RESUMO
El uso de métodos de planificación familiar, principalmente de métodos anticonceptivos modernos -por su mayor eficacia-, está asociado a la disminución de casos de embarazo no deseado, abortos, y a una disminución de las tasas de fecundidad y mortalidad materna, viabilizando así una maternidad voluntaria y saludable. Sin embargo, su uso en el Perú es aún insuficiente, sobre todo en un departamento como Loreto que presenta el mayor porcentaje de demanda insatisfecha de planificación familiar a nivel nacional (14,2%) y altas tasas de fecundidad (3,8). Este es un problema importante para la salud sexual y reproductiva, y en general para la salud pública, ya que tiene repercusiones socioeconómicas relevantes. En este artículo se realiza una revisión narrativa de la evidencia disponible sobre tres intervenciones destinadas a incrementar la oferta de los métodos anticonceptivos modernos, su contextualización local y las consideraciones para su potencial implementación local.
The use of family planning methods, mainly modern contraceptive methods - due to their higher effectiveness - is associated with a reduction in the number of unplanned pregnancy and abortion cases, and also with a reduction in the maternal fertility and morbidity rates, leading to a greater visibility of a voluntary and healthy maternity. However, the use of these methods is still insufficient in Peru, especially in states such as Loreto, which has the highest unfulfilled demand rate for family planning methods on the national level (14.2%) and high fertility rates (3.8). This is an important issue for sexual and reproductive health and, in general terms, for public health, as it has relevant social and economic results. In this article, we carry out a narrative review of the available evidence on three interventions aimed to increase the supply of modern contraceptive methods, their local contextualization, and considerations for potential local implementation.
O uso de métodos de planejamento familiar, principalmente de métodos contraceptivos modernos -pela sua maior eficácia-, é associado à diminuição de casos de gravidez não desejada, abortos, e diminuição das taxas de fecundidade e mortalidade materna, possibilitando assim uma maternidade voluntaria e saudável. No entanto, o uso no Peru ainda é insuficiente, sobretudo em um departamento como Loreto que apresenta a maior porcentagem de demanda insatisfeita de planejamento familiar no nível nacional (14,2%) e altas taxas de fecundidade (3,8). Este é um problema importante de saúde sexual e reprodutiva e em geral para a saúde pública, pois tem repercussões socioeconómicas relevantes. Neste artigo realiza-se uma revisão narrativa da evidencia disponível sobre três intervenções destinadas a incrementar a oferta dos métodos anticoncepcionais modernos, sua contextualização local e as considerações para sua potencial implementação local.
RESUMO
Reports from several sites in South America suggest the presence of isolated cases of chloroquine-resistant Plasmodium vivax malaria. To investigate the possibility of chloroquine-resistant P. vivax in Peru, we conducted 28-day in vivo drug efficacy trials at three sites in the Amazon region and one site on the northern Pacific Coast between 1998 and 2001. A total of 242 patients between the ages of 2 and 60 years were enrolled (177 from the Amazon region and 65 from the northern coast). All subjects received directly observed therapy with chloroquine, 25 mg/kg, over a three-day period. On enrollment, 49% had a documented fever and 96% had a history of fever; their geometric mean parasite density was 5,129 parasites/microL. A total of 212 (88%) of the 242 subjects completed their 28-day follow-up. Four of the 177 patients from the Amazon region had a recurrence of P. vivax parasitemia on days 21 and 28 after treatment was initiated. Two of these patients had chloroquine-resistant infections, based on polymerase chain reaction-single-stranded conformational polymorphism genotyping and chloroquine-desethylchloroquine blood levels, which were > or = 97 ng/mL at the time of the reappearance of parasitemia. None of the subjects studied on the northern Pacific Coast had recurrent parasitemia.
