Rural-urban migration as a factor associated with physical and sexual intimate partner violence Peru 2015-2017: a secondary analysis of a national study.

BACKGROUND: Internal migration, a consequence of the demographic transition towards urbanization driven by globalization, represents a particular public health challenge. Change in residence from one sociocultural geographic context to another, with not only economic implications, but also changes in women's long-established relationships of family interdependence, influences gender relations and can influence Intimate Partner Violence (IPV) against women. Different migratory trajectories may be related to IPV. The aim of this study was to identify the association between internal migration and physical and/or sexual violence against women in the last 12 months. METHODS: A secondary analytical cross-sectional analysis of the publicly accessible 2015-2017 Demographic and Family Health Survey (DHS) was performed. The outcome variable was reported physical and/or sexual violence inflicted by the partner (IPV) during the last 12 months. Exposure variable was internal migration, operationalized from three questions: current place of residence, principal place of residence before 12 years of age and number of years of residence in the current place. Migrants were classified as those who reported having lived for 5 years or more in the current location and were categorized as rural-rural migrants, urban-urban migrants, urban-rural migrants and rural-urban migrants, recent migrants and nonmigrants those who resided in the same place all their lives. To identify the association between internal migration and physical violence, a generalized linear model (GLM) of the family and the log Poisson link log option was used, and the results are presented as prevalence ratios (PRs). A crude model and a model adjusted for confounding variables were performed. RESULTS: Rural-urban migrant women had a 15.0% higher probability of experiencing IPV than nonmigrant women (PRa 1.15, 95% CI 1.03-1.29, p = 0.015), while the probability of experiencing IPV in the last 12 months for urban-rural, rural-rural,urban-urban migrantand recent migrant women was not significantly different from that of nonmigrant women. CONCLUSION: Rural-urban migration among women of childbearing age is a factor associated with a higher probability of IPV in the last 12 months. The identification of women with this rural-urban migration pattern could help prioritize those that may experience a greater probability of physical and/or sexual violence in Peru, it must be studied if this pattern is the same in other countries.

The effect of the efflux pump inhibitor Carbonyl Cyanide m-Chlorophenylhydrazone (CCCP) on the susceptibility to imipenem and cefepime in clinical strains of Acinetobacter baumannii.

INTRODUCTION: In the last years the rapid expansion of multidrug-resistant A. baumannii strains have become a major health problem. Efflux pumps are a group of transport proteins that contribute to the development of antibiotic resistance. The aim of this study was to evaluate the effect of the efflux pump inhibitor carbonyl cyanide 3-chlorophenylhydrazone (CCCP) on the antimicrobial action of imipenem and cefepime on clinical strains of A. baumannii. MATERIALS AND METHODS: A total of 49 non-duplicate clinical samples were collected during January through December of 2018 from patients hospitalized in the Hospital Regional Docente de Cajamarca. Of the 49 samples obtained, the confirmatory identification of A. baumannii was performed on 47 samples by molecular methods. The amplification of the blaOXA-51-like gene was carried out by polymerase chain reaction (PCR). The determination of the minimum inhibitory concentration (MIC) was calculated using the microdilution method in culture broth. The susceptibility to both antibiotics (cefepime and imipenem) was evaluated in the presence and absence of the inhibitor carbonyl cyanide 3-chlorophenylhydrazone (CCCP). RESULTS: A total of 47 strains of A. baumannii were isolated: 97.87% (46/47) were resistant to Imipenem, 2.13% (1/47) of them were classified as intermediate and none of these strains were susceptible. On the other hand, 51.06% (24/47) of isolates were resistant to cefepime; 19.15% (9/47) intermediate and 29.79% (14/47) susceptible. We considered a significant difference in antibiotic susceptibility if the MIC changed at least 4 dilutions, after the addition of the inhibitor. In the case of CCCP in addition to imipenem, 2.1% (1/47) had a significant change of 4 or more reductions in MIC, 59.6% (28/47) achieved a change equal or less than 3 dilutions and 17.0% (8/47) did not have any change. In the case of CCCP with cefepime the percentage of strains with the significant change of MIC was 8.5% (4/47). On the other hand, 53.2% (24/47) presented a reduction equal or less than 3 dilutions and 12.8% (6/47) did not show changes. CONCLUSION: In conclusion, our results demonstrate that the use of CCCP may improve the antibiotic effect of imipenem and cefepime on clinical strains of A. baumannii. The relevance of this study is that it provides evidence that this efflux pump inhibitor may be an alternative treatment against multidrug-resistant A. baumannii.

Is Vitamin A Supplementation Associated With Anemia in Children Under 5 Years of Age in Peru: Secondary Analysis of the "Demographic Health Survey" 2015-2018?

Vitamin A deficiency (VAD) affects 12% of Peruvians under 5 years of age. Recent studies have shown an association with hematopoiesis and iron metabolism. In Peru, 3-quarters of a million children have anemia. We aimed to identify an association between Vitamin A supplementation (VAS) and anemia in children under 5 years of age. A cross-sectional secondary analytical study from the Peruvian Demographic Survey and Family Health (DHS) was conducted. The primary outcome, anemia, was measured through hemoglobin concentration and adjusted by altitude. The DHS interviewer ensured the participant's VAS in the last 6 months through a structural healthcare card. The association was statistically significant using crude regression but disappeared when adjusted per socioeconomic level and gender. VAS was not significantly associated with a lower prevalence of anemia. Further studies are required to help identify the association between VAS and anemia.