Browsing by Author "Chis Ster, Irina"

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    Impact of COVID-19 pandemic on asthmasymptoms and management: a prospectiveanalysis of asthmatic children in Ecuador
    (2021) Rodríguez, Alejandro; Romero Sandoval, Natalia Cristina; Cruz, Alvaro A.; Cooper , Philip John; Arteaga Vaca, Karen Alexandra; Maldonado G., Augusto; Maestre Calderón, Manolo Patricio; Chis Ster, Irina; Rodas Espinoza, Claudia Rosana; Molina Cando, María José; Morillo Argudo, Diana Alexandra; Ochoa Avilés, María Cristina; Ochoa Avilés, Angélica María
    ackground:Asthma affects up to 33% of children in Latin American settings. The ongoingCOVID-19 pandemic has had a significant impact on access to and use of health services. Weaimed to evaluate the impact of the COVID-19 lockdown on asthma exacerbations, medical facilityvisits, and use of asthma medications in children.Methods:We used data from a prospective cohort of 213 children aged 5–17 years in 3 Ecua-dorian cities and analysed the impact of the COVID-19 lockdown on asthma. Outcomes (asthmaexacerbations, emergency room [ER] visits, planned and unplanned outpatient visits, and use ofinhaled corticosteroids and Beta-2 agonists) were analysed using repeated Poisson counts (ie,number of events per participant before and during the COVID-19 lockdown).Results:During compared to before lockdown: a) the number of asthma exacerbations remainedconstant (IRR, 0.87; 95% CI: 0.72–1.05; p¼0.152); b) outpatient visits (IRR 0.26, 95% CI 0.14–0.47,p<0.001) declined 74% while ER visits declined 89% (IRR 0.11, 95% CI 0.04–0.32, p<0.001); andc) there was no change in inhaled corticosteroids use (IRR 1.03, 95% CI 0.90–1.16, P¼0.699) whileBeta-2 agonist use increased (IRR 1.32, 95% CI 1.10–1.58, P¼0.003).Conclusions:In a cohort of Ecuadorian children with asthma, health services attendancedecreased dramatically after COVID-19 lockdown, but asthma exacerbations and use of inhaledcorticosteroids were unchanged. Future analyses will address the question of the effect of SARS-CoV-2 infection on asthma exacerbations and control in this paediatric population.
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    Prospective study of factors associated with asthma attack recurrence (ATTACK) in children from three Ecuadorian cities during COVID-19: a study protocol
    (2022) Alchundia, Jéssica; Chico, Martha E; Ochoa Avilés, Angélica María; Mena Bucheli, Santiago; Morillo, Diana; Figueiredo, Camila Alexandrina; Rodriguez, Alejandro; Solorzano, Karla; Cooper, Philip John; Romero, Natalia Cristina; Cruz, Álvaro Augusto; Chis Ster, Irina; Perkin, Michael Richard; Bachmann, Max Oscar; Ardura García, Cristina; Arteaga, Karen; Maldonado, Augusto; Rodas, Claudia
    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.