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1.
Vaccine ; 2020 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-33187765

RESUMEN

In Latin America, the country of Ecuador was one of the first and most severely affected by the COVID-19 pandemic. This study aimed to evaluate the demand for a COVID-19 vaccine in Ecuador by estimating individuals' willingness to pay (WTP) for the vaccine, and by assessing the effect of vaccine attributes (duration of protection and efficacy) and individuals' characteristics on this valuation. The sample used (N = 1,050) was obtained through an online survey conducted from April 2 to April 7, 2020. Two levels of vaccine efficacy (70% and 98%) and two levels of vaccine duration of protection (1 and 20 years) were considered. The willingness to pay estimates were obtained using a double-bounded dichotomous-choice contingent valuation format. Survey results show that a very large proportion of individuals (at least 97%) were willing to accept a COVID-19 vaccine, and at least 85% of individuals were willing to pay a positive amount for that vaccine. Conservative estimates of the average WTP values ranged from USD 147.61 to 196.65 and the median WTP from USD 76.9 to 102.5. Only the duration of protection was found to influence individuals' WTP for the vaccine (p < 0.01). On average, respondents were willing to pay 30% more for a COVID-19 vaccine with 20 years of protection relative to the vaccine with 1 year of protection. Regression results show that WTP for the vaccine was associated with income, employment status, the perceived probability of needing hospitalization if contracting the virus causing COVID-19, and region of residence.

3.
PLoS One ; 15(11): e0242185, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33175877

RESUMEN

Many affected counties have had experienced a shortage of personal protective equipment (PPE) during the coronavirus disease (COVID-19) pandemic. We aimed to investigate the needs of healthcare professionals and the technical difficulties faced by them during the initial outbreak. A cross-sectional web-based survey was conducted among the healthcare workforce in the most populous cities from three Latin American countries in April 2020. In total, 1,082 participants were included. Of these, 534 (49.4%), 263 (24.3%), and 114 (10.5%) were physicians, nurses, and other professionals, respectively. At least 70% of participants reported a lack of PPE. The most common shortages were shortages in gown coverall suits (643, 59.4%), N95 masks (600, 55.5%), and face shields (569, 52.6%). Professionals who performed procedures that generated aerosols reported shortages more frequently (p<0.05). Professionals working in the emergency department and primary care units reported more shortages than those working in intensive care units and hospital-based wards (p<0.001). Up to 556 (51.4%) participants reported the lack of sufficient knowledge about using PPE. Professionals working in public institutions felt less prepared, received less training, and had no protocols compared with their peers in working private institutions (p<0.001). Although the study sample corresponded to different hospital centers in different cities from the participating countries, sampling was non-random. Healthcare professionals in Latin America may face more difficulties than those from other countries, with 7 out of 10 professionals reporting that they did not have the necessary resources to care for patients with COVID-19. Technical and logistical difficulties should be addressed in the event of a future outbreak, as they have a negative impact on healthcare workers. Clinical trial registration: NCT04486404.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Personal de Salud/psicología , Equipo de Protección Personal/estadística & datos numéricos , Neumonía Viral/diagnóstico , Betacoronavirus/aislamiento & purificación , Brasil , Colombia , Infecciones por Coronavirus/virología , Estudios Transversales , Ecuador , Instituciones de Salud , Humanos , Pandemias , Neumonía Viral/virología , Encuestas y Cuestionarios
4.
Invest. educ. enferm ; 38(3): [e07], Octubre 20 2020. Table 1, Table 2, Table 3, Table 4, Table 5, Table 6
Artículo en Inglés | LILACS, BDENF - Enfermería, COLNAL | ID: biblio-1128920

RESUMEN

Objective. To explore the feelings, stress factors, and adaptation strategies of nurses during the COVID-19 pandemic in Guayaquil, Ecuador. Methods. A cross-sectional, descriptive quantitative study, conducted through the application of a 52-item questionnaire with four sections (feelings, perceived stress, stress-reducing factors, and adaptation strategies). The study population was 227 nursing professionals from "Hospital General del Guasmo Sur" of the Ministry of Public Health, who worked during the peak of the pandemic from March to May 2020. The sample comprised 155 nurses who voluntarily accepted to participate. The study received 127 complete questionnaires for analysis. Results. The data showed the priority of humanist feelings and professional duty for these nurses, mostly young (59% under 35 years of age and with the professional exercise of three and fewer years), against the fear of contagion and the stress of strenuous work. They also revealed the great importance for them of the institutional support, recognition to the staff, and strict organization of safe care, like strategies for coping with this difficult experience. Conclusion. The COVID-19 pandemic represented for nurses from Guayaquil a great professional and emotional challenge. Health services and society could consider these findings to avoid burning out nurses and their professional desertion.


Objetivo. Explorar los sentimientos, factores de estrés y estrategias de adaptación de los enfermeros durante la pandemia del COVID-19 en Guayaquil, Ecuador. Métodos. Estudio cuantitativo, descriptivo, de corte transversal, realizado mediante la aplicación de un cuestionario de 52 ítems con cuatro secciones (sentimientos, estrés percibido, factores reductores de estrés y estrategias de adaptación). La población del estudio fueron 227 profesionales de enfermería del "Hospital General del Guasmo Sur" del Ministerio de Salud Pública, que laboraron durante el pico de la pandemia en los meses de marzo a mayo de 2020. La muestra fueron 155 enfermeros que aceptaron voluntariamente participar. Se recibieron 127 cuestionarios completos para el análisis Resultados. Los datos mostraron la prioridad de los sentimientos humanistas y del deber profesional para estos enfermeros, en su mayoría jóvenes (59% menores de 35 años y con ejercicio profesional de tres y menos años), frente al temor al contagio y al estrés de un trabajo extenuante. Revelaron también la gran importancia que tiene para ellos el soporte institucional, el reconocimiento al personal y la estricta organización de una prestación segura, como estrategias para el afrontamiento de esta difícil experiencia. Conclusión. La pandemia del COVID-19 representó para los enfermeros de Guayaquil un gran desafío tanto profesional como emocional. Los servicios de salud y la sociedad podrían considerar estos hallazgos para evitar el desgaste de los enfermeros y su deserción profesional.


Objetivo. Explore os sentimentos, fatores de estresse e estratégias de adaptação de enfermeiras durante a pandemia COVID-19 em Guayaquil, Equador. Métodos. Estudo quantitativo, descritivo, transversal, realizado por meio da aplicação de um questionário de 52 itens com quatro seções (sentimentos, estresse percebido, fatores redutores do estresse e estratégias de adaptação). A população do estudo foi de 227 profissionais de enfermagem do "Hospital Geral de Guasmo Sur" do Ministério da Saúde Pública, que trabalharam durante o pico da pandemia nos meses de março a maio de 2020. A amostra foi de 155 enfermeiros que aceitaram participar voluntariamente. Foram recebidos para análise 127 questionários completos. Resultados. Os dados evidenciaram a prioridade do sentimento humanístico e do dever profissional para esses enfermeiros, em sua maioria jovens (59% menores de 35 anos e com prática profissional de até três anos), frente ao medo do contágio e ao estresse do trabalho extenuante. Também revelaram a grande importância do apoio institucional, do reconhecimento da equipe e da estrita organização de uma prestação segura, como estratégias para o enfrentamento dessa difícil experiência. Conclusão. A pandemia COVID-19 representou um grande desafio profissional e emocional para as enfermeiras de Guayaquil. Os serviços de saúde e a sociedade poderiam considerar essas descobertas para evitar a exaustão do enfermeiro e sua deserção profissional.


Asunto(s)
Humanos , Estrés Psicológico , Estudios Transversales , Factores de Riesgo , Infecciones por Coronavirus , Ecuador , Pandemias , Enfermeras y Enfermeros
5.
PLoS One ; 15(10): e0240011, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33022023

RESUMEN

BACKGROUND: Understanding public perceptions of government responses to COVID-19 may foster improved public cooperation. Trust in government and population risk of exposure may influence public perception of the response. Other population-level characteristics, such as country socio-economic development, COVID-19 morbidity and mortality, and degree of democratic government, may influence perception. METHODS AND FINDINGS: We developed a novel ten-item instrument that asks respondents to rate key aspects of their government's response to the pandemic (COVID-SCORE). We examined whether the results varied by gender, age group, education level, and monthly income. We also examined the internal and external validity of the index using appropriate predefined variables. To test for dimensionality of the results, we used a principal component analysis (PCA) for the ten survey items. We found that Cronbach's alpha was 0.92 and that the first component of the PCA explained 60% of variance with the remaining factors having eigenvalues below 1, strongly indicating that the tool is both reliable and unidimensional. Based on responses from 13,426 people randomly selected from the general population in 19 countries, the mean national scores ranged from 35.76 (Ecuador) to 80.48 (China) out of a maximum of 100 points. Heterogeneity in responses was observed across age, gender, education and income with the greatest amount of heterogeneity observed between countries. National scores correlated with respondents' reported levels of trust in government and with country-level COVID-19 mortality rates. CONCLUSIONS: The COVID-SCORE survey instrument demonstrated satisfactory validity. It may help governments more effectively engage constituents in current and future efforts to control COVID-19. Additional country-specific assessment should be undertaken to measure trends over time and the public perceptions of key aspects of government responses in other countries.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Gobierno , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Opinión Pública , Proyectos de Investigación , Encuestas y Cuestionarios , Adolescente , Adulto , Anciano , China/epidemiología , Infecciones por Coronavirus/virología , Estudios Transversales , Ecuador/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/virología , Análisis de Componente Principal , Salud Pública/métodos , Cuarentena/métodos , Confianza , Adulto Joven
7.
Edumecentro ; 12(3): 277-283, jul.-set. 2020.
Artículo en Español | LILACS | ID: biblio-1124715

RESUMEN

RESUMEN Las autoras analizan el impacto social de la COVID-19 en Ecuador y Brasil como una muestra representativa de las tendencias de América Latina bajo las llamadas democracias capitalistas. El objetivo es valorar críticamente estas realidades a la luz de las teorías de las ciencias sociales y otros estudios previos.


ABSTRACT Authors analyze the social impact of COVID-19 on Ecuador and Brazil as a representative sample of Latin American trends under the so-called capitalist democracies. The purpose of the paper is to critically assess these realities in the light of social science theories and other previous studies.


Asunto(s)
Población , Pobreza , Infecciones por Coronavirus , Impacto de los Desastres
8.
PLoS One ; 15(9): e0240008, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32997705

RESUMEN

Ecuador has been one of the most affected countries by the Corona Virus Disease 19 (COVID-19) pandemic, by April 2020 this country presented the highest rates of mortality in Latin America. The purpose of the present study was to identify behaviors during confinement and sociodemographic variables associated with the mental health status of confirmed or suspected COVID-19 patients who were part of the epidemiological surveillance program in Ecuador that included mandatory confinement and self-isolation. A cross-sectional study was performed from March 22th to April 18th, 2020 using an online survey. The survey collected socio-demographic information and severity of depressive symptoms using the Patient Health Questionnaire-9 and anxiety symptoms through the Generalized Anxiety Disorder-7. A total of 759 patients completed the questionnaire, 20.3% presented moderate to severe symptoms of depression and 22.5% moderate to severe symptoms of anxiety. Being a woman and from the Coastal region were risk factors. Exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to an hour was associated with better mental health. Regression analysis indicated that the mentioned behaviors explained approximately 17% of the variance for depression sum scores and 11.8% of the variance for anxiety sum scores while controlling for gender and region. Understanding the association between sociodemographic variables and psychological states in patients with COVID-19 is relevant to tackle future public mental health problems and to implement health policies that are intended to palliate further psychiatric complications. Promotion of modifiable behaviors such as exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to less than an hour is recommended.


Asunto(s)
Ansiedad/epidemiología , Infecciones por Coronavirus/psicología , Depresión/epidemiología , Neumonía Viral/psicología , Actividades Cotidianas , Adolescente , Adulto , Betacoronavirus , Trazado de Contacto , Estudios Transversales , Ecuador/epidemiología , Monitoreo Epidemiológico , Ejercicio Físico , Femenino , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Pandemias , Cuestionario de Salud del Paciente , Cuarentena , Factores de Riesgo , Factores Socioeconómicos , Adulto Joven
9.
Atmos Pollut Res ; 2020 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-32863711

RESUMEN

The COVID-19 lockdown presented a peculiar opportunity to study a shift in the photochemical regime of ozone production in Quito (Ecuador) before and after mobility restrictions. Primary precursors such as NO and CO dropped dramatically as early as 13 March 2020, due to school closures, but ambient ozone did not change. In this work we use a chemical box model in order to estimate regimes of ozone production before and after the lockdown. We constrain the model with observations in Quito (ozone, NOx, CO, and meteorology) and with estimations of traffic-associated VOCs that are tightly linked to CO. To this end, we use the closest observational data of VOC/CO ratios at an urban area that shares with Quito conditions of high altitude and is located in the tropics, namely Mexico City. A shift in the chemical regime after mobility restrictions was evaluated in light of the magnitude of radical losses to nitric acid and to hydrogen peroxide. With reduced NOx in the morning rush hour (lockdown conditions), ozone production rates at 08:30-10:30 increased from 4.2 to 17 to 9.7-23 ppbv h-1, respectively. To test further the observed shift in chemical regime, ozone production was recalculated with post-lockdown NOx levels, but setting VOCs to pre-lockdown conditions. This change tripled ozone production rates in the mid-morning and stayed higher throughout the day. In light of these findings, practical scenarios that present the potential for ozone accumulation in the ambient air are discussed.

10.
Am J Case Rep ; 21: e927304, 2020 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-32978364

RESUMEN

BACKGROUND This case series describes 5 patients with SARS-CoV-2 infection and COVID-19 in Ecuador who had been treated with hydroxychloroquine for systemic lupus erythematosus (SLE) prior to their COVID-19 illness. CASE REPORT Case #1 reports a 29-year-old woman who had been treated with 200 mg of hydroxychloroquine per day for 1 year and presented with flu-like symptoms, chest pain, fever, odynophagia, asthenia, dry cough, and chills. Case #2 was a 34-year-old woman whose treatment for SLE included 200 mg of hydroxychloroquine per day since 2017. She arrived at the clinic with a dry cough, asthenia, and myalgias. Case #3 was a 24-year-old woman who had been using 200 mg of hydroxychloroquine per day since 2010. She presented with asthenia, myalgias, headaches, hypogeusia, and anosmia. Case #4 was a 39-year-old woman taking 200 mg of hydroxychloroquine every day for SLE who presented with dyspnea, chest pain, odynophagia, hypogeusia, anosmia, diarrhea, and fever. Case #5 was a 46-year-old woman who had been taking 200 mg of hydroxychloroquine since 2019. She came to our hospital complaining of chest pain, fever, and dyspnea. In all 5 patients, SARS-CoV-2 infection was confirmed with a nasopharyngeal SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test using the Cepheid/GeneXpert system. CONCLUSIONS All 5 of our patients with SLE who were taking hydroxychloroquine presented with SARS-CoV-2 infection and symptoms of COVID-19. This case series provides support for a lack of prevention of COVID-19 by hydroxychloroquine.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Hidroxicloroquina/administración & dosificación , Lupus Eritematoso Sistémico/tratamiento farmacológico , Pandemias/prevención & control , Neumonía Viral/prevención & control , Adulto , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Disnea/diagnóstico , Disnea/etiología , Ecuador , Servicio de Urgencia en Hospital , Femenino , Fiebre/diagnóstico , Fiebre/etiología , Humanos , Persona de Mediana Edad , Pandemias/estadística & datos numéricos , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , ARN Viral/análisis , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Medición de Riesgo , Muestreo , Insuficiencia del Tratamiento , Adulto Joven
11.
Disaster Med Public Health Prep ; : 1-4, 2020 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-32900417

RESUMEN

OBJECTIVES: Evaluate the relevance of the coronavirus disease 2019 (COVID-19) positive case detection policy or model implemented by the Ministry of Public Health (MPH) of Ecuador and to compare it with the experiences of other countries. METHODS: Data contained the daily reports publicized by the MPH. The formulations were carried out under the Conditioned Probability modality applying Bayes' Theorem. All the COVID-19 tests applied in relation to the confirmed cases per million inhabitants were considered to obtain their level of positivity, and compared with the experience of Iceland and South Korea. RESULTS: The probability of detecting positive cases of COVID-19 in Ecuador was higher than Iceland and South Korea, because the diagnostic tests were aimed at symptomatic patients, without identifying asymptomatic or mild symptomatic, who play an important role in the transmission of the disease. In addition, many symptomatic patients were examined but will remain undiagnosed due to the unavailability of tests and the low quality of many of them. CONCLUSIONS: The daily reports on the behavior of the COVID-19 issued by the Ecuadorian government do not adequately represent the growth in the number of those infected each day, nor the actual behavior of the epidemic, affecting possible control measures.

12.
J Community Health ; 45(6): 1158-1167, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32915380

RESUMEN

Preventing the transmission of SARS-CoV-2 (causative agent for COVID-19) requires implementing contact and respiratory precautions. Modifying human behavior is challenging and requires understanding knowledge, attitudes, and practices (KAPs) regarding health threats. This study explored KAPs among people in Ecuador. A cross-sectional, internet-based questionnaire was used to assess knowledge about COVID-19, attitudes toward ability to control COVID-19, self-reported practices related to COVID-19, and demographics. A total of 2399 individuals participated. Participants had moderate to high levels of knowledge. Participants expressed mixed attitudes about the eventual control of COVID-19 in Ecuador. Participants reported high levels of adoption of preventive practices. Binomial regression analysis suggests unemployed individuals, househusbands/housewives, or manual laborers, as well as those with an elementary school education, have lower levels of knowledge. Women, people over 50 years of age, and those with higher levels of schooling were the most optimistic. Men, individuals 18-29, single, and unemployed people took the riskiest behaviors. Generally, knowledge was not associated with optimism or with practices. Our findings indicate knowledge about COVID-19 is insufficient to prompt behavioral change among Ecuadorians. Since current COVID-19 control campaigns seek to educate the public, these efforts' impacts are likely to be limited. Given attitudes determine people's actions, further investigation into the factors underlying the lack of confidence in the ability of the world, and of Ecuador, to overcome COVID-19, is warranted. Edu-communicational campaigns should be accompanied by efforts to provide economically disadvantaged populations resources to facilitate adherence to recommendations to prevent the spread of the virus.


Asunto(s)
Infecciones por Coronavirus , Conocimientos, Actitudes y Práctica en Salud , Pandemias , Neumonía Viral , Betacoronavirus , Estudios Transversales , Brotes de Enfermedades , Ecuador/epidemiología , Femenino , Humanos , Masculino , Encuestas y Cuestionarios
13.
Air Qual Atmos Health ; : 1-10, 2020 Jul 06.
Artículo en Inglés | MEDLINE | ID: mdl-32837612

RESUMEN

Many governments around the world have enforced quarantine policies to control the spread of the new coronavirus (SARS-CoV-2). These policies have had positive and negative effects on the environment. For example, the concentrations of certain harmful pollutants have decreased in some countries. In contrast, the concentrations of other pollutants have increased. This research analyzes the effect of quarantine policies on air quality in Quito, Ecuador. Using a parametric approach, it was found that NO2 and PM2.5 concentrations have decreased significantly since the establishment of lockdown measures. However, O3 concentrations have increased considerably in 2020.

14.
Am J Trop Med Hyg ; 103(3): 1207-1210, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32755528

RESUMEN

The SARS-CoV-2 pandemic is now expanding into the developing world with devastating consequences. Departing from a population-based study in rural Ecuador where all adult individuals (aged 40 years or older) were tested for SARS-CoV-2 IgG and IgM antibodies, we expanded it to include a house-based case-control component assessing in-house clustering and other variables potentially associated with infection. We selected houses where exactly two study participants lived and were both seropositive (case-houses), and matched 1:1 to control-houses where both were seronegative. Younger household members had an antibody test performed. Infected household members were found in 33 (92%) case-houses and in only six (17%) control-houses. In 28/29 discordant house pairs, the case-house had seropositive household members and the control-house did not (odds ratio: 28; 95% CI: 4.6-1,144). Our data demonstrate strong in-house clustering of infection in community settings, stressing the importance of early case ascertainment and isolation for SARS-CoV-2 control.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Antivirales/sangre , Estudios de Casos y Controles , Niño , Análisis por Conglomerados , Ecuador/epidemiología , Composición Familiar , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Pandemias , Adulto Joven
15.
Pediatr Infect Dis J ; 39(10): e291-e296, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32773657

RESUMEN

BACKGROUND: Human coronaviruses (HCoVs) cause respiratory tract infections during childhood manifesting as common colds, bronchiolitis, croup and pneumonia. In temperate geographies, HCoV activity peaks between December and March. The epidemiology and manifestations of HCoV infections have not been previously reported from Ecuador. METHODS: Children <5 years who presented with ≥2 symptoms consistent with an acute respiratory tract infection were eligible for enrollment. After obtaining informed consent, demographic data and details regarding the acute illness were recorded. Secretions collected with a nasopharyngeal swab underwent diagnostic testing using multiplex polymerase chain reaction. RESULTS: A total of 850 subjects were enrolled. A total of 677 (80%) tested positive for at least 1 pathogen, including 49 (7.2%) who tested positive for ≥1 HCoV type. HCoV-NL63 was the most frequent type detected (39%), followed by HCoV-OC43 (27%), 229E (22%) and HKU1 (12%). Nearly all subjects who tested positive for HCoV had nasal congestion or secretions (47/49; 96%). The most frequent syndromic diagnosis was common cold (41%), followed by bronchiolitis (27%). We found no association between the infecting HCoV type and subject's syndromic diagnosis (P > 0.05) or anatomic location of infection (upper vs. lower respiratory tract; P > 0.05). The 2018-2019 peak HCoV activity occurred from October to November; the 2019-2020 peak occurred from January to February. CONCLUSIONS: HCoVs were detected in ~7% of outpatient Ecuadorean children <5 years of age with symptoms of acute respiratory tract infection. The most frequently detected HCoV types, and the period of peak HCoV activity differed for the 2018-2019 and 2019-2020 seasons.


Asunto(s)
Infecciones por Coronavirus/virología , Coronavirus/aislamiento & purificación , Infecciones del Sistema Respiratorio/virología , Enfermedad Aguda , Atención Ambulatoria/estadística & datos numéricos , Preescolar , Coronavirus/clasificación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/patología , Ecuador/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Nasofaringe/virología , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/patología , Estaciones del Año
16.
Int J Infect Dis ; 99: 226-228, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32781165

RESUMEN

A sudden increase in adult mortality associated with respiratory diseases was noticed in Atahualpa (a rural Ecuadorian village), coinciding with the introduction of SARS-CoV-2 in the region. From a total of 1,852 individuals aged ≥18 years, 40 deaths occurred between January and June, 2020. In addition, a seroprevalence survey showed that 45% of the adult population have SARS-CoV-2 antibodies. Verbal autopsies revealed SARS-CoV-2 as the most likely cause of death in 29 cases. The mean age of suspected or confirmed SARS-CoV-2 cases was 76.9±12.1 years, while that of those dying from unrelated causes was 60.3±20.4 years (p=0.003). The overall mortality rate was 21.6 per 1,000 population (95% C.I.: 15.9 - 29.2), almost three-quarters of it due to SARS-CoV-2 (15.7 per 1,000; 95% C.I.: 11 - 22.4). This configures a 266% of excess mortality when compared to 5.9 per 1,000 (95% C.I.: 3.3 - 10.6) deaths from other causes. When SARS-CoV-2 mortality rate was calculated in individuals aged ≥60 years, it raised up to 68.9 per 1,000 (95% C.I.: 47.8 - 98.4). After peaking in April and May, mortality significantly decreased. It is possible that the high proportion of infected individuals and the resulting herd immunity contributed to the observed reduction in mortality.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Población Rural , Estudios Seroepidemiológicos , Adulto , Anciano , Anciano de 80 o más Años , Infecciones por Coronavirus/mortalidad , Ecuador/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/mortalidad
17.
Am J Trop Med Hyg ; 103(4): 1590-1592, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32830642

RESUMEN

The SARS-CoV-2 virus has emerged and rapidly evolved into a current global pandemic. Although bacterial and fungal coinfections have been associated with COVID-19, little is known about parasitic infection. We report a case of a COVID-19 patient who developed disseminated strongyloidiasis following treatment with high-dose corticosteroids and tocilizumab. Screening for Strongyloides infection should be pursued in individuals with COVID-19 who originate from endemic regions before initiating immunosuppressive therapy.


Asunto(s)
Infecciones por Coronavirus/parasitología , Diabetes Mellitus/parasitología , Hipertensión/parasitología , Enfermedades del Sistema Nervioso Periférico/parasitología , Neumonía Viral/parasitología , Strongyloides stercoralis/patogenicidad , Estrongiloidiasis/parasitología , Corticoesteroides/administración & dosificación , Anciano , Animales , Antihelmínticos/uso terapéutico , Anticuerpos Monoclonales Humanizados/administración & dosificación , Betacoronavirus/patogenicidad , Coinfección , Connecticut , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/virología , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/inmunología , Diabetes Mellitus/virología , Ecuador , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/inmunología , Hipertensión/virología , Factores Inmunológicos/administración & dosificación , Masculino , Pandemias , Enfermedades del Sistema Nervioso Periférico/tratamiento farmacológico , Enfermedades del Sistema Nervioso Periférico/inmunología , Enfermedades del Sistema Nervioso Periférico/virología , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/inmunología , Neumonía Viral/virología , Estrongiloidiasis/tratamiento farmacológico , Estrongiloidiasis/inmunología , Estrongiloidiasis/virología
18.
Eur Rev Med Pharmacol Sci ; 24(15): 8226-8231, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32767354

RESUMEN

OBJECTIVE: To explore whether the climate has played a role in the COVID-19 outbreak, we compared virus lethality in countries closer to the Equator with others. Lethality in European territories and in territories of some nations with a non-temperate climate was also compared. MATERIALS AND METHODS: Lethality was calculated as the rate of deaths in a determinate moment from the outbreak of the pandemic out of the total of identified positives for COVID-19 in a given area/nation, based on the COVID-John Hopkins University website. Lethality of countries located within the 5th parallels North/South on 6 April and 6 May 2020, was compared with that of all the other countries. Lethality in the European areas of The Netherlands, France and the United Kingdom was also compared to the territories of the same nations in areas with a non-temperate climate. RESULTS: A lower lethality rate of COVID-19 was found in Equatorial countries both on April 6 (OR=0.72 CI 95% 0.66-0.80) and on May 6 (OR=0.48, CI 95% 0.47-0.51), with a strengthening over time of the protective effect. A trend of higher risk in European vs. non-temperate areas was found on April 6, but a clear difference was evident one month later: France (OR=0.13, CI 95% 0.10-0.18), The Netherlands (OR=0.5, CI 95% 0.3-0.9) and the UK (OR=0.2, CI 95% 0.01-0.51). This result does not seem to be totally related to the differences in age distribution of different sites. CONCLUSIONS: The study does not seem to exclude that the lethality of COVID-19 may be climate sensitive. Future studies will have to confirm these clues, due to potential confounding factors, such as pollution, population age, and exposure to malaria.


Asunto(s)
Clima , Infecciones por Coronavirus/mortalidad , Neumonía Viral/mortalidad , Estaciones del Año , Tiempo (Meteorología) , Betacoronavirus , Brunei/epidemiología , Burundi/epidemiología , Congo/epidemiología , Infecciones por Coronavirus/epidemiología , Ecuador/epidemiología , Guinea Ecuatorial/epidemiología , Europa (Continente) , Francia/epidemiología , Gabón/epidemiología , Humanos , Islas del Oceano Índico/epidemiología , Indonesia/epidemiología , Kenia/epidemiología , Malasia/epidemiología , Melanesia/epidemiología , Micronesia/epidemiología , Países Bajos/epidemiología , Pandemias , Papúa Nueva Guinea/epidemiología , Neumonía Viral/epidemiología , Rwanda/epidemiología , Samoa/epidemiología , Santo Tomé y Príncipe/epidemiología , Seychelles/epidemiología , Singapur/epidemiología , Somalia/epidemiología , Timor Oriental/epidemiología , Clima Tropical , Uganda/epidemiología , Reino Unido/epidemiología
19.
JMIR Public Health Surveill ; 6(3): e20737, 2020 07 21.
Artículo en Inglés | MEDLINE | ID: mdl-32658859

RESUMEN

BACKGROUND: During the coronavirus disease (COVID-19) pandemic, social media platforms have become active sites for the dissemination of conspiracy theories that provide alternative explanations of the cause of the pandemic, such as secret plots by powerful and malicious groups. However, the association of individuals' beliefs in conspiracy theories about COVID-19 with mental health and well-being issues has not been investigated. This association creates an assessable channel to identify and provide assistance to people with mental health and well-being issues during the pandemic. OBJECTIVE: Our aim was to provide the first evidence that belief in conspiracy theories regarding the COVID-19 pandemic is a predictor of the mental health and well-being of health care workers. METHODS: We conducted a survey of 252 health care workers in Ecuador from April 10 to May 2, 2020. We analyzed the data regarding distress and anxiety caseness with logistic regression and the data regarding life and job satisfaction with linear regression. RESULTS: Among the 252 sampled health care workers in Ecuador, 61 (24.2%) believed that the virus was developed intentionally in a lab; 82 (32.5%) experienced psychological distress, and 71 (28.2%) had anxiety disorder. Compared to health care workers who were not sure where the virus originated, those who believed the virus was developed intentionally in a lab were more likely to report psychological distress and anxiety disorder and to have lower levels of job satisfaction and life satisfaction. CONCLUSIONS: This paper identifies belief in COVID-19 conspiracy theories as an important predictor of distress, anxiety, and job and life satisfaction among health care workers. This finding will enable mental health services to better target and provide help to mentally vulnerable health care workers during the ongoing COVID-19 pandemic.


Asunto(s)
Infecciones por Coronavirus , Coronavirus , Pandemias , Neumonía Viral , Betacoronavirus , Estudios Transversales , Ecuador , Personal de Salud , Humanos , Salud Mental , Encuestas y Cuestionarios
20.
Clin Infect Dis ; 2020 Jul 27.
Artículo en Inglés | MEDLINE | ID: mdl-32717052

RESUMEN

Antibodies to SARS-CoV-2 were detected in 303/673 rural Ecuadorian adults (45%), 77% of whom had compatible clinical manifestations. Seropositivity was associated with the use of open latrines. Our findings support the fears of mass spread of SARS-CoV-2 in rural Latin America and cannot exclude a contributing role for fecal-oral transmission.

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