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dc.contributor.authorTorres, Irene
dc.contributor.authorSippy, Rachel
dc.contributor.authorSacoto, Fernando
dc.date.accessioned2022-01-20T15:30:07Z
dc.date.available2022-01-20T15:30:07Z
dc.date.issued2021-04-01
dc.identifier.citationTorres , I , Sippy , R & Sacoto , F 2021 , ' Assessing critical gaps in COVID-19 testing capacity : the case of delayed results in Ecuador ' , BMC Public Health , vol. 21 , 637 . https://doi.org/10.1186/s12889-021-10715-xen
dc.identifier.issn1471-2458
dc.identifier.otherPURE: 277522575
dc.identifier.otherPURE UUID: cfd4cc73-d9f6-49c1-bba3-cc800b2c831b
dc.identifier.otherPubMed: 33794837
dc.identifier.otherPubMedCentral: PMC8013207
dc.identifier.otherScopus: 85103807034
dc.identifier.otherORCID: /0000-0003-3617-2093/work/106838515
dc.identifier.urihttps://hdl.handle.net/10023/24720
dc.description.abstractBackground: Testing is crucial for COVID-19 response and management, however, WHO's preparedness index omits estimations of actual testing capabilities, which influence the ability to contain, mitigate and clinically manage infectious diseases. With one of the highest excess death rates globally, Ecuador had a comparatively low number of confirmed COVID-19 cases, which may have been influenced by limited availability of data for decision-making due to low laboratory capacity. Methods: We examine de-identified data on 55,063 individuals with suspected COVID-19 between February 27 and April 30, 2020 included in the RT-PCR testing database collected by the Ministry of Health. Processing times and rates per province, and the number of pending tests, were tallied cumulatively. We assessed the relationship between sample shipping, laboratory capacity and case completion using a negative binomial generalized linear model. Results: The national average time for case completion was 3 days; 12.1% of samples took ≥10 days to complete; the national average daily backlog was 29.1 tests per 100,000 people. Only 8 out of 24 provinces had authorized COVID-19 processing laboratories but not all processed samples. There was an association between samples coming from outside the processing laboratory province, the number of other samples present at the laboratory during processing, and the amount of time needed to process a sample. Samples from another province took 1.29 times as long to process, on average. The percentage of pending results on April 30 was 67.1%. Conclusion: A centralized RT-PCR testing system contributes to critical delays in processing, which may mask a case burden higher than reported, impeding timely awareness, and adequate clinical care and vaccination strategies and subsequent monitoring. Although Ecuador adapted or authorized existing facilities to address limitations in laboratory capacity for COVID-19, this study highlights the need to estimate and augment laboratory capabilities for improved decision making and policies on diagnostic guidelines and availability. Support is needed to procure the necessary human and physical resources at all phases of diagnostic testing, including transportation of samples and supplies, and information management. Strengthening emergency preparedness enables a clear understanding of COVID-19 disparities within and across the country.
dc.format.extent8
dc.language.isoeng
dc.relation.ispartofBMC Public Healthen
dc.rightsCopyright © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.en
dc.subjectCOVID-19/diagnosisen
dc.subjectCOVID-19 nucleic acid testingen
dc.subjectEcuador/epidemiologyen
dc.subjectHealth policyen
dc.subjectHumansen
dc.subjectRNA, viral/geneticsen
dc.subjectSARS-CoV-2/geneticsen
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.subject3rd-DASen
dc.subjectSDG 3 - Good Health and Well-beingen
dc.subject.lccRA0421en
dc.titleAssessing critical gaps in COVID-19 testing capacity : the case of delayed results in Ecuadoren
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. Statisticsen
dc.identifier.doihttps://doi.org/10.1186/s12889-021-10715-x
dc.description.statusPeer revieweden


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