Efectos de los beneficios tributarios del IGV en el sector agropecuario: un análisis a nivel de hogares Perú 2015 – 2019

En esta tesis, el objetivo es analizar si la exoneración del IGV a los productos agropecuarios ha logrado mejorar el bienestar del productor agropecuario. El bienestar se mide mediante el ingreso y gasto anualizado de los productores. Para ello se usó la ENAHO en panel de datos del 2015 al 2019, conteniendo 15,112 datos efectivos para el modelo de ingresos y 34,157 datos para el modelo de gasto. Se emplearon dos modelos, uno de diferencias en diferencias y otro de regresión en doble diferencia, donde la variable tiempo por tratamiento (tt) fue el indicador de efecto de la exoneración. Los resultados en diff en diff, indican que los ingresos de los productores agrarios exonerados, han mejorado y reducido su brecha en el tiempo, respecto a los productores no agrarios. La diferencia estimada fue de 1,819 soles, donde los que más ganan son los no agrarios. Esta misma estimación en regresión usando otros controles, resultó en una diferencia de 1,925 soles. En cuanto al gasto monetario, los hogares de productores agrarios, han tenido un menor gasto que aquellos no agrarios, la brecha se ha ido ampliando en el tiempo, resultando de -486 soles en el modelo diff en diff, mientras que la regresión estimó una diferencia de -960 soles. En ambos casos la variable “tt” fue significativa y los modelos tenían buen ajuste. Finalmente se encuentra que las evidencias de las exoneraciones tributarias del IGV, son parciales y algo regresivas

Mobilizing digital technology to implement a population-based psychological support response during the COVID-19 pandemic in Lima, Peru

Abstract Background The COVID-19 pandemic caused considerable burden on mental health worldwide. To address this emergency in Peru, Socios en Salud (SES) implemented an innovative digital system for the diagnosis and psychological therapy in vulnerable populations. We describe the development, implementation, and participant outcomes of this intervention. Methods We conducted an intervention in a general population of Lima, Peru using a digital tool, ChatBot-Juntos, incorporating the abbreviated Self-Reporting Questionnaire (SRQ) to screen psychological distress. Participants positive for psychological distress received remote Psychological First Aid (PFA) and grief therapy if needed. Participants with a mental health condition or safety concern were referred to mental health services. SRQ scores were collected 3 months after PFA sessions. Differences between screening and follow-up scores were compared using Wilcoxon sign-rank test. Results In total, 2027 people were screened; 1581 (77.9%) screened positive for psychological distress. Nine hundred ninety-seven (63%) people with psychological distress received PFA, and 320 (32.1%) of those were also referred for mental health care. At 3 months after follow-up, SRQ scores were collected for 579 (58%) participants. Significant reduction in SRQ scores was observed 3 months after PFA [median SRQ score changed from 9 to 5 (p < 0.001)], and after PFA plus referral to mental health services [median SRQ score changed from 11 to 6 (p < 0.001)]. Conclusion Digital technology can be used to screen for psychological distress and deliver mental health support for populations affected by the COVID-19 pandemic. More research is needed to determine whether technology contributes to improved mental health outcomes

Impact of HIV on mortality among patients treated for tuberculosis in Lima, Peru: a prospective cohort study

Background: Human immunodeficiency virus (HIV)-associated tuberculosis deaths have decreased worldwide over the past decade. We sought to evaluate the effect of HIV status on tuberculosis mortality among patients undergoing treatment for tuberculosis in Lima, Peru, a low HIV prevalence setting. Methods: We conducted a prospective cohort study of patients treated for tuberculosis between 2005 and 2008 in two adjacent health regions in Lima, Peru (Lima Ciudad and Lima Este). We constructed a multivariate Cox proportional hazards model to evaluate the effect of HIV status on mortality during tuberculosis treatment. Results: Of 1701 participants treated for tuberculosis, 136 (8.0 %) died during tuberculosis treatment. HIV-positive patients constituted 11.0 % of the cohort and contributed to 34.6 % of all deaths. HIV-positive patients were significantly more likely to die (25.1 vs. 5.9 %, P < 0.001) and less likely to be cured (28.3 vs. 39.4 %, P = 0.003). On multivariate analysis, positive HIV status (hazard ratio [HR] = 6.06; 95 % confidence interval [CI], 3.96–9.27), unemployment (HR = 2.24; 95 % CI, 1.55–3.25), and sputum acid-fast bacilli smear positivity (HR = 1.91; 95 % CI, 1.10–3.31) were significantly associated with a higher hazard of death. Conclusions: We demonstrate that positive HIV status was a strong predictor of mortality among patients treated for tuberculosis in the early years after Peru started providing free antiretroviral therapy. As HIV diagnosis and antiretroviral therapy provision are more widely implemented for tuberculosis patients in Peru, future operational research should document the changing profile of HIV-associated tuberculosis mortality

Identificación de especies de levaduras del género Candida aislados aislados de exudados vaginales de pacientes en el Hospital Materno Germán Urquídi

Objectives: the purpose of this study is to identify the Candida species. Methods: we made the identification of 103 strains of yeasts isolated from vaginal swabs of patients treated at Hospital Materno Infantil Germán Urquídi from February to September 2009, for identification, conventional microbiological methods were used as germ tube , production of chlamydospores, mycelium formation and / or pseudomycelia, growth at 45 ° C, urease and other more specific methods such as CHROMagar candida and auxograma (API ID32C). Results: based on the data obtained it was determined that the percentage of Candida albicans was 62.1% (n = 64), followed by Candida glabrata 34.9% (36) and Candida krusei 3% (n = 3). Conclusions: if we perform an analysis of the data should be considered when interpreting conventional tests that non-albicans species may give results similar to Candida albicans and if it is the most frequently isolated species from vaginal secretions , is not negligible isolation of �non-albicans�species.Objetivos: el propósito de este estudio es identificar las especies de levaduras del Género Cándida. Métodos: con este fin se realizó la identificación de 103 cepas de levaduras aisladas a partir de exudados vaginales de pacientes atendidos en Consulta Externa del Hospital Materno Infantil Germán Urquídi entre Febrero - Septiembre 2009, para su identificación, se utilizaron métodos microbiológicos convencionales como: tubo germinativo, producción de clamidosporas, formación de micelio y/o pseudomicelio, crecimiento a 45ºC, ureasa y otros métodos más específicos como el CHROMagar cándida y el auxograma (API ID32C). Resultados: a partir de los datos obtenidos se determinó que el porcentaje de Cándida albicans fue de 62,1%(n=64), seguido de Cándida glabrata 34,9% (36) y Cándida krusei 3% (n=3). Conclusiones: realizando un análisis sobre los datos obtenidos debe considerarse que al momento de hacer la interpretación de las pruebas convencionales debe considerarse que las especies no albicans pueden dar resultados similares a Cándida albicans y que si bien es la especie aislada con mayor frecuencia de secreciones vaginales, no es despreciable el aislamiento de las especies �no albicans