CAGUA ORDONEZ, JAEN CARLOS

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CAGUA ORDONEZ, JAEN CARLOS
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    Sociodemographic and spatiotemporal distribution of tuberculosis and human immunodeficiency virus co-infection in three cantons of Guayas, Ecuador: A cross-sectional study.
    (Medwave Estudios Limitada, 2025-04-16)
    Ronald Cedeño Vega
    ;
    Inti Kory Quevedo
    ;
    ANGAMARCA IGUAGO, JAIME WLADIMIR  
    ;
    CAGUA ORDONEZ, JAEN CARLOS  
    ;
    PARISE VASCO, JUAN MARCOS  
    Introduction Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection are major public health problems in Latin America and Africa. The province of Guayas in Ecuador has a high proportion of cases but there is limited information on their sociodemographic characteristics and spatial distribution. The aim of this study was to analyze the sociodemographic and spatiotemporal characteristics of TB/HIV coinfection patients in three cantons of the Guayas province, Ecuador, in 2018. Methods A cross-sectional study was conducted using secondary data from the Ministry of Public Health of Ecuador. The study population was all adult patients with a diagnosis of TB/HIV co-infection residing in the three cantons of the three cantons. Data were analyzed to determine prevalence, incidence and mortality, as well as socio-demographic variables such as age, sex, educational level and housing conditions. Spatial distribution was assessed using QGIS software version 3.24 to identify high-prevalence areas. Results A total of 379 cases of TB/HIV coinfection were identified, with a predominance of males (80.74%) and a mean age of 35 years. The prevalence was 1.24 per 100 000 inhabitants, with a case fatality rate of 15.57%. Individuals below the poverty line showed a stronger association with co-infection (PR=6.773, 95% CI: 4.985 to 9.202). Spatially, cases were concentrated in socioeconomically disadvantaged municipalities of Guayaquil. Conclusions TB/HIV co-infection shows a clear association with social determinants, especially poverty and educational level. The heterogeneous spatial distribution among the three cantons and the high case fatality rate suggests the need to strengthen epidemiological surveillance and implement targeted interventions addressing social determinants in the most vulnerable areas.
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    Expert Consensus on the Nutrition Care Process in Guatemalan Hospitals: Findings from a Delphi Study of nutritionDay 2022 Participants
    (MDPI AG, 2025-09-30)
    Karen Girón
    ;
    Isabel Chinchilla
    ;
    Christa Gómez
    ;
    Marietta Lau
    ;
    María René Oroxon
    Background: Disease-related malnutrition (DRM) remains an underdiagnosed condition in Latin American hospitals, with substantial clinical and economic consequences. The global nutritionDay initiative, promoted by ESPEN, provides a standardized audit to evaluate and improve hospital nutritional care. This study aimed to develop expert consensus recommendations to optimize the nutritional care process in Guatemalan hospitals, based on the findings from nutritionDay 2022. Methods: A modified Delphi study was conducted, including three meetings held before and after each round to discuss the results. Sixteen clinical nutrition professionals from eleven hospitals participated. A total of 89 items were assessed, with a predefined consensus threshold of 70%. Data were analyzed using R software (version 4.5.0) and Kendall’s W coefficient was applied to evaluate inter-round agreement. Results: Consensus was achieved for 51 key recommendations covering nutritional screening, clinical assessment, anthropometry, body composition, functional assessment, biochemical monitoring, dietary intervention, and post-discharge follow-up. The proposed actions are aligned with international guidelines (ESPEN, ASPEN, GLIM) and adapted to the Guatemalan healthcare context. Conclusions: This consensus provides a comprehensive and context-specific framework for standardizing and improving hospital nutritional care in Guatemala and similar settings. Its implementation could help reduce DRM prevalence and foster the development of quality indicators and digital tools for clinical nutrition management.
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    El triple brote en Ecuador: entre la sindemia y la infodemia
    (2025)
    SIMANCAS RACINES, DANIEL ALEJANDRO  
    ;
    REYTOR GONZÁLEZ, CLAUDIA MARÍA  
    ;
    CAGUA ORDONEZ, JAEN CARLOS  
    Brotes simultáneos de tosferina, fiebre amarilla y leptospirosis en zonas rurales y amazónicas del Ecuador evidenciaron una combinación crítica de factores estructurales y sanitarios. La baja cobertura de vacunación, la escasez de servicios básicos, la pobreza, la desnutrición infantil y la limitada capacidad de vigilancia epidemiológica contribuyeron a una mayor carga de enfermedad. Estos eventos, potenciados por una infodemia marcada por desinformación y alarma social, configuraron una sindemia con consecuencias desproporcionadas en poblaciones vulnerables. Ante este escenario, resultan prioritarias acciones integradas que fortalezcan el primer nivel de atención, promuevan la comunicación en salud adaptada al contexto y garanticen condiciones dignas de vida como ejes fundamentales de una respuesta sindémica integral, equitativa y resiliente.