Situación epidemiológica de las anomalías congénitas en Paraguay en el periodo 2017-2021

Introduction: Congenital anomalies (CA) are structural or functional defects that occur during fetal development and are detected before, during or after birth. They represent an important public health problem due to their contribution to neonatal morbidity and mortality. Objective: To analyze the epidemiological situation of congenital anomalies in Paraguay from 2017-2021, in terms of prevalence and mortality using public data. Methods: Ecological study with data obtained from the digital platform of the Vital Statistics Computer Subsystem (SSIEV) and the Latin American Network of Congenital Malformations (ReLAMC) for the period 2017-2021. Results: Data from 273,239 births were analyzed, cardiac and large vessel anomalies were the most prevalent, accounting for 64% of all CAs. In terms of mortality, 2090 of 2639 deaths occurred in the first 11 months of life. The Central department had the highest frequency of deaths related to CA, with 881 deaths, representing 33.38% of the total. Conclusion: Congenital anomalies, particularly those related to heart defects, represent an important cause of morbidity and mortality in Paraguay. The most affected population was the pediatric population, and a high prevalence of heart and ear defects was observed. These results highlight the need to improve diagnostic and treatment capacities to reduce mortality associated to congenital anomalies.Introducción: Las anomalías congénitas (AC) son defectos estructurales o funcionales que ocurren durante el desarrollo fetal, detectándose antes, durante o después del nacimiento. Estas representan un importante problema de salud pública debido a su contribución a la mortalidad y morbilidad neonatal. Objetivo: Analizar la situación epidemiológica en términos de prevalencia y mortalidad utilizando datos de acceso público de las anomalías congénitas en Paraguay en el periodo 2017-2021. Metodología: Estudio ecológico con datos obtenidos de la plataforma digital del Sub Sistema Informático de Estadísticas Vitales (SSIEV) y la Red Latinoamericana de Malformaciones Congénitas (ReLAMC) durante el periodo 2017-2021. Se analizaron las prevalencias de cada tipo de AC, número de muertes según grupos de edad y región sanitaria de residencia. Resultados: Se analizaron los datos de 273.239 nacimientos, donde los defectos del corazón y grandes vasos fueron los más comunes, representando el 64% de todas las AC. En términos de mortalidad, 2090 de 2639 muertes ocurrieron en los primeros 11 meses de vida. El departamento Central tuvo la mayor frecuencia de muertes por AC con 881 defunciones representando el 33.38% del total. Conclusión: Las anomalías congénitas, particularmente las relacionadas con defectos del corazón, representan una importante causa de morbi-mortalidad en Paraguay. La población más afectada es la pediátrica con una alta prevalencia de defectos cardíacos y de los oídos. Estos resultados resaltan la necesidad de mejorar los sistemas de diagnóstico y tratamiento para reducir la mortalidad asociada a AC

Beyond the Rash: The Neuropsychiatric Impact of Measles and the Urgency of Prevention

Estimado editor: El pasado 7 de agosto de 2025, la Dirección General de Vigilancia de la Salud del Ministerio de Salud Pública de Paraguay emitió una alerta epidemiológica por sarampión, tras la confirmación de cuatro casos en el departamento de San Pedro, todos ellos sin antecedentes de vacunación documentada (1). El último brote con transmisión autóctona en el país se registró en 1998. Más recientemente, en 2023, se notificó un caso confirmado de fuente de infección desconocida, que no generó casos secundarios (1). Esta señal de alarma no es un hecho aislado: se enmarca en un contexto global de reemergencia del virus, favorecido por las brechas en la cobertura vacunal, la circulación internacional de personas y la complacencia que a veces se instala cuando una enfermedad ha sido declarada eliminada en un país. La rápida diseminación y el riesgo de brotes secundarios en comunidades vulnerables invitan a replantear una pregunta que, pese a décadas de evidencia científica, sigue sin recibir suficiente atención en el discurso público: ¿continuamos subestimando al sarampión como una enfermedad meramente febril y exantemática?    Estimado editor: El pasado 7 de agosto de 2025, la Dirección General de Vigilancia de la Salud del Ministerio de Salud Pública de Paraguay emitió una alerta epidemiológica por sarampión, tras la confirmación de cuatro casos en el departamento de San Pedro, todos ellos sin antecedentes de vacunación documentada (1). El último brote con transmisión autóctona en el país se registró en 1998. Más recientemente, en 2023, se notificó un caso confirmado de fuente de infección desconocida, que no generó casos secundarios (1). Esta señal de alarma no es un hecho aislado: se enmarca en un contexto global de reemergencia del virus, favorecido por las brechas en la cobertura vacunal, la circulación internacional de personas y la complacencia que a veces se instala cuando una enfermedad ha sido declarada eliminada en un país. La rápida diseminación y el riesgo de brotes secundarios en comunidades vulnerables invitan a replantear una pregunta que, pese a décadas de evidencia científica, sigue sin recibir suficiente atención en el discurso público: ¿continuamos subestimando al sarampión como una enfermedad meramente febril y exantemática

Consumo de prebióticos y probióticos y su relación con la presencia del síndrome metabólico y/o marcadores de riesgo asociados en pacientes ambulatorios

Introduction: The global prevalence of Metabolic Syndrome (MS) has been increasing in recent years, constituting a challenge for public health. There is scientific evidence that demonstrates positive effects of prebiotics and probiotics in the prevention and treatment of MS and associated risk markers. Objectives: We aimed to evaluate the consumption of prebiotics and probiotics and its relationship with the presence of MS, and associated risk markers in outpatients in the period from September to October 2022. Materials and Methods: Analytical, cross-sectional observational study, with primary data, carried out on 70 patients, obtained by non-probabilistic sampling. Anthropometric, biochemical, body composition, blood pressure, and level of physical activity variables were recorded to determine the presence of MS and its risk markers. Results: The sample consisted of 54 female subjects and 16 male subjects. The average age was 38.63 ±12.15 years. Only 29% of the subjects consumed the recommended daily amount of inulin every day. Significant differences were found between the consumption of prebiotics with nutritional status and skeletal muscle mass, with a lower proportion of overweight and greater skeletal muscle mass observed in those who consumed prebiotics. Conclusion: The consumption of prebiotics could exert a protective effect in overweight patients and, in relation to the presence of MS, in those patients who have a family history of arterial hypertension.   Likewise, a positive relationship was found between the consumption of prebiotics and skeletal muscle mass.Introducción: La prevalencia mundial de Síndrome Metabólico (SM) ha ido aumentando en los últimos años, constituyendo un reto para la salud pública. Existen evidencias científicas que demuestran efectos positivos de los prebióticos y probióticos en la prevención y tratamiento del SM y marcadores de riesgo asociados. Objetivos: Evaluar el consumo de prebióticos y probióticos y su relación con la presencia de SM y marcadores de riesgo asociados en pacientes ambulatorios en el periodo de setiembre a octubre 2022. Materiales y Métodos: Estudio observacional analítico, de corte transversal, con datos primarios, realizado en 70 pacientes, obtenido por muestreo no probabilístico, por conveniencia. Se registraron variables antropométricas, bioquímicas, de composición corporal, presión arterial, y nivel de actividad física, para determinar la presencia de SM y sus marcadores de riesgo. Resultados: La muestra estuvo constituida por 54 sujetos del sexo femenino y 16 del sexo masculino. La edad promedio fue de 38,63 ±12,15 años. El 29 % consumió todos los días la cantidad diaria recomendada de inulina. Se encontró diferencias significativas entre el consumo de prebióticos con el estado nutricional y la masa muscular esquelética, observándose menor proporción de sobrepeso y mayor masa muscular esquelética en los que consumen prebióticos. Conclusión: El consumo de prebióticos podría ejercer un efecto protector en pacientes con sobrepeso y con relación a la presencia de SM, y en aquellos pacientes que presenten antecedentes patológicos familiares de hipertensión arterial. Asimismo, se encontró una relación positiva entre el consumo de prebióticos y la masa músculo esquelética

Gender gap in pharmacological reperfusion and outcomes of ST-elevation acute myocardial infarction: Paraguayan cohort 2019–2023.

Introducción: El infarto agudo de miocardio con elevación del ST (IAMCEST) es una de las principales causas de morbimortalidad cardiovascular. La reperfusión temprana mediante fibrinólisis sigue siendo esencial en países en desarrollo, aunque se han documentado inequidades de género en el acceso y los desenlaces. En Paraguay no existía un análisis nacional que evaluara estas diferencias. Objetivo: Evaluar la brecha de género en la reperfusión farmacológica y los desenlaces intrahospitalarios en pacientes con IAMCEST en Paraguay entre 2019 y 2023. Metodología: Estudio observacional, retrospectivo y multicéntrico basado en el registro nacional del Código IAM. Se incluyeron pacientes consecutivos con síndrome coronario agudo y se analizaron características clínicas, estrategias de reperfusión, tiempos críticos y desenlaces. Se aplicaron pruebas ?² y U de Mann–Whitney, con significancia en p<0,05. Resultados: Se incluyeron 1.831 pacientes. Las mujeres fueron de mayor edad (65,6 ± 12,4 vs. 60,3 ± 11,4 años; p<0,001) y presentaron más hipertensión, diabetes y obesidad, mientras que el tabaquismo y consumo de alcohol fueron más frecuentes en varones. La fibrinólisis se realizó en el 64,1 % de los casos, con menor proporción en mujeres (61,1 % vs. 66,2 %; p=0,048). Los tiempos críticos fueron mayores en mujeres: síntoma–puerta (310 vs. 280 min), puerta–aguja (50 vs. 40 min) e isquemia total (370 vs. 340 min; p<0,001). La mortalidad intrahospitalaria fue superior en mujeres (12,4 % vs. 7,8 %; p<0,001), al igual que la insuficiencia cardíaca (15,2 % vs. 10,5 %; p=0,01). No hubo diferencias en arritmias ventriculares, accidente cerebrovascular ni sangrado mayor. Conclusión: Las mujeres con IAMCEST en Paraguay presentan menor acceso a fibrinólisis, mayores retrasos y peor pronóstico intrahospitalario, lo que evidencia una brecha de género en la atención cardiovascular aguda.Introduction: ST-elevation acute myocardial infarction (STEMI) is one of the leading causes of cardiovascular morbidity and mortality. Early reperfusion, mainly through fibrinolysis in developing countries, is essential to reduce complications and mortality. However, multiple international registries have documented gender inequities in access to reperfusion therapies, with greater delays and worse outcomes in women. In Paraguay, where fibrinolysis remains the most widely used strategy under the IAM Code, there had been no national analysis to assess these differences. Objective: To assess the gender gap in pharmacological reperfusion and in-hospital outcomes in patients with STEMI in Paraguay between 2019 and 2023. Methodology: Observational, retrospective, multicenter study based on the national registry of the IAM Code. Consecutive patients with acute coronary syndrome were included. Clinical characteristics, risk factors, reperfusion strategies, critical times, and in-hospital outcomes were analyzed using ?² and Mann–Whitney U tests, with significance set at p<0.05. Results: A total of 1,831 patients were included. Women were older (65.6 ± 12.4 vs. 60.3 ± 11.4 years; p<0.001) and had more hypertension, diabetes, and obesity, while smoking and alcohol consumption were more common in men. Fibrinolysis was performed in 64.1% of patients, less frequently in women than in men (61.1% vs. 66.2%; p=0.048). Critical times were longer in women: symptom-to-door (310 vs. 280 min), door-to-needle (50 vs. 40 min), and total ischemia (370 vs. 340 min; p<0.001). In-hospital mortality was higher in women (12.4% vs. 7.8%; p<0.001), as was heart failure (15.2% vs. 10.5%; p=0.01), while no significant sex differences were found in ventricular arrhythmias, stroke, or major bleeding. Conclusion: Women with STEMI in Paraguay have lower access to fibrinolysis, longer treatment delays, and worse in-hospital outcomes, confirming persistent gender inequities that require targeted health strategies

Una Adaptación y traducción del Psy-Flex en estudiantes universitarios de Lima Metropolitana

Introduction: The PsyFlex is a relevant measure for clinical practice given that it facilitates therapeutic planning and represents a measure of change in intervention sessions; however, it is not adapted to the Peruvian context. Objective: To adapt and translate the Psy-Flex in a sample of Peruvian university students. Methodology: Two samples of 273 participants, each aged 18 to 59 years of both sexes, were used. Results: Absolute (RMSEA=.000 to .074; SRMR=.014 to .031) and relative (CFI=.977 to 1.000; TLI=.962 to 1.005) optimal fit indices and reliability indices above .85 for the one-factor structure were identified, thus, the instrument has optimal evidence of validity and reliability. Discussion: The findings are partially consistent with other studies due to morpho-syntactic characteristics of the translation process from English to Spanish, reflecting the unidimensional nature of the test.Introducción: El PsyFlex es una medida relevante para la práctica clínica dado que facilita la planificación terapéutica y representa una medida del cambio en las sesiones de intervención, sin embargo, no se encuentra adaptada al contexto peruano. Objetivo: Adaptar y traducir el Psy-Flex en una muestra de estudiantes universitarios peruanos. Metodología: Se empleó dos muestras de 273 participantes cada una con edades entre 18 a 59 años de ambos sexos. Resultados: Se identificó índices de ajuste absolutos (RMSEA=.000 a .074; SRMR=.014 a .031) y relativos (CFI=.977 a 1.000; TLI=.962 a 1.005) óptimos e índices de fiabilidad por encima de .85 para la estructura de un factor, por lo cual, el instrumento tiene óptimas evidencias de validez y confiabilidad. Discusión: Los hallazgos son parcialmente consistentes con otros estudios debido a características morfo sintácticas del proceso de traducción de inglés a español, reflejando la naturaleza unidimensionalidad de la prueba

The Distance to Mental Health Services and the Use of Public Transportation: A Challenge for Timely Care

Access to mental health services is a crucial issue in healthcare worldwide, particularly in low- and middle-income countries, such as Paraguay. Factors such as geographical distance to care centers and availability of public transportation can significantly influence how quickly a person receives treatment. This editorial draws on findings from a study conducted at the Hospital de Clínicas of the National University of Asunción, which analyzed the relationship between distance to psychiatric services, use of public transportation, and duration of untreated mental disorders (1). Effective treatment of mental disorders depends on timely and continuous access to specialized services. However, physical distance from health centers and limited public transportation options often delay treatment, exacerbate symptoms, and diminish the quality of life. In this study, it was found that, although the average distance to the hospital was 10 km, there was no significant relationship between distance and the severity of anxiety or depression symptoms. Nevertheless, patients who spent more time traveling reported higher levels of anxiety, indicating that it is the duration of the journey, rather than the distance itself, that impacts anxiety levels (2,3). Access to mental health services, particularly in urban areas, depends heavily on public transportation. In the aforementioned study by Márquez (1), 45.2% of the patients relied on public transport to reach the hospital, and most had to take two buses. A small percentage required more connections, leading to long and exhausting trips. These findings highlight how public transportation quality and availability directly affect access to mental health services, a trend also observed in studies from other countries, where inadequate transport is a major barrier to timely mental healthcare (4). Research has consistently shown that inefficient public transportation is a significant obstacle in accessing psychiatric care. In areas where transportation is limited or expensive, the likelihood of seeking treatment drops dramatically (5). This issue is particularly pressing in rural areas, where people often travel long distances without access to regular public transportation or emergency psychiatric services, which adds another layer of difficulty in receiving adequate care. The duration of untreated mental disorders is a critical factor for symptom severity. This study found a correlation between delayed diagnosis and the severity of depression symptoms, reinforcing existing evidence that untreated mental health issues tend to worsen over time, increasing the burden on both patients and the healthcare system. The phenomenon known as "distance decay," which refers to the decreasing likelihood of seeking medical care as the distance to health services increases, has been documented in numerous studies (5). Given these findings, it is imperative to consider strategies for improving access to mental health services. One potential solution is to decentralize psychiatric care, allowing rural and disadvantaged communities to receive quality care without having to travel long distances. Establishing community mental health centers in peripheral areas, staffed with trained personnel, and equipped with telehealth capabilities could ease the strain on urban hospitals and ensure earlier access to treatment (5,6). Moreover, enhancing the public transportation infrastructure is essential for improving access to mental health services. Implementing policies that subsidize transportation costs for patients, such as free or reduced-fare bus passes for medical appointments, could help mitigate barriers related to transportation (7). In some countries, such measures have successfully improved mobility and healthcare access for vulnerable populations, suggesting that similar policies in Paraguay can yield comparable benefits. Ultimately, access to mental health services should not depend on geographical location or reliable transportation. Distance and transportation barriers are avoidable obstacles that, if properly addressed, can reduce the duration of untreated mental disorders and substantially improve the quality of life of affected individuals. Achieving this will require coordinated efforts among health authorities, urban planners, and policymakers to ensure that public transportation is accessible and that mental health services are available to all, regardless of location. Access to mental health services is a basic right and ensuring efficient provision is crucial for the well-being of the population. As the mental health systems in Paraguay and other low- and middle-income countries continue to evolve, addressing barriers such as distance and transportation must be a priority. Only then can it be guaranteed that all citizens, regardless of where they live, have access to the mental health care they need.Access to mental health services is a crucial issue in healthcare worldwide, particularly in low- and middle-income countries, such as Paraguay. Factors such as geographical distance to care centers and availability of public transportation can significantly influence how quickly a person receives treatment. This editorial draws on findings from a study conducted at the Hospital de Clínicas of the National University of Asunción, which analyzed the relationship between distance to psychiatric services, use of public transportation, and duration of untreated mental disorders (1). Effective treatment of mental disorders depends on timely and continuous access to specialized services. However, physical distance from health centers and limited public transportation options often delay treatment, exacerbate symptoms, and diminish the quality of life. In this study, it was found that, although the average distance to the hospital was 10 km, there was no significant relationship between distance and the severity of anxiety or depression symptoms. Nevertheless, patients who spent more time traveling reported higher levels of anxiety, indicating that it is the duration of the journey, rather than the distance itself, that impacts anxiety levels (2,3). Access to mental health services, particularly in urban areas, depends heavily on public transportation. In the aforementioned study by Márquez (1), 45.2% of the patients relied on public transport to reach the hospital, and most had to take two buses. A small percentage required more connections, leading to long and exhausting trips. These findings highlight how public transportation quality and availability directly affect access to mental health services, a trend also observed in studies from other countries, where inadequate transport is a major barrier to timely mental healthcare (4). Research has consistently shown that inefficient public transportation is a significant obstacle in accessing psychiatric care. In areas where transportation is limited or expensive, the likelihood of seeking treatment drops dramatically (5). This issue is particularly pressing in rural areas, where people often travel long distances without access to regular public transportation or emergency psychiatric services, which adds another layer of difficulty in receiving adequate care. The duration of untreated mental disorders is a critical factor for symptom severity. This study found a correlation between delayed diagnosis and the severity of depression symptoms, reinforcing existing evidence that untreated mental health issues tend to worsen over time, increasing the burden on both patients and the healthcare system. The phenomenon known as "distance decay," which refers to the decreasing likelihood of seeking medical care as the distance to health services increases, has been documented in numerous studies (5). Given these findings, it is imperative to consider strategies for improving access to mental health services. One potential solution is to decentralize psychiatric care, allowing rural and disadvantaged communities to receive quality care without having to travel long distances. Establishing community mental health centers in peripheral areas, staffed with trained personnel, and equipped with telehealth capabilities could ease the strain on urban hospitals and ensure earlier access to treatment (5,6). Moreover, enhancing the public transportation infrastructure is essential for improving access to mental health services. Implementing policies that subsidize transportation costs for patients, such as free or reduced-fare bus passes for medical appointments, could help mitigate barriers related to transportation (7). In some countries, such measures have successfully improved mobility and healthcare access for vulnerable populations, suggesting that similar policies in Paraguay can yield comparable benefits. Ultimately, access to mental health services should not depend on geographical location or reliable transportation. Distance and transportation barriers are avoidable obstacles that, if properly addressed, can reduce the duration of untreated mental disorders and substantially improve the quality of life of affected individuals. Achieving this will require coordinated efforts among health authorities, urban planners, and policymakers to ensure that public transportation is accessible and that mental health services are available to all, regardless of location. Access to mental health services is a basic right and ensuring efficient provision is crucial for the well-being of the population. As the mental health systems in Paraguay and other low- and middle-income countries continue to evolve, addressing barriers such as distance and transportation must be a priority. Only then can it be guaranteed that all citizens, regardless of where they live, have access to the mental health care they need

Discrimination capacity of the pirate test to detect vision disorders in preschool children

Introduction: The presence of amblyopia due to untreated vision disorders is a serious global problem, which prevalence will increase from 13 to 26% in 2060. Despite having stablished screening programs for early detection of vision disorders in schools and training teachers for the correct use of ophthalmic instruments. However, due to the high rate of false positive results, its validity decreased. This situation implies the need to find a simple, low cost and reproducible test that allows the detection of vision disorders without prior ophthalmological knowledge, which is the main reason why the Pirate Test was proposed. Objective: To determine the discrimination capacity of Pirate Test to detect vision disorders in preschool children in Piura city. Methodology: Diagnostic study test (“Pirate Test”) was applied to 447 preschoolers by their parents and then they were evaluated by an ophthalmologist who determined if they really had vision disorders and specify the validity of the applied Test through the analysis of its sensitivity (Se), specificity (Sp), and ROC curve using SPSS v16. Results: The Se and Sp values to detect refractive errors were 85.4% and 78.8%, whereas for amblyopia the values were 83% and 93.7%, respectively. Also, ROC curves in both cases reported good discrimination capacity to detect visual disorders and amblyopia. Conclusion: Pirate Test has good discrimination capacity to detect visual disorders and amblyopia in preschoolers. The cut-off point was less than 5 minutes, which implies that the possibility of having important visual disorders or amblyopia is high.Introduction: The presence of amblyopia due to untreated vision disorders is a serious global problem, which prevalence will increase from 13 to 26% in 2060. Despite having stablished screening programs for early detection of vision disorders in schools and training teachers for the correct use of ophthalmic instruments. However, due to the high rate of false positive results, its validity decreased. This situation implies the need to find a simple, low cost and reproducible test that allows the detection of vision disorders without prior ophthalmological knowledge, which is the main reason why the Pirate Test was proposed. Objective: To determine the discrimination capacity of Pirate Test to detect vision disorders in preschool children in Piura city. Methodology: Diagnostic study test (“Pirate Test”) was applied to 447 preschoolers by their parents and then they were evaluated by an ophthalmologist who determined if they really had vision disorders and specify the validity of the applied Test through the analysis of its sensitivity (Se), specificity (Sp), and ROC curve using SPSS v16. Results: The Se and Sp values to detect refractive errors were 85.4% and 78.8%, whereas for amblyopia the values were 83% and 93.7%, respectively. Also, ROC curves in both cases reported good discrimination capacity to detect visual disorders and amblyopia. Conclusion: Pirate Test has good discrimination capacity to detect visual disorders and amblyopia in preschoolers. The cut-off point was less than 5 minutes, which implies that the possibility of having important visual disorders or amblyopia is high

Knowledge and Compliance of Mothers of Children Under 5 Years Regarding the Vaccination Schedule: San Expedito Settlement, Paraguay, 2024

Introducción: El esquema de vacunación constituye una recomendación basada en evidencia que permite a la población prevenir enfermedades transmisibles en diferentes grupos de edad mediante la inmunización. Objetivo: Determinar los conocimientos y el cumplimiento del esquema de vacunación en madres de niños menores de 5 años, en el asentamiento San Expedito, San Lorenzo, Paraguay, 2024. Metodología: Estudio observacional, descriptivo, no experimental, con enfoque cuantitativo. La población estuvo conformada por madres de niños menores de 5 años. La muestra incluyó 40 madres seleccionadas mediante muestreo no probabilístico. Se aplicó un cuestionario estructurado a través de entrevistas. Los datos fueron tabulados en Microsoft Excel 2010 y analizados con EpiInfo 7.2.0.1. Se elaboraron tablas y gráficos descriptivos. Resultados: La edad de las participantes osciló entre 18 y 36 años (media 27). Más de la mitad de los niños eran lactantes menores. La mitad de las madres tenía educación media completa, la cuarta parte eran amas de casa y más del 10 % trabajaba como cajeras. Más de la mitad de los hogares reportó ingresos menores a un salario mínimo. En relación al conocimiento, más de la mitad de las madres desconocía aspectos del esquema de vacunación. En cuanto al cumplimiento global, más de la mitad seguía el esquema de vacunación de acuerdo con la edad del niño. Conclusión: Se evidenció un nivel limitado de conocimientos sobre vacunación entre las madres, aunque más de la mitad cumplía con la aplicación de vacunas según edad, lo que resalta la necesidad de fortalecer las estrategias de educación y sensibilización en la comunidad.Introduction: Vaccination schedules are evidence-based recommendations that allow populations to prevent communicable diseases in different age groups through immunization. Objective: To determine the knowledge and compliance with vaccination schedules among mothers of children under 5 years of age in the San Expedito settlement, San Lorenzo, Paraguay, 2024. Methodology: A descriptive, observational, non-experimental, quantitative study was conducted. The study population consisted of mothers of children under 5 years of age. The sample included 40 mothers selected through non-probabilistic sampling. Data were collected through interviews using a structured questionnaire. Information was tabulated in Microsoft Excel 2010 and analyzed with EpiInfo 7.2.0.1. Tables and descriptive graphs were generated. Results: Participants ranged in age from 18 to 36 years (mean 27). More than half of the children were infants. Half of the mothers had completed secondary education, a quarter were housewives, and over 10% worked as cashiers. More than half of the households reported incomes below the minimum wage. Regarding knowledge, more than half of the mothers lacked information about vaccination. However, more than half complied with the vaccination schedule according to the child’s age. Conclusion: Limited knowledge about vaccination was observed among mothers, although compliance with the vaccination schedule was above 50%. These findings highlight the need to strengthen education and awareness strategies in the communit

Ansiedad en personal de salud de un Hospital del Ministerio de Salud durante la pandemia de COVID-19 en la Región Sur del Perú

Introduction: The pandemic of COVID-19 had affected dramatically the mental health of general population, but specifically the health personnel, so there were reported higher levels of anxiety in physicians and nurses in several countries. Objective: To determine the levels of anxiety in health personnel who work in Hospital from Ministry of Health Hospital from Arequipa City and its association with the attemption of patients with COVID-19. Methodology: This is a descriptive transectional study, in which there were assessed 147 healthcare workers in Hospital with and there Zung Axiety Scale. Results: The 53.1% of the health personnel assessed presents some levels of anxiety, that is associated in the 66% of the cases with ethical dilemmas for working with people infected with COVID-19. Conclusion: There is a significant association between anxiety and the attemption of patients with COVID-19.Introducción: La pandemia del COVID-19 ha afectado dramáticamente la salud mental de la población en general, pero de forma particular al personal de salud, por lo que se ha registrado un aumento de los niveles de ansiedad de médicos y enfermeras en diversos países. Objetivo: Determinar los niveles de ansiedad en personal de salud que labora en un hospital del Ministerio de Salud en Arequipa y su asociación con la atención de pacientes con COVID-19. Metodología: Se trata de un estudio descriptivo transeccional, en el que se evaluó a 147 trabajadores de salud un hospital del Ministerio de Salud mediante la Escala de Evaluación de la ansiedad de Zung. Resultados: El 53.1% del personal evaluado presenta ansiedad desde leve a severa, de los cuales, en el 66% de los casos se encuentra asociada con los dilemas éticos que presentan los trabajadores por atender pacientes infectados con COVID-19. Conclusión: Existe una asociación significativa entre la ansiedad y la atención de pacientes infectados por COVID-1

Percepción de Soledad y Autoestima como Predictores de la Salud Mental en Adultos: Un Estudio en un País Sudamericano

Introduction: The presence of mental health problems among adults in Ecuador underscores the need to identify potential predictors of their occurrence. This study aimed to examine the impact of loneliness perception and self-esteem as potential predictors of mental health problems in a sample of Ecuadorian adults. Methods: A descriptive, correlational, predictive, and cross-sectional study was conducted with a sample of 1,293 Ecuadorian adults aged 18 to 63 years, of whom 42.3% were men and 57.7% were women. Results: Loneliness and self-esteem levels were found to be moderate, while the prevalence of mental health problems was low. Loneliness showed a positive moderate correlation with somatization, whereas self-esteem displayed a slight negative correlation with depression. Both loneliness and self-esteem emerged as significant predictors of these conditions. Conclusions: Loneliness and self-esteem influence the development and progression of specific mental health problems, such as somatization and depression, highlighting their relevance in interventions aimed at promoting mental health.Introducción: la presencia de problemas de salud mental en adultos en Ecuador destaca la necesidad de identificar posibles predictores de su incidencia. En este sentido, el objetivo de la investigación fue determinar el impacto de la percepción de soledad y la autoestima como posibles predictores de problemas de salud mental en una muestra de adultos ecuatorianos. Métodos: se llevó a cabo un estudio descriptivo, correlacional, predictivo y transversal con una muestra de 1,293 adultos ecuatorianos entre 18 y 63 años. El 42,3 % eran hombres y el 57,7 % mujeres. Resultados: los niveles de soledad y autoestima fueron moderados, mientras que la presencia de problemas de salud mental fue baja. La soledad se correlacionó de manera positiva y moderada con la somatización, mientras que la autoestima se correlacionó de forma negativa y leve con la depresión. Además, la soledad y la autoestima resultaron ser predictores significativos de estas condiciones. Conclusiones: la soledad y la autoestima influyen en la aparición y curso de problemas específicos de salud mental, como la somatización y la depresión, lo que subraya la importancia de considerarlos en intervenciones orientadas a la promoción de la salud mental