Background Vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses in pregnant women and their children. In Ecuador, the coverage of seasonal influenza vaccination in pregnant women is low. The aim of this study was to assess the knowledge, attitudes, and practices (KAP) of pregnant women toward influenza vaccination in Quito-Ecuador. Methods A cross-sectional study enrolled 842 women who delivered at three main public gynecological-obstetric units of the Metropolitan District of Quito. A questionnaire regarding demographics, antenatal care, risk conditions and knowledge, attitudes and practices related to influenza vaccination was administered. We examined factors associated with vaccination using log-binomial regression models. Results A low vaccination rate (36.6%) against influenza was observed among pregnant women. The factors associated with vaccination included the recommendations from health providers (adjusted PR: 15.84; CI 95% 9.62–26.10), belief in the safety of the influenza vaccine (adjusted PR: 1.53; CI 95% 1.03–2.37) and antenatal care (adjusted PR: 1.21; CI 95% 1.01–1.47). The most common reasons for not vaccinating included the lack of recommendation from health care providers (73.9%) and lack of access to vaccine (9.0%). Conclusions Health educational programs aimed at pregnant women and antenatal care providers have the most potential to increase influenza vaccination rates. Further studies are needed to understand the barriers of health care providers regarding influenza vaccination in Ecuador.

Background: Vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses in pregnant women and their children. In Ecuador, the coverage of seasonal influenza vaccination in pregnant women is low. The aim of this study was to assess the knowledge, attitudes and practices of pregnant women toward influenza vaccination in Quito-Ecuador.Methods: A cross-sectional study enrolled 842 women who delivered at three main public gynecological-obstetric units of the Metropolitan District of Quito. A questionnaire regarding demographics, antenatal care, risk conditions and knowledge, attitudes and practices related to influenza vaccination was administered. We examined factors associated with vaccination using log-binomial regression models.Results: A low vaccination rate (36.6%) against influenza was observed among pregnant women. The factors associated with vaccination included the recommendations from health providers (adjusted PR: 15.84; CI 95% 9.62-26.10), belief in the safety of the influenza vaccine (adjusted PR: 1.53; CI 95% 1.03-2.37) and antenatal care (adjusted PR: 1.21; CI 95% 1.01-1.47). The most common reasons for not vaccinating included the lack of recommendation from health care providers (73.9%) and lack of access to vaccine (9.0%).Conclusions: Health educational programs aimed to pregnant women and antenatal care providers have the most potential to increase influenza vaccination rates. Further studies are needed to understand the barriers of health care providers regarding influenza vaccination in Ecuador.

We introduce HydroLang Markup Language (HL-ML), a programming interface that uses markup language to perform environmental analyses using the hydrological and environmental framework HydroLang. The software acts as a self-contained interface that uses HTML tags powered by the web components specification to generate simple hydrological computations that enable data analysis, visualization and manipulation via semantically driven instructions. It enables hydrological researchers and professionals to use markup language to retrieve, analyze, visualize, and map data without the need for a programming experience. The components' adaptability enables users to run analytical routines that perform simple and complex analyses on the client side. We present the implementation details of the approach, the use of custom elements in web technologies and academia, and share sample usages to demonstrate the simplicity of use of the human-readable and computer-executable framework.

IntroductionThere is evidence that demonstrates lower incidence rates of cardiometabolic factors at the highlands. There are no studies which correlate the altitude with formally calculated cardiovascular risk by a meter-by-meter approach. Under the hypothesis that cardiovascular risk is inversely associated with altitude, this study was aimed to assess such association.Materials and methodsCross sectional study using data from the Ecuadorian National Health Survey of 2012. We analyzed available information of adults of ≥ 40 to 60 years old who have sociodemographic, anthropometric, cardiovascular risk factors, and laboratory biomarkers that were included in the survey. We assessed the independent association between altitude of the housing in which survey participants lived at, on a meter-by-meter approach, and cardiovascular health risk at ten years, formally calculated by Framingham equations.ResultsLinear regression model showed that participants had 0.0005 % less probability of developing cardiovascular disease at 10 years per each increase in a meter in the altitude that participants live at (p<0.001), adjusted for sex, age, ethnicity, educational level, availability of social security, immigrants in family, area, income quintile, overcrowding (≥ 7 inhabitants in the house), any alcohol consumption, history of hypertension, body mass index, hematocrit, and triglycerides.ConclusionFrom a public health perspective, altitude at which individuals live is an important health determinant of cardiovascular risk. Specifically, per each increase of 1000 m in the altitude that people live at, there is a reduction of almost half a percentual point in the cardiovascular risk at 10 years.

Background: Vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses in pregnant women and their children. In Ecuador, the coverage of seasonal influenza vaccination in pregnant women is low. The aim of this study was to assess the knowledge, attitudes and practices (KAP) of pregnant women toward influenza vaccination in Quito-Ecuador.Methods: A cross-sectional study enrolled 842 women who delivered at three main public gynecological-obstetric units of the Metropolitan District of Quito. A questionnaire regarding demographics, antenatal care, risk conditions and knowledge, attitudes and practices related to influenza vaccination was administered. We examined factors associated with vaccination using log-binomial regression models.Results: A low vaccination rate (36.6%) against influenza was observed among pregnant women. The factors associated with vaccination included the recommendations from health providers (adjusted PR: 15.84; CI 95% 9.62-26.10), belief in the safety of the influenza vaccine (adjusted PR: 1.53; CI 95% 1.03-2.37) and antenatal care (adjusted PR: 1.21; CI 95% 1.01-1.47). The most common reasons for not vaccinating included the lack of recommendation from health care providers (73.9%) and lack of access to vaccine (9.0%).Conclusions: Health educational programs aimed to pregnant women and antenatal care providers have the most potential to increase influenza vaccination rates. Further studies are needed to understand the barriers of health care providers regarding influenza vaccination in Ecuador.