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1.
BMC Psychiatry ; 23(1): 408, 2023 06 07.
Article in English | MEDLINE | ID: covidwho-20241220

ABSTRACT

OBJECTIVES: To determine the association between internet addiction disorder (IAD) and anxiety and depressive symptomatology in high school students in two private schools in Chiclayo, Peru, during the COVID-19 pandemic. MATERIALS AND METHODS: Analytical cross-sectional investigation of 505 adolescents from two private schools. The dependent variables were anxiety and depressive symptomatology, measured with the Beck Adapted Depression Questionnaire (BDI-IIA) and the Beck Anxiety Inventory (BAI), respectively. The main independent variable was IAD, measured with the Internet Addiction Test instrument(IATI). Prevalence ratios (PR) and 95% confidence intervals (95%CI) were estimated. RESULTS: The average age was 14.16 years and 54.9% were women. 22.2% and 3.2% presented mild and moderate IAD; respectively. 9.3% presented severe anxiety and 34.3% severe depressive symptomatology. In the simple regression, adolescents with mild, moderate and severe IAD presented 19% (PR = 1.19; 95%CI: 1.05-1.35), 25% (PR = 1.25; 95%CI: 1.02-1.53) and 53% (PR = 1.47; 95% CI: 1.47-1.60) higher prevalence of depressive symptomatology; however, this association was not maintained in the multiple model. Anxiety increased 196% in adolescents with severe IAD (PR = 2.96; 95%CI: 1.86-4.71). CONCLUSION: We found that 2, 1, and 3 out of 10 students presented IAD, depressive symptomatology, and anxiety, respectively. We did not find an association between IAD and depressive symptomatology, but we did find an association with anxiety. Among the factors associated with the development of depressive symptomatology were the male sex, the presence of eating disorders, subclinical insomnia, using devices for more than 2 h, and using the Internet for academic activities. About anxiety, the associated factors are the female sex, the presence of eating disorders, subclinical insomnia, and the use of the Internet as social interaction. We recommend implementing counseling programs in view of the imminent introduction of the Internet as a pillar in education.


Subject(s)
Behavior, Addictive , COVID-19 , Sleep Initiation and Maintenance Disorders , Adolescent , Humans , Male , Female , Cross-Sectional Studies , Internet Addiction Disorder/epidemiology , Peru/epidemiology , Sleep Initiation and Maintenance Disorders/epidemiology , Mental Health , Pandemics , COVID-19/epidemiology , Students/psychology , Internet , Behavior, Addictive/epidemiology , Behavior, Addictive/psychology , Depression/epidemiology , Depression/psychology
2.
Int J Environ Res Public Health ; 20(11)2023 May 28.
Article in English | MEDLINE | ID: covidwho-20234494

ABSTRACT

The COVID-19 pandemic forced the government to rapidly modify its legal framework to adopt telemedicine and promote the implementation of telehealth services to meet the healthcare needs of patients in Peru. In this paper, we aim to review the main changes to the regulatory framework and describe selected initiatives to promote the telehealth framework that emerged in Peru during the COVID-19 pandemic. In addition, we discuss the challenges to integrate telehealth services for strengthening health systems in Peru. The Peruvian telehealth regulatory framework began in 2005, and in subsequent years, laws and regulations were established that sought to progressively implement a national telehealth network. However, mainly local initiatives were deployed. In this sense, significant challenges remain to be addressed, such as infrastructure in healthcare centers, including high-speed Internet connectivity; infostructure of health-information systems, including interoperability with electronic medical records; monitoring and evaluation of the national agenda for the health sector in 2020-2025; expanding the healthcare workforce in terms of digital health; and developing the capacities of healthcare users on health literacy, including digital aspects. In addition, there is enormous potential for telemedicine as a key strategy to deal with the COVID-19 pandemic and to improve access to rural and hard-to-reach areas and populations. There is thus an urgent need to effectively implement an integrated national telehealth system to address sociocultural issues and strengthen the competencies of human resources in telehealth and digital health in Peru.


Subject(s)
COVID-19 , Telemedicine , Humans , COVID-19/epidemiology , Peru/epidemiology , Pandemics , Delivery of Health Care
3.
BMC Public Health ; 23(1): 1054, 2023 06 01.
Article in English | MEDLINE | ID: covidwho-20232910

ABSTRACT

BACKGROUND: The COVID-19 pandemic has affected the world in multiple ways and has been a challenge for the health systems of each country. From the beginning, risk factors for the severity and mortality of the disease were considered, as the spread of the virus was related to the living conditions of each population. METHODS: In this ecological study we have evaluated the role of geography, precisely the altitude above sea level in the incidence and mortality of COVID-19 in Peru. Incidence and mortality data were taken from the open-access database of the government of Peru until March 2021. COVID-19 cases and COVID-19 mortality were treated as cases/density population and 1000 x cases/inhabitants while altitude was treated as continuous and as a categorical variable divided in 7 categories. The relationship between COVID-19 cases or deaths for COVID-19 and altitude as continuous variable was determined using Spearman correlation test. Meanwhile when altitude was considered as a categorical variable, Poisson regression or negative binomial analyses were applied. RESULTS: A significant inverse correlation was found between COVID-19 cases by population density and altitude (r=-0.37 p < 0.001). By altitude categories, the lowest risk for infection was observed between 3,000 and 3,500 m (IRR 0.08; 95% CI 0.05,0.12). Moreover, we found an inverse correlation between altitude and COVID-19 mortality (r=-0.39 p < 0.001). Also, the lowest risk for mortality was observed between 3,000 and 3,500 m (IRR 0.12; 95%CI 0.08; 0.18). Similar results were found when analyses were adjusted for inhabitants and stratified by sex. CONCLUSION: This study reports an inverse relationship between COVID-19 incidence and mortality with respect to the altitude of residence, particularly, a u-shaped protection is shown, with a highest benefit between 3000 and 3500 m. The possibility of using hypoxia as an alternative treatment requires more complex studies that should allow knowing the physiological and environmental mechanisms of the protective role.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Altitude , Peru/epidemiology , Pandemics/prevention & control , Risk Factors
4.
Int J Environ Res Public Health ; 20(11)2023 May 24.
Article in English | MEDLINE | ID: covidwho-20242414

ABSTRACT

AIM: Biosafety is a set of preventive measures aimed at controlling risk factors arising from biological, physical, and/or chemical agents. This topic is particularly important in the dental field since saliva is the main biological agent of the transmission of coronavirus. The present study aimed to determine the factors associated with the level of knowledge about biosafety against COVID-19 in Peruvian dentistry students. MATERIALS AND METHODS: The present observational, cross-sectional, and analytical study evaluated 312 Peruvian dentistry students. A validated 20-question questionnaire was used to measure the level of knowledge. The nonparametric Mann-Whitney U and Kruskal-Wallis tests were used to compare levels of knowledge between categories of each variable. A logit model was used to evaluate associated factors such as sex, age, marital status, place of origin, academic year of study, being in the academic upper third, history of COVID-19, and living with vulnerable family members. A significance level of p < 0.05 was considered. RESULTS: 36.2%, 31.4%, and 32.4% presented poor, fair, and good knowledge levels, respectively. Students under 25 years of age were 64% less likely to pass the biosafety against COVID-19 questionnaire than students 25 years of age and older (OR = 0.36; CI: 0.20-0.66). Students in the academic upper third were nine times more likely to pass the test than other students (OR = 9.38; CI: 4.61-19.07). Finally, third-year students were 52% less likely to pass the exam than fifth-year students (OR = 0.48; CI: 0.28-0.83). CONCLUSION: Only a minority of dentistry students had a good level of knowledge about biosafety against COVID-19. Younger and less educated students were more likely to fail the questionnaire. On the other hand, those students with outstanding academic performance were more likely to pass the questionnaire.


Subject(s)
COVID-19 , Adult , Humans , Containment of Biohazards , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Peru/epidemiology , Students, Dental , Young Adult
5.
Int J Tuberc Lung Dis ; 27(5): 411-413, 2023 05 01.
Article in English | MEDLINE | ID: covidwho-2317997
6.
Glob Public Health ; 18(1): 2207410, 2023 01.
Article in English | MEDLINE | ID: covidwho-2316177

ABSTRACT

Researchers and practitioners recognise the importance of context when implementing healthcare interventions, but the influence of wider environment is rarely mapped. This paper identifies the country and policy-related factors potentially explaining the country differences in outcomes of an intervention focused on improving detection and management of heavy alcohol use in primary care in Colombia, Mexico and Peru. Qualitative data obtained through interviews, logbooks and document analysis are used to explain quantitative data on number of alcohol screenings and screening providers in each of the countries. Existing alcohol screening standards in Mexico, and policy prioritisation of primary care and consideration of alcohol as a public health issue in Colombia and Mexico positively contributed to the outcome, while the COVID-19 pandemic had a negative impact. In Peru, the context was unsupportive due to a combination of: political instability amongst regional health authorities; lack of focus on strengthening primary care due to the expansion of community mental health centres; alcohol considered as an addiction rather than a public health issue; and the impact of COVID-19 on healthcare. We found that wider environment-related factors interacted with the intervention implemented and can help explain country differences in outcomes.


Subject(s)
COVID-19 , Pandemics , Humans , Mexico/epidemiology , Colombia/epidemiology , Peru/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , Policy , Primary Health Care
7.
PLoS One ; 18(5): e0285133, 2023.
Article in English | MEDLINE | ID: covidwho-2312230

ABSTRACT

INTRODUCTION: COVID-19 caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spread worldwide, becoming a long-term pandemic. OBJECTIVES: To analyze the factors associated with mortality in patients hospitalized for COVID-19 in a tertiary hospital in the Lambayeque region of Peru. METHODS: A retrospective cohort study of patients with a diagnosis of COVID-19, hospitalized in a hospital in northern Peru, was conducted from March to September 2020. RESULTS: Of the 297 patients studied, 69% were women, the mean age was 63.99 years (SD = ±15.33 years). Hypertension was the most frequent comorbidity (36.67%), followed by diabetes mellitus (24.67%) and obesity (8.33%). The probability of survival at 3 days of ICU stay was 65.3%, at 7 days 24.2%, and 0% on day 14. Risk factors associated with mortality in patients hospitalized for COVID-19 are age, male sex, tachypnea, low systolic blood pressure, low peripheral oxygen saturation, impaired renal function, elevated IL-6 and elevated D-dimer. CONCLUSIONS: Mortality in hospitalized patients with COVID-19 was 51.18 per 100 persons, Mortality was found to be associated with hypertension, type of infiltrating, and sepsis.


Subject(s)
COVID-19 , Hypertension , Humans , Male , Female , Middle Aged , COVID-19/epidemiology , SARS-CoV-2 , Tertiary Care Centers , Retrospective Studies , Pandemics , Peru/epidemiology , Hospitalization , Risk Factors , Hypertension/epidemiology , Hospital Mortality
9.
Rev Salud Publica (Bogota) ; 22(2): 155-163, 2020 03 01.
Article in Spanish | MEDLINE | ID: covidwho-2295682

ABSTRACT

OBJECTIVE: The objective of the study is to analyze the behavior dynamics of COVID-19 in Peru, estimate and evaluate the impact of the suppression public policy (quarantine). METHODS: The SIR epidemiological model and the estimation with the ordinary Least Squares (OLS) method. RESULTS: It was found that the basic number of propagation (Ro) fell from 6,0 to 3,2 having been reduced by 54% due to the suppression strategy; and two months later it falls to 1,7. However, it remains high and evidence that the level of those infected continues to expand with its adverse social and economic effects. CONCLUSION: COVID-19 is a disease that grows exponentially, and that the health policy based on the suppression strategy has allowed to flatten the contagion curve, thus avoiding the collapse of the Health System.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , SARS-CoV-2 , Pandemics/prevention & control , Peru/epidemiology , Public Policy , Health Policy , Public Health
10.
Curr Alzheimer Res ; 20(2): 80-88, 2023.
Article in English | MEDLINE | ID: covidwho-2293773

ABSTRACT

BACKGROUND: Neuropsychiatric symptoms (NPS) in patients with Alzheimer's disease (AD) worsened during the COVID-19 lockdowns, but their progression thereafter is unknown. We present the first longitudinal study tracking them before, during, and after restrictions. OBJECTIVES: To describe the effect of the COVID-19 mandatory lockdowns on Cognitive and Neuropsychiatric symptoms in patients with Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD). METHODS: Cohort of 48 patients with amnestic MCI and 38 with AD in Lima, Peru. They received three rounds of cognitive (RUDAS, CDR, M@T), behavioral (NPI), and functional (ADCS-ADL) assessments. We assessed the change in score means across the time points and for each domain of NPS and tracked the changes in individual patients. RESULTS: RUDAS declined 0.9 (SD 1.0) from baseline to lockdown and 0.7 (SD 1.0) after restrictions. M@T declined 1.0 (SD 1.5) from baseline to lockdown and 1.4 (SD 2.0) after restrictions. CDR worsened in 72 patients (83.72%) from baseline to post-lockdown. NPI worsened by 10 (SD 8.3) from baseline to lockdown but improved by 4.8 (SD 6.4) after restrictions. Proportionally, 81.3% of all patients had worsened NPS during the lockdowns, but only 10.7% saw an increase thereafter. Improvement was statistically significant for specific NPS domains except hallucinations, delusions, and appetite changes. Anxiety, irritability, apathy, and disinhibition returned to baseline levels. CONCLUSION: Following confinement, cognition continued to decline, but NPS demonstrated either stability or improvement. This highlights the role modifiable risk factors may have on the progression of NPS.


Subject(s)
Alzheimer Disease , COVID-19 , Cognitive Dysfunction , Humans , Alzheimer Disease/diagnosis , Longitudinal Studies , Peru/epidemiology , Neuropsychological Tests , Communicable Disease Control , Cognitive Dysfunction/diagnosis , Cognition
11.
Arch Prev Riesgos Labor ; 26(2): 127-149, 2023 Apr 15.
Article in Spanish | MEDLINE | ID: covidwho-2293071

ABSTRACT

INTRODUCTION: The COVID-19 pandemic led to massive use of personal protective equipment (PPE). However, evidence on the frequency of appropriate use is sparse. In this study, we evaluated the level of knowledge about COVID-19 and biosafety measures, and the frequency of correct use of masks in workers at a university in Lima, Peru. METHODS: Cross-sectional study conducted in a population of 109 workers of a private university who were physically onsite. We used a structured questionnaire to measure knowledge of COVID-19, together with use of and training in PPE. In addition, we explored factors associated with the correct use of masks and an adequate level of knowledge about COVID-19 and related biosafety measurSpain. Results were expressed as prevalence, using student's T-test and Pearson chi-square tests. RESULTS: We evaluated 82 workers, 35.4% of whom showed an adequate level of knowledge about COVID-19 and biosafety measurSpain. Younger participants and those who regularly washed their hands at work had an adequate level of knowledge, with 90.2% of these reporting correct use of their masks. Workers in general service areas or with a low level of education reported less frequent correct use of their mask compared to those who did not have these characteristics.  Conclusion: We found a low level of knowledge about COVID-19 and biosafety measures among the workers of a private university; a higher level of education was associated with a greater prevalence of correct mask use. Training programs by work areas are needed, to improve biosafety practices among workers.


Introducción: La pandemia por la COVID-19 llevó al uso masivo de equipos de protección individual (EPI). Sin embargo, la evidencia sobre la frecuencia de su uso adecuado es escasa. El objetivo de este estudio es evaluar el nivel de conocimiento sobre la COVID-19 y medidas de bioseguridad, y la frecuencia de uso correcto de mascarilla en los trabajadores de una universidad en Lima, Perú, durante la pandemia. Métodos: Estudio transversal realizado en los 109 trabajadores de una universidad privada que se encontraban en modalidad presencial entre junio y septiembre 2021. Se utilizó un cuestionario estructurado. Se estimaron las prevalencias del nivel de conocimiento y uso correcto de EPIs, y los factores asociados mediante la T student y Chi-2 de Pearson.  Resultados: Participaron en total 82 trabajadores (75%). El 35% mostró un adecuado nivel de conocimiento sobre la COVID-19 y medidas de bioseguridad. Los más jóvenes y los que se lavaban las manos en el trabajo mostraron un mayor conocimiento, refiriendo el 90% utilizar correctamente su mascarilla. Los trabajadores de áreas de servicios generales o con bajo nivel de educación refirieron un menor uso correcto de su mascarilla.  Conclusión: El nivel de conocimiento sobre la COVID-19 y las medidas de bioseguridad entre los trabajadores de una universidad privada fue bajo y el nivel de educación se mostró inversamente asociado al uso correcto de mascarilla. Es necesario implementar programas de capacitación por áreas de trabajo para mejorar las prácticas de bioseguridad en los trabajadorSpain.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Pandemics/prevention & control , Peru/epidemiology , Cross-Sectional Studies , Universities , Health Personnel
12.
BMC Public Health ; 23(1): 691, 2023 04 13.
Article in English | MEDLINE | ID: covidwho-2305112

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, increased workload and stress could have increased mental health problems (anxiety and depression) in military personnel. However, the number of studies in military members is scarce, especially in regard to mental health. The objective of this study was determine the prevalence and factors associated with depression and anxiety in Peruvian military personnel. METHODS: We undertook an analytical cross-sectional study. The survey was distributed face to face between November 02 and 09, 2021, during the second wave of the COVID-19 pandemic among the military personnel. We used some instruments to measure depression (Patient Health Questionnaire, PHQ-9), anxiety (Generalized Anxiety Disorder, GAD-7), insomnia (Insomnia Severity Index, ISI), food insecurity (Household Food Insecurity Access Scale, HFIAS), physical activity (International Physical Activity Questionnaires, IPAQ-S), resilience (abbreviated CD-RISC), and fear of COVID-19 scale. The exclusion criteria included those who did not completely fill out the evaluation instruments. RESULTS: We analyzed the data of 615 military personnel that participated in the survey. Of them, 93.7% were male and the median age was 22 years old. There was a prevalence of 29.9% and 22.0% in regard to depression and anxiety symptoms, respectively. In addition, it was found that being married (PR: 0.63; 95% IC: 0.42-0.94), having a relative with mental health problems (PR: 2.16), having experienced food insecurity (PR: 1.48), insomnia (PR: 2.71), fear of COVID-19 (PR: 1.48), and a high level of resilience (PR: 0.65) were factors associated with depression. In regard to anxiety, the factors associated were working for more than 18 months since the beginning of the COVID-19 pandemic (PR: 0.52), a high level of resilience (PR: 0.50; 95% IC: 0.33-0.77), insomnia (PR: 3.32), fear of COVID-19 (PR: 2.43). CONCLUSION: We found a prevalence of symptoms of depression and anxiety of 29.9% and 22.0%, respectively. In regard to the factors that attenuate depression, we can mention being married and having resilience; and among the aggravating factors, having a relative with mental health problems, food insecurity, insomnia, and fear of COVID-19. Finally, anxiety increased through working time, insomnia, and fear of COVID-19.


Subject(s)
COVID-19 , Military Personnel , Sleep Initiation and Maintenance Disorders , Humans , Male , Young Adult , Adult , Female , COVID-19/epidemiology , Pandemics , Cross-Sectional Studies , Depression/psychology , Sleep Initiation and Maintenance Disorders/epidemiology , Peru/epidemiology , Anxiety/psychology , Anxiety Disorders/epidemiology
13.
Soc Sci Med ; 325: 115890, 2023 05.
Article in English | MEDLINE | ID: covidwho-2303109

ABSTRACT

The COVID-19 pandemic has introduced dramatic adversities for public health around the world, especially in low and middle-income countries. While research has shown the pandemic to have direct effects on a variety of major economic and health crises, its impact on health-related behaviors is not clear. In this paper, I examine how exposure to the pandemic affects alcohol use and smoking in Peru, which experienced one of the highest COVID-related death rates albeit implementing one of the strictest lockdown policies in the world. I find that post pandemic consumption of alcohol and smoking in the last 30 days decreases by 41.3% and 44.1% respectively when compared to pre-pandemic rates. I also conclude that the intensity of engaging in these behaviors change such that the frequency of consuming alcohol in the last 30 days, binge drinking and the probability of smoking daily falls. While drinking behavior returns to pre-pandemic levels, the negative effect on smoking weakens but remains for almost two years preceding the pandemic.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Pandemics , Peru/epidemiology , Communicable Disease Control , Alcohol Drinking/epidemiology , Tobacco Use/epidemiology
15.
Am J Trop Med Hyg ; 108(6): 1249-1255, 2023 06 07.
Article in English | MEDLINE | ID: covidwho-2301935

ABSTRACT

The COVID-19 pandemic affected the main Amazon cities dramatically, with Iquitos City reporting the highest seroprevalence of anti-SARS-CoV-2 antibodies during the first COVID-19 wave worldwide. This phenomenon raised many questions about the possibility of a co-circulation of dengue and COVID-19 and its consequences. We carried out a population-based cohort study in Iquitos, Peru. We obtained a venous blood sample from a subset of 326 adults from the Iquitos COVID-19 cohort (August 13-18, 2020) to estimate the seroprevalence of anti-dengue virus (DENV) and anti-SARS-CoV-2 antibodies. We tested each serum sample for anti-DENV IgG (serotypes 1, 2, 3, and 4) and SARS-CoV-2 antibodies anti-spike IgG and IgM by ELISA. We estimated an anti-SARS-CoV-2 seroprevalence of 78.0% (95% CI, 73.0-82.0) and an anti-DENV seroprevalence of 88.0% (95% CI, 84.0-91.6), signifying a high seroprevalence of both diseases during the first wave of COVID-19 transmission in the city. The San Juan District had a lower anti-DENV antibody seroprevalence than the Belen District (prevalence ratio, 0.90; 95% CI, 0.82-0.98). However, we did not observe these differences in anti-SARS-CoV-2 antibody seroprevalence. Iquitos City presented one of the highest seroprevalence rates of anti-DENV and anti-SARS-CoV-2 antibodies worldwide, but with no correlation between their antibody levels.


Subject(s)
COVID-19 , Adult , Humans , COVID-19/epidemiology , SARS-CoV-2 , Peru/epidemiology , Cohort Studies , Seroepidemiologic Studies , Pandemics , Antibodies, Viral , Immunoglobulin G
16.
Lancet Microbe ; 4(6): e452-e460, 2023 06.
Article in English | MEDLINE | ID: covidwho-2299324

ABSTRACT

BACKGROUND: Integrated molecular testing could be an opportunity to detect and provide care for both tuberculosis and COVID-19. Many high tuberculosis burden countries, such as Peru, have existing GeneXpert systems for tuberculosis testing with GeneXpert Xpert MTB/RIF Ultra (Xpert Ultra), and a GeneXpert SARS-CoV-2 assay, GeneXpert Xpert Xpress SARS-CoV-2 (Xpert Xpress), is also available. We aimed to assess the feasibility of integrating tuberculosis and COVID-19 testing using one sputum specimen with Xpert Ultra and Xpert Xpress in Lima, Peru. METHODS: In this cross-sectional, diagnostic accuracy study, we recruited adults presenting with clinical symptoms or suggestive history of tuberculosis or COVID-19, or both. Participants were recruited from a total of 35 primary health facilities in Lima, Peru. Participants provided one nasopharyngeal swab and one sputum sample. For COVID-19, we tested nasopharyngeal swabs and sputum using Xpert Xpress; for tuberculosis, we tested sputum using culture and Xpert Ultra. We compared diagnostic accuracy of sputum testing using Xpert Xpress with nasopharyngeal swab testing using Xpert Xpress. Individuals with positive Xpert Xpress nasopharyngeal swab results were considered COVID-19 positive, and a positive culture indicated tuberculosis. To assess testing integration, the proportion of cases identified in sputum by Xpert Xpress was compared with Xpert Xpress on nasopharyngeal swabs, and sputum by Xpert Ultra was compared with culture. FINDINGS: Between Jan 11, 2021, and April 26, 2022, we recruited 600 participants (312 [52%] women and 288 [48%] men). In-study prevalence of tuberculosis was 13% (80 participants, 95% CI 11-16) and of SARS-CoV-2 was 35% (212 participants, 32-39). Among tuberculosis cases, 13 (2·2%, 1·2-3·7) participants were concurrently positive for SARS-CoV-2. Regarding the diagnostic yield of integrated testing, Xpert Ultra detected 96% (89-99) of culture-confirmed tuberculosis cases (n=77), and Xpert Xpress-sputum detected 67% (60-73) of COVID-19 cases (n=134). All five study staff reported that integrated molecular testing was easy and acceptable. INTERPRETATION: The diagnostic yield of Xpert Xpress on sputum was moderate, but integrated testing for tuberculosis and COVID-19 with GeneXpert was feasible. However, systematic testing for both diseases might not be the ideal approach for everyone presenting with presumptive tuberculosis or COVID-19, as concurrent positive cases were rare during the study period. Further research might help to identify when integrated testing is most worthwhile and its optimal implementation. FUNDING: Canadian Institutes of Health Research and International Development Research Centre. TRANSLATION: For the Spanish translation of the abstract see Supplementary Materials section.


Subject(s)
COVID-19 , Mycobacterium tuberculosis , Tuberculosis, Pulmonary , Tuberculosis , Male , Adult , Humans , Female , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/epidemiology , Mycobacterium tuberculosis/genetics , COVID-19 Testing , Cross-Sectional Studies , Peru/epidemiology , Sensitivity and Specificity , COVID-19/diagnosis , COVID-19/epidemiology , SARS-CoV-2/genetics , Canada , Tuberculosis/diagnosis , Tuberculosis/epidemiology , Molecular Diagnostic Techniques/methods
17.
Int J Environ Res Public Health ; 20(6)2023 03 15.
Article in English | MEDLINE | ID: covidwho-2277659

ABSTRACT

During the COVID-19 pandemic, most of the deaths in Peru were related to COVID-19; however, cancer deaths have also been exacerbated in the first months of the pandemic. Despite this, excess mortalities of prostate, breast, and uterus cancer are not available by age group and region from January to December 2020. Therefore, we estimated the excess deaths and excess death rates (per 100,000 habitants) due to prostate, breast, and uterus cancer in 25 Peruvian regions. We did a time series analysis. Prostate, breast, and uterus cancer death data for 25 Peruvian regions were retrieved during the COVID-19 pandemic in 2020, as well as data for up to 3 years prior (2017-2019) from the Sistema Informatico Nacional de Defunciones at the Ministry of Health of Peru. Deaths in 2020 were defined as observed deaths. The expected deaths (in 2020) were estimated using the average deaths over 3 preceding years (2017, 2018 and 2019). Excess mortality was calculated as the difference between observed mortality and expected mortality in 2020. We estimated that the number of excess deaths and the excess death rates due to prostate, breast, and uterus cancer were 610 deaths (55%; 12.8 deaths per 100,000 men), 443 deaths (43%; 6 deaths per 100,000 women), and 154 deaths (25%; 2 deaths per 100,000 women), respectively. Excess numbers of deaths and excess death rates due to prostate and breast cancer increased with age. These excess deaths were higher in men aged ≥ 80 years (596 deaths (64%) and 150 deaths per 100,000 men) and women aged 70-79 years (229 deaths (58%) and 15 deaths per 100,000 women), respectively. In summary, during the COVID-19 pandemic, there were excess prostate and breast cancer mortalities in 2020 in Peru, while excess uterus cancer mortalities were low. Age-stratified excess death rates for prostate cancer and breast cancer were higher in men ≥ 80 years and in women ≥ 70 years, respectively.


Subject(s)
Breast Neoplasms , COVID-19 , Uterine Neoplasms , Male , Humans , Female , Pandemics , Peru/epidemiology , Prostate , Time Factors , Uterine Neoplasms/epidemiology , Mortality
18.
PLoS One ; 18(3): e0280528, 2023.
Article in English | MEDLINE | ID: covidwho-2274869

ABSTRACT

The present study evaluated the factors associated with the perception of anxiety during the first wave of covid-19 in Ibero-American countries. This cross-sectional study was carried out with 5.845 participants of both sexes, over 18 years of age, and residents of four Latin American countries-Argentina (16.7%), Brazil (34.5%), Mexico (11.1%), and Peru (17.5%), and one European country-Spain (20.1%). Data were collected in 2020, between April 1st and June 30th in Spain and between July 13th and September 26th in the Latin American countries. We used an online questionnaire with sociodemographic, lifestyle, self-reported anxiety, and covid-19 related questions. The chi-square statistical test and Multivariate logistic regressions were performed to analyze the factors associated with self-reported anxiety. The presence of self-reported anxiety was found in 63.8% of the participants during the isolation period. The association occurred mainly in women (OR:1.52; CI: 1.3-1.7), those aged 18 to 29 years (OR: 1.51; CI: 1.2-1.9) and 30 to 49 years (OR: 1.56; CI: 1.3-1.9), residents of Argentina (OR: 1.55 CI: 1.2-1.9), Brazil (OR: 2.38; CI: 2.0-2.8) and Mexico (OR: 1.52; CI: 1.2-1.9), those who gained weight (OR:1.71 CI: 1.5-1.9) or lost weight (OR: 1.40; CI: 1.2-1.6), and those who reported having slept more (OR: 1.56; CI: 1.3-1.8) or less (OR: 2.89; CI: 2.5-3.4). We conclude that the prevalence of self-reported anxiety in Ibero-American countries was high during the period studied, highlighting a higher likelihood of its occurrence in Brazil, in those who began to sleep less and gained weight.


Subject(s)
COVID-19 , Pandemics , Male , Adult , Female , Humans , Adolescent , Cross-Sectional Studies , Self Report , Spain , Brazil/epidemiology , Mexico/epidemiology , Peru/epidemiology , Prevalence , Argentina/epidemiology , COVID-19/epidemiology , Anxiety/epidemiology
19.
J Gerontol B Psychol Sci Soc Sci ; 78(6): 1109-1117, 2023 05 26.
Article in English | MEDLINE | ID: covidwho-2259340

ABSTRACT

OBJECTIVES: To explore the experiences of older Peruvian adults living in urban areas of Lima under lockdown due to the National COVID-19 Emergency, this study analyzes how older adults (aged 60 and older) exercise agency while also living with the negative impacts of coronavirus disease 2019 (COVID-19) and related control measures. METHODS: Between August and December 2020, our research team conducted a telephone-based, qualitative study, in which we undertook semistructured interviews with a purposive sample of low-income older adults living with chronic multimorbidities and limited resources. Forty older adults, 24 women and 16 men, with a mean age of 72 years, participated in the study. For data analysis, we employed thematic analysis with a predominantly inductive approach. RESULTS: Older adults demonstrated several forms of agency to regulate emotions, maintain crucial bonds, foster social relationships, and seek economic and food security. Older adults experienced entertainment and support by caring for pets, undertaking farm work, and practicing their religious beliefs. For several participants and their families, quarantine was an opportunity to strengthen family relationships and learn new technologies. Older adults and their families reorganized themselves to assume new roles and perform activities that improved self-worth and confidence, thereby improving their well-being and mental health. DISCUSSION: Peruvian older adults exerted agency in different ways to respond to and sustain their mental health during the COVID-19 lockdown. Policymakers should value and recognize the agency of older adults when planning future health responses.


Subject(s)
COVID-19 , Male , Humans , Female , Middle Aged , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Mental Health , Peru/epidemiology , Learning
20.
Int J Environ Res Public Health ; 19(24)2022 12 15.
Article in English | MEDLINE | ID: covidwho-2259121

ABSTRACT

During the pandemic, the elderly population was the most exposed to disease and changes in their daily lives. The objective was to determine the association between demographic factors, access to health services, sources of information, and physical symptoms in the mental health of the elderly during the COVID-19 pandemic-a study with 3828 older adults residing in nine cities in Peru. The data was collected using a web-based survey, and the instruments of demographic data; exposure to information (radio, television, and internet); and presence of physical symptoms, anxiety, and perceived stress were used. Descriptive and analytical analysis was performed. Female sex, those aged between 60 and 79 years old, those with secondary education, those in their own home, those residing in an urban area, and those using public services of health predominated in this study. Likewise, 62.9% presented depressive symptoms; on the stress scale, an average of 27.81 (SD = 8.71), and on the anxiety scale, an average of 27.24 (SD = 6.04). Moreover, 65.1% reported fatigue, 62.2% had a headache, and 61.2% lack of energy. There is an association between demographic variables and the physical and psychological symptoms of stress, anxiety, and depressive symptoms in the elderly during the pandemic.


Subject(s)
COVID-19 , Humans , Aged , Female , Middle Aged , COVID-19/epidemiology , Pandemics , Peru/epidemiology , Mental Health , SARS-CoV-2 , Depression/epidemiology , Depression/psychology , Anxiety/epidemiology , Anxiety/psychology
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