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1.
BMC Psychiatry ; 21(1): 111, 2021 02 18.
Artículo en Inglés | MEDLINE | ID: mdl-33602157

RESUMEN

BACKGROUND: Population health and well-being in Latin America, the current epicenter of the COVID-19 pandemic, has been severely affected during the past semester. Despite the growing evidence about the link between the pandemic, its control measures, and mental health worldwide, there is still no regional evidence of the potential mental health impact. We describe the prevalence and distribution of depressive symptoms across demographic and socioeconomic risk factors in the Peruvian population amidst a national lockdown during the COVID-19 pandemic. METHODS: Cross-sectional study conducted during the community transmission phase and national lockdown in Peru (May 4th-16th, 2020). We recorded 64,493 responses from adult Peruvian residents through an opt-in online questionnaire. All analyses were weighted using raking based on proportions of sociodemographic variables from the last Peruvian census in 2017. The prevalence of depressive symptoms was calculated using the Patient Health Questionnaire (PHQ-9) score of 10 or more. We identified associated demographic and socioeconomic factors by prior mental health diagnosis. Sensitivity analysis considered an alternative cut-off point for depressive symptoms of PHQ-9 ≥ 14. RESULTS: A total of 57,446 participants were included in the analytical sample. A third of the participants (n = 23,526, unweighted) showed depressive symptoms in the 2 weeks prior to the study. Participants who reported a previous mental health diagnosis doubled the sample prevalence of depressive symptoms (59, 95%CI 56.7, 61.4%) of those without a prior diagnosis. Psychosocial and functioning reactions were largely more prevalent among females and young adults. A dose-response relationship was found between household income and depressive symptoms across previous mental health diagnosis strata, being as low as 32% less in the wealthiest than the most impoverished group (PR: 0.68, 95%CI 0.58,0.79). Other critical factors associated with a higher burden of depressive symptoms were lower education level, single, unemployed, and chronic comorbidity. CONCLUSIONS: An increased burden of depressive symptoms and psychosocial reactions has emerged during the COVID-19 pandemic in Peru compared to previous years. The mental health burden disproportionately affects women, the younger population, and those with low income and education. As the country eases the social distancing measures, it is crucial to use local evidence to adjust public health policies and mental health services to the renewed population needs.


Asunto(s)
Pandemias , Ansiedad , Control de Enfermedades Transmisibles , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Perú/epidemiología , Adulto Joven
2.
Dis Aquat Organ ; 143: 129-138, 2021 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-33570046

RESUMEN

Ichthyophonus infection was first detected in Peruvian Oncorhynchus mykiss in 1986, but the occurrence of ichthyophonosis disease in the region is unknown. This study investigated the presence and distribution of Ichthyophonus sp. in Peruvian rainbow trout using traditional and DNA sequencing tools. Between 2007 and 2008, 205 rainbow trout from 13 hatcheries in the Mantaro river basin were examined for the presence of Ichthyophonus, and at that time only 3 farms were positive. This early study confirmed the presence of Ichthyophonus sp. in the Tranca Grande lagoon for the first time, at a prevalence of 50%. In 2012, examination of 240 trout from 24 fish farms in 2 Peruvian Departments found 9 infected farms. More recently, in 2018, Ichthyophonus sp. was found in Lake Titicaca, infecting a trout in the Ichu area (in the Department of Puno). Our molecular analysis of the infected trout showed that ichthyophonosis disease in the Peruvian trout was caused by Ichthyophonus sp. Clade C. The finding of this pathogen in Lake Titicaca should be an alert for nearby farms and entities dealing with fish of economic importance in the rivers of Peru.


Asunto(s)
Enfermedades de los Peces , Mesomycetozoea , Oncorhynchus mykiss , Animales , Enfermedades de los Peces/epidemiología , Mesomycetozoea/genética , Perú/epidemiología , Ríos
4.
Malar J ; 20(1): 88, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33579285

RESUMEN

BACKGROUND: Malaria remains a serious health threat in the Amazonas Region of Peru and approximately 95% of the cases, mainly Plasmodium vivax, are found in native communities of The Rio Santiago District, Condorcanqui Province. In 2019, more than one thousand malaria cases were reported, with an unusual number of Plasmodium falciparum autochthonous cases. The present study aims to report this P. falciparum outbreak while describing the epidemiology of malaria and the risk factors associated in the native communities of Amazonas, Peru. METHODS: The DIRESA-Amazonas in collaboration with the Condorcanqui Health Network and the Institute of Tropical Diseases of the UNTRM carried out a malaria Active Case Detection (ACD III) between January 31st and February 10th of 2020. A total of 2718 (47.4%) individuals from 21 native communities grouped in eight sanitary districts, were screened for malaria infections. Each participant was screened for malaria using microscopy. Follow-up surveys were conducted for all malaria positive individuals to collect socio-demographic data. Spatial clustering of infection risk was calculated using a generalized linear model (GLM). Analysis of risk considered factors such as gender, age, type of infection, symptomatology, and parasitaemia. RESULTS: The study suggests that the P. falciparum index case was imported from Loreto and later spread to other communities of Rio Santiago during 2019. The ACD III reported 220 (8.1%) malaria cases, 46 P. falciparum, 168 P. vivax and 6 mixed infections. SaTScan analysis detected a cluster of high infection risk in Middle Rio Santiago and a particular high P. falciparum infection risk cluster in Upper Rio Santiago. Interestingly, the evaluation of different risk factors showed significant associations between low parasitaemia and P. falciparum asymptomatic cases. CONCLUSION: This is the first report of a P. falciparum outbreak in native communities of Condorcanqui, Amazonas. Timely identification and treatment of symptomatic and asymptomatic cases are critical to achieve malaria control and possible elimination in this area. However, the current malaria situation in Condorcanqui is uncertain, given that malaria ACD activities have been postponed due to COVID-19.


Asunto(s)
Brotes de Enfermedades , Malaria Falciparum/epidemiología , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Perú/epidemiología , Población Rural , Adulto Joven
7.
Codas ; 32(6): e20190235, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33503211

RESUMEN

PURPOSE: to evaluate the lingual frenulum and breastfeeding in infants from a maternal-perinatal referral center, as well as to monitor infants with ankyloglossia up to six months of age. METHODS: a cohort study conducted at the Instituto Nacional Materno Perinatal - Maternidad de Lima in Lima, Peru. The consecutive intentional sample consisted of 304 newborns and their respective mothers, evaluated during December 2017 and January 2018, which were the baseline of the study. A clinical evaluation of the lingual frenulum adapted and the Clinical Evaluation of Breastfeeding Efficacy (CEBE) scale, was performed. RESULTS: of the 304 newborns, 15 (4.9%) were considered with altered frenulum, and only 4 (26.7%) presented a low score in CEBE. The mean of the CEBE score was 9.3. (DP=1.35, Min=3, Max=10). Of the follow-up infants, only 2 (13.3%) persisted with breastfeeding difficulties for which frenotomy was indicated. CONCLUSION: This study demonstrates the low prevalence of ankyloglossia in infants, as it does not indicate a trend of difficulty or negative interference in breastfeeding.


Asunto(s)
Anquiloglosia , Lactancia Materna , Estudios de Cohortes , Femenino , Humanos , Lactante , Recién Nacido , Estudios Longitudinales , Perú/epidemiología , Embarazo
10.
Adv Gerontol ; 33(4): 686-690, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33342098

RESUMEN

Aging can be associated with decreasing muscle strength, and related factors are comorbidities, sex, physical activity, and possibly genetic factors. Among genetic factors the renin-angiotensin system is of interest, but data on the Peruvian population is lacking. The objective of our study was to evaluate the association of grip strength and angiotensin convertase enzyme (ACE) polymorphism in Peruvian older people. A cross-sectional study in a convenience sample of 104 participants over 60 years in Lima, Perú, with analysis of the ACE polymorphism, was performed. We studied 104 participants, 46 men (44,2%) and 58 women (55,8%), with a mean age and standard deviation (SD) of 73,7 (7,4) years, range between 60-90 years. The frequency of D/D, I/D and I/I genotypes was 12,7; 43,7 and 43,7% respectively. The genotype distribution of ACE polymorphism agreed with the Hardy-Weinberg equilibrium (p=0,746). The mean (SD) of grip strength in the D/D, I/D and I/I polymorphisms were 24,8 (7,2); 22,8 (7,2) and 23,4 (7,6) kg respectively; no significant difference was observed (p=0,41) between genetic groups. In this small convenience sample of older Peruvians, no association was found between grip strength and ACE genotype.


Asunto(s)
Peptidil-Dipeptidasa A , Polimorfismo Genético , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Genotipo , Humanos , Masculino , Fuerza Muscular/genética , Peptidil-Dipeptidasa A/genética , Perú/epidemiología
11.
BMJ Open ; 10(12): e044197, 2020 12 29.
Artículo en Inglés | MEDLINE | ID: mdl-33376182

RESUMEN

AIM: To explore indigenous communities' responses to the COVID-19 pandemic and its consequences for maternal and neonatal health (MNH) care in the Peruvian Amazon. METHODS: Mamás del Río is a community-based, MNH programme with comprehensive supervision covering monthly meetings with community health workers (CHW), community leaders and health facilities. With the onset of the lockdown, supervisors made telephone calls to discuss measures against COVID-19, governmental support, CHW activities in communities and provision of MNH care and COVID-19 preparedness at facilities. As part of the programme's ongoing mixed methods evaluation, we analysed written summaries of supervisor calls collected during the first 2 months of Peru's lockdown. RESULTS: Between March and May 2020, supervisors held two rounds of calls with CHWs and leaders of 68 communities and staff from 17 facilities. Most communities banned entry of foreigners, but about half tolerated residents travelling to regional towns for trade and social support. While social events were forbidden, strict home isolation was only practised in a third of communities as conflicting with daily routine. By the end of April, first clusters of suspected cases were reported in communities. COVID-19 test kits, training and medical face masks were not available in most rural facilities. Six out of seven facilities suspended routine antenatal and postnatal consultations while two-thirds of CHWs resumed home visits to pregnant women and newborns. CONCLUSIONS: Home isolation was hardly feasible in the rural Amazon context and community isolation was undermined by lack of external supplies and social support. With sustained community transmission, promotion of basic hygiene and mask use becomes essential. To avoid devastating effects on MNH, routine services at facilities need to be urgently re-established alongside COVID-19 preparedness plans. Community-based MNH programmes could offset detrimental indirect effects of the pandemic and provide an opportunity for local COVID-19 prevention and containment.


Asunto(s)
Control de Enfermedades Transmisibles , Servicios de Salud Comunitaria , Salud del Lactante , Salud Materna , Adulto , /prevención & control , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/normas , Servicios de Salud Comunitaria/métodos , Servicios de Salud Comunitaria/organización & administración , Servicios de Salud Comunitaria/normas , Transmisión de Enfermedad Infecciosa/prevención & control , Femenino , Conocimientos, Actitudes y Práctica en Salud , Necesidades y Demandas de Servicios de Salud , Servicios de Salud del Indígena/tendencias , Humanos , Salud del Lactante/estadística & datos numéricos , Salud del Lactante/tendencias , Recién Nacido , Masculino , Salud Materna/estadística & datos numéricos , Salud Materna/tendencias , Perú/epidemiología , Embarazo , Servicios Preventivos de Salud/métodos
14.
Ann Parasitol ; 66(3): 339-346, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33128517

RESUMEN

In Peru, only 12.7% (n=207) of fish species have had some record as parasitic metazoan hosts. The objective of this investigation was to determine the community of helminth parasites in black cusk-eel Genypterus maculatus (Tschudi, 1846) of north Peru. Fifty specimens of G. maculatus from Puerto Pimentel, province of Chiclayo, department of Lambayeque, Peru were evaluated. For the analysis of the parasitic community, the parasitological ecological indexes of prevalence (P), mean abundance (MA), mean intensity (MI) of infection, the dispersion indices, the correlation between total length (TL) and sex of fish vs parasitological ecological indexes, were calculated. The component community of the parasitic helminths in the evaluated fish was dominated by the presence of endoparasitic flatworms and absence of ectoparasites. The parasitic fauna of G. maculatus included eight endoparasitic species, four trematodes, two cestodes, one acanthocephalan and one nematode species. The species with the highest prevalence and abundance were Helicometra fasciata (Rudolphi, 1819), Scolex pleuronectis Müller, 1788 and Corynosoma australe Johnston, 1937. The prevalence of infection of C. australe was found positively related to the total length of G. maculatus. The sex of G. maculatus was not found associated with the P, MA and MI of any of the helminth parasites. This is the first study of ecological aspect in the parasitic fauna of G. maculatus made in Peru.


Asunto(s)
Helmintiasis Animal , Helmintos , Parásitos , Trematodos , Animales , Peces , Helmintiasis Animal/epidemiología , Perú/epidemiología
15.
Medwave ; 20(8): e8031, 2020 Sep 25.
Artículo en Español | MEDLINE | ID: mdl-33017383

RESUMEN

Objective: To compare excess mortality by district quintiles according to the Human Development Index (HDI) in Metropolitan Lima, the capital of Peru, and analyze the socioeconomic factors associated with excess mortality within the context of COVID-19. Methods: Retrospective cross-sectional analysis of the mortality records from non-violent causes registered in the National Death Information System in the 50 districts of Metropolitan Lima of the first 24 weeks of the years 2019 and 2020. Descriptive analysis was performed using contingency tables and time series graphs by sex, age group, and quintile of the district of residence according to the HDI. Negative binomial regression analysis was performed to identify possible explanatory factors for excess mortality. Results: An excess of 20 093 non-violent deaths and 2,979 confirmed deaths from COVID-19 were registered in Metropolitan Lima during the study period. The increase was observed primarily in men and adults aged 60 and over. Residents in the districts belonging to the fifth quintile, according to HDI, presented, in most cases, the lowest rates. Multivariate analysis revealed that a higher HDI level (p = 0.009) and a higher proportion of inhabitants living in extreme poverty (p = 0.014) decreased the excess mortality. Conclusion: Excess of non-violent deaths in Metropolitan Lima is higher in the quintiles with the lowest HDI, in men, and the age group from 60 to more years of age. The study of social and economic health determinants in Peru is crucial for the design of measures to be taken by the government against the COVID-19 pandemic.


Asunto(s)
Causas de Muerte , Infecciones por Coronavirus/epidemiología , Mortalidad/tendencias , Neumonía Viral/epidemiología , Adolescente , Adulto , Distribución por Edad , Niño , Preescolar , Infecciones por Coronavirus/mortalidad , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Pandemias , Perú/epidemiología , Neumonía Viral/mortalidad , Pobreza , Estudios Retrospectivos , Distribución por Sexo , Factores Socioeconómicos , Adulto Joven
16.
Enferm. clín. (Ed. impr.) ; 30(5): 340-348, sept.-oct. 2020. graf, tab
Artículo en Español | IBECS | ID: ibc-196777

RESUMEN

OBJETIVO: El Maslach Burnout Inventory (MBI) es un instrumento de uso habitual para la evaluación del síndrome de burnout. La versión del MBI-Human Service Survey (MBI-HSS) fue aplicado en enfermeros peruanos para explorar la prevalencia de este síndrome, sin considerar previamente posibles evidencias de validez para acreditar su uso. El propósito de la presente investigación es evaluar la estructura interna y la confiabilidad del MBI-HSS en enfermeros peruanos. MÉTODO: El estudio se elaboró mediante análisis secundario de datos a partir de la información recogida a 2.809 enfermeros del Perú obtenidos de la Encuesta Nacional de Satisfacción de Usuarios en Salud (ENSUSALUD) aplicado el año 2014. Se elaboró un análisis factorial exploratorio y confirmatorio; la confiabilidad fue estimada con el alfa de Cronbach y Omega. RESULTADOS: Los análisis indicaron la presencia de 3 factores, pero con una reducción de 7 ítems; la confiabilidad fue aceptable con el coeficiente Omega. CONCLUSIONES: Los resultados cuestionan la validez de la versión original del MBI-HSS para su aplicación en las enfermeras peruanas, por tanto, se requiere tomar con cautela su utilidad diagnóstica. Como alternativa, es recomendable priorizar la versión de 15 ítems y continuar con los estudios de validación


OBJECTIVE: The Maslach Burnout Inventory (MBI) is an instrument commonly used for the evaluation of burnout syndrome. The version of the MBI-Human Service Survey (MBI-HSS) was applied to Peruvian nurses to explore the prevalence of this syndrome without previously considering possible evidence of validity to accredit its use. The purpose of this research is to evaluate the internal structure and reliability of the MBI-HSS in Peruvian nurses. METHODS: The study was prepared through secondary data analysis based on the information collected from 2809 nurses in Peru obtained from the National Survey of Satisfaction of Health Users (ENSUSALUD) applied in 2014. An exploratory and confirmatory factor analysis was prepared; reliability was estimated with Cronbach alpha and omega. RESULTS: The analyses indicated the presence of three factors, but with a reduction of 7 items; reliability was acceptable with the omega coefficient. CONCLUSION: The results question the validity of the original version of the MBI-HSS for its application in Peruvian nurses, therefore, its diagnostic utility should be viewed with caution. As an alternative, it is advisable to prioritise the 15-item version and to continue with validation studies


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Salud Mental , Enfermeras y Enfermeros , Encuestas y Cuestionarios/normas , Agotamiento Profesional/enfermería , Perú/epidemiología , Análisis Factorial
18.
Rev Peru Med Exp Salud Publica ; 37(2): 195-202, 2020.
Artículo en Español, Inglés | MEDLINE | ID: mdl-32876206

RESUMEN

OBJECTIVES: To determine the probability of controlling the outbreak of COVID-19 in Peru, in a pre- and post-quarantine scenario using mathematical simulation models. MATERIALS AND METHODS: Outbreak si mulations for the COVID-19 pandemic are performed, using stochastic equations under the following assumptions: a pre-quarantine population R0 of 2.7 or 3.5, a post-quarantine R0 of 1.5, 2 or 2.7, 18% or 40%, of asymptomatic positives and a maximum response capacity of 50 or 150 patients in the intensive care units. The success of isolation and contact tracing is evaluated, no other mitigation measures are included. RESULTS: In the pre-quarantine stage, success in controlling more than 80% of the simulations occurred only if the isolation of positive cases was implemented from the first case, after which there was less than 40% probability of success. In post-quarantine, with 60 positive cases it is necessary to isolate them early, track all of their contacts and decrease the R0 to 1.5 for outbreak control to be successful in more than 80% of cases. Other scenarios have a low probability of success. CONCLUSIONS: The control of the outbreak in Peru during pre-quarantine stage demanded requirements that were difficult to comply with, therefore quarantine was necessary; to successfully suspend it would require a significant reduction in the spread of the disease, early isolation of positives and follow-up of all contacts of positive patients.


Asunto(s)
Simulación por Computador , Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades/prevención & control , Neumonía Viral/epidemiología , Trazado de Contacto/métodos , Infecciones por Coronavirus/prevención & control , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Modelos Teóricos , Pandemias/prevención & control , Perú/epidemiología , Neumonía Viral/prevención & control , Probabilidad , Cuarentena
19.
Rev Peru Med Exp Salud Publica ; 37(2): 327-334, 2020.
Artículo en Español | MEDLINE | ID: mdl-32876225

RESUMEN

Since December 2019, 414,179 cases of people with coronavirus disease 2019 (COVID-19) have been reported. As a result of the rapid increase in confirmed cases and deaths, population and health personnel, have experienced psychological problems, such as anxiety, depression, and stress. Although scientific information on COVID-19 is constantly increasing, it mainly focuses on genetic, epidemiological aspects, and public health measures, leaving aside possible effects on mental health. In order to summarize the current evidence, we present a narrative review of the effects of the COVID-19 pandemic on mental health. So far, the presence of anxiety, depression, and stress has been reported mostly in general population. Nonetheless, mental health issues have also been reported in health care workers, especially among female professionals, nurses, and those who work directly with suspected or confirmed cases of COVID-19. In efforts to reduce the spread of the disease, attention should be paid to the diagnosis and treatment of mental health issues. We believe that addressing them adequately will empower Peru to contain and eradicate COVID-19.


Asunto(s)
Infecciones por Coronavirus/psicología , Personal de Salud/psicología , Salud Mental , Neumonía Viral/psicología , Ansiedad/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Depresión/epidemiología , Humanos , Pandemias/prevención & control , Perú/epidemiología , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Estrés Psicológico/epidemiología
20.
PLoS Negl Trop Dis ; 14(9): e0008640, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32986701

RESUMEN

Several hundred thousand Zika cases have been reported across the Americas since 2015. Incidence of infection was likely much higher, however, due to a high frequency of asymptomatic infection and other challenges that surveillance systems faced. Using a hierarchical Bayesian model with empirically-informed priors, we leveraged multiple types of Zika case data from 15 countries to estimate subnational reporting probabilities and infection attack rates (IARs). Zika IAR estimates ranged from 0.084 (95% CrI: 0.067-0.096) in Peru to 0.361 (95% CrI: 0.214-0.514) in Ecuador, with significant subnational variability in every country. Totaling infection estimates across these and 33 other countries and territories, our results suggest that 132.3 million (95% CrI: 111.3-170.2 million) people in the Americas had been infected by the end of 2018. These estimates represent the most extensive attempt to determine the size of the Zika epidemic in the Americas, offering a baseline for assessing the risk of future Zika epidemics in this region.


Asunto(s)
Infección por el Virus Zika/epidemiología , Américas/epidemiología , Infecciones Asintomáticas/epidemiología , Teorema de Bayes , Ecuador/epidemiología , Epidemias , Humanos , Incidencia , Perú/epidemiología , Virus Zika , Infección por el Virus Zika/transmisión , Infección por el Virus Zika/virología
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