Adapting for the COVID-19 pandemic in Ecuador, a characterization of hospital strategies and patients.

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.

Caracterización epidemiológica de los nacimientos bajo peso en Sancti-Spíritus: 2000-2006 / Epidemiology of low birth weight in Sancti Spiritus: 2000-2006

Introducción: El recién nacido bajo peso, es aquel niño cuyo peso al nacer sea inferior a 2500 gr La etiología es multifactorial. En Cuba, el índice de bajo peso al nacer, aumentó al inicio de la década de los noventa, con grandes diferencias entre las distintas regiones del país, estando por debajo de la media nacional en la provincia de Sancti Spíritus. Objetivo: Describir características epidemiológicas de los recién nacidos bajo peso en la provincia de Sancti Spíritus del año 2000 al 2006. Material y Método: Se realizó un estudio descriptivo transversal del comportamiento del bajo peso en la provincia Sancti-Spíritus. La población fueron 1680 casos nacidos bajo peso en ese período. Los datos fueron obtenidos del registro estadístico del sectorial provincial de salud. Resultados: La incidencia de nacimientos bajo peso en la provincia fue 4,7 con tendencia decreciente. Fallecieron 91 niños con bajo peso al nacer, para un 42,5 porciento, de ellos menores de 1000 gramos de peso al nacer el 90 porciento, mientras que entre 1000 gramos y 1500 fue de 60 porciento. La hemorragia intraventricular fue la mayor causa de muerte con 14,2 porciento. Conclusiones: El bajo peso al nacer mostró tendencia decreciente. Los municipios Trinidad, Sancti Spíritus, Taguasco y la Sierpe estuvieron por encima de la media provincial de 4,7. Las principales causas de muerte fueron: hemorragia intraventricular, cardiopatías congénitas, hemorragia pulmonar y la membrana hialina(AU)

Introduction: A low birthweight newborn, is that child with a birth weight less than 2500g. The etiology is multifactorial. In Cuba, the rate of low birthweight, increased at the beginning of the nineties, with wide variations among different regions of the country, and a mean value below the national average in the province of Sancti Spiritus. Objective: To describe epidemiological characteristics of low birthweight newborns in Sancti Spiritus province from 2000 to 2006. Material and Methods: A cross sectional study was made of the behavior of low birthweight in Sancti Spiritus province. The population was made up of 1680 low birthweight cases born in that period. Data were obtained from the statistical registry of the Provincial Health Direction. Results: The incidence of low weight births in the province was 4,7 with a decreasing tendency. 91 children with a low birthweight died, for a 42,5 percent. 90 percent of them had a birthweight lower than 1000 grams, while 60 percent weighted at birth between 1000 and 1500 grams. Intraventricular haemorrhage was the major cause of death with 14,2 percent. Conclusions: Low birthweight showed a decreasing trend. The municipalities of Trinidad, Sancti Spiritus, Taguasco and La Sierpe were above the provincial mean of 4,7. The leading causes of death were intraventricular haemorrhage, congenital heart disease, pulmonary haemorrhage and hyaline membrane(AU)