Ecological approach to the characteristics and determinants of sexual violence against adolescents in Perú / Aproximación ecológica a las características y factores determinantes de la violencia sexual contra adolescentes en Perú.

Introduction. Sexual violence against adolescents is a global problem that affects young people around the world. The ecological model examines its forms and determinants through interconnected levels. Objective. To determine the frequency, characteristics, and predictors of sexual violence in adolescents attending school in Perú. Materials and methods. This was a cross-sectional study that secondarily analyzed data from the Encuesta Nacional de Relaciones Sociales (2019). A stratified probabilistic sample involved 1,579 youth aged 12-17 from 93 schools. The questionnaire evaluated physical, psychological, and sexual violence in the family and at school. Models were estimated using logistic regression analysis, calculating odds ratio (OR). Results. Eighteen point sixty eight per cent (95% CI: 16.80-20.60) suffered some type of sexual assault. In addition, 9.75% (95% CI: 8.28-11.21) reported having been touched in some part of the body and 1.84% (95% CI: 1.17-2.50) reported that was a victim of rape. Age was identified as a risk factor in the microsystem (OR = 1.48) (95% CI: 1.26-1.74), while the age of the first experienced sexual violence acted as a protective factor (OR = 0.61) (95% CI: 0.54-0.69). In addition, in the macrosystem, the perception that violence occurs mainly outside the home increased the risk (OR = 2.06) (95% CI: 1.01-4.19). Conclusions. Approximately two out of ten respondents reported having experienced some type of sexual violence, with verbal harassment and invasive personal contact being the most common. No single level or factor can fully explain adolescent sexual violence without considering its ecological interconnectedness.

Introducción. La violencia sexual contra los adolescentes es un problema global que afecta a jóvenes de todo el mundo. El modelo ecológico examina sus formas y factores determinantes a través de niveles interconectados. Objetivo. Determinar la frecuencia, las características y los predictores de la violencia sexual contra adolescentes escolarizados en Perú. Materiales y métodos. Se llevó a cabo un estudio transversal en el cual se analizaron de manera secundaria los datos de la Encuesta Nacional de Relaciones Sociales (2019). Una muestra probabilística estratificada incluyó a 1.579 jóvenes de 12 a 17 años de 93 escuelas. Con el cuestionario se evaluó la violencia sexual en la familia y en la escuela. Se estimaron modelos mediante análisis de regresión logística, calculando la razón de momios (odds ratio, OR). Resultados. El 18,68 % (IC95%: 16,80-20,60) sufrió algún tipo de agresión sexual. Además, el 9,75 % (IC95%: 8,28-11,21) informó haber sido tocado en alguna parte del cuerpo y el 1,84 % (IC95%: 1,17-2,50) informó que fue víctima de violación. La edad se identificó como factor de riesgo en el microsistema (OR=1,48) (IC95%: 1,26-1,74), mientras que la edad de la primera violencia sexual actuó como factor protector (OR=0,61) (IC95%: 0,54-0,69). Además, en el macrosistema, la percepción de que la violencia ocurre principalmente fuera del hogar incrementó el riesgo (OR=2,06) (IC95%: 1,01-4,19). Conclusión. Aproximadamente, dos de cada diez encuestados informaron haber experimentado algún tipo de violencia sexual, siendo el acoso verbal y el contacto personal invasivo los más comunes. Ningún nivel del modelo ecológico o factor único puede explicar completamente la violencia sexual contra los adolescentes sin considerar su interconexión ecológica.

Highly pathogenic avian influenza A virus subtype H5N1 (clade 2.3.4.4b) isolated from a natural protected area in Peru.

The panzootic caused by H5N1 avian influenza viruses is a high concern for wild birds' conservation and the study of spillover events into mammals. The near coding-complete genome of H5N1 clade 2.3.3.4b sequencing in the Miseq Illumina platform was performed from a bird located in Pantanos of Villa National Wildlife Refuge.

Vulnerable Lives, Irrelevant Deaths? Dying Alone and Receiving Flawed Care in an Institution for the Aged in Lima, Peru.

This ethnographic exploration of death in the Peruvian context draws on fieldwork among abandoned-both by their families and the state-older adults in a shelter for the homeless in Lima, Peru. I examine the conditions and local forces that shape the ways people at this institution socially and physically die. My argument is that people in this long-term care facility who have lived entire lives on the margins, usually, end up having irrelevant deaths to their families, other residents of the institution, and the Peruvian state. At this shelter, dying in an irrelevant way means dying without companionship from family members and receiving poor and flawed care from the institution that shelters them.

Risk Factors for Depression Among Middle-Aged to Older People Living With HIV in Lima, Peru.

INTRODUCTION: Depression is prevalent among aging people living with HIV (PLWH) worldwide. We sought to identify depression risk factors among a group of middle-aged and older PLWH in Lima, Peru. MATERIALS AND METHODS: We assessed risk factors for depression among PLWH over age 40 receiving care in an HIV clinic in Lima, Peru. The Patient Health Questionnaire-9 (PHQ-9) was administered. We performed descriptive statistics and logistic regression analyses. RESULTS: Mean age was 51.7 ± 7.7 years with 15.3% females. One-quarter of participants had depression with higher frequency in females. Risk factors that significantly increased the risk of depression included female sex (adjusted prevalence ratio [aPR] = 2.19 [95%CI 1.07-4.49]), currently smoking (aPR = 2.25 [95%CI 1.15-4.43]), and prior opportunistic infection (aPR = 2.24 [95%CI 1.05-4.76]). DISCUSSION: Our study demonstrates that PLWH who are female, current smokers, or had an opportunistic infection have higher risk of depression. Identifying PLWH at-risk for depression is key to early mental health interventions.

Factors affecting depression in older people with HIV in PeruIntroductionDepression is common in older people living with HIV (PLWH) worldwide. We identified depression risk factors among a group of middle-aged and older PLWH in Lima, Peru.Materials and MethodsWe assessed risk factors for depression among PLWH over age 40 receiving care in an HIV clinic in Lima, Peru. The Patient Health Questionnaire-9 (PHQ-9) was administered.ResultsMean age was 51.7 ± 7.7 years with 15.3% females. One-quarter of participants had depression with higher frequency in females. Risk factors that significantly increased the risk of depression included female sex (adjusted prevalence ratio [aPR] = 2.19 [95%CI 1.07-4.49]), currently smoking (aPR = 2.25 [95%CI 1.15-4.43]), and prior opportunistic infection (aPR = 2.24 [95%CI 1.05-4.76]).DiscussionOur study demonstrates that PLWH who are female, current smokers, or had an opportunistic infection have higher risk of depression. Identifying PLWH at-risk for depression is key to early treatment or interventions that can improve mental health in PLWH in Peru.

Combining spaceborne lidar from the Global Ecosystem Dynamics Investigation with local knowledge for monitoring fragmented tropical landscapes: A case study in the forest-agriculture interface of Ucayali, Peru.

Improving our ability to monitor fragmented tropical ecosystems is a critical step in supporting the stewardship of these complex landscapes. We investigated the structural characteristics of vegetation classes in Ucayali, Peru, employing a co-production approach. The vegetation classes included three agricultural classes (mature oil palm, monocrop cacao, and agroforestry cacao plantations) and three forest regeneration classes (mature lowland forest, secondary lowland forest, and young lowland vegetation regrowth). We combined local knowledge with spaceborne lidar from NASA's Global Ecosystem Dynamics Investigation mission to classify vegetation and characterize the horizontal and vertical structure of each vegetation class. Mature lowland forest had consistently higher mean canopy height and lower canopy height variance than secondary lowland forest (µ = 29.40 m, sd = 6.89 m vs. µ = 20.82 m, sd = 9.15 m, respectively). The lower variance of mature forest could be attributed to the range of forest development ages in the secondary forest patches. However, secondary forests exhibited a similar vertical profile to mature forests, with each cumulative energy percentile increasing at similar rates. We also observed similar mean and standard deviations in relative height ratios (RH50/RH95) for mature forest, secondary forest, and oil palm even when removing the negative values from the relative height ratios and interpolating from above-ground returns only (mean RH50/RH95 of 0.58, 0.54, and 0.53 for mature forest, secondary forest, and oil palm, respectively) (p < .0001). This pattern differed from our original expectations based on local knowledge and existing tropical forest succession studies, pointing to opportunities for future work. Our findings suggest that lidar-based relative height metrics can complement local information and other remote sensing approaches that rely on optical imagery, which are limited by extensive cloud cover in the tropics. We show that characterizing ecosystem structure with a co-production approach can support addressing both the technical and social challenges of monitoring and managing fragmented tropical landscapes.

Functional prediction based on 16S rRNA metagenome data from bacterial microbiota associated with macroalgae from the Peruvian coast.

Macroalgae are vital reservoirs for essential epibiotic microorganisms. Among these are growth-promoting bacteria that support the growth and healthy development of their host macroalgae, and these macroalgae can be utilized in agriculture as biostimulants, offering an alternative to traditional agrochemicals. However, to date, no comparative studies have been conducted on the functional profile and bacterial diversity associated with coastal macroalgae of Peru. In this study, we employed amplicon sequencing of the V3-V4 region of 16S rRNA gene in twelve host macroalgae collected from two rocky shores in central Peru to compare their bacterial communities. The results revealed high bacterial diversity across both sites, but differences in microbial composition were noted. The phyla Bacteroidota and Pseudomonadota were predominant. The functional prediction highlighted 44 significant metabolic pathways associated with the bacterial microbiota when comparing host macroalgae. These active pathways are related to metabolism and genetic and cellular information processing. No direct association was detected between the macroalgal genera and the associated microbiota, suggesting that the bacterial community is largely influenced by their genetic functions than the taxonomic composition of their hosts. Furthermore, some species of Chlorophyta and Rhodophyta were observed to host growth-promoting bacteria, such as Maribacter sp. and Sulfitobacter sp.

Net primary productivity and litter decomposition rates in two distinct Amazonian peatlands.

Measurements of net primary productivity (NPP) and litter decomposition from tropical peatlands are severely lacking, limiting our ability to parameterise and validate models of tropical peatland development and thereby make robust predictions of how these systems will respond to future environmental and climatic change. Here, we present total NPP (i.e., above- and below-ground) and decomposition data from two floristically and structurally distinct forested peatland sites within the Pastaza Marañón Foreland Basin, northern Peru, the largest tropical peatland area in Amazonia: (1) a palm (largely Mauritia flexuosa) dominated swamp forest and (2) a hardwood dominated swamp forest (known as 'pole forest', due to the abundance of thin-stemmed trees). Total NPP in the palm forest and hardwood-dominated forest (9.83 ± 1.43 and 7.34 ± 0.84 Mg C ha-1 year-1, respectively) was low compared with values reported for terra firme forest in the region (14.21-15.01 Mg C ha-1 year-1) and for tropical peatlands elsewhere (11.06 and 13.20 Mg C ha-1 year-1). Despite the similar total NPP of the two forest types, there were considerable differences in the distribution of NPP. Fine root NPP was seven times higher in the palm forest (4.56 ± 1.05 Mg C ha-1 year-1) than in the hardwood forest (0.61 ± 0.22 Mg C ha-1 year-1). Above-ground palm NPP, a frequently overlooked component, made large contributions to total NPP in the palm-dominated forest, accounting for 41% (14% in the hardwood-dominated forest). Conversely, Mauritia flexuosa litter decomposition rates were the same in both plots: highest for leaf material, followed by root and then stem material (21%, 77% and 86% of mass remaining after 1 year respectively for both plots). Our results suggest potential differences in these two peatland types' responses to climate and other environmental changes and will assist in future modelling studies of these systems.

Mediciones de la productividad primaria neta (PPN) y la descomposición de materia orgánica de las turberas tropicales son escasas, lo que limita nuestra capacidad para parametrizar y validar modelos de desarrollo de las turberas tropicales y, en consecuencia, realizar predicciones sólidas sobre la respuesta de estos sistemas ante futuros cambios ambientales y climáticos. En este estudio, presentamos datos de PPN total (es decir, biomasa aérea y subterránea) y descomposición de la materia orgánica colectada en dos turberas boscosas con características florísticas y estructurales contrastantes dentro de la cuenca Pastaza Marañón al norte del Perú, el área de turberas tropicales más grande de la Amazonia: (1) un bosque pantanoso dominado por palmeras (principalmente Mauritia flexuosa) y (2) un bosque pantanosos dominado por árboles leñosos de tallo delgado (conocido como 'varillal hidromórfico'). La PPN total en el bosque de palmeras y el varillal hidromórfico (9,83 ± 1,43 y 7,34 ± 0,84 Mg C ha­1 año­1 respectivamente) fue baja en comparación con los valores reportados para los bosques de tierra firme en la región (14,21­15,01 Mg C ha­1 año­1) y para turberas tropicales en otros lugares (11,06 y 13,20 Mg C ha­1 año­1). A pesar de que la PPN total fue similar en ambos tipos de bosque, hubo diferencias considerables en la distribución de la PPN. La PPN de las raíces finas fue siete veces mayor en el bosque de palmeras (4,56 ± 1,05 Mg C ha­1 año­1) que en el varillal hidromórfico (0,61 ± 0,22 Mg C ha­1 año­1). La PPN de la biomasa aérea de las palmeras, un componente ignorado frecuentemente, contribuyó en gran medida a la PPN total del bosque de palmeras, representando el 41% (14% en el varillal hidromórfico). Por el contrario, la tasa de descomposición de materia orgánica de Mauritia flexuosa fue la misma en ambos sitios: la más alta corresponde a la hojarasca, seguida por las raíces y luego el tallo (21%, 77% y 86% de la masa restante después de un año, respectivamente para ambos sitios). Nuestros resultados sugieren diferencias potenciales en la respuesta de estos dos tipos de turberas al clima y otros cambios ambientales, y ayudarán en futuros estudios de modelamiento de estos sistemas.

Nanopore sequencing of IPNV vp2 gene in Peruvian Andean trout (Oncorhynchus mykiss) cultures.

Nanopore sequencing of the infectious pancreatic necrosis virus (IPNV) vp2 gene from Andean trout cultures in Peru reveals genogroups 1 and 5. This insight aids in understanding strain diversity and pathogenicity, vital for effective disease surveillance, and control measures in aquaculture.

Derecho de acceso a la salud en los establecimientos penitenciarios de mujeres del Perú

Introducción: En el Perú las mujeres en los establecimientos penitenciarios carecen de acceso a la salud ante la falta de políticas públicas que conduce a una brecha de desigualdad en dicho acceso. La investigación tiene por objetivo diagnosticar la situación del acceso a los servicios de la salud en los establecimientos penitenciarios de mujeres del Perú durante el año 2021. Métodos: Se realizó un estudio descriptivo, transversal, con datos de los 13 establecimientos, que constituyen la totalidad de los establecimientos penitenciarios de mujeres en el Perú. Resultados: Los resultados señalan que las atenciones en salud se concentraron en la región penitenciaria de Lima, se encontró que las regiones que no presentaban profesionales de la salud permanentes carecían de atención adecuada. Discusión: el Estado peruano no ha cumplido con su rol como garante en relación con el derecho fundamental al acceso a los servicios de salud por parte de las entidades penitenciarias en beneficio de todas las mujeres internas que integran los Establecimientos Penitenciarios de Mujeres en el Perú. Se recomienda, bajo los principios de razonabilidad y proporcionalidad, es más que urgente definir nuevas directrices de acceso a la salud femenina, coadyuvando a que el personal de salud desempeñe un enfoque preventivo, con la capacidad de integrar la buena cultura de la institución penitenciaria.

Introduction: In Peru, women in prisons lack access to health due to the lack of public policies that lead to an inequality gap in said access. The objective of the research is to diagnose the situation of access to health services in women's penitentiary establishments in Peru during the year 2021. Method: A descriptive, cross-sectional study was carried out with data from the 13 establishments, which constitute all of the women's penitentiary establishments in Peru. The results indicate that health care was concentrated in the prison region of Lima; it was found that regions that did not have permanent health professionals lacked adequate care. Results: Therefore, the importance of placing permanent health professionals in penitentiary centers is accentuated to guarantee care for women. Discussion: The peruvian state has not fulfilled its role as guarantor in relation to the fundamental right of access to health services by penitentiary entities for the benefit of all female inmates who make up the Women's Penitentiary Establishments in Peru. It is recommended, under the principles of reasonableness and proportionality, that it is more than urgent to define new guidelines for access to women's health, helping health personnel to carry out a preventive approach, with the ability to integrate the good culture of the penitentiary institution.

Subcutaneous versus intravenous administration of Trastuzumab: a minimization cost analysis with real world data from a reference cancer centre in Peru.

Breast cancer (BC) is a global concern, with Peru experiencing a high incidence and mortality. Trastuzumab, a crucial treatment for human epidermal growth factor receptor 2-positive BC, is administered intravenously or subcutaneously (SC). This study evaluates the costs associated with both methods at Peru's Instituto Nacional de Enfermedades Neoplásicas. Real data indicate that SC administration reduces treatment costs by approximately S/15,049.09. Cross-continental comparisons highlight a global trend favouring SC administration for efficiency and cost-effectiveness. The analysis provides insights for informed decision-making in resource-constrained healthcare settings like Peru, emphasising the need to consider local contexts in optimising oncology care.

Social, economic, and physical side effects impact PrEP uptake and persistence among transgender women in Peru.

INTRODUCTION: Oral pre-exposure prophylaxis (PrEP) for HIV-1 infection is over 99% effective in protecting against HIV acquisition when used consistently and appropriately. However, PrEP uptake and persistent use remains suboptimal, with a substantial gap in utilization among key populations who could most benefit from PrEP. In Latin America specifically, there is poor understanding of barriers to PrEP uptake and persistence among transgender (trans) women. METHODS: In April-May 2018, we conducted qualitative interviews lasting 25-45 min as part of an end-of-project evaluation of TransPrEP, a pilot RCT that examined the impact of a social network-based peer support intervention on PrEP adherence among trans women in Lima, Peru. Participants in the qualitative evaluation, all adult trans women, included individuals who either (1) screened eligible to participate in the TransPrEP pilot, but opted not to enroll (n = 8), (2) enrolled, but later withdrew (n = 6), (3) were still actively enrolled at the time of interview and/or successfully completed the study (n = 16), or (4) were study staff (n = 4). Interviews were audio recorded and transcribed verbatim. Codebook development followed an immersion/crystallization approach, and coding was completed using Dedoose. RESULTS: Evaluation participants had a mean age of 28.2 years (range 19-47). When describing experiences taking PrEP, participant narratives highlighted side effects that spanned three domains: physical side effects, such as prolonged symptoms of gastrointestinal distress or somnolence; economic challenges, including lost income due to inability to work; and social concerns, including interpersonal conflicts due to HIV-related stigma. Participants described PrEP use within a broader context of social and economic marginalization, with a focus on daily survival, and how PrEP side effects negatively contributed to these stressors. Persistence was, in some cases, supported through the intervention's educational workshops. CONCLUSION: This research highlights the ways that physical, economic, and social side effects of PrEP can impact acceptability and persistence among trans women in Peru, amplifying and layering onto existing stressors including economic precarity. Understanding the unique experiences of trans women taking PrEP is crucial to informing tailored interventions to improve uptake and persistence.

Epidemiological and clinical characteristics of monkeypox among people with and without HIV in Peru: a national observational study.

BACKGROUND: In Latin America, Peru has the second highest number of cases of monkeypox (Mpox), of which more than 50 % are Human Immunodeficiency Virus (HIV)-positive. Here, we compared the epidemiological and clinical characteristics of Mpox between people with and without HIV in Peru. METHODS: We conducted a national retrospective study using data on confirmed cases of Mpox reported by the Peruvian National Surveillance System from 15 June 2022 to 31 December 2023. RESULTS: A total of 3561 confirmed cases of Mpox were included. Of these, 2123 (60 %) patients were people living with HIV (PLWH), with increased odds for those aged 30 years or older, homosexual (adjusted odds ratio [aOR] 8.58 [6.95-10.59], p<0.0001), bisexual (aOR=4.44 [3.46-5.69], p<0.0001), sex workers (aOR=2.24 [1.07-4.68], p=0.032), people with a history of syphilis (aOR=2.07 [1.66-2.58], p<0.001), and hospitalized (aOR=3.08 [2.03-4.68], p<0.001). PLWH were more likely to have proctitis (aOR=1.73 [1.26-2.37], p=0.001). The overall mortality was 20 of 3561 (0.56 %). Among PLWH and Mpox, more deaths occurred in hospitalized (p<0.001) and non-ART (p<0.001) individuals. CONCLUSION: Our findings highlight that HIV infection among Mpox cases in Peru is associated with high-risk sexual behaviour and a high likelihood of hospitalization.

Late-childhood foundational cognitive skills predict educational outcomes through adolescence and into young adulthood: evidence from Ethiopia and Peru.

We estimate associations between foundational cognitive skills (inhibitory control, working memory, long-term memory, and implicit learning) measured at age 12 and educational outcomes measured at ages 15 and 19-20 in Ethiopia and Peru, using the Young Lives data. The estimates adjust for rich sets of controls and include measurements of children's baseline abilities. For a subset of the outcomes, we exploit within-household variation. Working memory and long-term memory are consistently and positively associated with subsequent domain-specific cognitive achievement tests (measuring specifically numeracy, vocabulary and literacy achievement) in both countries, university enrolment in Peru (long-term memory) and lower secondary-school completion in Ethiopia (working memory). Inhibitory control predicts subsequent math-test scores in both countries, grade attainment (Ethiopia), and university enrolment (Peru). Value-added estimates show that these skills play roles during adolescence, with the memory-related skills predicting higher domain-specific test scores (Peru and Ethiopia) and grade attainment (Ethiopia), while inhibitory control has associations with math (both countries). These results provide additional evidence to justify the importance of promoting investments in cognitive skills throughout childhood and adolescence, and elucidate how such investments impact educational achievements.

In-Person and Teleconsultation Services at a National Hospital in Peru: Time Series Analysis of General and Psychiatric Care Amid the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic led to a global reduction in health care accessibility for both infected and noninfected patients, posing a particular burden on those with chronic conditions, including mental health issues. Peru experienced significant devastation from the pandemic, resulting in a collapsed health care system and leading to the world's highest per capita mortality rate as a result of COVID-19. Understanding the trends in health care utilization, particularly in mental health care, is crucial for informing pandemic response efforts and guiding future recovery strategies. OBJECTIVE: This study aims to analyze the trends of outpatient medical and psychiatric consultations during the COVID-19 pandemic in a national hospital in Peru. METHODS: This observational study was conducted at a national hospital in Lima, Peru. We analyzed data on user care across all services, including psychiatric services, from May 2019 to December 2022. The data were calculated for users served per month, including the number of users seen monthly in mental health services. Sociodemographic variables such as sex (female or male), age (≥0 years), type of medical appointment (regular or additional), and modality of care (in-person or teleconsultations) were taken into account. An interrupted time series regression model was conducted to assess the number of outpatient medical and psychiatric consultations. Subgroup analyses were performed based on service modality, including overall consultations, telemonitoring/teleconsultations only, or face-to-face only, for all service users and for mental health service users. RESULTS: A total of 1,515,439 participants were included, with females comprising 275,444/484,994 (56.80%) of the samples. Only 345,605/1,515,439 (22.81%) visits involved telemedicine. The total monthly outpatient visits were significantly reduced compared with the expected projection (P<.001) at the beginning of the pandemic, followed by a later monthly increment of 298.7 users. Face-to-face interventions experienced a significant reduction at the beginning of the pandemic (P<.001), gradually recovering in the following months. By contrast, telemedicine use initially increased but subsequently declined toward the end of the pandemic. A similar trend was observed in mental health units. CONCLUSIONS: During the pandemic years, health care utilization in both general and psychiatric services experienced a significant decrease, particularly at the beginning of the pandemic (March 2020). However, no significant trends were observed in either case throughout the pandemic period. Telemedicine consultations witnessed a significant increase overall during this period, particularly among mental health users.

Clinical and microbiological characteristics of a hospital outbreak of Candida auris in a referral hospital in Lima, Peru.

BACKGROUND: Candida auris, a multidrug-resistant fungal pathogen, has received considerable attention owing to its recent surge, especially in South America, which coincides with the ongoing global COVID-19 pandemic. Understanding the clinical and microbiological characteristics of outbreaks is crucial for their effective management and control. OBJECTIVE: This retrospective observational study aimed to characterize a C. auris outbreak at a Peruvian referral hospital between January 2021 and July 2023. METHODS: Data were collected from hospitalized patients with positive C. auris culture results. Microbiological data and antifungal susceptibility test results were analysed. Additionally, infection prevention and control measures have been described. Statistical analysis was used to compare the characteristics between the infected and colonized patients. RESULTS: Thirty-three patients were identified, mostly male (66.7%), with a median age of 53 years. Among them, 18 (54.5%) were colonized, and 15 (45.5%) were infected. Fungemia was the predominant presentation (80%), with notable cases of fungemia in tuberculosis patients with long-stay devices for parenteral anti-tuberculosis therapy. Seventy-five percent of the isolates exhibited fluconazole resistance. Echinocandins were the primary treatment, preventing fungemia recurrence within 30 days. Infected patients had significantly longer hospital stays than colonized patients (100 vs. 45 days; p = .023). Hospital mortality rates were 46.7% and 25% in the infected and fungemia patients, respectively. Simultaneous outbreaks of multidrug-resistant bacteria were documented. CONCLUSIONS: This study underscores the severity of a C. auris outbreak at a referral hospital in Peru, highlighting its significant impact on patient outcomes and healthcare resources. The high prevalence of fluconazole-resistant isolates, leading to prolonged hospital stay and high mortality rates, particularly in cases of fungemia, underscores the critical need for effective infection prevention and control strategies.

Spatio-temporal evaluation of metals and metalloids in the water of high Andean livestock micro-watersheds, Amazonas, Peru.

Cattle ranching is a fundamental economic activity in northern Peru, where proper management of water resources is crucial. This study, a pioneer in the region, evaluated water quality and its suitability for human consumption, vegetable irrigation, and livestock production. It is also the first study to document the presence of metals and metalloids in vulnerable areas because they are located at the headwaters of river watersheds. The spatiotemporal evaluation of physicochemical parameters, metals, and metalloids was performed in five micro-watersheds (Cabildo, Timbambo, Pomacochas, Atuen, and Ventilla) from water samples collected in the dry season (October 2017) and wet season (March 2018). The parameters were analyzed using microwave plasma atomic emission spectrometry. The results were contrasted with international and Peruvian quality standards related to dairy cow production. The highest values of pH, total dissolved solids, and electrical conductivity were reported during the dry season, and the highest turbidity during the wet season. Of the metals evaluated, arsenic (As) was omnipresent in all the micro-watersheds, followed by lead (Pb). In contrast to World Health Organization regulations, concentrations of As, cadmium (Cd), Pb, and iron represent a risk; according to Peruvian regulations, As and Pb exceed the concentrations established for use in animal drinking water and vegetable irrigation, and according to water guidelines for dairy cattle, concentrations of As, Pb, Cd, and Al exceed the permitted limits. The high concentrations of these metals in the study area are attributable to a synergy between natural factors, such as Andean geology and livestock activity. The data reported will allow for proper water resource management, pollution prevention, and the design and adoption of mitigation measures.

Analysis of the legal situation regarding euthanasia in Ecuador, Colombia, and Peru: Towards a Latin American model of medical assistance in dying?

Colombia was one of the first countries to decriminalise euthanasia. However, what is known in the international academic literature about the country's regulations is scarce and outdated. Such lack of information on the situation in Latin America is even more evident in the case of Peru, where the Lima Superior Court of Justice set a precedent by allowing a person to have access to euthanasia in 2021. Ecuador, which has just decriminalised euthanasia for all its citizens in February 2024, risks being similarly absent from the international dialogue. This article summarises for the first time all the regulations in force regarding euthanasia in Latin America, through a study of primary sources in Spanish, and analyses some of the convergences between these three neighbouring countries.

Identifying Gaps in the Treatment Guidelines for Hepatitis C in Peru to Meet International Standards: A Narrative Review.

Hepatitis C virus still represents a major cause of morbidity and mortality worldwide. In Peru, two national practice guidelines for the management of this infection were published more than 5 years ago; however, the latest breakthroughs in the treatment make it necessary to update these guidelines. We reviewed the most recent recommendations of the international guidelines and compared them with the current Peruvian guidelines. We found major differences, such as the use of Glecaprevir/Pibrentasvir as a first-line therapy, which is contemplated in the World Health Organization guideline, and recommended by American and European guidelines, but is not considered in the Peruvian guidelines. Another crucial difference lies in the management of patients with chronic kidney disease, who are treated nowadays with a variety of direct-acting antivirals, with no restrictions on the use of Sofosbuvir-based regimens in first-world countries, an approach that has not been adopted in Peru. We believe that standardization of the recommendations of the Peruvian guidelines is imperative, including the new therapeutic strategies that have emerged in recent years. We also suggest conducting a cost effectiveness analysis in the Peruvian context to allow for the implementation of new antivirals, and to achieve a better control of hepatitis C in the country.

Academic accountability to local communities and society through Programme Science: a case study from the HPV self-sampling programme HOPE in Peru.

INTRODUCTION: Health challenges in the 21st century underscore the need for adaptable and innovative approaches in public health. Academic institutions can and should contribute much more effectively to generate and translate scientific knowledge that will result in better programmes to improve societal health. Academic accountability to local communities and society requires universities to actively engage with local communities, understanding the context, their needs, and leveraging their knowledge and local experience. The Programme Science initiative provides a framework to optimize the scale, quality and impact of public health programmes, by integrating diverse approaches during the iterative cycle of research and practice within the strategic planning, programme implementation and programme management and evaluation. We illustrate how the Programme Science framework could be a useful tool for academic institutions to accomplish accountability to local communities and society through the experience of Project HOPE in Peru. DISCUSSION: Project HOPE applied the Programme Science framework to introduce HPV self-sampling into a women's health programme in Peru. Collaboration with local authorities and community members was pivotal in all phases of the project, ensuring interventions aligned with community needs and addressing social determinants of health. The HOPE Ladies-community women trained and empowered to promote and provide the HPV kits-crafted the messages used through the study and developed strategies to reach individuals and provided support to women's journey through health centres. By engaging communities in co-creating knowledge and addressing health inequities, academic institutions can generate contextually relevant and socially just scientific knowledge. The active participation of community women in Project HOPE was instrumental in improving service utilization and addressing barriers to self-sampling. CONCLUSIONS: The Programme Science approach offers a pathway for academic institutions to enhance their accountability to communities and society at large. By embedding researchers within public health programmes and prioritizing community engagement, academic institutions can ensure that research findings directly inform policy improvements and programmatic decisions. However, achieving this requires a realignment of research agendas and recognition of the value of community engagement. Establishing Programme Science networks involving academia, government and funding entities can further reinforce academic accountability and enhance the impact of public health programmes.

Factors associated with non-treatment for long-term illness among incarcerated individuals.

PURPOSE: The prison population is seldom studied and often overlooked in many countries despite their vulnerability to long-term illness. This study aims to explore the factors associated with the non-treatment for long-term illnesses among incarcerated individuals. DESIGN/METHODOLOGY/APPROACH: This study is a cross-sectional analysis. The authors conducted a secondary data analysis using information collected in the Peruvian census of incarcerated individuals. The study population consisted of incarcerated individuals diagnosed with a long-term illness. To evaluate the factors associated with non-treatment, the authors used a Poisson regression model. FINDINGS: The authors included 12,512 incarcerated individuals (age: 40.9 ± 13.1 years), and 39% of them did not receive treatment for their long-term illness. The authors observed that non-treatment was statistically associated with gender, age, having children, use of the Spanish language, sexual identity, judicial situation, penitentiary location, discrimination inside the penitentiary and health insurance before incarceration. However, only having children (prevalence ratio [PR]: 1.11, confidence interval [CI]95% 1.03-1.19), using the Spanish language (PR: 1.15, CI95%: 1.01-1.31), being in a penitentiary not in Lima (PR: 1.11, CI95%: 1.06-1.17) and perceiving discrimination inside the penitentiary (PR: 1.12, CI95% 1.06-1.18) increased the prevalence of non-treatment. ORIGINALITY/VALUE: Identifying the factors associated with non-treatment will allow us to implement measures for prioritizing groups and developing strategies for the evaluation, close follow-up of their health and management of comorbidities.