jueves, 19 de noviembre de 2015

Impacto del fenómeno "El Niño" de 1997-1998 en la salud de la población peruana, riesgo potencial para el 2015

Impact of the "El Niño" phenomenon from 1997 to 1998 on the health of the peruvian population: Risk potencial for 2015

Sr. Editor. El National Oceanic and Atmospheric Administration de los Estados Unidos y el Servicio Nacional de Meteorología e Hidrología del Perú han comunicado que en el 2015 se presentará un nuevo fenómeno “El Niño” (El Niño Oscilación Sur-ENSO). Este fenómeno produce elevación de la temperatura ambiental y un incremento de las precipitaciones pluviales (1); ocasionando inundaciones y aluviones (“huaycos”) como consecuencias inmediatas y posteriormente alteración del ecosistema favoreciendo el incremento de la vegetación y la aparición de plagas de insectos y roedores.

Author(s): Suarez Ognio, LuisEstela Ayamamani, DavidCáceres Mejía, BrendaGambirazio Carbajal, CarlosCabrera, Rufino
Source:  Revista Peruana de Medicina Experimental y Salud Pública (Rev Peru Med Exp Salud Publica (Rev Peru Med Exp Salud Publica)

URL: http://hdl.handle.net/10757/559080

Adherence to HAART: multi-dimensional approach

Leímos con interés el artículo de Varela y cols.1 sobre depresión y adherencia a terapia anti-retroviral en Chile, tema importante en el éxito de la terapia. Quisiéramos comentar lo siguiente: en primer lugar, muchos estudios coinciden en que las enfermedades psiquiátricas son las co-morbilidades que afectan en mayor medida a la adherencia terapia anti-retroviral de gran actividad (TARGA) directa o indirectamente2. En forma directa porque es la enfermedad psiquiátrica más diagnosticada en pacientes con infección por VIH e indirectamente porque es producto de otros factores de riesgo como uso de alcohol y drogas, efectos secundarios de fármacos, falta de soporte social y familiar, actitudes y creencias del paciente acerca del tratamiento2. Asimismo, se ha visto que la depresión afecta la adherencia al tratamiento de enfermedades crónicas3, por lo que la hipótesis de la asociación de depresión en adherencia a TARGA es a nuestro parecer válida.

Author(s): Vadillo, SandraLópez, RosalieMoreno, Jacqueline
Source: Revista chilena de infectología (Rev. chil. infectol)

URL: http://hdl.handle.net/10757/559077

Association between depression and glycemic control among type 2 diabetes patients in Lima, Peru

Introduction: There is limited and controversial information regarding the potential impact of depression on glycemic control. This study aims to evaluate the association between depression and poor glycemic control. In addition, the prevalence of depression and rates of poor glycemic control were determined. Methods: Cross-sectional study performed in the endocrinology unit of two hospitals of ESSALUD in Peru. The outcome of interest was poor glycemic control, evaluated by glycated hemoglobin (HbA1c: < 7% versus ≥ 7%), whereas the exposure of interest was depression defined as 15 or more points in the Patient Health Questionnaire-9 tool. The association of interest was evaluated using Poisson regression models with robust standard errors reporting prevalence ratios (PR) and 95% confidence intervals (95% CI) adjusting for potential confounders. Results: A total of 277 participants, 184 (66.4%) males, mean age 59.0 (SD: 4.8), and 7.1 (SD: 6.8) years of disease were analyzed. Only 31 participants (11.2%; 95% CI: 7.5%–14.9%) had moderately severe or severe depression, whereas 70 (25.3%; 95% CI 20.3%–30.8%) had good glycemic control. Depression increased the probability of having poor glycemic control (PR = 1.32; 95% CI 1.15–1.51) after adjusting for several potential confounders. Conclusions: There is an association between depression and poor glycemic control among type 2 diabetes patients. Our results suggest that early detection of depression might be important to facilitate appropriate glycemic control and avoid further metabolic complications.

Author(s): Crispín Trebejo, BrendaRobles Cuadros, María CristinaBernabé Ortiz, Antonio
Source: Asia-Pacific Psychiatry

URL: http://hdl.handle.net/10757/556689

Quantitative real-time polymerase chain reaction for enteropathogenic Escherichia coli: a tool for investigation of asymptomatic versus symptomatic infections

BACKGROUND: Enteropathogenic Escherichia coli (EPEC) strains are pediatric pathogens commonly isolated from both healthy and sick children with diarrhea in areas of endemicity. The aim of this study was to compare the bacterial load of EPEC isolated from stool samples from children with and without diarrhea to determine whether bacterial load might be a useful tool for further study of this phenomenon. METHODS: EPEC was detected by polymerase chain reaction (PCR) of colonies isolated on MacConkey plates from 53 diarrheal and 90 healthy children aged <2 years. DNA was isolated from stool samples by cetyltrimethylammonium bromide extraction. To standardize quantification by quantitative real-time PCR (qRT-PCR), the correlation between fluorescence threshold cycle and copy number of the intimin gene of EPEC E2348/69 was determined. RESULTS: The detection limit of qRT-PCR was 5 bacteria/mg stool. The geometric mean load in diarrhea was 299 bacteria/mg (95% confidence interval [CI], 77-1164 bacteria/mg), compared with 29 bacteria/mg (95% CI, 10-87 bacteria/mg) in control subjects (P = .016). Bacterial load was significantly higher in children with diarrhea than in control subjects among children <12 months of age (178 vs 5 bacteria/mg; P = .006) and among children with EPEC as the sole pathogen (463 vs 24 bacteria/mg; P = .006). CONCLUSIONS: EPEC load measured by qRT-PCR is higher in diarrheal than in healthy children. qRT-PCR may be useful to study the relationship between disease and colonization in settings of endemicity.

Author(s): Barletta, FrancescaOchoa, Theresa J.Mercado, Erik H.Ruiz, JoaquimEcker, LucieLopez, GiovanniMispireta, Monica;Gil, Ana I.Lanata, Claudio F.Cleary, Thomas G.
Source: Clinical Infectious Diseases (Clin Infect Dis)

URL: http://hdl.handle.net/10757/556075

Disability, caregiver's dependency and patterns of access to rehabilitation care: results from a national representative study in Peru

PURPOSE: To determine the prevalence of disability in Peru, explore dependency on caregiver's assistance and assess access to rehabilitation care. METHOD: Data from Disability National Survey (ENEDIS), including urban and rural areas, were analyzed. Disability was defined as a permanent limitation on movement, vision, communication, hearing, learning/remembering or social relationships. Dependency was defined as the self-reported need for a caregiver to help with daily activities; and access to rehabilitation care was defined as the self-report of any therapy for disabilities. Estimates and projections were calculated using sample strata, primary sampling units and population weights, and prevalence ratios (PRs) and 95%CI were reported. RESULTS: From 798 308 people screened, 37 524 (5.1%; 95%CI 4.9--5.2%) had at least one disability. A total of 37 117 were included in further analysis, mean age 57.8 (SD ± 24.1) years, 52.1% women. Dependency was self-reported by 14 980 (40.5%; 95%CI: 39.2-41.9%) individuals with disabilities. A family member, usually female, was identified as a caregiver in 94.3% (95%CI: 93.3-95.3%) of dependent participants. Only 2881 (10.7%; 95%CI: 9.7-11.9%) of people with disabilities reported access to rehabilitation care. Major inequality patterns of disability burden versus access to rehabilitation care were observed by age and education level. Older age groups had higher disability burden yet lower chances of access to rehabilitation care. Conversely, the higher the education level, the lesser the overall disability burden but also the higher chances of reporting receiving care. Private healthcare insurance doubled the probability of having access to rehabilitation compared with those without insurance. CONCLUSIONS: Approximately 1.6 million Peruvians have at least one disability, and 40% of them require assistance with daily activities. Informal caregiving, likely female and relative-provided, is highly common. Rehabilitation care access is low and inequitable. Our results signal a major need to implement strategies to guarantee the highest standard of health care for people with disabilities. Implications for Rehabilitation Major inequality patterns in terms of burden of disability versus access to rehabilitation care were observed: those groups who concentrate more disability reported receiving less rehabilitation care. Caregiving is mostly informal and provided by a direct relative, mainly a woman, who resigned to their usual activities in order to help care for the person with disability. As a result, there is a need to develop appropriate support and training for caregivers. Access to care services in Peru is low and inequitable, but especially for people with disabilities: they experience greater barriers when accessing healthcare services even in the case of having health insurance.

Author(s): Bernabe Ortiz, AntonioDiez Canseco, FranciscoVásquez, AlbertoMiranda, J. Jaime
Source:  Disability and Rehabilitation (Disabil Rehabil)

URL:  http://hdl.handle.net/10757/556094