Mental health among the sugarcane industry farmers and non-farmers in Peru: a cross-sectional study on occupational health.

OBJECTIVE: Describe the occupational characteristics of farmer and non-farmer workers and investigate critical occupational risk factors for mental disorders in sugarcane farmers in Peru. METHOD: We conducted a cross-sectional study with occupational health and safety focus among farmers and non-farmers. Mental disorder symptoms were evaluated through the local validated version of the 12-Item General Health Questionnaire (GHQ-12). We explored the association between mental disorder symptoms, work conditions and known occupational risk factors (weekly working hours, pesticide exposures, heat stress and heavy workload). Negative binomial regression models were fitted, and 95% CIs were calculated. RESULTS: We assessed 281 workers between December 2019 and February 2020. One hundred and six (37.7%) respondents identified themselves as farmworkers. The mean GHQ-12 scores for farmers and non-farmers were 3.1 and 1.3, respectively. In the fully adjusted multivariable model, mental disorder symptom counts among farmers were more than twice as high as those of non-farmers (ß: 2.11; 95% CI: 1.48 to 3.01). The heavy workload increased the mean number of mental disorder symptoms by 68% (95% CI: 21% to 133%), and each additional working hour per day increased the mean number of mental disorder symptoms by 13% (95% CI: 1% to 25%). CONCLUSION: Farmers have higher mental disorder symptoms than non-farmers. A heavy workload and more working hours per day are independently associated with more mental disorder symptoms. Our findings highlight the importance of including mental health within occupational programmes and early interventions tailored to sugarcane industrial mill workers in the Latin American context.

Home-Based Respiratory Physiotherapy and Telephone-Based Psychological Support for COVID-19 Survivors in Peru: Protocol for a Randomized Controlled Trial.

BACKGROUND: Both pulmonary and mental health are affected following hospitalization for COVID-19 pneumonia. Pulmonary rehabilitation therapy has demonstrated benefits in improving mental health, but no validated combined programs that include mental health have been proposed. OBJECTIVE: This article presents the design of a trial that aimed to assess whether the participation in a combined rehabilitation program that includes home-based respiratory physiotherapy and telephone-based psychological support is associated with a greater improvement of pulmonary and mental health outcomes 7-12 weeks after COVID-19 hospitalization discharge compared with posthospital usual care provided by a public Peruvian hospital. METHODS: WAYRA (the word for air in the Quechua language) was an open-label, unblinded, two-arm randomized controlled trial. We recruited 108 participants aged 18-75 years who were discharged from the hospital after COVID-19 pneumonia that required >6 liters/minute of supplemental oxygen during treatment. Participants were randomly assigned at a 1:1 ratio to receive the combined rehabilitation program or usual posthospital care provided by a public Peruvian hospital. The intervention consisted of 12 at-home respiratory rehabilitation sessions and 6 telephone-based psychological sessions. The primary outcome was the 6-minute walk distance. Secondary outcomes included lung function, mental health status (depression, anxiety, and trauma), and quality of life. Outcomes were assessed at baseline (before randomization) and at 7 and 12 weeks after hospital discharge to assess the difference between arms. RESULTS: This study was funded by the Peruvian National Council of Science Technology and Technology Innovation in July 2020. Ethics approval was obtained on September 2, 2020. Recruitment and data collection occurred between October 2020 and June 2021. Results are expected to be published by the end of 2022. CONCLUSIONS: WAYRA was the first randomized controlled trial evaluating combined pulmonary-mental health rehabilitation for hospitalized COVID-19 survivors in resource-limited settings, potentially providing a foundation for the cost-effective scale-up of similar multidisciplinary rehabilitation programs. TRIAL REGISTRATION: ClinicalTrials.gov NCT04649736; https://clinicaltrials.gov/ct2/show/NCT04649736. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/36001.

Paridad de género en las ciencias de la salud en el Perú: Una deuda urgente / Gender equity in Peruvian health sciences: an urgent debt

En un país tan complejo y con un contexto tan convulsionado como el peruano múltiples eventos, y más recientemente la pandemia de COVID-19, han resaltado la precariedad de su sistema de salud. Infraestructura centralizada, desmejoraday envuelta en escándalos de mala administración y manejosescasa protección a la vida y la salud de los profesionales del sector, y muchas veces el desamparo en que se encuentran nuestros compatriotas cuando están en el rol de pacientes

Operations research study to implement HIV and syphilis point-of-care tests and assess client perceptions in a marginalised area of Lima, Peru.

In Peru, a significant proportion of people tested for HIV and syphilis do not receive timely results. Our objective was to assess the institutional feasibility of implementing simultaneous HIV/syphilis point-of-care tests and client perceptions regarding these point-of-care tests. Point-of-care tests were implemented in a hospital consultation room in a marginalised zone of Lima. A time-series design was used to compare the proportion of tested clients who received timely results, with and without the point-of-care test intervention. Experience and satisfaction with point-of-care tests was evaluated with 149 people. In the 6 months without intervention, 69% and 61% of clients tested for HIV and syphilis, respectively, received their results within the required 45-minute window. During the 2-month point-of-care test intervention, all clients tested for HIV (n = 387) and syphilis (n = 398) received their results within 45 minutes. All clients surveyed were completely satisfied (52%) or satisfied (48%) with the simultaneous HIV/syphilis point-of-care test screening process. Additionally, 73% strongly agreed with the statement 'I feel satisfied with the rapid testing process.' Screening using point-of-care tests represents an important opportunity to reduce the time, resource and cost burden for users and institutions and increase the proportion of users receiving their test results in a timely manner.

Social capital and chronic post-traumatic stress disorder among survivors of the 2007 earthquake in Pisco, Peru.

This study aimed to evaluate the association between chronic Post-Traumatic Stress Disorder (PTSD) and both structural and cognitive social capital in adult survivors of the 2007 earthquake in Pisco, Peru. Cognitive social capital measures trust, sense of belonging and interpersonal relationships in the community and structural social capital measures group membership, support from community groups and individuals, and involvement in citizenship activities. We conducted a population-based cross-sectional study in five counties in Pisco, selecting 1012 adults through complex, multi-stage random sampling. All participants completed socio-demographic questions and validated Spanish-language versions of the Adapted Social Capital Assessment Tool (SASCAT) and the civilian PTSD checklist (PCL-C). After performing descriptive and bivariate analyses, we carried out prevalence ratio (PR) regression. The overall prevalence of chronic PTSD was 15.9% (95% CI: 12.3, 19.8), much higher than anticipated based on existing evidence. Cognitive social capital was found to be negatively associated with chronic PTSD, while no significant association was found for structural social capital. Specifically, those with high cognitive social capital had an almost two times lower prevalence of chronic PTSD (PR = 1.83, 95% CI: 1.50, 2.22) compared with those with low cognitive social capital. No independent association between structural social capital and chronic PTSD was found (PR = 1.44, 95% CI: 0.70, 2.97). In conclusion, cognitive social capital, but not structural social capital, has a protective influence on the occurrence of chronic PTSD in survivors of natural disasters. These results may have public health implications. For example, pre- and post-disaster community-based interventions that catalyze and foster dimensions of cognitive social capital may aid in ameliorating the effect of earthquakes and other natural disasters on populations with high vulnerability to such events and poor access to mental health and other support services.