A bibliometric analysis of the global research on sofosbuvir

In this article, we examine the research on sofosbuvir with a bibliometric analysis of global research production. The study of sofosbuvir has been a field of intense research in the past few years, with Latin American contributions playing a modest role. With continued drug development and approval of hepatitis C antivirals, research is expected to increase. Our findings will assist scholars and policy makers in their efforts to improve scientific research policies, with the goal of maximizing the access to treatments, especially in low and middle-income countries.Completo1-10In this article, we examine the research on sofosbuvir with a bibliometric analysis of global research production. The study of sofosbuvir has been a field of intense research in the past few years, with Latin American contributions playing a modest role. With continued drug development and approval of hepatitis C antivirals, research is expected to increase. Our findings will assist scholars and policy makers in their efforts to improve scientific research policies, with the goal of maximizing the access to treatments, especially in low and middle-income countries

Geographic and socioeconomic inequalities in cesarean birth rates in Peru: A comparison between 2009 and 2018

Background There is a global concern about the high rates of cesarean birth (CB). This study aimed to investigate the geographic and socioeconomic inequalities in CB rates in the Peruvian population. Methods We conducted a population-based study using the Peruvian Demographic and Family Health Surveys (ENDES, the Spanish acronym for Encuesta Demográfica y de Salud Familiar) between 2009 and 2018. ENDES reported data from births registered in the five years preceding survey execution. For the years 2009 (n = 10 289) and 2018 (n = 23 077), we calculated the weighted rates of CB among variables such as natural geographic domain (Coast, Andean, or Amazon), area of residence (rural or urban), wealth index quintile (quintile 1 is poorest, and quintile 5 is richest), and educational level. To assess inequalities, we calculated the concentration index (CIs), the slope index of inequality (SII), and the relative index of inequality (RII). Results The CB rates by year were 21.4% (95% confidence interval [CI]: 20.0-22.9) in 2009 and 34.5% (95% CI: 33.4-35.5) in 2018. Women living in urban and coastal regions and with a higher education level had the highest CB rates. All the CIs were positive, reflecting a prowealthy inequality in CB rates, and both SII and RII were positive, indicating a gap between the use of cesarean in women in the higher wealth quintile compared with those in the lower quintile. Conclusions Cesarean birth rates have increased by 60% during the last decade in Peru. The richest wealth quintiles had the highest CB rates during the study years, which were well above global recommendations

Socio-economic inequalities in smoking prevalence and involuntary exposure to tobacco smoke in Argentina: Analysis of three cross-sectional nationally representative surveys in 2005, 2009 and 2013

Background: Understanding patterns of socio-economic inequalities in tobacco consumption is key to design targeted public health policies for tobacco control. This study examines socio-economic inequalities in smoking and involuntary exposure to tobacco smoke between 2005 and 2013. Methods: Data were derived from the Argentine National Risk Factors Surveys, conducted in 2005, 2009, and 2013. Two inequality measures were calculated: the age-adjusted prevalence ratio (PR) and the disparity index (DI). Educational level, household income per consumer unit and employment status were used as proxies for socio-economic status (SES). Generalized linear models were used in the analysis. Results: Prevalence of smoking decreased from 29.7% to 25.1% between 2005 and 2013, mainly in women (p<0.001). Despite the overall prevalence reduction, socio-economic inequalities in smoking persisted. For both men and women, the DI was moderately high for smoking (14.47%-33.06%) across the three surveys. In men, the PR indicated a higher smoking prevalence for lower educational levels and lower household income throughout the analyzed period. In women, unlike previous years, the 2013 survey showed disparity related to unemployment. Involuntary exposure to tobacco smoke in 2013 was associated with educational level and household income, with lower involuntary exposure among those with higher SES. Conclusions: While overall smoking rates have decreased in Argentina, socio-economic disparities related to tobacco smoking persist. Comprehensive tobacco control programs targeted to address these inequalities are essential in developing strategies to reduce health disparities in tobacco-related diseases.Fil: Santero, Marilina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Melendi, Santiago Ezequiel. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Hernández Vásquez, Akram. Universidad San Ignacio de Loyola; PerúFil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentin

Indigenous communities of Peru: Level of accessibility to health facilities

"Objectives: This study aimed to geospatially model the level of geographic accessibility to health facilities among Amazonian Indigenous communities in a region of Peru. Methods: Spatial modeling of the physical accessibility of the Indigenous communities to the nearest health facility was performed through cost-distance analysis. The study area was Loreto, the region with the largest territorial area and number of Indigenous communities in Peru. The time required to reach a health facility was determined by cumulatively adding the time needed to cross the grids on the lowest cost route from the Indigenous communities’ locations to the nearest health facility, by considering Amazonian geographical conditions and the main types of transport used. Results: The median time to reach a health facility was 0.96 h (interquartile range: 0.45e2.41). Of the total communities (n ¼ 1043), only 479 (45.93%) communities were within 1 h from the nearest health facility, and 161 (15.44%) were more than 8 h away. The Indigenous communities more than 8 h away from a health estab- lishment were located in the border areas of the depart- ment of Loreto. Conclusion: One in two Indigenous communities is more than 1 h from the nearest health facility.

Manipulación, análisis y visualización de datos de la Encuesta Demográfica y de Salud Familiar con el programa R

La Encuesta Demográfica de Salud Familiar (ENDES) es una encuesta nacional de base poblacional con representatividad a nivel departamental y área de residencia, constituyéndose en una fuente de información del estado de salud de la población peruana. Con el objetivo de estandarizar su procesamiento y posterior reutilización por parte de la comunidad académica y otros actores interesados; documentamos el código para la manipulación, análisis y visualización de datos del cuestionario de salud de la ENDES 2017, mediante un ejemplo sobre prevalencia de hipertensión arterial y obesidad, utilizando el entorno y lenguaje de programación estadístico R. Se presenta y detalla secuencialmente el código en R, así como, el sustento teórico de la estructura de la encuesta para la manipulación de las bases de datos, considerando que la compleja estructura de la ENDES podría ser una potencial barrera que enfrentan los investigadores. Finalmente, este ejemplo puede servir de base para que se generen mayores estudios basados en la ENDES que sean relevantes para la toma de decisiones en salud pública

Analysis of tobacco consumption, before and during the COVID-19 pandemic in Peru

Revisión por pare

Socioeconomic Inequalities in the Prevalence of Diabetes in Argentina: A Repeated Cross-Sectional Study in Urban Women and Men

"This study measured the socioeconomic inequalities in the prevalence of diabetes between 2005 and 2018 in an urban Argentinian population. Data were obtained from the repeated crosssectional surveys “National Survey of Risk Factors” (ENFR is its acronym in Spanish). From 2005 to 2018, four rounds of ENFR were administered to men and women over 18 years of age. Concentration curves (CC) and the Erreygers concentration index (ECI) were used to describe the socioeconomic inequalities in diabetes’ prevalence. A decomposition analysis was performed to determine the contribution of each variable to inequality in diabetes’ prevalence. Data from 41,219 (2005), 34,583 (2009), 32,232 (2013), and 29,094 (2018) individuals were analyzed. Women reported a greater prevalence of diabetes compared with men for all the years included. According to the CC and ECI, we found no evidence of inequality in men throughout all study years. For women, throughout all years, the CCs were above the line of equity, and the ECIs during all the years were negative and different from zero (p < 0.01). For women, we found no evidence of a reduction in inequalities between 2005 and 2018 (p = 0.475). The socioeconomic inequality for women was largely driven by public insurance, primary and secondary education, and employment. Diabetes’ prevalence was not associated with socioeconomic status in men, while the prevalence of diabetes in women was more concentrated among poorer women. During the 13 years, there was no evidence of a reduction of inequality in women, noting that interventions must prioritize and should focus on the main contribution of inequalities, such as education and employment.

Measuring out-of-pocket payment, catastrophic health expenditure and the related socioeconomic inequality in Peru : a comparison between 2008 and 2017

Q2Objectives: Describe out-of-pocket payment (OOP) and the proportion of Peruvian households with catastrophic health expenditure (CHE) and evaluate changes in socioeconomic inequalities in CHE between 2008 and 2017. Methods: We used data from the 2008 and 2017 National Household Surveys on Living and Poverty Conditions (ENAHO in Spanish), which are based on probabilistic stratified, multistage and independent sampling of areas. OOP was converted into constant dollars of 2017. A household with CHE was assumed when the proportion between OOP and payment capacity was ≥0.40. OOP was described by median and interquartile range while CHE was described by weighted proportions and 95% confidence intervals (CIs). To estimate the socioeconomic inequality in CHE we computed the Erreygers concentration index. Results: The median OOP reduced from 205.8 US dollars to 158.7 US dollars between 2008 and 2017. The proportion of CHE decreased from 4.9% (95% CI, 4.5 to 5.2) in 2008 to 3.7% (95% CI, 3.4 to 4.0) in 2017. Comparison of socioeconomic inequality of CHE showed no differences between 2008 and 2017, except for rural households in which CHE was less concentrated in richer households (p<0.05) and in households located on the rest of the coast, showing an increase in the concentration of CHE in richer households (p<0.05). Conclusions: Although OOP and CHE reduced between 2008 and 2017, there is still socioeconomic inequality in the burden of CHE across different subpopulations. To reverse this situation, access to health resources and health services should be promoted and guaranteed to all populations.Revista Internacional - Indexad

Análisis espacial y del entorno físico de accidentes de tránsito en la ciudad de Resistencia, Chaco, Argentina

Traffic accidents are an emerging problem in cities with high mobility and little urban planning. Evidence is lacking in Argentina regarding the relationship between the environment and accident occurrence; we therefore conducted a geospatial analysis and estimated the risk of accidents and their possible association with the characteristics of the physical environment in the city of Resistencia, Argentina occurring in 2012. Kernel density estimates were used for the spatial distribution of accidents and in parallel an observational, analytical study was carried out to analyze the factors associated with accident occurrence. The results show three critical areas (in the northwest, center and south of the city) with greater accident frequency. Environmental factors that were associated with the occurrence of accidents were the presence of street lighting (23% greater), the presence of a tree close to the road (47% greater), the presence of a traffic light (28% greater), and if the road was a major avenue (122% greater) and had curves (129% greater). This study shows the city of Resistencia to be in a situation of urban vulnerability due not only to its socioeconomic status but also to the unequal development compared to neighboring cities, a reality that fosters an unfavorable environment.Los accidentes de tránsito constituyen un problema emergente en ciudades con alta movilidad y baja planificación urbana. No existe suficiente evidencia en Argentina acerca de la relación entre el entorno y la ocurrencia de accidentes. Por ello, realizamos un análisis espacial de ocurrencia y estimamos el riesgo de ocurrencia de accidentes en el año 2012 y su posible asociación con las características del entorno físico en la ciudad de Resistencia, provincia del Chaco, Argentina. Para el análisis espacial de los accidentes se utilizó la estimación de densidad kernel. Luego, a través de un estudio observacional y analítico se procedió a analizar los factores asociados a la ocurrencia de los accidentes. Los resultados muestran que existen tres zonas críticas (noroeste, centro y sur) con mayor frecuencia de accidentes. Los factores del entorno que estuvieron asociados con la ocurrencia de accidentes fueron la presencia de iluminación vial (23% menor), árbol próximo a la calzada (47% mayor), la presencia de semáforo (28% mayor), avenidas (122% mayor) y disposición curva de la calzada (129% mayor). Este estudio ubica a la ciudad de Resistencia en una situación de vulnerabilidad urbana, no solo por el contexto socioeconómico donde se encuentra sino por el desigual desarrollo territorial que presenta respecto a las ciudades vecinas, que propicia un entorno desfavorable