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Silva-Valencia J, Lapadula C, Westfall JM, Gaona G, de Lusignan S, Kristiansson RS, Ling ZJ, Goh LH, Soto-Becerra P, Cuba-Fuentes MS, Wensaas KA, Flottorp S, Baste V, Chi-Wai Wong W, Pui Ng AP, Ortigoza A, Manski-Nankervis JA, Hallinan CM, Zingoni P, Scattini L, Heald A, Tu K. Effect of the COVID-19 pandemic on mental health visits in primary care: an interrupted time series analysis from nine INTRePID countries. EClinicalMedicine 2024; 70:102533. [PMID: 38495523 PMCID: PMC10940140 DOI: 10.1016/j.eclinm.2024.102533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/19/2024] Open
Abstract
Background The COVID-19 pandemic impacted mental health disorders, affecting both individuals with pre-existing conditions and those with no prior history. However, there is limited evidence regarding the pandemic's impact on mental health visits to primary care physicians. The International Consortium of Primary Care Big Data Researchers (INTRePID) explored primary care visit trends related to mental health conditions in Argentina, Australia, Canada, China, Norway, Peru, Singapore, Sweden, and the USA. Methods We conducted an interrupted time series analysis in nine countries to examine changes in rates of monthly mental health visits to primary care settings from January 1st, 2018, to December 31st, 2021. Sub-group analysis considered service type (in-person/virtual) and six categories of mental health conditions (anxiety/depression, bipolar/schizophrenia/other psychotic disorders, sleep disorders, dementia, ADHD/eating disorders, and substance use disorder). Findings Mental health visit rates increased after the onset of the pandemic in most countries. In Argentina, Canada, China, Norway, Peru, and Singapore, this increase was immediate ranged from an incidence rate ratio of 1·118 [95% CI 1.053-1.187] to 2.240 [95% CI 2.057-2.439] when comparing the first month of pandemic with the pre-pandemic trend. Increases in the following months varied across countries. Anxiety/depression was the leading reason for mental health visits in most countries. Virtual visits were reported in Australia, Canada, Norway, Peru, Sweden, and the USA, accounting for up to 40% of the total mental health visits. Interpretation Findings suggest an overall increase in mental health visits, driven largely by anxiety/depression. During the COVID-19 pandemic, many of the studied countries adopted virtual care in particular for mental health visits. Primary care plays a crucial role in addressing mental ill-health in times of crisis. Funding Canadian Institutes of Health Research grant #173094 and the Rathlyn Foundation Primary Care EMR Research and Discovery Fund.
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Affiliation(s)
- Javier Silva-Valencia
- Center for Research in Primary Health Care (CINAPS), Universidad Peruana Cayetano Heredia, Peru
| | - Carla Lapadula
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Zheng Jye Ling
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lay Hoon Goh
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | - Knut-Arne Wensaas
- Research Unit for General Practice, NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Signe Flottorp
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Valborg Baste
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
| | - William Chi-Wai Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Amy Pui Pui Ng
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Angela Ortigoza
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jo-Anne Manski-Nankervis
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christine Mary Hallinan
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Paula Zingoni
- Ministry of Health of the Autonomous City of Buenos Aires, Buenos Aires, Argentina
| | - Luciano Scattini
- Ministry of Health of the Autonomous City of Buenos Aires, Buenos Aires, Argentina
| | - Adrian Heald
- School of Medical Sciences, Division of Diabetes, Endocrinology and Gastroenterology, University of Manchester, UK
| | - Karen Tu
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Departments of Research and Innovation and Family Medicine-North York General Hospital, Toronto Western Family Health Team-University Health Network, Toronto, Ontario, Canada
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Montero S, Maguiña JL, Soto-Becerra P, Failoc-Rojas VE, Chira-Sosa J, Apolaya-Segura M, Díaz-Vélez C, Tello-Vera S. Laboratory biomarkers associated with COVID-19 mortality among inpatients in a Peruvian referral hospital. Heliyon 2024; 10:e27251. [PMID: 38500972 PMCID: PMC10945112 DOI: 10.1016/j.heliyon.2024.e27251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 01/16/2024] [Accepted: 02/27/2024] [Indexed: 03/20/2024] Open
Abstract
Aim To evaluate the biochemical and hematological markers associated with the risk of death due to COVID-19 in a clinical cohort with a severe clinical profile. Methods A retrospective study was conducted among 215 anonymized inpatient records from the Hospital Nacional Almanzor Aguinaga Asenjo, Peru, between April and June 2020. The association between biomarkers and death due to COVID-19 was assessed using Cox regression, with a multivariable modeling of 1) biochemical and 2) hematological markers. Kaplan-Meier analyses and time-dependent receiver operating characteristic curves were calculated for each associated biomarker (p < 0.05). Results Data analysis of 215 inpatient records revealed an overall mortality rate of 51.30% (95% CI 44.70-58.50), a mean age of 63.90 ± 14.10 years, and a median oxygen saturation of 88% (interquartile range 82-92%). The best-fitted biochemical model included higher levels of C-reactive protein (CRP), D-dimer, fibrinogen, urea, and lactate dehydrogenase. Similarly, the best-fitted hematological model included higher absolute neutrophil and prothrombin time, and lower absolute platelet counts. The best area under the curve values in both models were found to be CRP and D-dimer values (>0.74) and the absolute neutrophil count (0.63). Conclusions Some specific biochemical markers outperformed hematological markers. Evaluated hematological counts analyzed in multivariable models proved to be better markers and could be useful to discriminate COVID-19 patients at high risk of death.
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Affiliation(s)
- Stephanie Montero
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, ESSALUD, Lima, 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
| | - Percy Soto-Becerra
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, ESSALUD, Lima, Peru
- Universidad Continental, Huancayo, Peru
| | - Virgilio E. Failoc-Rojas
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, ESSALUD, Lima, Peru
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Jorge Chira-Sosa
- Laboratorio de Biología Molecular, Citometría de flujo y Citogenética, Hospital Nacional Almanzor Aguinaga Asenjo, ESSALUD, Chiclayo, Peru
| | - Moisés Apolaya-Segura
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, ESSALUD, Lima, Peru
- Facultad de Medicina Humana, Universidad Privada Antenor Orrego, Trujillo, Peru
| | - Cristian Díaz-Vélez
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, ESSALUD, Lima, Peru
- Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru
| | - Stalin Tello-Vera
- Laboratorio de Biología Molecular, Citometría de flujo y Citogenética, Hospital Nacional Almanzor Aguinaga Asenjo, ESSALUD, Chiclayo, Peru
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Bravo-Zúñiga J, Chávez-Gómez R, Soto-Becerra P. Multicentre external validation of the prognostic model kidney failure risk equation in patients with CKD stages 3 and 4 in Peru: a retrospective cohort study. BMJ Open 2024; 14:e076217. [PMID: 38184316 PMCID: PMC10773413 DOI: 10.1136/bmjopen-2023-076217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/26/2023] [Indexed: 01/08/2024] Open
Abstract
OBJECTIVES To externally validate the four-variable kidney failure risk equation (KFRE) in the Peruvian population for predicting kidney failure at 2 and 5 years. DESIGN A retrospective cohort study. SETTING 17 primary care centres from the Health's Social Security of Peru. PARTICIPANTS Patients older than 18 years, diagnosed with chronic kidney disease stage 3a-3b-4 and 3b-4, between January 2013 and December 2017. Patients were followed until they developed kidney failure, died, were lost, or ended the study (31 December 2019), whichever came first. PRIMARY AND SECONDARY OUTCOME MEASURES Performance of the KFRE model was assessed based on discrimination and calibration measures considering the competing risk of death. RESULTS We included 7519 patients in stages 3a-4 and 2798 patients in stages 3b-4. The estimated cumulative incidence of kidney failure, accounting for competing event of death, at 2 years and 5 years, was 1.52% and 3.37% in stages 3a-4 and 3.15% and 6.86% in stages 3b-4. KFRE discrimination at 2 and 5 years was high, with time-dependent area under the curve and C-index >0.8 for all populations. Regarding calibration in-the-large, the observed to expected ratio and the calibration intercept indicated that KFRE underestimates the overall risk at 2 years and overestimates it at 5 years in all populations. CONCLUSIONS The four-variable KFRE models have good discrimination but poor calibration in the Peruvian population. The model underestimates the risk of kidney failure in the short term and overestimates it in the long term. Further research should focus on updating or recalibrating the KFRE model to better predict kidney failure in the Peruvian context before recommending its use in clinical practice.
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Affiliation(s)
- Jessica Bravo-Zúñiga
- Instituto de Evaluación de Tecnologías en Salud e Investigación-IETSI, ESSALUD, Lima, Peru
- Departamento de Nefrología, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ricardo Chávez-Gómez
- Departamento de Nefrología, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
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Villar-López M, Soto-Becerra P, Chedraui P, Osorio-Manyari JD, Al-Kassab-Córdova A, Osorio-Manyari AA, Fernandez-Sosaya JL, Moya-Silvestre E, Rojas PA, Lugo-Martínez G, Mezones-Holguín E. Short-term effects and safety of a natural oral supplement containing glucosinolates, phytosterols, and citrus flavonoids compared with hormone treatment for the management of postmenopausal symptomatic women: a pilot single-center randomized phase 2 clinical trial. Menopause 2023; 30:1230-1240. [PMID: 37874969 DOI: 10.1097/gme.0000000000002268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
OBJECTIVE This study aimed to evaluate the short-term efficacy and safety of an oral herbal supplement containing glucosinolates, phytosterols, and citrus flavonoids for menopausal symptoms in comparison with estrogen plus progestogen therapy (EPT) among postmenopausal women. METHODS This was a pilot single-blinded, three-armed phase II randomized clinical trial, controlled with EPT. Sixty participants were randomly assigned to receive treatment for 3 months: (1) an oral herbal supplement of 1,500 mg/d (G1, n = 20), (2) an oral herbal supplement of 3,000 mg/d (G2, n = 20), or (3) conjugated equine estrogens 0.625 mg/d plus medroxyprogesterone acetate of 5 mg/d (EPT group, n = 20). The primary endpoint was the intensity of menopausal symptoms as measured using the Menopause-Specific Quality of Life Questionnaire (global and domain scores). The Menopause-Specific Quality of Life Questionnaire uses a 7-point scale to rate the symptom intensity, with higher scores indicating severity. The secondary endpoints were hormonal, lipid, and safety profiles. RESULTS Fifty-four participants (n = 54) completed the study. The mean, model-estimated, and global menopausal symptom scores at 3 months were 85.8 in the EPT group, 61.3 in G1, and 62.5 in G2. Participants treated with the herbal compound had lower global (13.7 [6.9-20.4], P < 0.001) and physical symptom scores (6.6 [1.6-11.5], P = 0.002) on the second month and lower psychosocial symptom scores (3.8 [1.3 to 6.3], P < 0.001) on the third month of follow-up, compared with EPT. Conversely, participants receiving EPT showed better outcomes on vasomotor symptoms since the first month of treatment (-6.1 [-8.3 to -4.0], P < 0.001). The EPT group exhibited higher values of estradiol and lower follicle-stimulating hormone and luteinizing hormone since the first month of follow-up. Also, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were significantly higher in this group than in G2. CONCLUSIONS In this small single-blind exploratory trial, the oral herbal supplement was more efficacious in reducing global, physical, and psychosocial menopausal symptoms in the short term than EPT. However, further studies are needed to adequately assess the efficacy and safety of this herbal supplement in the treatment of menopausal symptoms.
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Affiliation(s)
| | | | - Peter Chedraui
- Escuela de Posgrado en Salud, Universidad Espíritu Santo, Samborondón, Ecuador
| | | | - Ali Al-Kassab-Córdova
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Perú
| | | | | | | | - Percy A Rojas
- Universidad Peruana Cayetano Heredia, Laboratorios de Investigación y Desarrollo, Unidad de Biotecnología Molecular, Lima, Perú
| | - Gabriela Lugo-Martínez
- Instituto Politécnico Nacional, Escuela Superior de Medicina, Sección de Estudios de Posgrado e Investigación, Ciudad de México, México
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Culquichicón C, Zapata-Castro LE, Soto-Becerra P, Silva-Santisteban A, Konda KA, Lescano AG. Contributing factors for self-reported HIV in male Peruvian inmates: results of the 2016 prison census. Front Public Health 2023; 11:1241042. [PMID: 37818296 PMCID: PMC10560882 DOI: 10.3389/fpubh.2023.1241042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/04/2023] [Indexed: 10/12/2023] Open
Abstract
Introduction Worldwide, prisons are high-risk settings for the transmission of infectious diseases such as HIV. There is a need to understand the health conditions of prisoners to improve and implement timely strategies for HIV diagnosis and control. Hence, we aimed to identify factors associated with self-reported HIV (srHIV) among Peruvian inmates. Methods This study is a secondary data analysis of the First Peruvian Prison Census conducted in 2016. We estimated the prevalence of srHIV in prisoners who were male at birth and the association of srHIV with other social conditions, criminal records, and prevalent health conditions. Nested models identified a multivariable parsimonious model for factors associated with srHIV and yielding prevalence ratios adjusted by the included parameters. Results The census surveyed 71,087 male inmates of whom 0.4% reported srHIV (n = 305), and 82% of whom were receiving antiretroviral treatment (n = 220). In our final multivariable model, srHIV was independently associated with age between 36 and 55 years old vs. >55 years old [parsimonious prevalence ratio (pPR) = 1.98, 95% CI, 0.96-4.08], having a stable partner out of prison (pPR = 1.64, 95% CI, 1.24-2.19), being homosexual (pPR = 4.16, 95% CI, 2.50-6.90), self-report of prevalent tuberculosis co-infection (pPR = 2.55, 95% CI, 1.82-3.58), self-report of prevalent sexually transmitted infections (pPR = 34.49, 95% CI, 24.94-47.70), and self-report of prevalent illicit drug use 30 days before the survey (pPR = 1.91, 95% CI, 1.43-2.56). Conclusion Self-reported HIV is associated with multiple social, health and prison risks among Peruvian inmates. Deeply understanding these factors would help to design HIV prevention and control strategies in Peruvian prisons.
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Affiliation(s)
- Carlos Culquichicón
- CI-Emerge, Center of Emerging Diseases and Climate Change Research, Universidad Nacional de Piura, Piura, Peru
- School of Health Sciences, Universidad Nacional de Piura, Piura, Peru
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luis E. Zapata-Castro
- CI-Emerge, Center of Emerging Diseases and Climate Change Research, Universidad Nacional de Piura, Piura, Peru
- School of Health Sciences, Universidad Nacional de Piura, Piura, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Piura, Piura, Peru
| | - Percy Soto-Becerra
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Alfonso Silva-Santisteban
- Center for Interdisciplinary Studies in Sexuality, AIDS and Society, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Kelika A. Konda
- Center for Interdisciplinary Studies in Sexuality, AIDS and Society, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States
| | - Andrés G. Lescano
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
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Villarreal-Zegarra D, Reátegui-Rivera CM, Otazú-Alfaro S, Yantas-Alcantara G, Soto-Becerra P, Melendez-Torres GJ. Estimated impact of the COVID-19 pandemic on the prevalence and treatment of depressive symptoms in Peru: an interrupted time series analysis in 2014-2021. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1375-1385. [PMID: 36884090 PMCID: PMC9993377 DOI: 10.1007/s00127-023-02446-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
PURPOSE The COVID-19 pandemic increased the burden of mental disorders worldwide. Peru has been one of the countries most affected by COVID-19, however, studies evaluating the medium and long-term consequences of the pandemic on Peruvians' mental health are recent and represent a new field of study in proliferation. We aimed to estimate the impact of the COVID-19 pandemic on the prevalence and treatment of depressive symptoms using nationally representative surveys in Peru. METHODS Our study is an analysis of secondary data. We carried out a time series cross-sectional analysis based on the National Demographic and Health Survey of Peru, collected using a complex sampling design. The Patient Health Questionnaire-9 was used to measure mild (5-9 points), moderate (10-14 points), and severe (15 points or more) depressive symptoms. The participants were men and women aged 15 years and older, living in urban and rural areas of all regions of Peru. The main statistical analysis used segmented regression with Newey-West standard errors, taking into account that each year of the evaluation was divided into four measures (quarter measure). RESULTS We included 259,516 participants. An average quarterly increase of 0.17% (95% CI 0.03-0.32%) in the prevalence of moderate depressive symptoms was identified after the onset of the COVID-19 pandemic (approximately an increase of 1583 new cases of moderate depressive symptoms by each quarter). The percentage of cases treated for mild depressive symptoms increased quarterly by an average of 0.46% (95% CI 0.20-0.71%) after the onset of the COVID-19 pandemic (approximately an increase of 1242 new cases treated for mild depressive symptoms by each quarter). CONCLUSION In Peru, increases in the prevalence of moderate depressive symptoms and the proportion of cases treated with mild depressive symptoms were found after the COVID-19 pandemic. Therefore, this study is a precedent for future research assessing the prevalence of depressive symptoms and the proportion of cases receiving treatment during the pandemic and post-pandemic years.
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Affiliation(s)
- David Villarreal-Zegarra
- Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru
- Instituto Peruano de Orientación Psicológica, Lima, Peru
| | - C. Mahony Reátegui-Rivera
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Unidad de Telesalud, Universidad Nacional Mayor de San Marcos, Lima, Peru
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Montero S, Urrunaga-Pastor D, Soto-Becerra P, Cvetkovic-Vega A, Guillermo-Roman M, Figueroa-Montes L, Sagástegui AA, Alvizuri-Pastor S, Contreras-Macazana RM, Apolaya-Segura M, Díaz-Vélez C, Maguiña JL. Humoral response after a BNT162b2 heterologous third dose of COVID-19 vaccine following two doses of BBIBP-CorV among healthcare personnel in Peru. Vaccine X 2023; 14:100311. [PMID: 37207103 PMCID: PMC10162476 DOI: 10.1016/j.jvacx.2023.100311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/14/2023] [Accepted: 04/30/2023] [Indexed: 05/21/2023] Open
Abstract
Background The inactivated virus vaccine, BBIBP-CorV, was principally distributed across low- and middle-income countries as primary vaccination strategy to prevent poor COVID-19 outcomes. Limited information is available regarding its effect on heterologous boosting. We aim to evaluate the immunogenicity and reactogenicity of a third booster dose of BNT162b2 following a double BBIBP-CorV regime. Methods We conducted a cross-sectional study among healthcare providers from several healthcare facilities of the Seguro Social de Salud del Perú - ESSALUD. We included participants two-dose BBIBP-CorV vaccinated who presented a three-dose vaccination card at least 21 days passed since the vaccinees received their third dose and were willing to provide written informed consent. Antibodies were determined using LIAISON® SARS-CoV-2 TrimericS IgG (DiaSorin Inc., Stillwater, USA). Factors potentially associated with immunogenicity, and adverse events, were considered. We used a multivariable fractional polynomial modeling approach to estimate the association between anti-SARS-CoV-2 IgG antibodies' geometric mean (GM) ratios and related predictors. Results We included 595 subjects receiving a third dose with a median (IQR) age of 46 [37], [54], from which 40% reported previous SARS-CoV-2 infection. The overall geometric mean (IQR) of anti-SARS-CoV-2 IgG antibodies was 8,410 (5,115 - 13,000) BAU/mL. Prior SARS-CoV-2 history and full/part-time in-person working modality were significantly associated with greater GM. Conversely, time from boosting to IgG measure was associated with lower GM levels. We found 81% of reactogenicity in the study population; younger age and being a nurse were associated with a lower incidence of adverse events. Conclusions Among healthcare providers, a booster dose of BNT162b2 following a full BBIBP-CorV regime provided high humoral immune protection. Thus, SARS-CoV-2 previous exposure and working in person displayed as determinants that increase anti-SARS-CoV-2 IgG antibodies.
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Affiliation(s)
- Stephanie Montero
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, ESSALUD, Lima, Peru
| | - Diego Urrunaga-Pastor
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, ESSALUD, Lima, Peru
- Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola (USIL), Lima, Peru
| | - Percy Soto-Becerra
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, ESSALUD, Lima, Peru
- Universidad Continental, Huancayo, Perú
| | - Aleksandar Cvetkovic-Vega
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, ESSALUD, Lima, Peru
- Facultad de Medicina Humana, Universidad Privada Antenor Orrego, Trujillo, Peru
| | - Martina Guillermo-Roman
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, ESSALUD, Lima, Peru
| | | | | | | | | | - Moisés Apolaya-Segura
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, ESSALUD, Lima, Peru
- Facultad de Medicina Humana, Universidad Privada Antenor Orrego, Trujillo, Peru
| | - Cristian Díaz-Vélez
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, ESSALUD, Lima, Peru
- Facultad de Medicina Humana, Universidad Privada Antenor Orrego, Trujillo, 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
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Silva-Valencia J, Soto-Becerra P, Escobar-Agreda S, Fernandez-Navarro M, Moscoso-Porras M, Solari L, Mayta-Tristán P. Effectiveness of the BBIBP-CorV vaccine in preventing infection and death in health care workers in Peru 2021. Travel Med Infect Dis 2023; 53:102565. [PMID: 36933851 PMCID: PMC10019038 DOI: 10.1016/j.tmaid.2023.102565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/03/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND During 2021, Peru started the vaccination against SARS-CoV-2 using the BBIBP-CorV inactivated virus vaccine for health care workers (HCW). We aim to evaluate the effectiveness of the BBIBP-CorV vaccine to prevent SARS-CoV-2 infection and deaths among HCWs. METHODS Retrospective cohort study, from February 9 to June 30, 2021, using national registries of health care workers, laboratory tests for SARS-CoV-2 and deaths. We calculated the vaccine effectiveness for preventing laboratory-confirmed SARS-CoV-2 infection, COVID-19-mortality, and all-cause mortality among partially immunized and fully immunized HCWs. An extension of Cox proportional hazards regression was used to model the mortality results, and Poisson regression was used to model SARS-CoV-2 infection. RESULTS The study included 606,772 eligible HCWs, the mean age was 40 (IQR: 33.0, 51.0). In fully immunized HCW, the effectiveness for preventing all-cause mortality was 83.6 (95% CI: 80.2 to 86.4), 88.7 (95% CI: 85.1 to 91.4) for preventing COVID-19 mortality, and 40.3 (95% CI 38.9 to 41.6) for preventing SARS-CoV-2 infection. CONCLUSION The BBIBP-CorV vaccine showed high levels of effectiveness for preventing all-cause and COVID-19 deaths among fully immunized HCW. These results were consistent within different subgroups and sensitivity analyses. However, the effectiveness for preventing infection was suboptimal in this particular setting.
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Affiliation(s)
| | - Percy Soto-Becerra
- Universidad Continental, Av San Carlos 1980, Huancayo, 12000, Peru; Seguro Social en Salud (EsSalud), Instituto de Evaluación de Tecnologías Sanitarias e Investigación - IETSI, EsSalud, Domingo Cueto 109, Jesus Maria, Lima, Peru
| | | | | | - Miguel Moscoso-Porras
- Instituto Nacional de Salud (INS), Jr. Capac Yupanqui 1400, Jesus Maria, Lima, Peru; Universidad Continental, Av San Carlos 1980, Huancayo, 12000, Peru
| | - Lely Solari
- Instituto Nacional de Salud (INS), Jr. Capac Yupanqui 1400, Jesus Maria, Lima, Peru.
| | - Percy Mayta-Tristán
- Universidad Científica del Sur, Dirección General de Investigación, Desarrollo e Innovación, Antigua panamericana Sur Km19, Lima, Peru
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9
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Leyva EO, Bockos IF, Vela Barba CL, Aldazabal DA, Vitorino CE, García-Mostajo JA, Atauje HV, Rojas-Cama LF, Soto-Becerra P. Pain prevalence and chronicity in a developing country in Latin America: a population-based survey in Lima, Peru. Pain Manag 2023; 13:45-59. [PMID: 36264070 DOI: 10.2217/pmt-2022-0061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background: No population-based epidemiological studies have estimated pain prevalence and its characteristics in Peru. Patients & methods: A representative sample of adults aged over 18 years (n = 502) living in metropolitan Lima, Peru was enrolled. We analyzed prevalence data of pain in the last 3 months and other pain-related characteristics. Results: Pain prevalence was 65.3% (95% CI: 57.7-70.4%). Chronic pain prevalence was 38.5% (95% CI: 33.5-44.0%) and acute pain prevalence was 24.8% (95% CI: 20.7-29.0%). In participants with chronic pain, almost half (55.7%) reported having not used any medication. Conclusion: Pain is prevalent in this population and our results suggest high undertreatment rates.
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Affiliation(s)
| | - Ian Falvy Bockos
- Asociación Peruana para el Estudio del Dolor, Lima, Perú.,Hospital Central de la Fuerza Aérea del Perú, Lima, Perú
| | - Carlos L Vela Barba
- Asociación Peruana para el Estudio del Dolor, Lima, Perú.,Hospital Central de la Fuerza Aérea del Perú, Lima, Perú
| | - Daniel Arbaiza Aldazabal
- Asociación Peruana para el Estudio del Dolor, Lima, Perú.,Instituto Nacional de Enfermedades Neoplásicas - INEN, Lima, Perú
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10
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Cvetkovic-Vega A, Urrunaga-Pastor D, Soto-Becerra P, Figueroa-Montes LE, Fernandez-Bolivar L, Alvizuri-Pastor S, Oyanguren-Miranda M, Neyra-Vera I, Carrillo-Ramos E, Sagástegui A, Contreras-Macazana R, Lecca-Rengifo D, Grande-Castro N, Apolaya-Segura M, Maguina JL. Post-vaccination seropositivity against SARS-CoV-2 in peruvian health workers vaccinated with BBIBP-CorV (Sinopharm). Travel Med Infect Dis 2022; 52:102514. [PMID: 36462747 PMCID: PMC9710108 DOI: 10.1016/j.tmaid.2022.102514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/23/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To estimate the prevalence of post-vaccination seropositivity against SARS-CoV-2 and identify its predictors in Peruvian Social Health Insurance (EsSalud) personnel in 2021. METHODS We conducted a cross-sectional study in a representative simple stratified sample of EsSalud workers. We evaluated IgG anti-SARS-CoV-2 antibodies response (seropositivity) by passive (previous infection) and active immunization (vaccination), and epidemiological and occupational variables obtained by direct interview and a data collection form. Descriptive and inferential statistics were used with correction of sample weights adjusted for non-response rate, and crude and adjusted odds ratio (OR) and geometric mean ratio (GMR) with their respective 95% confidence intervals (95%CI) were estimated. RESULTS We enrolled 1077 subjects. Seropositivity was 67.4% (95%CI: 63.4-71.1). Predictors of seropositivity were age (negative relation; p < 0.001), previous infection (aOR = 11.7; 95%CI: 7.81-17.5), working in COVID-19 area (aOR = 1.47; 95%CI: 1.02-2.11) and time since the second dose. In relation to antibody levels measured by geometric means, there was an association between male sex (aGMR = 0.77; 95%CI: 0.74-0.80), age (negative relation; p < 0.001), previous infection (aGMR = 13.1; 95%CI:4.99-34.40), non-face-to-face/licensed work modality (aGMR = 0.78; 95%CI: 0.73-0.84), being a nursing technician (aGMR = 1.30; 95%CI: 1.20-1.41), working in administrative areas (aGMR = 1.17; 95%CI: 1.10-1.25), diagnostic support (aGMR = 1.07; 95%CI: 1.01-1.15), critical care (aGMR = 0.85; 95%CI: 0.79-0.93), and in a COVID-19 area (aGMR = 1.30; 95%CI: 1.24-1.36) and time since receiving the second dose (negative relation; p < 0.001). CONCLUSIONS Seropositivity and antibody levels decrease as the time since receiving the second dose increases. Older age and no history of previous infection were associated with lower seropositivity and antibody values. These findings may be useful for sentinel antibody surveillance and the design of booster dose strategies.
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Affiliation(s)
| | - Diego Urrunaga-Pastor
- 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
| | - Percy Soto-Becerra
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima, Peru; Universidad Continental, Huancayo, Peru
| | | | - Lizette Fernandez-Bolivar
- Departamento de Patología Clínica, Servicio de Inmunología y Bioquímica, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Peru
| | - Sergio Alvizuri-Pastor
- Unidad de Inmunología Especializada, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - Martin Oyanguren-Miranda
- Unidad de Cuidados Intensivos, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Peru
| | - Ibeth Neyra-Vera
- Departamento de Patología Clínica, Servicio de Inmunología y Bioquímica, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Peru
| | - Elizabeth Carrillo-Ramos
- Departamento de Patología Clínica, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Peru
| | - Arturo Sagástegui
- Departamento de Patología Clínica, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Peru
| | - Roxana Contreras-Macazana
- Departamento de Patología Clínica, Servicio de Bioquímica e Inmunoquímica, Hospital Nacional Alberto Sabogal Sologuren, EsSalud, Lima, Peru
| | - Diana Lecca-Rengifo
- Subgerencia de Proyectos Especiales, Gerencia de Oferta Flexible, EsSalud, Lima, Peru
| | - Nikolai Grande-Castro
- Departamento de Patología Clínica, Unidad de Inmuno-diagnóstico, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - Moises Apolaya-Segura
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima, Peru
| | - Jorge L Maguina
- Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima, Peru.
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11
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Silva-Valencia J, Soto-Becerra P, Escobar-Agreda S, Fernandez-Navarro M, Elorreaga OA, Mayta-Tristán P, Mezones-Holguin E, Solari L. Relative vaccine effectiveness of the booster dose of COVID-19 vaccine for preventing death in individuals with a primary regimen based on the BBIBP-CorV, ChAdOx1-S, or BNT162b2 vaccines during the Omicron wave in Peru: A nested case-control study using national population data. Vaccine 2022; 40:6512-6519. [PMID: 36202642 PMCID: PMC9515342 DOI: 10.1016/j.vaccine.2022.09.066] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/07/2022] [Accepted: 09/22/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Studies have reported evidence about the effectiveness of a third dose with BNT162b2 for preventing hospitalization and death by COVID-19. However, there is little evidence regarding other primary vaccine schedules such as BBIBP-CorV and ChAdOx1-S. We estimated the relative vaccine effectiveness (RVE) of the booster dose versus the primary regimens of COVID-19 vaccines based on BBIBP-CorV, ChAdOx1-S, or BNT162b2 for preventing death during the Omicron wave in Peruvian adult people. METHODS We carried out a nested case-control study with a risk set sampling of controls using data from Peru between December 20, 2021, and February 20, 2022 (during the Omicron wave). Data on vaccination, COVID-19 tests and deaths were collected from national surveillance databases. We performed conditional logistic regression models to estimate the RVE on the adult population. In addition, we executed sub-group analysis per age group (18 to 59 years, and 60 years or more) and per primary regime (based on BNT162b2, BBIBP-CorV, or ChAdOx1-S). RESULTS Of the 11,188,332 people eligible to enter the study 1,974 met the case definition (death from COVID-19) and were matched to 9,183 controls. The overall RVE of a third dose to prevent death was 87.2% (84.2%-89.7%), which varied according to the primary regime (87.3% for BNT162b2, 82.0% for BBIPB-CorV-2, and 79.5% for ChAdOx-S). In older adults, the RVE was 87.1%, without significant variations according to the primary regime (86.1% for BNT162b2, 86.1 for BBIBP-CorV, and 82% for ChAdOx-S). CONCLUSIONS The booster) dose of vaccine against COVID-19 had a high RVE for preventing death by COVID-19 in the Peruvian population in all primary regimes of vaccines during the Omicron wave. This effect was consistent in people over 60 years of age, the group most vulnerable to die from this infection.
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Affiliation(s)
| | - Percy Soto-Becerra
- Instituto de Evaluación de Tecnologías Sanitarias e Investigación - IETSI, EsSalud, Lima, Peru,Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | | | | | - Oliver A. Elorreaga
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Percy Mayta-Tristán
- Dirección General de Investigación, Desarrollo e Innovación, Universidad Científica del Sur, Lima, Peru
| | - Edward Mezones-Holguin
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Lely Solari
- Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Peru,Corresponding author
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12
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Vargas-Herrera N, Fernández-Navarro M, Cabezudo NE, Soto-Becerra P, Solís-Sánchez G, Escobar-Agreda S, Silva-Valencia J, Pampa-Espinoza L, Bado-Pérez R, Solari L, Araujo-Castillo RV. Immunogenicity and reactogenicity of a third dose of BNT162b2 vaccine for COVID-19 after a primary regimen with BBIBP-CorV or BNT162b2 vaccines in Lima, Peru. PLoS One 2022; 17:e0268419. [PMID: 36251630 PMCID: PMC9576087 DOI: 10.1371/journal.pone.0268419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 09/25/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The administration of a third (booster) dose of COVID-19 vaccines in Peru initially employed the BNT162b2 (Pfizer) mRNA vaccine. The national vaccination program started with healthcare workers (HCW) who received BBIBP-CorV (Sinopharm) vaccine as primary regimen and elderly people previously immunized with BNT162b2. This study evaluated the reactogenicity and immunogenicity of the "booster" dose in these two groups in Lima, Peru. METHODS We conducted a prospective cohort study, recruiting participants from November to December of 2021 in Lima, Peru. We evaluated immunogenicity and reactogenicity in HCW and elderly patients previously vaccinated with either two doses of BBIBP-CorV (heterologous regimen) or BTN162b2 (homologous regimen). Immunogenicity was measured by anti-SARS-CoV-2 IgG antibody levels immediately before boosting dose and 14 days later. IgG geometric means (GM) and medians were obtained, and modeled using ANCOVA and quantile regressions. RESULTS The GM of IgG levels increased significantly after boosting: from 28.5±5.0 AU/mL up to 486.6±1.2 AU/mL (p<0.001) which corresponds to a 17-fold increase. The heterologous vaccine regimen produced higher GM of post-booster anti-SARS-CoV-2 IgG levels, eliciting a 13% increase in the geometric mean ratio (95%CI: 1.02-1.27) and a median difference of 92.3 AU/ml (95%CI: 24.9-159.7). Both vaccine regimens were safe and well tolerated. Previous COVID-19 infection was also associated with higher pre and post-booster IgG GM levels. CONCLUSION Although both boosting regimens were highly immunogenic, two doses of BBIBP-CorV boosted with BTN162b2 produced a stronger IgG antibody response than the homologous BNT162b2 regimen in the Peruvian population. Additionally, both regimens were mildly reactogenic and well-tolerated.
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Affiliation(s)
| | | | - Nestor E. Cabezudo
- Measles and Rubella National Reference Laboratory, Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Peru
| | - Percy Soto-Becerra
- Instituto de Evaluación de Tecnologías en Salud e Investigación (IETSI), Seguro Social de Salud del Peru (ESSALUD), Lima, Peru
| | - Gilmer Solís-Sánchez
- Oficina General de Investigación y Transferencia Tecnológica, Instituto Nacional de Salud, Lima, Peru
| | | | | | | | - Ricardo Bado-Pérez
- Centro Nacional de Epidemiología, Prevención y Control de Enfermedades, Ministerio de Salud – Perú, Lima, Peru
| | - Lely Solari
- Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Peru
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13
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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14
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Bustos JA, Arroyo G, Gilman RH, Soto-Becerra P, Gonzales I, Saavedra H, Pretell EJ, Nash TE, O’Neal SE, Del Brutto OH, Gonzalez AE, Garcia HH. Frequency and Determinant Factors for Calcification in Neurocysticercosis. Clin Infect Dis 2021; 73:e2592-e2600. [PMID: 32556276 PMCID: PMC8563199 DOI: 10.1093/cid/ciaa784] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/11/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Neurocysticercosis is a major cause of acquired epilepsy. Larval cysts in the human brain eventually resolve and either disappear or leave a calcification that is associated with seizures. In this study, we assessed the proportion of calcification in parenchymal neurocysticercosis and risk factors associated with calcification. METHODS Data for 220 patients with parenchymal NCC from 3 trials of antiparasitic treatment were assessed to determine what proportion of the cysts that resolved 6 months after treatment ended up in a residual calcification at 1 year. Also, we evaluated the risk factors associated with calcification. RESULTS The overall proportion of calcification was 38% (188/497 cysts, from 147 patients). Predictors for calcification at the cyst level were cysts larger than 14 mm (risk ratio [RR], 1.34; 95% confidence interval [CI], 1.02-1.75) and cysts with edema at baseline (RR, 1.39; 95% CI, 1.05-1.85). At the patient level, having had more than 24 months with seizures (RR, 1.25; 95% CI, 1.08-1.46), mild antibody response (RR, 1.14; 95% CI, 1.002-1.27), increased dose albendazole regime (RR, 1.26; 95% CI, 1.14-1.39), lower doses of dexamethasone (RR, 1.36; 95% CI, 1.02-1.81), not receiving early antiparasitic retreatment (RR, 1.45; 95% CI, 1.08-1.93), or complete cure (RR, 1.48; 95% CI, 1.29-1.71) were associated with a increased risk of calcification. CONCLUSIONS Approximately 38% of parenchymal cysts calcify after antiparasitic treatment. Some factors associated with calcification are modifiable and may be considered to decrease or avoid calcification, potentially decreasing the risk for seizure relapses.
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Affiliation(s)
- Javier A Bustos
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
- Center for Global Health, School of Public Health and Management, and School of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Gianfranco Arroyo
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
- Center for Global Health, School of Public Health and Management, and School of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Robert H Gilman
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Percy Soto-Becerra
- Center for Global Health, School of Public Health and Management, and School of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Isidro Gonzales
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
| | - Herbert Saavedra
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
| | - E Javier Pretell
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
- Department of Neurology, Hospital Alberto Sabogal, Callao, Perú
| | - Theodore E Nash
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Seth E O’Neal
- Center for Global Health, School of Public Health and Management, and School of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Perú
- School of Public Health, Oregon Health and Science University and Portland State University, Portland, Oregon, USA
| | - Oscar H Del Brutto
- School of Medicine, Universidad Espíritu Santo–Ecuador, Samborondón, Ecuador
| | - Armando E Gonzalez
- Center for Global Health, School of Public Health and Management, and School of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Hector H Garcia
- Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
- Center for Global Health, School of Public Health and Management, and School of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Perú
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15
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Villar-López M, Soto-Becerra P, Curse Choque R, Al-Kassab-Córdova A, Bernuy-Barrera F, Palomino H, Rojas PA, Vera C, Lugo-Martínez G, Mezones-Holguín E. Safety and tolerability of a natural supplement containing glucosinolates, phytosterols and citrus flavonoids in adult women: a randomized phase I, placebo-controlled, multi-arm, double-blinded clinical trial. Gynecol Endocrinol 2021; 37:906-913. [PMID: 34379025 DOI: 10.1080/09513590.2021.1960965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To evaluate the safety and tolerability of an oral herbal supplement containing glucosinolates, phytosterols, and citrus flavonoids (Warmi®, Lima Perú;) in otherwise healthy adult women. METHODS This was a phase-I, randomized parallel three arms, double-blinded, and a placebo-controlled clinical trial. A total of 55 participants aged 18-40 were randomly assigned to one of three groups to receive for three months: (1) an oral herbal supplement of 1650 mg/day; (2) an oral herbal supplement of 3300 mg/day; or (3) an oral placebo 3300 mg/day. The primary endpoints were oral safety and tolerability of the supplement. The secondary endpoint was its effect on vital functions, anthropometrics, and laboratory tests. We used an exploratory approach by covariance analysis (ANCOVA) adjusted for the variables' baseline value for the secondary outcomes. RESULTS All women completed three months of follow-up, reporting no side effects. Our exploratory analysis revealed that treatment with the herbal supplement of 1650 mg/day was associated with increased glucose and uric acid levels. In comparison, the herbal supplement 3300 mg/day was associated with reduced breathing rate, increased basal temperature, and systolic blood pressure, both compared to the placebo group. However, despite significant differences, none of these was clinically significant. CONCLUSION The oral herbal supplement had a favorable safety and tolerability profile in studied women. There is a need to study its potential as an option to treat menopausal symptoms.
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Affiliation(s)
- Martha Villar-López
- Universidad Nacional Mayor de San Marcos, Facultad de Medicina "San Fernando", Departamento de Medicina Preventiva y Salud Pública, Lima, Perú
| | - Percy Soto-Becerra
- Universidad San Ignacio de Loyola, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Lima, Perú
- Epi-gnosis Solutions, Piura, Perú
| | - Ruth Curse Choque
- Hospital Carlos Alcántara Butterfield, Servicio de Pediatría, Lima, Perú
| | - Ali Al-Kassab-Córdova
- Universidad Peruana de Ciencias Aplicadas, Facultad de Ciencias de la Salud, Lima, Perú
| | - Félix Bernuy-Barrera
- Universidad Nacional Federico Villarreal, Facultad de Medicina Hipólito Unanue, Lima, Perú
| | - Henry Palomino
- Hospital Nacional Edgardo Rebagliati Martins, Departamento de Obstetricia y Ginecología, Lima, Perú
| | - Percy A Rojas
- Universidad Peruana Cayetano Heredia, Laboratorios de Investigación y Desarrollo, Unidad de Biotecnología Molecular, Lima, Perú
| | - Carmela Vera
- Hospital Nacional Edgardo Rebagliati Martins Lima, Servicio de Psicología, Perú
| | - Gabriela Lugo-Martínez
- Instituto Politécnico Nacional, Escuela Superior de Medicina, Sección de Estudios de Posgrado e Investigación, Ciudad de México, México
| | - Edward Mezones-Holguín
- Universidad San Ignacio de Loyola, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Lima, Perú
- Epi-gnosis Solutions, Piura, Perú
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16
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Paredes-Noguni SR, Castro-Uriol DA, Salas-Rojas RM, Soto-Becerra P, Beltrán-Gárate BE. [Teleconsultations in oncology: experience in a hospital in Peru during the pandemic]. Rev Peru Med Exp Salud Publica 2021; 38:178-179. [PMID: 34190913 DOI: 10.17843/rpmesp.2021.381.6237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/23/2020] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sally Rose Paredes-Noguni
- Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú.,Centro de Medicina de Precisión, Universidad San Martin de Porres, Lima, Perú
| | - Denisse Angélica Castro-Uriol
- Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú.,Centro de Medicina de Precisión, Universidad San Martin de Porres, Lima, Perú
| | | | - Percy Soto-Becerra
- 3 Instituto de Evaluación de Tecnologías en Salud e Investigación (IETSI), Lima, Perú
| | - Brady Ernesto Beltrán-Gárate
- Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú.,Centro de Medicina de Precisión, Universidad San Martin de Porres, Lima, Perú
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17
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Lincango-Naranjo E, Espinoza-Suarez N, Solis-Pazmino P, Vinueza-Moreano P, Rodriguez-Villafuerte S, Lincango-Naranjo J, Barberis-Barcia G, Ruiz-Sosa C, Rojas-Velasco G, Gravholt D, Golembiewski E, Soto-Becerra P, Khan M, Ortiz-Prado E. Paradigms about the COVID-19 pandemic: knowledge, attitudes and practices from medical students. BMC Med Educ 2021; 21:128. [PMID: 33627116 PMCID: PMC7903404 DOI: 10.1186/s12909-021-02559-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/27/2021] [Indexed: 05/03/2023]
Abstract
BACKGROUND As the disease caused by the novel coronavirus has spread globally, there has been significant economic instability in the healthcare systems. This reality was especially accentuated in Ecuador where, the shortage of healthcare workers combined with cultural and macroeconomic factors has led Ecuador to face the most aggressive outbreak in Latin America. In this context, the participation of final-year medical students on the front line is indispensable. Appropriate training on COVID-19 is an urgent requirement that universities and health systems must guarantee. We aimed to describe the knowledge, attitudes, and practices of Ecuadorian final-year medical students that could potentially guide the design of better medical education curricula regarding COVID-19. METHODS This was a cross-sectional 33-item online survey conducted between April 6 to April 2020 assessing the knowledge, attitudes, and practices toward the diagnosis, treatment, prevention, and prognosis toward COVID-19 in Ecuadorian final-year medical students. It was sent by email, Facebook, and WhatsApp. RESULTS A total of 309 students responded to the survey. Out of which 88% of students scored high (≥ 70% correct) for knowledge of the disease. The majority of students were pessimistic about possible government actions, which is reflected in the negative attitude towards the control of COVID-19 and volunteering during the outbreak in Ecuador (77%, and 58% of the students, respectively). Moreover, 91% of students said they did not have adequate protective equipment. The latter finding was significantly associated with negative attitudes. CONCLUSIONS Although a large number of students displayed negative attitudes, the non-depreciable percentage of students who were willing to volunteer and the coexisting high level of knowledge displayed by students, suggests that Ecuador has a capable upcoming workforce that could benefit from an opportunity to strengthen, improve and advance their training in preparation for COVID-19. Not having personal protective equipment was significantly associated to negative attitudes. Providing the necessary tools and creating a national curriculum may be one of the most effective ways to ensure all students are trained, whilst simultaneously focusing on the students' most pressing concerns. With this additional training, negative attitudes will improve and students will be better qualified.
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Affiliation(s)
- Eddy Lincango-Naranjo
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | | | - Paola Solis-Pazmino
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, CA, USA
| | | | - Santiago Rodriguez-Villafuerte
- Facultad de Medicina, Programa de Pós-graduação em Hepatología, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
- Hospital Vozandes Quito, Quito, Ecuador
| | | | | | - Carlos Ruiz-Sosa
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Giovanni Rojas-Velasco
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
- Universidad de Sao Paulo, Sao Paulo, Brazil
| | - Derek Gravholt
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Maryam Khan
- Centro de Excelencia en Investigaciones Económicas y Sociales de Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Esteban Ortiz-Prado
- University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- OneHealth Global Research Group, Universidad de las Americas, Ecuador Calle de los Colimes y Avenida De los Granados, 170137, Quito, Ecuador.
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18
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Valdivia M, Soto-Becerra P, Laguna-Barraza R, Rojas PA, Reyes-Mandujano I, Gonzáles-Reyes P, Temoche H, Timoteo OS, Lugo-Martinez G, Calzada-Mendoza CC, Mezones-Holguin E. Effect of a natural supplement containing glucosinolates, phytosterols and citrus flavonoids on body weight and metabolic parameters in a menopausal murine model induced by bilateral ovariectomy. Gynecol Endocrinol 2020; 36:1106-1111. [PMID: 32954883 DOI: 10.1080/09513590.2020.1821639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To evaluate the effect of a herbal preparation containing glucosinolates, phytosterols and citrus flavonoids (supplement) on body weight and metabolic parameters usually impaired by menopause. METHODS A pre-clinical experimental study carried out in twenty-five Swiss strain mice (Mus musculus) randomly distributed (1:1:1:1:1 ratio) to five groups to receive for ten weeks: (1) oral gelatinized maca extract 0.5625 mg/kg/day + bilateral ovariectomy (Maca + OVX); (2) oral supplement 0.5625 mg/kg/day + bilateral ovariectomy (S1 + OVX); (3) oral supplement 1.6875 mg/kg/day + bilateral ovariectomy (S2 + OVX); (4) oral saline 100 µl/kg/day + bilateral ovariectomy (OVX); and (5) oral saline 100 µl/kg/day + sham surgery (sham). The primary endpoint was change in body weight gain from baseline to final. Secondary endpoints were uterine weight and cholesterol, triglyceride, glucose, and glucose/triglycerides index values at the end of the study. A modified intention-to-treat analysis was performed through linear regression models and using the Bonferroni method to penalized p-values by multiple comparisons. RESULTS Twenty-three animals completed the study. There was a significant average difference in weight gain, with a greater reduction in the S2 + OVX group compared to the OVX group (difference= -3.5; 95% CI (-5.27; -1.74); p < .001). S2 + OVX group also displayed a significant average reduction of total blood cholesterol (difference: -16.94; 95% CI (-33.73; -0.15); p = .037). No significant effects of the supplement were found on other secondary endpoints. CONCLUSION In this murine menopausal model, triple oral supplement dose resulted in an average reduction of weight gain and total cholesterol levels, suggesting that the compound could have a potential effect at regulating menopausal altered metabolism.
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Affiliation(s)
- Martha Valdivia
- Facultad de Ciencias Biológicas, Laboratorio de Fisiología de la Reproducción Animal, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Percy Soto-Becerra
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Universidad San Ignacio de Loyola, Lima, Peru
- Epi-gnosis Solutions, Piura, Peru
| | - Ricardo Laguna-Barraza
- Facultad de Ciencias Biológicas, Laboratorio de Fisiología de la Reproducción Animal, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Percy A Rojas
- Laboratorios de Investigación y Desarrollo, Unidad de Biotecnología Molecular, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ivonne Reyes-Mandujano
- Facultad de Ciencias Biológicas, Laboratorio de Fisiología de la Reproducción Animal, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Paola Gonzáles-Reyes
- Facultad de Ciencias Biológicas, Laboratorio de Fisiología de la Reproducción Animal, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Haydee Temoche
- Facultad de Ciencias Biológicas, Laboratorio de Fisiología de la Reproducción Animal, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Olga S Timoteo
- Laboratorios de Investigación y Desarrollo, Unidad de Biotecnología Molecular, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Gabriela Lugo-Martinez
- Instituto Politécnico Nacional, Escuela Superior de Medicina, Sección de Estudios de Posgrado e Investigación, Ciudad de México, Mexico
| | - Claudia C Calzada-Mendoza
- Instituto Politécnico Nacional, Escuela Superior de Medicina, Sección de Estudios de Posgrado e Investigación, Ciudad de México, Mexico
| | - Edward Mezones-Holguin
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Universidad San Ignacio de Loyola, Lima, Peru
- Epi-gnosis Solutions, Piura, Peru
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19
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Maguiña JL, Soto-Becerra P, Hurtado-Roca Y, Araujo-Castillo RV. Las pruebas de laboratorio para la identificación de SARS-CoV-2 en tiempos de pandemia en el Perú: algunas precisiones acerca del «rendimiento diagnóstico». Rev Peru Med Exp Salud Publica 2020; 37:575-576. [DOI: 10.17843/rpmesp.2020.373.5802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/27/2020] [Indexed: 11/06/2022] Open
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20
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Toribio L, Santivanez S, Scott AL, Enriquez R, Sedano C, Soto-Becerra P, Garcia HH, Shiff CJ. Diagnostic urinary cfDNA detected in human cystic echinococcosis. Mol Biochem Parasitol 2020; 239:111314. [PMID: 32866606 PMCID: PMC8801304 DOI: 10.1016/j.molbiopara.2020.111314] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/31/2020] [Accepted: 08/01/2020] [Indexed: 02/06/2023]
Abstract
Cystic echinococcosis (CE) is a major neglected tropical zoonotic disease caused by the tissue-dwelling larval stage of the cestode parasite Echinococcus granulosus. For individuals suspected of CE, the diagnostic standard is imaging using ultrasonography, X rays, or computed tomography. These resource-demanding and expensive procedures are rarely available in endemic rural areas where CE is most prevalent. There is a critical need for a new approach to identify CE patients so that they can be managed early in the course of their infection. This study reports on the results of a diagnostic approach that identifies E. granulosus-derived cell-free DNA (cfDNA) in the urine of CE patients. Utilizing PCR to amplify a fragment of a major tandem repeat element found in E. granulosus nuclear DNA, urine samples from all seven imaging-confirmed CE patients who harbored active liver cysts were positive. In addition, the urine samples from 2/4 patients who presented with non-viable/calcified liver cysts were also PCR positive for the repeat fragment. To our knowledge, this is the first report of using parasite cfDNA from urine to diagnose CE. This approach provides an easy to implement and cost-effective method to survey for the prevalence of E. granulosus in humans populations.
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Affiliation(s)
- Luz Toribio
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Saul Santivanez
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru; Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | - Alan L Scott
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Raul Enriquez
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cesar Sedano
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Percy Soto-Becerra
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hector H Garcia
- Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru; W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Clive J Shiff
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
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21
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Sánchez-Zarza SC, Mezones-Holguín E, López-Baena MT, Soto-Becerra P, Pérez-López FR, Gavilanes AWD, Chedraui P. Association between depressed mood and sexual function among mid-aged Paraguayan women. Climacteric 2020; 23:566-573. [PMID: 32266841 DOI: 10.1080/13697137.2020.1742684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Depressive symptoms may affect female mid-life sexuality, whereas sexual problems tend to aggravate depression. Despite this, data assessing this association drawn from mid-aged Paraguayan women are scarce. OBJECTIVE This study aimed to assess the association between depressed mood and the risk of sexual dysfunction during female mid-life. METHODS Sexually active urban-living women from Asunción, Paraguay (n = 193, aged 40-60 years) were surveyed with the 6-item Female Sexual Function Index (FSFI-6), the 10-item Center for Epidemiological Studies Depression Scale (CESD-10), and a general questionnaire containing personal and partner information. Depressed mood was defined as a total CESD-10 score of 10 or more, and an increased risk for sexual dysfunction as an FSFI-6 total score of 19 or less. The association of depressed mood and an increased risk of sexual dysfunction was evaluated with multivariable Poisson regression. RESULTS The mean age (±standard deviation) of surveyed woman was 48.3 ± 6.0 years and 61.1% (n = 118) were perimenopausal and postmenopausal. A total of 21.8% (n = 42) had depressed mood and 28.5% (n = 55) had an increased risk of sexual dysfunction. The final adjusted regression model determined that women with depressed mood were twice as likely to have an increased risk of sexual dysfunction, compared to women with normal mood (adjusted prevalence ratio = 2.14, 95% confidence interval 1.26-3.60). On the other hand, depressed mood was associated with a mean total FSFI-6 score that was 20% lower than that observed among women with normal mood (adjusted incidence rate ratio = 0.80, 95% confidence interval 0.68-0.93). CONCLUSION In this mid-aged Paraguayan female sample there was a significant association between depressed mood and an increased risk of sexual dysfunction.
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Affiliation(s)
| | - E Mezones-Holguín
- Centro de Estudios Económicos y Sociales en Salud, Universidad San Ignacio de Loyola, Lima, Perú
| | - M T López-Baena
- Instituto de Investigaciones Sanitarias de Aragón, Zaragoza, Spain
| | - P Soto-Becerra
- Centro de Salud Global, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - F R Pérez-López
- Instituto de Investigaciones Sanitarias de Aragón, Zaragoza, Spain.,Departamento de Obstetricia y Ginecología, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
| | - A W D Gavilanes
- School of Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.,Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - P Chedraui
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.,Facultad de Ciencias de la Salud, Universidad Católica 'Nuestra Señora de la Asunción', Asunción, Paraguay
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22
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Sánchez-Zarza S, Mezones-Holguín E, Soto-Becerra P, Pérez-López FR, Gavilanes AW, Chedraui P. Sexual dysfunction was associated to depressed mood in mid-aged women from Paraguay. Maturitas 2019. [DOI: 10.1016/j.maturitas.2019.04.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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23
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Mezones-Holguin E, Soto-Becerra P, Danckers L, Chedraui P. “Warmi” and the menopause: synthesis of the evidence after 10 years of commercialization. Maturitas 2019. [DOI: 10.1016/j.maturitas.2019.04.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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24
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Soto-Becerra P, Wong P. [The 1, 2, 3… and 4 of laboratory animal experimentation: the arrive guidelines]. Rev Peru Med Exp Salud Publica 2016; 33:836-837. [PMID: 28327864 DOI: 10.17843/rpmesp.2016.334.2579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 10/26/2016] [Indexed: 11/06/2022] Open
Affiliation(s)
- Percy Soto-Becerra
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos. Lima, Perú
| | - Paolo Wong
- Facultad de Medicina, Universidad de Piura. Lima, Perú
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