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1.
Nat Commun ; 14(1): 303, 2023 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-36658111

RESUMO

Recent rises in incident tuberculosis (TB) cases in Paraguay and the increasing concentration of TB within prisons highlight the urgency of targeting strategies to interrupt transmission and prevent new infections. However, whether specific cities or carceral institutions play a disproportionate role in transmission remains unknown. We conducted prospective genomic surveillance, sequencing 471 Mycobacterium tuberculosis complex genomes, from inside and outside prisons in Paraguay's two largest urban areas, Asunción and Ciudad del Este, from 2016 to 2021. We found genomic evidence of frequent recent transmission within prisons and transmission linkages spanning prisons and surrounding populations. We identified a signal of frequent M. tuberculosis spread between urban areas and marked recent population size expansion of the three largest genomic transmission clusters. Together, our findings highlight the urgency of strengthening TB control programs to reduce transmission risk within prisons in Paraguay, where incidence was 70 times that outside prisons in 2021.


Assuntos
Mycobacterium tuberculosis , Tuberculose , Humanos , Mycobacterium tuberculosis/genética , Prisões , Paraguai/epidemiologia , Filogeografia , Estudos Prospectivos , Tuberculose/epidemiologia , Tuberculose/prevenção & controle
2.
Rev. cient. cienc. salud ; 5(1)26-01-2023.
Artigo em Espanhol | BDNPAR | ID: biblio-1413372

RESUMO

Introducción. La vacunación es una de las estrategias de salud pública más eficaces, sin embargo, puede producir efectos adversos (EA). En Paraguay, en diciembre del 2020, se lanzó el Plan Nacional de Vacunación como parte de las medidas de control y prevención contra la COVID-19, que contempla la vigilancia de eventos supuestamente atribuibles a la vacunación o inmunización (ESAVI). Objetivo. Determinar los EA de las vacunas contra la COVID-19 aplicadas en el Paraguay en el 2021. Metodología. Estudio analítico transversal que incluyó una encuesta en Google Forms difundida a través de las redes sociales. Se recolectaron variables sociodemográficas, tipo de vacuna, dosis y EA. Los datos se analizaron con Epi InfoTM, y se calculó Odd Ratio (OR) con su IC95% a un nivel de significancia de <0,05. Resultados. Participaron del estudio, 641 personas (edad media: 27 ± 13 años), 69% mujeres y 54% del departamento Central. El 75% recibió dos dosis de la vacuna, 56,3% presentó EA con la primera dosis y 45,7% con la segunda. La presencia de EA en la primera dosis se asoció con el sexo femenino (OR 1,73; IC95% 1,23­2,42; p=0,001) y edad menor de 30 años (OR 1,73; IC95% 1,30­2,46; p<0,001); presentar EA en la primera dosis estuvo asociada a presentarlos con la segunda dosis (OR 3,84, IC95% 2,39­5,09, p<0,001). Conclusión. Las reacciones adversas a las vacunas fueron frecuentes, pero leves y autolimitadas. Aquellos encuestados que presentaron EA en la primera dosis tuvieron mayor chance de volverlos a presentar en la segunda.


ntroduction. Vaccine is one of the most effective public health strategies, however, it can produce adverse effects (AE). In Paraguay, in December 2020, the National Vaccination Plan was launched as part of the control and prevention measures against COVID-19, which contemplates the surveillance of events supposedly attributable to vaccination or immunization (ESAVI). Objective.to determine the AE of the vaccines against COVID-19 used in Paraguay in 2021. Methodology. Cross-sectional analytical study using Google Forms for a survey disseminated through social networks. Sociodemographic variables, type of vaccine, doses, AE were collected. Data were analyzed with Epi InfoTM, Odds Ratio was calculated with a 95% CI, at a significance level of p value <0.05. Results. A total of 641 people participated in the study (mean age: 27 ± 13 years), 69% women and 54% from the Central Department. Seventy-five percent received two doses of the vaccine, 56.3% had AE with the first dose and 45.7% AE with the second. AE in the first dose was associated with females (OR 1.73 (95%CI 1.23­2.42); p=0.001) and age under 30 years old (OR 1.73; 95%CI 1.30­2.46; p <0.001); presenting AEs in the first dose was associated with presenting them with the second dose (OR 3.84; 95%CI 2.39­5.09; p<0.001). Conclusion. Adverse reactions to vaccines were common but mild and self-limited. Those respondents who presented AE in the first dose had a high chance of presenting them again in the second dose.


Assuntos
Humanos , Masculino , Feminino , SARS-CoV-2 , Paraguai , Vacinas contra COVID-19 , Vacina BNT162 , ChAdOx1 nCoV-19
3.
PLoS One ; 17(12): e0279402, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36584065

RESUMO

BACKGROUND: Interpersonal violence among adolescents is a serious public health issue across the globe and has been one of the leading causes of death among Paraguayan adolescents. This study aims to investigate the prevalence of physical fighting among adolescents in Paraguay in order to identify problematic fighting behaviour. We also aim to examine the correlates of physical fighting and the extent to which previously identified factors correlate with physical fighting. METHODS: We used the Paraguay 2017 Global School-based Student Health Survey (GSHS). This survey collects health-related information on school-attending adolescents aged 13-17 years. We defined physical fighting as having participated in at least two physical fights in the previous 12 months. We chose 16 independent variables: 12 individual-level variables and four social-level variables. Multivariable logistic regression models were developed to identify factors associated with physical fighting. One of the limitations of this study is that it only captured the responses of the students who attended school on the day of the survey. FINDINGS: A total of 3,149 students completed the survey questionnaire, with the response rates for the school, student, and total response being 100%, 87%, and 87%, respectively. In 2017, 8% of the survey participants (11.4% of the males, and 4.7% of the females) had been involved in two or more physical fights during the past 12 months. In the multivariable model, having been physically attacked, male gender, physical activity, alcohol use, early sexual debut, and suicide planning were significantly associated with involvement in physical fighting. Having helpful peers and supportive parents was not statistically significant in the model adjusted for all variables. CONCLUSIONS: Although Paraguay shows relatively lower prevalence of physical fighting than other countries, the high association between physical fighting and having been physically attacked is noteworthy. Considering the serious interpersonal violence among Paraguayan adolescents, preventive attributes should be considered, and further assessment of other types of interpersonal violence should be made.


Assuntos
Consumo de Bebidas Alcoólicas , Feminino , Humanos , Masculino , Adolescente , Prevalência , Paraguai/epidemiologia , Inquéritos e Questionários , Inquéritos Epidemiológicos
4.
Rev Peru Med Exp Salud Publica ; 39(2): 170-177, 2022.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-36477317

RESUMO

OBJECTIVE: To determine the genetic diversity of Aedes aegypti in the Central-Alto Paraná cross-border road corridor of Paraguay, an area that has reports of dengue cases. MATERIALS AND METHODS: Twenty adult females were selected from hatching Ae. aegypti eggs from households geolocated in the departments of Alto Paraná, Caaguazú, Cordillera and Central, between 2018 and 2019. DNA was extracted from the tissue of females for amplifying their polymorphic patterns by random amplification of polymorphic DNA by PCR (RAPD-PCR), using primers H3 and B03 in order to identify genetic parameters of population diversity. The relationships between mosquito populations according to locality were observed by unpaired arithmetic mean analysis. We used DIVA-GIS 7.3.0 and MAXENT to analyze the suitable areas of actual and potential geographic distribution of these Ae. aegypti populations. RESULTS: Forty loci were identified by RAPD-PCR profiling, with moderate gene differentiation (Gst = 0.12). The cross-border corridor presented bioclimatic conditions for the presence of variant populations of Ae. aegypti, with precipitation in the warmest quarter and mean temperature in the driest quarter being determinant in the distribution. CONCLUSIONS: There is evidence of moderate genetic diversity in Ae. aegypti populations from areas that have reported dengue cases in the cross-border road corridor linking the Central and Alto Paraná departments of Paraguay. The study of genetic variability of Ae. aegypti is very useful for entomo-epidemiological surveillance and evaluation of possible resistance to chemical control.


OBJETIVOS: Conocer la diversidad genética de Aedes aegypti en el corredor vial transfronterizo Central-Alto Paraná de Paraguay, con registros de casos de dengue. MATERIALES Y MÉTODOS: Se seleccionaron veinte hembras adultas de la eclosión de huevos de Ae. aegypti procedentes de casas geolocalizadas en los departamentos de Alto Paraná, Caaguazú, Cordillera y Central, entre el 2018 y 2019. Se extrajo ADN del tejido de las hembras para amplificación aleatoria de sus patrones polimórficos mediante amplificación aleatoria del ADN polimórfico por PCR (RAPD-PCR), usando cebadores H3 y B03 a fin de conocer parámetros genéticos de diversidad poblacional. Las relaciones entre las poblaciones de mosquitos según la localidad fueron visualizadas mediante análisis no apareado de la media aritmética. Las áreas idóneas de distribución geográfica real y potencial de estas poblaciones de Ae. aegypti fueron analizadas mediante DIVA-GIS 7.3.0 y MAXENT. RESULTADOS: Se identificaron 40 loci mediante perfiles RAPD-PCR, con diferenciación génica moderada (Gst = 0,12). El corredor transfronterizo presentó condiciones bioclimáticas para la presencia de poblaciones variantes de Ae. aegypti, siendo determinantes en la distribución la precipitación del trimestre más cálido y la temperatura media del trimestre más seco. CONCLUSIONES: Se evidencia que existe diversidad genética moderada en las poblaciones de Ae. aegypti procedentes de zonas con registros de casos de dengue ubicadas en el corredor vial transfronterizo que une los departamentos Central y Alto Paraná de Paraguay. El estudio de variabilidad genética de Ae. aegypti es de gran utilidad para la vigilancia entomoepidemiológica y evaluación de posibles eventos de resistencia al control químico.


Assuntos
Aedes , Animais , Aedes/genética , Técnica de Amplificação ao Acaso de DNA Polimórfico , Paraguai , Variação Genética
5.
Washington, D.C.; OPS; 2022-12-21. (OPS/FPL/IM/22-0016).
em Espanhol | PAHO-IRIS | ID: phr-56906

RESUMO

La fiebre amarilla es una enfermedad endémica en varios países de América Latina. Con vistas a brindar apoyo a los responsables de la toma de decisiones para priorizar las acciones preventivas frente a esta afección, la Organización Panamericana de la Salud presenta estos perfiles nacionales con una selección de datos concisa y exhaustiva de los países con endemicidad. En cada perfil se brinda un análisis de la situación actual del país, los factores ecológicos y climáticos asociados a la enfermedad, la distribución e incidencia de los vectores, y las claves de la actividad arboviral. Asimismo, se incluye una perspectiva histórica de la epidemiología y un resumen del estado de la vacunación contra la enfermedad en el país.


Assuntos
Febre Amarela , Vacinas , Imunização , Cobertura Vacinal , Paraguai
6.
PLoS One ; 17(12): e0278999, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36534658

RESUMO

Beef exports represent a substantial part of Paraguay's agricultural sector. Cattle movements involve a high risk due to the possible spread of bovine diseases that can have a significant impact on the country's economy. We analyzed cattle movements from 2014 to 2018 using the networks analysis methodology at the holding and district levels at different temporal scales. We built two types of networks to identify network characteristics that may contribute to the spread of two diseases with different epidemiological characteristics: i) a network including all cattle movements to consider the transmission of a disease of rapid spread like foot and mouth disease, and ii) a network including only cow movements to account for bovine brucellosis, a disease of slow spread that occurs mainly in adult females. Network indicators did not vary substantially among the cattle and cow only networks. The holdings/districts included in the largest strongly connected components were distributed throughout the country. Percolation analysis performed at the holding level showed that a large number of holdings should be removed to make the largest strongly connected component disappear. Higher values of the centrality indicators were found for markets than for farms, indicating that they may play an important role in the spread of an infectious disease. At the holding level (but not at the district level), the networks exhibited characteristics of small-world networks. This property may facilitate the spread of foot and mouth disease in case of re-emergence, or of bovine brucellosis in the country through cattle movements. They should be taken into account when implementing surveillance or control measures for these diseases.


Assuntos
Brucelose Bovina , Doenças dos Bovinos , Doenças Transmissíveis , Febre Aftosa , Feminino , Bovinos , Animais , Febre Aftosa/epidemiologia , Paraguai , Meios de Transporte , Doenças dos Bovinos/epidemiologia
7.
Rev. Nac. (Itauguá) ; 14(2): 018-029, jul.-dic. 2022.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1402658

RESUMO

Introducción: la prevalencia de sobrepeso y obesidad en Paraguay es del 58 % en la población adulta, y 34,5 % en niños y adolescentes. Para enfrentar esta situación existen varios tratamientos, siendo el quirúrgico el medio terapéutico actual que permite obtener la mayor pérdida de peso y por tiempo más prolongado. Objetivo: describir la morbimortalidad de las cirugías bariátricas en el Hospital Nacional de Itauguá en el periodo comprendido entre enero 2017 y setiembre 2021. Metodología: estudio descriptivo, observacional, retrospectivo de corte transversal, con un muestreo no probabilístico de casos consecutivos de todos los pacientes con diagnóstico de obesidad que recibieron tratamiento quirúrgico entre enero 2017 a setiembre del 2021. Se recabaron 126 historias clínicas, 121 de ellos cumplieron los criterios de inclusión. Resultados: de 121 pacientes, 82 % eran mujeres y 18 % hombres, con una edad media de 37 años. Se realizó una gastrectomía vertical en 68 % y by-pass gástrico en 21 %, con una estadía hospitalaria promedio de 61 h. La fístula fue la complicación postoperatoria más frecuente (7 %) seguida de la dehiscencia de anastomosis (2 %). La morbilidad de la cirugía bariátrica fue 11 %, con una mortalidad del 1 %. Conclusión: la morbilidad de la cirugía bariátrica en el Hospital Nacional de Itauguá es baja, con una mortalidad aceptable. La técnica más realizada es la gastrectomía vertical y la fístula es la complicación más común.


Introduction: the prevalence of overweight and obesity in Paraguay is 58 % in the adult population, and 34.5 % in children and adolescents. There are several treatments to deal with these conditions, with surgery being the current therapeutic option that allows for the greatest weight loss and for the longest time. Objective: to describe the morbidity and mortality of bariatric procedures at the Hospital Nacional, Itauguá from January 2017 to September 2021. Metodology: descriptive, observational, retrospective cross-sectional study, with a non- probabilistic sampling of consecutive cases of all patients diagnosed with obesity who received surgical treatment between January 2017 and September, 2021. 126 medical records were collected, 121 of them met the inclusion criteria. Results: of 121 patients, 82 % were women and 18 % men, with a mean age of 37 years. Vertical gastrectomy was performed in 68 % and gastric bypass in 21 %, with an average hospital stay of 61 hours. Fistula was the most frequent postoperative complication (7 %) followed by anastomosis dehiscence (2 %). The morbidity of bariatric surgery was 11 %, with a mortality of 1 %. Conclusion: the morbidity of bariatric surgery at the Hospital Nacional, Itauguá is low, with an acceptable mortality rate. The most common technique is sleeve gastrectomy and fistula is the most common complication.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Morbidade , Mortalidade , Sobrepeso , Cirurgia Bariátrica , Tempo de Internação , Obesidade , Paraguai/epidemiologia , Indicadores de Morbimortalidade , Prevalência , Diagnóstico , Fístula
8.
Rev. Nac. (Itauguá) ; 14(2): 67-82, jul.-dic. 2022.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1410692

RESUMO

Introducción:existe una sospecha sobre la relación bidireccional entre la apnea obstructiva del sueño (AOS) y la hipertensión arterial (HTA). Ambas ejercen una acción sinérgica sobre desenlaces cardiovasculares porlo quees trascendente ponderar la prevalencia de riesgo para AOS en los hipertensos. En este último grupo también hemos investigado la tasa de adherencia a los fármacos prescritos. Metodología:mediante un estudio de casos y controles y con la aplicación del cuestionario STOP-BANG se han discriminado las categorías de riesgo para apnea de sueño en las dos cohortes. Para el análisis de la adherencia a fármacos antihipertensivos se utilizó el cuestionario abreviado de Morisky. Resultados:se incluyeron a 590 individuos (295 casos y 295 controles. Se observó alto riesgo para AOS en el grupo de hipertensos (36,6%) comparado con el 14,2% del grupo control. Por otro lado, el sexo masculino OR 7,77 (IC95% 4,33-13,84), la obesidad OR 5,03 (IC95% 3,11-8,13) y la HTA OR 4,31 (IC95% 2,64-7,03) se ponderan significativos en un modelo de ajuste logístico aquí estudiado. El 61,69% de los hipertensos refería adherencia al tratamiento farmacológico prescrito. Discusión:el tamizaje de AOS es factible con un cuestionario aplicable en la práctica clínica diaria. De la probabilidad clínica pre-test hay que partir hacia métodos diagnósticos específicos para el diagnóstico de AOS, enfatizando casos de HTA resistente, HTA nocturna y HTA enmascarada. Se deberían realizar estudios locales que nos ayuden a comprender las causas de la falta de adherencia a fármacos antihipertensivos en una fracción importante de los individuos con HTA


Introduction:there is a suspicion about the bidirectional relationship between obstructive sleep apnea (OSA) and arterial hypertension (AHT). Both have a synergistic action on cardiovascular outcomes, so it is important to assess the prevalence of risk for OSA in hypertensive patients. In this last group we have also investigated the rate of adherence to prescribed drugs.Metodology:through a case-control study and with the application of the STOP-BANG questionnaire, the risk categories for sleep apnea in the two cohorts have been discriminated. For the analysis of adherence to antihypertensive drugs, the abbreviated Morisky questionnaire was used. Results:590 individuals were included (295 cases and 295 controls. A high risk for OSA was observed in the hypertensive group (36.6%) compared to 14.2% in the control group. On the other hand, the male sex OR 7.77 (95%CI 4.33-13.84), obesity OR 5.03 (95%CI 3.11-8.13) and hypertensionOR4.31(95%CI 2.64-7.03) they areweighted significant in a logistic adjustment model studied here.61.69% of hypertensive patients reported adherence to the prescribed pharmacological treatment.Discussion:OSA screening is feasible with a questionnaire applicable in daily clinical practice. From the pre-test clinical probability, specific diagnostic methods for the diagnosis of OSA must be started, emphasizing cases of resistant AHT, nocturnal AHT, andmasked AHT. Local studies should be carried out to help us understand the causes of non-adherence to antihypertensive drugs in a significant fraction of individuals with AHT


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Medição de Risco , Apneia Obstrutiva do Sono , Apneia Obstrutiva do Sono/epidemiologia , Cooperação e Adesão ao Tratamento , Obesidade , Paraguai/epidemiologia , Inquéritos e Questionários , Relação Cintura-Quadril , Hipertensão , Anti-Hipertensivos
9.
Rev. Nac. (Itauguá) ; 14(2): 030-043, jul.-dic. 2022.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1402679

RESUMO

Introducción: el primer caso de COVID-19 se confirmó en Paraguay el 7 de marzo de 2020. No se han encontrado publicaciones que haya caracterizado la frecuencia y características clínicoepidemiológica de COVID-19 en estudiantes de medicina. Objetivo: determinar la frecuencia de infección por SARS-CoV-2 y características clínicas de estudiantes de medicina de la Universidad del Pacífico en el periodo académico 2020-2021. Metodología: estudio observacional descriptivo de corte transversal, que incluyó a estudiantes de medicina de la Universidad del Pacifico. Los datos se obtuvieron mediante una encuesta virtual por Google Docs© que incluía la edad, sexo, curso, síntomas, secuelas, pruebas laboratoriales y resultados para SARS-CoV-2 y gravedad del cuadro. Resultados: se encuestaron 342 estudiantes entre 18 a 42 años de los 6 cursos, 70,8 % de sexo femenino, 66,4 % presentó síntomas compatibles con COVID-19, el más frecuente (44,2 %) fue el dolor de cabeza. El 67,5 % estuvo en contacto con alguna persona con COVID-19 y 40,4 % informó no haber respetado estrictamente la cuarentena, el 61,7 % se realizó alguna prueba laboratorial y de ellos el 42,7 % resultó positivo para el SARS-CoV-2, 98,9 % cursó con cuadro leve. El 86,7 % conocía el nexo de contagio. Se observó significativamente (p<0,001) mayor frecuencia de COVID19 en los estudiantes ≤21 años (65 % vs 32 %), los que tuvieron contacto con persona con COVID19 (49,1 % vs 10,5 %), y aquellos que presentaron síntomas compatibles (48,8 % vs 18,6 %). Conclusiones: casi la mitad de los participantes presentaron resultados positivos para SARS-CoV2, lo que pone de manifiesto una alta transmisión comunitaria.


Introduction: the first case of COVID-19 in Paraguay was confirmed on March 7, 2020. No publications characterizing the frequency and clinical-epidemiological characteristics of COVID-19 in medical students have been found. Objective: to determine the frequency of infection by SARS-CoV-2 and clinical characteristics of medical students at the Universidad del Pacífico during the 2020-2021 academic period. Methodology: this was a cross-sectional descriptive observational study, that included medical students from the Universidad del Pacífico. The data was obtained through an online survey by Google Docs© that included age, sex, academic year, symptoms, sequelae, laboratory testing and results for SARS-CoV-2 and severity of the condition. Results: 342 students between 18 and 42 years of age from the 6 courses were surveyed, 70.8% were female; 66.4 % presented symptoms compatible with COVID-19, the most frequent (44.2 %) was headache. 67.5 % were in contact with someone with COVID-19 and 40.4 % reported not strictly following quarantine guidelines, 61.7 % underwent some laboratory testing and 42.7 % of them were positive for SARS-CoV-2, 98.9 % had a mild infection. 86.7 % knew the contagion source. A significantly (p<0.001) higher frequency of COVID-19 was observed in students ≤21 years old (65 % vs 32 %), those who had contact with a person with COVID-19 (49.1 % vs 10.5 %), and those who presented compatible symptoms (48.8 % vs 18.6 %). Conclusions: almost half of the participants presented positive results for SARS-CoV-2, which shows high community transmission.


Assuntos
Estudantes de Medicina , Universidades , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa , COVID-19/epidemiologia , Paraguai , Estudantes de Medicina/estatística & dados numéricos , Epidemiologia Descritiva , Inquéritos e Questionários , Teste Sorológico para COVID-19/estatística & dados numéricos
10.
Rev. Nac. (Itauguá) ; 14(2): 04--17, jul.-dic. 2022. ilus
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1402655

RESUMO

Introducción: la donación de órganos sigue siendo un problema incluso en aquellos sistemas más exitosos en la detección de donantes. Objetivo: identificar la actitud hacia la Ley Anita en estudiantes de la Facultad de ciencias de la salud Universidad Nacional del Caaguazú, año 2021. Metodología: estudio observacional, tipo descriptivo y de corte transversal. Se llevó a cabo en la Facultad de Ciencias de la Salud, de la Universidad Nacional de Caaguazú, en el periodo comprendido durante los meses de junio a agosto del año 2021. El instrumento fue un cuestionario de preguntas cerradas con opciones múltiples. Resultado: en cuanto a la actitud respecto a la donación de órganos el 81.9 % donaría sus órganos y el 95.1 % donaría sus órganos si es un familiar el que necesita del mismo, el 69.8 % afirmó donarían los órganos de sus familiares. La opinión de la familia es favorable para el 43.4 % es favorable mientras que el 52.2 % de la población manifestó que su religión condice con la donación de órganos. El 92.3 % está a favor de la ley Anita. Conclusión: la actitud favorable hacia la donación de órganos estuvo relacionada con la opinión favorable de la familia y de la religión, además de ser positiva para los que están de acuerdo con la donación de sangre. La opinión de la familia y la religión influye también en la actitud favorable hacia la donación de órganos de familiares, además de asociarse hacia la actitud favorable hacia la Ley Anita.


Introduction: organ donation continues to be a problem even in the most successful systems in donor detection. Objective: to identify the attitude towards the Anita Law in students at the College of Health Sciences, Universidad Nacional de Caaguazú, during 2021. Methodology: this was an observational, descriptive and cross-sectional study. It was carried out at the College of Health Sciences, Universidad Nacional de Caaguazú, from June to August, 2021. The instrument was a questionnaire of closed questions with multiple-choice answers. Result: regarding attitudes towards organ donation, 81.9 % would donate their organs and 95.1 % would donate their organs if a family member required so, 69.8 % said they would donate the organs of their relatives. Family opinions were favorable for 43.4 % while 52.2 % of the population stated that their religious denomination agrees with organ donation. 92.3 % support the Anita law. Conclusion: the favorable attitude towards organ donation was related to the favorable opinions of the family and religious denomination, in addition to being positive for those who agree with blooddonation. The opinion of the family and religious denomination also influences the favorable attitude towards family organ donation, in addition to being associated with a favorable attitude towards the Anita Law.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Estudantes de Medicina , Transplante , Obtenção de Tecidos e Órgãos , Emoções Manifestas , Otimismo , Fatores Sociais , Paraguai , Inquéritos e Questionários
11.
PLoS One ; 17(11): e0273290, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36346807

RESUMO

BACKGROUND: Patients with chronic disease represent an at-risk group in the face of the COVID-19 crisis as they need to regularly monitor their lifestyle and emotional management. Coping with the illness becomes a challenge due to supply problems and lack of access to health care facilities. It is expected these limitations, along with lockdown and social distancing measures, have affected the routine disease management of these patients, being more pronounced in low- and middle-income countries with a flawed health care system. OBJECTIVES: The purpose of this study is to describe a protocol for a randomized controlled trial to test the efficacy of the Adhera® MejoraCare Digital Program, an mHealth intervention aimed at improving the quality of life of patients with chronic diseases during the COVID-19 outbreak in Paraguay. METHOD: A two-arm randomized controlled trial will be carried out, with repeated measures (baseline, 1-month, 3-month, 6-month, and 12-month) under two conditions: Adhera® MejoraCare Digital Program or waiting list. The primary outcome is a change in the quality of life on the EuroQol 5-Dimensions 3-Levels Questionnaire (EQ-5D-3L). Other secondary outcomes, as the effect on anxiety and health empowerment, will be considered. All participants must be 18 years of age or older and meet the criteria for chronic disease. A total of 96 participants will be recruited (48 per arm). CONCLUSIONS: It is expected that the Adhera® MejoraCare Digital Program will show significant improvements in quality of life and emotional distress compared to the waiting list condition. Additionally, it is hypothesized that this intervention will be positively evaluated by the participants in terms of usability and satisfaction. The findings will provide new insights into the viability and efficacy of mHealth solutions for chronic disease management in developing countries and in times of pandemic. TRIAL REGISTRATION: ClinicalTrials.gov NCT04659746.


Assuntos
COVID-19 , Telemedicina , Humanos , Adolescente , Adulto , COVID-19/epidemiologia , Qualidade de Vida , SARS-CoV-2 , Paraguai/epidemiologia , Controle de Doenças Transmissíveis , Doença Crônica , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
Artigo em Espanhol | PAHO-IRIS | ID: phr-56623

RESUMO

[EXTRACTO]. La presente crítica se encuentra orientada al artículo de Galván y cols, que tuvo como objetivo principal, estudiar la factibilidad de la utilización de la inteligencia artificial como método sensible y específico para el cribado de COVID-19 en pacientes con afecciones respiratorias, empleando imágenes de tórax obtenidas con tomógrafo y una plataforma de telemedicina, reportándose que es viable la utilización de esta tecnología para la detección rápida de COVID-19 en los hospitales públicos de Paraguay. El primer problema que observamos se relaciona con la reducida cantidad de pacientes (5%) que mostraron lesiones altamente compatibles con COVID-19, otro es el deficit de equipamiento y de profesionales especializados, limitando su uso. Por lo tanto, la IA solo podría ser utilizada por hospitales de gran envergadura. Además, según el estudio Kundu y cols., del cual se guiaron los autores del articulo original, quedan claro las limitaciones del diseño del estudio ya que no todos los casos de COVID-19 están asociados con patología torácica. Por último, detalla la importancia de especificar en qué características principales se basan para dar el diagnóstico (tamizaje) de COVID-19 de otras patologías relacionadas en las imágenes TAC. La respuesta a esta carta está disponible en: https://doi.org/10.26633/ RPSP.2022.190


Assuntos
COVID-19 , Teste para COVID-19 , Inteligência Artificial , Telemedicina , Paraguai
13.
Artigo em Espanhol | PAHO-IRIS | ID: phr-56619

RESUMO

[EXTRACTO]. En respuesta a la carta al editor titulada: Critica al estudio de factibilidad de la utilización de la inteligencia artificial para el cribado de pacientes con COVID-19 en Paraguay, los autores del artículo de referencia elevan a consideración la réplica sobre el contenido de esta, con el objeto de esclarecer los cuestionamientos mencionados en la misma. Respecto al primer problema mencionado en la carta al editor; el estudio utilizó el programa de inteligencia artificial (IA) que fue desarrollado por un equipo de informáticos biomédicos, neumólogos y radiólogos (imagenólogos). El programa utilizado dispone de un método de aprendizaje profundo para realizar el diagnóstico rápido de COVID-19; es decir, cuenta con un algoritmo para detectar patologías neumológicas y un algoritmo de diagnóstico de neumopatías compatibles con COVID-19. En cuanto al segundo problema mencionado en la carta al editor; el presente estudio se realizó entre marzo del 2020 y junio del 2021 en 14 hospitales de las 18 regiones sanitarias del Ministerio de Salud Pública y Bienestar Social (MSPBS), que ya contaban con al menos un tomógrafo funcionando al momento del estudio. El informe de diagnóstico del médico radiólogo y el resultado del diagnóstico por IA fueron remitidos luego a un equipo de neumólogos para su valoración, análisis, correlación y validación; los neumólogos correlacionaron los valores porcentuales del diagnóstico por IA con el resultado de los médicos radió- logos, el resultado del análisis molecular (RT-PCR) y el cuadro clínico del paciente para determinar los grados de concordancia o discordancia entre los resultados, y llegar a un diagnóstico definitivo que permitiera informar al médico del hospital donde se trataba al paciente en cuestión. Esto permitió reducir las aglomeraciones en los centros especializados y optimizar el uso de los limitados recursos disponibles. Esta respuesta se refiere a la carta disponible en: https://doi.org/10. 26633/RPSP.2022.193


Assuntos
Inteligência Artificial , COVID-19 , Paraguai
14.
Vector Borne Zoonotic Dis ; 22(10): 520-526, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36255416

RESUMO

Objective: The objective of this work was to adapt a diagnostic kit developed for humans to identify Dengue (DENV1, DENV2, DENV3, DENV4), Zika (ZIKV) and Chikungunya virus (CHIKV) in females of Aedes aegypti and Aedes albopictus and to verify if the occurrence of mosquitoes infected with these three arboviruses are being found in regions with high occurrence of these diseases in humans. Materials and Methods: For this purpose, live mosquitoes were captured between January and June 2020 using 3,476 traps permanently installed in the field were used. After capture, the species were identified, then the females were placed in a pool of 2 to 10 specimens and sent to the laboratory for detection of DENV1, DENV2, DENV3, DENV4, ZIKV and CHIKV by RT-PCR using a commercial human kit for arboviruses. Results: Of the 76 mosquito pools collected, six (7.9%) pools tested positive for the DENV2 virus. The DENV-positive mosquitoes were collected in regions with a high incidence of reported cases of Dengue or in adjacent areas. Conclusion: The absence of kits for the detection of these arboviruses in Aedes is a limiting factor and the adequacy of commercial kits, already used for the diagnosis of arboviruses in humans, the results presented demonstrate that it is possible to identify the presence of DENV2 in mosquitoes with the respective kit, reinforcing the use of RT-qPCR as a robust diagnostic tool for epidemiological surveillance allowing managers to receive timely results for decision-making regarding prevention and control actions.


Assuntos
Aedes , Arbovírus , Febre de Chikungunya , Vírus Chikungunya , Vírus da Dengue , Dengue , Infecção por Zika virus , Zika virus , Feminino , Humanos , Animais , Zika virus/genética , Vírus Chikungunya/genética , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/veterinária , Febre de Chikungunya/diagnóstico , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/veterinária , Brasil/epidemiologia , Saúde Pública , Argentina , Paraguai , Vírus da Dengue/genética , Mosquitos Vetores , Dengue/epidemiologia , Dengue/veterinária
15.
Int J STD AIDS ; 33(14): 1212-1222, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36257834

RESUMO

BACKGROUND: Our study aimed to measure HIV prevalence and associated risk factors among men who have sex with men (MSM) in three regions of Paraguay in 2020. METHODS: MSM were recruited for cross-sectional surveys in three regions of Paraguay using respondent-driven sampling. Interview were conducted face-to-face to collect demographic characteristics and risk and preventive behaviors. The analysis assessed HIV prevalence and associated risk factors in the three samples of MSM within each region. RESULTS: A total of 1,207 MSM were recruited, including 559 in Asunción-Central, 245 in Alto Paraná, and 403 in Caaguazú. HIV prevalence was 24.2% (95% CI 20.6-27.9) in Asunción-Central, 10.2% (95% CI 6.7-14.6) in Alto Paraná, and 3.2% (95% CI 1.7-5.4) in Caaguazú. In Asunción-Central, associations with HIV were age ≥25 years (1.86, 95% CI 1.15-3.00), being employed (1.82, 95% CI 1.07-3.11), self-reporting as homosexual (1.90, 95% CI 1.06-3.43), having sex with a known HIV-positive partner acquisition (4.19, 95% CI 2.37-7.43), self-perceived as being at higher risk for HIV acquisition (4.15, 95% CI 2.54-6.77), and able to access condoms and lubricants (1.82, 95% CI 1.08-3.05). In Alto Paraná, associations with HIV were self-reporting as homosexual (4.33, 95% CI 1.19-15.65) and having higher HIV knowledge (2.53, 95% CI 0.97-6.61). In Caaguazú, associations with HIV were self-reporting as homosexual (7.06, 95% CI 1.53-32.46) and being diagnosed with depression (4.68, 95% CI 0.89-24.43). CONCLUSIONS: HIV prevalence among MSM in Paraguay varied by region, being highest in the capital and major metropolitan area of Asunción-Central, followed by the border area of Alto Paraná. While being self-identified as homosexual was associated with HIV in all three regions, other associations differed, indicating prevention programs need to be tailored to the locale.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Masculino , Humanos , Adulto , Homossexualidade Masculina , Comportamento Sexual , Prevalência , Estudos Transversais , Paraguai/epidemiologia , Infecções por HIV/diagnóstico , Fatores de Risco , Inquéritos e Questionários , Assunção de Riscos
16.
Artigo em Inglês | MEDLINE | ID: mdl-36231491

RESUMO

Dengue fever has been endemic in Paraguay since 2009 and is a major cause of public-health-management-related burdens. However, Paraguay still lacks information on the association between climate factors and dengue fever. We aimed to investigate the association between climatic factors and dengue fever in Asuncion. Cumulative dengue cases from January 2014 to December 2020 were extracted weekly, and new cases and incidence rates of dengue fever were calculated. Climate factor data were aggregated weekly, associations between dengue cases and climate factors were analyzed, and variables were selected to construct our model. A generalized additive model was used, and the best model was selected based on Akaike information criteria. Piecewise regression analyses were performed for non-linear climate factors. Wind and relative humidity were negatively associated with dengue cases, and minimum temperature was positively associated with dengue cases when the temperature was less than 21.3 °C and negatively associated with dengue when greater than 21.3 °C. Additional studies on dengue fever in Asuncion and other cities are needed to better understand dengue fever.


Assuntos
Dengue , Clima , Dengue/epidemiologia , Humanos , Umidade , Incidência , Paraguai/epidemiologia , Temperatura
17.
Artigo em Inglês | MEDLINE | ID: mdl-36232228

RESUMO

We aimed to determine the prevalence of depression, anxiety, and stress in university students in Paraguay during the COVID-19 pandemic. A cross-sectional study was conducted among 293 students from four universities in Paraguay in 2021. The DASS-21 mental health scale was used to measure the outcomes (depression, anxiety, and stress) and evaluate their association with socio-educational variables. A total of 77.1% of the participants were women and 136 (46.4%) were between 21 and 25 years old. The prevalence of depression, anxiety, and stress was 74.7%, 87.4%, and 57%, respectively. We found that being a woman and studying at a public university was positively associated with depression, anxiety, and stress. Receiving COVID-19 training increases the prevalence of mental health problems. In conclusion, high levels of anxiety, depression, and stress were found in university students during the COVID-19 pandemic. Being a woman, studying at a public university, and receiving training on COVID-19 were factors associated with a higher prevalence of presenting all the mental health problems evaluated. Furthermore, students aged 31 and over had a higher prevalence of depression and stress.


Assuntos
COVID-19 , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , COVID-19/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pandemias , Paraguai/epidemiologia , Prevalência , SARS-CoV-2 , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Estudantes/psicologia , Universidades , Adulto Jovem
18.
Rev. cient. cienc. salud ; 4(2): 56-63, 28-10-2022.
Artigo em Espanhol | BDNPAR | ID: biblio-1400313

RESUMO

Introducción. El embarazo no planeado durante la adolescencia se configura como un problema de salud pública. Son múltiples los factores de riesgo relacionados con esta situación, estos pueden ser individuales, familiares y sexuales. Objetivo. Describir la distribución de los factores de riesgo relacionados con el embarazo adolescente, a partir de los datos obtenidos en la Unidad de Salud San Gerónimo de Limpio-Paraguay, de enero 2020 a noviembre 2021. Metodología. Estudio descriptivo, cuantitativo, transversal de adolescentes embarazadas con por lo menos dos consultas prenatales. Se obtuvieron datos por fuente primaria mediante una encuesta y por fuente secundaria por revisión de fichas de consultas prenatales. Se aplicaron medidas estadísticas de distribución de frecuencia y porcentaje. Se describieron los factores de riesgo posiblemente relacionados con el embarazo en adolescentes. Resultados.Se incluyeron en el estudio 45 adolescentes embarazadas. Entre los factores individuales, el 69% de las adolescentes encuestadas manifestaron tener un grado de conocimiento básico y deficiente sobre planificación familiar y métodos anticonceptivos. En cuanto al factor familiar, en el 71% se observó la repetición de patrones familiares, como embarazos precoces. Conclusión.El estudio brinda información sobre los factores de riesgo de este grupo vulnerable de mujeres de la Unidad de Salud de la Familia de la localidad, mostrando la necesidad de incrementar acciones de promoción-prevención hacia este grupo de edad, para mejorar su salud sexual y reproductiva.


Introduction.Unplanned pregnancy during adolescence is configured as a public health problem. There are multiple risk factors related to this situation, these can be individual, family and sexual. Objective:To describe the distribution of risk factors related to adolescent pregnancy, based on the data obtained at the San Gerónimo de Limpio-Paraguay Health Unit, from January 2020 to November 2021. Methodology:descriptive, quantitative, cross-sectional study of adolescent pregnant women with at least two prenatal visits. Data were obtained by primary source through a survey and by secondary source by reviewing prenatal consultation records. Statistical measures of frequency and percentage distribution were applied. Risk factors possibly related to pregnancy in adolescents were described. Results:45 pregnant adolescents were included in the study. Among the individual factors, 69% of the adolescents surveyed stated that they had a basic and deficient level of knowledge about family planning and contraceptive methods. Regarding the family factor, in 71% the repetition of family patterns was observed, such as early pregnancies. Conclusion:the study provides information on the risk factors of this vulnerable groupof women from the local Family Health Unit, showing the need to increase promotion-prevention actions towards this age group, to improve their sexual health and reproductive.


Assuntos
Humanos , Feminino , Adolescente , Gravidez na Adolescência , Paraguai , Atenção Primária à Saúde , Fatores de Risco
19.
Rev. cient. cienc. salud ; 4(2): 64-73, 28-10-2022.
Artigo em Espanhol | BDNPAR | ID: biblio-1400319

RESUMO

Introducción.Las patologías neurológicas bacterianas constituyen un problema de salud mundial. En Paraguay, se emplean dos tipos de vigilancia epidemiológica para las infecciones meningocócicas: universal y centinela. Objetivo. Evaluar el sistema de vigilancia epidemiológica universal de las meningoencefalitis. Metodología.Estudio descriptivo transversal, basado en las directrices del Updated Guidelines for Evaluating Public Health Surveillance Systems-CDC-2001. Se analizó la base de datos del sistema nacional del 2016 seleccionando en forma aleatoria una muestra de 240 casos sospechosos de un total de 640 casos para evaluar los atributos de calidad de datos, aceptabilidad, oportunidad, sensibilidad y valor predictivo positivo (VPP), mediante una escala de calificaciones. Las medidas de frecuencias y tendencia central (media, mediana) fueron calculadas en Excel. Resultado.La evaluación de la calidad de los datos mostró una completitud de 95% e inconsistencia 4,2%. La aceptabilidad de los actores alcanzó 92%. La oportunidad de toma de muestra ≤ 24h (mediana= 1 día; rango= -31-35 días), el de diagnóstico ≤72h (mediana= 0 día; rango= 0-61 días) y la de notificación ha superado las 24h requeridas (mediana= 3 días; rango= 0-41 días). La sensibilidad del sistema fue 90% y elVPP 7,5%. Conclusión. El sistema es sensible en cuanto a la vigilancia clínica con un VPP bajo, la calidad de datos es excelente, aceptable por los actores, oportuna para la toma de muestras y de diagnóstico. Sin embargo, se debe mejorar la oportunidad de notificación.


Introduction. Bacterial neurological diseases are a global health problem. In Paraguay, two types of epidemiological surveillance are used for meningococcal infections: universal and sentinel. Objetive.The objective was to evaluate the universal epidemiological surveillance system for meningoencephalitis. Methodology:Cross-sectional descriptive study, following the guidelines of the Updated Guidelines for Evaluating Public Health Surveillance Systems-CDC-2001. The database of the national system of 2016 was analyzed. To evaluate the attributes: data quality, acceptability, timeliness, sensitivity and positive predictive value (PPV) the sample size of a total population of 640 was calculated using EpiInfo7.2.2.2, confidence level 95%. The minimum size studied was 240 suspected cases. The grading scale was developed. Random samples of records, frequency measurements and central tendency (mean, median) were calculated in Excel. Results:Epidemiological files were evaluated, the quality of the data in terms of completeness was 95% and inconsistency 4.2%. The acceptability of the actors reached 92%. The opportunity to take a sample ≤ 24 hours (Me= 1 day; R= -31-35 days), diagnosis ≤72h (Me= 0 days; R= 0-61 days) and notification has exceeded the required 24h (Me= 3 days; R= 0-41 days). The sensitivity of thesystem was found to be 90% with a PPV of 7.5%. Conclusion.In conclusion, the system is sensitive in terms of clinical surveillance with a low PPV, the data quality is excellent, acceptable by the actors, timely for sampling and diagnosis. However, the timeliness of notification needs to be improved.


Assuntos
Humanos , Meningoencefalite , Paraguai , Sistema de Vigilância Sanitária , Monitoramento Epidemiológico
20.
Asunción; OPS; 2022-09-23. (OPS/PRY/22-0001).
Não convencional em Espanhol | PAHO-IRIS | ID: phr2-56354

RESUMO

En el 2022 se celebra el 120.º aniversario de la Organización Panamericana de la Salud (OPS). En calidad de organismo independiente especializado en salud del sistema interamericano, la OPS brinda cooperación técnica a sus Estados Miembros para abordar las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, como Oficina Regional de la Organización Mundial de la Salud para la Región de las Américas, participa en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible a nivel de país. A nivel subregional, la OPS trabaja con los mecanismos de integración para que la salud y sus determinantes tengan un lugar en la agenda política. En el informe anual correspondiente al 2021 se presenta la cooperación técnica de la OPS en los países y territorios en este período, con la aplicación de las estrategias de cooperación en los países, la respuesta a sus necesidades y prioridades, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la OPS y los Objetivos de Desarrollo Sostenible. En consonancia con el tema general de "responder a la COVID-19 y prepararse para el futuro", se ponen de relieve las medidas que ha adoptado la OPS con respecto a la pandemia de COVID-19 y sus esfuerzos continuos en áreas prioritarias como las emergencias de salud, los sistemas y servicios de salud, las enfermedades transmisibles, las enfermedades no transmisibles y la salud mental, la salud a lo largo del curso de vida y la equidad en la salud. También se presenta un resumen financiero del bienio 2020-2021.


Assuntos
COVID-19 , Emergências , Sistemas de Saúde , Serviços de Saúde , Doenças Transmissíveis , Equidade , Equidade de Gênero , Diversidade Cultural , Cooperação Técnica , América , Paraguai
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