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Marcos-Carbajal P, Yareta-Yareta J, Otiniano-Trujillo M, Galarza-Pérez M, Espinoza-Culupu A, Ramirez-Melgar JL, Chambi-Quispe M, Luque-Chipana NA, Gutiérrez Ajalcriña R, Sucñer Cruz V, López Chegne SN, Santillán Ruiz D, Segura Chavez LF, Sias Garay CE, Salazar Granara A, Tsukayama Cisneros P, Tapia Paniagua ST, González-Domenech CM. Detection of SARS-CoV-2 variants in hospital wastewater in Peru, 2022. Rev Peru Med Exp Salud Publica 2024; 41:140-145. [PMID: 39166636 PMCID: PMC11300693 DOI: 10.17843/rpmesp.2024.412.13484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 03/06/2024] [Indexed: 08/23/2024] Open
Abstract
OBJECTIVE. To identify the presence of the SARS-CoV-2 virus in wastewater from hospitals in Peru. MATERIALS AND METHODS. Water samples were collected from the effluents of nine hospitals in Peru during March and September 2022. SARS-CoV-2 was identified by using Illumina sequencing. Variant, lineage and clade assignments were carried out using the Illumina and Nextclado tools. We verified whether the SARS-CoV-2 variants obtained from wastewater were similar to those reported by the National Institute of Health of Peru from patients during the same period and region. RESULTS. Eighteen of the 20 hospital wastewater samples (90%) provided sequences of sufficient quality to be classified as the Omicron variant according to the WHO classification. Among them, six (30%) were assigned by Nextclade to clades 21K lineage BA.1.1 (n=1), 21L lineage BA.2 (n=2), and 22B lineages BA.5.1 (n=2) and BA .5.5 (n=1). CONCLUSIONS. SARS-CoV-2 variants were found in hospital wastewater samples and were similar to those reported by the surveillance system in patients during the same weeks and geographic areas. Wastewater monitoring could provide information on the environmental and temporal variation of viruses such as SARS-CoV-2. Motivation for the study. To contribute to the surveillance of environmental samples from hospital effluents in order to achieve early warning of possible infectious disease outbreaks. Main findings. The Omicron variant of the COVID-19 virus was detected in wastewater from hospitals in Puno, Cuzco and Cajamarca; these results are similar to the reports by the Peruvian National Institute of Health based on nasopharyngeal swab samples. Implications. The presence of the Omicron variant in hospital wastewater during the third wave of the pandemic should raise awareness of the treatment system before wastewater is discharged into the public sewer system.
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Affiliation(s)
- Pool Marcos-Carbajal
- Universidad Peruana Unión, Escuela Profesional Medicina, Laboratorio de Investigación en Biología Molecular. Lima, Perú
| | - José Yareta-Yareta
- Universidad Peruana Unión, Escuela Profesional Medicina, Laboratorio de Investigación en Biología Molecular. Lima, Perú
| | - Miguel Otiniano-Trujillo
- Universidad Peruana Unión, Escuela Profesional Medicina, Laboratorio de Investigación en Biología Molecular. Lima, Perú
| | - Marco Galarza-Pérez
- Instituto Nacional de Salud, Centro Nacional de Salud Pública, Laboratorio de Biotecnología y Biología molecular. Lima, Perú
| | | | | | | | - Néstor Alejandro Luque-Chipana
- Universidad Peruana Unión, Escuela Profesional Medicina, Laboratorio de Investigación en Biología Molecular. Lima, Perú
- Hospital de Ate Vitarte, Unidad de Cuidados Intensivos. Lima, Perú
| | | | | | | | - Diana Santillán Ruiz
- Hospital de Tarapoto, Departamento de Anatomía Patológica y Patología Clínica. Tarapoto, Perú
| | - Luis Felipe Segura Chavez
- Universidad Peruana Unión, Escuela Profesional Medicina, Laboratorio de Investigación en Biología Molecular. Lima, Perú
| | - Cinthia Esther Sias Garay
- Universidad Peruana Unión, Escuela Profesional Medicina, Laboratorio de Investigación en Biología Molecular. Lima, Perú
| | - Alberto Salazar Granara
- Universidad San Martin de Porres, Centro de Investigación en Medicina Tradicional y Farmacología. Lima, Perú
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Alcas O, Saldaña D, Triveño A, Salazar M, Mejía P. Association between olfactory dysfunction and COVID-19 severity: A prospective study in a highly complex hospital in Peru. EAR, NOSE & THROAT JOURNAL 2024; 103:10S-18S. [PMID: 34908507 DOI: 10.1177/01455613211066691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Olfactory dysfunction has been included among the early symptoms of coronavirus disease (COVID-19). Evidence suggests that a relationship exists between the duration of olfaction disorders and the probability of developing severe COVID-19. Given the scope of the COVID-19 pandemic, this study aimed to determine the frequency of smell alteration and its association with the severity of COVID-19 in a referral hospital in Peru, which is one of the most affected countries in the Latin American region. MATERIALS AND METHODS This study was an observational, prospective cohort study that included patients with COVID-19 who were treated at the Hospital Nacional Edgardo Rebagliati Martins from August to November 2020. To assess the association, the chi-square test of independence or Fisher's exact test was performed. The outcome variable was COVID-19 severity, and the exposure variable was olfactory dysfunction. The first data collection was in the emergency department and the follow-up was via telephone. RESULTS A total of 179 patients were included. The mean age was 61.6 ± 15.5 years, and 129 patients (72.1%) were male. Olfactory dysfunction was observed in 43 patients (24%). An inverse association was found between age and olfactory dysfunction (P = .002). No significant association was found between COVID-19 severity level and olfactory alteration (P = .056). However, a direct association was found between COVID-19 severity and age (P = .003), cough (P < .001), and respiratory distress (P = .003). CONCLUSION This study did not find any association between the severity of COVID-19 and olfactory dysfunction. It showed a low incidence rate of smell alteration compared with studies from other regions. Moreover, smell alteration was associated with younger age.
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Affiliation(s)
- Olenka Alcas
- Service of Otolaryngology, Hospital Nacional Edgardo Rebagliati Martins - HNERM, Lima, Perú
| | - Diego Saldaña
- Service of Otolaryngology, Hospital Nacional Edgardo Rebagliati Martins - HNERM, Lima, Perú
| | - Andy Triveño
- Service of Otolaryngology, Hospital Nacional Edgardo Rebagliati Martins - HNERM, Lima, Perú
| | - Miguel Salazar
- Service of Otolaryngology, Hospital Nacional Edgardo Rebagliati Martins - HNERM, Lima, Perú
| | - Paola Mejía
- Departament of Emergency, Hospital Nacional Edgardo Rebagliati Martins - HNERM, Lima, Perú
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Galarza CRC, Sánchez OND, Pimentel JS, Bulhões R, López-Gonzales JL, Rodrigues PC. Bayesian Spatio-Temporal Modeling of the Dynamics of COVID-19 Deaths in Peru. ENTROPY (BASEL, SWITZERLAND) 2024; 26:474. [PMID: 38920483 PMCID: PMC11202420 DOI: 10.3390/e26060474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/17/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024]
Abstract
Amid the COVID-19 pandemic, understanding the spatial and temporal dynamics of the disease is crucial for effective public health interventions. This study aims to analyze COVID-19 data in Peru using a Bayesian spatio-temporal generalized linear model to elucidate mortality patterns and assess the impact of vaccination efforts. Leveraging data from 194 provinces over 651 days, our analysis reveals heterogeneous spatial and temporal patterns in COVID-19 mortality rates. Higher vaccination coverage is associated with reduced mortality rates, emphasizing the importance of vaccination in mitigating the pandemic's impact. The findings underscore the value of spatio-temporal data analysis in understanding disease dynamics and guiding targeted public health interventions.
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Affiliation(s)
- César Raúl Castro Galarza
- Escuela de Posgrado, Universidad Peruana Unión, Lima 15468, Peru; (C.R.C.G.); (O.N.D.S.); (J.L.L.-G.)
| | | | - Jonatha Sousa Pimentel
- Department of Statistics, Federal University of Pernambuco, Recife 50740-540, PE, Brazil
| | - Rodrigo Bulhões
- Department of Statistics, Federal University of Bahia, Salvador 40170-110, BA, Brazil; (R.B.); (P.C.R.)
| | | | - Paulo Canas Rodrigues
- Department of Statistics, Federal University of Bahia, Salvador 40170-110, BA, Brazil; (R.B.); (P.C.R.)
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4
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Portmann-Baracco AS, Alcorta-Proaño RG, Nuñez-Mochizaki C, Webb CM, Trelles J, Caparo C, La Rosa MF. Severe Acute Respiratory Syndrome-Coronavirus-2 Antibody Status at the Time of Delivery and the Risk of Preeclampsia. Am J Perinatol 2024; 41:e2124-e2128. [PMID: 37230476 DOI: 10.1055/a-2099-8758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Our objective was to evaluate the association between severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) serologic status in immunologically naive patients and the risk of preeclampsia at the time of delivery. STUDY DESIGN We conducted a retrospective cohort study of pregnant patients admitted to our institution from August 1 to September 30, 2020. We recorded maternal medical and obstetric characteristics and SARS-CoV-2 serologic status. Our primary outcome was the incidence of preeclampsia. Antibody testing was performed, and patients were classified into seropositive groups: immunoglobulin (Ig)G + , IgM + , or both IgG+ and IgM + . Bivariate and multivariable analyses were performed. RESULTS We included 275 patients that were negative for SARS-CoV-2 antibodies, and 165 that were positive. Seropositivity was not associated with higher rates of preeclampsia (p = 0.183) or with preeclampsia with severe features (p = 0.916) even after adjusting for maternal age >35, BMI ≥ 30, nulliparity, and previous history of preeclampsia, and type of serologic status. Previous preeclampsia had the greatest association with the development of preeclampsia (odds ratio [OR] = 13.40; 95% confidence interval [CI]: 4.98-36.09; p < 0.05) and with preeclampsia with severe features (OR = 5.46; 95% CI: 1.65-18.02; p < 0.05). CONCLUSION We found that in an obstetric population, there was no association between SARS-CoV-2 antibody status and the risk of preeclampsia. KEY POINTS · Pregnant people with acute COVID-19 are at an increased risk of developing preeclampsia.. · Seroconversion during pregnancy was not associated with an increased risk of preeclampsia.. · Further study regarding the timing of infection and its association with preeclampsia is necessary..
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Affiliation(s)
| | | | | | - Camille M Webb
- Department of Obstetrics and Gynecology, Cayetano Heredia University, Lima, Perú
- Department of Maternal Fetal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Juan Trelles
- Department of Obstetrics and Gynecology, Cayetano Heredia University, Lima, Perú
| | - Carlos Caparo
- Department of Obstetrics and Gynecology, Cayetano Heredia University, Lima, Perú
| | - Mauricio F La Rosa
- Department of Obstetrics and Gynecology, Cayetano Heredia University, Lima, Perú
- Department of Maternal Fetal Medicine, University of Texas Medical Branch, Galveston, Texas
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Ruggeri K, Stock F, Haslam SA, Capraro V, Boggio P, Ellemers N, Cichocka A, Douglas KM, Rand DG, van der Linden S, Cikara M, Finkel EJ, Druckman JN, Wohl MJA, Petty RE, Tucker JA, Shariff A, Gelfand M, Packer D, Jetten J, Van Lange PAM, Pennycook G, Peters E, Baicker K, Crum A, Weeden KA, Napper L, Tabri N, Zaki J, Skitka L, Kitayama S, Mobbs D, Sunstein CR, Ashcroft-Jones S, Todsen AL, Hajian A, Verra S, Buehler V, Friedemann M, Hecht M, Mobarak RS, Karakasheva R, Tünte MR, Yeung SK, Rosenbaum RS, Lep Ž, Yamada Y, Hudson SKTJ, Macchia L, Soboleva I, Dimant E, Geiger SJ, Jarke H, Wingen T, Berkessel JB, Mareva S, McGill L, Papa F, Većkalov B, Afif Z, Buabang EK, Landman M, Tavera F, Andrews JL, Bursalıoğlu A, Zupan Z, Wagner L, Navajas J, Vranka M, Kasdan D, Chen P, Hudson KR, Novak LM, Teas P, Rachev NR, Galizzi MM, Milkman KL, Petrović M, Van Bavel JJ, Willer R. A synthesis of evidence for policy from behavioural science during COVID-19. Nature 2024; 625:134-147. [PMID: 38093007 PMCID: PMC10764287 DOI: 10.1038/s41586-023-06840-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/06/2023] [Indexed: 12/22/2023]
Abstract
Scientific evidence regularly guides policy decisions1, with behavioural science increasingly part of this process2. In April 2020, an influential paper3 proposed 19 policy recommendations ('claims') detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms 'physical distancing' and 'social distancing'. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization.
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Affiliation(s)
- Kai Ruggeri
- Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York City, NY, USA.
- Policy Research Group, Centre for Business Research, Judge Business School, University of Cambridge, Cambridge, UK.
- 274th ASOS, US Air Force/New York Air National Guard, Syracuse, NY, United States.
| | - Friederike Stock
- Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany
- Department of Psychology, Humboldt University of Berlin, Berlin, Germany
| | | | | | - Paulo Boggio
- Mackenzie Presbyterian University, São Paulo, Brazil
- National Institute of Science and Technology on Social and Affective Neuroscience, CNPq, São Paulo, Brazil
| | | | | | | | - David G Rand
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | | | - Eli J Finkel
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Kellogg School of Management, Northwestern University, Evanston, IL, USA
| | | | - Michael J A Wohl
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Richard E Petty
- Department of Psychology, Ohio State University, Columbus, OH, USA
| | - Joshua A Tucker
- Department of Politics & Center for Social Media and Politics, New York University, New York, NY, USA
| | - Azim Shariff
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Jolanda Jetten
- University of Queensland, St Lucia, Queensland, Australia
| | - Paul A M Van Lange
- Institute for Brain and Behavior Amsterdam, Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Global Faculty, Social and Economic Behavior, University of Cologne, Cologne, Germany
| | | | - Ellen Peters
- Center for Science Communication Research, School of Journalism and Communication, University of Oregon, Eugene, OR, USA
- Psychology Department, University of Oregon, Eugene, OR, USA
| | | | - Alia Crum
- Department of Psychology, Stanford University, Stanford, CA, USA
| | | | | | - Nassim Tabri
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | | | - Linda Skitka
- University of Illinois Chicago, Chicago, IL, USA
| | | | - Dean Mobbs
- Department of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA
- Computation and Neural Systems Program, California Institute of Technology, Pasadena, CA, USA
| | | | - Sarah Ashcroft-Jones
- Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York City, NY, USA
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Anna Louise Todsen
- Department of Social Policy and Evaluation, University of Oxford, Oxford, UK
| | | | | | | | | | - Marlene Hecht
- Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany
- Department of Psychology, Humboldt University of Berlin, Berlin, Germany
| | - Rayyan S Mobarak
- Department of Agricultural and Resource Economics, University of Maryland, College Park, MD, USA
| | | | - Markus R Tünte
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Siu Kit Yeung
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - R Shayna Rosenbaum
- Department of Psychology, York University, Toronto, Ontario, Canada
- Rotman Research Institute, Baycrest Academy for Research and Education, Toronto, Ontario, Canada
| | - Žan Lep
- Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia
- Centre for Applied Epistemology, Educational Research Institute, Ljubljana, Slovenia
| | - Yuki Yamada
- Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
| | | | | | | | - Eugen Dimant
- Center for Social Norms and Behavioral Dynamics, University of Pennsylvania, Philadelphia, PA, USA
- CESifo, Munich, Germany
| | - Sandra J Geiger
- Environmental Psychology, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Hannes Jarke
- Policy Research Group, Centre for Business Research, Judge Business School, University of Cambridge, Cambridge, UK
| | - Tobias Wingen
- University of Bonn, University Hospital Bonn, Institute of General Practice and Family Medicine, Bonn, Germany
| | - Jana B Berkessel
- Mannheim Centre for European Social Research, University of Mannheim, Mannheim, Germany
| | - Silvana Mareva
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Psychology Department, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Lucy McGill
- University College Dublin, Dublin, Ireland
- University of Groningen, Groningen, Netherlands
| | - Francesca Papa
- Organisation for Economic Co-operation and Development, Paris, France
| | | | | | - Eike K Buabang
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Marna Landman
- Gordon Institute of Business Science, University of Pretoria, Johannesburg, South Africa
| | - Felice Tavera
- Department of Psychology, University of Cologne, Cologne, Germany
| | - Jack L Andrews
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- University College, Oxford, UK
| | - Aslı Bursalıoğlu
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Zorana Zupan
- Institute of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Lisa Wagner
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Joaquín Navajas
- Laboratorio de Neurociencia, Universidad Torcuato Di Tella, Buenos Aires, Argentina
- Escuela de Negocios, Universidad Torcuato Di Tella, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | | | - David Kasdan
- Sungkyunkwan University, Seoul, Republic of Korea
| | - Patricia Chen
- University of Texas at Austin, Austin, TX, USA
- National University of Singapore, Singapore, Singapore
| | | | | | - Paul Teas
- University of Illinois Chicago, Chicago, IL, USA
| | - Nikolay R Rachev
- Department of General, Experimental, Developmental, and Health Psychology, Sofia University St. Kliment Ohridski, Sofia, Bulgaria
| | - Matteo M Galizzi
- Department of Psychological and Behavioural Science, London School of Economics, London, UK
| | | | - Marija Petrović
- Department of Psychology & Laboratory for Research of Individual Differences, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Jay J Van Bavel
- Department of Psychology & Center for Neural Science, New York University, New York, NY, USA
| | - Robb Willer
- Department of Sociology, Stanford University, Stanford, CA, USA
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Sara R, Radoias V, Kim Y. Hypertension effects of the COVID-19 lockdowns: Evidence from a repeated cross-sectional survey in Peru. ECONOMICS AND HUMAN BIOLOGY 2024; 52:101332. [PMID: 38113604 DOI: 10.1016/j.ehb.2023.101332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 09/06/2023] [Accepted: 11/26/2023] [Indexed: 12/21/2023]
Abstract
Using data from Peru and a quasi-experimental approach, we document significant increases in arterial blood pressure and in the incidence of arterial hypertension caused by the restrictive measures employed by the Peruvian authorities during the COVID-19 pandemic. The effects are more pronounced for women, older respondents, and urban residents. The effects are statistically significant and high in magnitude relative to the pre-pandemic incidence of disease in the Peruvian population. A main channel of disease propagation seems to be the changes in dietary habits and physical activity imposed by the COVID-19 lockdowns, which affected several anthropometric measurements that are common risk factors for hypertension.
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Affiliation(s)
- Raisa Sara
- Sam Houston State University, United States of America.
| | - Vlad Radoias
- Sam Houston State University, United States of America.
| | - Younoh Kim
- Sam Houston State University, United States of America.
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Toyama M, Vargas L, Ticliahuanca S, Quispe AM. Regional clustering and waves patterns due to COVID-19 by the index virus and the lambda/gamma, and delta/omicron SARS-CoV-2 variants in Peru. Gates Open Res 2023; 6:74. [PMID: 38045771 PMCID: PMC10692151 DOI: 10.12688/gatesopenres.13644.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 12/05/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) impact varies substantially due to various factors, so it is critical to characterize its main differences to inform decision-makers about where to focus their interventions and differentiate mitigation strategies. Up to this date, little is known about the patterns and regional clustering of COVID-19 waves worldwide. Methods We assessed the patterns and regional clustering of COVID-19 waves in Peru by using the weekly mortality rates for each of the 25 regions as an outcome of interest. We obtained the death counts from the National Informatics System of Deaths and population estimates from the National Registry of Identification and Civil Status. In addition, we characterized each wave according to its duration, peak, and mortality rates by age group and gender. Additionally, we used polynomial regression models to compare them graphically and performed a cluster analysis to identify regional patterns. Results We estimated the average mortality rate at the first, second, and third waves at 13.01, 14.12, and 9.82 per 100,000 inhabitants, respectively, with higher mortality rates among elders and men. The patterns of each wave varied substantially in terms of duration, peak, impact, and wave shapes. Based on our clustering analysis, during the first wave caused by the index virus, the 25 regions of Peru presented six different wave patterns. However, the regions were clustered in two different wave patterns during the second and third, caused by alpha/lambda/delta and omicron. Conclusions The propagation of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) variants behaved in Peru with varying wave patterns and regional clustering. During the COVID-19 pandemic, the weekly mortality rates followed different spatiotemporal patterns with solid clustering, which might help project the impact of future waves of COVID-19.
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Affiliation(s)
- Melissa Toyama
- Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Lima, 15001, Peru
| | - Lucía Vargas
- Facultad de Derecho y Ciencia Política, Universidad Nacional Mayor de San Marcos, Lima, Lima, Peru
| | - Sofía Ticliahuanca
- Facultad de Derecho y Ciencia Política, Universidad Nacional Mayor de San Marcos, Lima, Lima, Peru
| | - Antonio M Quispe
- Facultad de Medicina Humana, Universidad Continental, Huancayo, Junin, 12000, Peru
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Azañedo D, Hernández-Vásquez A, Visconti-Lopez FJ, Turpo Cayo EY. Frequency, inequalities and spatial distribution of oral health services utilization in Peruvian children under twelve years of age: a population-based comparative analysis of the years 2017 and 2021. BMC Oral Health 2023; 23:778. [PMID: 37872527 PMCID: PMC10594705 DOI: 10.1186/s12903-023-03528-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/11/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Oral diseases pose a significant public health challenge among Peruvian children. However, oral health services utilization among them is marked by inequalities, which may have been exacerbated by the COVID-19 pandemic. The objective was to compare the frequency, inequalities, determinants of inequality, and spatial distribution in oral health services utilization in Peruvian children under 12 years of age in 2017 and 2021. METHODS Comparative secondary data analysis from the Demographic and Family Health Survey (ENDES) for the years 2017 (38,787 minors) and 2021 (36,729 minors). Age-adjusted prevalence ratios (PR) with 95% confidence intervals (CI) were calculated to assess the change in oral health services utilization in the last 12 months between the years 2017 and 2021, stratifying by demographic and socioeconomic covariates. Inequality was assessed by decomposing the Erreygers Concentration Index (ECI) and calculating the percentage contribution to inequality of the independent variables. Spatial analysis was performed using spatial autocorrelation methods, Hot Spot Analysis, Cluster and Outlier analysis, Inverse Distance Weighting, ordinary Kriging, and Kulldorff analysis. RESULTS The probability of Peruvian children under 12 years of age using oral health services in the last 12 months was reduced by 45% in 2021 compared to 2017. The ECI identified a significant reduction in oral health services utilization inequalities at the national level (Diff: -0.0963; p < 0.001). The main contributor to inequality was higher tutor education level (55.2% in 2017 and 82.7% in 2021). In the comparison of spatial distribution, there was a greater dispersion of the conglomerates in which the use of oral health services is concentrated in 2021. CONCLUSIONS The frequency of oral health services utilization in the Peruvian children under 12 years of age was halved between 2017 and 2021. This problem is transversal to the entire population at the demographic and socioeconomic level. The key factor contributing to inequalities in the utilization of oral health services was the higher educational attainment of caregivers or guardians. Despite the improvement observed in inequalities and spatial distribution of the concentration of oral health services utilization, it is necessary to keep monitoring these patterns to guide decision-making.
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Affiliation(s)
| | - Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.
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Herrera-Añazco P, Segura MA, Bravo-Zúñiga J, Vásquez JL, Taype-Rondán A. Hospitalization and mortality during the pandemic in chronic hemodialysis patients and the general population in Peru. J Bras Nefrol 2023; 45:440-448. [PMID: 37186943 PMCID: PMC10726660 DOI: 10.1590/2175-8239-jbn-2022-0149en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/10/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Patients with chronic kidney disease have a higher risk of severe disease and mortality from COVID-19 than the general population. OBJECTIVE To compare hospitalization and mortality rates during the pandemic among chronic hemodialysis (HD) patients and the general population in Lima (Peru). METHODS This retrospective cohort included an assessment of the database of chronic HD patients of the health service providers of the social health insurance benefit networks of Lima and Callao between 2019 and 2021. Hospitalization and mortality rates were obtained for every 1,000 individuals, and variations in the percentages of COVID-19 cases and deaths were calculated. These rates were compared with those of the general population data and standardized by age and sex. RESULTS An average of 3,937 chronic HD patients were evaluated each month. Of these, 4.8% had COVID-19 and 64.97% were mild cases. The hospitalization rates per 1,000 patients were 19.5, 29.28, and 36.7 in 2019, 2020, and 2021, respectively. The mortality rates per 1,000 patients were 5.9, 9.74, and 11.49 in 2019, 2020, and 2021, respectively. When compared to the standardized general population, the peaks of both rates coincided with the plateaus of the waves during the pandemic. The hospitalization rate for COVID-19 was 12 times higher in HD patients than in the general population, and the mortality rate for COVID-19 was twice as high. CONCLUSION HD patients had higher hospitalization and standardized mortality rates than the general population. Peaks in hospitalizations and mortality coincided with the plateaus of the first and second waves of the pandemic.
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Affiliation(s)
- Percy Herrera-Añazco
- Universidad Privada del Norte, Trujillo, Peru
- Red Peruana de Salud Colectiva, Lima, Peru
| | | | - Jessica Bravo-Zúñiga
- Hospital Nacional Edgardo Rebagliati Martins, Departamento de Nefrología, Lima, Peru
| | | | - Alvaro Taype-Rondán
- Universidad San Ignacio de Loyola, Unidad de Investigación Para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
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10
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Samsamshariat T, Madhivanan P, Reyes Fernández Prada A, Moya EM, Meza G, Reinders S, Blas MM. Hear my voice: understanding how community health workers in the Peruvian Amazon expanded their roles to mitigate the impact of the COVID-19 pandemic through community-based participatory research. BMJ Glob Health 2023; 8:e012727. [PMID: 37832965 PMCID: PMC10583076 DOI: 10.1136/bmjgh-2023-012727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/30/2023] [Indexed: 10/15/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic led to the collapse of the Peruvian health system, disrupting healthcare access for indigenous communities in the Amazon. Our study analysed how community health workers (CHWs) from indigenous communities in the Peruvian Amazon expanded their roles to mitigate the effects of the COVID-19 pandemic. METHODS Fourteen CHWs from Loreto, Peru, participated in a community-based participatory research project using Photovoice, a technique encouraging vulnerable groups to take photos and develop stories illustrating their lived experiences. Participants were recruited from Mamás del Río, a local university-based programme, through purposive sampling. CHWs were asked to photograph how the pandemic affected their lives and work. Participants met four times over 5 months to share photos and develop action items. Data were organised into key themes using thematic analysis. CHWs shared photo galleries with policy-makers in Loreto and Lima. RESULTS CHWs produced 36 photos with 33 texts highlighting their roles during COVID-19. Three core themes emerged: the (1) collapse of health infrastructure, (2) use of medicinal plants versus pharmaceuticals and (3) community adaptations and struggles. The leadership of CHWs emerged as a cross-cutting theme as CHWs supported COVID-19 efforts without government training or resources. CHWs asked policy-makers for formal integration into the health system, standardisation of training and management of community pharmacies. CONCLUSION CHWs demonstrated their leadership and expanded their roles during the pandemic with little to no training from the government. Global investment in robust CHW programmes can fortify healthcare delivery.
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Affiliation(s)
- Tina Samsamshariat
- The University of Arizona College of Medicine, Phoenix, Arizona, USA
- Department of Emergency Medicine, LAC USC Medical Center, Los Angeles, California, USA
| | - Purnima Madhivanan
- Mel & Enid Zuckerman College of Public Health, University of Arizona Medical Center - University Campus, Tucson, Arizona, USA
| | | | - Eva M Moya
- Department of Social Work, The University of Texas, El Paso, Texas, USA
| | - Graciela Meza
- Faculty of Medicine, Universidad Nacional de la Amazonia Peruana, Iquitos, Peru
| | - Stefan Reinders
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Magaly M Blas
- Epidemiology, STD, HIV Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
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11
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Pérez JE, Coronado ROF, Vilchez YRP, Heredia Ñahui MA, Marcos KMA, Meza RES, Valenzuela HS, Oh P, Ghisi GLDM. Characteristics and correlates of disease-related knowledge and exercise self-efficacy among cardiac patients attending virtual cardiac rehabilitation during the first COVID-19 lockdown in Peru. JOURNAL OF VASCULAR NURSING 2023; 41:103-108. [PMID: 37684086 PMCID: PMC10176106 DOI: 10.1016/j.jvn.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/27/2023] [Accepted: 05/09/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Government responses and restrictions due to the COVID-19 pandemic (e.g., limits to non-urgent health care services, including non-urgent outpatient appointments) led to the suspension of center-based (in-person) cardiac rehabilitation (CR), with many programs switching to virtual delivery. This study aimed to understand the characteristics and correlates of disease-related knowledge and exercise self-efficacy in a group of patients attending a virtual CR program during the first COVID-19 lockdown in Peru. METHODS In this prospective observational study, 240 patients receiving virtual CR care (exercise instructions and patient education) between August/2020 and December/2021 completed questionnaires pre- and post-CR assessing disease-related knowledge (CADE-Q SV questionnaire) and self-efficacy (SE; Bandura's Exercise SE scale). Paired t tests were used to investigate changes pre/post-CR and Pearson correlation coefficients were used to determine the association between knowledge/SE and patients' characteristics. RESULTS Participants were mainly comprised of men, with a cardiac diagnosis of stable coronary artery disease, who underwent percutaneous coronary intervention or had a known diagnosis of hypertension and with at least one cardiovascular risk factor (95.8%). Mean total knowledge scores improved significantly at post-CR (12.9 ± 2.4 to 15.6 ± 2.0/20; p<0.001), as well as in 4/5 knowledge areas (cardiovascular risk factors, exercise, nutrition, and psychosocial risk; p<0.001). Mean SE scores improved significantly at post-CR (1.9 ± 0.9 to 3.0 ± 0.9/5; p = 0.01). Post-CR knowledge and SE were significantly correlated with cardiac diagnosis and surgical procedures (r = 0.17, p = 0.02 and r = 0.27, p = 0.02, respectively). CONCLUSIONS The virtual CR program improved disease-related knowledge and SE of cardiac patients during the first months of the COVID-19 pandemic. Post-CR outcomes were correlated with cardiac diagnosis and surgical procedures and more research with other characteristics is warrantied.
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Affiliation(s)
- Jessica Espinoza Pérez
- Unidad Funcional de Rehabilitación Cardiaca, Centro Asistencial: Instituto Nacional Cardiovascular (INCOR - ESSALUD), Lima, Peru
| | | | - Yolanda Rocio Palomino Vilchez
- Unidad Funcional de Rehabilitación Cardiaca, Centro Asistencial: Instituto Nacional Cardiovascular (INCOR - ESSALUD), Lima, Peru
| | - Marco Antonio Heredia Ñahui
- Unidad Funcional de Rehabilitación Cardiaca, Centro Asistencial: Instituto Nacional Cardiovascular (INCOR - ESSALUD), Lima, Peru
| | | | - Renzo Eduardo Soca Meza
- Unidad Funcional de Rehabilitación Cardiaca, Centro Asistencial: Instituto Nacional Cardiovascular (INCOR - ESSALUD), Lima, Peru
| | - Hanna Silva Valenzuela
- Unidad Funcional de Rehabilitación Cardiaca, Centro Asistencial: Instituto Nacional Cardiovascular (INCOR - ESSALUD), Lima, Peru
| | - Paul Oh
- KITE Research Institute, Toronto Rehabilitation Institute (TRI), University Health Network (UHN), University of Toronto, 347 Rumsey Road, Toronto, Ontario M4G 2R6, Canada
| | - Gabriela Lima de Melo Ghisi
- KITE Research Institute, Toronto Rehabilitation Institute (TRI), University Health Network (UHN), University of Toronto, 347 Rumsey Road, Toronto, Ontario M4G 2R6, Canada; Department of Physical Therapy, University of Toronto, Canada..
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12
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Martínez-Pérez GZ, Shilton S, Mallma Salazar PS, Pflucker Oses P, Torres-Slimming PA, Batheja D, Banerji A, Mallery A, Ivanova Reipold E, Carcamo C. SARS-CoV-2 self-testing in Peru: a cross-sectional survey of values and attitudes of the general population. BMJ Open 2023; 13:e068980. [PMID: 37407037 DOI: 10.1136/bmjopen-2022-068980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVES To assess the values of and attitudes towards the use of rapid SARS-CoV-2 antigen-detection tests for self-testing in a rural and an urban area in Peru. DESIGN Cross-sectional, street-based population survey. SETTING A series of over 400 randomly selected street points in Valle del Mantaro and in Lima. PARTICIPANTS 438 respondents (203 female) participated. They were all older than 17 years and provided informed consent for participation. INTERVENTION All respondents answered on the spot, a 35-item questionnaire developed in KoboToolbox. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes of interest were: likelihood to use a SARS-CoV-2 self-test; willingness to pay for a SARS-CoV-2 self-test and likelihood to comply with recommended actions following a positive SARS-CoV-2 self-test result. Bivariate analyses and Poisson regression (PR) analyses were performed to identify significant associations between dependent variables and independent variables pertaining to respondents' characteristics, risk perception and previous experiences with conventional COVID-19 testing. RESULTS Of the 438 respondents, 51.49% had previous experience with conventional COVID-19 testing; 20.37% had COVID-19 disease; 86.96% accepted the idea of SARS-CoV-2 self-testing; and, 78.95% would be likely to use it if needed. Almost all (94.75%) would pay for a self-testing device (mean acceptable payment: US$10.4) if it was not provided free of charge by health authorities. Overall, 93.12%, 86.93% and 85.32% would self-isolate, report the results and warn their contacts, respectively. Being a female (adjusted PR 1.05, 95% CI 1.00 to 1.09, p<0.018), having completed secondary education (adjusted PR 1.18, 95% CI 1.02 to 1.37, p<0.024) and expressing likelihood to use self-testing (adjusted PR 1.08, 95% CI 1.01 to 1.16, p<0.0.24) could be predictors of willingness to pay for a self-test. CONCLUSIONS Self-testing is perceived as an acceptable approach. Health authorities in Peru should facilitate access to this approach to complement healthcare facilities-led testing efforts for COVID-19. Future research is necessary to understand the impact of self-testing in case detection and pandemic control.
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Affiliation(s)
| | | | | | - Paola Pflucker Oses
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | - Abhik Banerji
- Center for Disease Dynamics Economics & Policy, Delhi, India
| | - Amber Mallery
- FIND, the global alliance for diagnostics, Geneva, Switzerland
| | | | - Cesar Carcamo
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
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13
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Freeman T, Baum F, Musolino C, Flavel J, McKee M, Chi C, Giugliani C, Falcão MZ, De Ceukelaire W, Howden-Chapman P, Nguyen TH, Serag H, Kim S, Carlos AD, Gesesew HA, London L, Popay J, Paremoer L, Tangcharoensathien V, Sundararaman T, Nandi S, Villar E. Illustrating the impact of commercial determinants of health on the global COVID-19 pandemic: Thematic analysis of 16 country case studies. Health Policy 2023; 134:104860. [PMID: 37385156 DOI: 10.1016/j.healthpol.2023.104860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 07/01/2023]
Abstract
Previous research on commercial determinants of health has primarily focused on their impact on non-communicable diseases. However, they also impact on infectious diseases and on the broader preconditions for health. We describe, through case studies in 16 countries, how commercial determinants of health were visible during the COVID-19 pandemic, and how they may have influenced national responses and health outcomes. We use a comparative qualitative case study design in selected low- middle- and high-income countries that performed differently in COVID-19 health outcomes, and for which we had country experts to lead local analysis. We created a data collection framework and developed detailed case studies, including extensive grey and peer-reviewed literature. Themes were identified and explored using iterative rapid literature reviews. We found evidence of the influence of commercial determinants of health in the spread of COVID-19. This occurred through working conditions that exacerbated spread, including precarious, low-paid employment, use of migrant workers, procurement practices that limited the availability of protective goods and services such as personal protective equipment, and commercial actors lobbying against public health measures. Commercial determinants also influenced health outcomes by influencing vaccine availability and the health system response to COVID-19. Our findings contribute to determining the appropriate role of governments in governing for health, wellbeing, and equity, and regulating and addressing negative commercial determinants of health.
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Affiliation(s)
- Toby Freeman
- Stretton Health Equity, University of Adelaide, Adelaide, SA, 5005 Australia.
| | - Fran Baum
- Stretton Health Equity, University of Adelaide, Adelaide, SA, 5005 Australia
| | - Connie Musolino
- Stretton Health Equity, University of Adelaide, Adelaide, SA, 5005 Australia
| | - Joanne Flavel
- Stretton Health Equity, University of Adelaide, Adelaide, SA, 5005 Australia
| | - Martin McKee
- London School of Hygiene & Tropical Medicine, London WC1H 9SH, United Kingdom
| | - Chunhuei Chi
- Center for Global Health, Oregon State University, Corvallis, OR 7331, USA
| | - Camila Giugliani
- Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcellos, 2400 CEP 90035-003, Porto Alegre, Brazil
| | - Matheus Zuliane Falcão
- University of São Paulo, Brazil, Av. Dr. Arnaldo, 715 - 211 - Cerqueira César, São Paulo - SP, 01246-904, Brazil
| | | | | | - Thanh Huong Nguyen
- Faculty of Social Science and Behavior, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang Ward, North Tu Liem District, Hanoi, Vietnam
| | - Hani Serag
- University of Texas Medical Branch (UTMB), 301 University Blvd., Galveston, Texas, 77555, USA
| | - Sun Kim
- People's Health Institute, 36 Sadang-ro 13-gil, Dongjak-gu, Seoul 07004, South Korea
| | - Alvarez Dardet Carlos
- CIBERESP, Center for Research in Epidemiology and Public Health, University of Alicante, 03560 Spain
| | - Hailay Abrha Gesesew
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, 5000 AUSTRALIA & College of Health Sciences, Mekelle University, Mekelle, 231 Ethiopia
| | - Leslie London
- School of Public Health, University of Cape Town, South Africa
| | - Jennie Popay
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Bailrigg, Lancaster LA1 4YW, United Kingdom
| | - Lauren Paremoer
- Political Studies, University of Cape Town, Cape Town, South Africa
| | | | | | | | - Eugenio Villar
- Universidad Peruana Cayetano Heredio, San Martín de Porres 15102, Peru
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Ramírez-Soto MC. Monkeypox Outbreak in Peru. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1096. [PMID: 37374300 DOI: 10.3390/medicina59061096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/28/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
Monkeypox (Mpox) is a zoonotic disease caused by the Orthopoxvirus monkeypox virus (MPXV). Since 1970, outbreaks of MPXV have occurred in several Sub-Saharan African countries. However, from May 2022 to April 2023, recent outbreaks of Mpox occurred in several countries outside of Africa, and these cases quickly spread to over 100 non-endemic countries on all continents. Most of these cases were found in the region of the Americas and the Europe region. In Latin America, the highest all-age Mpox rates per million inhabitants were in Peru, Colombia, Chile, and Brazil. Given its global impact, Mpox was declared as an international Public Health Emergency by WHO in July 2022. MPXV infection disproportionately affects men who have sex with men and members of the HIV-infected population. Vaccination is the current strategy for controlling and preventing Mpox in high-risk groups. In this context, Peru has the fourth-highest number of Mpox cases in Latin America and faces significant challenges in disease control. Because of this, in this review, we discuss the epidemiology, public health indicators, and prevention of Mpox in the 2022 Peru outbreak so that health authorities can join forces to control MPXV transmission.
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Affiliation(s)
- Max Carlos Ramírez-Soto
- Centro de Investigación en Salud Pública, Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima 15011, Peru
- Facultad de Ciencias de la Salud, Universidad Tecnológica del Peru, Lima 15046, Peru
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15
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Sara R. The impact of the COVID-19 pandemic on alcohol and tobacco consumption: Evidence from Peru. Soc Sci Med 2023; 325:115890. [PMID: 37087851 PMCID: PMC10088362 DOI: 10.1016/j.socscimed.2023.115890] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/09/2022] [Accepted: 04/03/2023] [Indexed: 04/25/2023]
Abstract
The COVID-19 pandemic has introduced dramatic adversities for public health around the world, especially in low and middle-income countries. While research has shown the pandemic to have direct effects on a variety of major economic and health crises, its impact on health-related behaviors is not clear. In this paper, I examine how exposure to the pandemic affects alcohol use and smoking in Peru, which experienced one of the highest COVID-related death rates albeit implementing one of the strictest lockdown policies in the world. I find that post pandemic consumption of alcohol and smoking in the last 30 days decreases by 41.3% and 44.1% respectively when compared to pre-pandemic rates. I also conclude that the intensity of engaging in these behaviors change such that the frequency of consuming alcohol in the last 30 days, binge drinking and the probability of smoking daily falls. While drinking behavior returns to pre-pandemic levels, the negative effect on smoking weakens but remains for almost two years preceding the pandemic.
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Affiliation(s)
- Raisa Sara
- Department of Economics and International Business, Sam Houston State University, 232 Smith-Hutson Business Building, Huntsville, TX, 77341, USA.
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16
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Llanos-Cuentas A, Schwalb A, Quintana JL, Delfin B, Alvarez F, Ugarte-Gil C, Guerra Gronerth RI, Lucchetti A, Grogl M, Gotuzzo E. Hydroxychloroquine to prevent SARS-CoV-2 infection among healthcare workers: early termination of a phase 3, randomised, open-label, controlled clinical trial. BMC Res Notes 2023; 16:22. [PMID: 36849996 PMCID: PMC9970848 DOI: 10.1186/s13104-023-06281-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/30/2023] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVE To assess the effectiveness and safety of hydroxychloroquine (HCQ) prophylaxis for the prevention of SARS-CoV-2 infection in healthcare workers (HCW) on duty during the COVID-19 pandemic. RESULTS A total of 68 HCWs met the eligibility criteria were randomly allocated to receive HCQ (n = 36) or not (n = 32). There were no significant differences between groups in respects to age, gender, or medical history. Eight participants met the primary efficacy endpoint of SAR-CoV-2 infection during the study period; there was no difference in incidence of SARS-CoV-2 infections between both study arms (HCQ: 5 vs Control: 3, p = 0.538). The relative risk of SARS-CoV-2 infection in the HCQ arm was 1.69 compared to the control group (95%CI 0.41-7.11, p = 0.463); due to poor participant accrual, the resulting statistical power of the primary efficacy outcome was 11.54%. No serious adverse events occurred; however, two (2/36, 5.6%) participants no longer wished to participate in the study and withdrew consent due to recurring grade 1 and 2 adverse events. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT04414241. (Registered on June 4, 2020).
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Affiliation(s)
- Alejandro Llanos-Cuentas
- Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres, 15102, Lima, Peru.
| | - Alvaro Schwalb
- grid.11100.310000 0001 0673 9488Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres, 15102 Lima, Peru
| | - Juan Luis Quintana
- grid.11100.310000 0001 0673 9488School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Brian Delfin
- grid.414881.00000 0004 0506 242XDepartment of Infectious Diseases, Hospital Cayetano Heredia, Lima, Peru
| | - Fiorela Alvarez
- grid.11100.310000 0001 0673 9488Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres, 15102 Lima, Peru
| | - César Ugarte-Gil
- grid.11100.310000 0001 0673 9488Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres, 15102 Lima, Peru ,grid.11100.310000 0001 0673 9488School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rosio I. Guerra Gronerth
- Centro Médico Naval Cirujano Mayor Santiago Tavara, Callao, Peru ,grid.430666.10000 0000 9972 9272School of Medicine, Universidad Científica del Sur, Lima, Peru
| | - Aldo Lucchetti
- grid.441917.e0000 0001 2196 144XSchool of Medicine, Universidad Peruana de Ciencias Aplicadas, Lima, Peru ,Department of Infectious Diseases, Hospital Nacional Arzobispo Loayza, Lima, Peru
| | - Max Grogl
- grid.415929.20000 0004 0486 6610U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | - Eduardo Gotuzzo
- grid.11100.310000 0001 0673 9488Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres, 15102 Lima, Peru
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Concha-Velasco F, Moncada-Arias AG, Antich MK, Delgado-Flores CJ, Ramírez-Escobar C, Ochoa-Linares M, Velásquez-Cuentas L, Dueñas de la Cruz H, Loyola S. Factors Associated with COVID-19 Death in a High-Altitude Peruvian Setting during the First 14 Months of the Pandemic: A Retrospective Multicenter Cohort Study in Hospitalized Patients. Trop Med Infect Dis 2023; 8:133. [PMID: 36977134 PMCID: PMC10051565 DOI: 10.3390/tropicalmed8030133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/25/2023] Open
Abstract
Risk factors for COVID-19 death in high-altitude populations have been scarcely described. This study aimed to describe risk factors for COVID-19 death in three referral hospitals located at 3399 m in Cusco, Peru, during the first 14 months of the pandemic. A retrospective multicenter cohort study was conducted. A random sample of ~50% (1225/2674) of adult hospitalized patients who died between 1 March 2020 and 30 June 2021 was identified. Of those, 977 individuals met the definition of death by COVID-19. Demographic characteristics, intensive care unit (ICU) admission, invasive respiratory support (IRS), disease severity, comorbidities, and clinical manifestation at hospital admission were assessed as risk factors using Cox proportional-hazard models. In multivariable models adjusted by age, sex, and pandemic periods, critical disease (vs. moderate) was associated with a greater risk of death (aHR: 1.27; 95%CI: 1.14-1.142), whereas ICU admission (aHR: 0.39; 95%CI: 0.27-0.56), IRS (aHR: 0.37; 95%CI: 0.26-0.54), the ratio of oxygen saturation (ROX) index ≥ 5.3 (aHR: 0.87; 95%CI: 0.80-0.94), and the ratio of SatO2/FiO2 ≥ 122.6 (aHR: 0.96; 95%CI: 0.93-0.98) were associated with a lower risk of death. The risk factors described here may be useful in assisting decision making and resource allocation.
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Affiliation(s)
- Fátima Concha-Velasco
- Universidad Continental, Cusco 08000, Peru
- Dirección de Epidemiología e Investigación, Gerencia Regional de Salud (GERESA), Cusco 08200, Peru
| | - Ana G. Moncada-Arias
- Dirección de Epidemiología e Investigación, Gerencia Regional de Salud (GERESA), Cusco 08200, Peru
| | - María K. Antich
- Dirección de Epidemiología e Investigación, Gerencia Regional de Salud (GERESA), Cusco 08200, Peru
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima 150135, Peru
| | | | - Cesar Ramírez-Escobar
- Dirección de Epidemiología e Investigación, Gerencia Regional de Salud (GERESA), Cusco 08200, Peru
| | | | | | | | - Steev Loyola
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima 150135, Peru
- Doctorado en Medicina Tropical, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias 130014, Colombia
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18
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Takasaki Y, Abizaid C, Coomes OT. COVID-19 contagion across remote communities in tropical forests. Sci Rep 2022; 12:20727. [PMID: 36456613 PMCID: PMC9713114 DOI: 10.1038/s41598-022-25238-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
Understanding COVID-19 contagion among poor populations is hampered by a paucity of data, and especially so in remote rural communities with limited access to transportation, communication, and health services. We report on the first study on COVID-19 contagion across rural communities without road access. We conducted telephone surveys with over 400 riverine communities in the Peruvian Amazon in the early phase of the pandemic. During the first wave (April-June, 2020), COVID-19 spread from cities to most communities through public and private river transportation according to their remoteness. The initial spread was delayed by transportation restrictions but at the same time was driven in unintended ways by government social assistance. During the second wave (August, 2020), although people's self-protective behaviors (promoted through communication access) helped to suppress the contagion, people responded to transportation restrictions and social assistance in distinct ways, leading to greater contagion among Indigenous communities than mestizo communities. As such, the spatial contagion during the early phase of the pandemic in tropical forests was shaped by river transportation and social behaviors. These novel findings have important implications for research and policies on pandemics in rural areas.
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Affiliation(s)
- Yoshito Takasaki
- Graduate School of Economics, University of Tokyo, Tokyo, Japan.
| | - Christian Abizaid
- Department of Geography and Planning and School of the Environment, University of Toronto, Toronto, ON, Canada
| | - Oliver T Coomes
- Department of Geography, McGill University, Montreal, QC, Canada
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19
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Hidalgo-Padilla L, Vilela-Estrada AL, Toyama M, Flores S, Ramirez-Meneses D, Steffen M, Heritage P, Fung C, Priebe S, Diez-Canseco F. Using Arts-Based Methodologies to Understand Adolescent and Youth Manifestations, Representations, and Potential Causes of Depression and Anxiety in Low-Income Urban Settings in Peru. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15517. [PMID: 36497592 PMCID: PMC9737895 DOI: 10.3390/ijerph192315517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/15/2022] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Arts-based methodologies can be beneficial to identify different representations of stigmatized topics such as mental health conditions. This study used a theater-based workshop to describe manifestations, representations, and potential causes of depression and anxiety as perceived by adolescents and young adults. METHODS The theater company Teatro La Plaza conducted three online sessions with a group of adolescents and another with a group of young adults from Lima, Peru. The artistic outputs, which included images, similes, monologues, and narrations, were used to describe the experiences of depression and anxiety symptoms following a content analysis using posteriori categories. RESULTS Seventeen participants joined the sessions. The artistic outputs showed: physical, behavioral, cognitive, and emotional manifestations of depression and anxiety; a perception that both disorders have a cyclical nature; and an awareness that it is often difficult to notice symptom triggers. The mandatory social isolation due to the COVID-19 pandemic was highlighted as an important symptom trigger, mostly linked to anxiety. CONCLUSIONS The findings are consistent with the literature, especially with regard to the manifestations, representations, and potential causes that trigger depression and anxiety. Using arts-based methods allowed adolescents and young adults to expand the articulation of their representations of mental disorders.
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Affiliation(s)
- Liliana Hidalgo-Padilla
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 15074, Peru
| | - Ana L Vilela-Estrada
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 15074, Peru
| | - Mauricio Toyama
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 15074, Peru
| | - Sumiko Flores
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 15074, Peru
| | - Daniela Ramirez-Meneses
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 15074, Peru
| | - Mariana Steffen
- People's Palace Projects, School of English and Drama, Queen Mary University of London, London E1 4QA, UK
| | - Paul Heritage
- People's Palace Projects, School of English and Drama, Queen Mary University of London, London E1 4QA, UK
| | - Catherine Fung
- Unit for Social and Community Psychiatry, Queen Mary University of London, London E13 8SP, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London E13 8SP, UK
| | - Francisco Diez-Canseco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 15074, Peru
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20
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Zegarra-López AC, Florentino-Santisteban B, Flores-Romero J, Delgado-Tenorio A, Cernades-Ames A. A Cross-Sectional Study on the Prevalence of Depressive Symptoms and Its Associated Sociodemographic Factors in Peru during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14240. [PMID: 36361118 PMCID: PMC9654240 DOI: 10.3390/ijerph192114240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
The present study aims to analyze the prevalence of depressive symptoms and its sociodemographic-associated factors in Peruvian adults. Data was extracted from a nation-wide representative survey in which depression symptoms were measured with the PHQ-9 and sociodemographic information was extracted from household data. Depression severity rates were estimated for each symptom, and responses were modeled through the Rating Scale Model to obtain a depression measure used as dependent variable on a Generalized Mixed Linear Model. The most frequent depression symptoms were emotional, such as discouragement, sad mood, hopelessness, and lack of pleasure when doing activities. Our model showed that, after controlling the effects of all the variables considered, the most relevant predictors were gender, education level, physiographic region, age, marital status, and number of coresidents. Higher depression levels were found in women, people who did not complete higher education, participants living in the Highlands, older adults, single participants, and people living alone. Thus, interventions to promote or prevent depression severity during similar situations as the pandemic should focus on specific sociodemographic groups and their particular needs.
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Affiliation(s)
- Angel Christopher Zegarra-López
- Faculty of Psychology, Universidad de Lima, Lima 15023, Peru
- Grupo de Investigación en Psicología, Bienestar y Sociedad, Instituto de Investigación Científica, Universidad de Lima, Lima 15023, Peru
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21
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Valladares-Garrido MJ, Failoc-Rojas VE, Soto-Becerra P, Zeña-Ñañez S, Torres-Roman JS, Fernández-Mogollón JL, Colchado-Palacios IG, Apolaya-Segura CE, Dávila-Gonzales JA, Arce-Villalobos LR, Neciosup-Puican RDP, Calvay-Requejo AG, Maguiña JL, Apolaya-Segura M, Díaz-Vélez C. Clinical-epidemiologic variation in patients treated in the first and second wave of COVID-19 in Lambayeque, Peru: A cluster analysis. Int J Infect Dis 2022; 123:212-220. [PMID: 35872099 PMCID: PMC9303067 DOI: 10.1016/j.ijid.2022.07.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To identify differences in the clinical and epidemiologic characteristics of patients during the first and second waves of the COVID-19 pandemic at the EsSalud Lambayeque health care network, Peru. METHODS An analytical cross-sectional study of 53,912 patients enrolled during the first and second waves of COVID-19 was conducted. Cluster analysis based on clustering large applications (CLARA) was applied to clinical-epidemiologic data presented at the time of care. The two pandemic waves were compared using clinical-epidemiologic data from epidemiologic surveillance. RESULTS Cluster analysis identified four COVID-19 groups with a characteristic pattern. Cluster 1 included the largest number of participants in both waves, and the participants were predominantly female. Cluster 2 included patients with gastrointestinal, respiratory, and systemic symptoms. Cluster 3 was the "severe" cluster, characterized by older adults and patients with dyspnea or comorbidities (cardiovascular, diabetes, obesity). Cluster 4 included asymptomatic, pregnant, and less severe patients. We found differences in all clinical-epidemiologic characteristics according to the cluster to which they belonged. CONCLUSION Using cluster analysis, we identified characteristic patterns in each group. Respiratory, gastrointestinal, dyspnea, anosmia, and ageusia symptoms were higher in the second COVID-19 wave than the first COVID-19 wave.
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Affiliation(s)
- Mario J. Valladares-Garrido
- Instituto de Evaluación de Tecnologías en Salud e Investigación – IETSI, EsSalud, Lima, Peru,South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
| | - Virgilio E. Failoc-Rojas
- Instituto de Evaluación de Tecnologías en Salud e Investigación – IETSI, EsSalud, Lima, Peru,Universidad San Ignacio de Loyola, Lima, Peru,Corresponding author: Virgilio E. Failoc-Rojas, Tel: (+51) 948845837
| | - Percy Soto-Becerra
- Instituto de Evaluación de Tecnologías en Salud e Investigación – IETSI, EsSalud, Lima, Peru,Universidad Continental, Huancayo, Peru
| | - Sandra Zeña-Ñañez
- Instituto de Evaluación de Tecnologías en Salud e Investigación – IETSI, EsSalud, Lima, Peru,Universidad Continental, Huancayo, Peru
| | | | | | | | | | | | | | | | | | - Jorge L. Maguiña
- Instituto de Evaluación de Tecnologías en Salud e Investigación – IETSI, EsSalud, Lima, Peru,Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru
| | - Moisés Apolaya-Segura
- Instituto de Evaluación de Tecnologías en Salud e Investigación – IETSI, EsSalud, Lima, Peru,Facultad de Medicina, Universidad Cesar Vallejo, Chiclayo, Peru
| | - Cristian Díaz-Vélez
- Instituto de Evaluación de Tecnologías en Salud e Investigación – IETSI, EsSalud, Lima, Peru,Facultad de Medicina, Universidad Privada Antenor Orrego, Trujillo, Peru
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22
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Canorio J, Sánchez F, Ramírez-Soto MC. COVID-19, Non-Communicable Diseases, and Behavioral Factors in the Peruvian Population ≥ 15 Years: An Ecological Study during the First and Second Year of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11757. [PMID: 36142027 PMCID: PMC9517029 DOI: 10.3390/ijerph191811757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
A range of health-related and behavioral risk factors are associated with COVID-19 incidence and mortality. In the present study, we assess the association between incidence, mortality, and case fatality rate due to COVID-19 and the prevalence of hypertension, obesity, overweight, tobacco and alcohol use in the Peruvian population aged ≥15 years during the first and second year of the COVID-19 pandemic. In this ecological study, we used the prevalence rates of hypertension, overweight, obesity, tobacco, and alcohol use obtained from the Encuesta Demográfica y de Salud Familiar (ENDES) 2020 and 2021. We estimated the crude incidence and mortality rates (per 100,000 habitants) and case fatality rate (%) of COVID-19 in 25 Peruvian regions using data from the Peruvian Ministry of Health that were accurate as of 31 December 2021. Spearman correlation and lineal regression analysis was applied to assess the correlations between the study variables as well as multivariable regression analysis adjusted by confounding factors affecting the incidence and mortality rate and case fatality rate of COVID-19. In 2020, adjusted by confounding factors, the prevalence rate of obesity (β = 0.582; p = 0.037) was found to be associated with the COVID-19 mortality rate (per 100,000 habitants). There was also an association between obesity and the COVID-19 case fatality rate (β = 0.993; p = 0.014). In 2021, the prevalence of obesity was also found to be associated with the COVID-19 mortality rate (β = 0.713; p = 0.028); however, adjusted by confounding factors, including COVID-19 vaccination coverage rates, no association was found between the obesity prevalence and the COVID-19 mortality rate (β = 0.031; p = 0.895). In summary, Peruvian regions with higher obesity prevalence rates had higher COVID-19 mortality and case fatality rates during the first year of the COVID-19 pandemic. However, adjusted by the COVID-19 vaccination coverage, no association between the obesity prevalence rate and the COVID-19 mortality rate was found during the second year of the COVID-19 pandemic.
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23
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Schwalb A, Armyra E, Méndez-Aranda M, Ugarte-Gil C. COVID-19 in Latin America and the Caribbean: Two years of the pandemic. J Intern Med 2022; 292:409-427. [PMID: 35411985 PMCID: PMC9115176 DOI: 10.1111/joim.13499] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Worldwide, nations have struggled during the coronavirus disease 2019 (COVID-19) pandemic. However, Latin America and the Caribbean faced an unmatched catastrophic toll. As of March 2022, the region has reported approximately 15% of cases and 28% of deaths worldwide. Considering the relatively late arrival of SARS-CoV-2, several factors in the region were determinants of the humanitarian crisis that ensued. Pandemic unpreparedness, fragile healthcare systems, forthright inequalities, and poor governmental support facilitated the spread of the virus throughout the region. Moreover, reliance on repurposed and ineffective drugs such as hydroxychloroquine and ivermectin-to treat or prevent COVID-19-was publicised through misinformation and created a false sense of security and poor adherence to social distancing measures. While there were hopes that herd immunity could be achieved after the region's disastrous first peak, the emergence of the Gamma, Lambda, and Mu variants made this unattainable. This review explores how Latin America and the Caribbean fared during the first 2 years of the pandemic, and how, despite all the challenges, the region became a global leader in COVID-19 vaccination, with 63% of its population fully vaccinated.
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Affiliation(s)
- Alvaro Schwalb
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.,London School of Hygiene and Tropical Medicine, London, UK
| | - Eleonora Armyra
- Health Innovation Lab, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Melissa Méndez-Aranda
- Facultad de Ciencias y Filosofía, Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - César Ugarte-Gil
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.,London School of Hygiene and Tropical Medicine, London, UK.,School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
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24
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Yuen CM, Brooks MB, Millones AK, Acosta D, Del Águila-Rojas E, Campos H, Farroñay S, Morales G, Ramirez-Sandoval J, Nichols TC, Jimenez J, Jenkins HE, Lecca L. Geospatial analysis of reported activity locations to identify sites for tuberculosis screening. Sci Rep 2022; 12:14094. [PMID: 35982104 PMCID: PMC9387880 DOI: 10.1038/s41598-022-18456-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
Mobile screening units can help close tuberculosis case detection gaps. Placing screening units where people at high risk for undiagnosed tuberculosis preferentially spend time could make screening more resource-effective. We conducted a case–control study in Lima, Peru to identify locations where people with tuberculosis were more likely to spend time than community controls. We surveyed participants about activity locations over the past 6 months. We used density-based clustering to assess how patient and control activity locations differed, and logistic regression to compare location-based exposures. We included 109 tuberculosis patients and 79 controls. In density-based clustering analysis, the two groups had similar patterns of living locations, but their work locations clustered in distinct areas. Both groups were similarly likely to use public transit, but patients predominantly used buses and were less likely to use rapid transit (adjusted odds ratio [aOR] 0.31, 95% confidence interval [CI] 0.10–0.96) or taxis (aOR 0.42, 95% CI 0.21–0.85). Patients were more likely to have spent time in prison (aOR 11.55, 95% CI 1.48–90.13). Placing mobile screening units at bus terminals serving locations where tuberculosis patients have worked and within and around prisons could help reach people with undiagnosed tuberculosis.
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Affiliation(s)
- Courtney M Yuen
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA. .,Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
| | - Meredith B Brooks
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | | | | | | | | | | | | | | - Tim C Nichols
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Helen E Jenkins
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Leonid Lecca
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.,Socios En Salud Sucursal Peru, Lima, Peru
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25
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Ramos-Yataco A, Salcedo Davila EA, Meza K, Harbuz-Miller I. New-Onset and Persistent Insulin-Dependent Diabetes in Patients With COVID-19: A Peruvian Experience. Cureus 2022; 14:e27272. [PMID: 36039206 PMCID: PMC9404677 DOI: 10.7759/cureus.27272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/30/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) has been recognized as a risk factor for severe coronavirus disease 2019 (COVID-19) infection, and COVID-19 in diabetic patients is associated with a poor prognosis. New evidence suggests that patients with T2DM may experience diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar state (HHS) if infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, there is limited literature on new-onset diabetes in patients infected by SARS-CoV-2 without a history of diabetes. We present a case series of three patients who developed new-onset diabetes while suffering from acute COVID-19 infection; they presented with DKA even though they had no prior history or risk factors for diabetes. They remain persistently insulin-dependent several months post-recovery.
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26
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Takasaki Y, Coomes OT, Abizaid C. COVID-19 information and self-protective behaviors among rural communities in tropical forests. BMC Public Health 2022; 22:1394. [PMID: 35858862 PMCID: PMC9299405 DOI: 10.1186/s12889-022-13772-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Health risk communication plays a key role in promoting self-protective measures, which are critical in suppressing COVID-19 contagion. Relatively little is known about the communication channels used by rural poor populations to learn novel measures and their effectiveness in promoting self-protective behaviors. Behavioral change can be shaped by people's trust in government institutions which may be differentiated by social identity, including indigeneity. METHODS During an early phase of the pandemic, we conducted two telephone surveys with over 460 communities - both Indigenous and mestizo - without road access and limited communication access in the Peruvian Amazon. This is the first report on the association of information sources about self-protective measures against COVID-19 with the adoption of self-protective behaviors in remote rural areas in developing countries. RESULTS People mainly relied on mass media (radio, television, newspapers) and interpersonal sources (local authorities, health workers, neighbors/relatives) for information and adopted handwashing, mask-wearing, social distancing, and social restrictions to varying degrees. Overall, self-protective behaviors were largely positively and negatively associated with mass media and interpersonal sources, respectively, depending on the source-measure combination. Mistrust of the government seems to have shaped how Indigenous and mestizo peoples distinctively responded to interpersonal information sources and relied on mass media. CONCLUSIONS Our findings call for improved media access to better manage pandemics in rural areas, especially among remote Indigenous communities.
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Affiliation(s)
- Yoshito Takasaki
- Graduate School of Economics, University of Tokyo, Tokyo, Japan.
| | - Oliver T Coomes
- Department of Geography, McGill University, Montreal, QC, Canada
| | - Christian Abizaid
- Department of Geography & Planning and School of the Environment, University of Toronto, Toronto, ON, Canada
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27
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Toyama M, Vargas L, Ticliahuanca S, Quispe AM. Regional clustering and waves patterns due to COVID-19 by the index virus and the lambda/gamma, and delta/omicron SARS-CoV-2 variants in Peru. Gates Open Res 2022. [DOI: 10.12688/gatesopenres.13644.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) impact varies substantially due to various factors, so it is critical to characterize its main differences to inform decision-makers about where to focus their interventions and differentiate mitigation strategies. Up to this date, little is known about the patterns and regional clustering of COVID-19 waves worldwide. Methods: We assessed the patterns and regional clustering of COVID-19 waves in Peru by using the weekly mortality rates for each of the 25 regions as an outcome of interest. We obtained the death counts from the National Informatics System of Deaths and population estimates from the National Registry of Identification and Civil Status. In addition, we characterized each wave according to its duration, peak, and mortality rates by age group and gender. Additionally, we used polynomial regression models to compare them graphically and performed a cluster analysis to identify regional patterns. Results: We estimated the average mortality rate at the first, second, and third wave at 13.01, 14.12, and 9.82 per 100,000 inhabitants, respectively, with higher mortality rates among elders and men. The patterns of each wave varied substantially in terms of duration, peak, impact, and wave shapes. Based on our clustering analysis, during the first wave caused by the index virus, the 25 regions of Peru presented six different wave patterns. However, the regions were clustered in two different wave patterns during the second and third, caused by alpha/lambda/delta and omicron. Conclusions: The propagation of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) variants behaved in Peru with varying wave patterns and regional clustering. During the COVID-19 pandemic, the weekly mortality rates followed different spatiotemporal patterns with solid clustering, which might help project the impact of future waves of COVID-19.
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28
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High mortality among hospitalized adult patients with COVID-19 pneumonia in Peru: A single centre retrospective cohort study. PLoS One 2022; 17:e0265089. [PMID: 35259196 PMCID: PMC8903290 DOI: 10.1371/journal.pone.0265089] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/22/2022] [Indexed: 12/15/2022] Open
Abstract
Background Peru is the country with the world’s highest COVID-19 death rate per capita. Characteristics associated with increased mortality among adult patients with COVID-19 pneumonia in this setting are not well described. Methods Retrospective, single-center cohort study including 1537 adult patients hospitalized with a diagnosis of SARS-CoV-2 pneumonia between May 2020 and August 2020 at a national hospital in Lima, Peru. The primary outcome measure was in-hospital mortality. Results In-hospital mortality was 49.71%. The mean age was 60 ± 14.25 years, and 68.38% were males. We found an association between mortality and inflammatory markers, mainly leukocytes, D-dimer, lactate dehydrogenase, C-reactive protein and ferritin. A multivariate model adjusted for age, hypertension, diabetes mellitus, and corticosteroid use demonstrated that in-hospital mortality was associated with greater age (RR: 2.01, 95%CI: 1.59–2.52) and a higher level of oxygen requirement (RR: 2.77, 95%CI: 2.13–3.62). Conclusions: In-hospital mortality among COVID-19 patients in Peru is high and is associated with greater age and higher oxygen requirements.
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29
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Ramírez-Soto MC, Ortega-Cáceres G. Analysis of Excess All-Cause Mortality and COVID-19 Mortality in Peru: Observational Study. Trop Med Infect Dis 2022; 7:tropicalmed7030044. [PMID: 35324591 PMCID: PMC8950420 DOI: 10.3390/tropicalmed7030044] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/21/2022] [Accepted: 03/02/2022] [Indexed: 02/01/2023] Open
Abstract
During the COVID-19 pandemic, an excess of all-cause mortality has been recorded in several countries, including Peru. Most excess deaths were likely attributable to COVID-19. In this study, we compared the excess all-cause mortality and COVID-19 mortality in 25 Peruvian regions to determine whether most of the excess deaths in 2020 were attributable to COVID-19. Excess deaths were calculated as the difference between the number of observed deaths from all causes during the COVID-19 pandemic (in 2020) and the number of expected deaths in 2020 based on a historical from recent years (2017–2019). Death data were retrieved from the Sistema Informatico Nacional de Defunciones (SINADEF) at the Ministry of Health of Peru from January 2017 to December 2020. Population counts were obtained from projections from Peru’s Instituto Nacional de Estadística e Informática (INEI). All-cause excess mortality and COVID-19 mortality were calculated by region per 100,000 population. Spearman’s test and linear and multiple regression models were used to estimate the correlation between excess all-cause mortality and COVID-19 mortality per 100,000 population. Excess all-cause death rates varied widely among regions (range: 115.1 to 519.8 per 100,000 population), and COVID-19 mortality ranged between 83.8 and 464.6 per 100,000 population. There was a correlation between the all-cause excess mortality and COVID-19 mortality (r = 0.90; p = 0.00001; y = 0.8729x + 90.808; R2 = 0.84). Adjusted for confounding factors (mean age in the region, gender balance, and number of intensive care unit (ICU) beds), the all-cause excess mortality rate was correlated with COVID-19 mortality rate (β = 0.921; p = 0.0001). These findings suggest that most of the excess deaths in Peru are related to COVID-19. Therefore, these findings can help decision-makers to understand the high COVID-19 mortality rates in Peru.
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Affiliation(s)
- Max Carlos Ramírez-Soto
- Facultad de Ciencias de la Salud, Universidad Tecnológica del Perú, Lima 15046, Peru
- Correspondence:
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30
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Mezones-Holguin E, Al-Kassab-Córdova A, Herrera-Añazco P, Benites-Zapata VA, Toro-Huamanchumo CJ, Flores-Gavino A, Muñoz Del Carpio-Toia A, Rodríguez-Morales AJ. Frequency of Correct Mask Use Among Pedestrians in High-Flow Indoor Public Spaces: A Multicenter Analysis in the First and Second Waves of the COVID-19 Pandemic in Peru. J Prim Care Community Health 2022; 13:21501319221134851. [PMID: 36348573 PMCID: PMC9647236 DOI: 10.1177/21501319221134851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Our study aimed to describe the variation in the frequency of correct mask
use among pedestrians in the first and second waves of the COVID-19 pandemic
in high-flow indoor public spaces from different geographic and social
settings in Peru. Methods: We carried out a cross-sectional exploratory study among pedestrians in Lima
(the capital city) and other coastal and highland cities in Peru.
Pedestrians were directly observed by trained medical students in 2
high-flow indoor areas at different times in November 2020 (first wave) and
October 2021 (second wave). Primary outcomes included the frequencies of
mask use and correct use. We applied multinomial logistic models and
estimated crude and adjusted relative prevalence ratios for sex, age,
obesity, and location. Additionally, we used binomial generalized linear
models to estimate prevalence ratios in crude and adjusted models. Results: We included 1996 participants. The frequency of mask use was similar in both
years: 96.9% in 2020 and 95.5% in 2021. However, the frequency of correct
mask use significantly decreased from 81.9% (95% CI, 79.4-84.3) in 2020 to
60.3% (95% CI, 57.2-67.3) in 2021. In 2020, we observed an increase in the
probability of misuse in the cities of Lima (aRP: 1.42;
P = .021) and Chiclayo (aPR: 1.62,
P = .001), whereas, in 2021, we noted an increase in the
probability of misuse in the cities of Lima (aRP: 1.72;
P < .001) and Piura (aPR: 1.44;
P < .001). Conclusions: The correct mask use decreased during the second wave, although no
significant overall variations were observed in mask use in pedestrians
between both periods. Also, we found regional differences in correct mask
use in both periods.
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Affiliation(s)
| | | | - Percy Herrera-Añazco
- Universidad San Juan Bautista, Lima, Peru.,Instituto de Evaluación de Tecnologías en Salud e Investigación (IETSI), EsSalud, Lima, Peru
| | | | | | | | | | - Alfonso J Rodríguez-Morales
- Latin American Network of COVID-19 Research (LANCOVID), Pereira, Risaralda, Colombia.,Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
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31
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Huancahuire-Vega S, Newball-Noriega EE, Rojas-Humpire R, Saintila J, Rodriguez-Vásquez M, Ruiz-Mamani PG, Morales-García WC, White M. Changes in Eating Habits and Lifestyles in a Peruvian Population during Social Isolation for the COVID-19 Pandemic. J Nutr Metab 2021; 2021:4119620. [PMID: 34868677 PMCID: PMC8633849 DOI: 10.1155/2021/4119620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/15/2021] [Accepted: 11/18/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Peru has one of the highest infection and death rates in the world for the COVID-19 pandemic. The government implemented house confinement measures with probable consequences on lifestyle, particularly affecting eating habits, physical activity, sleep quality, and mental health. OBJECTIVES The aim of this study was to assess the lifestyles, physical activity, and sleep characteristics, as well as changes in eating habits in a Peruvian population during the first wave of the COVID-19 pandemic. METHODS A cross-sectional descriptive study was performed. We analyzed Peruvian adults based on an online self-administered questionnaire divided into sociodemographic, anthropometrics, COVID-19 diagnosis reported, lifestyle habits, and frequency of consumption of foods. RESULTS During confinement for COVID-19, 1176 participants were studied. Of these, most reported weight gain (1 to 3 kg) and 35.7% were overweight. The lifestyles habits showed that 54.8% reported doing physical activity and 37.2% sleep less. The Peruvian sample presented a main meal pattern of breakfast (95.7%), lunch (97.5%), and dinner (89.1%). Likewise, eating habits before and during COVID-19 pandemic showed that vegetables (OR:1.56, CI95% 1.21-200), fruit (OR: 1.42, CI95% 1.10-1.81), legumes (OR:1.67, CI95% 1.23-2.28), and eggs (OR: 2.00, CI95% 1.52-2.65) presented significant consumption increase during social isolation, while bakery products (OR: 0.74, CI95% 0.56-0.97), meat, snack, refreshment, and fast food decreased in consumption. Other foods showed no significant differences. CONCLUSION This study showed an important frequency of overweight and sleep changes. There was a slight increase in physical activity despite the social isolation measures and an increase in healthy eating habits; nevertheless, the majority reported gaining weight.
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Affiliation(s)
- Salomón Huancahuire-Vega
- Grupo de Investigación P53, Escuela de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Peru
| | - Edda E. Newball-Noriega
- Grupo de Investigación P53, Escuela de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Peru
| | - Ricardo Rojas-Humpire
- Grupo de Investigación P53, Escuela de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Peru
| | - Jacksaint Saintila
- Departamento de Nutrición, Escuela de Nutrición Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Peru
| | - Mery Rodriguez-Vásquez
- Departamento de Nutrición, Escuela de Nutrición Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Peru
| | - Percy. G. Ruiz-Mamani
- Escuela Profesional de Enfermería, Facultad de Ciencias de la Salud, Universidad Privada San Juan Bautista, Lima, Peru
| | | | - Michael White
- Dirección General de Investigación, Universidad Peruana Unión, Lima, Peru
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32
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Lima EEC, Vilela EA, Peralta A, Rocha M, Queiroz BL, Gonzaga MR, Piscoya-Díaz M, Martinez-Folgar K, García-Guerrero VM, Freire FHMA. Investigating regional excess mortality during 2020 COVID-19 pandemic in selected Latin American countries. GENUS 2021; 77:30. [PMID: 34744175 PMCID: PMC8564791 DOI: 10.1186/s41118-021-00139-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 10/11/2021] [Indexed: 11/10/2022] Open
Abstract
In this paper, we measure the effect of the 2020 COVID-19 pandemic wave at the national and subnational levels in selected Latin American countries that were most affected: Brazil, Chile, Ecuador, Guatemala, Mexico, and Peru. We used publicly available monthly mortality data to measure the impacts of the pandemic using excess mortality for each country and its regions. We compare the mortality, at national and regional levels, in 2020 to the mortality levels of recent trends and provide estimates of the impact of mortality on life expectancy at birth. Our findings indicate that from April 2020 on, mortality exceeded its usual monthly levels in multiple areas of each country. In Mexico and Peru, excess mortality was spreading through many areas by the end of the second half of 2020. To a lesser extent, we observed a similar pattern in Brazil, Chile, and Ecuador. We also found that as the pandemic progressed, excess mortality became more visible in areas with poorer socioeconomic and sanitary conditions. This excess mortality has reduced life expectancy across these countries by 2-10 years. Despite the lack of reliable information on COVID-19 mortality, excess mortality is a useful indicator for measuring the effects of the coronavirus pandemic, especially in the context of Latin American countries, where there is still a lack of good information on causes of death in their vital registration systems. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1186/s41118-021-00139-1.
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Affiliation(s)
| | | | - Andrés Peralta
- Public Health Institute, Pontifical Catholic University of Ecuador (PUCE) – Ecuador, Quito, Ecuador
| | | | | | - Marcos R. Gonzaga
- Departamento de Demografia e Ciências Atuariais, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | | | - Kevin Martinez-Folgar
- Urban Health Collaborative & Department of Epidemiology and Biostatistics, Dornsife School of Public
Health, Drexel University, Philadelphia, PA USA
| | | | - Flávio H. M. A. Freire
- Departamento de Demografia e Ciências Atuariais, Universidade Federal do Rio Grande do Norte, Natal, Brazil
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33
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Ramírez-Soto MC, Alarcón-Arroyo M, Chilcon-Vitor Y, Chirinos-Pérez Y, Quispe-Vargas G, Solsol-Jacome K, Quintana-Zavaleta E. Association between Obesity and COVID-19 Mortality in Peru: An Ecological Study. Trop Med Infect Dis 2021; 6:tropicalmed6040182. [PMID: 34698315 PMCID: PMC8544728 DOI: 10.3390/tropicalmed6040182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 11/16/2022] Open
Abstract
There is a gap in the epidemiological data on obesity and COVID-19 mortality in low and middle-income countries worst affected by the COVID-19 pandemic, including Peru. In this ecological study, we explored the association between body mass index (BMI), the prevalence of overweight and obesity, and the COVID-19 mortality rates in 25 Peruvian regions, adjusted for confounding factors (mean age in the region, mean income, gender balance and number of Intensive Care Unit (ICU) beds) using multiple linear regression. We retrieved secondary region-level data on the BMI average and prevalence rates of overweight and obesity in individuals aged ≥ 15 years old, from the Peruvian National Demographics and Health Survey (ENDES 2020). COVID-19 death statistics were obtained from the National System of Deaths (SINADEF) from the Peruvian Ministry of Health and were accurate as of 3 June 2021. COVID-19 mortality rates (per 100,000 habitants) were calculated among those aged ≥ 15 years old. During the study period, a total of 190,046 COVID-19 deaths were registered in individuals aged ≥ 15 years in 25 Peruvian regions. There was association between the BMI (r = 0.74; p = 0.00001) and obesity (r = 0.76; p = 0.00001), and the COVID-19 mortality rate. Adjusted for confounding factors, only the prevalence rate of obesity was associated with COVID-19 mortality rate (β = 0.585; p = 0.033). These findings suggest that as obesity prevalence increases, the COVID-19 mortality rates increase in the Peruvian population ≥ 15 years. These findings can help to elucidate the high COVID-19 mortality rates in Peru.
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34
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Caycho-Rodríguez T, Tomás JM, Vilca LW, García CH, Rojas-Jara C, White M, Peña-Calero BN. Predictors of mental health during the COVID-19 pandemic in older adults: the role of socio-demographic variables and COVID-19 anxiety. PSYCHOL HEALTH MED 2021; 27:453-465. [PMID: 34157907 DOI: 10.1080/13548506.2021.1944655] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The objective of this study was to evaluate factors related to the mental health of Peruvian older adults during the COVID-19 pandemic. The study had a cross-sectional and observational design. A total of 274 older adults in Lima, Peru (Mage = 67.86) filled out a sociodemographic survey, the Coronavirus Anxiety Scale, Mental Health Inventory-5, Patient Health Questionnaire-2 item, and Generalized Anxiety Disorder Scale. A Structural Equation Model (SEM) was estimated to test an a priori model that relates the sociodemographic variables, COVID-19 Anxiety, psychological well-being, anxiety and depression. The model fit indices indicated a good fit to the data. The socio-demographic variables explained 23.8% of the variance of the COVID-19 Anxiety (R2 = .238). Socio-demographic variables explained 50.5% of psychological well-being variance, 52% of anxiety and 46.9% of depression. Also, sex, work; being diagnosed with COVID-19; family member with COVID-19 diagnosis; and time of exposure to COVID-19 information had statistically significant effects psychological well-being, anxiety and depression. In conclusion, some sociodemographic characteristics and COVID-19 anxiety affect the psychological well-being, anxiety and depression. The findings may allow for a better understanding of the mental health of older adults during the COVID-19 pandemic and guide government responses to detect, anticipate and minimize its impact on the mental health of this population.
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Affiliation(s)
| | - José M Tomás
- Department of Methodology for the Behavioral Sciences, Universidad de Valencia, Valencia, España
| | - Lindsey W Vilca
- Departamento de Psicología, Universidad Peruana Unión, Lima, Perú
| | - Cirilo H García
- Facultad de Psicología, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, México
| | - Claudio Rojas-Jara
- Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile
| | - Michael White
- Dirección General de Investigación, Universidad Peruana Unión, Lima, Peru
| | - Brian Norman Peña-Calero
- Grupo de Estudios Avances en Medición Psicológica, Universidad Nacional Mayor de San Marcos, Lima, Perú
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