56 research outputs found
Type 2 Diabetes Mellitus and Demodex folliculorum Infestation: A Cross-Sectional Study in Peruvian Patients
"Background: Demodex folliculorum is a mite that causes human demodicosis, which is characterized by producing lesions on the face, and its infestation could be associated with factors that alter the immune response, including Type 2 Diabetes (T2D). This study aimed to evaluate the relationship between T2D and D. folliculorum infestation in patients attended at a hospital in Peru in 2021.
Methods: A cross-sectional study enrolling patients who were classified according to the presence (n = 100) and absence (n = 100) of T2D was conducted. Information was obtained on age, sex, domestic animal husbandry, and symptoms and signs associated with demodicosis. Demodicosis was determined to be present when counts of D. folliculorum greater than five mites per cm2 were found in superficial facial skin biopsies.
Results: A frequency of demodicosis in 76 and 35 patients with and without T2D, respectively, was observed. In the multivariate analysis adjusted for confounders age, sex, and domestic animal husbandry, T2D was found to be associated with D. folliculorum infestation (PR: 2.13; 95% CI95: 1.42-3.19).
Conclusions: T2D was associated with D. folliculorum infestation. In this sense, it is important to strengthen surveillance to identify of D. folliculorum infestation in people with T2D.
"Relationship between Butyrylcholinesterase Activity and Cognitive Ability in Workers Exposed to Chlorpyrifos"
"Background. The use of Chlorpyrifos leads to a public, environmental, and occupational
health problem associated with adverse effects in the exposed population, generating alterations
mainly in the central nervous system, such as cognitive function. This study aimed to estimate the
association between butyrylcholinesterase activity (BChE) and cognitive ability in workers exposed
to chlorpyrifos. Methods. We designed a cross-sectional study, where we measured BChE in serum
samples as an indicator of exposure to chlorpyrifos. The cognitive ability was assessed by the
mean score of the Peruvian version of the Mini-Mental State Examination (MMSE). We also used a
questionary to collect demographic and occupational information. Results. We evaluated 120 farmers
with a predominance of males (92%) and a mean age of 32.1 ± 9.0 years. We found most of the
workers in fumigation activities (84%). The mean BChE was 6144.7 ± 2355.0 U/L, and 46% presented
inhibition enzyme (<5500 U/L). The median MMSE score was 28 (interquartile range: 26.5–31.5; 6%
showed an alteration in cognitive ability (score < 24)). The MMSE test found a significant association
between BChE inhibition and MMSE score (β: −0.071, 95%CI: −0.108 to −0.025). Conclusion. In this
study, 45.8% of workers exposed to chlorpyriphos presented BChE inhibition. The BChE inhibition is
significantly associated with the MMSE score in workers exposed to chlorpyrifos.
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
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.
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.
Characteristics of theses Characteristics of theses for physician graduation: a cross-sectional study in Peru
Introduction Research in Peru presents several barriers that impede its development and that also affects the theses to graduate as physician. Our objective was to characterize the theses for obtaining a medical degree in Peru. Methods An observational and descriptive study evaluating the theses for obtaining a medical degree of 2019, evaluated in January 2022 from 22 universities that are full members of the Peruvian Association of Faculties of Medicine. Characteristics of the universities and theses were evaluated, including the evaluation of a institutional research ethics committee , the aligment with a national research priority, and publication status in a scientific journal. The absolute and relative frequencies of the study variables were described. Results A total of 1838 theses were evaluated. Most of the theses were written by a single student (66.16%). The most common study design was the descriptive cross-sectional type (42.33%). We found that 53.86% of the theses responded to a national research priority, the most common being "maternal, perinatal and neonatal health" (26.01%). Of the total, 56.75% did not indicate whether they had the approval of an institutional research ethics committee. Only 40 theses (2.19%) were published in a scientific journal (14 in indexed journals). Conclusion Two-thirds of the theses conducted by medical students in Peru are descriptive studies. Half respond to national research priorities. Four out of ten theses were approved by an institutional research ethics committee. The number of published theses is low. The results show shortcomings in university institutional policies that encourage ethical compliance and research development
Utility of massive open online courses (MOOCs) concerning outbreaks of emerging and reemerging diseases
ABSTRACT
The emergence and re-emergence of infectious diseases such as Ebola, chikungunya, and Zika increase the necessity of knowledgeable and skilled health professionals. Massive open online courses (MOOCs) arise as opportunities that allow people around the world to participate in higher education courses. A search was conducted on specialized MOOC platforms to find courses related to outbreaks, using terms included in the list of the WHO disease outbreaks from January 1st to December 31st, 2016. We found seven courses about Ebola, two about Zika, three about the dynamics of epidemics and pandemics, and only one course about dengue, chikungunya, and malaria. Most of the courses were conducted in English. The courses on Ebola, Zika and chikungunya were released after their last outbreak. MOOCs could be used to learn about health issues of global relevance, and with the necessity of fast divulgation of knowledge and skills. Translating the courses into more languages could give these courses more traction, and allow participation of professionals in regions affected by these outbreaks
Prevalence and Factors Associated with Gaming Disorder in Latin America and the Caribbean: A Systematic Review
"We aimed to determine the prevalence and factors associated with gaming disorder (GD)
in the population of Latin America and the Caribbean (LAC). A systematic review was performed
(PROSPERO protocol registration: CRD42021230565). We included studies that identified participants
with GD and/or factors associated with this condition, reported the prevalence of GD, or contained
data that assisted in its estimation, were published after 2013 (the year of inclusion of GD in the
Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders) and were carried out
in a population residing in an LAC country. Evaluation of the quality of the studies was carried
out using the Joanna Briggs Institute Critical appraisal checklist tool. A qualitative synthesis of the
data was performed. Of the total of 1567 records identified, 25 passed the full-text review phase,
and 6 met the selection criteria. These studies were published between 2018 and 2021 and had a
cross-sectional design (three in Brazil, one in Ecuador, Mexico, and the other was multi-country,
including a LAC country [Peru]). The prevalence of GD ranged from 1.1% to 38.2%. The three studies
in Brazil had the highest figures of GD prevalence (20.4–38.2%). Four studies evaluated factors
associated with GD. Characteristics regarding the game (type), pattern of use (hours played), as well
as gender (higher in men), tobacco and alcohol consumption, poor interpersonal relationships, and
the presence of mental disorders were found to be associated with GD in LAC. Evidence on the
prevalence and factors associated with GD in LAC is limited. Studies on GD in LAC evaluate different
population subgroups, describing a wide prevalence of this condition (present in up to 38 out of
100 evaluated). Characteristics such as the type and hours of use of the games, sociodemographic data,
lifestyles, interpersonal relationships, and the presence of mental disorders increase the probability of
presenting GD.
Access to HIV/STI testing among male and female Venezuelan migrants in Peru: evidence from a nationwide survey
Background: Human immunodeficiency virus (HIV) infection and sexually transmitted infections (STIs) are major global public health issues. Migrants represent a vulnerable group that faces multiple barriers to access to healthcare services, including HIV/STI testing. This study aimed to assess the factors associated with access to HIV/STI testing in male and female Venezuelan migrants in Peru. Methods: This was a cross-sectional study involving secondary data analysis of the 2022 Venezuelan Population Residing in Peru Survey. The study was conducted in the eight most populated cities inhabited by Venezuelan migrants and refugees. For each city, the sampling design was probabilistic, stratified, and independent. The outcome variable was whether participants had access to HIV or other STI testing during their stay in Peru. Statistical analysis was stratified by sex owing to potential effect modification. Crude and adjusted prevalence ratios were calculated using generalized linear models Poisson family with log link function. Confidence intervals were calculated to 95%. Results: A total of 3,723 male and 3,984 female migrants were included. Access to HIV/STI testing among male and female migrants was 19.85% and 25.16%, respectively. Among male migrants, being LGBTI, health insured, and married or cohabiting were associated with increased access to HIV/STI testing. Among females, those aged 18–44 years, those who were married or cohabiting and were health insured, and those residing for more than 1 year in Peru were significantly more likely to have access to HIV/STI testing. Moreover, physical/mental disability and unemployed status were associated with a lower probability of HIV/STI testing in females. Conclusions: Only two in ten Venezuelan migrants and refugees in Peru were screened for HIV/STI, with fewer males than females. Sex-specific sociodemographic, health-related, and migration-related variables were independently associated with access to HIV/STI testing
Cursos en línea abiertos y masivos: oportunidad de aprendizaje sobre salud global en Latinoamérica
Introducción. Los cursos en línea, masivos y abiertos, brindan la oportunidad de formar profesionales e investigadores en Latinoamérica sobre salud global.
Objetivos. Determinar la oferta global de los cursos en línea, masivos y abiertos, sobre salud global y conocer las características de su contenido.
Materiales y métodos. Se examinaron las plataformas especializadas en cursos en línea, masivos y abiertos, para recopilar aquellos sobre salud global. La búsqueda no tuvo restricción de tiempo y se realizó por última vez en noviembre de 2021. La estrategia de búsqueda solo incluyó el descriptor “global health”. Posteriormente, se obtuvieron las características del curso, su contenido y el dominio abordado de salud global. Estos datos fueron analizados descriptivamente, y se reportaron frecuencias absolutas y relativas.
Resultados. La estrategia de búsqueda identificó 4.724 cursos en línea, masivos y abiertos. De ellos, solo 92 estaban relacionados con salud global. La mayoría de estos cursos (n=44; 47,8 %) se ofrecieron mediante la plataforma Coursera. Más de la mitad de los cursos (n=50; 54,4 %) fueron realizados por instituciones de Estados Unidos y en idioma inglés (n=90; 97,8 %). La mayor parte de los cursos se centró en la “globalización de la salud y la asistencia sanitaria” (n=24; 26,1 %), seguido de los dominios “fortalecimiento de capacidades” (n=16; 17,4 %), “carga global de enfermedad” y “determinantes sociales y ambientales de la salud” (n=15; 16,3 %).
Conclusiones. Se encontró una importante oferta de cursos en línea, masivos y abiertos, sobre salud global. Estos cursos abordaron las competencias de la salud global que se requieren para los profesionales sanitarios
- …