RESUMO
Introducción: Las características de los donantes de sangre pueden variar entre centros de hemoterapia y pueden relacionarse con la seropositividad de marcadores infecciosos. Objetivo: Relacionar la seropositividad de marcadores infecciosos con los factores demográficos de los donantes de sangre peruanos. Métodos: Estudio observacional en los bancos de sangre del hospital nacional Cayetano Heredia y el Instituto Nacional Materno Perinatal durante el año 2019. La población la conformaron los 11 936 donantes que fueron tamizados para 7 agentes infecciosos según el Programa Nacional de Hemoterapia y Banco de Sangre. Se usó la prueba de correlación de Pearson para determinar la asociación entre las variables demográficas con los marcadores infecciosos. Resultados: Del total 8449 (70,8 por ciento) fueron varones y el grupo etario de 35 a 55 años fue el más frecuente en ambos hospitales (~ 44,5 por ciento). La mayoría de donantes procedían de la costa (4944; 41,4 por ciento), aunque en el Hospital Nacional Cayetano Heredia hubo 734 (8,9 por ciento) de la selva. La seropositividad fue de 507 (4,25 por ciento) donaciones; los más frecuentes fueron el antígeno del core del virus de Hepatitis B, los anticuerpos contra el virus linfotrópico de células T humanas 1-2, y sífilis, con 51,2 por ciento, 16,8 por ciento y 14,9 por ciento, respectivamente. La seropositividad de los marcadores infecciosos se asoció con factores demográficos como la edad, sexo y lugar de procedencia (p< 0,05). Conclusiones: Existe relación entre los factores demográficos con la seropositividad de los marcadores infecciosos en donantes peruanos(AU)
Introduction: The characteristics of blood donors may vary between hemotherapy centers and may be related to the seropositivity of infectious markers. Objective: To related the seropositivity of infectious markers with the demographic factors of Peruvian blood donors. Methods: Observational in the blood banks of the Hospital Nacional Cayetano Heredia and the Instituto Nacional Materno Perinatal during 2019. The population consisted of 11,936 donors who were screened for the seven infectious agents according to the National Hemotherapy and Blood Bank Program. Pearson's correlation test was used to determine the association between demographic variables and infectious markers. Results: Of the total, 8,449 (70.8 percent) were male and the age group from 35 to 55 years was the most frequent in both hospitals (~ 44.5 percent). Most donors came from the coast (4,944; 41.4 percent), although at the Cayetano Heredia National Hospital, there were 734 (8.9 percent) from the jungle. Seropositivity was 507 (4.25 percent) donations, then most frequent was Hepatitis B virus core antigen, antibodies against human T-cell lymphotropic virus 1-2, and syphilis, with 51.2 percent, 16.8 percent, and 14.9 percent, respectively. Seropositivity of infectious markers was associated with demographic factors such as age, gender, and place of origin (p< 0.05). Conclusions: There is a relationship between demographic factors with the seropositivity of infectious markers in Peruvian donors(AU)
Assuntos
HumanosRESUMO
Introduction: Cervical cancer is the second most frequent malignant disease in the Peruvian female population, and the Papanicolaou test is its main screening tool. However, the COVID-19 pandemic can hinder cervical cancer screening, reducing its scope. Objective: To analyze the decline of Papanicolaou-based cervical cancer screening due to COVID-19 in a specialized hospital in Lima. Methods: We designed a retrospective study (from 2015 to 2020) on 355 029 Papanicolaou smears at the Hospital Nacional Madre Niño San Bartolomé. T-test and one-way ANOVA were used to define differences in the study period and Ljung-Box test with ARIMA (1,0,0) model to describe and forecast monthly expected Papanicolaou smears for 2020. Results: Throughout the six years of the study, the average Papanicolaou smears was 59 171.5 ± 8898.7 per year. However, in 2020 only 16 273 (4.58%) Papanicolaou tests were performed with a monthly mean of 1356.1 ± 684.2 (95% confidence interval 149.7 to 2861.9) (p < 0.001). The forecast showed 66 960 Papanicolaou smears for 2020 and a monthly mean of 5580 ± 129.3. Actual screenings during that year were only 16 273 Papanicolaou smears, resulting in a 76.7% reduction in cervical cancer screening during the pandemic. Conclusions: Our results suggest a dramatic decrease in cervical cancer screening based on Papanicolaou smears during 2020 in Peru due to prevention and control measures against COVID-19.
Introducción: El cáncer de cuello uterino es la segunda neoplasia más frecuente en la población femenina peruana y la prueba de Papanicolau es la principal estrategia de cribado. Sin embargo, la pandemia de COVID-19 puede bloquear el tamizaje cervicovaginal pudiendo reducir su alcance. Objetivo: Analizar el declive del cribado de cáncer de cuello uterino basado en la prueba de Papanicolaou, debido a COVID-19 en un hospital especializado de Lima. Métodos: Diseñamos un estudio retrospectivo (de 2015 a 2020) en 355 029 pruebas de Papanicolau en el Hospital Nacional Madre Niño San Bartolomé. Se utilizó la prueba T y ANOVA para definir las diferencias en el periodo del estudio y la prueba de Ljung-Box con modelo ARIMA (1,0,0) para describir y pronosticar mensualmente las pruebas de Papanicolau esperadas para el año 2020. Resultados: Durante los seis años del estudio el promedio fue de 59 171,5 ± 8898,7 pruebas de Papanicolau por año. Sin embargo, en 2020 solo se realizaron 16 273 (4,58%) pruebas de Papanicolau con una media mensual de 1356,1 ± 684,2 (intervalo de confianza 95%: 149,7 a 2861,9) (p < 0,001). El pronóstico mostró 66 960 pruebas de Papanicolau para el año 2020 y una media mensual de 5580 ± 129,3. Los tamizajes reales durante ese año fueron solamente de 16 273 pruebas de Papanicolau , generando un 76,7% de reducción del tamizaje de cáncer de cuello uterino durante la pandemia. Conclusiones: Conclusiones.
Assuntos
COVID-19 , Neoplasias do Colo do Útero , Feminino , Humanos , Detecção Precoce de Câncer , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , COVID-19/diagnóstico , Peru/epidemiologia , Pandemias , Estudos RetrospectivosRESUMO
OBJECTIVES: The objective of the study was to verify the strength of association of depression as a comorbidity of diabetes with the presence of six types of disability in the elderly in prison. MATERIAL AND METHOD: Cross-sectional association study based on a secondary analysis of the 2016 Peru National Penitentiary Census. The population were older adults, who were held in prisons in Peru. Inmates 60 years of age or older, and both sexes were included. The response variables were the six types of permanent disability. The exposure variables were the self-report of diabetes, depression and the comorbidity of depression with diabetes diagnosed by a health professional. The sample was constituted by 2. 658 older adults. RESULTS: There was an increase in the probability of presenting the six disabilities analyzed due to the presence of comorbid diabetes with depression (p <0.05). The measure of greatest strength of association is for the disability to relate OR(a) 10.23, followed by the disability to move OR(a) 6.12 and the lowest strength of association found was for the hearing impairment OR(a) 2.80. DISCUSSION: A significant increase was found in the probability of presenting the six disabilities analyzed due to the presence of comorbid diabetes with depression compared to suffering from only one of these conditions or not suffering from them.
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Diabetes Mellitus , Prisioneiros , Masculino , Feminino , Humanos , Idoso , Estudos Transversais , Prisões , Depressão/epidemiologia , Comorbidade , Diabetes Mellitus/epidemiologiaRESUMO
Campylobacter jejuni infection is considered the most frequent factor associated with Guillain-Barré syndrome (GBS). In 2019, a large outbreak of GBS was detected in Peru, being associated with C. jejuni detected in stool samples from these patients. The aim of this study was to determine the molecular epidemiology of C. jejuni strains (ST-2993) associated with a large GBS outbreak in Peru. In this study, 26 C. jejuni strains belonging to the ST-2293, obtained from 2019 to 2020, were sequenced using Illumina technology. Five low-quality sequences were removed using bioinformatics, and 21 genomes (17 clinical strains and 4 chicken strains) were considered in the phylogenetic analysis and comparative genomics. Phylogenetic reconstruction, including genomes from international databases, showed a connection between Peruvian and Chinese GBS strains, both of them having lipooligosaccharides (LOS) locus genes related to molecular mimicry with gangliosides in peripheral nerves. Also, ST-2993 was detected in Amazon strains recovered many years before the 2019 outbreak, but with no epidemiological connection with GBS. Besides, a close relationship between human and chicken C. jejuni strains indicated chicken as one of the probable reservoirs. Finally, comparative genomics revealed differences between Chinese and Peruvian strains, including the presence of a prophage inserted into the genome. In conclusion, C. jejuni ST-2993 strains recovered from the GBS outbreak are closely related to Peruvian Amazon strains. Moreover, ST-2993 has been circulated in Peru since 2003 in the Peruvian Amazonia, showing the necessity to reinforce the epidemiological surveillance of C. jejuni to improve the prevention and control of future GBS outbreaks. IMPORTANCE This article describes the molecular epidemiology of C. jejuni strains (ST-2993) associated with a large Guillain-Barré Syndrome (GBS) outbreak in Peru, sequencing several strains recovered from GBS patients and chickens from 2019 to 2020. Phylogenetic analysis showed a connection between Peruvian and Chinese GBS strains, both of them having lipooligosaccharides (LOS) locus genes related to molecular mimicry with gangliosides in peripheral nerves. Also, ST-2993 strains were detected in isolates recovered many years before the 2019 outbreak, but with no epidemiological connection with GBS. Besides, a close relationship between human and chicken strains indicated those animals as a probable reservoir. This information will help to understand the real situation of GBS in Peru and its causal agent, C. jejuni ST-2993, showing the necessity to increase epidemiological tracking of these kinds of pathogens to detect them and avoid GBS outbreaks in the future.
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Infecções por Campylobacter , Campylobacter jejuni , Síndrome de Guillain-Barré , Humanos , Animais , Campylobacter jejuni/genética , Peru/epidemiologia , Epidemiologia Molecular , Filogenia , Galinhas , Síndrome de Guillain-Barré/epidemiologia , Infecções por Campylobacter/epidemiologia , Gangliosídeos , Surtos de DoençasRESUMO
OBJECTIVE: This study aimed to adapt a Peruvian version of the brief scale to assess psychological violence in health professionals (EVP-salud), exploring its validity and reliability properties. METHODS: We made a cross-sectional study of psychometric evaluation conducted between January 2019 and February 2020. It involved the voluntary and anonymous participation of 316 health professionals and administrative workers from 17 health centers in Peru, who were administered the 22-item psychological violence scale. In addition, three other instruments were used to assess convergent and discriminative validity. RESULTS: In contrast to other findings using similar instruments, the item composition of the abbreviated psychological violence scale converges on three components that assess isolation, intimidation, and belittling violence. This validation provides evidence of good fit in criterion and construct, explaining 66.7% of the accumulated variance and up to 54.3% when the final version is reduced to 13 items and three factors. The data reflect a high inverse association between psychological violence and intrinsic job satisfaction. CONCLUSIONS: The empirical results indicate psychometric properties of the instrument, with strong support in the validity and appropriate reliability according to the internal consistency indexes.
OBJETIVO: El objetivo de este estudio fue adaptar una versión peruana de la escala breve para evaluar la violencia psicológica en profesionales sanitarios (EVP-salud), explorando sus propiedades de validez y de fiabilidad. MÉTODOS: Estudio transversal de evaluación psicométrica. El estudio se llevó a cabo entre enero de 2019 y febrero de 2020. En él participaron en forma voluntaria y anónima 316 profesionales de la salud y trabajadores administrativos de 17 centros sanitarios del país, a quienes se aplicó la escala de violencia psicológica de 22 reactivos. Además, se administraron otros tres instrumentos para evaluar la validez convergente y discriminativa. RESULTADOS: En contraste con los hallazgos reportados para instrumentos similares, la composición de ítems de la escala abreviada de violencia psicológica converge en tres componentes que evalúan la violencia de aislamiento, de intimidación y de desprestigio. La validación abordada proporciona evidencias con buen ajuste, tanto de criterio como de constructo, que explican el 66,7% de la varianza acumulada y hasta 54,3%, aproximadamente, al reducirse la versión final a 13 reactivos y tres factores. Los datos reflejan una alta asociación inversa entre la violencia psicológica y la satisfacción laboral intrínseca. CONCLUSIONES: Los resultados empíricos indican propiedades psicométricas del instrumento, con fuerte apoyo en la validez y apropiada fiabilidad, según los índices de consistencia interna.
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Pessoal de Saúde/psicologia , Estresse Psicológico/psicologia , Inquéritos e Questionários/normas , Violência no Trabalho/estatística & dados numéricos , Estudos Transversais , Humanos , Idioma , Peru , Psicometria/instrumentação , Psicometria/métodos , Reprodutibilidade dos Testes , Traduções , Violência no Trabalho/psicologiaRESUMO
Background: Cytological samples are cleared with xylene in two or three baths during a Pap test, however, this solvent has a high degree of toxicity, and being a controlled reagent infers high costs for its purchase and implications for environmental pollution. We estimated the impact of xylene during the Pap test in terms of the number of liters and cost of two baths of xylene, and also estimated the impact with three baths Methods: This cross-sectional study was carried out in four hospitals of EsSalud in Peru in two stages. First, the analysis of the impact due to the use of two baths of xylene was conducted during the period 2015-2019, and second, the estimates were calculated based on the assumption of three baths of xylene for the years 2020-2025. The assumption was based on the recommendations of the 2018 EsSalud cytology guideline. The monthly amount of xylene was ~10 liters per bath/month and the cost per liter was estimated at 8.13 USD (27 soles). Results: For the staining of 594,898 cytology tests, 7,848 liters of xylene were necessary, resulting in a cost of 60,861 USD (202,068 soles) during the period 2015-2019. The estimates showed a maximum assumption of 9,483 liters and 77,110 USD (256,040 soles) for the use of three baths of xylene in the four EsSalud hospitals (p = 0.0025) during the period 2020-2025. Conclusions: We determined that there was a high economic impact of using xylene with two baths from 2015 to 2019 and a dramatic increase in costs with the possible use of three baths of xylene in the Pap test for the following five years.