Anemia infantil en poblaciones residentes en diferentes altitudes geográficas de Arequipa, Perú: factores maternos asociados

Objective: Determine the relationship between socio-demographic characteristics, knowledge, and good practices in anemic children and anemic child healthcare in Arequipa, Peru. Study design:  This is a cross-sectional survey. Participants were asked about their knowledge of childhood anemia, practices related to caring for anemic children, and adherence to treatment. Methods: This is a descriptive, transversal, relational field study. Three hundred mothers with anemic children were interviewed, from six districts of Arequipa, distributed at different geographic altitudes: medium-altitude, great-altitude, and sea level. Studied variables were related to socio-demographic factors, level of knowledge, anemic children care-related practices, and treatment adherence.  Results: 77.3% of children had mild anemia, 21.6% moderate, and 1% severe anemia. The number of children and disease severity were significantly related (p<0.05) to knowledge about anemia. Knowledge about anemia, living area, and geographic altitude were significantly correlated (p<0.05) with good practices in child anemia. Conclusion: the prevalence of anemia in the region of Arequipa is incremented by socio-economic factors, mother’s education, number of children, altitude, and geographic zone. The implementation of mother-centered educational programs by the government is necessary. In this sense, the results suggest further studies in social representations to understand, analyze and deepen the knowledge of the subject.Objetivo: Determinar la relación entre las características sociodemográficas, conocimientos y buenas prácticas en anemia infantil y la atención al niño anémico en Arequipa, Perú. Diseño del estudio: Se trata de una encuesta transversal. Se preguntó a los participantes sobre su conocimiento sobre la anemia infantil, las prácticas relacionadas con el cuidado de los niños anémicos y la adherencia al tratamiento. Métodos: Se trata de un estudio de campo, descriptivo, transversal, relacional. Se entrevistaron 300 madres con niños anémicos, de seis distritos de Arequipa, distribuidos en diferentes altitudes geográficas: mediana, gran y nivel del mar. Las variables estudiadas se relacionaron con factores sociodemográficos, nivel de conocimiento, prácticas relacionadas con el cuidado del niño anémico y adherencia al tratamiento. Resultados: El 77,3% de los niños presentaron anemia leve, el 21,6% moderada y el 1% anemia severa. El número de hijos y la gravedad de la enfermedad se relacionaron significativamente (p<0,05) con el conocimiento sobre la anemia. Los conocimientos sobre anemia, lugar de residencia y altitud geográfica se correlacionaron significativamente (p<0,05) con las buenas prácticas en anemia infantil. Conclusión: la prevalencia de anemia en la región de Arequipa se ve incrementada por factores socioeconómicos, escolaridad de la madre, número de hijos, altitud y zona geográfica. Es necesaria la implementación de programas educativos centrados en la madre por parte del gobierno. En ese sentido, los resultados sugieren profundizar los estudios en representaciones sociales para comprender, analizar y profundizar  el conocimiento del tema

Ethic Policy Forum: Inclusión de minorías étnicas latinoamericanas en los ensayos clínicos

Objetive: To analyze the normative and ethical aspects related to the inclusion of ethnic minorities in clinical trials in Latin America and the Caribbean. Methods: The results of the ethical and normative analysis carried out by the group of researchers in bioethics of the Ethic Policy Forum are presented; forum for analysis, discussion and formulation of proposals in policies and regulations related to aspects of ethics in research in the countries of Latin America and the Caribbean, constituted by the Institute for the Evaluation of Technologies in Health and Research of the Social Security of Health of Peru, the Universidad Católica Santa María de Arequipa, Peru and the International Network of Collective Health and Intercultural Health of the Autonomous University of the State of Mexico. Results: It is evident that ethnic minorities are not adequately represented in clinical trials in Latin America and the Caribbean and the regulations in this regard are not standardized, or do not exist in all the countries of the Region. Trials with ethnic minorities can have benefits but also potential risks and ethical conflicts, which require an adequate assessment of vulnerabilities, effective support in informed consent and the research process, by Research Ethics Committees trained in intercultural health and research ethics. research with indigenous peoples and Afro-descendants. Conclusion: Clinical trials should include ethnic minorities, with potential benefit from research products. Research must be developed under ethical and regulatory principles that protect these minorities.Objetivo: Analizar los aspectos normativos y éticos relacionados a la inclusión de las minorías étnicas en los ensayos clínicos en Latinoamérica y el Caribe. Métodos:  Se presentan resultados del análisis ético y normativo realizado por el grupo de investigadores en bioética, del Ethic Policy Forum;  foro de análisis, discusión y formulación de propuestas en políticas y normativas relacionadas con aspectos de ética en investigación en los países de Latinoamérica y el Caribe, constituido por el Instituto de Evaluación de Tecnologías en Salud e Investigación del Seguro Social de Salud del Perú,  la Universidad Católica Santa María de Arequipa, Perú y la Red Internacional de Salud Colectiva y salud Intercultural de la Universidad Autónoma del Estado de México. Resultados: Se evidencia que las minorías étnicas no están adecuadamente representadas en los ensayos clínicos en Latinoamérica y el Caribe y la normativa al respecto no está estandarizada, o no existe en todos los países de la Región. Los ensayos con minorías étnicas, pueden tener beneficios, pero también potenciales riesgos y conflictos éticos, que requieren una adecuada evaluación de las vulnerabilidades, acompañamiento efectivo en el consentimiento informado y proceso de investigación, por Comités de ética de investigación capacitados salud intercultural y en ética de la investigación con pueblos indígenas y afrodescendientes. Conclusiones: Los ensayos clínicos deben incluir a minorías étnicas, con potencial beneficio de los productos de investigación. La investigación debe desarrollarse bajo principios éticos y normativas que protejan a estas minorías

Fear of monkeypox and intention to vaccinate against monkeypox: a network analysis

Introduction: The presence of fear of an infectious disease triggers psychological factors associated with perceived behavioral control over vaccination acceptance, subjective norms of vaccination acceptance, attitudes toward vaccination acceptance, and perceived infectiousness from disease. Objective: The study evaluated how symptoms of fear of Monkeypox specifically relate to intention to be vaccinated against Monkeypox in a sample of 506 Peruvian individuals with a mean age of 27.11 years (SD = 9.77). Methods: Participants responded to the Monkeypox Fear Scale (MFS) and a single item of Intention to be vaccinated against Monkeypox. Using network analysis, central fear symptoms and associations between symptoms and intention to vaccinate were identified. Results: The results suggest that the node with the highest centrality was item 5 of the MFS. Regarding the connection between the intention to be vaccinated and the MFS items, a direct relationship was observed with item 1 and an inverse relationship with item 6. In addition, the relationship between these MFS items and intention to vaccinate is higher in men compared to women. While it would be expected that a greater presence of symptoms of fear of Monkeypox could lead people to have a greater intention to be vaccinated against the disease, the results could lead other researchers to generate evidence to explain this relationship in other Latin American countries. Discussion:  The evidence is useful for developing policies that favor vaccination against Monkeypox in Peru and other Latin American countries

Datos en tiempos de pandemia: la urgencia de un nuevo pacto. Reflexiones desde América Latina y el Caribe

Los avances de las Tecnologías de la Información y la Comunicación (TIC) permiten acceder en tiempo real a una cantidad ingente de datos, a través de los cuales es posible conocer el comportamiento de hechos sociales. En este escenario, la actual pandemia por SARS-CoV-2 ha permitido, bajo cuestionables criterios de inmediatez y urgencia, circular información que genera realidad e impacta en la toma de decisiones; y, además, ha favorecido la apropiación del dato, exponiendo a las personas a violaciones de sus derechos fundamentales. Ambos asuntos son sensibles para América Latina y el Caribe, región que hoy se presenta no sólo como el epicentro de la pandemia sino también de las desigualdades. La contribución que desde la reflexión y deliberación bioética puede realizarse en esta materia, adquiere especial relevancia con vistas a generar un nuevo pacto para el tratamiento de los datos.

Zero by 2030 and OneHealth: The multidisciplinary challenges of rabies control and elimination

"Rabies, caused by a negative strand RNA-virus belonging to the genus Lyssavirus (family Rhabdoviridae of the order Mononegavirales), remains of global concern [1]. This vaccine-preventable viral zoonotic disease is present in more than 150 countries and territories [2]. Ac- cording to the World Health Organization (WHO), rabies is estimated to cause ~59,000 human deaths annually, with 95% of cases occurring in Africa and Asia [3,4]. However, rabies still occurs in other regions, such as Latin America and the Caribbean [5–8], Central Asia and the Middle East [9,10]. Whilst a number of animals can host the rabies virus, dogs are the main source of human rabies deaths, contributing up to 99% of all rabies transmissions to humans. Dog-mediated rabies has been eliminated from Western Europe, Canada, the United States of America (USA), Japan and some Latin American countries [11]. Nevertheless, the risk of reintroduction and disease among travellers to risk areas is a matter of concern [12–15]. As occurred with many other communicable and non-communicable diseases, the 2020–2022 COVID-19 pandemic negatively impacted the efforts of control and reemergence of rabies in certain countries [7,16,17]. Post-pandemic challenges to enhance con- trol and prevention are multiple and need urgent actions to achieve the goal in eight years by 2030 [16].

Mortality from COVID-19 in Amazonian and Andean original indigenous populations of Peru

Objective: To compare the mortality rates from COVID-19 among indigenous populations of the Amazon and Andean regions of Peru during the years 2020, 2021 and 2022. Methods: Secondary analysis of 33,567 data from the COVID-19 Notification System of the National Epidemiology Center, Prevention and Control of Diseases (CDC-Peru), from the years 2020–2022. The variables were age, sex, belonging to the Andean or Amazonian ethnic group, number and type of symptoms and risk conditions, abnormal findings in chest X-rays, year of data collection for hospitalization and death from COVID-19. Poisson family generalized linear regression models with logarithmic linkage and robust variance were used to establish differences in mortality between ethnic groups. Crude and adjusted risk ratio (RR) with 95 % confidence intervals (CI) were calculated. Results: 33,567 participants with an average age of 33.6 years were included, 44.4 % were men and 70.2 % belonged to the Amazonian ethnic group. Most of those affected by COVID-19 presented 2 symptoms (38.8 %), 4.8 % presented some risk condition, 1451 (4.3 %) were hospitalized, and 433 (1.3 %) died. The adjusted analysis showed that the Andean group, compared to the Amazonian, tended to have a higher probability of death, and this association was statistically significant, RR =7.6, 95 % CI (5.5–10.5). Conclusions: Patients from Andean indigenous communities had an almost 8 times higher risk of death from COVID-19

Relationship Between Fear of Monkeypox and Intention to be Vaccinated Against Monkeypox in a Peruvian Sample. The Mediating Role of Conspiracy Beliefs About Monkeypox

The present study evaluated the predictive capacity of fear of Monkeypox (MPX) on the intention to be vaccinated against MPX and the influence of conspiracy beliefs as a mediating variable in this relationship in 516 Peruvian sample with an average age of 27.10 years participated. Monkeypox Fear Scale, MPX Conspiracy Beliefs Scale and a single item of intention to be vaccinated against MPX were used. Statistical analyses have included estimation of descriptive statistics for all variables in the model tested and Structural Equation Modeling to predict intention to be vaccinated against monkeypox. It has been found that fear has a positive impact on conspiracy beliefs about MPX and intention to be vaccinated against MPX. Finally, conspiracy beliefs are negatively related to intention to be vaccinated. As for indirect effects, both are statistically significant. The model explains 11.4% of the variance in beliefs and 19.1% in intention to be vaccinated. It is concluded that fear of MPX played an important role, both directly and indirectly, in the intention to be vaccinated against MPX, having conspiratorial beliefs about MPX as a mediating variable. The results have important implications for public health practices aimed at combating doubts about MPX vaccination

Intention to receive the monkeypox vaccine and its psychological and sociodemographic predictors: a cross-sectional survey in the general population of Peru

Abstract Objective The objective of this study was to identify predictors of intention to be vaccinated against Monkeypox (Mpox) in a sample of Peruvian citizens.  Methods A set of sociodemographic and psychological predictors were used, such as sex, sexual orientation, educational level, previous diagnosis of COVID-19, marital status, complete vaccination against COVID-19, employment status, living with vulnerable people, presence of chronic disease, area of residence, perceived usefulness of COVID-19 vaccines, fear of Mpox, conspiracy beliefs about Mpox, among others. A total of 472 Peruvian adults participated, selected by non-probabilistic snowball convenience sampling. A sociodemographic survey, the Mpox Fear Scale, was used. Conspiracy Beliefs about Mpox was assessed using three questions created specifically for this study. For inferential purposes, simple ordinal regressions ("crude models") were performed between each factor and the outcome.  Results Regarding their intention to be vaccinated against Mpox, more than 60% expressed clear approval. Being non-heterosexual, having greater emotional fear of Mpox, and perceiving some potential for this disease to become the next pandemic were related to greater intention to vaccinate. On the other hand, being older, having low perceived usefulness of COVID-19 vaccines, and having higher conspiracy beliefs about Mpox were associated with lower intention to vaccinate.  Conclusion The study provides initial information for future research seeking to better analyze Mpox vaccination intention. In addition, cross-sectional data are provided that can be used to develop public health policies that target subgroups with low prevalence of intention to vaccinate against Mpox

Cross-cultural invariance of the Spanish version of the COVID-19 Assessment Scorecard to measure the perception of government actions against COVID-19 in Latin America

Objectives: The present study aimed to evaluate the measurement invariance of a general measure of the perception of governmental responses to COVID-|19 (COVID-SCORE-10) in the general population of 13 Latin American countries. Methods: A total of 5780 individuals from 13 Latin American and Caribbean countries selected by non-probabilistic snowball sampling participated. A confirmatory factor analysis was performed and the alignment method was used to evaluate invariance. Additionally, a graded response model was used for the assessment of item characteristics. Results: The results indicate that there is approximate measurement invariance of the COVID-SCORE-10 among the participating countries. Furthermore, IRT results suggest that the COVID-SCORE-10 measures with good psychometric ability a broad spectrum of the construct assessed, especially around average levels. Comparison of COVID-SCORE-10 scores indicated that participants from Cuba, Uruguay and El Salvador had the most positive perceptions of government actions to address the pandemic. Thus, the underlying construct of perception of government actions was equivalent in all countries. Conclusion: The results show the importance of initially establishing the fundamental measurement properties and MI before inferring the cross-cultural universality of the construct to be measured