COVID-19 outbreak in Amazon: a challenge for public health surveillance in Colombia

  • Vaccine preventable diseases
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Background:
The highest Covid-19 incidence rates in the country were registered in Leticia with 2,014 cases per 100.000 inhabitants up to epidemiological week 19. To characterize the outbreak, to identify sources of infection by the causative agent, risk factors and to recommend control and prevention measures.

Methods:
A specific case definition was established to identify Covid-19 cases in the Amazonas Department between the 14th and the 19th epidemiological week. Data were collected from patients confirmed by screening, active community search in risk groups, notification sheets, medical records, laboratory results and epidemiological investigation. Epidemic curves, frequency distribution, measures of central tendency and dispersion, attack rates, fatality rate and georeferencing of cases were established.

Results:
1,104 cases were reported; 61% (n=671) were men, the 25 to 29 years age group was the most affected [12.1% (n=134)], with a median of 35 years (IQR: 24-25 years), 25.5% (n=281) of the cases are indigenous. The Ticuna, Cocama and Uitoto indigenous ethnic groups accounted for 82% of the cases; 26.4% (n=292) were asymptomatic cases. Cough [52% (n=576)], fever [51% (n=567) and odynophagia [13% (n=146)] were the main symptoms. The fatality rate was 4%. Nineteen clusters were identified, and the attack rate in the prison population was 83%.

Conclusions:
There was a widespread Covid-19 outbreak affecting the indigenous population. The rapid community transmission was due to the transit of people at the border crossings and to the high number of asymptomatic cases. The definition of specific zone case allowed an early identification of Covid-19 cases.

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