lunes, 5 de febrero de 2018

Factores asociados a la no utilización de los servicios formales de prestación en salud en la población peruana: análisis de la Encuesta Nacional de Hogares (ENAHO) 2015

Associated factors to non-use of formal health services in the Peruvian population: Analysis of the national household survey (Enaho) 2015
RESUMEN :
El objetivo del estudio fue estimar la prevalencia de la no utilización de los servicios formales de prestación de salud (NUSFPS) y sus factores asociados en Perú. Se realizó un análisis secundario de datos de la Encuesta Nacional de Hogares (ENAHO) del año 2015. Se definió como NUSFPS a aquellos participantes que, pese a haber presentado algún síntoma, malestar, enfermedad, recaída de enfermedad crónica o accidente durante el último mes, no acudieron a los servicios de salud. Se analizaron 35 036 participantes; la prevalencia de NUSFPS fue de 53,9% (IC95%:52,9-54,8). La NUSFPS fue superior en la costa (razón de prevalencia ajustada [RPa] = 1,24;IC95%:1,17-1,31), sierra (RPa = 1,38;IC95%:1,31-1,46) y selva (RP = 1,25;IC95%:1,18-1,33) en comparación a Lima Metropolitana. Hubo mayor prevalencia de NUSFPS en los participantes sin seguro (RPa = 1,59;IC95%:1,52-1,66) y afiliados al seguro integral de salud (RPa = 1,16;IC95%:1,11-1,22) comparados con los afiliados a la Seguridad Social. En conclusión, más de la mitad de los participantes padecieron NUSFPS, lo cual se asoció con condiciones geográficas y de aseguramiento. Se sugieren políticas públicas informadas en la evidencia para mejorar esta situación.

SUMMARY:
The aim of the study was to estimate the prevalence of non-use of health services (NUHS) and its associated factors using the National Household Survey (ENAHO 2015). The participants were defined as NUHS if they have presented any symptoms, discomfort, illness, relapse of chronic illness or accident during the last month and did not go to the health services. 35036 participants were analyzed; the prevalence of NUHS was 53,9%. NUHS was higher in the coastal region (adjusted Prevalence Ratio [aPR]=1.24;95%CI:1.17-1.31), highlands (aPR=1.38;95%CI:1.31-1.46) and jungle (aPR=1.25,95%CI:1.18-1.33) compared to Lima. Likewise, there were a higher prevalence of NUHS in participants without health insurance (aPR=1.59;95%CI:1.52-1.66) and those affiliated to Ministry of Health insurance (aPR=1.16;95%CI:1.11-1.22) compared to those affiliated to Social Security. More than half of the participants suffered from NUHS, which was associated with geographical and health system conditions. It is required evidenced-informed public policies to improve this situation.

AUTOR :
Benites Zapata, Vicente A. ( 0000-0002-9158-1108 )  Lozada-Urbano, MichelleDiego Urrunaga-PastorMárquez-Bobadilla, EdithMoncada-Mapelli, EnriqueMezones Holguín, Edward ( 0000-0001-7168-8613 ) 
EDITORIAL :
Instituto Nacional de Salud (INS)
REVISTA:
Revista Peruana de Medicina Experimental y Salud Pública
URL :
http://hdl.handle.net/10757/622485
full text:
http://repositorioacademico.upc.edu.pe/upc/bitstream/10757/622485/2/2864-12496-2-PB.pdf


PALABRAS CLAVE :
Accesibilidad a los Servicios de SaludSistemas de saludServicio Ambulatorio en HospitalAdministración de los Servicios de SaludSeguroPerú

Etiology, epidemiology and clinical characteristics of acute diarrhea in hospitalized children in rural Peru



RESUMEN :
Introduction: Diarrhea remains one of the main causes of morbidity and mortality in children under five years of age especially in low-income countries. In Peru, epidemiological reports about enteropathogens related to acute diarrhea are scarce in rural areas. The aim of this study was to describe the etiology, epidemiology, and clinical characteristics of the principal causes of acute infectious diarrhea in in a northern rural region of Peru. Methodology: A prospective study was conducted from January 2011 to December 2012 to describe the main pathogens causing acute diarrhea using PCR assay. Results: A total of 117 children diagnosed with acute diarrhea were included in the study. A single etiological agent was identified in 41.03% of samples, being rotavirus followed by norovirus and Shigella. Co-infections containing virus and bacteria were found in 22.22% of samples. Vomiting was most commonly found symptoms in 58.97% cases followed by fever (54.70%). Malnutrition was detected in 14.53% of the children. Conclusions: High prevalence of rotavirus, as well as adenovirus and norovirus, was observed in the present study. Shigella was the most common bacteria found in acute diarrhea in the area. The implementation of a better surveillance system is mandatory in order to identify the principal etiologies of gastroenteritis in the rural areas of Peru and to develop of better prevention strategies and reduce diarrhea-associated mortalities.

AUTOR :Cornejo-Tapia, AngelaOrellana- Peralta, FiorellaWeilg, PabloBazan-Mayra, JorgeCornejo-Pacherres, HernánUlloa-Urizar, GabrielaAguilar-Luis, Miguel AngelPons, Maria Jesusdel Valle-Mendoza, Juana ( 0000-0002-6011-5040 ) 






jueves, 18 de enero de 2018

Systematic review and meta-analysis of secondary prophylaxis for prevention of HIV-related toxoplasmic encephalitis relapse using trimethoprim-sulfamethoxazole

A recent systematic literature and meta-analysis reported relative efficacy of trimethoprim-sulfamethoxazole (TMP-SMX) for the treatment of toxoplasmic encephalitis (TE) in HIV-infected adults. Here, we estimated relapse rates during secondary prophylaxis with TMP-SMX, and further explored differences in relapse rates prior to introduction of highly active antiretroviral therapy (HAART) and the widespread adoption of HAART... read more


AUTOR :
Connolly, Mark P.Haitsma, GertruudHernández, Adrián V. ( 0000-0002-9999-4003 )  Vidal, José E.
EDITORIAL :
Taylor and Francis Ltd.
REVISTA:
Pathogens and Global Health

URL: http://hdl.handle.net/10757/622484
FULL TEXT: https://goo.gl/9v8KuR



Molecular etiological profile of atypical bacterial pathogens, viruses and coinfections among infants and children with community acquired pneumonia admitted to a national hospital in Lima, Peru



Objective: The main objective of this study was to detect the presence of 14 respiratory viruses and atypical bacteria (Mycoplasma pneumoniae, Chlamydia pneumoniae), via polymerase chain reaction in patients under 18 years old hospitalized due to community-acquired pneumonia (CAP) from Lima, Peru. Results: Atypical pathogens were detected in 40% (58/146); viral etiologies in 36% (52/146) and coinfections in 19% (27/146). The most common etiological agent was M. pneumoniae (n = 47), followed by C. pneumoniae (n = 11). The most frequent respiratory viruses detected were: respiratory syncytial virus A (n = 35), influenza virus C (n = 21) and parainfluenza virus (n = 10). Viral-bacterial and bacterium-bacterium coinfections were found in 27 cases. In our study population, atypical bacteria (40%) were detected as frequently as respiratory viruses (36%). The presence of M. pneumoniae and C. pneumoniae should not be underestimated as they can be commonly isolated in Peruvian children with CAP.


AUTOR : del Valle-Mendoza, Juana ( 0000-0002-6011-5040 )  ; Silva-Caso, Wilmer; Cornejo-Tapia, Angela; Orellana-Peralta, Fiorella; Verne, Eduardo; Ugarte, Claudia; Aguilar-Luis, Miguel Angel; De Lama-Odría, María del Carmen; Nazario-Fuertes, Ronald; Esquivel-Vizcarra, Mónica; Casabona-Ore, Verónica; Weilg, Pablo; del Valle, Luis J.
REVISTA: BMC Research Notes
URL: http://hdl.handle.net/10757/622481
FULL TEXT: https://goo.gl/6rcY9L





Inclusion of persons with disabilities in systems of social protection: a population-based survey and case–control study in Peru

AUTOR : Bernabe-Ortiz, Antonio ( 0000-0002-6834-1376 )  ; Diez-Canseco, Francisco; Vasquez, Alberto; Kuper, Hannah; Walsham, Matthew; Blanchet, Karl
REVISTA: BMJ Open


OBJECTIVE: This study aims to assess the needs of people with disabilities and their level of inclusion in social protection programmes. DESIGN: Population based-survey with a nested case-control study. SETTING: Morropon, a semiurban district located in Piura, northern Peru. PARTICIPANTS: For the population survey, a two-stage sampling method was undertaken using data from the most updated census available and information of each household member aged ≥5 years was collected. In the nested case-control study, only one participant, case or control, per household was included in the study. PRIMARY AND SECONDARY OUTCOME MEASURES: Disability was screened using the Washington Group short questionnaire. A case, defined as an individual aged ≥5 years with disabilities, was matched with one control without disabilities by sex and age (±5 years). Information was collected on socioeconomic status, education, health and rehabilitation and social protection participation. RESULTS: The survey included 3684 participants, 1848 (50.1%) females, mean age: 36.4 (SD: 21.7). A total of 290 participants (7.9%; 95% CI 7.0% to 8.7%) were classified as having disability. Adults with disabilities were more likely to be single (OR=3.40; 95% CI 1.54 to 7.51) and not to be working (OR=4.36; 95% CI 2.26 to 8.40), while those who did work were less likely to receive the national minimum wage (ie, 750 PEN or about US$265; p=0.007). People with disabilities were more likely to experience health problems. There was no difference between those enrolled in any social protection programme among participants with and without disabilities. CONCLUSIONS: People with disabilities were found to have higher needs for social protection, but were not more likely to be enrolled in social protection programmes. The Peruvian social protection system should consider adding disability status to selection criteria in their cash transfer programmes as well as implementing disability-specific interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/