Undersecretary of Health Planning, Buenos Aires City Health Services, Buenos Aires, Argentina
Undersecretary of Health Planning, Buenos Aires City Health Services, Buenos Aires, Argentina.
BMJ Open. 2021 Jan 20;11(1):e044592. doi: 10.1136/bmjopen-2020-044592.
To summarise the unfolding of the COVID-19 epidemic among slum dwellers and different social strata in the city of Buenos Aires during the first 20 weeks after the first reported case.
Observational study using a time-series analysis. Natural experiment in a big city.
Population of the city of Buenos Aires and the integrated health reporting system records of positive RT-PCR for COVID-19 tests.
Records from the Argentine Integrated Health Reporting System for all persons with suspected and RT-PCR-confirmed diagnosis of COVID-19 between 31 January and 14 July 2020.
To estimate the effects of living in a slum on the standardised incidence rate of COVID-19, corrected Poisson regression models were used. Additionally, the impact of socioeconomic status was performed using an ecological analysis at the community level.
A total of 114 052 people were tested for symptoms related with COVID-19. Of these, 39 039 (34.2%) were RT-PCR positive. The incidence rates for COVID-19 towards the end of the 20th week were 160 (155 to 165) per 100 000 people among the inhabitants who did not reside in the slums (n=2 841 997) and 708 (674 to 642) among slums dwellers (n=233 749). Compared with the better-off socioeconomic quintile (1.00), there was a linear gradient on incidence rates: 1.36 (1.25 to 1.46), 1.61 (1.49 to 1.74), 1.86 (1.72 to 2.01), 2.94 (2.74 to 3.16) from Q2 to Q5, respectively. Slum dwellers were associated with an incidence rate of 14.3 (13.4 to 15.4).
The distribution of the epidemic is socially conditioned. Slum dwellers are at a much higher risk than the rest of the community. Slum dwellers should not be considered just another risk category but an entirely different reality that requires policies tailored to their needs.
总结 2020 年首例报告病例后 20 周内，布宜诺斯艾利斯市贫民窟居民和不同社会阶层的 COVID-19 疫情发展情况。
使用时间序列分析的观察性研究。大城市中的自然实验。
布宜诺斯艾利斯市人口和综合健康报告系统记录的 COVID-19 检测 RT-PCR 阳性病例。
2020 年 1 月 31 日至 7 月 14 日期间，阿根廷综合健康报告系统记录的所有疑似 COVID-19 和 RT-PCR 确诊病例的患者信息。
为了估计居住在贫民窟对 COVID-19 标准化发病率的影响，使用校正泊松回归模型进行了分析。此外，还在社区层面进行了社会经济地位的影响的生态分析。
共有 114052 人因 COVID-19 相关症状接受了检测。其中 39039 人（34.2%）的 RT-PCR 检测结果呈阳性。第 20 周末，未居住在贫民窟的居民（2841997 人）的 COVID-19 发病率为 160（155 至 165）/100000 人，而居住在贫民窟的居民（233749 人）的发病率为 708（674 至 642）/100000 人。与社会经济状况较好的五分位数（1.00）相比，发病率呈线性梯度分布：Q2 至 Q5 分别为 1.36（1.25 至 1.46）、1.61（1.49 至 1.74）、1.86（1.72 至 2.01）、2.94（2.74 至 3.16）。居住在贫民窟的居民的发病率为 14.3（13.4 至 15.4）。
疫情的分布受到社会条件的影响。居住在贫民窟的居民面临着比社区其他成员更高的风险。贫民窟居民不应仅仅被视为另一个风险类别，而应被视为一个完全不同的现实，需要制定针对其需求的政策。
