Consumo de psicofármacos estimulantes y tranquilizantes sin indicación médica y factores psicosociales asociados en la población escolar adolescente del Perú, 2009 / Use of stimulants and tranquilizers psychotropic medication whitout medical prescription and psychosocial factors associated in peruvian teen school population, 2009

Objetivo: Describir las características del consumo, así como los factores psicosociales asociados al consumo de psicofármacos estimulantes y tranquilizantes sin indicación médica en estudiantes de educación secundaria. Métodos: Se procedió a la revisión y análisis de la base de datos del III Estudio Nacional ôPrevención y Consumo de Drogas en Estudiantes de Secundariaõ realizado el año 2009, que corresponde a un estudio analítico transversal desarrollado en 57850 estudiantes de primero a quinto grado de secundaria de colegios públicos y privados de 26 regiones del país. Resultados: La prevalencia de vida de consumo de psicofármacos tranquilizantes sin indicación médica fue de 7.1% y de estimulantes 6.3% a nivel nacional; entre las regiones que reportan una prevalencia mayor se encuentran Madre de Dios, Tumbes, Ica y Junín. La edad promedio de inicio de consumo de tranquilizantes fue 12.1±2.5 años, y para estimulantes 11.9±2.4 años. Respecto al acceso a los tranquilizantes y estimulantes, estos se obtuvieron por prescripción de un médico amigo en 11% y 19% de los casos respectivamente. Entre los factores asociados al consumo, se encontraron relación conflictiva con la familia, ser testigo de violencia y ser víctima de violencia física, agresión verbal y sexual, así como de discriminación. Conclusiones: El consumo sin indicación médica de psicofármacos estimulantes y tranquilizantes está directamente relacionado con un entorno social desfavorable para el adolescente, reportándose con mayor frecuencia experiencias de agresión de diferente índole.

Objective: Describe the characteristics of consumption, and psychosocial factors associated with the consumption of stimulants and tranquilizers psychotropic medication in high school students. Methods: We proceeded to the review and analysis of the National Study "Prevention and Drug Use in High School Students" database held in 2009. This corresponds to a cross-sectional descriptive study developed in 57 850 students from first through fifth grade school of public and private schools in 26 regions of the country. Results: The national lifetime prevalence of psychotropic consumption is 7.1% for tranquilizers and is 6.3% for stimulants, across regions; a higher prevalence was reported in Madre de Dios, Tumbes, Ica and Junín. In relation to the age of onset the consumption was 12.1±2.5 years for tranquilizers and 11.9±2.4 years for stimulants. Regarding access to tranquilizers and stimulants, these were obtained by prescription from a doctor friend in 11% and 19% of cases respectively. Factors associated with drug use were found conflicted relationship with the family, witnessing violence and being victims of physical, sexual and verbal abuse and discrimination. Conclusions: The consumption of stimulants and tranquilizers psychotropic drugs without a prescription is directly related to an unfavorable social environment for the adolescent, where the experiences of different kinds of aggression were the most frequently reported.

Determinants of bed net use in children under five and household bed net ownership on Bioko Island, Equatorial Guinea.

BACKGROUND: As part of comprehensive malaria control strategies, the Bioko Island Malaria Control Project (BIMCP) distributed 110,000 long-lasting insecticide-treated nets (LLIN) in late 2007 with the aim of providing one net for each sleeping area. Despite attaining initially very high levels of net coverage and net use, many children under five years of age did not sleep under a net by 2009, according to annual malaria indicator surveys. The aim of this study was to assess the determinants of bed net use in children under five and bed net ownership of the households in which they live. METHODS: Using data from annual cross-sectional household surveys of 2008 and 2009, we investigated factors associated with sleeping under a mosquito net the night prior to the survey, and a households owning at least one net, in all households which had at least one child under five years. Amongst others, caregiver's knowledge of malaria and household characteristics including a socio-economic score (SES), based on ownership of household assets, were analysed for their effect on net ownership and use. RESULTS: There was a decline of around 32% in the proportion of households that owned at least one net between 2008 and 2009. Higher household bed net ownership was associated with knowing how malaria was prevented and transmitted, having the house sprayed in the previous 12 months, having fewer children under five in the household, and children being sick at some point in the previous 14 days. Higher bed net use in children < 5 was associated with being sick at some point in the last 14 days prior to the survey, living in an urban area, more years of education of the head of the household, household ownership of at least one ITN (as opposed to an untreated net) and the year in which the survey took place. CONCLUSIONS: The big fall in bed net use from 2008 to 2009 was attributable to the striking decline in ownership. Although ownership was similar in rural and urban areas, rural households were less likely to protect their children with bed nets. Knowledge about malaria was an important determinant of bed net ownership. Further research is needed to elucidate the decline in bed net ownership between 2008 and 2009.

How much does malaria vector control quality matter: the epidemiological impact of holed nets and inadequate indoor residual spraying.

BACKGROUND: Insecticide treated nets (ITN) and indoor residual spraying (IRS) are the two pillars of malaria vector control in Africa, but both interventions are beset by quality and coverage concerns. Data from three control programs were used to investigate the impact of: 1) the physical deterioration of ITNs, and 2) inadequate IRS spray coverage, on their respective protective effectiveness. METHODS: Malaria indicator surveys were carried out in 2009 and 2010 in Bioko Island, mainland Equatorial Guinea and Malawi to monitor infection with P. falciparum in children, mosquito net use, net condition and spray status of houses. Nets were classified by their condition. The association between infection and quality and coverage of interventions was investigated. RESULTS: There was reduced odds of infection with P. falciparum in children sleeping under ITNs that were intact (Odds ratio (OR): 0.65, 95% CI: 0.55-0.77 and OR: 0.81, 95% CI: 0.56-1.18 in Equatorial Guinea and in Malawi respectively), but the protective effect became less with increasingly worse condition of the net. There was evidence for a linear trend in infection per category increase in deterioration of nets. In Equatorial Guinea IRS offered protection to those in sprayed and unsprayed houses alike when neighbourhood spray coverage was high (≥80%) compared to those living in areas of low IRS coverage (<20%), regardless of whether the house they lived in was sprayed or not (adjusted OR = 0.54, 95% CI 0.33-0.89). ITNs provided only personal protection, offering no protection to non users. Although similar effects were seen in Malawi, the evidence was much weaker than in Equatorial Guinea. CONCLUSIONS: Universal coverage strategies should consider policies for repair and replacement of holed nets and promote the care of nets by their owners. IRS programs should ensure high spray coverage since inadequate coverage gives little or no protection at all.