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COVID-19 in Cuban Children and Adolescents. First Report. Epidemiological Weeks 12 to 22. June 2020

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COVID-19 in Cuban children and adolescents. First report. Epidemiological weeks 12 to 22. June 2020 Luisa Iñiguez Rojas. Latin American Faculty of Social Sciences - Cuba. University of Havana Edgar Figueroa Fernández. Center for Population and Development Studies National Office of Statistics and Information of Cuba Angel Miguel Germán Almeida. Pedro Kouri National Institute of Tropical Medicine Ministry of Public Health María Esther Álvarez. Cuba’s National Schools of Public Health. Ministry of Public Health Lorenzo Somarriba. Director. Centre for Health Surveillance. Ministerial Management Centre. Ministry of Public Health. Antonio Herrada Hidalgo. Latin American Faculty of Social Sciences - Cuba. University of Havana Laura Almora Adarcio. Center for Psychological and Sociological Research Ministry of Science, Technology and Environment CONTENT Description of children and adolescents diagnosed with COVID-19 (according to sex, age and place of residence) | 03 Territorial distribution of COVID-19 cases in children and adolescents aged 0-18 years | 06 Distribution of cases by human settlements | 09 Preliminary considerations | 16 On 11 March 2020, Cuba confirmed the first cases of equal or higher than 10 cases in a few days (6), after the COVID-19. Three tourists from Italy, who were visiting first diagnosis. Figure 1. a heritage city in Central Cuba, tested positive. Ten Date days later, on 21 March, an 18-month-old child, who 21/03/20 was on a family visit with his mother (19) from Spain, 24/03/20 became the first child to be diagnosed, along with his 27/03/20 mother. The time elapsed between entering the coun- 30/03/20 try and showing symptoms shows that they both arri- 02/04/20 ved in the country carrying the SARS-CoV-2 virus. 05/04/20 They were both registered according to the place of 08/04/20 residence of their relatives, in the urban settlement of Guisa, from the homonymous municipality of over 20 11/04/20 000 residents, one of the Sierra Maestra’s mountainous 14/04/20 municipalities in the eastern Granma Province, 17 km 17/04/20 from the provincial capital Bayamo. 20/04/20 In the following days, other children travelling 23/04/20 from the United States, Guyana and France were also 26/04/20 diagnosed. Two children from France were consi- 29/04/20 dered as imported cases. They were joined by other 02/05/20 children who were in contact with confirmed cases 05/05/20 from overseas (imported cases) and Cubans (indige- 08/05/20 nous cases). Seventy days after the beginning of the 11/05/20 epidemic in the country, 223 children and adolescents 14/05/20 have been diagnosed with COVID-19; four of them 17/05/20 were Cubans residing abroad, two foreign tourists 20/05/20 and one Cuban resident who returned to the country 23/05/20 with her mother. 26/05/20 29/05/20 Description of children and adolescents diagnosed with 0241618 10 2 41618 Cases COVID-19 (according to sex, age Indigenous Imported and place of residence) Figure 1. Cuba. COVID-19 cases by date of confirmation (21 March to 30 May) According to the date of confirmation, the amount Source: Ministry of Health’s daily briefings, Department of of cases per day shows a wide variation with figures Health Surveillance’s Database -3- EPIDEMIOLOGICAL CHARACTERISTICS AND SPATIAL DIFFUSION OF COVID-19 IN CHILDREN AND ADOLESCENTS The evolution of the disease during epidemiolo- 2 weeks. This behaviour coincides with the evolution gical weeks1 12 to 22 shows the increase of notifica- of total cases in the country by epidemiological weeks. tions starting on week 13, which reaches a maximum Figures 2a and 2b. number of confirmed cases in weeks 15 (55), 16 (36) and In terms of the weekly evolution of the disease in 17 (39). In the following weeks, the cases are reduced the country, there are no sex-specific differences until to 5 in week 20, with a slight increase over the next week 15. From then on, the highest number of notified cases is reached, the number of infected children in- 1 In general, the term epidemiological week is used in the analy- creases and this trend continues in most of the subse- sis of the behaviour of diseases, especially communicable ones, in accordance with an international calendar quent weeks. Figures 3a and 3b. Confirmed Percentage cases of the total 250 18 16 200 14 150 12 10 100 8 6 50 4 0 2 11 12 13 14 15 16 17 18 19 20 21 22 Week 0 Cases per week Cumulative cases 11 12 13 14 15 16 17 18 19 20 21 22 Week Figure 2a. COVID -19 cases in children and adolescents by Figure 2b. Percentage of cases in individuals confirmation date. aged 0-18 years. Source: Ministry of Health’s daily briefings, Department of Source: Ministry of Health’s daily briefings, Department of Health Surveillance’s Database. Health Surveillance’s Database. Cases Cumulative per week cases 60 250 50 200 40 150 30 100 20 50 10 0 0 0 0 Date 12 13 14 15 16 17 18 19 20 21 22 23 24 Week 4/05/2 9/05/2 21/03/20 28/03/20 31/03/20 03/04/20 06/04/20 09/04/20 12/04/20 16/04/20 19/04/20 23/04/20 28/04/20 13/05/20 18/05/20 22/05/20 26/05/20 29/05/20 Total Female Male Female Male Figure 3a. Cuba. Distribution of COVID-19 confirmed cases Figure 3b. Cuba. Dynamics of COVID-19 case by sex and epidemiological weeks. confirmations by sex. Source: Ministry of Health’s daily briefings, Department of Source: Ministry of Health’s daily briefings, Department of Health Surveillance’s Database. Health Surveillance’s Database. -4- EPIDEMIOLOGICAL CHARACTERISTICS AND SPATIAL DIFFUSION OF COVID-19 IN CHILDREN AND ADOLESCENTS The distribution of children and adolescents confirmed cal week 15 (5 – 11 April), and week 16 for the 0-5 age with COVID-19 by age group shows the highest number group. Up until week 15, a similar behaviour in terms of cases among children aged 12–18 years. A comparison of age groups is observed, as the distribution by group between the proportion of population and the propor- is varies in the following week. tion of cases in each group indicates a smaller impact on The distribution by sex and age shows a relatively the 0-5 age group, a similar one in the 5-11 age group and homogenous behaviour of cases by sex in the age higher in the 12-18 group. Figures 4a and 4b. group 12-18. Boys are predominant in week 15 and gir- The highest numbers of confirmed cases in the age ls in week 17. The behaviour by sex is irregular in the groups 12-18 and 6-11 were reached in epidemiologi- rest of the groups. Figure 5. Cases Cumulative per week cases 60 250 50 200 40 150 30 100 20 50 10 0 0 0 0 0 0 0 0 0 0 0 0 Date 0 11 12 13 14 15 16 17 18 19 20 21 22 Week 21/03/2 28/03/2 04/04/2 11/04/2 18/04/2 25/04/2 02/05/2 09/05/2 16/05/2 23/05/2 29/05/2 0-5 years old 6-11 years old 12-18 years old 0-5 years old 6-11 years old 12-18 years old Figure 4. Cuba. Distribution of COVID-19 confirmed cases by age group: a) cumulative number of cases per week, b) cumulative number of cases per day (confirmation date). Source: Ministry of Health’s daily briefings, Department of Health Surveillance’s Database. Confirmed cases 18 16 14 12 10 8 6 4 2 0 12 13 14 15 16 17 18 19 20 21 22 Week 0-5 years old female 6-11 years old female 12-18 years old female 0-5 years old male 6-11 years old male 12-18 years old male Figure 5. Cuba. Cases of COVID-19 in children and adolescents by sex and epidemiological week. Source: Ministry of Health’s daily briefings, Department of Health Surveillance’s Database -5- EPIDEMIOLOGICAL CHARACTERISTICS AND SPATIAL DIFFUSION OF COVID-19 IN CHILDREN AND ADOLESCENTS Territorial distribution of COVID-19 In some provinces, confirmed cases of COVID-19 in cases in children and adolescents population aged 0-18 years are concentrated in cities. aged 0-18 years In others cases, are more prevalent in rural settle- Up to 30 May, the last day of epidemiological week 22, ments, like in the Güanes municipality, Pinar del Río at least one child or adolescent had been diagnosed Province (66.6 %), where 10 out of 15 cases confirmed with COVID-19 in 63 out of 168 municipalities in the are found in rural settlements. The distribution of ca- country (37.5 % of the total). Rural settlements registe- ses by province shows that just over 50 % of cases are red2 13.45 % of cases and urban settlements registered concentrated in 2 of the 15 provinces in the country, 86.54 %. The urban incidence rate doubles the rural La Habana (34.53 %) and Villa Clara (16.14 %). one (10.57 per 100 000 and 5.77 per 100 000 children According to the rate of territorial distribution, and adolescents). which considers Cuba=1, six provinces in the country From another territorial perspective, the highest have been at a disadvantage compared to the general percentage of cases is concentrated in municipal cen- evolution of the epidemics in the country.
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