A systematic review of mental health in rural Andean populations in Latin America during the COVID-19 pandemic

BackgroundCOVID-19 has been causing mental health problems around the world, with rural and indigenous peoples likely to be the most affected. This systematic review synthesizes and critically analyzes the existing literature on mental disorders in the rural Andean population in Latin America.MethodsA systematic review with narrative synthesis was carried out following the PRISMA guidelines. We searched nine databases (PubMed/MEDLINE, Scopus, EMBASE, ScienceDirect, Web of Science, Cochrane, Scielo, LILACS, and Latindex), five public prepublication servers (SocArXiv, medRxiv, bioRxiv, SportRXiv, and Preprints), ALICIA, and Google Scholar for articles that included the analysis of mental health problems using data collected from the rural Andean population in Latin America. These were eligible for inclusion. Articles that included Non-Latin American populations (including European or African migrants) and studies conducted prior to the COVID-19 pandemic (since the declaration of national lockdown) were excluded.ResultsA total of 23,761 articles were retrieved, 14 of which met the inclusion requirements. Most were cross-sectional (n = 12) and related to anxiety (n = 9), depression (n = 8), and stress (n = 5). The mental health analysis of 5,976 rural dwellers from four countries in Latin America also included gray literature studies (n = 7) that allowed the quantification of mental health problems in adults (n = 7) and adolescents/children (n = 4). Only one study was multinational, and the quality of publications varied. Despite the high frequency of anxiety, depression, and stress symptoms among rural Latin American populations during COVID-19, published research is very limited. This review found preliminary evidence that the frequency of anxiety (45%), depression (27.6%), and stress (33.1%) in the rural population was associated with pandemic restrictions across countries. Measures of other psychiatric problems, such as distress or suicidal ideation, cannot be estimated.ConclusionRegional-wide studies investigating changes in the frequency of symptoms of mental health problems in the context of the COVID-19 pandemic are warranted to inform culturally adapted prevention strategies. This study is limited to a narrative synthesis and may be subject to publication bias.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=320489

Where Do Medical Students Look for Information? A Study on Scientific Consultation Sources in Peru

"Introduction: Scientific consultation sources is essential in the quality of information during medical training worldwide. The sources of consultation should provide quality information to students who begin with clinical courses; however, it is unknown how and where students seek data in all medical schools in Peru. In this study, we determine the most frequent sources of scientific consultation of medical students at Norbert Wiener University. Materials and methods: We conducted a survey-based observational study in 148 volunteers (mean age 22.1±5.4 years) during 2019. A 21-items questionnaire was divided into three components: demographic data (10 questions), scientific consultation sources (7 questions), and Information search engines (4 questions). Results: Eighty (54.1%) students were between 20-30 years, and 26.8% worked < 20 hours per week. The scientific search sources considered very usefully were scientific articles (75.4%) and specialized books (49.3%), while 33% did not know Medscape. Regarding audiovisual sources, documentaries on the history of medicine and YouTube were considered useful in 41% and 48%, respectively. We found differences in the use of consultation sources (p =0.031), Medscape (p =0.001), documentaries (p=0.009), and YouTube (p=0.022) among medical years. Sixty-three percent considered Wikipedia useful, and 19.3% used PubMed, while Google was the most frequent information search engine, followed of Scielo and Google scholar. We found a correlation between year of students and SciELO (p=0.024) and Google (p=0.024) engine use. Conclusions: Our results suggest that scientific articles, specialized books and audiovisual sources (documentaries and YouTube) were convenient for medical students. In addition, we have found that as students’ progress through the years in medical school, they make less use of rigorous scientific reference sources.

Quality of life in families under quarantine: a cross-sectional study in seven countries during the first outbreak of COVID-19

BackgroundThe COVID-19 pandemic has disrupted human well-being worldwide in unforeseen ways. In early 2020, the spread of the virus left its mark on every affected country, impacting mental health by limiting daily activities and causing fatalities amidst public health strategies to mitigate its impact. The influence of COVID-19 on the quality of life (QoL) may vary between countries, underscoring the need to examine its effects on individuals and families during the mandatory home quarantine. We aimed to assess the QoL of individuals and families during home isolation by COVID-19 lockdown.MethodsA cross-sectional study was conducted from February to May 2020. We included adult partners (≥18 years) of families from Brazil, Colombia, Spain, Japan, Peru, Russia, and Venezuela. Using the 26-item World Health Organization Quality of Life Brief (WHOQOL-BREF) questionnaire we assess the impact of COVID-19 on their partner/family member’s QoL.ResultsThe survey was completed by 466 participants (mean age = 38.59 ± 13.75 years; females = 298) and 76% worked mostly as health professionals from South America (69.2%), Europe (18.4%), and Asia (12.4%). The WHOQOL-BREF mean score from 38.38 ± 11.55 (range = 22.8–43.4). The average quality of life in South America (41.9 ± 1.2) was significantly higher than that of European countries (30.9 ± 11.5) (p = 0.002). The social relations dimension was the only one with values close to 100 (mean = 83.3) in 6/7 evaluated countries, where only Spain had a low score (41 ± 33.12). Women had a slightly lower quality of life than men, but it was not significant (40.2 ± 8.8 vs. 41.5 ± 9.9, p = 0.354), while we found differences in the overall QoL between young and older, and by employment type (p &lt; 0.05). According to family structure, we found differences on QoL between nuclear and siblings’ families (p = 0.024).ConclusionFamilies from seven countries of three continents reported poor QoL during the first outbreak of COVID-19. The pandemic scenario has dramatically weakened the QoL in 3/4 dimensions, where social relationships have remained high. It is important to fully address the impact of this reduced QoL on families after several waves of infection and to provide comprehensive support in the post-COVID future

Alterations in the coagulation markers did not showdifferences with the severity of COVID‐19 in Peruvianpatients: A cross‐sectional single‐center study

Background and Aims:COVID‐19 is a pandemic disease that can lead to alteredlung function, systemic inflammatory events, and altered coagulation. During severestages of the disease, changes in coagulation homeostasis increase, leading tothrombosis, and increased risk of death. In this cross‐sectional study, we aimedto assess coagulation markers by COVID‐19 severity in Peruvian adults.Methods:During the second wave of infections, we included 186 adults diagnosedwith COVID‐19 (mean age 53.3 ± 16.3 years). Patients were divided into mild,moderate, and severe stages of COVID‐19, and coagulation markers includedprothrombin time (PT), activated partial prothrombin time (aPTT), fibrinogen,D‐dimer, and platelet count.Results:Of the total, 120 (64.5%) were males and 39 (21%) were in the intensivecare unit. We determine 104 (55.9%), 43 (24.7%), and 36 (19.4%) patients in mild,moderate, and severe stages of COVID‐19, respectively. In the severe stage ofCOVID‐19, patients had an average concentration of PT, aPTT, fibrinogen,D‐dimer,and platelets of 13.2 ± 0.9 s, 28.9 ± 4.3 s, 679.4 ± 185.1 mg/dL, 1.9 ± 3.1 μg/mL, and272.8 ± 88.9 cel/10 mm,3respectively. We found no differences in the concentra-tion of each marker according to severity (p< 0.05). Patients with severe COVID‐19had altered the aPTT, fibrinogen,D‐dimer, and PT in 31 (57.4%), 48 (88.9%), 37(68.5%), and 15 (27.8%) cases, respectively.Conclusions:Our results showed that although there is an alteration in coagulationmarkers, mainly fibrinogen andD‐fiber, there are no differences in concentrationaccording to the severity of COVID‐19

Assessing empathy in healthcare services: a systematic review of South American healthcare workers’ and patients’ perceptions

BackgroundEmpathy in healthcare service refers to the ability of healthcare workers (HCWs) to put themselves in patients’ shoes, which is necessary to ensure a good physician-patient relationship and provide quality care. Various studies have shown that empathy varies depending on the country, the instrument used, the evaluator, and the HCW’s specialty. This systematic review aims to estimate the levels of empathy among HCWs in South American countries between 2000 and 2019.MethodsWe conducted searches in 15 databases (PubMed, Scopus, Web of Science, EMBASE, Scielo, PsycoInfo, ScientDirect, Latindex, and LILIACS), four preprint servers (medRxiv, bioRxiv, SportRxiv, and Preprints), and other search engines such as Dimensions (20), Google Scholar, Yahoo!, and Alicia CONCyTec (c). We followed the PRISMA guidelines, and this study was registered in PROSPERO (CRD42023454007).ResultsOut of 18,532 documents identified from November 10 to 28, 2021, 10 articles were included (n = 2,487 participants, of which 1989 were patients). Among the studies focusing on self-evaluated empathy, four relied on the Jefferson Scale of Empathy for medical professionals (JSE-HP). However, assessments from patients employing Jefferson Scale of Patient’s Perceptions of Physician Empathy (JSPPPE) and Consultation and Relational Empathy (CARE) scale suggested high levels of empathy We found that both professionals and patients perceived that empathic care was provided, often at a medium or regular level. Surgery residents presented lower levels of empathy compared to obstetrics-gynecology and pediatrics physicians.ConclusionEmpathy is crucial in determining the quality of care and patient satisfaction during healthcare services provided by HCWs. Therefore, it is important to support professionals so that the various stressful situations they encounter in their work and daily life do not negatively influence the approach they provide to patients

"What is the perception of medical students about eLearning during the COVID-19 pandemic? A multicenter study in Peru"

"Introduction: As face-to-face medical education was restricted during the pandemic; digital tools have been deployed to continue education showing a good educational impact in most countries. However, the perception of medical students in Peru on eLearning has not yet been investigated. This study assessed the perception of 440 medical students from two national universities in Peru on the characteristics and limitations of eLearning during 2021. Materials and methods: We conducted a cross-sectional study using the self-administered survey Encuesta Virtual en Tiempos de COVID-19 (EVI-CV19) on students between the second and sixth medical year of the Universidad Nacional Mayor de San Marcos (UNMSM) and the Universidad Nacional San Luis Gonzaga (UNSLG, n=325). Results: The majority of students were under 30 years of age (93.9% vs. 97.2%, p=0.084), and female (67% vs. 64%, p=0.107). Of the total, 63.9% and 81.5% UNMSM and UNSLG students considered the virtual platform effective in favouring feedback with recorded lectures (85.2% vs. 85.5%) and the organization of documents (61.7% vs. 80.9%), respectively (p>0.05). Seventy per cent and 46.8% of UNMSM and UNSLG students perceived that teachers were nottrained (p=0.063), and 26.1% and17.2% of students perceived thatthe virtual modality affected their academic performance a lot, respectively (p=0.003). About 38% of students from both universities perceived the virtual platforms as very secure. We found differences between UNMSM and UNSLG students on whether the virtual exams were fair (28.7% vs. 52.3%, p<0.001). Conclusions: This study reported a favorable perception of medical eLearning with clear differences in the limitations of the virtual environment.

Deaths, infections, and herd immunity in the COVID-19 pandemic: a comparative study of the strategies for disease containment implemented in Peru and the United Kingdom

Introduction: In light of the threat posed by the COVID-19 pandemic, most countries have implemented several containment and prevention measures to slow down the rapid spread of the disease.Objectives: To compare the COVID-19 pandemic containment strategies implemented in Peru [World Health Or-ganization (WHO) - confinement and social distancing] and the United Kingdom [herd immunity (HI)] in terms of morbidity and mortality, and to simulate the implementation of HI in Peru during the initial stage of the pandemic.Materials and methods: Exploratory study with a simulation model based on official data obtained from both countries at the beginning of the pandemic. Mortality, case fatality, and infection rates documented within the first 55 days after the first COVID-19 case report in the United Kingdom and the start of the WHO-recommended containment and prevention strategy implementation in Peru were evaluated. Additionally, the impact of applying HI, according to WHO guidelines, as the initial strategy in Peru was simulated. The Paired-samples t-test was used to determine the differences between the two strategies at both stages of the study.Results: During the follow-up period, 15 034 and 33 931 COVID-19 cases were reported in the United Kingdom and Peru, respectively. The case fatality rate was higher in the United Kingdom (7.82% vs. 2.74%), while the cumulative mortality rate was higher in Peru (2.89 vs. 1.74×100 000 inhabitants p= 0.0001). Regarding the simulation, a minimum critical population of 60% (>19 million positive cases) was established for Peru to achieve HI, with 1 223 473.1 deaths and a hospitalization rate of 44 770×100 000 patients.Conclusions: During the follow-up period (55 days), the United Kingdom’s strategy resulted in a higher case fatality rate, while the Peruvian strategy in over twice as many COVID-19 cases. The HI simulation strategy in Peru showed a sharp increase in all unfavorable indicators of the pandemic.Campus Lima Centr

Alterations in the coagulation markers did not show differences with the severity of COVID-19 in Peruvian patients: A cross-sectional single-center study

Background and Aims:COVID‐19 is a pandemic disease that can lead to alteredlung function, systemic inflammatory events, and altered coagulation. During severestages of the disease, changes in coagulation homeostasis increase, leading tothrombosis, and increased risk of death. In this cross‐sectional study, we aimedto assess coagulation markers by COVID‐19 severity in Peruvian adults.Methods:During the second wave of infections, we included 186 adults diagnosedwith COVID‐19 (mean age 53.3 ± 16.3 years). Patients were divided into mild,moderate, and severe stages of COVID‐19, and coagulation markers includedprothrombin time (PT), activated partial prothrombin time (aPTT), fibrinogen,D‐dimer, and platelet count.Results:Of the total, 120 (64.5%) were males and 39 (21%) were in the intensivecare unit. We determine 104 (55.9%), 43 (24.7%), and 36 (19.4%) patients in mild,moderate, and severe stages of COVID‐19, respectively. In the severe stage ofCOVID‐19, patients had an average concentration of PT, aPTT, fibrinogen,D‐dimer,and platelets of 13.2 ± 0.9 s, 28.9 ± 4.3 s, 679.4 ± 185.1 mg/dL, 1.9 ± 3.1 μg/mL, and272.8 ± 88.9 cel/10 mm,3respectively. We found no differences in the concentra-tion of each marker according to severity (p< 0.05). Patients with severe COVID‐19had altered the aPTT, fibrinogen,D‐dimer, and PT in 31 (57.4%), 48 (88.9%), 37(68.5%), and 15 (27.8%) cases, respectively.Conclusions:Our results showed that although there is an alteration in coagulationmarkers, mainly fibrinogen andD‐fiber, there are no differences in concentrationaccording to the severity of COVID‐1

Image_1_A systematic review of mental health in rural Andean populations in Latin America during the COVID-19 pandemic.TIFF

BackgroundCOVID-19 has been causing mental health problems around the world, with rural and indigenous peoples likely to be the most affected. This systematic review synthesizes and critically analyzes the existing literature on mental disorders in the rural Andean population in Latin America.MethodsA systematic review with narrative synthesis was carried out following the PRISMA guidelines. We searched nine databases (PubMed/MEDLINE, Scopus, EMBASE, ScienceDirect, Web of Science, Cochrane, Scielo, LILACS, and Latindex), five public prepublication servers (SocArXiv, medRxiv, bioRxiv, SportRXiv, and Preprints), ALICIA, and Google Scholar for articles that included the analysis of mental health problems using data collected from the rural Andean population in Latin America. These were eligible for inclusion. Articles that included Non-Latin American populations (including European or African migrants) and studies conducted prior to the COVID-19 pandemic (since the declaration of national lockdown) were excluded.ResultsA total of 23,761 articles were retrieved, 14 of which met the inclusion requirements. Most were cross-sectional (n = 12) and related to anxiety (n = 9), depression (n = 8), and stress (n = 5). The mental health analysis of 5,976 rural dwellers from four countries in Latin America also included gray literature studies (n = 7) that allowed the quantification of mental health problems in adults (n = 7) and adolescents/children (n = 4). Only one study was multinational, and the quality of publications varied. Despite the high frequency of anxiety, depression, and stress symptoms among rural Latin American populations during COVID-19, published research is very limited. This review found preliminary evidence that the frequency of anxiety (45%), depression (27.6%), and stress (33.1%) in the rural population was associated with pandemic restrictions across countries. Measures of other psychiatric problems, such as distress or suicidal ideation, cannot be estimated.ConclusionRegional-wide studies investigating changes in the frequency of symptoms of mental health problems in the context of the COVID-19 pandemic are warranted to inform culturally adapted prevention strategies. This study is limited to a narrative synthesis and may be subject to publication bias.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=320489.</p

sj-doc-1-smo-10.1177_20503121241245069 – Supplemental material for Prolonged grief in relatives of deceased patients due to COVID-19 is associated with anxiety and depressive symptoms: A survey-based study in Peru

Supplemental material, sj-doc-1-smo-10.1177_20503121241245069 for Prolonged grief in relatives of deceased patients due to COVID-19 is associated with anxiety and depressive symptoms: A survey-based study in Peru by Jeel Moya-Salazar, Elizabeth Soto, Betsy Cañari, Eliane A Goicochea, Nahomi Zuñiga, Alexis Jaime-Quispe and Hans Contreras-Pulache in SAGE Open Medicine</p