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INTRODUCTION: The COVID-19 pandemic has caused a global health crisis. Vaccines against this disease have demonstrated variable efficacy and safety, although effectiveness has not been evaluated. In February 2021, the Ministry of Health of Peru approved the emergency use of the inactivated SARS-CoV-2 (Vero Cell) vaccine and initiated vaccination with health personnel at the national level. The objective of the study is to determine the effectiveness of this vaccine to reduce infections, hospitalizations, and deaths due to COVID-19. METHODOLOGY: We performed a retrospective cohort study in the period from 23 February to 26 June 2021; data were obtained from the Ministry of Health (including demographic, epidemiologic, clinical, hospital, laboratory results, deaths, and both date and quantity of vaccine doses delivered). The exposed cohort were those who received one or two vaccine doses and the non-exposed were unvaccinated. The events studied were infections, hospitalizations and deaths in the cohorts. We consider a case confirmed for COVID-19 if the test result was positive for SARS-CoV-2, via PCR or antigen test. Effectiveness was measured with incidence density ratio and risk. Confounding factors were controlled using a Poisson model with robust variance. RESULTS: We enlisted 520,733 health workers, of whom 415,212 had two vaccine doses and 105,521 were unvaccinated. The median age was 40 years (IQR: 32-50), and 65.6% were female. The effectiveness of two vaccine doses fourteen days after application adjusted by age, sex, hospitalization, and antecedent of having the infection was 90.9% (95% CI: 85.5-94.2%); effectiveness to avoid death from COVID-19; 67.7% (60.1-73.8%) effectiveness to avoid hospitalizations; and 26.3% (23.8-28.6%) effectiveness to reduce the risk of infection by SARS-CoV-2 relative to the unvaccinated cohort. CONCLUSIONS: The inactivated SARS-CoV-2 (Vero Cell) vaccine used in two doses has an acceptable effectiveness against death and risk of hospitalization, whereas it has less effectiveness in preventing COVID-19 infection.
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BACKGROUND: There is evidence of the occurrence of trachoma in Peru, and studies have shown that soil-transmitted helminthiases (STH) are affecting rural communities in the Amazon basin in Loreto Department. This study was done to estimate trachoma prevalence, STH prevalence, and the associated factors for both diseases in children aged 1-9 years in rural communities of Peru. METHODOLOGY: A population-based cross-sectional survey was carried out in rural communities of Loreto. A standardized survey questionnaire with individual and household risk factors related to both diseases was used. Ocular examination was done for all participants aged one year and above, and eye swab samples were collected from children with follicular trachoma (TF). Anthropometric measurements, stool samples for STH, and blood samples for hemoglobin measurement were taken from children. PRINCIPAL FINDINGS: TF prevalence was 7.74% (95% CI 5.08-11.63%), STH prevalence was 49.49% (95% CI 25.00-52.43%), and prevalence of co-occurrence of both diseases was 5.06% (95% CI 2.80-8.98%) in children aged 1-9 years. Being at age 3-8 years old (AOR = 6.76; 95% CI 1.346-33.947), have an unclean face (AOR = 24.64; 95% CI 6.787-89.444), and having been dewormed in the last six months (AOR = 2.47; 95% CI 1.106-5.514), were risk factors of TF. Being a female (AOR = 0.22; 95% CI 0.103-0.457) was associated with decreased odds of TF. Having been dewormed in the last six months (AOR = 0.30; 95% CI 0.139-0.628) was a preventative factor for STH. Risk factors for children with both diseases mirrored the findings for risk factors for individual diseases. CONCLUSIONS: Neglected tropical diseases and associated risk factors overlap in communities living in vulnerable conditions in the Amazon basin of Peru. These findings support the need to implement integrated interventions, including mass drug administration, water, sanitation, and hygiene for both diseases in the study area.
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Helmintiasis , Tracoma , Niño , Preescolar , Estudios Transversales , Femenino , Helmintiasis/epidemiología , Humanos , Lactante , Perú/epidemiología , Prevalencia , Factores de Riesgo , Población Rural , Suelo , Tracoma/epidemiologíaRESUMEN
UNLABELLED: Pneumonic plague is one of the clinical forms of plague, of low frequency and high mortality, transmitted by direct inhalation of Yersinia pestis coming from an animal or from person to person. OBJECTIVE: To describe the clinical and epidemiological characteristics of the cases of primary pneumonic plague in an outbreak in the north of Peru. MATERIALS AND METHODS: The clinical records of the confirmed cases of primary pneumonic plague presenting in an outbreak occurring in La Libertad, in July 2010, were reviewed, also the search and contact investigation was performed. RESULTS: The index case was identified, as well as three additional cases, out of these, two were nosocomial infections related to the index case. The initial clinical presentation was characterized by sudden onset of fever, chills, myalgia and chest pain, which in less than 24 hours evolved to hypotension and cyanosis. The initiation of specific treatment varied from 2 to 12 days, and cases with prompt initiation of treatment had a better clinical outcome. The lethality was 50% (2/4). CONCLUSION: Nosocomial transmission of pneumonic plague in Peru is evidenced, with severe clinical manifestations and high lethality.
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Infección Hospitalaria , Peste , Adulto , Preescolar , Infección Hospitalaria/diagnóstico , Infección Hospitalaria/epidemiología , Femenino , Humanos , Masculino , Perú/epidemiología , Peste/diagnóstico , Peste/epidemiología , Adulto JovenRESUMEN
La peste neumónica es una forma clínica de peste, de baja frecuencia y alta letalidad, transmitida por la inhalación directa de Yersinia pestis proveniente de un animal o de persona a persona. Objetivo: Describir las características clínicas y epidemiológicas de los casos de un brote de peste neumónica primaria humana en el norte de Perú. Materiales y Métodos. Se revisaron las historias clínicas de los casos confirmados de peste neumónica primaria presentados en un brote ocurrido en la región de La Libertad, en el mes de julio de 2010, asimismo, se efectuó la búsqueda e investigación de contactos. Resultados: Se identificó el caso Índice y tres casos adicionales, de estos últimos, dos fueron infecciones intrahospitalarias relacionadas con el caso índice. La presentación clínica inicial se caracterizó por fiebre de inicio súbito, escalofríos, mialgias y dolor torácico y evolución en menos de 24 horas a hipotensión arterial y cianosis. El inicio del tratamiento específico varió de 2 a 12 días, observándose que los casos con inicio precoz de tratamiento tuvieron un mejor resultado clínico. La lealtad fue de 50 por ciento (2/4). Conclusión: Se evidenció la transmisión intrahospitalaria de peste neumónica en el Perú con manifestaciones graves y alta letalidad.
Pneumonic plague is one of the clinical forms of plague, of low frequency and high mortality, transmitted by direct inhalation of Yersinia pestis coming from an animal or from person to person. Objective. To describe the clinical and epidemiological characteristics of the cases of primary pneumonic plague in an outbreak in the north of Peru. Materials and methods. The clinical records of the confirmed cases of primary pneumonic plague presenting in an outbreak occurring in La Libertad, in July 2010, were reviewed, also the search and contact investigation was performed. Results. The index case was identified, as well as three additional cases, out of these, two were nosocomial infections related to the index case. The initial clinical presentation was characterized by sudden onset of fever, chills, myalgia and chest pain, which in less than 24 hours evolved to hypotension and cyanosis. The initiation of specific treatment varied from 2 to 12 days, and cases with prompt initiation of treatment had a better clinical outcome. The lethality was 50 percent (2/4). Conclusion. Nosocomial transmission of pneumonic plague in Peru is evidenced, with severe clinical manifestations and high lethality.