Epidemiologic characteristics and clinical features of patients with monkeypox virus infection from a hospital in Peru between July and September 2022.

OBJECTIVES: Monkeypox (Mpox) recent outbreak has changed in terms of predominant transmission route and typical presentation. Describing current epidemiological and clinical characteristics is crucial to identifying cases and halting transmission. METHODS: An observational study was conducted at a Peruvian tertiary-level hospital and included all individuals with Mpox virus infection between July 01 and September 03, 2022. RESULTS: Among 205 confirmed cases, 99% (202/205) were men, 94% (192/205) were men who have sex with men or bisexual, and 66% (136/205) were living with HIV. Regarding sexual behavior, 87% (179/205) had a sexual encounter 21 days before consultation, although only 8% (17/205) identified sexual contact with a Mpox confirmed case; 65% (133/205) had sexual intercourse with casual partners, 55% (112/205) reported a last sexual partner unknown, and 21.5% (44/205) continued having sexual intercourse with symptoms. Systemic symptoms were fever (162/205, 79%), malaise (123/205, 60%), headache (119/205, 58%), fatigue (105/205, 52%), and lymphadenopathy (111/205, 54%). The distribution of skin lesions was generalized (166/205, 81%), located in the anogenital area (160/205, 78%), polymorphic (174/205, 85%), and it was the first symptom identified in 46% (94/205) of cases. Overall, 10% (21/205) required hospitalization, of whom 85.7% (18/205) have HIV infection. Complications included bacterial superinfection (n = 18), proctitis (n = 6), balanitis (n = 4), and necrosis of skin lesions (n = 3). CONCLUSION: In 2022, Mpox mainly affects men who have sex with men and People living with HIV/AIDS. It presents with skin lesions localized to the anogenital area and can lead to severe complications requiring hospitalization.

Percepción de la automedicación con antibióticos en los usuarios externos de un hospital público en Lima-Perú / Perception of self-medication with antibiotics in the external users of a public hospital in Lima, Peru

PROBLEMA: ¿Cuál es la percepción sobre la automedicación con antibióticos en los usuarios de consultorio externo del Hospital Nacional Arzobispo Loayza? Hipótesis: Existe relación directa entre el grado de instrucción y la automedicación con antibióticos en los sujetos de estudio. Objetivo: Identificar las percepciones más comunes sobre la automedicación con antibióticos en los usuarios de consultorio externo del HNAL. MATERIAL Y METODOS: Estudio tipo encuesta, de carácter prospectivo observacional, descriptivo y transversal. Población: Usuarios de Consultorios Externos del Hospital Nacional Arzobispo Loayza, Lima Perú, a partir del mes de Noviembre del año 2011 en adelante. Muestra: n=369. RESULTADOS: El 58 por ciento de los usuarios se auto medican con antibióticos, el grado de instrucción superior es menos prevalente en quienes se auto medican (38 por ciento) comparado con quienes no practican esta actividad (53,8 por ciento), (p=0,003). Los síntomas respiratorios fueron la causa más común para la automedicación y el 84,5 por ciento consideran a los antibióticos en el tratamiento del resfrío común. También perciben motivos no relacionados al estado de la salud para automedicarse, como tratamiento "Ya conocido", "Confianza en el personal de la farmacia" o "tiempo prolongado de espera en el hospital previo a la consulta médica". Los antibióticos más usados en la automedicación son los Betalactámicos, Quinolonas y Aminoglucósidos. Durante la automedicación, el 49,3 por ciento acceden a los antibióticos por petición directa y el 33,3 por ciento por sugerencia del personal de la farmacia. Durante el consumo de antibióticos sin receta médica, el 89,2 por ciento consideran "mejoría de sus síntomas". CONCLUSIONES: El 58 por ciento de los usuarios de consultorio externo del HNAL practica la automedicación con antibióticos, siendo probablemente las infecciones respiratorias, la causa más común, sin embargo se describen otras causas no relacionados al estado de salud...

PROBLEM: What is the perception of self-medication with antibiotics in outpatient users Hospital Nacional Arzobispo Loayza?. HYPOTHESIS: There is a direct relationship between the level of education and self- medication with antibiotics in the study subjects. Objective: To identify more usual perceptions on self medication with antibiotics in outpatient users the HNAL. MATERIAL AND METHODS: Interview-study. A prospective, observational, descriptive and transversal. Population: External Doctor users Hospital Nacional Arzobispo Loayza, Lima Peru, from the month of November, 2011 onwards. Sample: n=369. RESULTS: 58 per cent of users did self medicate with antibiotics, higher educational attainment is less prevalent in those who selfmedicate (38 per cent) compared to those who do not practice this activity (53.8 per cent), (p=0.003). Respiratory symptoms were the most common cause for self-medication and 84.5 per cent considered to antibiotics in the treatment of the common cold. Also reasons related to perceived health status to self-medicate, as treatment "already known", "Trust in the pharmacy staff" or "long time waiting in the hospital before medical consultation." The antibiotics used in self-medication are the beta-lactams, quinolones and aminoglycosides. During the self-medication, 49.3 per cent use direct request antibiotics and 33.3 per cent at the suggestion of pharmacy staff. During the consumption of antibiotics without prescription, 89.2 per cent consider "improvement in their symptoms". CONCLUSIONS: The 58 per cent of outpatient users of HNAL practiced self-medication with antibiotics, respiratory infections being probably the most common cause, however described other causes unrelated to health status as "therapy known as", "confidence in the pharmacy staff" or "prolonged delay before medical consultation" as possible causes of self-medication. Antibiotics groups used for this practice were the beta-lactams, quinolones and aminoglycosides.