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1.
Artigo em Inglês | MEDLINE | ID: mdl-38397657

RESUMO

Refugees and migrants experience an elevated risk for mental health problems and face significant barriers to receiving services. Interpersonal counseling (IPC-3) is a three-session intervention that can be delivered by non-specialists to provide psychological support and facilitate referrals for individuals in need of specialized care. We piloted IPC-3 delivered remotely by eight Venezuelan refugee and migrant women living in Peru. These counselors provided IPC-3 to Venezuelan refugee and migrant clients in Peru (n = 32) who reported psychological distress. Clients completed assessments of mental health symptoms at baseline and one-month post-intervention. A subset of clients (n = 15) and providers (n = 8) completed post-implementation qualitative interviews. Results showed that IPC-3 filled a gap in the system of mental health care for refugees and migrants in Peru. Some adaptations were made to IPC-3 to promote its relevance to the population and context. Non-specialist providers developed the skills and confidence to provide IPC-3 competently. Clients displayed large reductions in symptoms of depression (d = 1.1), anxiety (d = 1.4), post-traumatic stress (d = 1.0), and functional impairment (d = 0.8). Remote delivery of IPC-3 by non-specialists appears to be a feasible, acceptable, and appropriate strategy to address gaps and improve efficiency within the mental health system and warrants testing in a fully powered effectiveness study.

2.
Trop Med Infect Dis ; 9(2)2024 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-38393135

RESUMO

OBJECTIVE: this study aims to identify and characterise genomic and phylogenetically isolated SARS-CoV-2 viral isolates in patients from Lambayeque, Peru. METHODS: Nasopharyngeal swabs were taken from patients from the Almanzor Aguinaga Asenjo Hospital, Chiclayo, Lambayeque, Peru, which had been considered mild, moderate, and severe cases of COVID-19. Patients had to have tested positive for COVID-19, using a positive RT-PCR for SARS-CoV-2. Subsequently, the SARS-CoV-2 complete viral genome sequencing was carried out using Illumina MiSeq®. The sequences obtained from the sequence were analysed in Nextclade V1.10.0 to assign the corresponding clades, identify mutations in the SARS-CoV-2 genes and perform quality control of the sequences obtained. All sequences were aligned using MAFFT v7.471. The SARS-CoV-2 isolate Wuhan NC 045512.2 was used as a reference sequence to analyse mutations at the amino acid level. The construction of the phylogenetic tree model was achieved with IQ-TREE v1.6.12. RESULTS: It was determined that during the period from December 2020 to January 2021, the lineages s C.14, C.33, B.1.1.485, B.1.1, B.1.1.1, and B.1.111 circulated, with lineage C.14 being the most predominant at 76.7% (n = 23/30). These lineages were classified in clade 20D mainly and also within clades 20B and 20A. On the contrary, the variants found in the second batch of samples of the period from September to October 2021 were Delta (72.7%), Gamma (13.6%), Mu (4.6%), and Lambda (9.1%), distributed between clades 20J, 21G, 21H, 21J, and 21I. CONCLUSIONS: This study reveals updated information on the viral genomics of SARS-CoV-2 in the Lambayeque region, Peru, which is crucial to understanding the origins and dispersion of the virus and provides information on viral pathogenicity, transmission and epidemiology.

3.
Sci Rep ; 14(1): 3664, 2024 02 13.
Artigo em Inglês | MEDLINE | ID: mdl-38351170

RESUMO

During the pandemic, many individuals with chronic or infectious diseases other than COVID-19 were unable to receive the care they needed due to the high demand for respiratory care. Our study aims to assess the impact of the COVID-19 pandemic on services provided to people with chronic diseases in Peru from 2016 to 2022. We performed a secondary database analysis of data registered by the comprehensive health insurance (SIS), the intangible solidarity health fund (FISSAL), and private healthcare institutions (EPS), using interrupted time series analysis. Our study identified 21,281,128 individual users who received care. The pooled analysis revealed an average decrease of 1,782,446 in the number of users receiving care in the first month of the pandemic compared with the expected values for that month based on pre-pandemic measurements. In addition, during the pandemic months, there was an average increase of 57,911 in the number of new additional single users who received care per month compared with the previous month. According to the time-series analysis of users receiving care per month based on each chronic disease group, the most significant decreases included people with diabetes without complications and chronic lung disease.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Pandemias , Peru/epidemiologia , Doença Crônica , Bases de Dados Factuais
4.
Glob Epidemiol ; 7: 100131, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38188037

RESUMO

Background: The spread of the coronavirus disease 2019 (COVID-19) in Peru has been reported at the regional level, few studies have evaluated its spread at the provincial level, in which the mechanisms could be different. Methods: We conducted an analytical, cross-sectional, multistage observational population study to assess the seroprevalence of SARS-COV-2 at the provincial and urban/rural levels in a high-altitude setting. The sampling unit was the household, including a randomly selected family member. Sampling was performed using a data collection sheet on clinical and epidemiological variables. Chemiluminescence tests were used to detect total anti-SARS-COV-2 antibodies (IgG and IgM simultaneously). The percentages were adjusted to the sampling design. Results: The overall prevalence in the region of Cusco was 25.9%, with considerably different prevalence between the 13 provinces (from 15.9% in Acomayo to 40.1% in Canchis) and between rural (21.1%) and urban (31.7%) areas. In multivariable model, living in a rural area was a protective factor (adjusted prevalence ratio [aPR], 0.68; 95% confidence interval [CI], 0.61-0.76). Conclusions: Geographic diversity and population density determine different prevalence rates, typically lower in rural areas, possibly due to natural social distancing or limited interaction with people at risk.

5.
Artigo em Inglês | MEDLINE | ID: mdl-38280080

RESUMO

We aimed to determine the variations in the prevalence of childhood anemia according to the ethnic group before and during the COVID-19 pandemic in Peru. Secondary analysis of the Demographic and Family Health Survey during 2016-2021. The outcome variable was anemia, and the exposure variable was maternal ethnicity. Also, we included sociodemographic and clinical confounding variables. We constructed generalized linear models of the Poisson family with a logarithmic link function. We evaluated 85,905 records; 30.34% had anemia, 50.83% were mestizo, 25.98% were Quechua, and 2% were Aymara. Compared with mestizos, Quechua children (PR: 1.11; 95% CI: 1.07-1.15; p < 0.001), Aymara (PR: 1.35; 95% CI: 1.27-1 .44; p < 0.001), natives of the Amazon (PR: 1.20; 95% CI: 1.12-1.28; p < 0.001) and those who belonged to other indigenous peoples (PR: 1.29; 95% CI: 1.05-1.57; p = 0.013) had a higher prevalence of childhood anemia. On the contrary, compared to mestizos, white children had a lower prevalence of anemia (PR: 0.93; 95% CI: 0.89-0.99; p = 0.019). During the COVID-19 pandemic, compared to mestizos, only Quechua (PR: 1.15; 95% CI: 1.08-1.23; p < 0.001) and Aymara (PR: 1.38; 95% CI: 1.23-1.55; p < 0.001) had a higher prevalence of childhood anemia. Except for Afro-descendants, children from 6 to 59 months of age who belong to an ethnic minority had a higher probability of having childhood anemia than mestizos. However, only Quechua and Aymara children had higher odds of anemia during the COVID-19 pandemic than mestizos.

6.
Artigo em Inglês | MEDLINE | ID: mdl-38193824

RESUMO

The migration of health workforces tends to be economically based benefiting high-income countries, while draining lower-income countries of workers and skills However, national instability or civil conflict may also have the effect of forcing out health workers. However, few articles focus on the experiences of these types of migrants. Peru has become the second largest Latin American destination for Venezuelan forced displaced migrants, a number of which are health workers. While the exact numbers of these workers is unknown, it is estimated that 4000 and 3000 doctors and about 2500 nurses and health technicians from Venezuela reside in Peru. These workers find entry into the heath system difficult due to bureaucratic and costly registration and qualification validation procedures. However, during Covid-19 these conditions were relaxed, and a large number of these heath workers entered the heath workforce. These workers were primarily doctors and worked in urban medical facilities, though there was some distribution across the country's departments. This avenue to the health workforce allowed the mobilisation of dormant health skills and lifted workforce density numbers. Nonetheless, it is too early to see if there have been sustainable improvements, and it remains uncertain how these policies have contributed to the country's UHC goals. Peru's experiences raise the issue of how to mobilise dormant displaced health worker migrants.

7.
Brain Behav ; 14(1): e3361, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38236201

RESUMO

BACKGROUND: Neurodegenerative diseases lead to difficulties with functional activities. In Peru, most caregivers are family members. Little is known about the COVID-19 pandemic's effect on caregivers in Peru. METHODS: This was a cross-sectional, prospective study of family caregivers of dependent patients with dementia or Parkinson's Disease in Lima, Peru. A caregiver burden and mental health questionnaire was administered to the caregiver. RESULTS: We enrolled 48 caregivers (65% females, mean ± SD age 49.0 ± 12.3 years); 70% of patients had dementia. Nearly 40% of caregivers reported having full-time jobs, and 82% felt overwhelmed with almost 75% dedicating more time to caregiving during the pandemic. Caregivers perceived patients felt lonelier (52%), had an increase in hallucinations (50%), or forgetfulness (71%) compared to pre-pandemic. CONCLUSIONS: Our study highlights that perceived caregiver burden and patient behavioral symptoms may have been exacerbated during the pandemic. In countries such as Peru, more caregiving resources and interventions are needed.


Assuntos
COVID-19 , Demência , Doenças Neurodegenerativas , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Masculino , Cuidadores , Fardo do Cuidador , Pandemias , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/terapia , Peru/epidemiologia , Estudos Transversais , Saúde Mental , Estudos Prospectivos
8.
Lancet Glob Health ; 12(1): e100-e111, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38096882

RESUMO

Population confidence is essential to a well functioning health system. Using data from the People's Voice Survey-a novel population survey conducted in 15 low-income, middle-income, and high-income countries-we report health system confidence among the general population and analyse its associated factors. Across the 15 countries, fewer than half of respondents were health secure and reported being somewhat or very confident that they could get and afford good-quality care if very sick. Only a quarter of respondents endorsed their current health system, deeming it to work well with no need for major reform. The lowest support was in Peru, the UK, and Greece-countries experiencing substantial health system challenges. Wealthy, more educated, young, and female respondents were less likely to endorse the health system in many countries, portending future challenges for maintaining social solidarity for publicly financed health systems. In pooled analyses, the perceived quality of the public health system and government responsiveness to public input were strongly associated with all confidence measures. These results provide a post-COVID-19 pandemic baseline of public confidence in the health system. The survey should be repeated regularly to inform policy and improve health system accountability.


Assuntos
COVID-19 , Pandemias , Humanos , Feminino , Inquéritos e Questionários , COVID-19/epidemiologia , Peru
9.
Econ Hum Biol ; 52: 101332, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38113604

RESUMO

Using data from Peru and a quasi-experimental approach, we document significant increases in arterial blood pressure and in the incidence of arterial hypertension caused by the restrictive measures employed by the Peruvian authorities during the COVID-19 pandemic. The effects are more pronounced for women, older respondents, and urban residents. The effects are statistically significant and high in magnitude relative to the pre-pandemic incidence of disease in the Peruvian population. A main channel of disease propagation seems to be the changes in dietary habits and physical activity imposed by the COVID-19 lockdowns, which affected several anthropometric measurements that are common risk factors for hypertension.


Assuntos
COVID-19 , Hipertensão , Humanos , Feminino , Peru/epidemiologia , Estudos Transversais , Pandemias , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Hipertensão/epidemiologia
10.
J Travel Med ; 31(1)2024 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-38127642

RESUMO

BACKGROUND: The wellbeing and safety of international tourists is a paramount concern for governments and stakeholders. Mortality among travellers and the causes of death serve as a significant metric of destination safety. We describe the epidemiology and causes of death among international travellers in Peru. METHODS: Data retrieved from the Peruvian government's deaths certificates registry included all non-residents who died between January 2017 and December 2021. We analysed the national incidence and causes of death among international travellers in Peru. Causes of death were classified into non-communicable diseases (NCD), communicable diseases and injuries. We classified fatalities according to the existence of preventive measures that could be provided during the travel medicine consultation to decrease the risk. RESULTS: We obtained records from 1514 deaths among international travellers (973 males, 64%). The incidence increased from 0.2 deaths per 10 000 travellers in 2017 to 9.9 in 2021. NCDs were the most common causes of death (n = 560, 37%), followed by communicable diseases (n = 487, 32%), and injuries (n = 321, 21%). Causes of death were unknown in 9.7% of the records. The leading causes of death in these categories were cancer, cardiovascular disease, COVID-19 and trauma. We found similar sex distribution of NCDs in travellers aged >50 years and higher rates of communicable diseases among males across all ages. Injury-associated deaths were significantly higher among males aged 18-29 years (P < 0.001) compared with other sex-age groups. We estimated that for 57.7% of deaths risk could have been decreased through pre-travel advice. CONCLUSION: Rates of deaths among travellers to Peru increased over time. Most deaths were due to NCDs, followed by communicable diseases and injuries. Pre-travel medical optimization and effective advice focused on age-sex and destination specific risks could reduce risk among travellers. Increased awareness among travel medicine practitioners and improvement of emergency medical response systems in Peru could decrease mortality.


Assuntos
Doenças Cardiovasculares , Doenças Transmissíveis , Masculino , Humanos , Causas de Morte , Peru/epidemiologia , Doenças Transmissíveis/epidemiologia , Viagem
11.
Front Psychiatry ; 14: 1268872, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38090694

RESUMO

Objective: To determine the prevalence and factors associated with depressive, anxious, and stress symptoms in medical students in Peru, during the second pandemic wave of COVID-19. Methods: We conducted an analytical cross-sectional study in 405 medical students from a university in northern Peru. The DASS-21 instrument was used to evaluate mental health outcomes (depression, anxiety, and stress), and to investigate their association with socio-educational characteristics. Results: We found a prevalence of depressive, anxious, and stress symptoms of 71.6% (95% CI: 66.94-75.95), 71.9% (95% CI: 67.2-76.2), and 62.7% (95% CI: 57.8-67.4); respectively. Students with eating behavior disorders had a higher prevalence of depressive symptoms (PR: 1.35), anxious symptoms (PR: 1.27), and stress symptoms (PR: 1.31). The prevalence of depressive symptoms (PR: 1.57), anxious symptoms (PR: 1.27), and stress symptoms (PR: 1.24) increased in students who did not report regular physical activity. In addition, having almost always academic exhaustion increased the prevalence of depressive symptoms (PR: 1.46), stress symptoms (PR: 1.72). On the contrary, the prevalence of depressive symptoms (PR: 0.79), anxious symptoms (PR: 0.73) and stress symptoms (PR: 0.82) decreased in male students. Students who reported sleeping 8 or more hours daily had a lower prevalence of stress symptoms (PR: 0.82). Conclusion: Symptoms of depression and anxiety occurred in 7 out of 10 students, and stress in 6 out of 10. Among the factors associated with the presence of anxiety, depression, and stress were eating behavior disorder and not regularly exercising. Periodic evaluations of mental symptomatology are required and counseling should be promoted in medical schools.

12.
Front Pediatr ; 11: 1232522, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38078321

RESUMO

Objective: To determine the short-, mid-, and long-term complications after multisystem inflammatory syndrome in children (MIS-C) over a 24-month follow-up period in a hospital in Lima, Peru, 2020-2022, and to explore differences according to the immunomodulatory treatment received and type of SARS-CoV-2 virus circulating. Methods: Ambispective 24-month follow-up study in children <14 years of age diagnosed with MIS-C at the Hospital Nacional Edgardo Rebagliati Martins (HNERM). Results: A total of 62 children were admitted with MIS-C. The most common short-term complications and serious events were intensive care unit (ICU) admission, invasive mechanical ventilation (IMV) due to respiratory failure, and shock; predominantly during the second pandemic wave (lambda predominance) and in children that received intravenous immunoglobulin (IVIG) plus a corticosteroid. Two patients died during the first wave due to MIS-C. During prospective follow-up (median of 24 months; IQR: 16.7-24), only 46.7% of patients were followed for >18-24 months. Of the total, seven (11.3%) patients were identified with some sequelae on discharge. Among the 43 remaining children, sequelae persisted in five (11.6%) cases (neurological, hematological, and skin problems). Six patients (13.9%) presented with new onset disease (hematologic, respiratory, neurological, and psychiatric disorders). One patient died due to acute leukemia during the follow-up period. None of them were admitted to the ICU or presented with MIS-C reactivation. Two patients presented persistence of coronary aneurysm until 8- and 24-month post-discharge. Conclusion: In our hospital, children with MIS-C frequently developed short-term complications and serious events during the acute phase, with less frequent complications in the mid- and long-term. More studies are required to confirm these findings.

13.
BMC Psychiatry ; 23(1): 908, 2023 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-38053085

RESUMO

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.


Assuntos
COVID-19 , Ideação Suicida , Humanos , Feminino , Idoso , Masculino , Depressão/epidemiologia , Depressão/psicologia , Estudos Transversais , Peru/epidemiologia , Pandemias , COVID-19/epidemiologia , Ansiedade/epidemiologia , Ansiedade/psicologia , Pesar
14.
J. bras. nefrol ; 45(4): 440-448, Dec. 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1528894

RESUMO

ABSTRACT Background: Patients with chronic kidney disease have a higher risk of severe disease and mortality from COVID-19 than the general population. Objective: To compare hospitalization and mortality rates during the pandemic among chronic hemodialysis (HD) patients and the general population in Lima (Peru). Methods: This retrospective cohort included an assessment of the database of chronic HD patients of the health service providers of the social health insurance benefit networks of Lima and Callao between 2019 and 2021. Hospitalization and mortality rates were obtained for every 1,000 individuals, and variations in the percentages of COVID-19 cases and deaths were calculated. These rates were compared with those of the general population data and standardized by age and sex. Results: An average of 3,937 chronic HD patients were evaluated each month. Of these, 4.8% had COVID-19 and 64.97% were mild cases. The hospitalization rates per 1,000 patients were 19.5, 29.28, and 36.7 in 2019, 2020, and 2021, respectively. The mortality rates per 1,000 patients were 5.9, 9.74, and 11.49 in 2019, 2020, and 2021, respectively. When compared to the standardized general population, the peaks of both rates coincided with the plateaus of the waves during the pandemic. The hospitalization rate for COVID-19 was 12 times higher in HD patients than in the general population, and the mortality rate for COVID-19 was twice as high. Conclusion: HD patients had higher hospitalization and standardized mortality rates than the general population. Peaks in hospitalizations and mortality coincided with the plateaus of the first and second waves of the pandemic.


Resumo Histórico: Pacientes com DRC apresentam maior risco de doença grave e mortalidade por COVID-19 do que a população geral. Objetivo: Comparar taxas de hospitalização e mortalidade durante a pandemia entre pacientes em hemodiálise crônica (HD) e a população geral em Lima (Peru). Métodos: Esta coorte retrospectiva incluiu avaliação do banco de dados de pacientes em HD crônica dos prestadores de serviços de saúde das redes de benefícios do seguro social de saúde de Lima e Callao, entre 2019-2021. Obteve-se taxas de hospitalização e mortalidade para cada 1.000 indivíduos, e foram calculadas variações nas porcentagens de casos de COVID-19 e óbitos. Estas taxas foram comparadas com os dados da população geral e padronizadas por idade e sexo. Resultados: Uma média de 3.937 pacientes em HD crônica foram avaliados mensalmente. Destes, 4,8% tinham COVID-19, 64,97% eram casos leves. As taxas de hospitalização por 1.000 pacientes foram 19,5; 29,28; e 36,7 em 2019, 2020, e 2021, respectivamente. As taxas de mortalidade por 1.000 pacientes foram 5,9; 9,74 e 11,49 em 2019, 2020, e 2021, respectivamente. Quando comparados à população geral padronizada, os picos das taxas coincidiram com os platôs das ondas da pandemia. A taxa de hospitalização para COVID-19 foi 12 vezes maior em pacientes em HD do que na população geral e a taxa de mortalidade por COVID-19 foi duas vezes maior. Conclusão: Pacientes em HD apresentaram taxas de hospitalização e mortalidade padronizada mais elevadas do que a população geral. Os picos das hospitalizações e mortalidade coincidiram com os platôs da primeira e segunda ondas da pandemia.

15.
Rev. chil. infectol ; 40(6)dic. 2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1529992

RESUMO

Introducción: La mortalidad por pacientes por COVID-19 grave que desarrollaban neumonía grave y síndrome de dificultad respiratoria agudo (SDRA) grave ha sido significativa a pesar del tratamiento oportuno. Es importante determinar predictores tempranos de enfermedad que nos ayuden a estratificar aquellos pacientes con mayor riesgo de fallecer. Se pretende estudiar el comportamiento del puntaje APP (APPS) como predictor de ello, basados en algunos reportes de uso y utilidad en el SDRA. no COVID-19. Objetivo: Determinar si el APPS es útil como predictor de mortalidad en SDRA. por COVID-19 grave. Pacientes y Método: Se realizó un estudio tipo cohorte retrospectivo, incluyendo pacientes de la Unidad de Cuidados Intensivos (UCI), con SDRA. por COVID-19 grave, que ingresaron a la UCI del Hospital Regional Docente de Trujillo (HRDT) en el período abril 2020- abril 2021. Se evalúo la utilidad del APPS como predictor de mortalidad em dicha población. Resultados: El APPS demostró ser un factor asociado a mortalidad en pacientes con SDRA. y COVID-19 grave (RPa 1,34; IC 95% 1,16 a 1,56; p < 0,001). Además, encontramos que, al realizar un modelo de predicción ajustado por edad, sexo, SOFA, APPS, shock, Indice de Charlson (ICh), se comportan como factores asociados a mortalidad el APPS, el sexo masculino (RPa: 1,48; IC 95% 1,09 a 2,049; p < 0,05) y el ICh (RPa: 1,11; IC 95% 1,02 a 1,21; p < 0,05). Conclusión: El APPS, el sexo masculino y el ICh son predictores de mortalidad en SDRA. por COVID-19 grave.


Background: Mortality in patients with severe COVID-19 who developed severe pneumonia and severe Acute Respiratory Distress Syndrome (ARDS) has been significant despite timely treatment. It is important to determine early predictors of disease that help us to stratify those patients with a higher risk of death. It is intended to study the behavior of the APPS score as a predictor of this, based on some reports of use and usefulness in non-COVID-19 ARDS. Aim: To determine if the APP score is useful as a predictor of mortality in ARDS due to severe COVID-19. Method: A retrospective cohort study was carried out, including patients from the Intensive Care Unit (ICU) with ARDS due to severe COVID-19 who were admitted to the ICU of the Trujillo Regional Teaching Hospital (HRDT) in the period March 2020 to March 2021. The usefulness of the APP score as a predictor of mortality in mentioned population was evaluated. Results: The APP score proved to be a factor associated with mortality in patients with ARDS and severe COVID-19 (APR 1.34; 95% CI 1.16 to 1.56; p < 0.001). We also found that when performing a prediction model adjusted for age, sex, SOFA, APP score, shock and Charlson Index (ICh) we found that the APP score, male sex (APR: 1.48; 95% CI 1.09 to 2.049; p < 0.05) and the ICh behave as factors associated with mortality (RPa: 1.11; 95% CI 1.02 to 1.21; p < 0.05). Conclusion: The APP score, male sex, and ICh are predictors of mortality in ARDS due to severe COVID-19.

16.
Pharm. pract. (Granada, Internet) ; 21(4)oct.- dec. 2023. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-229983

RESUMO

Objective: The objective of this study was to identify the prevalence and factors associated with the use of drugs without evidence for the prevention of COVID-19 in Peruvians without symptoms or diagnosis, using the National Household Survey (ENAHO) 2021. Methods: A secondary analysis was made of the ENAHO 2021. We evaluated participants older than 18 years who did not undergo any test to diagnose COVID-19 and used any drug to prevent COVID-19. Adjusted prevalence ratios (aPRs) were estimated to determine the associated factors. Results: Among the 69,815 participants analyzed, the prevalence of taking a drug 4 weeks prior to the survey was 5.64%. Factors associated with drug consumption were: age 30-59 years (aPR 1.47; 95% confidence interval [CI]: 1.32-1.65); having a higher education (aPR 1.73; 95% CI:1.28-2.33); having a chronic disease (aPR 1.40; 95% CI: 1.26-1.56); not having poverty status (aPR 1.40; 95% CI: 1.26-1.56); living in an urban area (aPR 1.61; 95% CI: 1.31-1.99). Meanwhile, living in the highlands (aPR 0.77; 95% CI: 0.60-0.97) and not having a landline, cell phone, television or internet at home (aPR 0.65; 95% CI: 0.43-0.98) were protective factors from unnecessary drug consumption. Conclusion: It is concerning that even after one year of living with the pandemic and having refuted the utility of medications such as ivermectin and azithromycin, these drugs are still widely consumed by a sector of the population without symptoms or a diagnosis of COVID-19. Therefore, it is necessary to formulate and implement public health measures that address this problem, taking into account the associated factors to reduce this consumption (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Automedicação/estatística & dados numéricos , /prevenção & controle , Estudos Transversais , Prevalência , Peru/epidemiologia
17.
Artigo em Espanhol | IBECS | ID: ibc-230671

RESUMO

Introducción:En el marco de esta pandemia, el personal de salud ha sufrido cambios psicológicos, debido a su relación directa con pacientes contagiados por COVID-19, convirtiéndose así en parte de un grupo vulnerable.Objetivo:Conocer los factores asociados a los trastornos de la esfera mental en el personal de salud amazónico durante la pandemia COVID-19.Material y Métodos:La población estuvo conformada por el personal de salud de dos establecimientos de I y II nivel, donde la muestra fue de 341 personas. El tipo de estudio es observacional, transversal analítico, se usó como instrumento una encuesta auto aplicada.Resultados:Se encontró mayor depresión en mujeres (RPa: 1,71; IC95%: 1,29-2,26; valor p<0,001) y menor depresión con tener mayor edad (RPa: 0,98; IC95%: 0,97-0,99; valor p=0,018). La ansiedad se asoció con tener familiares fallecidos (RPa: 1,06; IC95%: 1,01-1,12; valor p=0,029). El tener enfermedades previas (RPa: 1,72; IC95%: 1,27-2,32; valor p<0,001), tener colegas fallecidos (RPa: 1,05; IC95%: 1,05-1,06; valor p<0,001) y ser enfermera (RPa: 1,40; IC95%: 1,05-1,85; valor p=0,020) tuvo estrecha relación con el estrés post traumático (EPT).Conclusión:Se concluye que existe factores asociados a la depresión, ansiedad, estrés y EPT en el personal de salud amazónico durante la pandemia COVID-19. (AU)


Introduction:In the context of this pandemic, healthcare personnel have experienced psychological changes, due to their direct contact with COVID-19 infected patients, becoming part of a vulnerable group.Objective:To identify factors associated with mental health disorders among amazonic healthcare personnel during the COVID-19 pandemic.Material and Methods:The population consisted of healthcare personnel from two level I and II establishments, with a sample size of 341 individuals. The study design was observational, cross sectional, and a self-administered survey was used as the instrument.Results:A higher prevalence of depression was found in women (adjusted prevalence ratio [aPR]: 1.71; 95% confidence interval [CI]: 1.29-2.26; p-value <0.001), and a lower prevalence of depression was associated with older age (aPR: 0.98; 95% CI: 0.97-0.99; p-value=0.018). Anxiety was associated with having deceased family members (aPR: 1.06; 95% CI: 1.01-1.12; p-value=0.029). Having previous illnesses (aPR: 1.72; 95% CI: 1.27-2.32; p-value <0.001), having deceased colleagues (aPR: 1.05; 95% CI: 1.05-1.06; p-value <0.001), and being a nurse (aPR: 1.40; 95% CI: 1.05-1.85; p-value=0.020) was closely related to post traumatic stress (PTSD).Conclusion:It is concluded that there are factors associated with depression, anxiety, stress, and PTSD among amazonic healthcare personnel during the COVID-19 pandemic. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Transtornos Mentais/etiologia , Transtornos Mentais/psicologia , Pessoal de Saúde/psicologia , /complicações , /psicologia , Estudos Transversais , Fatores de Risco , Peru
18.
Artigo em Espanhol | IBECS | ID: ibc-230672

RESUMO

Introducción: El comportamiento de la accidentabilidad durante la pandemia (2020-2021) fue distinto para cada país; además, se observó cambios en las características de los accidentes de trabajo.Objetivos:Describir el comportamiento y los fatores asociados a la accidentabilidad laboral atendida en el Servicio de Emergencia de un hospital del Seguro Social de Perú de Lima Metropolitana, durante la pandemia de la COVID-19. Material y Métodos: Estudio transversal analítico, que revisó la data de los reportes de accidentes que llegaron a un hospital del seguro social peruano, se tomó como variable principal al período de ocurrencia, según eso se obtuvo estadísticos descriptivos y analíticos. Resultados: De los 5753 accidentes analizados, los años con más accidentes fueron el 2018 (45,7%) y el 2019 (23,1%), durante la pandemia (2020 - 2021) hubo 26,0% de la totalidad de accidentes. En el modelo multivariado se encontró que en la pandemia hubo más accidentes por aplastamiento (RPa: 2,1; IC95%: 1,5-2,9; valor p<0,001) y de agresiones por arma (RPa: 1,2; IC95%: 1,1-1,4; valor p=0,005). Los accidentes más prevalentes fueron por trauma interno (RPa: 1,6; IC95%: 1,1-2,3; valor p=0,025), por torcedura (RPa: 1,2; IC95%: 1,0-1,4; valor p=0,025) y por fracturas (RPa: 1,5; IC95%: 1,1-1,9; valor p=0,002). Las zonas más afectadas fueron la región lumbosacra (RPa: 1,4; IC95%: 1,1-1,8; valor p=0,009) y los dedos (RPa: 1,1; IC95%: 1,0-1,3; valor p=0,046). Conclusión: Durante la pandemia, hubo más accidentes por aplastamiento, por agresiones, por trauma interno, por torcedura, por fracturas, en la región lumbosacra y en los dedos. (AU)


Introduction: The behavior of the accident rate during the pandemic (2020-2021) was different for each country; In addition, changes in the characteristics of work accidents were observed.Objective:To describe the behavior of occupational accidents attended in the Emergency Service of a Peruvian Social Security hospital in Metropolitan Lima, during the COVID-19 pandemic. Material and Methodo: Cross-sectional study, which reviewed the data from accident reports that arrived at a Peruvian social security hospital, taking the period of occurrence as the main variable, according to which descriptive and analytical statistics were obtained. Results: Of the 5,753 works accidents analyzed, the years with the most accidents were 2018 (45.7%) and 2019 (23.1%), during the pandemic (2020-2021) there were 26.0% of all accidents. In the multivariate model, it was found that during the pandemic there were more accidents due to crushing (aPR: 2,1; 95% CI: 1,5-2,9; value p<0,001) and attacks by weapons (aPR: 2,1; IC95%: 1,5-2,9; value p<0,001). The most prevalent accidents due to internal trauma (aPR: 1.6; 95%CI: 1.1-2.3; p value=0.025), sprain (aPR: 1.2; 95%CI: 1.0-1.4; p value=0.025) and fractures (aPR: 1.5; 95% CI: 1.1-1.9; p value=0.002). The most affected areas were the lumbosacral region (aPR: 1.4; 95% CI: 1.1-1.8; p value=0.009) and in fingers (aPR: 1.1; 95% CI: 1.0-1.3; p value=0.046). Conclusion: During the pandemic, there were more accidents due to crushing, assaults, internal trauma, sprains, fractures, in the lumbosacral region and in the fingers. (AU)


Assuntos
Humanos , Acidentes de Trabalho/estatística & dados numéricos , /epidemiologia , Hospitais Urbanos , Estudos Transversais , Peru/epidemiologia
19.
Psicol Reflex Crit ; 36(1): 39, 2023 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-38108935

RESUMO

OBJECTIVE: The objective of this study was to identify predictors of intention to be vaccinated against Monkeypox (Mpox) in a sample of Peruvian citizens.  METHODS: A set of sociodemographic and psychological predictors were used, such as sex, sexual orientation, educational level, previous diagnosis of COVID-19, marital status, complete vaccination against COVID-19, employment status, living with vulnerable people, presence of chronic disease, area of residence, perceived usefulness of COVID-19 vaccines, fear of Mpox, conspiracy beliefs about Mpox, among others. A total of 472 Peruvian adults participated, selected by non-probabilistic snowball convenience sampling. A sociodemographic survey, the Mpox Fear Scale, was used. Conspiracy Beliefs about Mpox was assessed using three questions created specifically for this study. For inferential purposes, simple ordinal regressions ("crude models") were performed between each factor and the outcome.  RESULTS: Regarding their intention to be vaccinated against Mpox, more than 60% expressed clear approval. Being non-heterosexual, having greater emotional fear of Mpox, and perceiving some potential for this disease to become the next pandemic were related to greater intention to vaccinate. On the other hand, being older, having low perceived usefulness of COVID-19 vaccines, and having higher conspiracy beliefs about Mpox were associated with lower intention to vaccinate.  CONCLUSION: The study provides initial information for future research seeking to better analyze Mpox vaccination intention. In addition, cross-sectional data are provided that can be used to develop public health policies that target subgroups with low prevalence of intention to vaccinate against Mpox.

20.
Lima; Perú. Ministerio de Salud. Dirección General de Personal de la Salud. Observatorio de Recursos Humanos en Salud del Perú; 1 ed; Dic. 2023. 56 p. ilus.(Serie Bibliográfica Recursos Humanos en Salud,, 36).
Monografia em Espanhol | MINSAPERÚ, LILACS, LIPECS | ID: biblio-1518853

RESUMO

La información, se orienta a la implementación de la política sectorial vinculada al personal de la salud, de modo tal que permita ser un elemento a tomar en cuenta para el desarrollo del trabajo decente de este, redimensionando las intervenciones del Estado a nivel sectorial en favor de la población; significando así, una apuesta clara y cierta para un cambio en la estructura de los procesos que materializan la garantía del Estado de brindar a través del personal de la salud una prestación de servicios de salud con calidad. La obra trasciende el contexto del tránsito de la emergencia sanitaria a un escenario de pospandemia con motivo de la presencia del COVID-19; lo cual significó un reto de grandes proporciones para el Estado Peruano y, como tal, para el Sector Salud. El marcado incremento de la demanda de atención y accesos a los servicios de salud demandó que el Estado Peruano estableciera estrategias para la contención y mitigación del avance de la pandemia. En materia de personal de la salud, bajo los alcances del Decreto Legislativo N° 1057, se incorporaron de manera excepcional al sector salud más de 58 mil profesionales de la salud, destinados a fortalecer la oferta de servicios de salud de las instituciones prestadoras de servicios de salud de los tres niveles de atención. A través de la publicación, la materia de personal de la salud es tratada a través de cinco secciones, que permiten tener una visión nacional a través de los diferentes actores que participan en el sector salud; permitiendo con ella, la elaboración de indicadores de densidad, disponibilidad y dotación de recursos humanos; los de asignación presupuestaria; así como, las curvas de evolución de los indicadores de dotación; entre otros fines, para lo cual es de vital importancia esta información


Assuntos
Ocupações Relacionadas com Saúde , Pandemias , Observatório de Recursos Humanos em Saúde , Necessidades e Demandas de Serviços de Saúde , Descrição de Cargo
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