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Objective. To evaluate the evidence regarding the association between iron deficiency anemia (IDA) and dental caries in children and adolescents. Methods. Searches were conducted in 4 international databases from the beginning of records until October 2023. Studies evaluating the association between IDA and dental caries in individuals aged 6 months to 18 years were included. Risk of bias was assessed using the Newcastle Ottawa Scale. Quantitative synthesis was performed using the inverse variance or Mantel-Haenzel method, depending on the type of outcome analyzed. Measures of association included odds ratios and mean differences, employing a random-effects model with a 95% confidence interval. Results. A total of 1161 studies were identified, of which 12 were selected for qualitative review and 9 for meta-analysis. A significant association was found between IDA and dental caries (odds ratio of 3.54; 95% CI: 2.54-4.94) and a higher rate of dental caries in the presence of IDA (mean difference of 1.96; 95% CI: 1.07-2.85). The certainty of evidence according to GRADE was rated as very low. Conclusions. Despite the limited certainty, the findings indicate a significant association between IDA and dental caries. It is prudent to interpret these results with caution, considering the methodological limitations of the studies. However, given the potential relevance of this association for public health, recommending oral health strategies, including preventive and corrective dental interventions, for anemia control programs underlines the importance of more rigorous future research to strengthen the certainty of the evidence and guide the implementation of these strategies.
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[This corrects the article DOI: 10.1371/journal.pgph.0001330.].
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BACKGROUND: Complicated grief (CG) resulting from poor adaptation to the death of a close person may have been related with the presence of other mental health problems in older adults in Peru during the COVID-19 pandemic. Our study aimed to assess the association between CG and anxiety, depression, and suicidal ideation in older adults in Peru in the context of the COVID-19 pandemic. METHODS: We conducted a cross-sectional analysis using data from the "Socioemotional evaluation form" applied in 2020 to mental health problems in older adults attending the Peruvian Social Security (EsSalud). For our study, we included older adults who reported the death of a close person during the last six months when this assessment was performed. CG, depression, anxiety, and suicidal ideation were initially evaluated using validated questionnaires. The association between CG and the presence of mental health problems was calculated through multivariate analysis, where prevalence ratios (PR) were estimated with 95% confidence intervals (CI). RESULTS: Of the 249 older adults included, 175 (70.3%) were female with a median age of 71 years (interquartile range: 9), and 35 (14.1%) reported the presence of CG. It was found that CG in this population was associated with the presence of anxiety (PR: 1.35, 95% CI: 0.98 to 1.85), depression (PR: 1.44, 95% CI: 1.06 to 1.95), and suicidal ideation (PR: 2.84, 95% CI: 1.06 to 7.59). CONCLUSIONS: CG is related to the presence of mental health problems in older adults in Peru. It is essential to implement measures that facilitate the prevention and proper management of this condition in this population, especially in the context of high population mortality such as the COVID-19 pandemic.
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COVID-19 , Idéation suicidaire , Humains , Femelle , Sujet âgé , Mâle , Dépression/épidémiologie , Dépression/psychologie , Études transversales , Pérou/épidémiologie , Pandémies , COVID-19/épidémiologie , Anxiété/épidémiologie , Anxiété/psychologie , ChagrinRÉSUMÉ
RESUMEN Introducción: La llegada de la pandemia de COVID-19 al Perú requirió una respuesta inmediata y múltiples cambios tanto en la atención sanitaria como en el entrenamiento de los profesionales de la salud. La Facultad de Medicina de la Universidad Peruana Cayetano Heredia implementó el Programa de Teleconsulta Docente (PTD), para continuar con la formación de estudiantes de medicina en un entorno virtual, sin embargo, se desconoce la aceptación de los involucrados respecto a una educación virtual, condición que puede reflejar lo ocurrido en otras escuelas de medicina del país. Objetivo: nuestro estudio buscó evaluar la percepción de alumnos y docentes respecto al PTD. Métodos: estudio observacional, descriptivo y transversal. Se elaboró un cuestionario para explorar las percepciones de la telemedicina en el escenario de la enseñanza. Resultados: más del 80 % de los profesores y el 60 % de los alumnos consideraron que la PTD podía utilizarse como herramienta de enseñanza. Más del 90 % de los profesores y los estudiantes consideran que realizar la telemedicina no fue más difícil que hacer una consulta presencial. El 60 % de los estudiantes y el 80 % de los profesores perciben que los estudiantes deben desarrollar habilidades en telemedicina; el 80 % de los profesores y estudiantes consideran que la PTD constituye un servicio de responsabilidad social. Profesores y alumnos consideran que el éxito en la implantación de un PTD está influenciado por el nivel de aceptación de la población (20,2 %), el uso de la historia clínica electrónica (19,4 %) y la formación en competencias digitales (18,6 %). Conclusión: los profesores y los estudiantes del PTD perciben la telemedicina como una herramienta útil para evaluar los problemas de salud de la población. Ambos perciben que a través de las sesiones de telemedicina se podrían adquirir las habilidades necesarias para completar el perfil de egresado de la carrera de medicina.
ABSTRACT Introduction : The occurrence of the COVID-19 pandemic in Peru required an immediate response and multiple changes in both healthcare and health professional training. The School of Medicine in Universidad Peruana Cayetano Heredia implemented the Teleconsultation Faculty Program (FTP), aiming to continue with training medicine students in a virtual environment. However, the acceptance of those involved in virtual education is unknown, a condition that may reflect what has happened in other medical schools in our country. Main : our study sought to assess the perception of students and teachers regarding FTP. Methods : observational, descriptive, cross-sectional study. A questionnaire was developed to explore perceptions of telemedicine in a teaching scenario. Results : More than 80% of teachers and 60% of students considered that the FTP could be used as a teaching tool. More than 90% of teachers and students consider that performing telemedicine was not more difficult than doing a face-to-face consultation. Sixty percent of students and 80% of teachers perceive that students must develop skills in telemedicine; 80% of teachers and students consider that FTP constitutes a service with social responsibility. Teachers and students consider that the success in the implementation of an FTP is influenced by the level of acceptance of the population (20.2%), the use of electronic medical records (19.4%), and training in digital skills (18.6%). Conclusion : Teachers and students using FTP perceive telemedicine as a useful tool for assessing health problems. Both perceive that through telemedicine sessions, skills required to complete the medical school graduate profile could be acquired.
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INTRODUCTION: COVID-19 not only acutely compromises peoples health but can also generate symptoms that remain weeks after the infection. Moreover, older adults may have different symptomatologic patterns than other age groups. OBJECTIVE: To describe the acute and persistent symptoms of COVID-19 in older adult users of Social Security senior centers. METHODS: A retrospective descriptive study was carried out by telephone call to older adults from five Peruvian senior centers, from July to September 2020, who reported being positive for COVID-19 in the last three months. Older adults were asked about associated symptoms, with a follow-up of up to four months. RESULTS: The most frequent acute symptoms were cough, fever, headache, and myalgia. The mean num- ber of symptoms per person was one to three. We also found that 4.4% of COVID-19 cases had symptoms that persisted over three weeks. CONCLUSIONS: Older persons in senior centers have a low frequency of persistent COVID-19 symptoms.
INTRODUCCIÓN: COVID-19 no sólo compromete agudamente la salud de las personas, sino que puede generar síntomas que permanecen luego de la infección aguda, incluso por más de tres semanas. Más aún, las personas adultas mayores podrían tener patrones sintomatológicos diferentes a otros grupos etarios. OBJETIVO: Describir los síntomas agudos y persistentes de COVID-19 en personas adultas mayores usuarias de centros del adulto mayor de la Seguridad Social. MÉTODO: Se realizó un estudio descriptivo retrospectivo por llamada telefónica a adultos mayores de cinco centros del adulto mayor peruanos, de julio a septiembre de 2020, quienes habían reportado ser positivos a COVID-19 en el monitoreo telefónico de los últimos tres meses. En las llamadas se les pregunto por los síntomas asociados, con un seguimiento de hasta cuatro meses. RESULTADOS: Los síntomas agudos más frecuentes fueron tos, fiebre, cefalea y mialgia. La media de síntomas por persona fue de uno a tres. Un 4,4% de los casos tuvo COVID-19 prolongado. CONCLUSIONES: Las personas mayores de los centros del adulto mayor presentan una baja frecuencia de síntomas post COVID-19 agudo.
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COVID-19 , Centres pour personnes âgées , Sujet âgé , Sujet âgé de 80 ans ou plus , Humains , Revenu , Études rétrospectives , SARS-CoV-2RÉSUMÉ
The COVID-19 pandemic has demanded governments and diverse organizations to work on strategies to prepare and help communities. Increasing recognition of the importance of identifying vulnerable populations has raised a demand for better tools. One of these tools is the Social Vulnerability Index (SVI). The SVI was created in 2011 to identify and plan assistance for socially vulnerable populations during hazardous events, by providing disaster management personnel information to target specific areas. We aimed to evaluate and determine the social vulnerability in different provinces and districts of Peru in the context of the COVID-19 pandemic using an adapted version of the SVI index. Ecological, observational, and cross-sectional study was conducted. We adapted the SVI and collected indicators related to COVID-19. We organized and analyzed the population data of the 196 provinces of Peru, using data from government institutions. We found a distribution of high and very high SVI in the mountainous areas of Peru. High and very high social vulnerability indexes, due to the presence of some or all the variables were predominantly distributed in the provinces located in the southern and highlands of the country. The association between mortality rate and social SVI-COVID19 was inverse, the higher the vulnerability, the lower the mortality. Our results identify that the provinces with high and very high vulnerability indexes are mostly located in rural areas nearby the Andes Mountains, not having a direct correlation with COVID-19 mortality.
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OBJECTIVE: To describe the clinical characteristics and sociodemographic factors associated with COVID-19 among pregnant women in a maternal and children's hospital in Lima, Peru. METHODS: Quantitative observational study. The population under study consisted of pregnant women who attended an emergency room and had a COVID-19 test. These women were assessed for age, gestational age, place of origin, occupation, education, marital status, number of children, previous body mass index, gestational body mass index, tetanus vaccination, prenatal controls, and hemoglobin. After bivariate analysis, a generalized linear regression model was applied. RESULTS: We included 200 women aged between 18 and 34 years (84.5%) with a median gestational age of 36 weeks. More than half were from Lima (52.5%), most were housewives (79%), had high school education (71.9%), and had a cohabiting marital status (60%). The COVID-19 test positivity was 31.5% by rapid tests. Pregestational body mass index assessment showed that 36.7% of normal weight, 38,1% of overweight, and 30.3% of obese pregnant women had COVID-19 infection. 39.7% of patients with hemoglobin levels greater than or equal to 11 g/dL, 21.2% of patients with values between 10 and 10.9 g/dL, and 20% of patients with values between 7 and 9.9 g/dL had COVID-19 infection. The prevalence ratio (with a 95% confidence interval) found that cohabitation was associated with a lower risk of having COVID-19 infection in pregnant women (prevalence ratio: 0.41, p < 0.001). CONCLUSION: Cohabiting pregnant women had a lower risk of COVID-19 infection compared with other marital statuses. Further research is needed to evaluate COVID-19 associated factors in pregnant women and possible sociodemographic or economic factors behind cohabiting marital status association among this population.
OBJETIVO: Describir las características clínicas y factores sociodemográficos asociados a COVID-19 en gestantes de un hospital materno infantil de Lima, Perú. MÉTODO: Estudio cuantitativo observacional. La población estuvo compuesta por gestantes atendidas en la unidad de emergencia, con la prueba para el diagnóstico de COVID-19. A las madres se les valoró edad, edad gestacional, lugar de procedencia, ocupación, nivel de estudios, estado civil, número de hijos, índice de masa corporal previa, índice de masa corporal de la gestación, vacuna antitetánica, controles prenatales, y hemoglobina. Después de un análisis bivariado se aplicó un modelo de regresión lineal generalizado. RESULTADOS: Incluimos a 200 mujeres, con edades de 18 a 34 años (84,5%). Más de la mitad procedía de Lima (52,5%), 79% tenía como ocupación el ser ama de casa, 71,9% alcanzó estudios secundarios y 60% registró estado civil de conviviente. La incidencia de COVID-19 fue de 31,5% mediante pruebas rápidas. La mediana de edad gestacional al momento de la evaluación para COVID-19 fue de 36 semanas. El índice de masa corporal pregestacional, comparado entre las gestantes con COVID-19 y las que no lo tuvieron, fue normal en 36,7 y 63,3%. Se detectó sobrepeso en 38,1 y 61,9% de las pacientes, obesidad en 30,3 y 69,7%, respectivamente. Los niveles de hemoglobina superiores o iguales a 11 gramos por decilitro se reportaron en 39,7 y 60,3% en cada grupo; hemoglobina entre 10 y 10,9 gramos por decilitro, en 21,2 y 78,8%; y hemoglobina entre 7 y 9,9 gramos por decilitro, en 20 y 80%, respectivamente. La razón de prevalencia con un intervalo de confianza al 95%, identificó al estado civil conviviente asociado a menor riesgo de tener COVID-19 en gestantes (razón de prevalencia: 0,41, valor p < 0,001). CONCLUSIÓN: Las gestantes cuyo estado civil fue de conviviente presentaron menor riesgo de experimentar COVID-19. Es necesario seguir estudiando los factores que se asocian a la presencia de COVID-19 en gestantes, así como posibles factores sociodemográficos o económicos detrás del estado civil conviviente.
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COVID-19/économie , COVID-19/épidémiologie , Hôpitaux publics , Complications infectieuses de la grossesse/économie , Complications infectieuses de la grossesse/épidémiologie , Femmes enceintes , Facteurs socioéconomiques , Adolescent , Adulte , Indice de masse corporelle , Femelle , Âge gestationnel , Humains , Pérou/épidémiologie , Grossesse , Femmes enceintes/enseignement et éducation , Facteurs de risque , SARS-CoV-2 , Jeune adulteRÉSUMÉ
El fenómeno denominado infodemia consiste en un flujo masivo de información que se produce durante las crisis sociales. La difusión y el consumo de información por diversos medios oficiales y no oficiales sobre la enfermedad del coronavirus (COVID-19) y los aspectos relacionados con los métodos de prevención, los síntomas de la enfermedad, las opciones terapéuticas, entre otros, han crecido de forma continua desde su reporte oficial a finales del año 2019.1) La información sin sustento científico o la información científica indebidamente utilizada y disponible en las redes sociales podría favorecer la promoción de medidas de seguridad ineficientes, opciones terapéuticas de eficacia desconocida, o ambos,2,3 por lo que resulta importante cuantificar ese tipo de información como una de las estrategias de afrontamiento4 y de aproximación a la almetría de las publicaciones científicas sobre COVID-19 en las redes sociales.5 En ese sentido, nuestro objetivo fue estimar la proporción de publicaciones con contenido verificado en artículos científicos que son compartidos en grupos de Facebook dedicados a la COVID-19 y que fueron creados entre los meses de enero y marzo del año 2020(AU)