• Paulina Ríos Quituizaca, Lilian Calderón, Santiago Piedra, Jhon Guerrero, and Alberto Narváez.
• Universidad Central del Ecuador, Facultad de Ciencias Médicas, Quito, Ecuador; Universidad de Sao Paulo, Facultad de Medicina de Ribeirao Preto, Sao Paulo, Brasil. Electronic address: paulina.riosq@gmail.com.
• Aten Primaria. 2021 May 1; 53 (5): 102021102021.

ObjectiveThe present study seeks to analyse sociodemographic determinants related to severe acute respiratory infections (SARI) and calculate the priorization index in the cantons of Ecuador to identify areas probably most vulnerable to COVID-19 transmission.DesignThis descriptive ecological observational study.Setting224 cantons (geographical area) of Ecuador with secondary data sources of hospital information.ParticipantsThe unit of measurement was 224 cantons of Ecuador, in which analysed morbidity and lethality rates for SARI using hospital release data (2016-2018).Main MeasurementsEight sociodemographic indicators were structuralized, and correlation tests applied for a multiple regression model. The priorization index was created with criteria of efficiency, efficacy, effect size (IRR) and equity. Using the sum of the index for each indicator, the priorization score was calculated and localized in a territorial map.ResultsMorbidity associated factors where: school attendance years, urbanization and population density; for mortality resulted: school attendance and ethnics (indigenous) IRR: 1.09 (IC95%:1.06-1.15) and IRR: 1.024 (IC95%:102-1.03) respectively. With lethality where related cantons, with population older than 60 years, IRR: 1.049 (IC95%: 1.03-1.07); 87 cantons had high priority mostly localized in the mountain region and the Morona Santiago Province.ConclusionsMorbidity and mortality of SARI in Ecuador are associated to social and demographic factors. Priorization exercises considering these factors permit the identification of vulnerable territories facing respiratory disease propagation. The social determinants characteristic for each territory should be added to known individual factors to analyse the risk and vulnerability for COVID in the population.Copyright © 2021 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

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