[Sexually transmitted infections in women living in a prison in Lima, Peru]. / Infecciones de transmisión sexual en mujeres de un establecimiento penitenciario de Lima, Perú

In order to determine the prevalence of sexually transmitted infections (STI) in recluse women of Chorrillos Penitentiary I in the city of Lima, Peru, a cross-sectional study was performed, including a simple random sample of women between ages 18 and 54, from whom 180 serum samples and 168 samples of cervical and vaginal discharge were analyzed. The most prevalent etiologic agents identified from cervical and vaginal discharge samples were Chlamydia trachomatis in 42.3%, Gardnerella vaginalis in 24.4% and Trichomonas vaginalis in 10.1% and for serum samples the most prevalent were syphilis and HIV, both in 2.2%. We conclude that there is a high prevalence of sexually transmitted infections in recluse women of Chorrillos Penitentiary I in the city of Lima, Peru. There should be routine screenings established for diagnosis and treatment of STIs within the prison system and this population should be included in the sexual and reproductive health programs.

Evaluación de la seroprotección contra sarampión, rubéola y hepatitis B en niños menores de cinco años del Perú, 2011 / Evaluation of the seroprotection against measles, rubella and hepatitis B in children under 5 years of age in Peru, 2011

Objetivos. Estimar la prevalencia de anticuerpos contra sarampión, rubéola y hepatitis B en niños de 1 a 4 años del Perú. Materiales y métodos. Se realizó una encuesta nacional basada en la aplicación de un cuestionario y obtención de muestra de sangre capilar en papel de filtro para el estudio de anticuerpos contra sarampión, rubéola y hepatitis B en niños de 1 a 4 años. Se utilizó un muestreo probabilístico, estratificado y multietápico con inferencia a nivel nacional y siete ámbitos de estudio: Lima metropolitana, resto de costa urbana, costa rural, sierra urbana, sierra rural, selva urbana y selva rural. Las muestras de sangre capilar fueron procesadas siguiendo protocolos estandarizados para la determinación de anticuerpos mediante técnica de ELISA utilizando reactivos comerciales. Resultados. Se encontró una prevalencia nacional de 91,6% (IC95%: 90,6-92,7%), 91,3% (IC 95%: 90,3-92,4%) y 95,9% (IC 95%: 95,0-96,8%) para anticuerpos contra sarampión, rubéola y hepatitis B respectivamente. No se evidenció diferencias significativas de las prevalencias entre los diferentes ámbitos de estudio y en los diferentes estratos socioeconómicos de los conglomerados. Conclusiones. En niños de 1 a 4 años se ha estimado una prevalencia nacional de anticuerpos contra sarampión y rubéola entre 90-93%, mientras que para anticuerpos contra hepatitis B (anti-HBsAg) entre 95-97%.

Objectives. To estimate the prevalence of antibodies against measles, rubella and hepatitis B in children aged between 1 and 4 years in Peru. Materials and methods. A national survey was conducted based on a questionnaire and capillary blood sample taken on filter paper in order to study antibodies against measles, rubella and hepatitis B in children from 1 to 4 years of age. A stratified, multistage, probability sampling design was used to be representative at the national level and at level of seven ambits, including the Metropolitan Lima Area, the rest of the urban coast, the rural coast, the urban highlands, the rural highlands, the urban jungle and the rural jungle. The capillary blood samples were processed according to the standardized protocols for detection of antibodies using the ELISA technique and commercial reagents. Results. The survey showed a national prevalence of antibodies against measles, rubella and hepatitis B of 91.6% (CI 95%: 90.6%; 92.7%), 91.3% (CI 95%: 90.3%; 92.4%) and 95.9% (CI 95%: 95.0%; 96.8%) respectively. There was no evidence of significant differences in the prevalence among the ambits of study or among the socioeconomic strata of the conglomerates for any of the three types of antibodies. Conclusions. In children from 1 to 4 years of age, the national prevalence of antibodies against measles and Rubella was between 90-93%, while the prevalence of antibodies against Hepatitis B (anti-HBsAg) was between 95-97%.

[Evaluation of the seroprotection against measles, rubella and hepatitis B in children under 5 years of age in Peru, 2011]. / Evaluación de la seroprotección contra sarampión, rubéola y hepatitis B en niños menores de cinco años del Perú, 2011.

OBJECTIVES: To estimate the prevalence of antibodies against measles, rubella and hepatitis B in children aged between 1 and 4 years in Peru. MATERIALS AND METHODS: A national survey was conducted based on a questionnaire and capillary blood sample taken on filter paper in order to study antibodies against measles, rubella and hepatitis B in children from 1 to 4 years of age. A stratified, multistage, probability sampling design was used to be representative at the national level and at level of seven ambits, including the Metropolitan Lima Area, the rest of the urban coast, the rural coast, the urban highlands, the rural highlands, the urban jungle and the rural jungle. The capillary blood samples were processed according to the standardized protocols for detection of antibodies using the ELISA technique and commercial reagents. RESULTS: The survey showed a national prevalence of antibodies against measles, rubella and hepatitis B of 91.6% (CI 95%: 90.6%; 92.7%), 91.3% (CI 95%: 90.3%; 92.4%) and 95.9% (CI 95%: 95.0%; 96.8%) respectively. There was no evidence of significant differences in the prevalence among the ambits of study or among the socioeconomic strata of the conglomerates for any of the three types of antibodies. CONCLUSIONS: In children from 1 to 4 years of age, the national prevalence of antibodies against measles and Rubella was between 90-93%, while the prevalence of antibodies against Hepatitis B (anti-HBsAg) was between 95-97%.

Congenital rubella syndrome surveillance as a platform for surveillance of other congenital infections, Peru, 2004-2007.

BACKGROUND: Rubella during pregnancy can cause serious fetal abnormalities and death. Peru has had integrated measles/rubella surveillance since 2000 but did not implement congenital rubella syndrome (CRS) surveillance until 2004, in accordance with the Pan American Health Organization recommendations for rubella elimination. The article describes the experience from the CRS sentinel surveillance system in Peru. METHODS: Peru has maintained a national sentinel surveillance system for reporting confirmed and suspected CRS cases since 2004. A surveillance protocol was implemented with standardized case definitions and instruments in the selected sentinel sites. Each sentinel site completes their case investigations and report forms and sends the reports to the Health Region Epidemiology Department, which forwards the data to the national Epidemiology Department. CRS surveillance data were analyzed for the period 2004-2007. RESULTS: During the period 2004-2007, 16 health facilities, which are located in 9 of the 33 health regions, representing the 3 main geographical areas (coast, mountain, and jungle), were included as sentinel sites for the CRS surveillance. A total of 2061 suspected CRS cases were reported to the system. Of these, 11 were classified as CRS and 23 as congenital rubella infection. Factors significantly associated with rubella vertical transmission were: (1) in the mother, maternal history of rash during pregnancy (odds ratio [OR], 12.0; 95% confidence interval [CI], 3.8-37.8); (2) and in the infant, pigmentary retinopathy (OR, 18.4; 95% CI, 3.2-104.6), purpura (OR, 14.7; 95% CI, 2.8-78.3), and developmental delay (OR, 4.4; 95% CI, 1.75-11.1). CONCLUSIONS: The surveillance system has been able to identify rubella vertical transmission, reinforcing the evidence that rubella was a public health problem in Peru. This system may serve as a platform to implement surveillance for other congenital infections in Peru.

Reporte de una intervención frente a un caso importado de sarampión en el Perú, mayo de 2008 / Report of an intervention against an imported case of measles in Peru, May 2008

Antecedentes: El sarampión es una enfermedad infecciosa de distribución mundial, salvo en aquellos países y regiones en las cuales se mantienen exitosas intervenciones de vacunación, como en América, donde este tipo de intervenciones ha logrado eliminarla. Sin embargo, existe el riesgo de reintroducción del virus a partir de casos importados. Objetivo: Describir las acciones desarrolladas por el Ministerio de Salud del Perú para evitar la presentación de casos secundarios de sarampión luego de la notificación al sistema de vigilancia epidemiológica de un caso sospechoso de sarampión. Material u métodos: Se realizó la evaluación clínica, epidemiológica y serológica del caso, se realizó la búsqueda, vacunación y seguimiento de contactos, y se realizó la búsqueda activa institucional de casos sospechosos para sarampión en la jurisdicción. Resultados: Paciente varón de 19 años de edad procedente de la India que trabajaba en un barco cisterna de transporte de gas. El paciente había partido de la India vía aérea el 19 de abril con destino a Guayaquil, arribando a esa ciudad el 21 de abril y de allí se movilizó a Puerto Bolívar donde abordó el barco el mismo día, llegando al Callao el 30 de abril. El 28 de abril de 2008 presentó malestar general y dolor de garganta, el 30 de abril se agregó sensación de alza térmica y el 1 de mayo erupción dérmica máculopapular. Fue trasladado entonces hasta clínica particular. Al momento de recibir la notificación el personal de la Dirección General de Epidemiología recomendó como primeras medidas el internamiento en habitación privada con puerta cerrada, el uso de mascarilla N95-N100 por parte del paciente y su atención por personal con prueba de inmunidad contra el sarampión. Se evaluó clínicamente al paciente y el resultado serológico fue positivo para sarampión (serotipo D4). Se hizo una relación de las personas expuestas al paciente, vacunándose 199 personas en las primeras 72 horas...

Background: Measles is an infectious disease of worldwide distribution, except in those countries and regions in which successful vaccination interventions are maintained, as in the American Region, where this strategy has managed to eliminate this disease. However, there is still the risk of the virus reintroduction from imported cases. Objective: To describe the actions taken by the Ministry of Health of Peru in order to avoid the presentation of secondary cases after the report to the epidemiological surveillance system of a suspected case of measles. Methods: Clinical, epidemiological, and serological assessment of the measles case was carried out; contacts census, vaccination and monitoring was performed as well as the active institutional case finding of suspected cases for measles in the compromised areas. Results: The confirmed case was a male patient of 19 years old from India that worked in a gas tanker ship. The patient had left India by airplane on April 19 2008, with final destination Guayaquil, arriving on April 21 and then moved to Port Bolivar where he boarded the tanker the same day, reaching Callao on April 30. On April 28 the patient presented general discomfort and sore throat, on April 30 the sensation of thermal raise was added and on May 1 maculopapular skin eruption appeared. He was then transferred to a private clinic. Upon receiving the report, the personnel of the Epidemiology Department of the Ministry of Health (Dirección General de Epidemiología) recommended, as first measures, to place the patient in private room withclosed door, the use of N95-N100 mask by the patient, and his attention by personnel with proven immunity tomeasles. The patient was evaluated clinically and the serological results were positive for measles (serotype D4). Follow up of the contacts was performed...

A rubella serosurvey in postpartum women in the three regions of Peru.

OBJECTIVE: To determine the proportion of postpartum women aged 15-49 in Peru who are susceptible to rubella, in order to help address strategies to eliminate rubella and to prevent congenital rubella syndrome (CRS) in the country. METHODS: A cross-sectional survey was conducted during March and April 2003 in six main regional hospitals, in the three geographic regions (coast, mountain, and jungle) of Peru. For the postpartum women who provided written informed consent, a questionnaire was administered and a blood specimen was collected. Sera were tested for rubella immunoglobulin G (IgG) antibody, using a commercial enzyme-linked immunosorbent serologic assay (ELISA) kit. Univariate, bivariate, and multivariate analyses were carried out to assess risk factors for susceptibility. RESULTS: In total, 1 236 postpartum women were enrolled. The overall proportion of IgG-antibody negative women was 12.8% (95% confidence interval (CI): 10.9%-14.6%). Bivariate analysis found the following variables associated with susceptibility: living in the jungle region (odds ratio (OR) = 1.65; 95% CI: 1.13-2.42); age < 19 years (OR = 2.02; 95% CI: 1.35-3.03); being a housewife (OR = 1.69; 95% CI: 1.12-2.55); and having < or = 11 years of education (OR = 2.12; 95% CI :1.20-3.75). Multivariate analysis found the following variables were associated with susceptibility: living in the jungle region (OR = 1.67; 95% CI: 1.13-2.46); age < 19 years (OR = 1.62; 95% CI: 1.07-2.47); having < 4 children born alive (OR = 1.85; 95% CI: 1.00-3.40); and having < or = 11 years of education (OR = 2.07; 95% CI: 1.16-3.71). CONCLUSIONS: The proportion of postpartum women at the study sites who were found to be susceptible to rubella was 12.8%, placing Peru among the countries facing a moderate level of risk for the occurrence of CRS cases. The findings suggest the need to also provide the rubella vaccine to other population groups, especially women of childbearing age.

A rubella serosurvey in postpartum women in the three regions of Peru

OBJECTIVE: To determine the proportion of postpartum women aged 15-49 in Peru who are susceptible to rubella, in order to help address strategies to eliminate rubella and to prevent congenital rubella syndrome (CRS) in the country. METHODS: A cross-sectional survey was conducted during March and April 2003 in six main regional hospitals, in the three geographic regions (coast, mountain, and jungle) of Peru. For the postpartum women who provided written informed consent, a questionnaire was administered and a blood specimen was collected. Sera were tested for rubella immunoglobulin G (IgG) antibody, using a commercial enzyme-linked immunosorbent serologic assay (ELISA) kit. Univariate, bivariate, and multivariate analyses were carried out to assess risk factors for susceptibility. RESULTS: In total, 1 236 postpartum women were enrolled. The overall proportion of IgG-antibody negative women was 12.8 percent (95 percent confidence interval (CI): 10.9 percent-14.6 percent). Bivariate analysis found the following variables associated with susceptibility: living in the jungle region (odds ratio (OR) = 1.65; 95 percent CI: 1.13-2.42); age < 19 years (OR = 2.02; 95 percent CI: 1.35-3.03); being a housewife (OR = 1.69; 95 percent CI: 1.12-2.55); and having < 11 years of education (OR = 2.12; 95 percent CI :1.20-3.75). Multivariate analysis found the following variables were associated with susceptibility: living in the jungle region (OR = 1.67; 95 percent CI: 1.13-2.46); age < 19 years (OR = 1.62; 95 percent CI: 1.07-2.47); having < 4 children born alive (OR = 1.85; 95 percent CI: 1.00- 3.40); and having < 11 years of education (OR = 2.07; 95 percent CI: 1.16-3.71). CONCLUSIONS: The proportion of postpartum women at the study sites who were found to be susceptible to rubella was 12.8 percent, placing Peru among the countries facing a moderate level of risk for the occurrence of CRS cases. The findings suggest the need to also provide...

OBJETIVO: Determinar la proporción de mujeres recién paridas de 15-49 años de edad susceptibles a la rubéola en Perú, a fin de contribuir a establecer estrategias para eliminar la rubéola y evitar el síndrome de rubéola congénita (SRC) en el país. MÉTODOS: Se realizó un estudio transversal en marzo y abril de 2003 en seis hospitales regionales principales de tres regiones geográficas (costa, sierra y selva) de Perú. A las mujeres recién paridas que dieron su consentimiento informado por escrito se les aplicó un cuestionario y se les tomó una muestra de sangre. La detección serológica de anticuerpos de la clase IgG contra rubéola se realizó mediante un ensayo inmunoenzimático comercial tipo ELISA. Se realizaron análisis con una, dos y múltiples variables para evaluar los factores de riesgo de ser susceptible a la enfermedad. RESULTADOS: En total participaron 1 236 mujeres recién paridas. La proporción de mujeres negativas a anticuerpos IgG contra rubéola fue de 12,8 por ciento (intervalo de confianza de 95 por ciento [IC95 por ciento]: 10,9 por ciento a 14,6 por ciento). Según el análisis bifactorial, las variables asociadas con la vulnerabilidad a la enfermedad fueron: vivir en la región de la selva (razón de posibilidades [odds ratio, OR] = 1,65; IC95 por ciento: 1,13 a 2,42); tener menor de 19 años de edad (OR = 2,02; IC95 por ciento: 1,35 a 3,03); ser ama de casa (OR = 1,69; IC95 por ciento: 1,12 a 2,55); y tener 11 años o menos de educación (OR = 2,12; IC95 por ciento: 1,20 a 3,75). Las variables asociadas con la vulnerabilidad a la enfermedad según el análisis multifactorial fueron: vivir en la región de la selva (OR = 1,67; IC95 por ciento: 1,13 a 2,46); tener menos de 19 años de edad (OR = 1,62; IC95 por ciento: 1,07 a 2,47); tener menos de 4 niños nacidos vivos (OR = 1,85; IC95 por ciento: 1,00 a 3,40); y tener 11 años o menos de educación (OR = 2,07; IC95 por ciento: 1,16 a 3,71). CONCLUSIONES: En la zona estudiada, la proporción...