Impact of COVID-19 on diagnosis of tuberculosis, multidrug-resistant tuberculosis, and on mortality in 11 countries in Europe, Northern America, and Australia. A Global Tuberculosis Network study.

OBJECTIVES: Although evidence is growing on the overall impact of the COVID-19 pandemic on tuberculosis (TB) services, global studies based on national data are needed to better quantify the extent of the impact and the countries' preparedness to tackle the two diseases. The aim of this study was to compare the number of people with new diagnoses or recurrence of TB disease, the number of drug-resistant (DR)-TB, and the number of TB deaths in 2020 vs 2019 in 11 countries in Europe, Northern America, and Australia. METHODS: TB managers or directors of national reference centers of the selected countries provided the agreed-upon variables through a validated questionnaire on a monthly basis. A descriptive analysis compared the incidence of TB and DR-TB and mortality of the pre-COVID-19 year (2019) vs the first year of the COVID-19 pandemic (2020). RESULTS: Comparing 2020 vs 2019, lower number of TB cases (new diagnosis or recurrence) was notified in all countries (except USA-Virginia and Australia), and fewer DR-TB notifications (apart from France, Portugal, and Spain). The deaths among TB cases were higher in 2020 compared to 2019 in most countries with three countries (France, The Netherlands, USA-Virginia) reporting minimal TB-related mortality. CONCLUSIONS: A comprehensive evaluation of medium-term impact of COVID-19 on TB services would benefit from similar studies in multiple settings and from global availability of treatment outcome data from TB/COVID-19 co-infected patients.

Diagnóstico de la vigilancia, prevención y control de la COVID-19 en el trabajo minero peruano

Introducción: En Perú, las empresas mineras debían registrar e implementar el plan para la vigilancia, prevención y control de la COVID-19 en el trabajo (requerido por el Ministerio de Salud), previo al reinicio de actividades suspendidas debido a la pandemia. Objetivo: Describir el estado situacional de los planes para la vigilancia, prevención y control de la COVID-19 en el trabajo del sector minero (1ra y 2da fase de reactivación económica, 2020). Métodos: Se realizó un estudio transversal de la base de datos del sistema SISCOVID-Empresas. Se reportaron frecuencias y proporciones de las características de los planes (región de procedencia, número de trabajadores, número de profesionales de salud, existencia de comité o supervisor de seguridad y salud en el trabajo, estado de registro y reporte de presupuesto) según el número de trabajadores de la empresa. Resultados: Se revisaron 2 236 registros de planes. El 6,2 % indica no contar con supervisor o comité de seguridad y salud en el trabajo y el 71,5 % no cuenta con profesional de la salud. El 81,2 % de las empresas con más de 500 trabajadores contaban con profesionales de medicina y enfermería. El 89,2 % de las empresas con 1 a 20 trabajadores no contaban con profesionales de la salud. Conclusiones: Tres de cada 4 empresas del sector minero incumplen lo requerido en el plan para la vigilancia, prevención y control de la COVID-19 en el trabajo.

Introduction: In Peru, mining companies had to register and implement the Plan for the surveillance, prevention, and control of COVID-19 at work (requested by the Ministry of Health), prior to restarting activities suspended due to the pandemic. Objective: To describe the situational status of the plans for the surveillance, prevention, and control of COVID-19 at work in the mining sector (1st and 2nd phases of economic reactivation, 2020). Methods: A cross-sectional study was carried out of the database from the SISCOVID- Empresas system. Frequencies and proportions of the characteristics of the plans were reported (region of origin, number of workers, number of health professionals, existence of an occupational health and safety committee or supervisor, status of registration and budget report) according to the number of company workers. Results: In total 2,236 plan records were reviewed. Of the total, 6.2% of the registered plans indicate that they do not have an occupational health and safety supervisor or committee, and 71.5% do not have a health professional. Furthermore, 81.2% of the companies with more than 500 workers had medicine and nursing professionals, and 89.2% of companies with 1 to 20 workers did not have health professionals. Conclusions: Three out of 4 companies in the mining sector fail to comply with the requirements of the plan for the surveillance, prevention, and control of COVID-19 at work.

Políticas de vigilancia, prevención y control de la COVID-19 en trabajadores del sector salud en el Perú / Surveillance, prevention, and control policies of COVID-19 in health sector workers in Peru

Antecedentes: El Perú ha sido uno de los países con mayor carga de enfermedad por la COVID-19. El Gobierno del Perú ha establecido pautas básicas para la elaboración y registro de los planes para la vigilancia, prevención y control de la COVID-19 en el trabajo (PVPC) de las instituciones del Perú. Objetivo: Caracterizar los PVPC de instituciones del sector salud del Perú. Material y Métodos: Estudio descriptivo retrospectivo de base de datos secundaria. Se evaluaron los PVPC del sector salud registrados en la plataforma SISCOVID-Empresas del Ministerio de Salud del Perú, registro obligatorio para la reactivación de actividades durante la pandemia por la COVID-19. Resultados: Se analizaron 1263 registros PVPC del sector salud registrados en la plataforma SISCOVID-Empresas. El 5,8% de empresas no cuenta con supervisor o comité de seguridad y salud en el trabajo, y 38,6% de empresas con más de 20 trabajadores no cuenta con profesional de salud. Conclusiones: Se identificó un elevado incumplimiento de lo requerido en los PVPC en instituciones del sector salud peruano. Se requiere reforzar y fiscalizar el cumplimiento adecuado de los PVPC en estas instituciones (AU)

Background: Peru has been one of the countries with the highest burden of disease due to COVID-19. The Government of Peru has established basic guidelines for the preparation and registration of plans for the surveillance, prevention, and control of COVID-19 at work (PVPC) of Peruvian institutions. Objective: To characterize the PVPC of health sector institutions in Peru. Materials and Methods: retrospective descriptive secondary database study. The PVPCs of the health sector registered in the SISCOVID-Empresas platform of the Ministry of Health of Peru, mandatory registration for the reactivation of activities during the COVID-19 pandemic, were evaluated. Results: 1263 PVPC records from the health sector registered on the SISCOVID-Empresas platform were analyzed. Of the registered PVPCs, 5.8% of companies do not have a supervisor or committee for occupational safety and health, and 38.6% of companies with more than 20 workers do not have a health professional. Conclusions: A high non-compliance with what is required in the PVPCs in institutions of the Peruvian health sector was identified. It is necessary to reinforce and supervise the adequate fulfillment of the PVPC in these institutions (AU)

Recurrent vitreous hemorrhage secondary to retinal vessel avulsion.

Spontaneous vitreous hemorrhage is a rare entity, present in 7 out of 100,000 inhabitants. It is associated with different pathologies; however, it is rarely reported to be caused by retinal vessel avulsion syndrome. In the present manuscript, we report a case of avulsion of retinal vessels associated with recurrent vitreous hemorrhage managed, at first, by photocoagulation, but due to the several recurrence of bleeding, the patient went into surgical management.

Salud mental y calidad de sueño en estudiantes de ocho facultades de medicina humana del Perú / Mental health and quality of sleep from eight faculties of medical students in Peru

Introduction: The quality of sleep refers to the fact that we sleep well at night and daytime functioning. Thus, influences health and quality of life. Sleep loss is one of the most striking problem of modern society especially in medical students. This is related to the constant academic demands causing mental health problems and high levels of stress. Methods: A cross-sectional study. We evaluated 1,040 medical students in 8 universities of Peru from the first to the sixth year of study. Of these, 892 surveys were used. Mental health were evaluated according to the scale of Depression, Anxiety and Stress (DASS-21) and "poor sleepers" students were established with a score > 5 according to the Pittsburgh Sleep Quality Index (PSQI). Results: It was found that 693 (77.69%) students were poor sleepers. About mental health was found that 290 (32.51%) suffered from depression, 472 (52.91%) of anxiety and 309 (34.64%) stress. A significant association (p < 0.05) was found between poor sleep quality and female sex (OR = 1.13, CI = 1.05 to 1.21); depression (OR = 1.23, CI = 1,15-1,31); anxiety (OR = 1.32, CI = 1.23 to 1.43); and stress (OR = 1.26, CI = 1.19 to 1.35). Conclusion: We observed a high frequency of poor sleepers in medical students from eight universities of Peru. The poor quality of sleep was associated with anxiety, depression and stress in students of second and third year, respectively.

Introducción: La calidad de sueño nos hace referencia al hecho de dormir bien durante la noche y el rendimiento diurno. De esa forma, influye en salud y la buena calidad de vida. La pérdida de sueño es uno de los problemas de la sociedad moderna más llamativos especialmente en estudiantes de medicina humana. Esto se relaciona a la constante y creciente exigencia académica ocasionando problemas de salud mental y altos niveles de estrés. Métodos: Estudio transversal analítico. Se evaluaron 1.040 estudiantes de medicina humana obtenidos en forma equitativa de 8 universidades del Perú desde el primer al sexto año de estudios. De ellos, se usaron 892 encuestas. Se evaluó la salud mental según la escala de Depresión, Ansiedad y Estrés (DASS-21) y se estableció a los estudiantes "malos dormidores" como aquellos con una puntuación > 5 según el índice de calidad de sueño de Pittsburgh (ICSP). Resultados: Se encontró que 693 (77,69%) alumnos fueron malos dormidores. Con respecto a la salud mental se halló que 290 (32,51%) sufrían de depresión, 472 (52,91%) de ansiedad y 309 (34,64%) de estrés. Se halló asociación significativa (p < 0,05) entre la mala calidad de sueño y el sexo femenino (RP = 1,13; IC = 1,051,21); depresión (RP = 1,23; IC = 1,15-1,31); ansiedad (RP = 1,32; IC = 1,23-1,43); y estrés (RP = 1,26; IC = 1,19-1,35). Conclusión: Se observa una frecuencia elevada de malos dormidores en estudiantes de medicina de ocho universidades del Perú. La mala calidad de sueño se asoció con la ansiedad, depresión y estrés en los estudiantes de segundo y tercer año, respectivamente.