Evaluation of School Children Nutritional Status in Ecuador Using Nutrimetry: A Proposal of an Education Protocol to Address the Determinants of Malnutrition

The education sector is a cornerstone in the battle against malnutrition in children. However, there are still no consolidated protocols that outline strategies for how nutrition programs in low- and middle-income countries can be delivered through the education sector. Establishing the correct community diagnosis is essential prior to the elaboration of an intervention plan for a school population that takes into account more than just traditional variables related to the nutritional status. A total of 574 boys and girls aged 3-11 years from three educational institutions in different municipalities in Ecuador participated in the study. Sociodemographic, anthropometric (weight and height) and coproparasitological data were obtained. Nutrimetry, which is a combination of two classical anthropometrics indicators, was used for the analysis of the nutritional status, and the indicators' frequencies varied among the schools. In order to improve the nutritional status of children, we proposed a framework mainly focusing on establishing alliances with the education sector and taking into account gender equality; respect for the environment; and the customs, beliefs and traditions of each population. The results obtained from the analyses of other variables demonstrated the importance of an adequate diagnosis prior to any type of intervention at the nutritional level, since characteristics could vary by local area and have an impact on the successfulness of the intervention

Suplementos probióticos en enfermedades del entorno gastrointestinal por alteración de la microbiota tras la antibioterapia

Introducción: La microbiota puede verse alterada debido al uso de antibióticos para el tratamiento de enfermedades del entorno gastrointestinal. La suplementación con probióticos podría emplearse terapéuticamente para regular o evitar esta disbiosis. Objetivo: Analizar la información relevante sobre el uso de probióticos como coadyuvante en el tratamiento con antibióticos en enfermedades del entorno gastrointestinal que pueden alterar su microbiota. Métodos: Revisión bibliográfica en bases de datos científicas de artículos relacionados con el tema y publicados entre enero de 2010 a junio de 2020. Se encontraron 132 artículos, 43 se incluyeron tras cumplir los criterios de selección, relevancia científica y metodológica. Conclusiones: El uso de ciertos probióticos está recomendado para tratar la diarrea asociada a antibióticos, infección por Clostridium difficile y prevención de su diarrea asociada e infección por Helicobater pylori, pero no se recomienda para la inflamación del reservorio íleoanal. La recomendación probiótica debe recetarse por un profesional sanitario cualificado. Aún se requieren estudios con mejores diseños metodológicos para lograr formulaciones enfocadas en la terapia personalizada

Mobility restrictions and mental health among young adults during the COVID-19 pandemic in Ecuador

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

Síndrome de Burnout en médicos/as y enfermeros/as ecuatorianos durante la pandemia de COVID-19

Objective: To determine the occurrence and intensity of Burnout Syndrome (SB) in Ecuadorian doctors and nurses during the COVID-19 pandemic.Materials and methods: Observational cross-sectional study. 224 physicians and nurses from establishments of the Ecuadorian comprehensive health network participated. Participants were administered the Maslach Burnout Inventory. Data were analyzed through linear regression models using R.Results: More than 90% of the medical and nursing staff presented moderate-severe SB, which was statistically significantly associated with function (doctor vs. nurse), age and gender. Medical personnel were affected more frequently than nursing personnel, both globally and on the emotional exhaustion and depersonalization subscales.Conclusions: During the COVID-19 pandemine more than 90% of the medical and nursingpersonnel presented moderate to severe SB, with the medical staff being the most frequentlyaffected.Objetivo: Determinar la ocurrencia e intensidad de Síndrome de Burnout (SB) en médicos y enfermeros/as ecuatorianos/as durante la pandemia del COVID-19.Materiales y métodos: Estudio observacional de corte transversal. Participaron 224 médicos/as y enfermeros/as de establecimientos de la red integral de salud ecuatoriana, a quienes se administró el Inventario de Burnout de Maslach. Se analizaron los datos a través de modelos deregresión lineal usando R.Resultados: Más del 90% del personal médico y de enfermería presento SB moderado-severo, el cual se asoció de manera estadísticamente significativa a función (médico vs. enfermera/o),edad y género. El personal médico es afectado con mayor frecuencia que el personal de enfermería, tanto a nivel global como en las subescalas de agotamiento emocional y despersonalización.Conclusión: Durante la pandemia de COVID-19 más del 90% del personal médico y de enfermería presentó SB moderado a severo, siendo el personal médico el afectado con más frecuencia

Sleep quality does not mediate the negative effects of chronodisruption on body composition and metabolic syndrome in healthcare workers in Ecuador

Background and aims: The objective of the present work was to determine to what extent sleep quality may mediate the association between chronodisruption (CD) and metabolic syndrome (MS), and between CD and body composition (BC). Methodology: Cross-sectional study which included 300 adult health workers, 150 of whom were night shift workers and thereby exposed to CD. Diagnosis of MS was made based on Adult Treatment Panel III criteria. Sleep quality was measured using the Pittsburgh Sleep Quality Index. Body mass index (BMI), fat mass percentage, and visceral fat percentage were mea

Assessment of the Health Status of Spanish Schoolchildren Based on Nutrimetry, Lifestyle and Intestinal Parasites

Malnutrition in Spanish schoolchildren, and its relationship with lifestyles, has been studied, but Nutrimetry (a nutritional status indicator), and data on intestinal parasitism and its risk factors, have never before been taken into account. A total of 206 children aged 3–11 years, from two schools in the Valencian Community, participated. Demographic characteristics, diet, lifestyles, behavioural habits and anthropometric (weight, height) and coproparasitological data were collected. Nutrimetry was used to analyse nutritional status. Statistical analyses were performed to ascertain associations between lifestyle, selected parasite species and nutritional status. Multivariate logistic regression analysis was used to assess the strength of the association of the suspected risk factors with the presence of intestinal parasitism. The prevalence of overweight was 32.6%. A total of 43.9% had a high adherence to the Mediterranean Diet, for which mean daily intake was 2428.7 kcal. Intestinal parasitism was identified in 49.5% of the children (Giardia duodenalis: 28.6%). The source of drinking water was found to be a risk factor for intestinal parasitism. No positive association between the variables analysed and nutritional status could be confirmed. Nutrimetry is a good indicator for a complete analysis of nutritional status. It highlights the prevalence of overweight. Intestinal parasitism was identified in almost half of the participants and is a variable that should not be underestimated

Parasitosis intestinales en edad infantil: ¿Conocen las madres y padres a los responsables y sus repercusiones?

Introducción: La población infantil es más susceptibles de sufrir enteroparasitosis por tener más oportunidades de contacto con los parásitos, inmadurez inmunológica y hábitos higiénicos-sanitarios inadecuados. Objetivo: Obtener una visión del conocimiento de la relación parásito-enfermedad entre las madres/padres o los tutores legales de población escolar. Métodos: Se realizó un estudio descriptivo de corte transversal en dos oficinas de farmacia de la provincia de Castellón. Se calculó un tamaño muestral de 320 participantes, se establecieron los criterios de inclusión y se administró una encuesta epidemiológica con datos sociodemográficos y sobre el conocimiento de enteroparásitos. Los adultos participaron de forma anónima. Resultados: Se obtuvo una tasa de participación del 92.8%. Se analizó la influencia de ciertos factores epidemiológicos que rodeaban a los encuestados sobre su conocimiento en torno a las parasitosis intestinales. Se detectó significación estadística respecto a un bajo nivel de conocimiento sobre parasitosis y las variables: procedencia autóctona y ningún antecedente de parasitación. Asimismo, se observó una relación significativa entre un destacable conocimiento de las parasitosis y sus implicaciones en la salud humana respecto a las familias numerosas y la escala educativa y económica. Conclusión: Los resultados obtenidos permiten reflexionar sobre la importancia de promocionar la Educación para la Salud en materia de parásitos intestinales y el interés que conlleva la realización de análisis coproparasitológicos. De manera que, se pueda revertir el desconocimiento de la población del entorno de niños/as en edad escolar sobre la frecuencia de las parasitosis intestinales, sus repercusiones sobre el desarrollo infantil y las medidas higiénico-sanitarias más efectivas para su prevención y control.

Sleep quality does not mediate the negative effects of chronodisruption on body composition and metabolic syndrome in healthcare workers in Ecuador

BACKGROUND AND AIMS: The objective of the present work was to determine to what extent sleep quality may mediate the association between chronodisruption (CD) and metabolic syndrome (MS), and between CD and body composition (BC). METHODOLOGY: Cross-sectional study which included 300 adult health workers, 150 of whom were night shift workers and thereby exposed to CD. Diagnosis of MS was made based on Adult Treatment Panel III criteria. Sleep quality was measured using the Pittsburgh Sleep Quality Index. Body mass index (BMI), fat mass percentage, and visceral fat percentage were measured as indicators of body composition (BC). Data were analyzed using logistic, linear regression and structural equation models. RESULTS: The odds of health workers exposed to CD to suffer MS was 22.13 (IC95 8.68-66.07) when the model was adjusted for age, gender, physical activity and energy consumption. CD was also significantly associated with an increase in fat mass and visceral fat percentages, but not to BMI. Surprisingly, there was not enough evidence supporting the hypothesis that sleep quality contributes to the association between CD and MS or between CD and BC. CONCLUSIONS: Sleep quality does not mediate the negative effects of CD on MS nor on BC

Prevalence and associated risk factors of intestinal parasites among schoolchildren in Ecuador, with emphasis on the molecular diversity of Giardia duodenalis, Blastocystis sp. and Enterocytozoon bieneusi.

BackgroundIntestinal helminths, including Soil-Transmitted Helminth (STH), and Gastrointestinal Protist (GP) infections are major contributors to the global burden of disease, particularly in low-income countries such Ecuador. Their epidemiology in these settings is largely unknown.MethodologyThis prospective cross-sectional study investigates the carriage of intestinal helminths, including STH, and GP in asymptomatic schoolchildren (3-11 years) in the Chimborazo and Guayas provinces, Ecuador. Single stool samples (n = 372) and epidemiological questionnaires on demographics and potential risk factors were collected from participating schoolchildren. Conventional microscopy examination was used as screening method, and molecular (PCR and Sanger sequencing) assays were used to further investigate the epidemiology of some GP. A multivariate logistic regression analysis was used to evaluate the strength of the association of suspected risk factors with the presence of helminths and GP.Principal findingsAt least one intestinal parasite species was observed by microscopy in 63.2% (235/372) of the participating schoolchildren. Enterobius vermicularis (16.7%, 62/372; 95% CI: 13.0-20.9) and Blastocystis sp. (39.2%, 146/372; 95% CI: 34.2-44.2) were the most prevalent among helminths and GP, respectively. Assemblages A (50.0%), B (37.5%) and A+B (12.5%) were detected within Giardia duodenalis and ST3 (28.6%), ST1 and ST2 (26.2% each), and ST4 (14.3%) within Blastocystis sp. Three genotypes, two known (A: 66.7%; KB-1: 16.7%) and a novel (HhEcEb1, 16.7%) were identified within Enterocytozoon bieneusi. Municipality of origin, household overcrowding, and poor sanitation and personal hygiene habits were risk factors for childhood intestinal parasites colonization.Conclusions/significanceDespite massive government drug administration programs, STH and GP infection remain a public health concern in paediatric populations living in poor-resource settings. Molecular analytical methods are required to better understand the epidemiology of these intestinal parasites. This study provides novel information on the occurrence of Blastocystis sp. and E. bieneusi genetic variants circulating in Ecuadorian human populations

Cognitive function and vitamin B12 and D among community-dwelling elders: A cross-sectional study

Background & aims: Little is know on the association between mild or sub-clinical vitamin B12 or D deficiencies and cognitive decline. The objective of the present work was to evaluate the association between vitamin B12 and D levels, and cognitive function in community-dwelling elders. Methods: Cross-sectional study that included data from elders who participated in the SABE study, a population-based study that was carried out in Ecuador. Participants of SABE were selected by probabilistic sampling from the whole country. Vitamin B12 and D were measured in blood and cognitive status was assessed using an abbreviated version of the minimental state examination (MMSE). Results: The sample included 1733 elders from whom 936 (54.01%) were female. Independently from sex, age, years of education, ethnicity, socioeconomic status and geographical zone of residence, we found that vitamin B12 levels were associated to MMSE scores and that this relationship changed depending on age. In this way, we observed that from 75 years of age, drop of cognitive function was particularly steep in individuals with low levels of vitamin B12. We did not find evidence to support an association between vitamin D levels and cognitive function. Conclusions: Low levels of vitamin B12 but not of vitamin D are associated with low cognitive functioning in a sample of community-dwelling elders