<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0864-3466</journal-id>
<journal-title><![CDATA[Revista Cubana de Salud Pública]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Salud Pública]]></abbrev-journal-title>
<issn>0864-3466</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0864-34662020000200011</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Tendencias y análisis espacio-temporal de la mortalidad por diabetes mellitus en Ecuador, 2001-2016]]></article-title>
<article-title xml:lang="en"><![CDATA[Trends and space-time analysis of mortality due to diabetes mellitus in Ecuador, 2001-2016]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Núñez-González]]></surname>
<given-names><![CDATA[Solange]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Delgado-Ron]]></surname>
<given-names><![CDATA[Andrés]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Simancas-Racines]]></surname>
<given-names><![CDATA[Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad UTE, Facultad de Ciencias de la Salud Eugenio Espejo Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC) ]]></institution>
<addr-line><![CDATA[Quito ]]></addr-line>
<country>Ecuador</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<volume>46</volume>
<numero>2</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0864-34662020000200011&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0864-34662020000200011&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0864-34662020000200011&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: La mortalidad por diabetes mellitus es un problema de salud pública en ascenso en el mundo.  Objetivos:  Analizar los patrones temporales y espaciales de mortalidad por diabetes mellitus en Ecuador durante el periodo 2001-2016.  Métodos: Se realizó un estudio ecológico mixto. Se calcularon las tasas de mortalidad específica y ajustada por edad para el periodo 2001-2016 en el Ecuador. Se utilizó el análisis de regresión de punto de inflexión para el análisis de las tendencias, y la metodología desarrollada por Kulldorf para el análisis de conglomerados espacio-temporales.  Resultados: Durante el periodo 2001-2016 se registraron 57 788 defunciones por diabetes mellitus en el Ecuador. En el análisis de punto de inflexión las tasas ajustadas por edad en hombres reportaron un ascenso significativo del porcentaje de cambio anual de 2,4 % (2001-2016; p &lt; 0,001) y en las mujeres ascendió al 1,50 % (2001-2016; p &lt; 0,001). En el análisis espacio-temporal se detectaron dos conglomerados de alta mortalidad estadísticamente significativos, el conglomerado primario conformado por las provincias: Santa Elena, Guayas, Manabí y Los Ríos (p &lt; 0,001) y el conglomerado secundario formado por la provincia de Santo Domingo de los Tsáchilas (p &lt; 0,001).  Conclusiones: La mortalidad por diabetes mellitus en el Ecuador se incrementó significativamente en la mayor parte de los grupos etarios y provincias durante el periodo 2001-2016. Las provincias de Santa Elena, Guayas, Manabí, Los Ríos y Santo Domingo, acumularon la mayor cantidad de muertes por esta causa. Esto obliga a quienes tienen que tomar las decisiones a direccionar el diseño e implementación de políticas en salud que permitan mejorar los sistemas de registro para una adecuada vigilancia epidemiológica de la incidencia y carga de esta enfermedad.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Diabetes mellitus mortality is a growing public health problem in the world.  Objectives:  To analyze the temporal and spatial patterns of mortality by diabetes mellitus in Ecuador during the period 2001-2016.  Methods:  A mixed ecological study was performed. There were calculated the specific mortality rates and they were adjusted by age for the period 2001-2016 in Ecuador. It was used a joinpoint´s regression analysis for the assessment of trends and it was used the methodology developed by Kulldorf for the analysis of time-space clusters.  Results:  During the period 2001-2016 there were 57 788 deaths from diabetes mellitus in Ecuador. In the joinpoint analysis, age-adjusted rates in men reported a significant increase in the percentage of annual change of 2.4% (2001-2016; p&lt;0.001) and in women increased to 1.50% (2001-2016; p&lt;0.001). In the time-space analysis identified, there were identified two clusters of statistically significant high mortality: the first conglomerate formed by the provinces Santa Elena, Guayas, Manabí and Los Ríos (p&lt; 0.001); and the second conglomerate formed by the province of Santo Domingo de los Tsáchilas (p&lt; 0.001).  Conclusions:  Mortality by diabetes mellitus in Ecuador was significantly increased in most age groups and provinces during the period 2001-2016. The provinces of Santa Elena, Guayas, Manabí, Los Ríos and Santo Domingo accumulated the biggest number of deaths due to this cause. This forces decision makers to address the design and implementation of health policies that allow improving the registration systems for an adequate epidemiological surveillance.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[diabetes mellitus]]></kwd>
<kwd lng="es"><![CDATA[mortalidad]]></kwd>
<kwd lng="es"><![CDATA[tendencias]]></kwd>
<kwd lng="es"><![CDATA[análisis espacio-temporal]]></kwd>
<kwd lng="es"><![CDATA[Ecuador]]></kwd>
<kwd lng="en"><![CDATA[diabetes mellitus]]></kwd>
<kwd lng="en"><![CDATA[mortality]]></kwd>
<kwd lng="en"><![CDATA[trends]]></kwd>
<kwd lng="en"><![CDATA[space-time analysis]]></kwd>
<kwd lng="en"><![CDATA[Ecuador]]></kwd>
</kwd-group>
</article-meta>
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