Browsing by Author "Delgado López, Dayanara Alejandra"

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Análisis comparativo de los costos de la prevención y tratamiento asociados al cáncer de cuello uterino en Ecuador
(2024) Mendieta Muñoz, Luis Rodrigo; Figueroa Campoverde, David Sebastián; Neira Molina, Vivian Alejandra; Delgado López, Dayanara Alejandra; Ramos Rodríguez, Lisseth Carolina; Dávila Sacoto, Santiago Arturo; Andrade Galarza, Andrés Fernando; Vega Crespo, Bernardo José
Background: Cervical cancer is the second leading cause of death due to oncological pathologies in Ecuadorian women. Vaccination and early detection are effective in preventing this disease. The costs of cervical cancer treatment are high. Objective: To compare the cost per person for cervical cancer prevention versus the treatment of cervical lesions. Methodology: An analysis of therapeutic recommendations and associated costs for treatment and prevention was conducted based on the cost schedule for the national health system of Ecuador. Results: The investment in prevention varies according to the scheme used. When using the optimal vaccination and scree-ning with cytology, the investment is $395.62 USD. When using the optimal vaccination and human papillomavirus detection scheme, the cost is $761.42 USD. The cost of follow-up for low-grade lesions is $490.7 USD; for high-grade lesions and in situ cancer with outpatient management, it is $685.43 USD. In the case of in situ cancer/Stage IAI/or non-conizable cervixes, the cost reaches $3465.68 USD. For invasive stages I to 2; IB; IIA, it is $23,762.20 USD, and for stages IIB-III-IV, the minimum cost is $28,560.22 USD. Conclusions: The cost of managing advanced and invasive cervical lesions is 10 to 101 times more expensive than prevention per person. The cost for a person with a basic salary of $460 USD would create inequities in access to treatment and survival. The cost per person that the state must cover for the treatment of advanced cervical cancer is much higher than the investment in preven
Human Papillomavirus Prevalence and Associated Factors in Indigenous Women in Ecuador: a Cross-Sectional Analytical Study
(2023) Ortiz Segarra, José Ignacio; Vega Crespo, Bernardo José; Salazar Torres, Zoila Katherine; Delgado López, Dayanara Alejandra; Ortiz Mejía, José Stalin; Campoverde Cisneros, Manuel Alfredo
Abstract: Cervical cancer (CC) is the second leading cause of death from malignancy in women in Ecuador. Human papillomavirus (HPV) is the main causative agent of CC. Although several studies have been conducted on HPV detection in Ecuador, there are limited data on indigenous women. This cross-sectional study aimed to analyze the prevalence of HPV and associated factors in women from the indigenous communities of Quilloac, Saraguro and Sevilla Don Bosco. The study included 396 sexually active women belonging to the aforementioned ethnicities. A validated questionnaire was used to collect socio-demographic data, and real-time Polymerase Chain Reaction (PCR) tests were used to detect HPV and other sexually transmitted infections (STIs). These communities are located in the southern region of Ecuador and face geographical and cultural barriers to accessing health services. The results showed that 28.35% of women tested positive for both types of HPV, 23.48% for high-risk (HR) HPV, and 10.35% for low-risk (LR) HPV. Statistically significant associations were found between HR HPV and having more than three sexual partners (OR 1.99, CI 1.03–3.85) and Chlamydia trachomatis infection (OR 2.54, CI 1.08–5.99). This study suggests that HPV infection and other sexually transmitted pathogens are common among indigenous women, highlighting the need for control measures and timely diagnosis in this population
Impact of an Educational Intervention for Healthy Eating in Older Adults: A Quasi-Experimental Study
(2023) Freire Argudo, Ulises Vicente; Delgado López, Dayanara Alejandra; Ortiz Mejía, José Stalin; Ortiz Segarra, José Ignacio
The elderly population in Ecuador is increasing rapidly, with an increasing incidence of diet-related diseases. The elderly living in the community seek alternative and complementary methods to improve their diet and quality of life. This study aimed to investigate the impact of an educational intervention on knowledge related to healthy eating among older adults. This intervention is rooted in the principles of meaningful learning and incorporates culturally adapted materials. A quasi-experimental study design was employed using a pre-test–post-test control group. Study participants were a total of 109 elderly (intervention: n = 51, control: n = 58) people in Cuenca, Ecuador. The educational intervention based on Ausubel’s theory of significant learning and Vygotsky’s sociocultural theory was programmed to be carried out for one session per week, over 24 weeks, with a duration of 120 min per session. The measures were the general characteristics of the study participants and knowledge about necessary amounts, food sources and the consequences of deficits or excesses in the consumption of macro- and micronutrients. Data were collected from August 2018 to February 2019. Statistically significant differences were observed between the intervention group (IG) and the control group (CG) in terms of knowledge about healthy eating for older adults following the educational intervention. The outcomes of this study strongly suggest the efficacy of the program in improving knowledge related to healthy eating among older adults. Healthcare providers should prioritize food education based on meaningful learning, utilizing culturally adapted materials for the elderly individuals residing within the community.
p16/Ki-67 dual staining as a predictive value for cervical cancer compared to other conventional triage tools: a descriptive literature review
(2024) Ochoa Avilés, María Cristina; Neira Molina, Vivian Alejandra; Vega Crespo, Bernardo José; Acosta Bedon, Ana Victoria; Delgado López, Dayanara Alejandra
Cervical cancer (CC) poses a significant global health concern, ranking as the fourth most frequently diagnosed cancer and the fourth leading cause of death among women worldwide. Ecuador bears a substantial burden of CC, with a considerable number of new cases and deaths reported annually. The primary cause of CC is the human papillomavirus (HPV), a sexually transmitted virus that is usually eliminated by cell immunity. However, around 5% of infections persist and can lead to invasive cancer. This literature review assessed the predictive value of p16 and Ki-67 dual staining (DS) as a standalone method or combined with conventional triage methods to improve CC screening programs. A total of 42 relevant articles were analyzed, evaluating the performance of DS in predicting cervical intraepithelial neoplasia (CIN) of varying severities. DS exhibited a median sensitivity and specificity of 87.7% and 76.7% for detecting CIN2+ and 89.7% and 79.6% for CIN3+. When combined with liquid-based (LB) cytology, DS demonstrated superior sensitivity and specificity compared to other screening strategies. This review suggests that p16 and Ki-67 DS alone or in combination with liquid base (LB) could enhance the accuracy and effectiveness of CC screening