Conference 2021 Live Talk
Epidemiological and spatial analysis of COVID-19 cases in Native Amazonian communities from Peru
Authors and Affiliations
Cecilia Pajuelo-Reyes1, Hugo J. Valencia1, Carla C. Montenegro1, Lizandro Gonzales2, Eduardo Quezada2, Norma Cruz2, Carlos Canelo3, Carla Ordinola1, Juan R. Tejedo1,4, Rafael Tapia-Limonchi1, Stella M. Chenet1
1. Instituto de Enfermedades Infecciosas. Universidad Nacional Toribio Rodríguez de Mendoza (UNTRM), Amazonas, Peru.
2. Dirección Regional de Salud (DIRESA), Amazonas, Peru.
3. Gobierno Regional de Amazonas (GOREA), Peru.
4. Universidad Pablo de Olavide (UPO), Sevilla, Spain.
Peru reported its first case of COVID-19 on March 6th. Ten days later, with 86 confirmed cases and no deaths, the Peruvian government declared national emergency, with a strict national lock-down and border closures. In the North of Peru, in a remote area of the Amazonas region, the Condorcanqui province is under particular threat since it is home of Wambisa and Awajun ethnic communities without basic living conditions. Therefore, an epidemiological study of COVID-19 cases is important to describe the impact of the pandemic and improve control strategies in these remote indigenous communities.
The COVID-19 database was provided by the Regional Directorate of Health of Amazonas (DIRESA-Amazonas), and all cases were diagnosed by rapid serological tests. Spatial-temporal analysis of cases was performed to detect clusters of high and low risk for COVID-19. Multivariate analysis was performed to evaluate death risk contributions of all clinical parameters. Transmission chains of the initial and remarkable cases were described.
The spatial-temporal analysis confirmed an area of high risk in the north of Amazonas region, mainly in the Condorcanqui province. Death risk analysis of 2640 closed cases with the multivariate Cox regression model showed nine significant risk factors in Amazonas and only three in Condorcanqui: ≥ 60 years, respiratory difficulty, and dyspnea. Also, the description of transmission chains indicated a late response to diagnose contacts, and a native community named Chorros already presented 60% seroprevalence by the end of July.
Death risk factors of COVID-19 cases evaluated in this population were consistent with studies in other populations around the world. The spread of COVID-19 in Amazonas, despite the harsh contention measures, was probably due to a lack of early diagnosis and social inequities, especially in Condorcanqui province where the health system is more precarious. A seroprevalence study on native communities is needed in order to accurately describe the spread of the disease, the mortality rate and the prioritization of COVID-19 vaccination.