Factors associated with the intention to participate in COVID-19 vaccine clinical trials: A cross-sectional study in Peru

Objective: To evaluate the factors associated with the intention to participate in COVID-19 vaccine clinical trials in the Peruvian population. Methods: Cross-sectional study and secondary analysis of a database that involved Peruvian population during September 2020. The Poisson regression model was used to estimate the associated factors. Results: Data from 3231 individuals were analyzed, 44.1% of whom intended to participate in COVID-19 vaccine clinical trials. Factors associated with the outcome were being male (RPa: 1.25; 95% CI: 1.15–1.35), being from the highlands region (RPa: 1.18; 95% CI: 1.09–1.28) or jungle (RPa: 1.30; 95% CI: 1.15–1.47), having a relative that is a healthcare professional (PRa: 1.16; 95% CI: 1.06–1.28), using a medical source of information (PRa: 1.28; 95% CI: 1.17–1.41), and trusting in the possible effectiveness of vaccines (PRa: 1.40; 95% CI: 1.29–1.51). The main reason for not participating in the trial was the possibility of developing side effects (69.80%). Conclusion: There is an urgent need to generate a perception of safety in COVID-19 vaccine clinical trials, to increase the population's intention to participate in these studies, and to provide evidence-based information about the vaccine.Revisión por pare

Producción científica en Scopus de los institutos de salud especializados públicos de Perú, 2010-2022

Objective: To evaluate the scientific production of Peruvian health institutes in Scopus, 2010-2022. Methods: We conducted a Bibliometric study in Scopus during September 2022, in 14 public specialized health institutes of Peru. We included original studies with at least one author from one of the institutes. Results: The institutes included published between 0 and 347 original articles (H-index between 0 and 51). The institutes in the city of Lima were the ones with the highest production. In the seven institutes with the highest production, the percentage of articles with a corresponding author from the institute evaluated ranged from 22.3% to 36.7%, and the percentage of studies that reported being financed by the institute ranged from 0% to 11.6%. Conclusion: The scientific production of the evaluated institutes was heterogeneous, with a predominance of those located in Lima. The institutes rarely participated in the financing of the published studies.Objetivo: Evaluar la producción científica de los institutos de salud de Perú en Scopus, 2010-2022. Métodos: Estudio bibliométrico realizado en Scopus durante septiembre del 2022, en 14 institutos de salud especializados públicos de Perú. Incluimos estudios originales que tuvieran al menos un autor de alguno de los institutos. Resultados: Los institutos incluidos publicaron entre 0 y 347 artículos originales (H-index entre 0 y 51). Los institutos de la ciudad de Lima fueron los que tuvieron mayor producción. En los siete institutos con mayor producción, el porcentaje de artículos con autor corresponsal del instituto evaluado varió entre 22.3% y 36.7%, y el porcentaje de estudios que declararon ser financiados por el instituto varió entre 0% y 11.6%. Conclusión: La producción científica de los institutos evaluados fue heterogénea, a predominio de aquellos ubicados en Lima. Los institutos raramente participaron en el financiamiento de los estudios publicados

Prevention and control practices against Sars-Cov2 infection in the peruvian population

Objetive: To describe the prevention and control practices for the infection to SARS-COV2 in the Peruvian population. Material and Methods: Observational descriptive study. We evaluated a non-probabilistic sample of adult residents in some departments of Peru. Preventive practices were evaluated in people without a history of COVID-19 and control practices in people who had suffered it. Results: We evaluated 3630 Peruvians (mean age 25.4 ± 9.5), of that 3231 don't have a history of COVID-19 and 399 who had suffered it. The prevention and control practices that were realized often or always, with more frequencies, was the use of a mask when they go out home (97.9% vs 87.7), cover their nose or mouth when they sneeze (95.4% vs 89.9%), save the distance to other people in the street (91.4% vs 74.7%), wash their hands when they came home (92.5% vs 88.7%), and disinfect the objects and personal places (82.6% vs 77.4%). The 22.1% and 83.7%, the 59.7% and 80.2, and the 8.0% and 16.8% consumed some type of medicine, medicinal plant, and chlorine dioxide to prevent and control the infection, respectively. Conclusion: In general, less than 50% of the participants performed prevention and control practices against COVID-19 often or always.Revisión por pare

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Enfermedad de Carrión una enfermedad estancada en el tiempo

La bartonelosis conocida como la enfermedad de Carrión, Verruga peruana o fiebre de la Oroya, describe las consecuencias patológicas de la infección humana por Bartonella bacilliformis. Además, se han informado tasas de letalidad del 2,4% (2019), siendo la mayoría de los casos registrados en Perú, documentados en los departamentos de Amazonas, Cajamarca, Áncash, Ayacucho y La Libertad, con mayor incidencia en niños y adolescentes. En la primera fase de la infección, el patógeno causa una fiebre hemolítica ("fiebre de la Oroya") con tasas de letalidad de aproximadamente ~90% en pacientes no tratados, seguida de una fase crónica que resulta en lesiones cutáneas angiogénicas (“verruga peruana”). Siendo la forma de transmisión mediante los mosquitos hembra del género lutzomia verrucarum y el único reservorio conocido de esta antigua enfermedad, los seres humanos. Los métodos de diagnósticos están reservados a técnica de PCR (reacción en cadena de polimerasa), hemocultivo e inmunoanálisis; siendo en orden de importancia el uso los métodos de secuenciación de bases e inmunoensayos. En la presente revisión, proporcionamos el conocimiento actual sobre B. bacilliformis y sus factores de patogenicidad, vectores, modelos de infección establecidos, potenciales aspectos inmunológicos de la enfermedad, métodos de diagnóstico y tratamiento

Análisis de producción, impacto y redes de colaboración en investigaciones científicas en Scopus en Perú de 2000 a 2019

Introduction Peru is a developing country with increasing scientific production. However, it is necessary to understand the trends, impact, and collaborative networks of research to plan for policy improvements. Objective We analyzed the production, impact, and collaboration networks in the Peruvian scientific production between 2000 and 2019. Methods We did an observational analytical study. We searched Scopus for all the publications with at least one author with a Peruvian affiliation declared in the author byline. A descriptive analysis of the different characteristics, trends, and scientific collaboration was carried out. Collaboration networks were plotted using VOSviewer. Results Between 2000 and 2019, Peru had a total of 24 482 publications in scientific journals, with an average annual growth of 13.6%. Of the total, 70% of all the articles were cataloged as Clinical Medicine and Biomedical Sciences. Only half of the articles had a Peruvian affiliation. The countries with the largest share of collaboration were the United States and Brazil, and the articles with international collaboration had the highest number of citations per publication. Conclusions Scientific production in Peru has increased in recent years, with a significant percentage of publications based on international collaboration and led by authors with non-Peruvian affiliations. It is necessary to strengthen collaboration ties between Peruvian and foreign institutions. Furthermore, it is essential to propitiate further research that will help solve the country's problems

Level of Knowledge Regarding Mpox among Peruvian Physicians during the 2022 Outbreak: A Cross-Sectional Study

Introduction: Due to the high incidence of mpox in Peru and the poor knowledge about this disease among healthcare workers in non-endemic countries, it is crucial to determine the knowledge status of Peruvian physicians. Methodology: We conducted an analytical cross-sectional study based on an online survey from August to September 2022. Physicians who had a medical license and lived and practiced medicine in Peru were included. To evaluate the factors associated with a higher level of knowledge, we used crude (cPR) and adjusted (aPR) prevalence ratios with 95% confidence intervals (95% CI) using Poisson regression. Results: We included 463 physicians. The mean age was 36.6 (SD: 10.3) years, and most were male (58.1%). Regarding knowledge, the median knowledge score was 14 [IQR: 13 to 15] out of 17 points. In terms of knowledge gaps, only 60.7% of the participants knew that there was an FDA-approved vaccine for mpox, 49.0% of participants knew about mpox proctitis and 33.3% acknowledged that it could be transmitted by the bite of an infected rodent. We found that taking care of patients with mpox (aPR: 1.39; 95% CI: 1.13 to 1.72) was associated with higher knowledge (>p50), while living in the eastern macro-region (aPR: 0.62; 95% CI: 0.42 to 0.93) was associated with lower knowledge (≤p50). Conclusions: Our study showed a high level of knowledge about mpox among Peruvian physicians. However, educational campaigns may be necessary, especially for physicians from the eastern region and those who do not have clinical experience with mpox

Nivel de conocimiento sobre Mpox entre médicos peruanos durante el brote de 2022: un estudio transversal

Introduction: Due to the high incidence of mpox in Peru and the poor knowledge about this disease among healthcare workers in non-endemic countries, it is crucial to determine the knowledge status of Peruvian physicians. Methodology: We conducted an analytical cross-sectional study based on an online survey from August to September 2022. Physicians who had a medical license and lived and practiced medicine in Peru were included. To evaluate the factors associated with a higher level of knowledge, we used crude (cPR) and adjusted (aPR) prevalence ratios with 95% confidence intervals (95% CI) using Poisson regression. Results: We included 463 physicians. The mean age was 36.6 (SD: 10.3) years, and most were male (58.1%). Regarding knowledge, the median knowledge score was 14 [IQR: 13 to 15] out of 17 points. In terms of knowledge gaps, only 60.7% of the participants knew that there was an FDA-approved vaccine for mpox, 49.0% of participants knew about mpox proctitis and 33.3% acknowledged that it could be transmitted by the bite of an infected rodent. We found that taking care of patients with mpox (aPR: 1.39; 95% CI: 1.13 to 1.72) was associated with higher knowledge (>p50), while living in the eastern macro-region (aPR: 0.62; 95% CI: 0.42 to 0.93) was associated with lower knowledge (≤p50). Conclusions: Our study showed a high level of knowledge about mpox among Peruvian physicians. However, educational campaigns may be necessary, especially for physicians from the eastern region and those who do not have clinical experience with mpox.Introducción: Debido a la alta incidencia de la mpox en Perú y al escaso conocimiento sobre esta enfermedad entre los trabajadores de la salud en países no endémicos, es crucial determinar el estado de conocimiento de los médicos peruanos. Metodología: Realizamos un estudio transversal analítico basado en una encuesta en línea de agosto a septiembre de 2022. Se incluyeron médicos que tenían licencia médica y residían y ejercían la medicina en Perú. Para evaluar los factores asociados a un mayor nivel de conocimiento se utilizaron razones de prevalencia crudas (cPR) y ajustadas (aPR) con intervalos de confianza del 95% (IC 95%) mediante regresión de Poisson. Resultados: Se incluyeron 463 médicos. La edad media fue de 36,6 (DE: 10,3) años y la mayoría eran hombres (58,1%). En cuanto a los conocimientos, la mediana de la puntuación de conocimientos fue de 14 [RIC: 13 a 15] sobre 17 puntos. En cuanto a las lagunas de conocimiento, solo el 60,7 % de los participantes sabía que existía una vacuna contra la mpox aprobada por la FDA, el 49,0 % de los participantes conocía la proctitis por mpox y el 33,3 % reconocía que podía transmitirse por la picadura de un roedor infectado. Encontramos que cuidar a pacientes con mpox (RPa: 1,39; IC 95%: 1,13 a 1,72) se asoció con un mayor conocimiento (>p50), mientras vivan en la macrorregión oriental (RPa: 0,62; IC 95%: 0,42 a 0,93) se asoció con un menor conocimiento (≤p50). Conclusiones: Nuestro estudio mostró un alto nivel de conocimiento sobre la mpox entre los médicos peruanos. Sin embargo, pueden ser necesarias campañas educativas, especialmente para los médicos de la región oriental y aquellos que no tienen experiencia clínica con la mpox