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1.
Medicina (Kaunas) ; 58(11)2022 Nov 19.
Article in English | MEDLINE | ID: covidwho-2115951

ABSTRACT

Background and Objectives: Drug consumption is a widely developed practice around the world. However, sometimes medicines are acquired with or without prescription, a practice termed self-medication, which can have negative impacts on the health of the population. It has been observed that with the arrival of the coronavirus disease 2019 (COVID-19) pandemic, self-medicated drug consumption figures increased in several countries. To describe the patterns of medication, use and the prevalence of self-medication during the COVID-19 pandemic in inhabitants of the capital province of Pichincha, Ecuador. Materials and Methods: A descriptive, cross-sectional study was conducted based on a self-administered online questionnaire from April to June 2022, among residents of the province of Pichincha, Ecuador. Participants were invited through social networks (WhatsApp and Facebook). A total of 401 surveys were included in this study. Consumption patterns (prescription of and treatment with) of medicines during the pandemic were evaluated, as well as the prevalence of self-medication and variables that characterize the way of acquiring medicines. The Chi-square test was used to look for relationships between consumption patterns, self-medication, and the characteristics of the participants. Results: Most participants were female (53.4%), and 59.4% reported having had COVID-19. A total of 244 (60.9%) consumed medications during the pandemic, mostly for the purpose of treating the infection. About half (48.4%) self-medicated. The most used medications were paracetamol (87.3%) and ibuprofen (47.5%). Drugs consumption as a treatment and informal sources of information (TV, social networks, advice) were associated with the practice of self-medication (p < 0.05). Conclusions: A significant percentage of over-the-counter (OTC) and legal drug use was found to persist after the COVID-19 pandemic. Our findings highlight the effects that alternative forms of information sources other than medical personnel can have on drug consumption and self-medication practices.


Subject(s)
COVID-19 , Female , Humans , Male , Cross-Sectional Studies , COVID-19/epidemiology , Pandemics , Ecuador/epidemiology , Self Medication , Nonprescription Drugs/therapeutic use
2.
Int J Environ Res Public Health ; 19(21)2022 Nov 02.
Article in English | MEDLINE | ID: covidwho-2099511

ABSTRACT

The COVID-19 pandemic has forced many companies to adopt different work modalities to ensure their operation during this period. In this study, we described and compared working conditions and perceptions among face-to-face workers, teleworkers, and hybrid workers in Ecuador. A cross-sectional study was conducted with a sample of 542 participants, using a self-report survey to assess sociodemographic data, working conditions, and workers' perceptions. Variables were described and then compared by the Chi-square test, ANOVA, and the Kruskal-Wallis test. The results indicated a higher proportion of on-site workers without higher education and in the public sector compared to the other modalities. At the same time, there was evidence of increased perceived productivity. People in the hybrid modality tended to have more than one job, earning a higher monthly salary, perceiving a decrease in productivity, an increase in daily working hours, and a lower capacity for time management. In addition, most teleworkers reported fair working conditions, a dedicated workspace, and easy adaptation to this work mode. This study builds a more in-depth understanding of how workers perceived their working conditions among work modalities for organizational decision-making because the evolution of the COVID-19 pandemic is modifying the ways of working permanently.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Pandemics , Teleworking , Cross-Sectional Studies , Ecuador/epidemiology
3.
Int J Public Health ; 67: 1604768, 2022.
Article in English | MEDLINE | ID: covidwho-2055115

ABSTRACT

Objective: To analyze sociodemographic factors' influence on COVID-19 case fatality rate (CFR) in Ecuador on a subnational level. Methods: Publicly available register-based observational study. A retrospective cohort of COVID-19 infections between epidemiological weeks 8-53 in the Ecuadorian public healthcare system was determined from available records. Statistical analyses were conducted to evaluate CFR trends according to factors such as sex, age, location, and healthcare provider. Results: Overall CFR was 9.4%; by canton, median CFR was 5.2%, with some cantons with much higher rates, like Santa Elena (39.1%). Overall CFR decreased during the period, from 16.6% (week 8) to 2.63% (week 53). Being in a rural area was an independent protective factor. Patients over 65 had a hazard ratio of 11.38 (95% CI [11.05, 11.72]). Sex, ethnicity, and treatment from public facilities were also associated with death risk. Conclusion: CFR is a proxy indicator of COVID-19 impact in Ecuador, and this location-based analysis provides new information on the disease's specific impact subnationally. Overall COVID-19 CFR during the entire period was high, suggesting the need to improve COVID-19 care in Ecuador.


Subject(s)
COVID-19 , Ecuador/epidemiology , Humans , Retrospective Studies , SARS-CoV-2
4.
Front Cell Infect Microbiol ; 12: 951383, 2022.
Article in English | MEDLINE | ID: covidwho-2043422

ABSTRACT

SARS-CoV-2 reinfection is defined as a new infection with a different virus variant in an individual who has already recovered from a previous episode of COVID-19. The first case of reinfection in the world was described in August 2020, since then, reinfections have increased over time and their incidence has fluctuated with specific SARS-CoV-2 variant waves. Initially, reinfections were estimated to represent less than 1% of total COVID-19 infections. With the advent of the Omicron variant, reinfections became more frequent, representing up to 10% of cases (based on data from developed countries). The frequency of reinfections in Latin America has been scarcely reported. The current study shows that in Ecuador, the frequency of reinfections has increased 10-fold following the introduction of Omicron, after 22 months of surveillance in a single center of COVID-19 diagnostics. Suspected reinfections were identified retrospectively from a database of RT-qPCR-positive patients. Cases were confirmed by sequencing viral genomes from the first and second infections using the ONT MinION platform. Monthly surveillance showed that the main incidence peaks of reinfections were reached within four to five months, coinciding with the increase of COVID-19 cases in the country, suggesting that the emergence of reinfections is related to higher exposure to the virus during outbreaks. This study performed the longest monitoring of SARS-CoV-2 reinfections, showing an occurrence at regular intervals of 4-5 months and confirming a greater propensity of Omicron to cause reinfections.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/diagnosis , COVID-19/epidemiology , Ecuador/epidemiology , Humans , Reinfection , Retrospective Studies , SARS-CoV-2/genetics
5.
Int J Environ Res Public Health ; 19(13)2022 06 28.
Article in English | MEDLINE | ID: covidwho-1911387

ABSTRACT

SARS-CoV-2 has spread throughout the world, including remote areas such as those located at high altitudes. There is a debate about the role of hypobaric hypoxia on viral transmission and COVID-19 incidence. A descriptive cross-sectional analysis of SARS-CoV-2 infection and viral load among patients living at low (230 m) and high altitude (3800 m) in Ecuador was completed. Within these two communities, the total number of infected people at the time of the study was 108 cases (40.3%). The COVID-19 incidence proportion at low altitude was 64% while at high altitude was 30.3%. The mean viral load from those patients who tested positive was 3,499,184 copies/mL (SD = 23,931,479 copies/mL). At low altitude (Limoncocha), the average viral load was 140,223.8 copies/mL (SD = 990,840.9 copies/mL), while for the high altitude group (Oyacachi), the mean viral load was 6,394,789 copies/mL (SD = 32,493,469 copies/mL). We found no statistically significant differences when both results were compared (p = 0.056). We found no significant differences across people living at low or high altitude; however, men and younger populations had higher viral load than women older populations, respectively.


Subject(s)
COVID-19 , SARS-CoV-2 , Altitude , COVID-19/epidemiology , Cross-Sectional Studies , Ecuador/epidemiology , Female , Humans , Male , Viral Load
6.
BMJ Open ; 12(6): e056295, 2022 06 16.
Article in English | MEDLINE | ID: covidwho-1901996

ABSTRACT

INTRODUCTION: Asthma is a growing health problem in children in marginalised urban settings in low-income and middle-income countries. Asthma attacks are an important cause of emergency care attendance and long-term morbidity. We designed a prospective study, the Asthma Attacks study, to identify factors associated with recurrence of asthma attacks (or exacerbations) among children and adolescents attending emergency care in three Ecuadorian cities. METHODS AND ANALYSIS: Prospective cohort study designed to identify risk factors associated with recurrence of asthma attacks in 450 children and adolescents aged 5-17 years attending emergency care in public hospitals in three Ecuadorian cities (Quito, Cuenca and Portoviejo). The primary outcome will be rate of asthma attack recurrence during up to 12 months of follow-up. Data are being collected at baseline and during follow-up by questionnaire: sociodemographic data, asthma history and management (baseline only); recurrence of asthma symptoms and attacks (monthly); economic costs of asthma to family; Asthma Control Test; Pediatric Asthma Quality of life Questionnaire; and Newcastle Asthma Knowledge Questionnaire (baseline only). In addition, the following are being measured at baseline and during follow-up: lung function and reversibility by spirometry before and after salbutamol; fractional exhaled nitric oxide (FeNO); and presence of IgG antibodies to SARS-CoV-2 in blood. Recruitment started in 2019 but because of severe disruption to emergency services caused by the COVID-19 pandemic, eligibility criteria were modified to include asthmatic children with uncontrolled symptoms and registered with collaborating hospitals. Data will be analysed using logistic regression and survival analyses. ETHICS AND DISSEMINATION: Ethical approval was obtained from the Hospital General Docente de Calderon (CEISH-HGDC 2019-001) and Ecuadorian Ministry of Public Health (MSP-CGDES-2021-0041-O N° 096-2021). The study results will be disseminated through presentations at conferences and to key stakeholder groups including policy-makers, postgraduate theses, peer-review publications and a study website. Participants gave informed consent to participate in the study before taking part.


Subject(s)
Asthma , COVID-19 , Adolescent , Asthma/diagnosis , Asthma/epidemiology , Asthma/therapy , COVID-19/epidemiology , Child , Cities/epidemiology , Ecuador/epidemiology , Humans , Pandemics , Prospective Studies , Quality of Life , SARS-CoV-2
7.
Sci Rep ; 12(1): 8496, 2022 05 19.
Article in English | MEDLINE | ID: covidwho-1900647

ABSTRACT

This study analyzed the frequency and intensity of acute stress among health professionals caring for COVID-19 patients in four Latin American Spanish-speaking countries during the outbreak. A cross-sectional study involved a non-probability sample of healthcare professionals in four Latin American countries. Participants from each country were invited using a platform and mobile application designed for this study. Hospital and primary care workers from different services caring for COVID-19 patients were included. The EASE Scale (SARS-CoV-2 Emotional Overload Scale, in Spanish named Escala Auto-aplicada de Sobrecarga Emocional) was a previously validated measure of acute stress. EASE scores were described overall by age, sex, work area, and experience of being ill with COVID-19. Using the Mann-Whitney U test, the EASE scores were compared according to the most critical moments of the pandemic. Univariate and multivariate analysis was performed to investigate associations between these factors and the outcome 'acute stress'. Finally, the Kruskal-Wallis was used to compare EASE scores and the experience of being ill. A total of 1372 professionals responded to all the items in the EASE scale: 375 (27.3%) Argentines, 365 (26.6%) Colombians, 345 (25.1%) Chileans, 209 (15.2%) Ecuadorians, and 78 (5.7%) from other countries. 27% of providers suffered middle-higher acute stress due to the outbreak. Worse results were observed in moments of peak incidence of cases (14.3 ± 5.3 vs. 6.9 ± 1.7, p < 0.05). Higher scores were found in professionals in COVID-19 critical care (13 ± 1.2) than those in non-COVID-19 areas (10.7 ± 1.9) (p = 0.03). Distress was higher among professionals who were COVID-19 patients (11.7 ± 1) or had doubts about their potential infection (12 ± 1.2) compared to those not infected (9.5 ± 0.7) (p = 0.001). Around one-third of the professionals experienced acute stress, increasing in intensity as the incidence of COVID-19 increased and as they became infected or in doubt whether they were infected. EASE scale could be a valuable asset for monitoring acute stress levels among health professionals in Latin America.ClinicalTrials: NCT04486404.


Subject(s)
COVID-19 , Health Personnel , Occupational Stress , Argentina/epidemiology , COVID-19/epidemiology , COVID-19/therapy , Chile , Colombia/epidemiology , Cross-Sectional Studies , Ecuador/epidemiology , Health Personnel/psychology , Humans , Occupational Stress/epidemiology , Risk Factors
8.
Viruses ; 14(6)2022 05 28.
Article in English | MEDLINE | ID: covidwho-1869822

ABSTRACT

The Omicron variant of SARS-CoV-2 is the latest pandemic lineage causing COVID-19. Despite having a vaccination rate ≥85%, Ecuador recorded a high incidence of Omicron from December 2021 to March 2022. Since Omicron emerged, it has evolved into multiple sub-lineages with distinct prevalence in different regions. In this work, we use all Omicron sequences from Ecuador available at GISAID until March 2022 and the software Nextclade and Pangolin to identify which lineages circulate in this country. We detected 12 different sub-lineages (BA.1, BA.1.1, BA.1.1.1, BA.1.1.14, BA.1.1.2, BA.1.14, BA.1.15, BA.1.16, BA.1.17, BA.1.6, BA.2, BA.2.3), which have been reported in Africa, America, Europe, and Asia, suggesting multiple introduction events. Sub-lineages BA.1 and BA.1.1 were the most prevalent. Genomic surveillance must continue to evaluate the dynamics of current sub-lineages, the early introduction of new ones and vaccine efficacy against evolving SARS-CoV-2.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , Ecuador/epidemiology , Humans , Phylogeny , SARS-CoV-2/genetics
9.
J Psychol ; 156(5): 381-394, 2022.
Article in English | MEDLINE | ID: covidwho-1815707

ABSTRACT

The COVID-19 pandemic has impacted the emotional health of adolescents, especially those with low resilience and life satisfaction. The aim is to analyze the predictors of anxiety, depression, and stress among adolescents in Ecuador during the COVID-19 pandemic.Participants were 586 adolescents from Ecuador aged between 12-18 years (M = 15.30; SD = 1.28). Satisfaction, resilience, anxiety, depression, stress and worries about COVID-19 were assessed. Structural equation models (SEM) and models based on qualitative comparative analysis (QCA) were performed. The results indicate that worries are associated with depression, anxiety, and stress. However, higher physical health worries are associated with lower emotional distress. SEM models indicate that life satisfaction is negatively associated with emotional distress. In QCA models, emotional distress is explained by high worries, low resilience, and life satisfaction. Life satisfaction plays a mediating role in emotional distress.In conclusion, adolescents are one of the groups particularly vulnerable to this situation of restriction created by COVID-19. It is necessary to detect signs of risk and protection in emotional adjustment, especially life satisfaction, that appears like principal damper variable.


Subject(s)
COVID-19 , Adolescent , Anxiety/epidemiology , COVID-19/epidemiology , Child , Depression/epidemiology , Depression/psychology , Ecuador/epidemiology , Humans , Pandemics , SARS-CoV-2
10.
Int J Environ Res Public Health ; 19(8)2022 04 12.
Article in English | MEDLINE | ID: covidwho-1809860

ABSTRACT

BACKGROUND: HPV primary screening has shown effectiveness for cancer prevention; however, gynaecological examination is considered uncomfortable. Self-sampling methods increase the acceptance of screening. The aim of this study is to compare the sensitivity and specificity of clinician sampling versus vaginal and urine self-sampling for HPV diagnosis. METHODS: A diagnostic test study was conducted in a rural parish of Cuenca, Ecuador. A total of 120 women participated. Each participant self-collected urine and vaginal samples and underwent clinician sampling for HPV testing. The latter was considered as the golden standard. All three samples were processed with the same amplification and hybridization protocol for HPV detection (Hybribio) following the manufacturer's instructions. RESULTS: Characteristics of the participants were: median age 35 years; 40.8% married; 46.7% had a primary level of education; and median age of sexual onset, 17.6 years. The prevalence of any type of HPV with clinician sampling was 15.0%, 17.5% with urine sampling and 18.3% with vaginal self-sampling. Self-sampling sensitivity reached 94.4% (IC 74.2-99.9), and specificity 92.1% (IC 85.2-95.9). Urine sampling had a sensitivity of 88.8% (IC 67.2, 96.9), and specificity 94.1% (IC 67.2-96.9). The negative predictive value was 98.9% (IC 94.2-99.8) for vaginal self-sampling and 97.6% (IC 92.6-99.4) for urine sampling. CONCLUSIONS: This study shows that vaginal and urine self-sampling methods have similar sensitivity and specificity compared with clinician sampling for the diagnosis of HPV. The correlation between HPV genotypes among the three tests is satisfactory.


Subject(s)
Cervical Intraepithelial Neoplasia , Papillomavirus Infections , Uterine Cervical Neoplasms , Adolescent , Adult , Cervical Intraepithelial Neoplasia/diagnosis , Diagnostic Tests, Routine , Early Detection of Cancer/methods , Ecuador/epidemiology , Female , Humans , Male , Papillomaviridae/genetics , Papillomavirus Infections/diagnosis , Papillomavirus Infections/epidemiology , Rural Population , Sensitivity and Specificity , Specimen Handling/methods , Uterine Cervical Neoplasms/prevention & control , Vaginal Smears
11.
Int J Environ Res Public Health ; 19(8)2022 04 15.
Article in English | MEDLINE | ID: covidwho-1792710

ABSTRACT

Expectations about a destination influence the tourist experience during the travel process stages. In the post-COVID-19 normalcy, people are adjusting their priorities and social values. Therefore, it becomes crucial to identify tourists' expectations before traveling. The objectives of this research were: (a) identify the preferences of tourists; (b) establish the attitudes of tourists; and (c) determine the expectations of tourists for post-COVID-19 destination selection. The study analyzed a sample of 491 people during pandemic lockdowns in Guayaquil, Ecuador. Statistical techniques such as exploratory and confirmatory factor analysis were used in data analysis. The results show that after the pandemic, tourists prefer urban tourism, followed by cultural tourism and traveling with relatives. It also shows a more responsible and supportive attitude when traveling. Likewise, the results support the dimensional structure that explains a set of post-pandemic tourist expectations. Five factors were identified: Smart Care, pricing strategy, safety, comfort, and social distancing. Finally, the theoretical and managerial implications of the results that will guide for tourism destination managers were discussed.


Subject(s)
COVID-19 , Attitude , COVID-19/epidemiology , Communicable Disease Control , Ecuador/epidemiology , Humans , Motivation , Travel
12.
PLoS Negl Trop Dis ; 16(4): e0010082, 2022 04.
Article in English | MEDLINE | ID: covidwho-1789168

ABSTRACT

BACKGROUND: Dozens of commercial RT-qPCR kits for SARS-CoV-2 detection are available with or without Emergency Use Authorization (EUA) by FDA or other regulatory agencies. OBJECTIVE: We evaluated the clinical performance of two SARS-CoV-2 RT-PCR kits designed and produced in South America, "COVID-19 RT-PCR Real TM FAST (CY5)" (ATGen, Uruguay) and "ECUGEN SARS-CoV-2 RT-qPCR" (UDLA-STARNEWCORP, Ecuador), for RT-qPCR SARS-CoV2 detection using "TaqMan 2019-nCoV Assay Kit v1" (Thermofisher, USA) as a gold standard technique. RESULTS: We report a great clinical performance and analytical sensitivity for the two South American kits with sensitivity values of 96.4 and 100%, specificity of 100% and limit of detection in the range of 10 copies/uL of RNA extraction. CONCLUSIONS: "COVID-19 RT-PCR Real TM FAST (CY5)" and "ECUGEN SARS-CoV-2 RT-qPCR" kits are reliable SARS-CoV-2 tests made in South America that have been extensively used in Uruguay, Argentina, Brazil, Bolivia and Ecuador. These locally produced SARS-CoV-2 tests have contributed to overcome supply shortages and reduce diagnosis cost, while maintaining the high quality standards of FDA EUA commercially available kits. This approach could be extended for other diagnostic products to improve infectious diseases surveillance at middle and low income countries beyond COVID-19 pandemic.


Subject(s)
COVID-19 , SARS-CoV-2 , Brazil , COVID-19/diagnosis , Carbocyanines , Ecuador/epidemiology , Humans , Pandemics , RNA, Viral/analysis , RNA, Viral/genetics , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2/genetics , Sensitivity and Specificity , Uruguay
13.
Int J Public Health ; 67: 1604626, 2022.
Article in English | MEDLINE | ID: covidwho-1785465

ABSTRACT

Objective: The global COVID-19 pandemic has challenged health systems. Healthcare professionals had to face harsh conditions that have caused psycho-emotional consequences. Ecuador has been one of the countries hit hardest by the pandemic in Latin America. The objective of this study was to analyse the levels of psychological distress among healthcare workers in Ecuador during the COVID-19 pandemic. Methods: A cross-sectional descriptive study was conducted with a convenience sample of 1,056 healthcare professionals, assessing their psychological distress, physical symptoms of COVID-19, state of health, the preventive measures adopted, and the history of contact with people infected with the SARS-CoV2 virus. Results: showed that 66.0% of the participants manifested psychological distress, with significantly higher levels in women with symptoms of COVID-19 and previous contact with infected people or objects (p < 0.001). However, adherence to preventive measures and perception of health were associated with less psychological distress (p < 0.001). Conclusions: The importance of monitoring the mental health of healthcare workers during the COVID-19 pandemic was confirmed, having identified factors associated with the development of psychological distress among professionals in Ecuador.


Subject(s)
COVID-19 , Psychological Distress , COVID-19/epidemiology , Cross-Sectional Studies , Ecuador/epidemiology , Female , Health Personnel/psychology , Humans , Pandemics , RNA, Viral , SARS-CoV-2
14.
Front Public Health ; 10: 844947, 2022.
Article in English | MEDLINE | ID: covidwho-1785449

ABSTRACT

Background: This study tests a framework that examines the role of several mental health factors (mood, wellbeing, health consciousness, and hoarding) on individuals' overconsumption behavior under the novel coronavirus context. This examination is relevant to public health literature because it increases our knowledge on how the context of COVID-19 pandemic affects people's mental health and provides answers to why individuals engage in overconsumption behavior. Additionally, this research also follows a cross-cultural perspective aiming to understand how individuals from different cultural orientations cope with the psychological effects of the COVID-19 pandemic. Methods: This is a cross-sectional study that compares samples from two countries: Ecuador (n = 334) and USA (n = 321). Data was collected via an online survey. The timing of data collection was set during the mandatory lockdowns and social distance measures taken by both countries to fight against the COVID-19 virus breakout. Partial least squares structural equation modeling was used to test the theorized framework. Multi-group analysis was used to explore cultural orientation differences among the relationships included in the model. Results: The results indicate that individuals' mood state has a positive relationship with health consciousness, as people try to regulate their health concerns by maintaining positive perceptions of their subjective wellbeing. Further, the increased concern individuals express in their health is responsible for them to engage in overconsumption behavior. Cultural orientation (individualism vs. collectivism) moderates the relationship between mood and health consciousness. No moderation effect was found for the relationship between health consciousness and overconsumption. Conclusions: The COVID-19 pandemic has generated negative effects in individuals' mental health. Findings from this study suggest that maintaining a positive mood is important for individuals at the time of mandatory lockdowns, and this effort is related to a greater concern and awareness of their health. Further, health consciousness is responsible to stimulate overconsumption behavior. This chain of effects can be explained by individuals' interest in their wellbeing. Culture plays a role in these effects. People from individualistic countries (USA) compared to people from collectivistic countries (Ecuador) demonstrate greater motivation in maintaining their positive mood by showing greater health consciousness.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Communicable Disease Control , Cross-Cultural Comparison , Cross-Sectional Studies , Ecuador/epidemiology , Humans , Mental Health , SARS-CoV-2
15.
Front Public Health ; 10: 711938, 2022.
Article in English | MEDLINE | ID: covidwho-1775960

ABSTRACT

Leptospirosis is a globally disseminated zoonotic disease with no national surveillance systems. On the other hand, surveillance is crucial for improving population health, and surveillance systems produce data that motivates action. Unfortunately, like many other countries, Ecuador put in place a monitoring system that has never been tested. The goal of this study was to use scenario tree modeling to assess the sensitivity of Ecuador's current national surveillance system to human leptospirosis as the basis for an economic assessment of the system. We created a decision-tree model to analyze the current system's sensitivity. The inputs were described as probabilities distributions, and the model assessed the program's sensitivity as an output. The model also considers the geographical and weather variations across Ecuador's three continental regions: Andean, Amazonia, and the Coast. Several data sources were used to create the model, including leptospirosis records from Ecuador's Ministry of Public Health, national and international literature, and expert elicitation, all of which were incorporated in a Bayesian framework. We were able to determine the most critical parameters influencing each scenario's output (CSU) sensitivity through sensitivity analysis. The Coast region had the best sensitivity scenario, with a median of 0.85% (IC 95% 0.41-0.99), followed by the Amazonia with a median of 0.54% (CI 95% 0.18-0.99) and the Andes with a median of 0.29% (CI 95% 0.02-0.89). As per the sensitivity study, the most influential criteria on the system's sensitivity were "Attendance or probability of going to a health center" and "probability of having symptoms," notably for the Coast and Amazonia Regions.


Subject(s)
Epidemiological Monitoring , Leptospirosis , Animals , Bayes Theorem , Ecuador/epidemiology , Humans , Leptospirosis/epidemiology , Zoonoses
16.
Int J Public Health ; 67: 1604366, 2022.
Article in English | MEDLINE | ID: covidwho-1765685

ABSTRACT

Objectives: to explore the emotional impact of the COVID-19 pandemic in the Galapagos Islands. Methods: an online survey of 369 participants, conducted on October of 2020, was used to assess levels of depression, anxiety, and stress, as well as specific behavioral and emotional reactions to the pandemic. Results: the prevalence of anxiety was 4% and depression 3.65%. Perceived stress level was higher, with 52% of the sample reporting moderate amounts. Women had higher levels of depression and perceived stress. Financial distress, interpersonal conflicts, feelings of isolation and fear of contagion of COVID-19 were all associated with higher levels of anxiety, depression, and stress. Conclusion: prevalence of anxiety and depression is lower in the Galápagos Islands during the pandemic compared to other regions, while stress levels are more significant and may warrant intervention. Despite being low, anxiety and depression were associated with potentially problematic behaviors and emotional reactions.


Subject(s)
COVID-19 , Psychological Distress , COVID-19/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Ecuador/epidemiology , Female , Humans , Pandemics , Stress, Psychological/epidemiology , Stress, Psychological/psychology
17.
Int J Public Health ; 67: 1604418, 2022.
Article in English | MEDLINE | ID: covidwho-1742286

ABSTRACT

Objective: Several studies have investigated the negative toll the pandemic has had on people's mental health. However, there is limited research on the pandemic's effect on positive mental health variables. This article reports on the levels of self-esteem and well-being (flourishing and happiness) in a sample of adults living in Ecuador and their relationships with the characteristics of their personal situation and the effects of the COVID-19 pandemic had on their personal lives. Methods: A total of 766 adults completed an anonymous online survey between March and August 2020. Results: Participants reported average scores in the flourishing scale, the majority considered themselves to be happy or very happy people, and more than half presented high levels of self-esteem. Age, education, socioeconomic status, time spent using mobile phones and on hobbies, among others, explained self-esteem, happiness, and flourishing. Conclusion: The relationships between sociodemographic and situational variables of confinement during the pandemic are discussed, as well as the possible predictors of happiness, flourishing, and self-esteem.


Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , Communicable Disease Control , Ecuador/epidemiology , Happiness , Humans , Pandemics , SARS-CoV-2
18.
Gac Sanit ; 36(6): 512-519, 2022.
Article in English | MEDLINE | ID: covidwho-1670507

ABSTRACT

OBJECTIVE: To study the association between mobility restriction and mental health outcomes among Ecuadorian young adults. METHOD: The present is a cross-sectional study that included a non-probabilistic sample of mostly highly educated young adults. Socio-demographic and mental health data were collected through an online survey, between May and June 2020, when confinement was mandatory in Ecuador. Data on mobility was extracted from Google Community Mobility Reports. Four aspects of the participants' mental health were evaluated: eating behavior (emotional eating), depression, sleep quality and sense of coherence as a proxy of resilience, using previously validated instruments. Data were analyzed using multiple linear regression models in R. RESULTS: Sample included 8426 young adults, with a mean age of 22.85 (standard deviation: 4.43), most of whom were women (n=5943, 70.53%). During mandatory confinement, in Ecuador mobility in general was reduced by nearly 50% in comparison to January/February, 2020. Less healthy eating behavior, depression, worse sleep quality and lower sense of coherence were associated with higher mobility restriction to workplaces and groceries/pharmacies. Women and youngsters more often showed depression, less healthy eating behavior, worse quality of sleep and lower sense of coherence in comparison with men and older respondents. CONCLUSIONS: Mobility restrictions during COVID-19 pandemic were associated with worse self-reported mental health in a sample of young highly-educated Ecuadorian adults. Women and youngsters were the most affected. Our findings highlight the need of implementing health promotion measures directed to ameliorate the effects of confinement on mental health, focusing on women and youngsters.


Subject(s)
COVID-19 , Male , Young Adult , Female , Humans , Adult , COVID-19/epidemiology , Pandemics , Mental Health , Ecuador/epidemiology , SARS-CoV-2 , Cross-Sectional Studies , Depression/epidemiology
19.
Infect Genet Evol ; 98: 105228, 2022 03.
Article in English | MEDLINE | ID: covidwho-1654924

ABSTRACT

The investigation of conventional complete blood-count (CBC) data for classifying the SARS-CoV-2 infection status became a topic of interest, particularly as a complementary laboratory tool in developing and third-world countries that financially struggled to test their population. Although hematological parameters in COVID-19-affected individuals from Asian and USA populations are available, there are no descriptions of comparative analyses of CBC findings between COVID-19 positive and negative cases from Latin American countries. In this sense, machine learning techniques have been employed to examine CBC data and aid in screening patients suspected of SARS-CoV-2 infection. In this work, we used machine learning to compare CBC data between two highly genetically distinguished Latin American countries: Brazil and Ecuador. We notice a clear distribution pattern of positive and negative cases between the two countries. Interestingly, almost all red blood cell count parameters were divergent. For males, neutrophils and lymphocytes are distinct between Brazil and Ecuador, while eosinophils are distinguished for females. Finally, neutrophils, lymphocytes, and monocytes displayed a particular distribution for both genders. Therefore, our findings demonstrate that the same set of CBC features relevant to one population is unlikely to apply to another. This is the first study to compare CBC data from two genetically distinct Latin American countries.


Subject(s)
COVID-19/blood , COVID-19/physiopathology , Hematologic Tests/methods , Hematologic Tests/statistics & numerical data , Mass Screening/methods , Mass Screening/statistics & numerical data , SARS-CoV-2/pathogenicity , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , Ecuador/epidemiology , Female , Humans , Male , Middle Aged
20.
Rev Clin Esp (Barc) ; 222(1): 37-41, 2022 01.
Article in English | MEDLINE | ID: covidwho-1626054

ABSTRACT

OBJECTIVE: This article aims to assess the utility of CURB-65 in predicting 30-day mortality in adult patients hospitalized with COVID-19. METHODS: This work is a cohort study conducted between March 1 and April 30, 2020 in Ecuador. RESULTS: A total of 247 patients were included (mean age 60 ± 14 years, 70% men, overall mortality 41.3%). Patients with CURB-65 ≥ 2 had a higher mortality rate (57 vs. 17%, p < .001) that was associated with other markers of risk: advanced age, hypertension, overweight/obesity, kidney failure, hypoxemia, requirement for mechanical ventilation, or onset of respiratory distress. CONCLUSIONS: CURB-65  ≥ 2 was associated with higher 30-day mortality on the univariate (Kaplan-Meier estimator) and multivariate (Cox regression) analysis.


Subject(s)
COVID-19 , Adult , Aged , Cohort Studies , Ecuador/epidemiology , Female , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2
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