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Izquierdo-Condoy JS, Naranjo-Lara P, Vásconez-Gonzalez J, Fernandez-Naranjo R, Placencia-André R, Davila MG, Carrington SJ, Ortiz-Prado E. A nationwide epidemiological and geodemographic analysis of lymphatic filariasis in Ecuador: a neglected and often forgotten disease in Ecuador. Front Public Health 2023; 11:1270015. [PMID: 38035299 PMCID: PMC10682787 DOI: 10.3389/fpubh.2023.1270015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/13/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Lymphatic filariasis (LF) is a neglected parasitic disease transmitted by mosquitoes and affecting the lymphatic system. The aim of this study was to analyze the epidemiological and sociodemographic characteristics of patients with LF during the last 11 years of available data in Ecuador. Methods A 11-year nationwide analysis of hospital admission and in-hospital mortality based on the National Institute of Statistics and Census (INEC) data was conducted in Ecuador from 2011 to 2021. The International Classification of Diseases 10th Revision (ICD-10) code for filariasis (ICD: B74) was used to retrieve information on severe LF as a proxy for incidence among 221 Ecuadorian cities. Results A total of 26 hospital admissions and 3 deaths due to LF were registered. The highest mortality rate was found in populations over 80 years. Men accounted for 62.5% (n = 17) of total number of cases with an average incidence rate of 1.7 cases per/1,000,000, while females accounted for 34.6% (n = 9), representing 1 case per/1,000,000 woman. Cities located at lower altitude (459/1,000,000) reported higher incidence rates than those located at higher altitudes (7.4/1,000,000). Conclusion This is the first study on LF in Ecuador. Although, Ecuador is not considered endemic for LF, we found evidence of the presence of this disease in recent years. The implementation and improvement of an adequate integrated epidemiological surveillance system will allow early identification of cases and therefore their respective treatment.
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Affiliation(s)
| | | | - Jorge Vásconez-Gonzalez
- One Health Global Research Group, Universidad de las Américas, Quito, Ecuador
- Pontificia Universidad Católica del Ecuador, Tecnologías PUCE TEC, Quito, Ecuador
| | | | | | - María G. Davila
- One Health Global Research Group, Universidad de las Américas, Quito, Ecuador
| | | | - Esteban Ortiz-Prado
- One Health Global Research Group, Universidad de las Américas, Quito, Ecuador
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Vásconez-González J, Yeager J, Izquierdo-Condoy JS, Fernandez-Naranjo R, López MB, Dávila MG, Cordovez S, López-Cortés A, Ortiz-Prado E. An 11-year epidemiological analysis of schistosomiasis in Ecuador: Investigating a non-endemic, neglected, and challenging-to-identify parasitic disease. Food Waterborne Parasitol 2023; 31:e00196. [PMID: 37273515 PMCID: PMC10236286 DOI: 10.1016/j.fawpar.2023.e00196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/06/2023] Open
Abstract
Schistosomiasis is a neglected disease caused by parasites of the genus Schistosoma and transmitted by snails of the genus Biomphalaria. At least five species have the potential to infect humans living in or visiting tropical areas worldwide. In Latin America, Schistosoma mansoni is particularly common; however, it has not been reported in Ecuador. In this study, we assess the available official data on schistosomiasis in Ecuador to describe the prevalence of this neglected disease. We conducted a nationwide study to determine the demographic and spatial distribution patterns of schistosomiasis infection in Ecuador, using hospital discharge official data as a proxy for infection incidence from 2011 to 2021. We calculated crude and age-sex-adjusted morbidity and hospital admission rates by region, province, canton, and elevation. In the last decade of available data, schistosomiasis accounted for at least 551 hospital admissions in Ecuador. Women represented 53.7% (n = 296) of cases, equivalent to 3.2 cases per 1,000,000 inhabits. The highest number of cases (61.2%, n = 337) was found in the Coastal region. However, the highest incidence rates were observed in the Amazon region's provinces of Pastaza (173.44 cases/1,000,000).
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Affiliation(s)
- Jorge Vásconez-González
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
- Pontificia Universidad Católica del Ecuador, Tecnologias PUCE-TEC, Quito, Ecuador
| | - Justin Yeager
- Grupo de Biodiversidad Medio Ambiente y Salud, Universidad de Las Américas, Quito, Ecuador
| | - Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Raul Fernandez-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - María-Belén López
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - María Gabriela Dávila
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Simone Cordovez
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
- Faculty of Health Science, Universidad San Gregorio de Portoviejo, Manabí, Ecuador
| | - Andrés López-Cortés
- Cancer Research Group (CRG), Faculty of Medicine, Universidad de Las Américas, Quito, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
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Vásconez-González J, Fernandez-Naranjo R, Izquierdo-Condoy JS, Delgado-Moreira K, Cordovez S, Tello-De-la-Torre A, Paz C, Castillo D, Izquierdo-Condoy N, Carrington SJ, Ortiz-Prado E. Comparative analysis of long-term self-reported COVID-19 symptoms among pregnant women. J Infect Public Health 2023; 16:430-440. [PMID: 36736066 PMCID: PMC9851727 DOI: 10.1016/j.jiph.2023.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/03/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The negative effects of COVID-19 infections during pregnancy have been amply described, however, the persistent sequels of this infection have not been explored so far. OBJECTIVE The aim of this study was to describe persisting symptoms after COVID-19 infection in pregnant and non-pregnant women in Ecuador. METHODS A cross-sectional analysis based on an online, self-reporting questionnaire was conducted in Ecuador from April to July 2022. Participants were invited by social media, radio, and TV to voluntarily participate in our study. A total of 457 surveys were included in this study. We compared risk factor variables and long-term persisting symptoms of pregnant and non-pregnant women in Ecuador. RESULTS Overall, 247 (54.1 %) responders claimed to have long-term symptoms after SARS-CoV-2 infection. Most of these symptoms were reported by non-pregnant women (94.0 %). The most common Long-COVID symptoms in pregnant women were fatigue (10.6 %), hair loss (9.6 %), and difficulty concentrating (6.2 %). We found that pregnant women who smoked had a higher risk of suffering fatigue. CONCLUSIONS The most frequent Long-COVID symptoms in pregnant women were fatigue, hair loss, and difficulty concentrating. Apparently, the patterns of presentation of long-term sequelae of SARS-CoV-2 infection in pregnant women do not differ significantly from reports available from studies in the general population.
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Affiliation(s)
- Jorge Vásconez-González
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador,Pontificia Universidad Católica del Ecuador, Tecnologias PUCE-TEC, Quito 170143, Ecuador
| | - Raul Fernandez-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador
| | - Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador,Health Management and Research Area, Universidad Internacional Iberoamericana, Arecibo 00613, Puerto Rico
| | - Karen Delgado-Moreira
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador
| | - Simone Cordovez
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador
| | - Andrea Tello-De-la-Torre
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador
| | - Clara Paz
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador
| | - Diana Castillo
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador
| | | | - Sarah J. Carrington
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, 170137 Quito, Ecuador.
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Vásconez-González J, Izquierdo-Condoy JS, Fernandez-Naranjo R, Gamez-Rivera E, Tello-De-la-Torre A, Guerrero-Castillo GS, Ruiz-Sosa C, Ortiz-Prado E. Severe Chagas disease in Ecuador: a countrywide geodemographic epidemiological analysis from 2011 to 2021. Front Public Health 2023; 11:1172955. [PMID: 37143984 PMCID: PMC10151800 DOI: 10.3389/fpubh.2023.1172955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/04/2023] [Indexed: 05/06/2023] Open
Abstract
Background Chagas disease is a neglected and often forgotten tropical disease caused by the Trypanosoma cruzi. This parasite can be transmitted through the direct contact of human skin with feces and urine of the triatomine insect. According to the World Health Organization (WHO), an estimated 6-7 million people are infected worldwide, killing at least 14,000 every year. The disease has been reported in 20 of the 24 provinces of Ecuador, with El Oro, Guayas, and Loja being the most affected. Methodology We analyzed the morbidity and mortality rates of severe Chagas disease in Ecuador on a nationwide, population-based level. Hospitalization cases and deaths were also examined based on altitude, including low (< 2,500 m) and high (> 2,500 m) altitudes, according to the International Society. Data was retrieved from the National Institute of Statistics and Census hospital admissions and in-hospital mortality databases from 2011 to 2021. Results A total of 118 patients have been hospitalized in Ecuador since 2011 due to Chagas disease. The overall in-hospital mortality rate was 69.4% (N = 82). Men have a higher incidence rate (4.8/1,000,000) than women, although women have a significantly higher mortality rate than men (6.9/1,000,000). Conclusion Chagas disease is a severe parasitic condition that primarily affects rural and poorer areas of Ecuador. Men are more likely to be infected due to differences in work and sociocultural activities. Using average elevation data, we conducted a geodemographic analysis to assess incidence rates by altitude. Our findings indicate that the disease is more common at low and moderate altitudes, but recent increases in cases at higher altitudes suggest that environmental changes, such as global warming, could be driving the proliferation of disease-carrying vectors in previously unaffected areas.
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Affiliation(s)
- Jorge Vásconez-González
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Raul Fernandez-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Esteban Gamez-Rivera
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | - Andrea Tello-De-la-Torre
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
| | | | - Carlos Ruiz-Sosa
- Postgraduate in Gastroenterology and Digestive Endoscopy, Faculty of Medicine, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito, Ecuador
- *Correspondence: Esteban Ortiz-Prado,
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Ortiz-Prado E, Izquierdo-Condoy JS, Fernandez-Naranjo R, Vasconez J, Dávila Rosero MG, Revelo-Bastidas D, Herrería-Quiñonez D, Rubio-Neira M. The deadly impact of COVID-19 among children from Latin America: The case of Ecuador. Front Pediatr 2023; 11:1060311. [PMID: 37152328 PMCID: PMC10160383 DOI: 10.3389/fped.2023.1060311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/17/2023] [Indexed: 05/09/2023] Open
Abstract
Background The SARS-CoV-2 pandemic remains a critical global health concern, with older adults being the most vulnerable group. Nonetheless, it is crucial to recognize that COVID-19 has caused numerous deaths in children worldwide. Emerging evidence indicates that infants and breastfeeding children, particularly those aged below one year, face a greater risk of hospitalization and mortality than older children with COVID-19. Objective This study aimed to describe the epidemiology of COVID-19 among children during the early phase of the pandemic in Ecuador. Methods We conducted a country-wide population-based analysis of the epidemiology of COVID-19, using incidence and mortality data reported from Ecuador between February 15, 2020 and May 14 2021. Measurements of frequency, central tendency, dispersion, and absolute differences were calculated for all categorical and continuous variables. Results At least 34,001 cases (23,587 confirmed cases, 5,315 probable and 5,099 suspected) and 258 COVID-19 related deaths have been reported among children in Ecuador during the first 16 months of the pandemic. The overall incidence rate was 612 cases per 100,000 children, the mortality rate was 3 per 100,000, while the case fatality rate was 0.76%. The highest risk group for infection was children and adolescents between 15 and 19 years of age; however, the highest mortality rate occurred in children under one year of age. The largest provinces, such as Pichincha, Guavas and Manabí, were the ones that reported the highest number of cases, 27%, 12.1% and 10.8%, respectively. Conclusions This study is the first to report on COVID-19 epidemics among children in Ecuador. Our findings reveal that younger children have a lower risk of SARS-CoV-2 infection, but a higher risk of mortality compared to older children and adolescents. Additionally, we observed significant disparities in infection rates and outcomes among children living in rural areas, those with comorbidities, and those from indigenous ethnic groups.
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Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Calle de los Colimes y Avenida De los Granados, Quito, Ecuador
- Facultad de Ciencias de la Salud, Universidad Latina de Costa Rica,San José, Costa Rica
- Correspondence: Esteban Ortiz-Prado
| | - Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Calle de los Colimes y Avenida De los Granados, Quito, Ecuador
| | - Raul Fernandez-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Calle de los Colimes y Avenida De los Granados, Quito, Ecuador
| | - Jorge Vasconez
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Calle de los Colimes y Avenida De los Granados, Quito, Ecuador
| | - María Gabriela Dávila Rosero
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Calle de los Colimes y Avenida De los Granados, Quito, Ecuador
| | - Doménica Revelo-Bastidas
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Calle de los Colimes y Avenida De los Granados, Quito, Ecuador
| | - Diva Herrería-Quiñonez
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Calle de los Colimes y Avenida De los Granados, Quito, Ecuador
| | - Mario Rubio-Neira
- Department of Cardiology, Baca Ortiz Pediatric Hospital, Quito, Ecuador
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Ortiz-Prado E, Simbaña-Rivera K, Cevallos G, Gómez-Barreno L, Cevallos D, Lister A, Fernandez-Naranjo R, Ríos-Touma B, Vásconez-González J, Izquierdo-Condoy JS. Waterborne diseases and ethnic-related disparities: A 10 years nationwide mortality and burden of disease analysis from Ecuador. Front Public Health 2022; 10:1029375. [PMID: 36620267 PMCID: PMC9811003 DOI: 10.3389/fpubh.2022.1029375] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Background Despite worldwide progress in terms of clean water supply, sanitation, and hygiene knowledge, some middle and most of low-income countries are still experiencing many diseases transmitted using unsafe water and the lack of sanitation. Methods To understand the impact of all waterborne diseases (WBD) registered in Ecuador. We performed a population-based analysis of all cases and deaths due to WBD in Ecuador based on the national public databases of hospital discharges as a proxy of incidence, in-hospital mortality, and countrywide general mortality rates from 2011 to 2020. Results In Ecuador, mestizos (mixed European and Indigenous American ancestry) had the greatest morbidity rate (141/100,000), followed by indigenous (63/100,000) and self-determined white patients (21/100,000). However, in terms of mortality, indigenous population have the greatest risk and rates, having a 790% additional mortality rate (2.6/100,000) than the reference group (self-determined white populations) at 0.29/100,000. The burden of disease analysis demonstrated that indigenous had the highest burden of disease caused by WBD with 964 YLL per every 100,000 people while mestizos have 360 YYL per 100,000 and self-determined white Ecuadorians have 109 YYL per 100,000. Conclusions In Ecuador, waterborne diseases (WBD) are still a major public health problem. We found that indigenous population had higher probability of getting sick and die due to WBD than the rest of the ethnic groups in Ecuador. We also found that younger children and the elderly are more likely to be admitted to the hospital due to a WBD. These epidemiological trends are probably associated with the lower life expectancy found among Indigenous than among the rest of the ethnic groups, who die at least, 39 years earlier than the self-determined white populations, 28 years earlier than Afro-Ecuadorians and 12 years earlier than the mestizos.
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Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Katherine Simbaña-Rivera
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Gabriel Cevallos
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Lenin Gómez-Barreno
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Domenica Cevallos
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Alex Lister
- University Hospital Southampton NHS FT, University of Southampton, Southampton, United Kingdom
| | - Raul Fernandez-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Blanca Ríos-Touma
- Biodiversity, Environment and Health Research Group (BIOMAS), Faculty of Engineering and Applied Sciences, Universidad de Las Américas, Quito, Ecuador
| | - Jorge Vásconez-González
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
- Facultad de Ciencias de la Salud, Universidad Latina de Costa Rica, San Pedro, Costa Rica
| | - Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
- Health Management and Research Area, Universidad Internacional Iberoamericana, Arecibo, Puerto Rico
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7
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Izquierdo-Condoy JS, Fernandez-Naranjo R, Vasconez-González E, Cordovez S, Tello-De-la-Torre A, Paz C, Delgado-Moreira K, Carrington S, Viscor G, Ortiz-Prado E. Long COVID at Different Altitudes: A Countrywide Epidemiological Analysis. Int J Environ Res Public Health 2022; 19:ijerph192214673. [PMID: 36429392 PMCID: PMC9690364 DOI: 10.3390/ijerph192214673] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Several reports from around the world have reported that some patients who have recovered from COVID-19 have experienced a range of persistent or new clinical symptoms after a SARS-CoV-2 infection. These symptoms can last from weeks to months, impacting everyday functioning to a significant number of patients. METHODS A cross-sectional analysis based on an online, self-reporting questionnaire was conducted in Ecuador from April to July 2022. Participants were invited by social media, radio, and TV to voluntarily participate in our study. A total of 2103 surveys were included in this study. We compared socio-demographic variables and long-term persisting symptoms at low (<2500 m) and high altitude (>2500 m). RESULTS Overall, 1100 (52.3%) responders claimed to have Long-COVID symptoms after SARS-CoV-2 infection. Most of these were reported by women (64.0%); the most affected group was young adults between 21 to 40 years (68.5%), and most long-haulers were mestizos (91.6%). We found that high altitude residents were more likely to report persisting symptoms (71.7%) versus those living at lower altitudes (29.3%). The most common symptoms were fatigue or tiredness (8.4%), hair loss (5.1%) and difficulty concentrating (5.0%). The highest proportion of symptoms was observed in the group that received less than 2 doses. CONCLUSIONS This is the first study describing post-COVID symptoms' persistence in low and high-altitude residents. Our findings demonstrate that women, especially those aging between 21-40, are more likely to describe Long-COVID. We also found that living at a high altitude was associated with higher reports of mood changes, tachycardia, decreased libido, insomnia, and palpitations compared to lowlanders. Finally, we found a greater risk to report Long-COVID symptoms among women, those with previous comorbidities and those who had a severer acute SARS-CoV-2 infection.
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Affiliation(s)
- Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
- Health Management and Research Area, Department of Health Sciences, Universidad Internacional Iberoamericana, Arecibo, PR 00613, USA
| | - Raul Fernandez-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
| | - Eduardo Vasconez-González
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
| | - Simone Cordovez
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
| | - Andrea Tello-De-la-Torre
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
| | - Clara Paz
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
| | - Karen Delgado-Moreira
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
| | - Sarah Carrington
- Lugar, Medio y Sociedad Research Group, School of Economics, Universidad de Las Américas, Quito 170124, Ecuador
| | - Ginés Viscor
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Americas, Quito 170137, Ecuador
- Correspondence: ; Tel.: +593-995-760-693
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8
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Ortiz-Prado E, Izquierdo-Condoy JS, Fernandez-Naranjo R, Simbaña-Rivera K, Vásconez-González J, Naranjo EPL, Cordovez S, Coronel B, Delgado-Moreira K, Jimbo-Sotomayor R. A Comparative Analysis of a Self-Reported Adverse Events Analysis after Receiving One of the Available SARS-CoV-2 Vaccine Schemes in Ecuador. Vaccines (Basel) 2022; 10:vaccines10071047. [PMID: 35891211 PMCID: PMC9323750 DOI: 10.3390/vaccines10071047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has put a lot of pressure on health systems worldwide. Mass vaccination against SARS-CoV-2 has reduced morbidity and mortality worldwide. Despite their safety profiles, vaccines, as with any other medical product, can cause adverse events. Yet, in countries with poor epidemiological surveillance and monitoring systems, reporting vaccine-related adverse events is a challenge. The objective of this study was to describe self-reported vaccine adverse events after receiving one of the available COVID-19 vaccine schemes in Ecuador. A cross-sectional analysis based on an online, self-reported, 32-item questionnaire was conducted in Ecuador from 1 April to 15 July 2021. Participants were invited by social media, radio, and TV to voluntarily participate in our study. A total of 6654 participants were included in this study. Furthermore, 38.2% of the participants reported having at least one comorbidity. Patients received AstraZeneca, Pfizer, and Sinovac vaccines, and these were distributed 38.4%, 31.1%, and 30.5%, respectively. Overall, pain or swelling at the injection site 17.2% (n = 4500) and headache 13.3% (n = 3502) were the most reported adverse events. Women addressed events supposedly attributable to vaccination or immunization [ESAVIs] (66.7%), more often than men (33.2%). After receiving the first dose of any available COVID-19 vaccine, a total of 19,501 self-reported ESAVIs were informed (87.0% were mild, 11.5% moderate, and 1.5% severe). In terms of the vaccine type and brand, the most reactogenic vaccine was AstraZeneca with 57.8%, followed by Pfizer (24.9%) and Sinovac (17.3%). After the second dose, 6776 self-reported ESAVIs were reported (87.1% mild, 10.9% moderate, and 2.1% severe). AstraZeneca vaccine users reported a higher proportion of ESAVIs (72.2%) in comparison to Pfizer/BioNTech (15.9%) and Sinovac Vaccine (11.9%). Swelling at the injection site, headache, muscle pain, and fatigue were the most common ESAVIs for the first as well as second doses. In conclusion, most ESAVIs were mild. AstraZeneca users were more likely to report adverse events. Participants without a history of COVID-19 infection, as well as those who received the first dose, were more prone to report ESAVIs.
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Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito 170507, Ecuador; (J.S.I.-C.); (R.F.-N.); (K.S.-R.); (J.V.-G.); (S.C.); (B.C.); (K.D.-M.)
- Correspondence:
| | - Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito 170507, Ecuador; (J.S.I.-C.); (R.F.-N.); (K.S.-R.); (J.V.-G.); (S.C.); (B.C.); (K.D.-M.)
- Health Management and Research Area, Universidad Internacional Iberoamericana, Campeche 24560, Mexico
| | - Raul Fernandez-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito 170507, Ecuador; (J.S.I.-C.); (R.F.-N.); (K.S.-R.); (J.V.-G.); (S.C.); (B.C.); (K.D.-M.)
| | - Katherine Simbaña-Rivera
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito 170507, Ecuador; (J.S.I.-C.); (R.F.-N.); (K.S.-R.); (J.V.-G.); (S.C.); (B.C.); (K.D.-M.)
| | - Jorge Vásconez-González
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito 170507, Ecuador; (J.S.I.-C.); (R.F.-N.); (K.S.-R.); (J.V.-G.); (S.C.); (B.C.); (K.D.-M.)
| | | | - Simone Cordovez
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito 170507, Ecuador; (J.S.I.-C.); (R.F.-N.); (K.S.-R.); (J.V.-G.); (S.C.); (B.C.); (K.D.-M.)
| | - Barbara Coronel
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito 170507, Ecuador; (J.S.I.-C.); (R.F.-N.); (K.S.-R.); (J.V.-G.); (S.C.); (B.C.); (K.D.-M.)
| | - Karen Delgado-Moreira
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito 170507, Ecuador; (J.S.I.-C.); (R.F.-N.); (K.S.-R.); (J.V.-G.); (S.C.); (B.C.); (K.D.-M.)
| | - Ruth Jimbo-Sotomayor
- Centro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador, Quito 17012184, Ecuador;
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9
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Ortiz-Prado E, Fernandez-Naranjo R, Torres-Berru Y, Lowe R, Torres I. Exceptional Prices of Medical and Other Supplies during the COVID-19 Pandemic in Ecuador. Am J Trop Med Hyg 2021; 105:81-87. [PMID: 34014837 PMCID: PMC8274761 DOI: 10.4269/ajtmh.21-0221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/17/2021] [Indexed: 12/02/2022] Open
Abstract
Shortages of essential supplies used to prevent, diagnose, and treat COVID-19 have been a global concern, and price speculation and hikes may have negatively influenced access. This study identifies variability in prices of products acquired through government-driven contracts in Ecuador during the early pandemic response, when the highest mortality rates were registered in a single day. Data were obtained from the National Public Procurement Service (SERCOP) database between March 1 and July 31, 2020. A statistical descriptive analysis was conducted to extract relevant measures for commonly purchased products, medical devices, pharmaceutical drugs, and other goods. Among the most frequently purchased products, the greatest amounts were spent on face masks (US$4.5 million), acetaminophen (US$2.2 million), and reverse transcriptase quantitative polymerase chain reaction assay kits (US$1.8 million). Prices varied greatly, depending on each individual contract and on the number of units purchased; some were exceptionally higher than their market value. Compared with 2019, the mean price of medical examination gloves increased up to 1,307%, acetaminophen 500 mg pills, up to 796%, and oxygen flasks, 30.8%. In a context of budgetary constraints that actually required an effective use of available funds, speculative price hikes may have limited patient access to health care and the protection of the general population and health care workers. COVID-19 vaccine allocations to privileged individuals have also been widely reported. Price caps and other forms of regulation, as well as greater scrutiny and transparency of government-driven purchases, and investment in local production, are warranted in Ecuador for improved infectious disease prevention.
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Affiliation(s)
- Esteban Ortiz-Prado
- 1One Health Research Group, Faculty of Medicine, Universidad de las Americas, Quito, Ecuador.,2Department of Cell Biology, Physiology and Immunology, Universidad de Barcelona, Barcelona, Spain
| | - Raul Fernandez-Naranjo
- 1One Health Research Group, Faculty of Medicine, Universidad de las Americas, Quito, Ecuador
| | - Yeferson Torres-Berru
- 3University of Salamanca, Salamanca, Spain.,4Instituto Superior Tecnológico Sudamericano, Loja, Ecuador
| | - Rachel Lowe
- 5Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.,6Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
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