Alcohol risk consumption during the COVID-19 pandemic quarantine time in Paraguay, 2020: a virtual survey

Introduction: The impact of the outbreak of pandemic proportions of COVID-19 has initiated several health and social measures worldwide. Thus, there is growing concern about the consequences of preventive social confinement associated with the pandemic due to the potential increase in the consumption of alcohol and other harmful substances. Between 2010-2014, in Paraguay approximately 5% of deaths over 15 years of age are attributable to alcohol consumption and are associated with external cause injuries, cancers, liver disease, cardiovascular diseases, addictions and domestic violence. Early detection and treatment are recommended intervention strategies to prevent these consequences. Objective: To determine the demographic characteristics of alcohol risk consumption during the covid-19 pandemic quarantine period. Methods: Analytical cross-sectional, exploratory observational study. It consisted of 16,538 virtual surveys carried out on persons of legal age throughout the national territory between June and September 2020. A total of 219 respondents were excluded for not meeting the inclusion criteria or for incorrectly filled out data. Risk consumption was determined using a test that rated consumption by scores. More than 5 points for men, more than 4 for women. Results: 12224 adult participants (18-65 years old) with a mean age of 31.9 years (±9.2), were part of the analysis, with a predominance of male participation 64.5% (n=10531). The 74.9% (n=12224) came from the Metropolitan Axis. According to gender, the OR was 1.15 CI95 (1.08-1.23), pv=0.001. When comparing educational level, high school complete/incomplete, the OR was 1.56 CI95 (1.19-2.06), pv=0.001. And when comparing by axes of residence, the OR was 0.83 CI95 (0.77-0.89), pv=0.001. Discussion: It was observed that, during the quarantine period, alcohol consumption increased as the educational level of the population increased. Males presented a higher risk consumption than males. Knowing this behavior would help to propose actions to help prevent alcohol consumption in the most atrisk group. © 2022, Faculty of Medical Sciences, Santa Rosa del Aguaray Branch, National University of Asuncion. All rights reserved.

VACCINATION AGAINST COVID-19 IN PARAGUAYAN PATIENTS WITH RHEUMATOID ARTHRITIS

BackgroundIn February 2021, the first doses of COVID-19 vaccines were received in Paraguay, and rheumatic patients were the preferred population to get these vaccines. Up to December 2022 the vaccination coverage in Paraguay was 59.4%, with at least one vaccine dose. 52.4% accessed the primary scheme (two doses), while 28.6% had at least one booster dose. Only 7.1% completed the COVID-19 immunization scheme.ObjectivesTo describe vaccination against COVID-19 in Paraguayan patients with Rheumatoid Arthritis (RA).MethodsDescriptive, cross sectional, observational study, in a Paraguayan cohort of RA patients meeting ACR/EULAR2010 criteria, under follow-up in two Rheumatology reference centers, from October to December 2022. A standardized questionnaire according to the variables included (clinical, vaccination, vaccine type, number of doses) was made. Quantitative variables were presented as means and qualitative as frequencies.Results568 patients with RA were included, 84.1% were female, mean age 55.48±13.94 years old. 23.9% patients were from Hospital de Clínicas and 76.1% from Hospital Central del Instituto de Previsión Social. The average number of received vaccinations doses was 2.54±1.19. 88.7% of patients acquired at least one dose of COVID-19 vaccine, 85% obtained two doses;and, while 60.9% of patients received the first booster, 21.2% had the second one.ConclusionIn this series of Paraguayan RA patients, vaccination against COVID-19 is higher than the general population, perhaps due to priority of patients with rheumatic diseases receiving immunization, and frequent access to medical care with physician's prompt to receive vaccinations. While over 80% of patients have a complete primary schedule, and more than 60% received the first booster;only 21% have a complete immunization schedule, which is still much higher than the general population in Paraguay.Table 1.Vaccines in Paraguayan patients with Reumatoid ArthritisVaccines against COVID-19First Dose n: 504Second Dose n: 483First booster n: 344Second booster n: 122Sputnik V(Gam--COVID-Vac) n (%)149 (26.2)137 (24.1)10 (1.8)0Astrazeneca (ChAdOx1 nCoV-19) n (%)172 (30.3)171 (30.1)110 (19.4)36 (29.5)Pfizer n (BNT162b2) (%)81 (14.3)80 (14.1)198 (34.9)68 (55.7)Moderna (mRNA-1273) n (%)41 (7.2)38 (6.7)22 (3.9)18 (14.8)Hayat Vax n (%)29 (5.1)28 (4.9)1 (0.2)0Sinopharm BBIBP n (%)2 (0.4)1 (0.2)00Covaxin n (%)28 (4.9)26 (4.6)3 (0.5)0CoronaVac n (%)2 (0.4)2 (0.4)00REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

The Experience of Testing for Coronavirus Disease (COVID-19) at a Single Diagnostic Center in Paraguay before the Introduction of Vaccination.

Soon after the declaration of the COVID-19 pandemic, the Institute for Health Sciences Research (IICS) of the National University of Asunción, Paraguay became a testing laboratory (COVID-Lab) for SARS-CoV-2. The COVID-Lab testing performance was assessed from 1 April 2020 to 12 May 2021. The effect of the pandemic on the IICS and how the COVID-Lab contributed to the academic and research activities of the institute were also assessed. IICS researchers and staff adjusted their work schedules to support the COVID-Lab. Of the 13,082 nasopharyngeal/oropharyngeal swabs processed, 2704 (20.7%) tested positive for SARS-CoV-2 by RT-PCR. Of the individuals testing positive, 55.4% were female and 48.3% were aged 21-40 years. Challenges faced by the COVID-Lab were unstable reagent access and insufficient staff; shifting obligations regarding research, academic instruction, and grantsmanship; and the continuous demands from the public for information on COVID-19. The IICS provided essential testing and reported on the progress of the pandemic. IICS researchers gained better laboratory equipment and expertise in molecular SARS-CoV-2 testing but struggled to manage their conflicting educational and additional research obligations during the pandemic, which affected their productivity. Therefore, policies protecting the time and resources of the faculty and staff engaged in pandemic-related work or research are necessary components of healthcare emergency preparedness.

Frequencies of Adverse Events Aftervaccination for Covid-19 in Patients with Systemic Lupus Erythematosus from a Reference Center in Asuncion, Paraguay

Objectives: The objective of this study was to determine the frequency of adverse effects (AE) of vaccination against COVID-19 in patients with SLE who visit medical centers in Asuncion, Paraguay. Method(s): The study performed was observational, transverse, descriptive. 152 patients with SLE were included, who received at least one dose of anti-COVID vaccine. A survey was carried out, which allowed the data collection through phone calls or instant messaging. Each investigator had a spreadsheet that related the generated code with the surveyed patient's name. Once the call ended and if the patient agreed to participate in the study, a code was generated. Result(s): 88.5% of the individuals were female, the average age was 33.93 +/- 11,102 years. Of these, 94.3% received their first dose, 86.3% the second dose, 39.7% the third dose, and 2.3% the fourth dose. Of the total vaccinated patients, 39.38% were administered Sputnik-V, 26.02% Pfizer, 16.43% AstraZeneca, 13.35% Moderna, 4.1% Covaxin, and 0.68% Hayat Vax. Of 292 doses administered, 103 AEs were recorded, 79.6% within the first 5 days and the rest within the next 5 days. 44.03% presented the AE after the first dose, 32.11% after the second dose and 23.85% after the third dose. Themean duration of symptoms was 7.49 +/- 9.877 days. The most important side effect was pain at the injection site, followed by fever and fatigue. The worsening of Lupus due to the administration of the anticovid vaccine was demonstrated in 9.93% of the cases. Conclusion(s): Mild effects were registered. It is concluded that vaccination against COVID-19 is safe for individuals with SLE.

Covid 19 in Patients with Rheumatic Diseases

Objectives: BIOBADAGUAY is the Paraguayan/Uruguayan registry of adverse events in patients with inflammatory rheumatic conditions under biologic therapy (BT). Three years have elapsed from the first case of coronavirus and data about South American patients with COVID are still scarce. In this study we analyzed the frequency and clinical outcomes of COVID-19 in a cohort of patients with rheumatic diseases from Paraguay. Method(s): A cross sectional study of Paraguayan patients with rheumatic diseases from BIOBADAGUAY and controls without BT. Clinical, epidemiological, and COVID-19 data were analyzed. Only cases confirmed by SARSCoV-2 positive PCR test were included. Descriptive analysis were performed for this study. Result(s): 832 patients were included (696 under BT and 136 controls). 116 (13.9%) had COVID-19. 22 had a second infection and 9 a third reinfection. Table 1 shows characteristic of COVID-19 patients. The most frequent diagnosis was rheumatoid arthritis (n = 93, 80.2%) followed by ankylosing spondylitis (n = 6, 5.2%), undifferentiated spondylarthritis (n = 5, 4.3%), psoriatic arthritis (n = 4, 3.4%), juvenile onset arthritis (n = 2, 1.7%), vasculitis (n = 2, 1.7%). Only 1 case (0.8%) were registered for Still's disease, enteropathic spondylarthritis, systemic sclerosis and seronegative polyarthritis, respectively. When comorbidities were analyzed, 46 (39.6%) patients had at least one (Table 1). Of the total treatments received: 65 (56.0%) had methotrexate, 53 (45.7%) leflunomide, 3 (2.5%) sulfasalazine, 15 (12.9%) hydroxychloroquine, 25 (21.5%) glucocorticoid, 52 (44.8%) anti-TNF and 20 (17.2%) non-anti-TNF. COVID-19 severity outcomes were: 101(87%) non severe, 31 (26.7%) severe and 1 fatal(0.8%). 189 (90.9%) patients received vaccination and the mean number of doses were 2.5 doses. 55 (26.4%) had COVID prior to vaccination Conclusion(s): In this study we examined the frequency of COVID-19 in Paraguayan patients with rheumatic diseases. In this cohort of rheumatologic patients, COVID 19 severity was similar to the one in the general population.

Usual food consumption and variations in lockdown during the first wave of COVID-19 in Argentina and Paraguay

The objective was to analyze food intake and its variations during lockdown in the first wave of COVID-19 in Argentina (AR) and Paraguay (PY), year 2020 and the impact of self-perception of anxiety regarding consumption. An online survey was implemented inquiring about socio-demographic characteristics, usual food intake, self-perception of changes in consumption and anxiety during lockdown. A logistics regression model was developed to analyze the association among variables. There were 2621 participants from AR and 2164 from PY. Only 46% from AR and 36% from PY usually fulfilled the recommendation of 2 servings of vegetables a day, and 11% in total complied with the recommended 3 fruits a day. Only 1 out of 4 participants drinks enough water and optional consumption products (processed products and with high sugar level, saturated fat and sodium) were usually present in an important proportion. Fifty-six percent from AR and 72% from PY showed anxiety because of pandemic and lockdown, affecting their eating habits. In AR, anxiety perception raised significantly the OR of modifying usual consumption of vegetables (OR=1.4), fruit (OR=1.7), meat (OR=1.6), dairy products (OR=1.09), sugary products (OR=2.1) and sugary drinks (OR=1.6). The same was observed in PY for intake of vegetables (OR=1.6), fruit (OR=1.8), meat (OR=2.8), dairy products (OR=2.8), sugary products (OR=3.9) and sugary drinks (OR=2.3). In conclusion, lockdown changed eating habits and there may be an impact on immunological state and general health.

Immunization against Covid-19 in a Population of Patients with Rheumatoid Arthritis

Objectives: Immunization against COVID-19 in Paraguay began in February 2021, and patients with rheumatic diseases were the preferred population to get vaccinated. Up to December 2022 the immunization coverage in Paraguay was 59.4%, with at least one vaccine dose. 52.4% accessed the primary immunization schedule (two doses), while 28.6% had at least one booster dose. Only 7.1% received the complete schedule. The aim of this study was to describe the frequency of vaccination, the number of doses, and the type of vaccines against COVID-19 in Paraguayan patients with Rheumatoid Arthritis (RA). Method(s): Descriptive, cross sectional, observational study, in a Paraguayan cohort of RA patients meeting the 2010 ACR/EULAR criteria, under follow-up in two Rheumatology reference centers, from October to December 2022. A standardized questionnaire according to the variables included (clinical, vaccination, vaccine type, number of doses)was made. Quantitative variables were presented as means and qualitative as frequencies. Result(s): 568 patients with RA were included, 84.1% were female, mean age 55.48 +/- 13.94 years. The average number vaccinations doses received was 2.54 +/- 1.19. 88.7% of patients acquired at least one dose of COVID-19 vaccine, 85%obtained two doses;and, while 60.9% of patients received the first booster, 21.2% had the second one. The table describes the characteristics of the received vaccines. Conclusion(s): In this series of Paraguayan RA patients, vaccination against COVID-19 was higher than the general population, perhaps due to priority of patients with rheumatic diseases receiving immunization, and frequent access to medical care with physician's prompting them to receive the vaccine. While over 80% of patients have a complete primary schedule, and more than 60% received the first booster;only 21% have a complete immunization schedule, which is still much higher than the general population of Paraguay.

SARS-CoV-2 seroprevalence in school children and teachers in Paraguay.

Background: In Paraguay there has been a gradual and voluntary return to classes in a blended mode. Aim(s): To estimate the anti-SARS-CoV2 seroprevalence in schoolchildren and teachers. Method(s): Cross-sectional descriptive study, carried out between October 25 and November 5, 2021. Structured surveys were applied to schoolchildren and teachers from five schools, two in Asuncion and three in the Central Department. In addition, samples of fingerstick blood for antibody de-tection by rapid immunochromatographic test were obtained. Result(s): A total of 148 teachers and 966 schoolchildren were included, 12.4% of the schoolchildren had received the anti-COVID-19 vaccine, which represents 61.9% of the students qualified for vaccination. Among the teachers, 97.3% received the COVID-19 vaccine, 95.9% had the complete schedule, 34.5% of teachers and 3.9% of schoolchildren reported having had COVID-19. The seroprevalence with no vaccine status discrimination was 37.7% in schoolchildren and 91.9% in teachers. In unvaccinated schoolchildren, seroprevalence was 30.9% and in unvaccinated teachers 25.0%. Conclusion(s): The high anti-SARS-CoV-2 seroprevalence reflects an important viral circulation in the community. Almost the entire teaching staff had the complete vaccination schedule, and more than half of the qualified students had received at least a dose. The high seropositivity in vaccinated is highlighted. It is recommended to continue with the preventive non-pharmacological measures and vaccination.Copyright © 2022, Sociedad Chilena de Infectologia. All rights reserved.

Assessing the Impact of COVID-19 on Indigenous Peoples in Latin America: Towards Effective Post-Pandemic Policies

[...]a broad and inclusive approach to post-pandemic policy-making—one that considers Indigenous forms of knowledge whilst fostering appreciation for their cultures and lives—is needed to adequately assist Indigenous peoples in repairing the harm they have suffered as a result of COVID-19.3 COVID-19 and its deadly impact on Indigenous communities There are no less than eight hundred distinct Indigenous communities across Latin America, each with its own unique identity, culture, and [End Page 169] history. In Bolivia, for example, where Indigenous groups comprise a significant portion of the electorate (between 41 and 62 percent of the population), Latin America's first Indigenous political executive was elected in 2006.4 In most instances, however, Indigenous peoples make up only a small proportion of Latin American country populations (generally ranging from 0.5–15 percent), one factor ensuring limited political influence and the widespread marginalization of their interests.5 As a consequence, Indigenous peoples across the region entered the pandemic whilst already suffering from a range of serious economic and socio-cultural inequalities.6 Inadequate access to medical care, chronic poverty and economic marginalization, racism and prejudice, and inadequate access to education are common issues that exacerbated the impact of the pandemic.7 The World Health Organization confirmed the arrival of the pandemic in the region on February 26, 2020. [...]Indigenous mortality rates were 4.03 percent in Brazil and 19.9 percent in Mexico—significantly higher than 2.2 percent and 5.7 percent overall mortality rates in each country respectively.9 Unfortunately, the lack of regional data on, and deliberate under-reporting of, Indigenous mortality rates across much of Latin America has problematized many of the available datasets.10 In Brazil, for example, organizations such as The Articulation of Indigenous Peoples (APIB), have shown that the total number of recognized Indigenous deaths (902 persons as of April 7, 2022), undercounts the actual figure by at least 31 percent.11 Other sources, such as the Special Secretariat for Indigenous Health (SESAI), which is responsible for Indigenous medical care, also provides incomplete data on Brazilian Indigenous mortality by failing to count Indigenous urban dwellers or those who live outside of recognized government-controlled territories in their data sets.12 Such groups are among some of the most vulnerable Indigenous communities in the country, receiving little, if any, support from government agencies charged with supporting Indigenous communities.13 As a result, the scale and scope of COVID-19's impact on Indigenous Brazilians is, and for the foreseeable future will likely remain, unknowable.14 Despite a lack of adequate data across much of Latin America, a growing body of evidence indicates that Indigenous peoples were particularly vulnerable to COVID-19, and that they likely died or suffered long-term health issues in disproportionate numbers.15 In a study of Indigenous peoples in Chile, for instance, regions with larger Indigenous populations recorded a noticeable increase in overall mortality.16 Where direct data do not exist, emerging studies suggest that the medical impact of COVID-19 was likely compounded by a range of structural inequalities and environmental factors.17 Many Indigenous peoples lack access to adequate medical care. [...]disproportionate exposure to pesticides—used extensively in agricultural industries in which many Indigenous people find employment, as well as exposure to smoke inhalation—caused by out-of-control forest fires across Latin America—likely exacerbated the repertory symptoms caused by COVID-19.18 As a consequence, Indigenous peoples had to face COVID-19 not only with fewer resources, but with greater exposure to the types of pre-existing conditions known to aggravate the impact of the disease.19 Particularly high mortality rates among Indigenous elders, who act as stores of traditional knowledge, affected cultural continuity and community cohesion.20 To better understand this we spoke with a representative of the Indigenous Kaingang people, Duko Vãgfy, who explained that "[t]he worst losses [we suffered] were the elders, because they held so much knowledge about [our] people.

Cannabis: Global Histories ed. by Lucas Richert and James H. Mills (review)

Peter Hynd replicates verbatim the language of excise reports in British India to narrate the colonial state's apparently successful fiscal measures to lower cannabis sales and maximize revenue. Besides misnaming Hemchunder Kerr as Dutt and misidentifying the Garhjat in Orissa as Gujarat sixteen hundred kilometers west, Hynd concludes that the infrastructure of cannabis revenue extraction by an oppressive colonial force is that reasonable but rare occasion where "modern governments stand to learn a thing or two from the example set by the British Raj.” Behind the story of the GW Pharmaceuticals product Sativex, Suzanne Taylor uncovers years of lobbying by middle-class citizen groups like the Multiple Sclerosis Society in the 1990s that pushed for controlled medical research on cannabis and gave it a respectable face. [...]the editors' invitation to a renewed research agenda around this assessment, tediously termed "globalization without globalizers,” is constrained by their neglect of the teeming scholarly assessments and critiques of the category "global” and the framework "globalization.” More importantly, in 2022, even as emerging mass spectrometry research on cannabinoid non-psychoactive acids at the Linus Pauling Institute suggest their potential to successfully bind Covid-19 spike proteins against human epithelial cells, states in the Global South continue to face restrictions from global narcotics control institutions on scientific studies of cannabis.

[Feasibility of using artificial intelligence for screening COVID-19 patients in ParaguayViabilidade do uso de inteligência artificial na triagem de pacientes com COVID-19 no Paraguai]. / Factibilidad de la utilización de la inteligencia artificial para el cribado de pacientes con COVID-19 en Paraguay.

Objective: Study the feasibility of using artificial intelligence as a sensitive and specific method for COVID-19 screening in patients with respiratory conditions, using chest CT scan images and a telemedicine platform. Methods: From March 2020 to June 2021, the authors conducted an observational descriptive multicenter feasibility study based on artificial intelligence (AI) for COVID-19 screening using chest images of patients with respiratory conditions who presented at public hospitals. The AI platform was used to diagnose chest CT scan images; this was then compared with molecular diagnosis (RT-PCR) to determine whether they matched and to analyze the feasibility of AI for screening patients with suspected COVID-19. A telemedicine platform was used to send images and diagnostic results. Results: Screening of 3 514 patients with a suspected COVID-19 diagnosis was performed in 14 hospitals around the country. Most patients were aged 27 to 59 years, followed by those over 60. The average age was 48.6 years; 52.8% were male. The most frequent findings were severe pneumonia, bilateral pneumonia with pleural effusion, bilateral pulmonary emphysema, and diffuse ground glass opacity, among others. There was an average of 93% matching and 7% mismatching between images analyzed by AI and RT-PCR. Sensitivity and specificity of the AI system, obtained by comparing AI and RT-PCR screening results, were 93% and 80% respectively. Conclusions: The use of sensitive and specific AI for stratified rapid detection of COVID-19 in patients with respiratory conditions by using chest CT scan images and a telemedicine platform in public hospitals in Paraguay is feasible.

Objetivo: Examinar a viabilidade do uso de inteligência artificial como um método sensível e específico de triagem de COVID-19 em pacientes com afecções respiratórias, empregando imagens obtidas por exame de tomografia do tórax e uma plataforma de telemedicina. Métodos: Entre março de 2020 e junho de 2021, foi realizado um estudo observacional descritivo multicêntrico sobre a viabilidade do uso de inteligência artificial (IA) para a triagem de COVID-19, empregando imagens do tórax de pacientes com afecções respiratórias atendidos em hospitais da rede pública. O diagnóstico das imagens obtidas em tomografia do tórax foi realizado por meio de uma plataforma de IA e, em seguida, cotejado com o diagnóstico molecular (RT-PCR) para determinar a concordância entre os métodos utilizados e analisar a viabilidade deste processo para a triagem de pacientes com suspeita de COVID-19. As imagens e os resultados do exame diagnóstico foram disponibilizados em uma plataforma de telemedicina. Resultados: Foi realizada a triagem de 3 514 pacientes com suspeita de COVID-19 atendidos em 14 hospitais de todo o país. Os pacientes, na sua maioria, tinham entre 27 e 59 anos de idade ou pertenciam à faixa etária acima de 60 anos, com média de idade de 48,6 anos, sendo que 52,8% eram do sexo masculino. Os achados mais comuns foram pneumonia grave, pneumonia bilateral com derrame pleural, enfisema pulmonar bilateral e opacidade difusa em vidro fosco, entre outros. Verificou-se, em média, 93% de concordância e 7% de discordância entre as imagens analisadas com uso de IA e os resultados do exame de RT-PCR, com uma sensibilidade de 93% e especificidade de 80% desse sistema de triagem. Conclusões: Demonstrou-se que o uso de um sistema de IA sensível e específico é viável nos hospitais públicos do Paraguai para a detecção rápida estratificada de COVID-19 em pacientes com afecções respiratórias, empregando imagens de exame de tomografia do tórax e uma plataforma de telemedicina.

Critical Issues in the English Language Classroom: ICT and Online Learning in Language Education

A critical issue in education since 2020 has been the impact of the COVID-19 pandemic in the teaching and learning process. The pandemic has affected all areas of education and foreign language teaching has not been the exception. The study presents key aspects of teacher experience and training in relation to their use of ICT, which has become ubiquitous for teaching and learning during the last two years. For this study, a mixed methodology approach was used with a semi-structured questionnaire that was administered through social networks as well as WhatsApp and emails. A total of 184 responses were recorded from English teachers from all educational levels, public and private schools as well as language institutions. The results showcase that the main aspects affecting the development of classes are teachers' experience using ICT tools, training received, and technology appropriation. Moreover, the availability of a variety of tools for synchronous and asynchronous instruction, communication, and evaluation allowed teachers to rapidly transition into Emergency Remote Teaching. These results inform education stakeholders of the difficulties and opportunities brought by the COVID-19 pandemic.

Institutionalized vulnerability: the social bases of lack ofprotection in the emergency scenario due to COVID-19 in Paraguay

Through a mixed approach, the research aimed to study the Paraguayan social structure in its relationship with the situation of the child and adolescent population in the context of the COVID-19 pandemic. This made it possible to identify three risks: first, the increase in poverty, because of the suspension of economic activities and the reduction in income. Second, the risk of social fragmentation, where the institutional support of the State focuses assistance on a segregated manner and, many times, under clientelist criteria, dismantling certain types of organization and collective action. Third, the affront against integrity, in which girls and adolescents are victims of gender inequalities. The three risks synthesize living conditions associated with concrete vulnerabilities, erected on the fragile terrain of poverty, precariousness, and exclusion.

Institutionalized vulnerability: the social bases of lack ofprotection in the emergency scenario due to COVID-19 in Paraguay

Through a mixed approach, the research aimed to study the Paraguayan social structure in its relationship with the situation of the child and adolescent population in the context of the COVID-19 pandemic. This made it possible to identify three risks: first, the increase in poverty, because of the suspension of economic activities and the reduction in income. Second, the risk of social fragmentation, where the institutional support of the State focuses assistance on a segregated manner and, many times, under clientelist criteria, dismantling certain types of organization and collective action. Third, the affront against integrity, in which girls and adolescents are victims of gender inequalities. The three risks synthesize living conditions associated with concrete vulnerabilities, erected on the fragile terrain of poverty, precariousness, and exclusion.

High Circulation of SARS-CoV-2 In Ciudad del Este District, Paraguay, 2020.

Introduction: Seroepidemiological studies can help to understand the dynamics of the infection by the type 2 severe acute respiratory syndrome virus (SARS-CoV-2) in the community. Objective(s): To determine the seroprevalence of COVID-19 Ciudad del Este district of Alto Parana department in Paraguay. Method(s): Descriptive cross-sectional study based on population. A rapid immunochromatographic test was used for the detection of anti-SARS-CoV-2 IgG/IgM antibodies. 1043 households were surveyed between October 27 and November 21, 2020. Result(s): Of the 1978 participants, women prevailed (60.3 %), 39.6 % had secondary education, 32.9 % were engaged in commerce. The most frequent risk factors were hypertension (13.7%), overweight or obesity (16.4%) and diabetes mellitus (6.1%). A total of 415 people (21%) had symptoms compatible with COVID-19, with headache being the most frequent (10.8%), followed by anosmia (10.4%) and sore throat (10.1%). 15.4% of respondents said they had been in contact with a COVID-19 case. 10.8% of participants had undergone a laboratory test for the diagnosis of COVID-19, of them, 72 people (33.6%) reported a positive result. Seroprevalence was high, with one in five reporting symptoms compatible with COVID-19. Conclusion(s): Despite the high anti-COVID-19 seroprevalence, most residents had mild infection, the proportion of hospitalized patients was low, and no fatal cases were reported.Copyright © 2023, Editorial Ciencias Medicas. All rights reserved.

Inequalities and pandemic in Paraguayan indigenous communities

This article discusses the measures introduced by Paraguay to respond to the health crisis between March and December 2020 and problematizes its impact on indigenous communities. Starting from a historicization of the origins of inequalities, it demonstrates that the marginalization that Paraguayan indigenous communities are currently experiencing is the result of a historical and institutional continuity that is rooted in a logic of dispossession of indigenous people and their territory. We argue that the interaction between previous structural conditions and the political choices emanating from the struggle against Covid-19 has not allowed for an institutional change in these relationships. Indeed, in Paraguay, the unprecedented health crisis and governmental responses accelerated the pre-existing trajectories affecting indigenous communities, resulting in institutional continuity in the formulation of public policies. © 2022 Institut des Hautes Etudes de l'Amerique Latine (IHEAL). All rights reserved.

Impactos del COVID-19 en la salud mental en universitarios de Paraguay

Palabras clave: ansiedad, COVID-19, depresión, salud mental, universitarios Mental health disorders have a significant impact on the quality of life of individuals, and the COVID-19 pandemic increased these problems. The aim of this study was to analyze the factors of greater risk associated with the symptomatology of mental health disorders in students of public and private universities as an impact of COVID-19. Based on these findings, it is considered necessary to promote mental health and early intervention of university students, through psychological and/or psychiatric support, specifically in female students and medical students. Keywords: anxiety, COVID-19, depression, mental health, university students El SARS-CoV-2, agente causal de la epidemia por COVID-19, fue considerada la primera pandemia del siglo XXI, convirtiéndose en un gran problema de salud a nivel mundial (Coronaviridae Study Group, 2020;Ruiz & Jiménez, 2020).

Economic impact of the interventions Pharmaceuticals adopted by COVID-19: The Paraguayan case

The objective of this article is to quantify the negative relationship between economic activity and COVID-19 containment through the implementation of nonpharmaceutical interventions in Paraguay. The article calibrates the model developed by Eichenbaum, Rebelo, and Trabandt using data from Paraguay. It uses the model to simulate the trajectory of economic activity, considering three different infection scenarios. The first is a flexibilization of the nonpharmaceutical intervention measures that are still in force. The second studies the economic impact of containing an acceleration of the infection. The third analyzes a reduction in infection and its effect on the economy. These case studies allow for an approximation of the economic cost of containing the infection. (English) [ FROM AUTHOR] El objetivo de este trabajo es cuantificar la relación negativa entre actividad económica y la contención de la COVID-19 mediante la implementación de intervenciones no farmacéuticas en Paraguay. Para esto, calibramos el modelo desarrollado por Eichenbaum, Rebelo y Trabandt con datos de Paraguay. Utilizamos el modelo para simular la trayectoria de la actividad económica, dados distintos escenarios de infección. Consideramos tres casos de estudio. En el primero, consideramos una flexibilizaci ón de las medidas de intervención no farmacéuticas aún vigentes. En el segundo, estudiamos el impacto económico de contener una aceleración de la infección. En el tercer caso, analizamos una reducción de la infección y su efecto en la economía. Mediante el estudio de estos casos obtenemos una aproximación del costo económico de contener la infección. (Spanish) [ FROM AUTHOR] Copyright of Latin American Research Review is the property of Latin American Studies Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Impacto económico de las intervenciones no farmacéuticas adoptadas por la COVID-19: El caso de Paraguay

El objetivo de este trabajo es cuantificar la relaci ón negativa entre actividad económica y la contencíon de la COVID-19 mediante la implementacíon de intervenciones no farmacéuticas en Paraguay. Para esto, calibramos el modelo desarrollado por Eichenbaum, Rebelo y Trabandt con datos de Paraguay. Utilizamos el modelo para simular la trayectoria de la actividad económica, dados distintos escenarios de infeccíon. Consideramos tres casos de estudio. En el primero, consideramos una flexibilizaci ón de las medidas de intervencíon no farmacéuticas aún vigentes. En el segundo, estudiamos el impacto económico de contener una aceleracíon de la infeccíon. En el tercer caso, analizamos una reduccíon de la infeccíon y su efecto en la economía. Mediante el estudio de estos casos obtenemos una aproximacíon del costo económico de contener la infeccíon.Alternate :The objective of this article is to quantify the negative relationship between economic activity and COVID-19 containment through the implementation of nonpharmaceutical interventions in Paraguay. The article calibrates the model developed by Eichenbaum, Rebelo, and Trabandt using data from Paraguay. It uses the model to simulate the trajectory of economic activity, considering three different infection scenarios. The first is a flexibilization of the nonpharmaceutical intervention measures that are still in force. The second studies the economic impact of containing an acceleration of the infection. The third analyzes a reduction in infection and its effect on the economy. These case studies allow for an approximation of the economic cost of containing the infection.

Interstitial Lung Diseases Virtual Clinics: a novel medicaleducation method during pandemic times

Introduction: SARS-COV-2 pandemic challenged the medical education face-to-face meetings. ILD Virtual Clinics(ILD-VC) were thought as a non-traditional medical education model to address topics about a holistic managementof ILDs. Weekly videoconferencing interviews with local experts and Q&A from the public were developed. Objective(s): To describe a virtual medical education model with an innovative format through interviews with experts indifferent ILD topics as a best practice.Implementation: 20 episodes of ILD-VC were carried out with an audience of pulmonologists, rheumatologists andgeneral physicians from Argentina, Paraguay and Uruguay. Each 60 minutes duration episode with the presence ofthe coordinators and an expert in a specific topic for each episode recognized as an unmet need. The main objectivewas to discuss ILD management from different points of view and create a digital library with advices from thechosen experts. Some of the topics were: antigen searching for HP;determining progression in PF-ILDs;amongothers. The number of virtual assistants was 217 per episode (average) with a maximum of 382 and more de 4300connections in total. A third season in planned for 2022. Conclusion(s): This innovate format provided a better understanding of ILD holistic management. Disclosures: The authors meet criteria for authorship as recommended by the International Committee of Medical Journal Editors (ICMJE). The authors did not receive payment related to the development of the abstract. Boehringer Ingelheim (BI) was given the opportunity to review the manuscript for medical and scientific accuracy as well as intellectual property considerations. The study was supported and funded by BI.