High SARS-CoV-2 Seroprevalence in Rural Peru, 2021: a Cross-Sectional Population-Based Study.

Latin America has been severely affected by the COVID-19 pandemic. The COVID-19 burden in rural settings in Latin America is unclear. We performed a cross-sectional, population-based, random-selection SARS-CoV-2 serologic study during March 2021 in the rural population of San Martin region, northern Peru. In total, 563 persons from 288 houses across 10 provinces were enrolled, reaching 0.2% of the total rural population of San Martin. Screening for SARS-CoV-2 IgG antibodies was done using a chemiluminescence immunoassay (CLIA), and reactive sera were confirmed using a SARS-CoV-2 surrogate virus neutralization test (sVNT). Validation of the testing algorithm using prepandemic sera from two regions of Peru showed false-positive results in the CLIA (23/84 sera; 27%) but not in the sVNT, highlighting the pitfalls of SARS-CoV-2 antibody testing in tropical regions and the high specificity of the two-step algorithm used in this study. An overall 59.0% seroprevalence (95% confidence interval [CI], 55 to 63%) corroborated intense SARS-CoV-2 spread in San Martin. Seroprevalence rates between the 10 provinces varied from 41.3 to 74.0% (95% CI, 30 to 84%). Higher seroprevalence was not associated with population size, population density, surface area, mean altitude, or poverty index in Spearman correlations. Seroprevalence and reported incidence diverged substantially between provinces, suggesting regional biases of COVID-19 surveillance data. Potentially, limited health care access due to environmental, economic, and cultural factors might lead to undetected infections in rural populations. Additionally, test avoidance to evade mandatory quarantine might affect rural regions more than urban regions. Serologic diagnostics should be pursued in resource-limited settings to inform country-level surveillance and vaccination strategies and to support control measures for COVID-19. IMPORTANCE Latin America is a global hot spot of the COVID-19 pandemic. Serologic studies in Latin America have been mostly performed in urban settings. Rural populations comprise 20% of the total Latin American population. Nevertheless, information on COVID-19 spread in rural settings is scarce. Using a representative population-based seroprevalence study, we detected a high seroprevalence in rural populations in San Martin, northern Peru, in 2021, reaching 41 to 74%. However, seroprevalence and reported incidence diverged substantially between regions, potentially due to limited health care access or test avoidance due to mandatory quarantine. Our results suggest that rural populations are highly affected by SARS-CoV-2 even though they are sociodemographically distinct from urban populations and that highly specific serological diagnostics should be performed in resource-limited settings to support public health strategies of COVID-19 control.

Factores asociados a la anemia en lactantes de 6 a 35 meses atendidos en el Hospital Nacional Docente Madre Niño San Bartolomé durante el año 2011 / Factors associated with anemia in infants of 6 to 35 months attended at the Teaching National Hospital Mother Child San Bartolome in 2011

El objetivo de la investigación es determinar los factores asociados a la anemia en lactantes de 6 a 35 meses atendidos en el Hospital Nacional Docente Madre Niño San Bartolomé durante el año 2011. El presente estudio es de tipo descriptivo, observacional y correlacional ya que busca especificar las propiedades, las características y los perfiles importantes y es descriptivo en cuanto describen las características variables en un momento determinado. Es correlacional dado que se encontró la relaciones entra los factores asociados y la anemia. La muestra será de 186 lactantes de 6 a 35 meses que fueron diagnosticados de anemia en el periodo de Enero a Diciembre del 2011 en el Hospital Nacional Docente Madre Niño San Bartolomé 2012. El 23.1 por ciento del total de madres tienen secundaria incompleta; el 24.1 por ciento tienen GI secundaria completa; el 18.3 por ciento presentan técnica completa y el 8.1 por ciento presentan técnica completa; el 67.2 por ciento del total de lactantes presentan anemia leve; el 28.5 por ciento presentan anemia moderada y el 4.3 por ciento presentan anemia severa; el 73.7 por ciento son multíparas y el 21.5 por ciento son gran multíparas; el 61.8 por ciento del total de lactantes presentaron nacimiento pre término; del total de madres el 48.9 por ciento les dan lactancia materna exclusiva mientras que el 51.1 por ciento les dan lactancia mixta; el 61.3 por ciento del total de lactantes presentan estado nutricional no adecuados; el 61.3 por ciento del total de lactantes presentan cualquier retardo en el TA; del total de lactantes con anemia severa el 50 por ciento presentan primaria completo, se encontró relación estadística P<0.05; el 75 por ciento son gran multípara, se encontró relación estadística P<0.05; el 87.5 por ciento presentan edad gestacional pre término, encontrándose relación estadística P<0.05; el 62.5 por ciento presentan lactancia mixta encontrándose relación estadística P<0.05; el 87.5 por ciento presentan estado...

The objective of the research is to determine the factors associated with anemia in infants 6 to 35 months seen in the National Teaching Hospital Child Mother San Bartolome in 2011. The present study is descriptive type, observational. Correlational as it seeks to specify the properties, characteristics and major profiles and descriptive as describe the variables at a given time. It is since the correlational relationships found hard and factors associated anemia. The sample is of 186 infants 6 to 35 months who were diagnosed with anemia in the period of January to December 2011 at the National Teaching Hospital Mother Child San Bartolome. 23.1 per cent of all mothers have completed secondary, 24.1 per cent had completed secondary GI, 18.3 per cent have complete technical and 8.1 per cent are complete technique, 67.2 per cent of all infants have mild anemia, 28.5 per cent have moderate anemia and 4.3 per cent with severe anemia are 73.7 per cent and 21.5 per cent multiparous are great multiparous cows. 61.8 per cent of all preterm infants had birth, total 48.9 per cent of mothers give exclusive breastfeeding while, 51.1 per cent give mixed breastfeeding, 61.3 per cent of all infants have inadequate nutritional status, 61.3 per cent of all infants have any delay in the TA, of all infants with severe anemia 50 per cent have full primary relationship was found statistical P<0.05, 75 per cent are large multipara statistical relationship P<0.05 was found, 87.5 per cent have preterm gestational age, being statistical relationship P<0.05, 62.5 per cent have MBF finding statistical relationship P<0.05, the 87.5 per cent have inadequate nutritional status, statistical relationship P<0.05 was found, and 75 per cent have a delay in the TA, statistical relationship P<0.05 was found.