Examining the relationship between intimate partner violence and child development program attendance in young children: A cross-sectional study.

The aim of the present study was to determine the association between different types of intimate partner violence against women and nonattendance at the Growth and Development Control Program (CRED or well-child visits) of their children under 5 years of age. This was an analytical cross-sectional study that comprised a secondary analysis of data from the Demographic and Family Health Survey (ENDES in Spanish) of Peru, 2019. Data from 19,647 mothers (aged 15-49 years) and their children under 5 years were analyzed. The independent variables were the types of intimate partner violence = emotional, physical, and sexual. The outcome variable was nonattendance at CRED in the last 6 months. The mean maternal age was 30.47 ±â€…6.66 years; 66.1% of children were between 25 and 60 months of age; the prevalence of nonattendance at CRED was 29.9%. A relationship was found between partner violence against the mother and nonattendance at CRED. Specifically, there was a higher probability of nonattendance in the children of women who experienced partner violence (sexual = aPR = 1.25 [95% CI = 1.07-1.44]; physical = aPR = 1.17 [95% CI = 1.08-1.26]; emotional = aPR = 1.12 [95% CI = 1.03-1.21]). This study showed an association indicating that children born to mothers experiencing intimate partner violence exhibit an elevated likelihood of nonattendance at CRED when compared to children of mothers not subjected to such violence. Therefore, emphasizing the promotion and monitoring of child development, especially for those with a history of maternal violence, should be a primary priority, particularly in primary care.

Association between intimate partner violence and pregnancy intention: evidence from the Peruvian demographic and health survey.

BACKGROUND: Intimate partner violence (IPV) in Peru represents a significant public health challenge. IPV can influence women's reproductive and social behaviors, undermining fertility control, and exacerbating unintended pregnancies. Our objective was to assess the association between IPV and pregnancy intention among Peruvian women of reproductive age. METHODS: We conducted a secondary analysis of Peru's 2020 Demographic and Family Health Survey data. The independent variable in this study was IPV against women, which includes psychological IPV, sexual IPV, and physical IPV. If a respondent experienced any of these three forms of IPV, the IPV variable was labeled as "yes"; if none were present, it was labeled as "no". The dependent variable was pregnancy intention (no vs. yes). We utilized a generalized linear model (GLM) from the Poisson family with a log link function to assess the relationship between IPV occurrences (total and each IPV type) and pregnancy intention. We report crude and adjusted prevalence ratios (aPR) with 95% confidence intervals (95%CI). RESULTS: We analyzed data from 8466 women aged 15 to 49. The prevalence of any IPV was 49.6% (psychological IPV: 45.8%; physical IPV: 22.2%; and sexual IPV: 4.3%). Exposure to physical IPV (aPR: 1.05; 95% CI: 1.03-1.07), psychological IPV (aPR: 1.04; 95% CI: 1.02-1.06), and sexual IPV (aPR: 1.09; 95% CI: 1.04-1.13), as well as a history of any IPV (aPR: 1.05; 95% CI: 1.02-1.07), were associated with a higher probability of not intending to become pregnant. This association persisted after adjusting for confounders like age, marital status, educational attainment, education level of the child's father, place of residence, wealth, ethnicity, and parity. CONCLUSION: One in two Peruvian women reported experiencing IPV. An association was observed between IPV exposure and a higher probability of not holding an intention to become pregnant.

Association between witnessing domestic violence against the mother in childhood and intimate partner violence in adulthood: A population-based analysis of Peru.

Objective: To assess the association between witnessing domestic violence against the mother in childhood and intimate partner violence (IPV) in adulthood. Study design: An analytical cross-sectional study was conducted using data from the 2019 Peruvian Demographic and Family Health Survey (ENDES). The independent variable was the condition of witnessing physical violence by the father against the mother during childhood. The dependent variable was IPV, defined by the presence of some subtype of violence (physical, psychological, and sexual) against the respondent in the last year by her husband or partner. To assess this association, generalized linear models of the Poisson Family with a logarithmic link function were performed to estimate crude and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95% CI). Results: Data from 17,911 Peruvian women between 15 and 59 years of age were analyzed. Most women were between 30 and 49 years old (71.4%), were cohabiting (65.0%), and had secondary education (43.2%). The prevalence of IPV in the last year was 16.0%, and the history of witnessing domestic violence against the mother during childhood was 42.0%. In the regression models, those with the studied exposure showed a higher prevalence of experiencing an episode of IPV in the last year (any IPV [aPR: 1.69; 95% CI: 1.50-1.91]; physical IPV [aPR: 1.70; 95% CI: 1.43-2.02], psychological IPV [aPR: 1.64; 95% CI:1.42-1.88], and sexual IPV [aPR: 1.68; 95% CI: 1.22-2.32]). Conclusions: Women with a history of domestic violence towards their mothers were likelier to have had IPV in the last year than women who did not report violence towards their mothers during childhood. Approximately two in ten Peruvian women reported having had IPV in the past year, and nearly half reported witnessing domestic violence against their mother as a child.

Access to HIV/STI testing among male and female Venezuelan migrants in Peru: evidence from a nationwide survey.

BACKGROUND: Human immunodeficiency virus (HIV) infection and sexually transmitted infections (STIs) are major global public health issues. Migrants represent a vulnerable group that faces multiple barriers to access to healthcare services, including HIV/STI testing. This study aimed to assess the factors associated with access to HIV/STI testing in male and female Venezuelan migrants in Peru. METHODS: This was a cross-sectional study involving secondary data analysis of the 2022 Venezuelan Population Residing in Peru Survey. The study was conducted in the eight most populated cities inhabited by Venezuelan migrants and refugees. For each city, the sampling design was probabilistic, stratified, and independent. The outcome variable was whether participants had access to HIV or other STI testing during their stay in Peru. Statistical analysis was stratified by sex owing to potential effect modification. Crude and adjusted prevalence ratios were calculated using generalized linear models Poisson family with log link function. Confidence intervals were calculated to 95%. RESULTS: A total of 3,723 male and 3,984 female migrants were included. Access to HIV/STI testing among male and female migrants was 19.85% and 25.16%, respectively. Among male migrants, being LGBTI, health insured, and married or cohabiting were associated with increased access to HIV/STI testing. Among females, those aged 18-44 years, those who were married or cohabiting and were health insured, and those residing for more than 1 year in Peru were significantly more likely to have access to HIV/STI testing. Moreover, physical/mental disability and unemployed status were associated with a lower probability of HIV/STI testing in females. CONCLUSIONS: Only two in ten Venezuelan migrants and refugees in Peru were screened for HIV/STI, with fewer males than females. Sex-specific sociodemographic, health-related, and migration-related variables were independently associated with access to HIV/STI testing.

Factors associated with non-help-seeking among women victims of physical or sexual intimate partner violence in Peru: Findings from the National Demographic and Family Health Survey, 2017 to 2019.

OBJECTIVE: To evaluate the factors associated with non-help-seeking in victims of physical or sexual intimate partner violence (IPV) in Peru. METHODS: This was an analytical cross-sectional study of 3-year data from the Peruvian Demographic and Health Survey. The sample comprised women aged 18 to 49 who had experienced physical or sexual IPV at some time in their lives. The dependent variable was non-help-seeking after suffering physical or sexual IPV. Adjusted prevalence ratios (aPR) with their 95% confidence interval (CI) were calculated to assess the factors associated with non-help-seeking. In addition, a sensitivity analysis was carried out in which only women who suffered physical or sexual IPV in the last year were considered. RESULTS: Data from 15,265 female victims of physical or sexual IPV were analyzed. It was found that 57.4% did not seek help after suffering physical or sexual IPV. The main reasons for non-help-seeking included thinking it was unnecessary (42.3%) and embarrassment (14.9%). Age between 30 and 49 years old (PRa:1.15; 95%CI [1.06, 1.25]) and residing in a rural area (PRa:1.07; 95%CI [1.00, 1.13]) were associated with a higher probability of non-help-seeking. On the other hand, having a secondary education level (PRa:0.91; 95% CI [0.86, 0.97]) or higher (PRa:0.90; 95%CI [0.82, 0.99]), having a partner who drinks alcohol (PRa:0.94; 95%CI [0.89, 0.99]), having experienced physical or sexual IPV during a pregnancy (PRa:0.87; 95%CI [0.80, 0.94]), and having experienced moderate (PRa:0.81; 95%CI [0.76, 0.86]), or severe physical or sexual IPV (PRa:0.74; 95%CI [0.67, 0.82]), were associated with a lower probability of non-help-seeking. These associations were consistent in the sensitivity analysis. CONCLUSION: Half of the women who experience physical or sexual IPV do not seek help. There are sociodemographic factors related to this non-seeking of help that are useful for identifying and prioritizing interventions to reduce IPV and improve the health status of women.

Association between teenage mothers and acute infections in children under five in Peru from 2015-2019 / Asociación entre madres adolescentes e infecciones agudas en menores de cinco años en el Perú 2015-2019

Abstract Objectives: to assess the association between mothers age and the presence of acute respiratory infections (ARIs) and acute diarrhea (AD) in Peruvian children under five years old. Methods: secondary analysis of the database of the "Demographic and Family Health Survey" of 2015 and 2019. We analyzed data from children under five and their reproductive-age mothers who live in the same household. Poisson regression models were used to generate adjusted prevalence ratios (aPR) with 95% confidence intervals (95%CI) to assess the association between mothers' age group and the presence of ARIs and AD in their children. Results: 84,671 mother/child data were analyzed. In the adjusted regression model, being a young mother (aPR= 1.18; 95%CI= 1.11-1.25; p<0.001) or an teenage (aPR= 1.11; 95%CI= 1.01-1.22; p=0.045) were associated with a higher prevalence of ARIs in their children. In addition, being a young mother a teenage (aPR= 1.18; 95%CI= 1.11-1.25; p<0.001) or a teenage (aPR= 1.22; 95%CI= 1.10-1.35; p<0.001) were also associated with a higher prevalence of AD cases in their children. Conclusions: mothers' age was found to be associated with the prevalence of ARIs and AD in Peruvian children under five, with teenagers and young mothers having the greatest probability of ARIs and AD.

Resumen Objetivos: evaluar la asociación entre la edad materna y la presencia de infecciones respiratorias agudas (IRAs) y enfermedades diarreicas agudas (EDAs) en niños peruanos menores de cinco años. Métodos: análisis secundario de la base de datos de la "Encuesta Demográfica y de Salud Familiar" de 2015 y 2019. Se analizaron datos de niños menores de cinco años y sus madres en edad reproductiva que viven en el mismo hogar. Se utilizaron modelos de regresión de Poisson para calcular razones de prevalencia ajustadas (RPa) con sus intervalos de confianza del 95% (IC95%) para evaluar la asociación entre el grupo de edad de las madres y la presencia de IRAs y EDAs en sus hijos. Resultados: se analizaron 84,671 datos madre/hijo. En el modelo de regresión ajustado, ser madre joven (RPa= 1,18; IC95%= 1,11-1,25; p<0,001) o adolescente (RPa= 1,11; IC95%= 1,01-1,22; p=0,045) se asoció con una mayor prevalencia de IRAs en sus hijos. Además, ser madre joven (RPa= 1,18; IC95%= 1,11-1,25; p<0,001) o adolescente RPa= 1,22; IC95%= 1,10-1,35; p<0,001 también se asoció con una mayor prevalencia de EDAs en sus hijos. Conclusiones: la edad de las madres se asoció con la prevalencia de IRAs y EDAs en niños peruanos menores de cinco años, siendo las madres adolescentes y jóvenes las que presentaron mayor probabilidad de IRAs y EDAs.

Sociodemographic factors associated with immediate puerperal control: A cross-sectional study based on the Peruvian demographic and health survey, 2019.

Introduction: Peru is the fifth country in Latin America with the highest maternal mortality. In Peru, immediate puerperal control (IPC) was established in 2013 as a measure to improve postnatal control, with a view in reducing maternal mortality. This study aimed to evaluate the frequency and sociodemographic factors associated with compliance with IPC in Peru, 2019. Methods: We conducted an analytical cross-sectional study based on the Demographic and Family Health Survey (ENDES, for its acronym in Spanish) of Peru, 2019. The dependent variable was compliance with IPC (control in the first 2 h) in women aged 15-49 years who had delivered within the last five years preceding the survey. To evaluate the associated factors, Poisson family generalized linear models were used to calculate crude (cPR) and adjusted (aPR) prevalence ratios, with their respective 95% confidence intervals (95%CI). Results: Data from 11,854 women were analyzed. The frequency of IPC was 59.6% (95%CI: 58.3-60.9). We found a lower proportion of IPC in urban areas (58.8%) and in the highlands (57%) and jungle (57.2%) of Peru. Residing in rural areas (aPR:1.13; 95%CI:1.08-1.19), having undergone appropriate antenatal care (ANC) (aPR:1.05; 95%CI:1.01-1.10) and having delivered a low-birth-weight newborn (aPR:1.20; 95%CI:1.12-1.29) were associated with a higher frequency of IPC, while living in the highlands (aPR:0.86; 95%CI:0.80-0.92) or jungle (aPR:0.86; 95%CI:0.80-0.92) was associated with a lower frequency of IPC. Conclusions: Approximately four out of ten women did not have IPC. There was a lower proportion of IPC in urban areas and in the highland and jungle regions.

Socio-demographic, migratory and health-related determinants of food insecurity among Venezuelan migrants in Peru.

OBJECTIVE: To evaluate the factors associated with food insecurity (FI) among Venezuelan migrants residing in Peru. Secondarily, to evaluate the psychometric properties of the Food Insecurity Experience Scale (FIES). DESIGN: A cross-sectional study based on secondary data analysis of the 2022 Venezuelan Population Residing in Peru Survey (ENPOVE-2022, from the Spanish acronym) was conducted. FI was measured with the FIES, whose properties were tested using the Rasch model. Multinomial logistic regression was performed to estimate relative prevalence ratios with their corresponding 95 % confidence intervals. SETTING: This survey was conducted in February and March 2022 in the eight cities most populated by Venezuelan migrants and refugees in Peru. PARTICIPANTS: Venezuelan migrants and refugees over the age of 18 years living in Peru. RESULTS: A total of 7727 participants were included. Rasch reliability was adequate (0·73). The prevalence of mild, moderate and severe FI was 36·71 %, 31·14 % and 10·48 %, respectively. Being aged 25-34 and 35-44 years, unemployed, uninsured, having no formal education or secondary, illegal status, living in a dwelling with 2-4 and more than 4 people, presenting one or more than one chronic disease, residing in Peru for 0-6 months and perceived discrimination were associated with a higher probability of moderate FI. Furthermore, having secondary education, being unemployed, uninsured, never married, illegal, residing in Tumbes, presenting one or more than one chronic disease and perceived discrimination were significantly associated with severe FI. CONCLUSION: Four out of ten Venezuelan migrants residing in Peru presented moderate to severe FI. The FIES showed adequate psychometric properties. Differences in the socio-demographic, health and migratory factors associated with FI levels were found. Inter-sectoral and multi-sectoral interventions are needed and should be focused on addressing the determinants of FI.

Association between receiving information on obstetric complications and institutional delivery: An analysis of the demographic and health survey of Peru, 2019.

Objective: To evaluate the association between receiving information on obstetric complications and institutional delivery in Peruvian women in 2019. Methods: We conducted a secondary analysis of the 2019 Peruvian Demographic and Family Health Survey (ENDES) database. The dependent variable was the type of delivery (institutional or non-institutional). The exposure variable was self-reporting of having received information on obstetric complications during prenatal care. The association of interest was evaluated using binary logistic regression models, obtaining crude odds ratios (cOR) and adjusted odds ratios (aOR) with their respective 95 % confidence intervals (95%CI). Values of p < 0.05 were considered statistically significant. Results: We included a total of 14,835 women in the analysis. Of the total, 14,088 (94.1 %) reported having received information on pregnancy complications. Also, 13,883 (92.5 %) had an institutional delivery in their last pregnancy. The adjusted model showed that women who reported knowing the complications that can occur in pregnancy had a higher probability of presenting an institutional delivery (aOR = 1.47; 95%CI: 1.04-2.08). Conclusions: Receiving information about pregnancy complications was found to be associated with a higher probability of institutional delivery. Ensuring the provision of information to the pregnant woman about pregnancy complications can be a useful strategy to increase institutional delivery.

Fetal Macrosomia and Postpartum Hemorrhage in Latin American and Caribbean Region: Systematic Review and Meta-analysis.

OBJECTIVE: To determine the association between fetal macrosomia (FM) and postpartum hemorrhage (PPH) in Latin American and Caribbean (LAC) women. DATA SOURCES: Studies evaluating the association between FM and PPH (≥ 500 ml) and severe PPH (≥ 1,000 ml) until November 4, 2021, indexed in CINHAL, Scopus, Embase, Cochrane Library, MEDLINE, LILACS, and SciELO. SELECTION OF STUDIES: Inclusion criteria were cohort and case-control studies that provided the number of PPH and FM cases. Exclusion criteria were studies lacking information about the number of cases, with a population of women who were not from LAC; published in a language other than English, Spanish, or Portuguese, and with a different design. DATA COLLECTION: Data extraction was performed independently by two authors, and discrepancies were resolved with a third author. Data regarding FM and PPH cases were retrieved. DATA SYNTHESIS: Of the 1,044 articles evaluated, 5 studies were included, from 6 different countries: Argentina and Uruguay (multi-country), West Indies, Antigua and Barbuda, French Guyana, and Suriname. The pooled odds ratio (OR) for FM and PPH in the meta-analysis (five studies) was 2.10 (95% confidence interval [CI]: 1.79-2.47; I2: 0%), with estimates within this 95% CI in the sensitivity analysis. The combined OR for severe PPH (3 studies) was 1.61 (95% CI: 0.40-6.48; I2: 91.89%), showing high heterogeneity. CONCLUSION: There was a positive association between FM and PPH in the LAC, increasing the risk of the presence of this event 2-fold. The high heterogeneity of the studies that measured severe PPH does not allow drawing conclusions about the estimates obtained.

OBJETIVO: Determinar a associação entre macrossomia fetal (FM) e hemorragia pós-parto (HPP) em mulheres da América Latina e Caribe (ALC). FONTES DE DADOS: Estudos avaliando a associação entre FM e HPP (≥ 500 ml) e HPP grave (≥ 1.000 ml) até 4 de novembro de 2021, indexados no CINHAL, Scopus, Embase, Biblioteca Cochrane, MEDLINE, LILACS e SciELO. SELEçãO DE ESTUDOS: Os critérios de inclusão foram estudos de corte e caso-controle que forneceram o número de casos de HPP e FM. Os critérios de exclusão foram estudos sem informação sobre o número de casos, com uma população de mulheres que não eram da ALC; publicado em um idioma diferente do inglês, espanhol ou português e com um design diferente. COLETA DE DADOS: A extração de dados foi realizada independentemente por dois autores, as discrepâncias foram resolvidas com um terceiro autor. Os dados relativos aos casos de FM e HPP foram recuperados. SíNTESE DOS DADOS: Dos 1.044 artigos avaliados, foram incluídos 5 estudos, de 6 países diferentes: Argentina e Uruguai (multipaíses), Índias Ocidentais, Antígua e Barbuda, Guiana Francesa e Suriname. O odds ratio agrupado (OR) para FM e HPP na meta-análise (cinco estudos) foi de 2,10 (intervalo de confiança de 95% [IC]: 1,79­2,47; I2: 0%), com estimativas dentro deste IC de 95% no análise sensitiva. O OR combinado para HPP grave (3 estudos) foi de 1,61 (95% CI: 0.40­6.48; I2: 91.89%), mostrando alta heterogeneidade. CONCLUSãO: Houve associação positiva entre FM e HPP na ALC, aumentando em 2 vezes o risco da presença desse evento. A alta heterogeneidade dos estudos que mediram a HPP grave não permite tirar conclusões sobre as estimativas obtidas.

Risk factors associated with hemorrhagic cerebrovascular accident: A cross-sectional study in patients from a hospital in Peru.

In Peru, cardiovascular accidents (CVA) cause around 15% of premature death, with an increase in CVA due to the prevalence of risk factors for CVA in the Peruvian population. Hemorrhagic CVA presents higher mortality compared to ischemic. This research aimed to identify the risk factors associated with hemorrhagic CVA. We carried out a retrospective cross-sectional study using the medical records of patients with a diagnosis of CVA treated at the Regional Hospital of Ica during the years 2018 and 2019. Independent variables included age, sex, type 2 diabetes, dyslipidemia, hypertension, smoking, obesity, and intracranial carotid artery calcification. To identify factors associated with an increased probability for hemorrhagic CVA compared to ischemic CVA, a generalized linear model with logit link and binomial family, obtaining the odds ratio (OR) and its 95% confidence interval (CI). we evaluated the data from 132 patients. Of them, 46 (34.85%) had hemorrhagic CVA. Only systolic blood pressure (OR: 1.04; 95% CI: 1.02-1.06) and hypertension (OR: 0.29; 95% CI: 0.10-0.89) were significantly associated with hemorrhagic CVA compared to ischemic CVA. Hypertension is associated with hemorrhagic CVA compared to ischemic CVA. These results are consistent with the literature.

Asociación entre el grado de severidad de la infección por COVID-19 durante el embarazo y la rotura prematura de membranas pretérmino en un hospital nivel III del Perú / Association between the degree of severity of COVID-19 infection during pregnancy and preterm premature rupture of membranes in a level III hospital in Peru

RESUMEN Objetivos. Determinar la asociación entre el grado de severidad de la infección por COVID-19 durante el embarazo y la rotura prematura de membranas pretérmino (RPMP) en un hospital nivel III de Perú. Materiales y Métodos. Estudio transversal, analítico y observacional en mujeres mayores de 18 años con diagnóstico de infección por COVID-19 en el embarazo durante el 2020-2022. Se recogieron variables clínicas y obstétricas. Para el análisis descriptivo se realizaron las pruebas de Chi Cuadrado y exacta de Fisher, y para el análisis multivariado, se calculó la razón de prevalencia mediante regresión de Poisson en modelos crudos y ajustados. Todas las pruebas estadísticas se realizaron considerando un valor de p<0,05 como significativo y con un nivel de confianza de 95%. Resultados. Se analizaron los datos de 163 gestantes con COVID-19, de las cuales el 9,2% tuvieron RPMP, todas fueron casos sintomáticos. Los casos leves de COVID-19 tuvieron 1,10 veces la probabilidad de presentar RPMP (RPa=1,10; IC95%: 1,02−1,18) y los casos moderados/severos tuvieron 1,64 veces esta probabilidad (RPa=1,64; IC95%: 1,43−1,87), en comparación con los casos asintomáticos. Conclusiones. Se identificó que un mayor grado de severidad de la infección por COVID-19 durante el embarazo se asoció a una mayor probabilidad de tener RPMP.

ABSTRACT Objectives. To determine the association between the degree of severity of COVID-19 infection during pregnancy and preterm premature rupture of membranes (PPROM) in a level III hospital in Peru. Materials and Methods. Cross-sectional, analytical and observational study in women older than 18 years diagnosed with COVID-19 infection during pregnancy, between the years 2020 and 2022. Clinical and obstetric variables were collected. The chi-square and Fisher's exact tests were used for the descriptive analysis. For the multivariate analysis, we calculated the prevalence ratio by using Poisson regression in crude and adjusted models. All statistical tests were performed considering a value of p<0.05 as significant and with a confidence level of 95%. Results. We analyzed data from 163 pregnant women with COVID-19, of which 9.2% had PPROM; all were symptomatic cases. Mild COVID-19 cases were 1.10 times more likely to have PPROM (RPa=1.10; 95%CI: 1.02-1.18) and moderate/severe cases were 1.64 times more likely (RPa=1.64; 95%CI: 1.43-1.87), compared to asymptomatic cases. Conclusions. We identified that a higher degree of severity of COVID-19 infection during pregnancy was associated with a higher probability of having PPROM.

Binge drinking and suicidal ideation in Peruvian adolescents: Evidence from a pooled cross-sectional survey.

BACKGROUND: Binge drinking and suicidal ideation are public health problems that have consequences on the well-being of Peruvian adolescents. This study aimed to evaluate the relationship between binge drinking and suicidal ideation in Peruvian adolescents. METHODS: A secondary data analysis of the health questionnaire of the Demographic and Family Health Surveys from 2013 to 2019 was performed. The outcome variable was suicidal ideation in the last 14 days, assessed with one of the Patient Health Questionnaire (PHQ-9) questions, while the independent variable was binge drinking in the last 30 days. Generalized linear models of the Poisson family with logarithmic link (crude and adjusted) were used to assess the association of interest. RESULTS: Data from a total of 11,609 participants were analyzed. The pooled prevalence of suicidal ideation was 8.5 % (95 % confidence interval [CI]: 7.8-9.2), and that of binge drinking was 5.8 % (95 % CI: 5.2-6.5). An association was found between binge drinking and suicidal ideation in the adjusted analysis (adjusted prevalence ratio: 2.95; 95 % CI: 1.69-3.09). LIMITATIONS: The cross-sectional design of the study does not allow for establishing a causal relationship. CONCLUSIONS: Between 2013 and 2019, nine out of every 100 Peruvian adolescents had suicidal ideation, and six out of every 100 adolescents had binge drinking. An association was found between both risk behaviors in Peruvian adolescents.

Migration Status and Utilization of Healthcare Services Among Venezuelan Immigrants in Peru.

BACKGROUND: In general, migrants in illegal situations encounter a greater barrier to accessing medical care because of their migration status due to not having the required documentation to be able to obtain insurance in the receiving country. OBJECTIVE: To evaluate the association between migration status and the use of health services in the Venezuelan population residing in Peru. METHODS: Data from the second Survey Directed to the Venezuelan Population Residing in Peru (ENPOVE) of 2022 were analyzed. The dependent variable was use of health services in the last month. The exposure variable was migration status (legal/illegal). Generalized linear models of the Poisson family with link log function were used to obtain crude and adjusted prevalence ratios (aPR), for potential confounding variables. Additionally, we evaluated the association of interest, stratified by gender. FINDINGS: Data from 1569 migrants were analyzed. Participants with illegal migration status represented 32.4% (men: 24.3%; women: 36.7%); likewise, 58.1% did not use health services. Illegal migration status was associated with lower health care use (aPR: 0.75; 95%CI: 0.61-0.92). Likewise, after stratifying by sex, the association was maintained only in male migrants (aPR: 0.53; 95%CI: 0.39-0.82) but not in women (aPR: 0.84; 95%CI: 0.67-1.05). CONCLUSION: 58.1% of Venezuelan migrants in Peru did not seek medical attention despite having health problems. Having an illegal immigration status leads to a lower probability of using these services, especially in men.

Massive open online courses: learning opportunities about global health for Latin American countries / Cursos en línea abiertos y masivos: oportunidad de aprendizaje sobre salud global en Latinoamérica

INTRODUCTION: Massive open online courses provide the opportunity to train health professionals and researchers from Latin America in global health. OBJETIVES: To determine the global offer of massive open online courses in global health and the characteristics of their content. MATERIAL AND METHODS: We examined massive open online course platforms to compile the global health offerings. The search had no time restriction and was last conducted in November, 2021. The search strategy only included the descriptor "global health". We obtained the characteristics of the courses, their content, and the global health domain covered. These data were analyzed using descriptive statistics, reporting absolute and relative frequencies. RESULTS: Our search strategy identified 4,724 massive open online courses. Of these, only 92 were related to global health. Most of these courses (n=44; 47.8%) were offered through Coursera. More than half (n=50; 54.4%) of the MOOCs were conducted by U.S.A. institutions and in English language (n=90; 97.8%). Most courses focused on "globalization of health and healthcare" (n=24; 26.1%), followed by the domains "capacity building" (n=16; 17.4%), "global burden of disease" and "social and environmental determinants of health" (n=15; 16.3%). CONCLUSIONS: We found a high offer of massive open online courses on global health. These courses covered the global health competencies required for health professionals.

Introducción: Los cursos en línea, masivos y abiertos, brindan la oportunidad de formar profesionales e investigadores en Latinoamérica sobre salud global. Objetivos: Determinar la oferta global de los cursos en línea, masivos y abiertos, sobre salud global y conocer las características de su contenido. Materiales y métodos. Se examinaron las plataformas especializadas en cursos en línea, masivos y abiertos, para recopilar aquellos sobre salud global. La búsqueda no tuvo restricción de tiempo y se realizó por última vez en noviembre de 2021. La estrategia de búsqueda solo incluyó el descriptor "global health". Posteriormente, se obtuvieron las características del curso, su contenido y el dominio abordado de salud global. Estos datos fueron analizados descriptivamente, y se reportaron frecuencias absolutas y relativas. Materiales y métodos: Se examinaron las plataformas especializadas en cursos en línea, masivos y abiertos, para recopilar aquellos sobre salud global. La búsqueda no tuvo restricción de tiempo y se realizó por última vez en noviembre de 2021. La estrategia de búsqueda solo incluyó el descriptor "global health". Posteriormente, se obtuvieron las características del curso, su contenido y el dominio abordado de salud global. Estos datos fueron analizados descriptivamente, y se reportaron frecuencias absolutas y relativas. Resultados: La estrategia de búsqueda identificó 4.724 cursos en línea, masivos y abiertos. De ellos, solo 92 estaban relacionados con salud global. La mayoría de estos cursos (n=44; 47,8 %) se ofrecieron mediante la plataforma Coursera. Más de la mitad de los cursos (n=50; 54,4 %) fueron realizados por instituciones de Estados Unidos y en idioma inglés (n=90; 97,8 %). La mayor parte de los cursos se centró en la "globalización de la salud y la asistencia sanitaria" (n=24; 26,1 %), seguido de los dominios "fortalecimiento de capacidades" (n=16; 17,4 %), "carga global de enfermedad" y "determinantes sociales y ambientales de la salud" (n=15; 16,3 %). Conclusiones: Se encontró una importante oferta de cursos en línea, masivos y abiertos, sobre salud global. Estos cursos abordaron las competencias de la salud global que se requieren para los profesionales sanitarios.

Association Between the Autonomy of Peruvian Women and the Choice of the Place of Delivery: Analysis of a National Survey, 2019.

OBJECTIVES: To determine the association between Peruvian women's autonomy and place of delivery. METHODS: An analytical cross-sectional study of secondary data from the Demographic and Family Health Survey 2019 was carried out. The dependent variable was institutionalized childbirth, and the independent variable was women's autonomy. Likewise, the association between women's autonomy and institutionalized childbirth was evaluated using Poisson family generalized linear models with logarithmic link function, and crude (PR) and adjusted prevalence ratios (aPR) with their respective 95% confidence interval (CI) were estimated. RESULTS: The analysis included 15,334 women aged 15-49 years. It was found that a high proportion of women had a low level of autonomy (42.6%; 95% CI: 41.5-43.7), while 92.1% (95% CI: 91.3-92.9) had institutionalized childbirth. Moderate (PR: 1.10; 95% CI: 1.08-1.12) and high (PR: 1.13; 95% CI: 1.12-1.15) levels of women's autonomy were found to be associated with institutionalized childbirth, and the same association was found in the adjusted analysis. CONCLUSION: Being a woman with a higher level of autonomy was related to a higher prevalence of institutionalized childbirth. Therefore, as decision-making is a multifactorial characteristic, it is necessary to study in depth the determinants of non-institutionalized childbirth in women with less autonomy.

Cursos en línea abiertos y masivos: oportunidad de aprendizaje sobre salud global en Latinoamérica / Massive open online courses: learning opportunities about global health for Latin American countries

Introducción. Los cursos en línea, masivos y abiertos, brindan la oportunidad de formar profesionales e investigadores en Latinoamérica sobre salud global. Objetivos. Determinar la oferta global de los cursos en línea, masivos y abiertos, sobre salud global y conocer las características de su contenido. Materiales y métodos. Se examinaron las plataformas especializadas en cursos en línea, masivos y abiertos, para recopilar aquellos sobre salud global. La búsqueda no tuvo restricción de tiempo y se realizó por última vez en noviembre de 2021. La estrategia de búsqueda solo incluyó el descriptor "global health". Posteriormente, se obtuvieron las características del curso, su contenido y el dominio abordado de salud global. Estos datos fueron analizados descriptivamente, y se reportaron frecuencias absolutas y relativas. Resultados. La estrategia de búsqueda identificó 4.724 cursos en línea, masivos y abiertos. De ellos, solo 92 estaban relacionados con salud global. La mayoría de estos cursos (n=44; 47,8 %) se ofrecieron mediante la plataforma Coursera. Más de la mitad de los cursos (n=50; 54,4 %) fueron realizados por instituciones de Estados Unidos y en idioma inglés (n=90; 97,8 %). La mayor parte de los cursos se centró en la "globalización de la salud y la asistencia sanitaria" (n=24; 26,1 %), seguido de los dominios "fortalecimiento de capacidades" (n=16; 17,4 %), "carga global de enfermedad" y "determinantes sociales y ambientales de la salud" (n=15; 16,3 %). Conclusiones. Se encontró una importante oferta de cursos en línea, masivos y abiertos, sobre salud global. Estos cursos abordaron las competencias de la salud global que se requieren para los profesionales sanitarios.

Introduction. Massive open online courses provide the opportunity to train health professionals and researchers from Latin America in global health. Objective. To determine the global offer of massive open online courses in global health and the characteristics of their content. Material and methods. We examined massive open online course platforms to compile the global health offerings. The search had no time restriction and was last conducted in November, 2021. The search strategy only included the descriptor "global health". We obtained the characteristics of the courses, their content, and the global health domain covered. These data were analyzed using descriptive statistics, reporting absolute and relative frequencies. Results. Our search strategy identified 4,724 massive open online courses. Of these, only 92 were related to global health. Most of these courses (n=44; 47.8%) were offered through Coursera. More than half (n=50; 54.4%) of the MOOCs were conducted by U.S.A. institutions and in English language (n=90; 97.8%). Most courses focused on "globalization of health and healthcare" (n=24; 26.1%), followed by the domains "capacity building" (n=16; 17.4%), "global burden of disease" and "social and environmental determinants of health" (n=15; 16.3%). Conclusions. We found a high offer of massive open online courses on global health. These courses covered the global health competencies required for health professionals.

Association between inadequate prenatal care and low birth weight of newborns in Peru: Evidence from a peruvian demographic and health survey.

Objective: To assess the association between inadequate prenatal care (IPNC) and Low birth weight (LBW) in newborns of singleton gestation mothers in Peru. Methods: We performed a secondary analysis of data from the 2019 Demographic and Health Survey. We included a total of 10,186 women of reproductive age (15 - 49 years) who had given birth to a singleton child in the last 5 years. The dependent variable was LBW (< 2500 g). The independent variables were IPNC (inadequate: when at least one of the IPNC components was absent [number of PNC visits ≥ 6, first PNC visit during the first trimester, compliance with PNC visit contents, and PNC visits provided by trained health personnel]) and each of its components. We evaluated the association using logistic regression models to estimate crude odds ratios and adjusted odds ratios (aOR) and their respective 95% confidence intervals (95% CI). Results: We found that approximately six out of 100 live births had LBW and that seven out of 10 women had received IPNC. We observed that receiving IPNC (aOR: 1.39; 95% CI: 1.09 - 1.77) and having less than six prenatal control visits (aOR: 3.20; 95% CI: 2.48 - 4.13) were associated with higher odds of LBW regardless of the mother's age, educational level, occupation, wealth, region, rural origin, ethnicity, sex of the newborns, and place of delivery. While, regarding to the other PNC components, first prenatal control in the first trimester (aOR: 0.99; 95% CI: 0.76 - 1.28) and compliance with prenatal control contents (aOR: 1.07; 95% CI: 0.86 - 1.34), they were associated with lower and higher odds of LBW, respectively, regardless of the same adjustment variables, but it was not statistically significant. Conclusions: IPNC and having less than six PNC visits were associated with higher odds of LBW. Therefore, it is very important to implement strategies that ensure access to quality prenatal care is necessary to reduce the consequences of LBW.

Characteristics of theses for physician graduation: a cross-sectional study in Peru. / Características de las tesis para titularse de médico: estudio transversal en Perú.

Introduction: Research in Peru presents several barriers that impede its development and that also affects the theses to graduate as physician. Our objective was to characterize the theses for obtaining a medical degree in Peru. Methods: An observational and descriptive study evaluating the theses for obtaining a medical degree of 2019, evaluated in January 2022 from 22 universities that are full members of the Peruvian Association of Faculties of Medicine. Characteristics of the universities and theses were evaluated, including the evaluation of a institutional research ethics committee, the aligment with a national research priority, and publication status in a scientific journal. The absolute and relative frequencies of the study variables were described. Results: A total of 1838 theses were evaluated. Most of the theses were written by a single student (66.16%). The most common study design was the descriptive cross-sectional type (42.33%). We found that 53.86% of the theses responded to a national research priority, the most common being "maternal, perinatal and neonatal health" (26.01%). Of the total, 56.75% did not indicate whether they had the approval of an institutional research ethics committee. Only 40 theses (2.19%) were published in a scientific journal (14 in indexed journals). Conclusion: Two-thirds of the theses conducted by medical students in Peru are descriptive studies. Half respond to national research priorities. Four out of ten theses were approved by an institutional research ethics committee. The number of published theses is low. The results show shortcomings in university institutional policies that encourage ethical compliance and research development.

Introducción: La investigación en Perú presenta diversas barreras que impiden su desarrollo. Ello afecta también las tesis para graduarse de médico. Nuestro objetivo fue caracterizar las tesis para obtener el título de médico en Perú. Métodos: Se realizó un estudio observacional y descriptivo de las tesis para obtener el título de médico del año 2019 en 22 universidades que son miembros titulares de la Asociación Peruana de Facultades de Medicina. La revisión se efectuó durante enero de 2022. Se evaluaron características de las universidades (región, régimen: pública/privada), y de las tesis, incluyendo el contar con la aprobación por un comité institucional de ética en investigación, si estuvieron alineadas con una prioridad de investigación nacional y si fueron publicadas en una revista científica. Los datos de cada tesis evaluada fueron extraídos en una ficha de recolección de datos para el posterior cálculo de frecuencias absolutas y relativas de las variables de estudio. Resultados: Se evaluaron 1838 tesis. La mayoría de ellas fueron elaboradas por un único alumno (66,16%). El diseño de estudio más común fue el tipo transversal descriptivo (42,3%). El 53,86% de las tesis respondieron a una prioridad de investigación nacional, siendo la más estudiada "salud materna, perinatal y neonatal" (26,01%). Del total de tesis, el 56,75% no indicó si contó con la aprobación de un comité institucional de ética en investigación. Sólo 40 tesis (2,19%) se publicaron en una revista científica (14 en revistas indexadas). Conclusión: Dos tercios de las tesis realizadas por estudiantes de medicina en Perú son estudios descriptivos. La mitad responde a prioridades nacionales de investigación. Cuatro de cada diez tesis informan sobre la aprobación por un comité institucional de ética en investigación. El número de las tesis publicadas es bajo. Los resultados muestran carencias de las políticas institucionales universitarias que estimulen al cumplimiento ético y desarrollo de la investigación.

Spatial and socioeconomic inequalities in the access to safe drinking water in Peruvian households.

Access to safe drinking water has increased in Peru over the last decades, from 47% (2008) to 52% (2018). Nevertheless, such access would differ according to socioeconomic and regional factors. Thus, this study aimed to assess the socioeconomic inequality in the access to safe drinking water and identify its spatial distribution. We conducted a cross-sectional study based on the secondary data analysis of the 2021 Peruvian Demographic and Health Survey. Access to safe drinking water was a dummy variable categorised as safe if the residual chlorine concentration was ≥0.5 mg/L. Nationwide, 29.22% of households had access to safe drinking water. A pro-rich inequality in access to safe drinking water was observed. The spatial distribution was clustered. Significant hotspots were found in the south and centre of the country; however, cold spots were found in most areas. SaTScan analysis identified 32 and 63 significant clusters at high and low risks of having access to safe drinking water, respectively. In conclusion, approximately one out of four Peruvian households has access to safe drinking water, which was mostly concentrated among the wealthier households. Intra- and interdepartmental inequalities in access to safe drinking water were found, with several high-risk clusters.