S20 • JPIDS 2021:10 (Suppl 2) • Abstracts of which were confrmed, 1 probable, and 4 suspected. Twenty-six cases met the CDC criteria, 13 (50%) of which were confrmed and 13 (50%) were suspected; there were 0 probable cases. Conclusions. Our fndings about COVID-19 in pediatric oncology patients are consistent with data reported globally that disease presentation is mostly asymptomatic or mild but with increased mortality. Te high contagiousness and unpredictable clin- ical response of children with cancer call for rigorous measures to prevent infections in this population. In low resource settings, the scarcity of antiviral, immunologic, and supportive medications further underscores this need. Additionally, we observed dif- ferences in our data depending on which COVID-19 case criteria were used (WHO versus CDC); this highlights the importance of standardized defnitions that can be used at all resource levels to promote reliable measurement of disease burden. COVID-19 Case Classifcation, The Hispaniola Project, March - September 2020 WHO* Hospital Confrmed Probable Suspected Total Santiago 2 0 1 3 Santo Domingo 8 1 3 12 Port-au-Prince 3 0 0 3 Total 13 1 4 18 CDC** Hospital Confrmed Probable Suspected Total Santiago 2 0 12 14 Santo Domingo 8 0 1 9 Port-au-Prince 3 0 0 3 Total 13 0 13 26 *WHO COVID-19 classifcation criteria: https://apps.who.int/iris/handle/10665/333752 **CDC COVID-19 classifcation criteria: https://wwwn.cdc.gov/nndss/conditions/ coronavirus-disease-2019-covid-19/case-defnition/2020/08/05/ #44: Hand Hygiene during the COVID-19 Pandemic in Three Pediatric Oncology Units in Hispaniola Island Pascale Yola Gassant 1 , Marie Immacula Fleury 1 , Genara Santana 2 , María Dolores Gil 2 , Manauri H. Morel 2 , Johanny Contreras 3 , Karina Rivera 3 , María Castillo 3 , Brooke Happ 4 , Milka  Vázquez 4 , Maysam R. Homsi 4 , Miguela A. Caniza 4 , 1 Hôpital Saint-Damien, Haïti. 2 Hospital Infantil Regional Universitario Dr. Arturo Grullón, Dominican Republic. 3 Hospital Infantil Dr. Robert Reid Cabral, Dominican Republic. 4 St. Jude Children’s Research Hospital, USA. Background. Hand hygiene (HH) is a basic measure to prevent the spread of infections in healthcare settings. We describe HH practices and resources in three pedi- atric oncology units (POUs) in Haiti and the Dominican Republic that comprise the Hispaniola Project (HP1: Santiago; HP2: Santo Domingo; HP3: Port-au-Prince). Tis project, started in January 2019, is a quality improvement initiative in infection care and prevention in pediatric oncology. Te POUs are main referral centers for pediatric oncology on the island, HP1 (24 inpatient beds) and HP2 (18 beds) are housed within large public pediatric hospitals; HP3 (17 beds) is housed in a mother/child hospital. Methods. Data related to HH resources and practices are intermittently collected as part of ongoing surveillance activities at Hispaniola Project sites; standardized data collection forms track infrastructure, supplies, compliance, and training. At regular intervals, the POUs conduct the World Health Organization (WHO) hand hygiene self-assessment framework (HHSAF) to assess the level (inadequate, basic, inter- mediate, advanced) of their units. Additionally, the POUs monitor HH compliance indirectly via alcohol gel (AG) consumption in liters, measured monthly. HP1 and HP3 also use direct observation to monitor HH compliance. Results. From baseline to September 2020, the WHO HHSAF scores increased from 65 (Inadequate) to 210 (Intermediate) at HP1, 260 (Intermediate) to 363 (Intermediate) at HP2, and 260 (Intermediate) to 270 (Intermediate) at HP3. Despite constraints imposed by COVID-19, all 3 participating POUs remained at the inter- mediate level (scoring 260–375). HH infrastructure, including the sink:bed and AG:patient ratios remained stable from January 2020 to present. Te AG:patient ratios were 1:3, 1:1 and 10:13 at HP1, HP2, and HP3 respectively. Te sink:bed ratios were 1:6, 1:5 and 5:13 at HP1, HP2 and HP3 respectively. Indirect compliance (AG con- sumption) was frst measured in January 2020 at HP1 and has remained relatively stable from June to present. At HP2, AG consumption increased from January to February but decreased throughout the year due to lack of AG which was replaced by soap and water. AG consumption at HP3 increased from January to March, with some variation throughout the year but generally at higher levels than in 2019. Direct HH observation data are limited; however, an increased number of observations at HP1 and increased compliance rates were noted for HP1 and HP3 between January and September 2020. As the pandemic emerged, all 3 POUs increased training of staf, patients, and caretakers. Between January and April, 8 training sessions were held for 349 attendees including 235 healthcare workers (HCWs) at HP1; 13 sessions were held for 443 attendees including 61 HCWs at HP2; 15 sessions were held for 288 attendees including 87 HCWs at HP3. Since these early eforts, a smaller number of sessions with fewer attendees have been held. Conclusion. During the COVID-19 pandemic, the importance of HH practice was reinforced for HCWs, patients, and caretakers. As organizations and individ- uals, it is essential to ensure the continuation and sustainability of HH improve- ment as a strategy to ensure safe healthcare even afer the threat of COVID-19 has subsided. #46: Changes in the hospital admission profile in a Peruvian National Tertiary Children’s Hospital during the First Year of Covid-19 Pandemic Yeni Baca 1 , Cesar  Muñante 1 , Carlos Santillan 1 , 1 Instituto Nacional de Salud del Niño San Borja (INSNSB), Lima, Peru Background. During the frst year of the current COVID-19 pandemic, health systems around the world have faced the challenge of maintaining health services for patients with non-communicable diseases, despite the logistical and personnel con- straints. Despite SARS-CoV-2 infection is usually more benign in children, there is limited information about how this pandemic afected their healthcare at a population level. Methods. We performed a cross sectional study at the Peruvian National Children´s Hospital San Borja, which is a 312-bed tertiary National referral health center, in Lima. We include all hospital admissions during 2020, with respect to the two previous years. We defned hospital admission as the permanence at the hospital for more than 24 hours irrespectively of patient´s initial destination (emergency obser- vation unit, regular medical foor, or intensive care unit). We described demographic characteristics among hospitalized patients and compared them between 2018–19 and 2020 using standard descriptive tests. We use the International Classifcation of Diseases 10th (ICD-10) codes from the electronic patient registration system to as- certain three major non-communicable conditions: congenital cardiopathies, hema- tooncological disorders and burns non-communicable conditions. We set level for statistical signifcance at 0.05. Results. Tere were 11635 patients admitted during 2018–19 period and 3480 patients admitted during 2020. Te average daily hospital admission during 2018–19 was diferent compared to 2020 (15.9±6.1 vs. 9.6±6.0, p<0.001). Tere were also dif- ferences in the frequency of the gender (male 55.1% vs. 58.9%, p<0.001) and if the patient´s place of origin was outside Lima (49.0% vs. 41.1%, p<0.001). Among hospi- talized patients, 3036 presented one of the three non-communicable conditions during the baseline period and 871 during 2020. Tere was a signifcant diference between the distribution of hospitalization among patients with one of the three non-communica- ble conditions (p<001), towards a decrease in hospitalizations due to congenital heart disease, and an increase in the hospitalizations due to burns. Conclusion. During the frst year of COVID-19 pandemic, there was a decrease in the number of hospitalizations of children with non-communicable conditions compared to the previous two years. It will be important to consider the imple- mentation of public health policies aimed to increase accessibility to health care for children with non-communicable conditions during the coming months of the pan- demic in Peru. Table: Demographic and clinical characteristics of Admitted patients at National Children´s Hospital San Borja in baseline period and 2020 Baseline (n = 11635) 2020 (n = 3480) p-value Year of hospital admission 2018 6010 - - 2019 5625 - - 2020 - 3480 - Daily admissions Average (SD) 15.9 (6.1) 9.6 (6.0) <0.001 Age at case’s index date (years) Median (IQR) 4 (1.0–9.0) 4 (1.0–10.0) 0.166 Age group, n (%) less than 1 year 2419 (20.8) 732 (21.0) 0.167 1 year – 4 years 4126 (35.5) 1293 (37.2) 5 years – 12 years 3531 (30.3) 1024 (29.4) 13 years – 18 years 1559 (13.4) 431 (12.4) Gender n (%) Male 6408 (55.1) 2053 (58.9) <0.001 Female 5227 (44.9) 1427 (41) Place of origin outside Lima n (%) Yes 5951 (49.0) 1427 (41.1) <0.001 No 5684 (51.0) 2053 (58.9) Public insurance n (%) Yes 10898 (93.6) 3261 (93.7) 0.912 No 737 (6.4 219 (6.3) Non-comunicable medical conditions of hospitalized patients n (%) Burns 516 (4.4) 195 (5.6) <0.001 Congenital heart disease 1285 (11.0) 272 (7.8) Hematooncological conditions 1235 (10.6) 404 (11.6) Tumores malignos 1051 (9.0) 356 (10.2) - Aplastic anemia 184 (1.6) 48 (1.4) - #55: Development of a quality improvement educational intervention in febrile neutropenia in pediatric cancer patients in Peru: Preliminary results of the DoTT project Ana Mendieta, MD 1 , Ligia Rios, MD 2 , Walter Delgadillo, MD 3 , Maria Vargas, MD 1 , Carlos Rueda, RN 4 , Carlos  Santillán, MD 5 , Liliana Vasquez, MD 6 , Miguela Caniza, MD 7 , 1 Pediatric Emergency Department, Rebagliati National Hospital, Lima, Peru; 2 Pediatric Oncology Unit, Rebagliati National Hospital, Lima, Peru; 3 Pediatric Hematology Unit, Rebagliati National Hospital, Lima, Peru; 4 Pediatric Emergency Nursing Department, Rebagliati National Hospital, Lima, Peru; 5 Epidemiology Downloaded from https://academic.oup.com/jpids/article/10/Supplement_2/S20/6310216 by guest on 31 May 2022