Cambios de las coberturas y usos del suelo en la microcuenca del Río Jucusbamba, Amazonas (Perú), 1992-2052

En la actualidad, el uso y cobertura del suelo sufre alteraciones en su estructura por las diferentes actividades antrópicas que se desarrollan. Los sistemas de información geográfica (SIG) y la teledetección son la tendencia en el manejo de información geoespacial que, a través de las imágenes satelitales, permiten evaluar reportes de los cambios del uso y cobertura del suelo. Este estudio tuvo como objetivo analizar los cambios de las coberturas y usos del suelo en la microcuenca Jucusbamba, Amazonas (Perú),1992-2052. Las imágenes satelitales de Landsat de 1992 a 2007 y Sentinel para 2022, estos fueron clasificadas por Random Forest en Google Earth Engine (GEE). La clasificación se basó en cinco clases CCUS, es decir, Áreas urbanizadas (ZU); Mosaico de Pastos y Cultivos (PC); Bosques (BO); Herbazal / Pajonal (PH) y Vegetación arbustiva / herbácea (AH). Los mapas obtenidos demostraron cambios de áreas de 1992 a 2022 en diferentes clases, donde las Áreas urbanizadas y Mosaico de Pastos y Cultivos aumentaron en 0.76% y 24.36%, respectivamente. Sin embargo, los Bosques y la Vegetación arbustiva/herbácea disminuyeron un 8.89% y 16.25%, respectivamente. El complemento Molusce Plugin y su algoritmo de red neuronal artificial (ANN) se utilizó para simular los CCUS entre 2037 y 2052. Se obtuvo un índice global de precisión del 89.8% y el coeficiente kappa fue de 0.86%. Los mapas de predicción de 2037 a 2052 demostraron tendencias decrecientes en Bosques (-1.47 %) y Vegetación arbustiva/herbácea (-3.35%) y tendencias crecientes en Mosaico de Pastos y Cultivos (4.74%) y Áreas urbanizadas (0.07%). Los resultados obtenidos permitirán al usuario tomar medidas de control de la administración de las coberturas del suelo, como también las decisiones al analizar los cambios de intensidad de cada tipo de cobertura y promover planes de desarrollo sostenible y la conservación ambiental

Glosario de principales bloques regionales, foros y cumbres internacionales

Desde su creación en 1995, la OMC es el ente rector y la única organización internacional que se ocupa de las normas globales que rigen el comercio entre sus 164 países miembros

Adherence to standards of care and mortality in the management of Staphylococcus aureus bacteraemia in Peru: A prospective cohort study.

BACKGROUND: Despite high mortality rates, physicians can alter the course of the Staphylococcus aureus bacteraemia (SAB) by following recommended standards of care. We aim to assess the adherence of these guidelines and their impact on mortality. METHODS: Substudy from a prospective cohort of hospitalized patients with SAB from three hospitals from Peru. Hazard ratios were calculated using Cox proportional regression to evaluate the association between 30-day mortality and the performance of standards of care: removal of central venous catheters (CVC), follow-up blood cultures, echocardiography, correct duration, and appropriate definitive antibiotic therapy. RESULTS: 150 cases of SAB were evaluated; 61.33% were MRSA. 30-day attributable mortality was 22.39%. CVC removal was done in 42.86% of patients. Follow-up blood cultures and echocardiograms were performed in 8% and 29.33% of cases, respectively. 81.33% of cases had appropriate empirical treatment, however, only 22.41% of MSSA cases were given appropriate definitive treatment, compared to 93.47% of MRSA. The adjusted regression for all-cause mortality found a substantial decrease in hazards when removing CVC (aHR 0.28, 95% CI: 0.10 - 0.74) and instituting appropriate definitive treatment (aHR 0.27, 95% CI: 0.08 - 0.86), while adjusting for standards of care, qPitt bacteraemia score, comorbidities, and methicillin susceptibility; similar results were found in the attributable mortality model (aHR 0.24, 95% CI: 0.08 - 0.70 and aHR 0.21, 95% CI: 0.06 - 0.71, respectively). CONCLUSIONS: Deficient adherence to standards of care was observed, especially definitive treatment for MSSA. CVC removal and the use of appropriate definitive antibiotic therapy reduced the hazard mortality of SAB

Tuberculosis Scientific Conferences in Peru: Sharing local evidence for local decisions.

INTRODUCTION: International conferences on tuberculosis (TB) have been held since the 19th century. In Peru, the TB Scientific Conferences have been held annually in Lima since 2013 as a means of developing a national TB research network and setting the stage for researchers and institutions to present and share new findings from studies conducted in Peru. METHODS: Systematization of information on speakers and presentations from TB Scientific Conferences in Peru. Presentation files and official agendas for the conferences from 2013 to 2019 were obtained from the Tuberculosis Prevention and Control Directorate's website. RESULTS: A total of 426 scientific presentations have been delivered by 230 speakers, with a steady annual increase. 37.1% of the talks were given by female speakers. To date, 61.4% of the research presented has been published. Out of all the studies, 10.9% (30/275) were part of international, multicentric research projects. Main research lines were epidemiology (40.1%), drug-resistance (29.6%) and treatment (22.1%). CONCLUSIONS: TB Scientific Conferences serve as a platform to share region-specific TB evidence between local stakeholders (health officials, academics, and others) who aim to facilitate the implementation of measures with the goal of reducing the national gaps towards the End TB Strategy goals

Association between tuberculosis and depression on negative outcomes of tuberculosis treatment: A systematic review and meta-analysis.

BACKGROUND: Depression is a common comorbidity of tuberculosis (TB) and is associated with poor adherence to treatment of multiple disorders. We conducted a systematic review to synthesize the existing evidence on the relationship between depression and negative outcomes of TB treatment. METHODS: We systematically reviewed studies that evaluated depressive symptoms (DS) directly or indirectly through psychological distress (PD) and measured negative treatment outcomes of drug-sensitive pulmonary TB, defined as death, loss to follow-up, or non-adherence. Sources included PubMed, Global Health Library, Embase, Scopus and Web of Science from inception to August 2019. RESULTS: Of the 2,970 studies initially identified, eight articles were eligible for inclusion and two were used for the primary outcome meta-analysis. We found a strong association between DS and negative TB treatment outcomes (OR = 4.26; CI95%:2.33-7.79; I2 = 0%). DS were also associated with loss to follow-up (OR = 8.70; CI95%:6.50-11.64; I2 = 0%) and death (OR = 2.85; CI95%:1.52-5.36; I2 = 0%). Non-adherence was not associated with DS and PD (OR = 1.34; CI95%:0.70-2.72; I2 = 94.36) or PD alone (OR = 0.92; CI95%:0.81-1.05; I2 = 0%). CONCLUSIONS: DS are associated with the negative TB treatment outcomes of death and loss to follow-up. Considerable heterogeneity exists in the definition of depression and outcomes such as non-adherence across the limited number of studies on this topic

Case Report: Multiorgan Involvement with Congenital Zika Syndrome.

We report the case of an infant born with congenital Zika syndrome (CZS). During the largest Zika virus (ZIKV) outbreak in Peru, the mother presented with fever and rash that were confirmed to be due to ZIKV by real-time PCR. The infant was born with severe microcephaly. Imaging revealed corpus callosum dysgenesis, lissencephaly, ventriculomegaly, and calcifications. Mild hypertrophic cardiomyopathy with diastolic dysfunction was reported in the echocardiogram. Valgus deviation of the lower extremities and a left clubfoot were diagnosed at birth. The hip ultrasound showed incipient signs of Graf type II dysplasia. The findings confirm that CZS is a multiorgan phenotype in which microcephaly is merely the tip of the iceberg. A multidisciplinary approach is needed for the evaluation of these children

Specimen sharing for epidemic preparedness:Building a virtual biorepository system from local governance to global partnerships

We present a framework for a federated, virtual biorepository system (VBS) with locally collected and managed specimens, as a 'global public good' model based on principles of equitable access and benefit sharing. The VBS is intended to facilitate timely access to biological specimens and associated data for outbreak-prone infectious diseases to accelerate the development and evaluation of diagnostics, assess vaccine efficacy, and to support surveillance and research needs. The VBS is aimed to be aligned with the WHO BioHub and other specimen sharing efforts as a force multiplier to meet the needs of strengthening global tools for countering epidemics. The purpose of our initial research is to lay the basis of the collaboration, management and principles of equitable sharing focused on low- and middle-income country partners. Here we report on surveys and interviews undertaken with biorepository-interested parties to better understand needs and barriers for specimen access and share examples from the ZIKAlliance partnership on the governance and operations of locally organized biorepositories.</p

Clinical, Radiological and Functional Characteristics of Pulmonary Diseases among HTLV-1 Infected Patients without Prior Active Tuberculosis Infection.

The lifelong infection with the human T lymphotropic virus type 1 (HTLV-1) has been associated with a variety of clinical manifestations; one of the less-explored is HTLV-1-associated pulmonary disease. Imaging of lung damage caused by the HTLV-1 hyperinflammatory cascade can be similar to sequelae from TB infection. Our study aims to describe the pulmonary lesions of HTLV-1-positive patients without past or current active TB and evaluate pulmonary function. We found that nine out of fourteen patients with no known TB disease history presented bronchiectasis, mainly found bilaterally while five presented pulmonary fibrosis. A normal pattern was found in most patients with a pulmonary functional test. Furthermore, there was no association between the PVL and the chest-CT scan findings, nor with spirometry results. However, the sample size was insufficient to conclude it

Fluoroquinolone susceptibility in first-line drug-susceptible M. tuberculosis isolates in Lima, Peru

OBJECTIVE: To determine at two distinct time points the prevalence of resistance to ofloxacin (OFX), the representative class drug of fluoroquinolones (FQs), in M. tuberculosis isolates susceptible to first-line drugs. RESULTS: There were 279 M. tuberculosis isolates from the two cohorts (2004-2005: 238 isolates; 2017: 41 isolates) that underwent OFX drug-susceptibility testing (critical concentration: 2 µg/ml). Of 238 isolates in Cohort 1, no resistance to OFX was detected (95% CI 0-0.016); likewise, in Cohort 2, no resistance to OFX was detected in 41 isolates (95% CI 0-0.086). Our findings suggest that FQ use remains a viable option for the treatment of first-line drug-susceptible TB in Peru