{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T16:56:45Z","timestamp":1772557005195,"version":"3.50.1"},"reference-count":61,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T00:00:00Z","timestamp":1678233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the associations of sociodemographic, socioeconomic, and behavioral factors with depression, anxiety, and self-reported health status during the COVID-19 lockdown in Ecuador. We also assessed the differences in these associations between women and men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Design, setting, and participants<\/jats:title>\n                    <jats:p>We conducted a cross-sectional survey between July to October 2020 to adults who were living in Ecuador between March to October 2020. All data were collected through an online survey. We ran descriptive and bivariate analyses and fitted sex-stratified multivariate logistic regression models to assess the association between explanatory variables and self-reported health status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>1801 women and 1123 men completed the survey. Their median (IQR) age was 34 (27\u201344) years, most participants had a university education (84%) and a full-time public or private job (63%); 16% of participants had poor health self-perception. Poor self-perceived health was associated with being female, having solely public healthcare system access, perceiving housing conditions as inadequate, living with cohabitants requiring care, perceiving difficulties in coping with work or managing household chores, COVID-19 infection, chronic disease, and depression symptoms were significantly and independently associated with poor self-reported health status. For women, self-employment, having solely public healthcare system access, perceiving housing conditions as inadequate, having cohabitants requiring care, having very high difficulties to cope with household chores, having COVID-19, and having a chronic disease increased the likelihood of having poor self-reported health status. For men, poor or inadequate housing, presence of any chronic disease, and depression increased the likelihood of having poor self-reported health status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Being female, having solely public healthcare system access, perceiving housing conditions as inadequate, living with cohabitants requiring care, perceiving difficulties in coping with work or managing household chores, COVID-19 infection, chronic disease, and depression symptoms were significantly and independently associated with poor self-reported health status in Ecuadorian population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0275698","type":"journal-article","created":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T13:42:10Z","timestamp":1678282930000},"page":"e0275698","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Determinants of self-reported health status during COVID-19 lockdown among surveyed Ecuadorian population: A cross sectional study"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6639-727X","authenticated-orcid":true,"given":"Iv\u00e1n","family":"Due\u00f1as-Esp\u00edn","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constanza","family":"Jacques-Avi\u00f1\u00f3","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ver\u00f3nica","family":"Egas-Reyes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Larrea","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Luc\u00eda","family":"Torres-Castillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricio","family":"Trujillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9s","family":"Peralta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,3,8]]},"reference":[{"key":"pone.0275698.ref001","article-title":"Impacto del confinamiento por la COVID-19 en la salud autopercibida en Chile seg\u00fan g\u00e9nero","author":"N L\u00f3pez-Contreras","year":"2022","journal-title":"Gac Sanit."},{"issue":"12 December","key":"pone.0275698.ref002","first-page":"1","article-title":"Impact of COVID-19 pandemic on mental health: An international study","volume":"15","author":"AT Gloster","year":"2020","journal-title":"PLoS One."},{"key":"pone.0275698.ref003","first-page":"1","article-title":"Life in lockdown: a longitudinal study investigating the impact of the UK COVID \u2011 19 lockdown measures on lifestyle behaviours and mental health","author":"S Moore","year":"2022","journal-title":"BMC Public Health"},{"issue":"6","key":"pone.0275698.ref004","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1192\/bjp.2020.212","article-title":"Mental health and well-being during the COVID-19 pandemic: Longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study","volume":"218","author":"RC O\u2019Connor","year":"2021","journal-title":"Br J Psychiatry"},{"key":"pone.0275698.ref005","first-page":"1","article-title":"Individual changes in stress, depression, anxiety, pathological worry, posttraumatic stress, and health anxiety from before to during the COVID \u2011 19 pandemic in adults from Southeastern Germany","author":"TF Wechsler","year":"2022","journal-title":"BMC Psychiatry"},{"issue":"6","key":"pone.0275698.ref006","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S2215-0366(20)30168-1","article-title":"Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science","volume":"7","author":"O Holmes EA","year":"2020","journal-title":"The Lancet Psychiatry"},{"issue":"June","key":"pone.0275698.ref007","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jad.2020.08.001","article-title":"Impact of COVID-19 pandemic on mental health in the general population: A systematic review","volume":"277","author":"J Xiong","year":"2020","journal-title":"J Affect Disord"},{"key":"pone.0275698.ref008","article-title":"The impact of COVID-19 lockdown on child and adolescent mental health: systematic review. Eur Child Adolesc Psychiatry","author":"U Panchal","year":"2021","journal-title":"Internet]"},{"issue":"October 2021","key":"pone.0275698.ref009","first-page":"104606","article-title":"COVID-19 lockdowns\u2019 effects on the quality of life, perceived health and well-being of healthy elderly individuals: A longitudinal comparison of pre-lockdown and lockdown states of well-being. Arch Gerontol Geriatr","volume":"99","author":"E Colucci","year":"2022","journal-title":"Internet]"},{"issue":"3","key":"pone.0275698.ref010","first-page":"10","article-title":"Perspective from Ecuador, the Second Country with More Confirmed Cases of Coronavirus Disease 2019 in South America: A Review","volume":"12","author":"A Hallo","year":"2020","journal-title":"Cureus."},{"key":"pone.0275698.ref011","first-page":"1","article-title":"El impacto del COVID-19 en Am\u00e9rica Latina y el Caribe","author":"Naciones Unidas","year":"2020","journal-title":"Of Nac Unidas para la Coord Asuntos Humanit -OCHA"},{"key":"pone.0275698.ref012","first-page":"1","volume-title":"Bases de Datos y Publicaciones Estad\u00edsticas","author":"CEPAL CE para AL e C","year":"2022"},{"issue":"5","key":"pone.0275698.ref013","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.1093\/heapro\/daaa139","article-title":"In the name of COVID-19: Legitimizing the exclusion of community participation in Ecuador\u2019s health policy","volume":"36","author":"I Torres","year":"2021","journal-title":"Health Promot Int."},{"key":"pone.0275698.ref014","article-title":"Excess mortality during the Coronavirus pandemic (COVID-19)\u2014Our World in Data","author":"M Roser","year":"2020","journal-title":"OurWorldInData.org"},{"issue":"2","key":"pone.0275698.ref015","first-page":"587","article-title":"Covid-19 in ecuador: Political fragility and vulnerability of public health","volume":"28","author":"R. Chauca","year":"2021","journal-title":"Hist Ciencias, Saude\u2014Manguinhos."},{"key":"pone.0275698.ref016","article-title":"Encuesta Nacional de Empleo, Desempleo y Subempleo (ENEMDU), junio 2021 Encuesta","author":"INEC","year":"2021","journal-title":"Bolet\u00edn T\u00e9cnico N\u00b0 09-2021-ENEMDU."},{"key":"pone.0275698.ref017","article-title":"Instituto Nacional de Estad\u00edsticas y Censos INEC","journal-title":"Estad\u00edsticas Laborales\u2013Abril 2022"},{"key":"pone.0275698.ref018","year":"2021","journal-title":"Encuesta Nacional Multiprop\u00f3sito de Hogares, 2020 (Seguimiento al Plan Nacional de Desarrollo)."},{"issue":"8","key":"pone.0275698.ref019","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1037\/bul0000102","article-title":"Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms","volume":"143","author":"RH Salk","year":"2017","journal-title":"Psychol Bull."},{"key":"pone.0275698.ref020","author":"GO Trujillo","year":"2021","journal-title":"Teletrabajo y pandemia en ecuador"},{"issue":"29","key":"pone.0275698.ref021","first-page":"1","article-title":"Facing covid-19 in Ecuador: a blueprint for monetary policy and food sovereignty","author":"K King","year":"2021","journal-title":"Rev la r\u00e9gulation."},{"issue":"2020","key":"pone.0275698.ref022","article-title":"COVID-19 impact on people with diabetes in South and Central America (SACA region)","volume":"166","author":"MTU Barone","year":"2020","journal-title":"Diabetes Res Clin Pract"},{"key":"pone.0275698.ref023","first-page":"2","article-title":"Organizaci\u00f3n para la Cooperaci\u00f3n y Desarrollo Econ\u00f3mico [OCDE]. Impacto social del COVID-19 en Ecuador: desaf\u00edos y respuestas [Social impact of COVID-19 in Ecuador: challenges and responses]","volume":"4","year":"2020","journal-title":"Mak Dev Happen"},{"issue":"6","key":"pone.0275698.ref024","doi-asserted-by":"crossref","first-page":"857","DOI":"10.3390\/vaccines10060857","article-title":"Routine Immunization Programs for Children during the COVID-19 Pandemic in Ecuador, 2020\u2014Hidden Effects, Predictable Consequences","volume":"10","author":"GL Su\u00e1rez-Rodr\u00edguez","year":"2022","journal-title":"Vaccines."},{"issue":"15","key":"pone.0275698.ref025","doi-asserted-by":"crossref","first-page":"11","DOI":"10.31095\/investigatio.2020.15.2","article-title":"Efectos Iniciales en la Salud Mental por la Pandemia de Covid-19 en algunas Provincias de Ecuador","volume":"15","author":"A Tusev","year":"2020","journal-title":"Investigatio"},{"issue":"11","key":"pone.0275698.ref026","doi-asserted-by":"crossref","first-page":"2792","DOI":"10.1111\/jan.14526","article-title":"Child abuse and neglect prevention by public health nurses during the COVID-19 pandemic in Japan","volume":"76","author":"C Honda","year":"2020","journal-title":"J Adv Nurs"},{"issue":"11","key":"pone.0275698.ref027","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/bmjopen-2020-044617","article-title":"Gender-based approach on the social impact and mental health in Spain during COVID-19 lockdown: A cross-sectional study","volume":"10","author":"C Jacques-Avin\u00f5","year":"2020","journal-title":"BMJ Open"},{"issue":"January","key":"pone.0275698.ref028","article-title":"Ecuadorian university English teachers\u2019 reflections on emergency remote teaching during the COVID-19 pandemic","volume":"3","author":"F. 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A Cross-Sectional Study","volume":"9","author":"V Abril-Ulloa","year":"2022","journal-title":"Front Nutr"},{"issue":"9","key":"pone.0275698.ref030","doi-asserted-by":"crossref","DOI":"10.3390\/healthcare10091662","article-title":"Job Motivation, Burnout and Turnover Intention during the COVID-19 Pandemic: Are There Differences between Female and Male Workers?","volume":"10","author":"MI Paredes-Aguirre","year":"2022","journal-title":"Healthc."},{"issue":"12","key":"pone.0275698.ref031","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-048469","article-title":"Relationship between self-care activities, stress and well-being during COVID-19 lockdown: A cross-cultural mediation model","volume":"11","author":"E Luis","year":"2021","journal-title":"BMJ Open"},{"issue":"6","key":"pone.0275698.ref032","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1007\/s10900-020-00916-7","article-title":"Knowledge, Attitudes, and Practices Towards COVID-19 Among Ecuadorians During the 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mortality in a multiethnic us cohort","volume":"149","author":"DL McGee","year":"1999","journal-title":"Am J Epidemiol"},{"issue":"10","key":"pone.0275698.ref036","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.1016\/S0277-9536(03)00408-8","article-title":"Social class and self-reported health status among men and women: What is the role of work organisation, household material standards and household labour?","volume":"58","author":"C Borrell","year":"2004","journal-title":"Soc Sci Med."},{"issue":"1","key":"pone.0275698.ref037","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13293-020-00301-y","article-title":"The impact of sex and gender on immunotherapy outcomes","volume":"11","author":"SL Klein","year":"2020","journal-title":"Biol Sex Differ"},{"issue":"10","key":"pone.0275698.ref038","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: The GAD-7","volume":"166","author":"RL Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"issue":"9","key":"pone.0275698.ref039","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","author":"K Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"issue":"October 2020","key":"pone.0275698.ref040","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.jad.2020.10.061","article-title":"Self-reported changes in anxiety, depression and suicidality during the COVID-19 lockdown in Greece","volume":"279","author":"KN Fountoulakis","year":"2021","journal-title":"J Affect Disord"},{"issue":"7","key":"pone.0275698.ref041","first-page":"267","article-title":"[Estimation of the sample size in clinical and epidemiological investigations]","volume":"111","author":"J Marrugat","year":"1998","journal-title":"Med Clin (Barc)"},{"key":"pone.0275698.ref042","first-page":"170","article-title":"Regression Modeling Strategies","volume":"45","author":"Harrell Frank E","year":"2003","journal-title":"Springer"},{"issue":"8 August 2021","key":"pone.0275698.ref043","first-page":"1","article-title":"Depressive and anxiety symptoms and COVID-19-related factors among men and women in Nigeria","volume":"16","author":"OA Oginni","year":"2021","journal-title":"PLoS One"},{"key":"pone.0275698.ref044","doi-asserted-by":"crossref","first-page":"1","DOI":"10.11606\/s1518-8787.2019053001410","article-title":"Developing a deprivation index to study geographical health inequalities in ecuador","volume":"53","author":"A Peralta","year":"2019","journal-title":"Rev Saude Publica"},{"key":"pone.0275698.ref045","first-page":"78","author":"Armas Amparo","year":"2009","journal-title":"La Econom\u00eda del cuidado, el trabajo no remunerado y remunerado en Ecuador"},{"issue":"S1","key":"pone.0275698.ref046","doi-asserted-by":"crossref","first-page":"S68","DOI":"10.1080\/14616696.2020.1808692","article-title":"Cause for concerns: gender inequality in experiencing the COVID-19 lockdown in Germany","volume":"23","author":"CS Czymara","year":"2021","journal-title":"Eur Soc"},{"key":"pone.0275698.ref047","doi-asserted-by":"crossref","first-page":"105296","DOI":"10.1016\/j.worlddev.2020.105296","article-title":"Gender inequality during the COVID-19 pandemic: Income, expenditure, savings, and job loss","volume":"140","author":"HAH Dang","year":"2021","journal-title":"World Dev"},{"issue":"14","key":"pone.0275698.ref048","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1093\/cvr\/cvaa284","article-title":"Higher mortality of COVID-19 in males: Sex differences in immune response and cardiovascular comorbidities","volume":"116","author":"LA Bienvenu","year":"2020","journal-title":"Cardiovasc 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Mor\u00e9","year":"2020","journal-title":"Rev Esp Sociol"},{"key":"pone.0275698.ref050","first-page":"0","article-title":"United Nations Children\u2019s Fund\u2014UNICEF-","year":"2022","journal-title":"Am\u00e9rica Latina & El Caribe"},{"key":"pone.0275698.ref051","author":"COVID-19","year":"2022","journal-title":"C\u00f3mo asegurar el aprendizaje de los ni\u00f1os sin acceso a Internet | UNICEF Ecuador"},{"issue":"8","key":"pone.0275698.ref052","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1016\/S0277-9536(02)00541-5","article-title":"Exploring relative deprivation: Is social comparison a mechanism in the relation between income and health?","volume":"57","author":"M \u00c5berg Yngwe","year":"2003","journal-title":"Soc Sci Med"},{"issue":"664","key":"pone.0275698.ref053","first-page":"1","article-title":"Relative deprivation and mortality\u2013a longitudinal study in a Swedish population of 4,7 million, 1990\u20132006","volume":"12","author":"Naoki Kondo Monica \u00c5berg Yngwe","year":"2012","journal-title":"BMC Public Heal"},{"issue":"22","key":"pone.0275698.ref054","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph192215327","article-title":"Mental and Sexual Health of Men in Times of COVID-19 Lockdown","volume":"19","author":"E Szuster","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0275698.ref055","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1146\/annurev.publhealth.25.101802.123036","article-title":"and public health","volume":"25","author":"Shaw M. 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