectional study. Analysis of database of the Department of Statistics and Health Information in patients aged 0 to 18 years, comparing 2019 and 2020. RESULTS: In 2020, HD due to CNSD were reduced in 39% compared to 2019. HD causes that mainly decreased were inflammatory CNS disease sequelae, cerebral palsy, migraine and paraplegia/cuadriplegia. The HD that increased were transient cerebral ischemia, CNS demyelinating diseases and inflammatory polyneuropathy. The monthly HD due to CNSD number was correlated with the number of Covid-19 cases (rho -0.774, p0.003) and with the country's monthly mobility (rho 0.928, p 0.001). CONCLUSIONS: Covid-19 pandemic was associated with a reduction in HD due to CNSD, with decrease of EH due to chronic pathologies and increase of acute diseases

[Prevalence estimation of Autism Spectrum disorders in chilean urban population]. / Estimación de la prevalencia de trastorno del Espectro Autista en población urbana chilena.

INTRODUCTION: The prevalence of Autism Spectrum Disorder has increased, varying between 0.5 and 1% around the world. The prevalence of ASD in Chile is unknown. OBJECTIVE: To estimate the prevalence of ASD in two urban communes of Santiago, Chile. SUBJECTS AND METHOD: Cross-sectional epidemiological study. 272 children aged between 18-30 months who attended well-child visits at two Family Health Centers in two urban communes of Santiago participated. Consecutive sampling was used and chil dren who were already being monitored by neurology were excluded. Screening was performed using the Modified Checklist for Autism in Toddlers (M-CHAT). Those children with altered M-CHAT were evaluated by a pediatric neurologist at the San Borja Arriarán Clinical Hospital and diagnosed with ASD according to clinical criteria. The Autism Diagnostic Observation Schedule - Second Ver sion (ADOS-2) was used as a diagnostic complement. The prevalence of ASD was estimated with a 95% confidence interval. RESULTS: 44 children had altered M-CHAT; 5 of them were clinically diagno sed with ASD. A 1.95% prevalence of ASD (95% CI 0.81-4.63) was obtained, with a sex distribution of 4 boys per 1 girl. CONCLUSIONS: This study is the first estimate of ASD prevalence in two communes of Santiago, Chile. A high prevalence of this condition was observed, which highlights the need for obtaining resources for an early multidisciplinary approach for these patients.

Autism screening and conditional cash transfers in Chile: Using the Quantitative Checklist (Q-CHAT) for early autism detection in a low resource setting.

LAY ABSTRACT: Getting a diagnosis of autism can take long, because autism is different across people, but also because it depends on the way it gets diagnosed. This is especially important in poorer countries or in the case of poor people living in wealthier countries that have significant groups of disadvantaged communities. We adapted a 10-item version of the Q-CHAT-25 questionnaire for use in routine health check-ups programme in Chile and recruited 287 participants under the age of three divided into three groups: Controls (125), Developmental Delay (149) and Autism Spectrum Condition (13). Our results show that a short questionnaire for autism screening can be successfully applied in a health-check programme in poor resource settings. Our results show that our questionnaire had good overall performance, not different to its longer version, the Q-CHAT-25. Our questionnaire was autism specific, with good sensitivity and reliability, and is suitable to be used in a screening setting. This study provides evidence that the implementation of Autism Spectrum Condition screening programmes using the Q-CHAT-10 provides value for money and improves diagnosis of Autism Spectrum Condition in those participating in routine health check-up programmes in developing countries or poor areas of wealthy countries.