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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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Abugattas-Núñez del Prado J, Quintana Reyes A, Leon J, Blume La Torre J, Gutiérrez Loli R, Pinzón Olejua A, Chamorro Chirinos ER, Loza Mauricio FA, Maguiña JL, Rodriguez-Aliaga P, Málaga-Trillo E. Clinical validation of RCSMS: A rapid and sensitive CRISPR-Cas12a test for the molecular detection of SARS-CoV-2 from saliva. PLoS One 2024; 19:e0290466. [PMID: 38527001 PMCID: PMC10962837 DOI: 10.1371/journal.pone.0290466] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/08/2023] [Indexed: 03/27/2024] Open
Abstract
Peru's holds the highest COVID death rate per capita worldwide. Key to this outcome is the lack of robust, rapid, and accurate molecular tests to circumvent the elevated costs and logistics of SARS-CoV-2 detection via RT-qPCR. To facilitate massive and timely COVID-19 testing in rural and socioeconomically deprived contexts, we implemented and validated RCSMS, a rapid and sensitive CRISPR-Cas12a test for the molecular detection of SARS-CoV-2 from saliva. RCSMS uses the power of CRISPR-Cas technology and lateral flow strips to easily visualize the presence of SARS-CoV-2 even in laboratories with limited equipment. We show that a low-cost thermochemical treatment with TCEP/EDTA is sufficient to inactivate viral particles and cellular nucleases in saliva, eliminating the need to extract viral RNA with commercial kits, as well as the cumbersome nasopharyngeal swab procedure and the requirement of biosafety level 2 laboratories for molecular analyses. Notably, RCSMS performed outstandingly in a clinical validation done with 352 patients from two hospitals in Lima, detecting as low as 50 viral copies per 10 μl reaction in 40 min, with sensitivity and specificity of 96.5% and 99.0%, respectively, relative to RT-qPCR. The negative and positive predicted values obtained from this field validation indicate that RCSMS can be confidently deployed in both high and low prevalence settings. Like other CRISPR-Cas-based biosensors, RCSMS can be easily reprogrammed for the detection of new SARS-CoV-2 variants. We conclude that RCSMS is a fast, efficient and inexpensive alternative to RT-qPCR for expanding COVID-19 testing capacity in Peru and other low- and middle-income countries with precarious healthcare systems.
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Affiliation(s)
| | | | - Julio Leon
- IMS RIKEN Center for Integrative Medical Sciences, Japan
- University of California San Francisco, San Francisco, California, United States of America
| | - Juan Blume La Torre
- Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Renzo Gutiérrez Loli
- Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
| | | | | | | | - Jorge L. Maguiña
- Instituto de Evaluación de Tecnologías en Salud e Investigación (IETSI), EsSalud, Lima, Perú
| | - Piere Rodriguez-Aliaga
- Department of Biology, Stanford University, Stanford, California, United States of America
| | - Edward Málaga-Trillo
- Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú
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Arce-Huamani MA, Barboza JJ, Martínez-Herrera JF, Torres-Roman JS, Maguiña JL. Correction: Arce-Huamani et al. Efficacy and Safety of Apixaban versus Dalteparin as a Treatment for Cancer-Associated Venous Thromboembolism: A Systematic Review and Meta-Analysis. Medicina 2023, 59, 1867. Medicina (Kaunas) 2024; 60:134. [PMID: 38256435 PMCID: PMC10821357 DOI: 10.3390/medicina60010134] [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] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 12/26/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024]
Abstract
There was an error in the original publication [...].
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Affiliation(s)
- Miguel A. Arce-Huamani
- Facultad de Ciencias de la Salud, Universidad Cientifica del Sur, Lima 15067, Peru;
- Cancer Research Networking, Universidad Cientifica del Sur, Lima 15067, Peru; (J.F.M.-H.); (J.S.T.-R.)
| | - Joshuan J. Barboza
- Centro de Investigación en Epidemiología y Medicina Basada en Evidencia, Universidad Norbert Wiener, Lima 13007, Peru;
| | - José Fabián Martínez-Herrera
- Cancer Research Networking, Universidad Cientifica del Sur, Lima 15067, Peru; (J.F.M.-H.); (J.S.T.-R.)
- Cancer Center, Medical Center American British Cowdray, Mexico City 01120, Mexico
| | - J. Smith Torres-Roman
- Cancer Research Networking, Universidad Cientifica del Sur, Lima 15067, Peru; (J.F.M.-H.); (J.S.T.-R.)
- Latin American Network for Cancer Research (LAN–CANCER), Lima 11702, Peru
| | - Jorge L. Maguiña
- Facultad de Ciencias de la Salud, Universidad Cientifica del Sur, Lima 15067, Peru;
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Failoc-Rojas VE, Silva-Díaz H, Maguiña JL, Rodriguez-Morales AJ, Díaz-Velez C, Apolaya-Segura M, Valladares-Garrido MJ. Evidence-based indications for ivermectin in parasitic diseases: An integrated approach to context and challenges in Peru. Parasite Epidemiol Control 2023; 23:e00320. [PMID: 37731824 PMCID: PMC10507222 DOI: 10.1016/j.parepi.2023.e00320] [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: 01/12/2023] [Revised: 06/07/2023] [Accepted: 07/29/2023] [Indexed: 09/22/2023] Open
Abstract
Ivermectin has emerged as a therapeutic option for various parasitic diseases, including strongyloidiasis, scabies, lice infestations, gnathostomiasis, and myiasis. This study comprehensively reviews the evidence-based indications for ivermectin in treating parasitic diseases, considering the unique context and challenges in Peru. Fourteen studies were selected from a systematic search of scientific evidence on ivermectin in PubMed, from 2010 to July 2022. The optimal dosage of ivermectin for treating onchocerciasis, strongyloidiasis, and enterobiasis ranges from 150 to 200 μg/kg, while lymphatic filariasis requires a higher dose of 400 μg/kg (Brown et al., 2000). However, increased dosages have been associated with a higher incidence of ocular adverse events. Scientific evidence shows that ivermectin can be safely and effectively administered to children weighing less than 15 kg. Systematic reviews and meta-analyses provide strong support for the efficacy and safety of ivermectin in combating parasitic infections. Ivermectin has proven to be an effective treatment for various parasitic diseases, including intestinal parasites, ectoparasites, filariasis, and onchocerciasis. Dosages ranging from 200 μg/kg to 400 μg/kg are generally safe, with adjustments made according to the specific pathology, patient age, and weight/height. Given Peru's prevailing social and environmental conditions, the high burden of intestinal parasites and ectoparasites in the country underscores the importance of ivermectin in addressing these health challenges.
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Affiliation(s)
- Virgilio E. Failoc-Rojas
- Instituto de Evaluación de Tecnologías en Salud e Investigación, EsSalud, Lima, Peru
- Universidad San Ignacio de Loyola, Lima, Peru
| | - Heber Silva-Díaz
- Facultad de Medicina Huamana, Universidad de San Martín de Porres, Chiclayo, Peru
| | - Jorge L. Maguiña
- Instituto de Evaluación de Tecnologías en Salud e Investigación, EsSalud, Lima, Peru
- School of Medicine, Universidad Científica del Sur, Lima, Peru
| | - Alfonso J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autónoma de las Américas, Pereira, Colombia
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut 1102, Lebanon
| | - Cristian Díaz-Velez
- Facultad de Medicina, Universidad Privada Antenor Orrego, Trujillo, Peru
- Instituto Nacional Cardiovascular, INCOR, EsSalud, Lima, Peru
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Arce-Huamani MA, Barboza JJ, Martínez-Herrera JF, Torres-Roman JS, Maguiña JL. Efficacy and Safety of Apixaban versus Dalteparin as a Treatment for Cancer-Associated Venous Thromboembolism: A Systematic Review and Meta-Analysis. Medicina (Kaunas) 2023; 59:1867. [PMID: 37893585 PMCID: PMC10607997 DOI: 10.3390/medicina59101867] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/06/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Venous thromboembolism (VTE) is common in cancer patients. Anticoagulant therapy with low-molecular-weight heparins (LMWHs) and direct oral anticoagulants (DOACs), such as dalteparin and apixaban, have demonstrated efficacy and safety. However, more comparative research of these drugs is still needed. This study aimed to synthesize evidence on the efficacy of apixaban compared to dalteparin in reducing recurrent VTE, major bleeding, and clinically relevant non-major bleeding associated with cancer. Materials and Methods: We systematically searched the PubMed, Scopus, Web of Science, Embase, Cochrane Library, and ClinicalTrials databases up to 5 January 2023, for randomized controlled trials comparing apixaban versus dalteparin as treatment for cancer-associated VTE. Five studies were included. Effects according to meta-analyses were reported as relative risks (RRs) and their 95% confidence intervals (CIs). Results: It was found that 33 of 734 (4.5%) patients treated with apixaban and 56 of 767 (7.3%) with dalteparin had recurrent VTE as the efficacy outcome (RR 0.49, 95% CI 0.15-1.58, I2 38%). Major bleeding occurred in 25 of 734 patients treated with apixaban (3.4%) and 27 of 767 with dalteparin (3.5%) (RR 1.29, 95% CI 0.31-5.27, I2 59%). Likewise, clinically relevant non-major bleeding occurred in 64 of 734 patients treated with apixaban (8.7%) and 46 of 767 (5.9%) with dalteparin (RR 1.52, 95% CI 1.05-2.19, I2 0%). Conclusions: Apixaban showed a lower risk of recurrent VTE than dalteparin in patients with cancer-associated VTE, albeit with no statistical difference. Statistical significance was observed for no major clinically relevant bleeding but not for major bleeding.
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Affiliation(s)
- Miguel A. Arce-Huamani
- Facultad de Ciencias de la Salud, Universidad Cientifica del Sur, Lima 15067, Peru;
- Cancer Research Networking, Universidad Cientifica del Sur, Lima 15067, Peru; (J.F.M.-H.); (J.S.T.-R.)
| | - Joshuan J. Barboza
- Centro de Investigación en Epidemiología y Medicina Basada en Evidencia, Universidad Norbert Wiener, Lima 13007, Peru;
| | - José Fabián Martínez-Herrera
- Cancer Research Networking, Universidad Cientifica del Sur, Lima 15067, Peru; (J.F.M.-H.); (J.S.T.-R.)
- Cancer Center, Medical Center American British Cowdray, Mexico City 01120, Mexico
| | - J. Smith Torres-Roman
- Cancer Research Networking, Universidad Cientifica del Sur, Lima 15067, Peru; (J.F.M.-H.); (J.S.T.-R.)
- Latin American Network for Cancer Research (LAN–CANCER), Lima 11702, Peru
| | - Jorge L. Maguiña
- Facultad de Ciencias de la Salud, Universidad Cientifica del Sur, Lima 15067, Peru;
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Robles-Mariños R, Alvarado GF, Maguiña JL, Bazo-Alvarez JC. The short-form of the Cyberchondria Severity Scale (CSS-12): Adaptation and validation of the Spanish version in young Peruvian students. PLoS One 2023; 18:e0292459. [PMID: 37796833 PMCID: PMC10553310 DOI: 10.1371/journal.pone.0292459] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 09/21/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Cyberchondria is defined as the increase in health-related anxiety or anguish associated with excessive or repeated online searches for health-related information. Our objective was to cross-culturally adapt and validate the CSS-12 scale for Peruvian Spanish speakers, to determine whether the Bifactor model works as well in our population as in previous studies' and to explore whether the Bifactor-ESEM is a more suitable model. METHODS We performed a cultural adaptation using the Delphi method and a validation study on medical students between 2018 and 2019. Reliability was evaluated by using Cronbach's alpha (α) and McDonald's omega (Ω) for internal consistency, and Pearson's r and intraclass correlation coefficient (ICC), for test-retest reliability. We evaluated construct validity by contrasting four measurement models for the CSS-12 and the convergent validity against health anxiety. RESULTS The Spanish CSS-12 showed excellent reliability (α = .93; Ω = .93; ICC = .93; r = .96). The Bifactor ESEM model showed the best fit, supporting a unidimensional measure of the general cyberchondria. This measure was positively associated with health anxiety (r = .51). CONCLUSIONS The Spanish CSS-12 provides a valid and reliable unidimensional measure of cyberchondria, which is distinguishable from the more general health anxiety. This can be applied to similar populations and future research. The Bifactor-ESEM model appears to offer a more accurate and realistic representation of the multifaceted nature of cyberchondria. We provide a free-to-use form of the Spanish CSS-12 as supplemental material.
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Affiliation(s)
| | - Germán F. Alvarado
- School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - Jorge L. Maguiña
- School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - Juan Carlos Bazo-Alvarez
- Research Department of Primary Care and Population Health, University College London (UCL), London, United Kingdom
- Universidad Privada Norbert Wiener, 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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Arteaga-Livias K, Panduro-Correa V, Maguiña JL, Osada J, Rabaan AA, Lijarza-Ushinahua K, Barboza JJ, Gomez-Gonzales W, Rodriguez-Morales AJ. Compliance with Antibiotic Prophylaxis in Obstetric and Gynecological Surgeries in Two Peruvian Hospitals. Antibiotics (Basel) 2023; 12:antibiotics12050808. [PMID: 37237711 DOI: 10.3390/antibiotics12050808] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION Surgical site infections (SSI) can be as high in gynecology and obstetrics surgeries compared to other areas. Antimicrobial prophylaxis is an effective tool in the prevention of SSIs; however, it is often not adequately administered, so this study aimed to understand the compliance and factors associated with the use of the clinical practice guidelines for antibiotic prophylaxis in gynecological surgeries in two hospitals in the city of Huanuco, Peru. METHODS An analytical cross-sectional study of all gynecologic surgeries performed during 2019 was performed. Compliance was determined based on the antibiotic chosen, dose, administration time, redosing, and prophylaxis duration. Age, hospital of origin, presence of comorbidities, surgery performed, as well as its duration, types of surgery, and anesthesia were considered as related factors. RESULTS We collected 529 medical records of patients undergoing gynecological surgery with a median age of 33 years. The prophylactic antibiotic was correctly indicated in 55.5% of cases, and the dose was correct in 31.2%. Total compliance with the five variables evaluated was only 3.9%. Cefazolin was the most commonly used antibiotic. CONCLUSION Low compliance with the institutional clinical practice guidelines for antibiotic prophylaxis was identified, showing that antimicrobial prophylaxis in the hospitals studied was inadequate.
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Affiliation(s)
- Kovy Arteaga-Livias
- Maestría en Epidemiologia Clinica y Bioestadistica, Universidad Científica del Sur, Lima 15014, Peru
| | - Vicky Panduro-Correa
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco 10000, Peru
- Escuela de Medicina, Universidad San Juan Bautista, Lima 15067, Peru
| | - Jorge L Maguiña
- Maestría en Epidemiologia Clinica y Bioestadistica, Universidad Científica del Sur, Lima 15014, Peru
| | - Jorge Osada
- Maestría en Epidemiologia Clinica y Bioestadistica, Universidad Científica del Sur, Lima 15014, Peru
| | - Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
| | - Kiara Lijarza-Ushinahua
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco 10000, Peru
- Sociedad Científica de Estudiantes de Medicina (SOCIEM-HCO), Universidad Nacional Hermilio Vadlizán, Huánuco 10000, Peru
| | - Joshuan J Barboza
- Vicerrectorado de Investigación, Universidad Norbert Wiener, Lima 15046, Peru
| | - Walter Gomez-Gonzales
- Escuela de Medicina-Filial Ica, Universidad Privada San Juan Bautista, Ica 11001, Peru
| | - Alfonso J Rodriguez-Morales
- Maestría en Epidemiologia Clinica y Bioestadistica, Universidad Científica del Sur, Lima 15014, Peru
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira 660005, Colombia
- GIlbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut P.O. Box 36, Lebanon
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Gómez-Gonzales W, Alvarado-Garcia A, Suárez-Mamani M, Dámaso-Mata B, Panduro-Correa V, Maguiña JL, Pecho-Silva S, Rabaan AA, Rodriguez-Morales AJ, Arteaga-Livias K. Contamination by Antibiotic-Resistant Bacteria on Cell Phones of Vendors in a Peruvian Market. Medicina (B Aires) 2023; 59:medicina59040669. [PMID: 37109628 PMCID: PMC10141064 DOI: 10.3390/medicina59040669] [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] [Received: 03/06/2023] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
Background and Objectives. Multiple studies have evaluated the presence of bacterial contamination on cell phones in clinical settings; however, the presence and transmission of antibiotic-resistant bacteria on cell phones in the community have not been adequately elucidated. Material and Methods. A cross-sectional study was carried out to determine the presence of bacteria resistant to antibiotics on the cell phones of vendors in a Peruvian market and the associated factors. A sample of 127 vendors was obtained through stratified probabilistic sampling using a data collection form validated by experts. Cell phone samples were cultured using a standard technique, and antibiotic sensitivity was determined using the Kirby–Bauer technique. Chi-squared and Mann-Whitney U tests were used to determine factors associated with resistance in cell phone cultures. Results. Among the cell phones, 92.1% showed bacterial growth, predominantly Gram-positive bacteria (coagulase-negative staphylococci and Staphylococcus aureus), and 17% of the cultures showed resistance to at least three antibiotics evaluated. Two strains fell into the category of methicillin-resistant S. aureus, and three strains of E. coli had resistance to carbapenems. Conclusions. A short distance between customers and vendors, lack of a cell phone case, and having a cell phone with touchscreen are factors associated with antibiotic-resistant bacteria on cell phones.
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Affiliation(s)
- Walter Gómez-Gonzales
- Escuela de Medicina-Filial Ica, Universidad Privada San Juan Bautista, Ica 11001, Peru;
| | - Anthony Alvarado-Garcia
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco 10003, Peru; (A.A.-G.); (M.S.-M.); (B.D.-M.); (V.P.-C.)
| | - Marytté Suárez-Mamani
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco 10003, Peru; (A.A.-G.); (M.S.-M.); (B.D.-M.); (V.P.-C.)
| | - Bernardo Dámaso-Mata
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco 10003, Peru; (A.A.-G.); (M.S.-M.); (B.D.-M.); (V.P.-C.)
| | - Vicky Panduro-Correa
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco 10003, Peru; (A.A.-G.); (M.S.-M.); (B.D.-M.); (V.P.-C.)
- Hospital Regional Hermilio Valdizan, Huánuco 15011, Peru
| | - Jorge L. Maguiña
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima 15067, Peru; (J.L.M.); (A.J.R.-M.)
| | | | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia;
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
| | - Alfonso J. Rodriguez-Morales
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima 15067, Peru; (J.L.M.); (A.J.R.-M.)
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas-Institución Universitaria Visión de las Américas, Pereira 660003, Colombia
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut P.O. Box 36, Lebanon
| | - Kovy Arteaga-Livias
- Escuela de Medicina-Filial Ica, Universidad Privada San Juan Bautista, Ica 11001, Peru;
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco 10003, Peru; (A.A.-G.); (M.S.-M.); (B.D.-M.); (V.P.-C.)
- Hospital II EsSalud, Huánuco 10001, Peru
- Correspondence:
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Escalante-Ramírez D, Bonilla K, Maguiña JL. Asociation between nutritional status and depressive symptoms in a Peruvian adult population: A population-based study in Peru. Salud Ment 2022. [DOI: 10.17711/sm.0185-3325.2022.037] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Introduction. Among the Peruvian population, the prevalence of overweight and obesity has increased, making it one of the main public health problems. There is also conflicting evidence on the association between increased BMI and depressive symptoms in the adult population. Objective. To determine the association between nutritional status (NS) and depressive symptoms (DS) in the Peruvian population. Method. We conducted a secondary data analysis of the Peruvian Demographic and Family Health Survey (ENDES). We assessed the NS according to body mass index (BMI), grouped into normal weight (BMI = 18.50 - 24.99), overweight (BMI = 25.00 - 29.99), 1A obesity (BMI = 30.00 - 32.49), and 1B obesity (BMI ≥ 32.50). DS were assessed using the Patient Health Questionnaire (PHQ-9) instrument. A generalized linear model stratified by sex was constructed to calculate crude (cPRc) and adjusted (aPR) prevalence ratios. Results. A total of 26,463 records of people aged 18-60 years were assessed, yielding a 6.3% prevalence of DS (≥ 10 points). Females had a higher frequency of DS than males, which increased depending on their NS: normal weight 7.8%, overweight 8.2%, 1A obesity 9.0%, and 1B obesity 12.0%. Likewise, in the multivariate analysis, women with 1B obesity reported a higher frequency of DS (aPR = 1.30; 95% CI = [1.03, 1.63]). Discussion and conclusion. There is a strong association between nutritional status and depressive symptoms in Peruvian women, with obese women being more likely to have depressive symptoms.
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11
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Al-Kassab-Córdova A, Silva-Perez C, Maguiña JL. Spatial distribution, determinants and trends of full vaccination coverage in children aged 12-59 months in Peru: A subanalysis of the Peruvian Demographic and Health Survey. BMJ Open 2022; 12:e050211. [PMID: 36368757 PMCID: PMC9660560 DOI: 10.1136/bmjopen-2021-050211] [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: 11/13/2022] Open
Abstract
OBJECTIVE To assess the spatial distribution, trends and determinants of crude full vaccination coverage (FVC) in children aged 12-59 months between 2010 and 2019 in Peru. DESIGN, SETTING AND ANALYSIS A cross-sectional study based on the secondary data analysis of the 2010 and 2019 Peruvian Demographic and Health Surveys (DHSs) was conducted. Logit based multivariate decomposition analysis was employed to identify factors contributing to differences in FVC between 2010 and 2019. The spatial distribution of FVC in 2019 was evaluated through spatial autocorrelation (Global Moran's I), ordinary kriging interpolation (Gaussian process regression) and Bernoulli-based purely spatial scan statistic. OUTCOME MEASURE FVC, as crude coverage, was defined as having completely received BCG; three doses of diphtheria, pertussis, and tetanus, and polio vaccines; and measles vaccine by 12 months of age. PARTICIPANTS A total of 5 751 and 14 144 children aged 12-59 months from 2010 and 2019 DHSs, respectively, were included. RESULTS FVC increased from 53.62% (95% CI 51.75% to 55.49%) in 2010 to 75.86% (95% CI 74.84% to 76.85%) in 2019. Most of the increase (70.39%) was attributable to differences in coefficients effects. Family size, visit of health workers in the last 12 months, age of the mother at first delivery, place of delivery and antenatal care follow-up were all significantly associated with the increase. The trend of FVC was non-linear and increased by 2.22% annually between 2010 and 2019. FVC distribution was heterogeneous at intradepartmental and interdepartmental level. Seven high-risk clusters of incomplete coverage were identified. CONCLUSIONS Although FVC has increased in Peru, it still remains below the recommended threshold. The increase of FVC was mainly attributed to the change in the effects of the characteristics of the population. There was high heterogeneity across Peruvian regions with the presence of high-risk clusters. Interventions must be redirected to reduce these geographical disparities.
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Affiliation(s)
- Ali Al-Kassab-Córdova
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Claudia Silva-Perez
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Jorge L Maguiña
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
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12
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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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13
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González-Olvera M, Hernandez-Colina A, Pérez JG, Ulloa GM, Montero S, Maguiña JL, Lescano AG, Santolalla ML, Baylis M, Mayor P. Haemosporidians from a Neglected Group of Terrestrial Wild Birds in the Peruvian Amazonia. Ecohealth 2022; 19:402-416. [PMID: 36030330 PMCID: PMC9573858 DOI: 10.1007/s10393-022-01612-9] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 07/29/2022] [Indexed: 06/15/2023]
Abstract
Haemosporidians are a widespread group of blood parasites transmitted by vectors. Despite their relevance for bird conservation, few studies have been conducted in the Amazonia and even less in terrestrial wild birds. We analysed blood samples from 168 game birds, collected from 2008 to 2015 by subsistence hunters of an indigenous rural community in the Peruvian Amazonia. DNA was tested for Haemoproteus spp., Plasmodium spp. and Leucocytozoon spp. and positive amplicons were sequenced and curated for phylogenetic analysis. Haemosporidian prevalence was 72% overall, 66.7% for Haemoproteus spp. and 5.4% for Plasmodium spp. and respectively by bird species: Spix's Guan (Penelope jacquacu, n = 72) 87.5% and 0%, Razor-billed Curassow (Mitu tuberosum, n = 45) 77.8% and 6.7%, White-winged Trumpeter (Psophia leucoptera, n = 20) 6.3% and 12.5%, Blue-throated Piping-guan (Pipile cumanensis, n = 16) 73.3% and 6.7%, and Great Tinamou (Tinamus major, n = 15) 10% and 15%. Leucocytozoon spp. was not found. P. leucoptera and T. major were less likely to be infected with Haemoproteus spp. Fruit abundance had a negative association with Haemoproteus spp. prevalence and precipitation was negatively associated with Plasmodium spp. prevalence. The 106 sequences examined represented 29 lineages, 82.8% of them were new lineages (Plasmodium n = 3, Haemoproteus n = 21). Novel host-parasite associations and lineages were unveiled, including probably new species of Plasmodium spp. Our results highlight the scientific value of alternative sampling methods and the collaboration with local communities.
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Affiliation(s)
- Merit González-Olvera
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, IC2 Liverpool Science Park, 146 Brownlow Hill, Liverpool, L3 5RF, UK
| | - Arturo Hernandez-Colina
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, IC2 Liverpool Science Park, 146 Brownlow Hill, Liverpool, L3 5RF, UK
- , Coventry, UK
| | - Jocelyn G Pérez
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, IC2 Liverpool Science Park, 146 Brownlow Hill, Liverpool, L3 5RF, UK
| | - Gabriela M Ulloa
- Programa de Pós-Graduação em Saúde e Produção Animal na Amazônia, Universidade Federal Rural da Amazônia (UFRA), Belém, Pará, Brazil
- Grupo Enfermedades Emergentes, Universidad Científica del Sur, Lima, Peru
| | - Stephanie Montero
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jorge L Maguiña
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Andrés G Lescano
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Meddly L Santolalla
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Matthew Baylis
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, IC2 Liverpool Science Park, 146 Brownlow Hill, Liverpool, L3 5RF, UK
- Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK
| | - Pedro Mayor
- Programa de Pós-Graduação em Saúde e Produção Animal na Amazônia, Universidade Federal Rural da Amazônia (UFRA), Belém, Pará, Brazil
- Departamento de Sanitat i Anatomia Animals, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
- ComFauna, Comunidad de Manejo de Fauna Silvestre en la Amazonía y en Latinoamérica, 332 Malecón Tarapacá, Iquitos, Peru
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14
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Morales-Villanueva DW, Sullca-Ccopa F, Gonzales-Huerta L, Damaso-Mata B, Panduro-Correa V, Maguiña JL, Pecho-Silva S, Rodriguez-Morales AJ, Gómez-Gonzales W, Arteaga-Livias K. Educational level and positive serology for dengue. a knowledge, attitudes and practices study in Huánuco, Peru. Rev Patol Trop 2022; 51:63-72. [DOI: 10.5216/rpt.v51i1.70543] [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] [Indexed: 10/16/2023] Open
Abstract
Dengue is a worldwide spread arboviral disease. Huánuco region is an endemic area for dengue. Understanding the influence of Knowledge, Attitudes and Practices (KAP) in dengue endemic areas can provide important insight for improving public health policies. The purpose of this study was to understand the KAP about dengue in the marginal urban city of Tingo Maria, district of Rupa-Rupa, a rain forest area in Huánuco region and its association with positive serology for dengue. An analytical, retrospective, cross-sectional study was carried out in which a randomized sample of 112 people were evaluated using a semi structured questionnaire and tested for IgG against dengue virus. Most participants recruited were from marginal urban settlements. The median age was 38 years and 64% were female. A bivariate analysis showed an association between educational level and serological positivity. Over 95% of participants with only primary school education had a positive serological test for dengue. No statistical significances were found between attitudes towards dengue control initiatives (p=0.221), preventive practices against dengue (p=0.773), and the level of knowledge about dengue (p=0.073). Although attitudes, preventive practices and level of knowledge were not related to positive serology in dengue cases, educational level showed an association with serological positivity for dengue.
KEY WORDS: Dengue; knowledge; attitude; practice; education; Peru.
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Hueda-Zavaleta M, Copaja-Corzo C, Benites-Zapata VA, Cardenas-Rueda P, Maguiña JL, Rodríguez-Morales AJ. Diagnostic performance of RT-PCR-based sample pooling strategy for the detection of SARS-CoV-2. Ann Clin Microbiol Antimicrob 2022; 21:11. [PMID: 35287682 PMCID: PMC8919688 DOI: 10.1186/s12941-022-00501-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/16/2021] [Accepted: 03/01/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The rapid spread of SARS-CoV-2 has created a shortage of supplies of reagents for its detection throughout the world, especially in Latin America. The pooling of samples consists of combining individual patient samples in a block and analyzing the group as a particular sample. This strategy has been shown to reduce the burden of laboratory material and logistical resources by up to 80%. Therefore, we aimed to evaluate the diagnostic performance of the pool of samples analyzed by RT-PCR to detect SARS-CoV-2. METHODS A cross-sectional study of diagnostic tests was carried out. We individually evaluated 420 samples, and 42 clusters were formed, each one with ten samples. These clusters could contain 0, 1 or 2 positive samples to simulate a positivity of 0, 10 and 20%, respectively. RT-PCR analyzed the groups for the detection of SARS-CoV-2. The area under the ROC curve (AUC), the Youden index, the global and subgroup sensitivity and specificity were calculated according to their Ct values that were classified as high (H: ≤ 25), moderate (M: 26-30) and low (L: 31-35) concentration of viral RNA. RESULTS From a total of 42 pools, 41 (97.6%) obtained the same result as the samples they contained (positive or negative). The AUC for pooling, Youden index, sensitivity, and specificity were 0.98 (95% CI, 0.95-1); 0.97 (95% CI, 0.90-1.03); 96.67% (95% CI; 88.58-100%) and 100% (95% CI; 95.83-100%) respectively. In the stratified analysis of the pools containing samples with Ct ≤ 25, the sensitivity was 100% (95% CI; 90-100%), while with the pools containing samples with Ct ≥ 31, the sensitivity was 80% (95% CI, 34.94-100%). Finally, a higher median was observed in the Ct of the clusters, with respect to the individual samples (p < 0.001). CONCLUSIONS The strategy of pooling nasopharyngeal swab samples for analysis by SARS-CoV-2 RT-PCR showed high diagnostic performance.
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Affiliation(s)
- Miguel Hueda-Zavaleta
- Faculty of Health Sciences, Universidad Privada de Tacna, Tacna, 23003, Peru. .,Hospital III Daniel Alcides Carrión EsSalud, Tacna, 23000, Peru.
| | - Cesar Copaja-Corzo
- Faculty of Health Sciences, Universidad Privada de Tacna, Tacna, 23003, Peru
| | - Vicente A Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, 15024, Peru
| | | | - Jorge L Maguiña
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, 15024, Peru
| | - Alfonso J Rodríguez-Morales
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, 15024, Peru. .,Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Belmonte, 660003, Pereira, Risaralda, Colombia.
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16
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Ulloque‐Badaracco JR, Ivan Salas‐Tello W, Al‐kassab‐Córdova A, Alarcón‐Braga EA, Benites‐Zapata VA, Maguiña JL, Hernandez AV. Prognostic value of neutrophil-to-lymphocyte ratio in COVID-19 patients: A systematic review and meta-analysis. Int J Clin Pract 2021; 75:e14596. [PMID: 34228867 PMCID: PMC9614707 DOI: 10.1111/ijcp.14596] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 07/01/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Neutrophil-to-lymphocyte ratio (NLR) is an accessible and widely used biomarker. NLR may be used as an early marker of poor prognosis in patients with COVID-19. OBJECTIVE To evaluate the prognostic value of the NLR in patients diagnosed with COVID-19. METHODS We conducted a systematic review and meta-analysis. Observational studies that reported the association between baseline NLR values (ie, at hospital admission) and severity or all-cause mortality in COVID-19 patients were included. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). Random effects models and inverse variance method were used for meta-analyses. The effects were expressed as odds ratios (ORs) and their 95% confidence intervals (CIs). Small study effects were assessed with the Egger's test. RESULTS We analysed 61 studies (n = 15 522 patients), 58 cohorts, and 3 case-control studies. An increase of one unit of NLR was associated with higher odds of severity (OR 6.22; 95%CI 4.93 to 7.84; P < .001) and higher odds of all-cause mortality (OR 12.6; 95%CI 6.88 to 23.06; P < .001). In our sensitivity analysis, we found that 41 studies with low risk of bias and moderate heterogeneity (I2 = 53% and 58%) maintained strong association between NLR values and both outcomes (severity: OR 5.36; 95% CI 4.45 to 6.45; P < .001; mortality: OR 10.42 95% CI 7.73 to 14.06; P = .005). CONCLUSIONS Higher values of NLR were associated with severity and all-cause mortality in hospitalised COVID-19 patients.
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Affiliation(s)
| | | | | | | | - Vicente A. Benites‐Zapata
- Vicerrectorado de Investigación Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de InvestigaciónUniversidad San Ignacio de LoyolaLimaPeru
| | - Jorge L. Maguiña
- Escuela de MedicinaUniversidad Peruana de Ciencias AplicadasLimaPeru
- Instituto de Evaluación de Tecnologías en Salud e Investigación — IETSI, EsSaludLimaPeru
| | - Adrian V. Hernandez
- Unidad de Revisiones Sistemáticas y Meta‐análisis, Guías de Práctica Clínica y Evaluaciones de Tecnología Sanitaria, Vicerrectorado de InvestigaciónUniversidad San Ignacio de LoyolaLimaPeru
- Health OutcomesPolicy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of PharmacyMansfieldCTUSA
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Pecho-Silva S, Navarro-Solsol AC, Panduro-Correa V, Rabaan AA, Maguiña JL, Rodriguez-Morales AJ, Arteaga-Livias K. Viral Replication and Antibody Kinetics in the Recognition of Asymptomatic COVID-19 Patients. Chemotherapy 2021; 66:53-57. [PMID: 33965937 PMCID: PMC8247824 DOI: 10.1159/000515748] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/08/2021] [Indexed: 11/22/2022]
Abstract
Following the discovery of COVID-19 disease caused by the SARS-CoV-2 coronavirus, different studies have been carried out to recognize the stages of the disease and the methods of achieving correct diagnosis. Investigations of cases and their contacts have revealed different degrees in the symptomatology of the disease, with asymptomatic patients gaining relevance because of the controversy regarding their role in the spread of the disease. Recognition and assessment of asymptomatic patients is essential to carry out containment actions such as public health measures for affected patients and contacts. In this review, we assess the diagnostic aspects of asymptomatic patients according to the available evidence of people with COVID-19.
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Affiliation(s)
- Samuel Pecho-Silva
- Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
- Escuela de Medicina, Universidad Científica del Sur, Lima, Peru
| | | | | | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | | | - Alfonso J. Rodriguez-Morales
- Escuela de Medicina, Universidad Científica del Sur, Lima, Peru
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de Las Américas, Pereira, Colombia
| | - Kovy Arteaga-Livias
- Escuela de Medicina, Universidad Científica del Sur, Lima, Peru
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco, Peru
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18
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Rodriguez-Morales AJ, Paniz-Mondolfi AE, Faccini-Martínez ÁA, Henao-Martínez AF, Ruiz-Saenz J, Martinez-Gutierrez M, Alvarado-Arnez LE, Gomez-Marin JE, Bueno-Marí R, Carrero Y, Villamil-Gomez WE, Bonilla-Aldana DK, Haque U, Ramirez JD, Navarro JC, Lloveras S, Arteaga-Livias K, Casalone C, Maguiña JL, Escobedo AA, Hidalgo M, Bandeira AC, Mattar S, Cardona-Ospina JA, Suárez JA. The Constant Threat of Zoonotic and Vector-Borne Emerging Tropical Diseases: Living on the Edge. Front Trop Dis 2021; 2:676905. [PMID: 34010366 PMCID: PMC8132189 DOI: 10.3389/fitd.2021.676905] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 04/06/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- Alfonso J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Pereira, Colombia
- Emerging Infectious Diseases and Tropical Medicine Research Group, Instituto para la Investigación en Ciencias Biomédicas - Sci-Help, Pereira, Colombia
- Coordinación Nacional de Investigación, Universidad Privada Franz Tamayo (UNIFRANZ), Cochabamba, Bolivia
- Master Program on Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru
| | - Alberto E. Paniz-Mondolfi
- Department of Pathology, Molecular and Cell-Based Medicine, Laboratory of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Instituto de Investigaciones Biomédicas IDB/Incubadora Venezolana de la Ciencia, Barquisimeto, Venezuela
| | | | - Andrés F. Henao-Martínez
- Department of Medicine, Division of Infectious Diseases, School of Medicine, University of Colorado Denver, Aurora, CO, United States
| | - Julian Ruiz-Saenz
- Grupo de Investigación en Ciencias Animales - GRICA, Facultad de Medicina Veterinaria y Zootecnia, Universidad Cooperativa de Colombia, Bucaramanga, Colombia
| | - Marlen Martinez-Gutierrez
- Grupo de Investigación en Ciencias Animales - GRICA, Facultad de Medicina Veterinaria y Zootecnia, Universidad Cooperativa de Colombia, Bucaramanga, Colombia
- Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Medellín, Colombia
| | - Lucia E. Alvarado-Arnez
- Coordinación Nacional de Investigación, Universidad Privada Franz Tamayo (UNIFRANZ), Cochabamba, Bolivia
| | - Jorge E. Gomez-Marin
- Grupo de Estudio en Parasitologia Molecular (GEPAMOL) Group, Facultad de Ciencias de la Salud, Universidad del Quindío, Armenia, Colombia
| | - Ruben Bueno-Marí
- Departamento de Investigación y Desarrollo (I+D), Laboratorios Lokímica, Paterna, Spain
- Área de Parasitología, Departamento de Farmacia y Tecnología Farmaceútica y Parasitología, Universidad de Valencia, Burjasot, Spain
| | - Yenddy Carrero
- Facultad de Ciencias de la Salud, Carrera de Medicina, Universidad Técnica de Ambato, Ambato, Ecuador
| | - Wilmer E. Villamil-Gomez
- Infectious Diseases and Infection Control Research Group, Hospital Universitario de Sincelejo, Sincelejo, Colombia
- Programa Del Doctorado de Medicina Tropical, SUE Caribe, Universidad Del Atlántico, Barranquilla, Colombia
| | - D. Katterine Bonilla-Aldana
- Semillero de Investigación en Zoonosis (SIZOO), Grupo de Investigación BIOECOS, Fundacion Universitaria Autonoma de las Americas, Pereira, Colombia
| | - Ubydul Haque
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Juan D. Ramirez
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Juan-Carlos Navarro
- Research Group of Emerging Diseases, Ecoepidemiology and Biodiversity, Health Sciences Faculty, Universidad Internacional SEK, Quito, Ecuador
| | - Susana Lloveras
- Sección Zoopatología Médica, Hospital de Infecciosas FJ Muñiz, Buenos Aires, Argentina
| | - Kovy Arteaga-Livias
- Master Program on Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru
- Faculty of Medicine, Universidad Nacional Hermilio Valdizán, Huánuco, Peru
| | | | - Jorge L. Maguiña
- Master Program on Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru
| | - Angel A. Escobedo
- Department of Epidemiology, Institute of Gastroenterology, Havana, Cuba
| | - Marylin Hidalgo
- Infectious Diseases Group, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Salim Mattar
- Instituto de Investigaciones Biologicas del Tropico, Universidad de Cordoba, Monteria, Colombia
| | - Jaime A. Cardona-Ospina
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Pereira, Colombia
- Emerging Infectious Diseases and Tropical Medicine Research Group, Instituto para la Investigación en Ciencias Biomédicas - Sci-Help, Pereira, Colombia
| | - Jose A. Suárez
- Investigador SNI Senacyt Panamá, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama, Panama
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Robles-Cabrera MX, Maguiña JL, Gonzales-Huerta L, Panduro-Correa V, Dámaso-Mata B, Pecho-Silva S, Navarro-Solsol AC, Rabaan AA, Rodríguez-Morales AJ, Arteaga-Livias K. Blastocystis species and Gastrointestinal Symptoms in Peruvian Adults Attended in a Public Hospital. Infect Chemother 2021; 53:374-380. [PMID: 34216131 PMCID: PMC8258296 DOI: 10.3947/ic.2021.0004] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/05/2021] [Indexed: 12/13/2022] Open
Abstract
The objective of this study was to evaluate the role of Blastocystis sp. in gastrointestinal symptoms reported by adult patients in a Peruvian hospital. A case-control 3:1 study was performed at the outpatient clinic. Direct stool examinations were done. One hundred sixty patients were included, 40 cases and 120 controls. Positivity to Blastocystis sp. was associated with dyspepsia (P <0.001), bloating (P <0.001) and abdominal pain (P = 0.03) in patients attending our hospital outpatient clinic.
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Affiliation(s)
| | - Jorge L Maguiña
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | - Luis Gonzales-Huerta
- Department of Infectious Diseases, Imperial College London, London, United Kingdom
| | - Vicky Panduro-Correa
- Faculty of Medicine, Universidad Nacional Hermilio Valdizán, Huánuco, Perú.,Hospital Regional Hermilio Valdizán Medrano, Huánuco, Perú
| | - Bernardo Dámaso-Mata
- Faculty of Medicine, Universidad Nacional Hermilio Valdizán, Huánuco, Perú.,Hospital II Huánuco, EsSalud. Huánuco, Perú
| | - Samuel Pecho-Silva
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | | | - Ali A Rabaan
- Molecular Diagnostic laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Alfonso J Rodríguez-Morales
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú.,Grupo de Investigacion Biomedicina, Faculty of Medicine, Fundacion Universitaria Autónoma de las Americas, Pereira, Risaralda, Colombia
| | - Kovy Arteaga-Livias
- Faculty of Medicine, Universidad Nacional Hermilio Valdizán, Huánuco, Perú.,Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú.,Hospital II Huánuco, EsSalud. Huánuco, Perú.
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20
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Pecho-Silva S, Navarro-Solsol AC, Panduro-Correa V, Rabaan AA, Maguiña JL, Rodriguez-Morales AJ, Arteaga-Livias K. Viral Replication and Antibody Kinetics in the Recognition of Asymptomatic COVID-19 Patients. Chemotherapy 2021. [DOI: https:/doi.org/10.1159/000515748] [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] [Indexed: 01/24/2023]
Abstract
Following the discovery of COVID-19 disease caused by the SARS-CoV-2 coronavirus, different studies have been carried out to recognize the stages of the disease and the methods of achieving correct diagnosis. Investigations of cases and their contacts have revealed different degrees in the symptomatology of the disease, with asymptomatic patients gaining relevance because of the controversy regarding their role in the spread of the disease. Recognition and assessment of asymptomatic patients is essential to carry out containment actions such as public health measures for affected patients and contacts. In this review, we assess the diagnostic aspects of asymptomatic patients according to the available evidence of people with COVID-19.
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21
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Mezones-Holguin E, Al-Kassab-Córdova A, Maguiña JL, Rodriguez-Morales AJ. Vaccination coverage and preventable diseases in Peru: Reflections on the first diphtheria case in two decades during the midst of COVID-19 pandemic. Travel Med Infect Dis 2020; 40:101956. [PMID: 33340773 DOI: 10.1016/j.tmaid.2020.101956] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Edward Mezones-Holguin
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Universidad San Ignacio de Loyola, Lima, Peru.
| | - Ali Al-Kassab-Córdova
- School of Medicine, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru; Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas (SOCIEMUPC), Lima, Peru
| | - Jorge L Maguiña
- School of Medicine, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru
| | - Alfonso J Rodriguez-Morales
- School of Medicine, Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru; Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnologica de Pereira, Pereira, Risaralda, Colombia; Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Pereira, Risaralda, Colombia.
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22
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Villena FE, Maguiña JL, Santolalla ML, Pozo E, Salas CJ, Ampuero JS, Lescano AG, Bishop DK, Valdivia HO. Molecular surveillance of the Plasmodium vivax multidrug resistance 1 gene in Peru between 2006 and 2015. Malar J 2020; 19:450. [PMID: 33276776 PMCID: PMC7718670 DOI: 10.1186/s12936-020-03519-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 02/04/2020] [Accepted: 11/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The high incidence of Plasmodium vivax infections associated with clinical severity and the emergence of chloroquine (CQ) resistance has posed a challenge to control efforts aimed at eliminating this disease. Despite conflicting evidence regarding the role of mutations of P. vivax multidrug resistance 1 gene (pvmdr1) in drug resistance, this gene can be a tool for molecular surveillance due to its variability and spatial patterns. METHODS Blood samples were collected from studies conducted between 2006 and 2015 in the Northern and Southern Amazon Basin and the North Coast of Peru. Thick and thin blood smears were prepared for malaria diagnosis by microscopy and PCR was performed for detection of P. vivax monoinfections. The pvmdr1 gene was subsequently sequenced and the genetic data was used for haplotype and diversity analysis. RESULTS A total of 550 positive P. vivax samples were sequenced; 445 from the Northern Amazon Basin, 48 from the Southern Amazon Basin and 57 from the North Coast. Eight non-synonymous mutations and three synonymous mutations were analysed in 4,395 bp of pvmdr1. Amino acid changes at positions 976F and 1076L were detected in the Northern Amazon Basin (12.8%) and the Southern Amazon Basin (4.2%) with fluctuations in the prevalence of both mutations in the Northern Amazon Basin during the course of the study that seemed to correspond with a malaria control programme implemented in the region. A total of 13 pvmdr1 haplotypes with non-synonymous mutations were estimated in Peru and an overall nucleotide diversity of π = 0.00054. The Northern Amazon Basin was the most diverse region (π = 0.00055) followed by the Southern Amazon and the North Coast (π = 0.00035 and π = 0.00014, respectively). CONCLUSION This study showed a high variability in the frequencies of the 976F and 1076L polymorphisms in the Northern Amazon Basin between 2006 and 2015. The low and heterogeneous diversity of pvmdr1 found in this study underscores the need for additional research that can elucidate the role of this gene on P. vivax drug resistance as well as in vitro and clinical data that can clarify the extend of CQ resistance in Peru.
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Affiliation(s)
- Fredy E Villena
- Department of Parasitology, U.S. Naval Medical Research Unit No, 6 (NAMRU-6), Lima, Peru.
| | - Jorge L Maguiña
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Meddly L Santolalla
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.,Departamento de Parasitología, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Edwar Pozo
- Piura Sanitary Intelligence Unit, Piura Health Region, Piura, Peru
| | - Carola J Salas
- Department of Parasitology, U.S. Naval Medical Research Unit No, 6 (NAMRU-6), Lima, Peru
| | - Julia S Ampuero
- Department of Parasitology, U.S. Naval Medical Research Unit No, 6 (NAMRU-6), Lima, Peru
| | - Andres G Lescano
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Danett K Bishop
- Department of Parasitology, U.S. Naval Medical Research Unit No, 6 (NAMRU-6), Lima, Peru
| | - Hugo O Valdivia
- Department of Parasitology, U.S. Naval Medical Research Unit No, 6 (NAMRU-6), Lima, Peru
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23
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Panduro-Correa V, Cubas WS, Herrera-Matta JJ, Maguiña JL, Dámaso-Mata B, Guisasola G, Navarro-Solsol AC, Pecho-Silva S, Arteaga-Livias K. Survival and adequate preoperative staging in patients undergoing gastric cancer surgery at a Peruvian Police Hospital. J Surg Oncol 2020; 123:425-431. [PMID: 33259662 DOI: 10.1002/jso.26315] [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: 09/09/2020] [Revised: 10/24/2020] [Accepted: 11/14/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Gastric cancer is the fifth most common malignant neoplasm and the third leading cause of cancer-related death worldwide. In Peru, its incidence is 15.8 per 100,000 population, and it is associated with high mortality rates, especially in areas with low socioeconomic status. The aim of this study was to compare preoperative, postoperative, and anatomopathological staging results and their relation to disease recurrence and survival. METHODS We conducted a retrospective cohort study of patients undergoing surgery for gastric cancer with a definitive postoperative anatomopathological diagnosis from 2005 to 2014 at the Hospital Nacional Luis N. Sáenz. Statistical analyses included descriptive and correlation statistics using the κ index, determination of associations between preoperative and postoperative staging and surgical reintervention and recurrence using the χ2 test, as well as Kaplan Meier survival analysis. RESULTS There was little correlation between preoperative staging and final anatomopathological diagnosis, while there was a good correlation with postoperative staging. A significant association was found between preoperative staging and cancer recurrence. In the survival analysis, survival was lower among patients with underestimated staging. CONCLUSIONS The survival of patients with gastric cancer can be affected by an overestimation of preoperative staging, therefore improvements in preoperative staging could lengthen the survival of patients undergoing gastric cancer surgery.
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Affiliation(s)
- Vicky Panduro-Correa
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco, Peru.,Hospital Regional Hermilio Valdizán, Huánuco, Peru
| | - W Samir Cubas
- Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | | | - Jorge L Maguiña
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru
| | | | - Germán Guisasola
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco, Peru
| | | | - Samuel Pecho-Silva
- Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.,Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru
| | - Kovy Arteaga-Livias
- Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco, Peru.,Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru
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24
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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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25
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Pérez JG, Carrera JP, Serrano E, Pittí Y, Maguiña JL, Mentaberre G, Lescano AG, Valderrama A, Mayor P. Serologic Evidence of Zoonotic Alphaviruses in Humans from an Indigenous Community in the Peruvian Amazon. Am J Trop Med Hyg 2020; 101:1212-1218. [PMID: 31571566 DOI: 10.4269/ajtmh.18-0850] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Alphaviruses (Togaviridae, Alphavirus) are arthropod-borne single-stranded RNA pathogens that cause febrile and neurologic disease in much of Latin America. However, many features of Alphavirus epidemiology remain unknown. In 2011, we undertook a cross-sectional study in Nueva Esperanza, an indigenous community in the Peruvian Amazon. Here, we present the first serologic evidence of Mayaro (MAYV), Venezuelan equine encephalitis (VEE) complex alphavirus, Una (UNAV), and Madariaga (MADV) viruses reported in humans (24%, 16%, 13%, and 1.5%, respectively) from an Amazonian indigenous community in Peru. Hunting activity and cohabiting with hunters were the main risk factors for Mayaro seroconversion, but only hunting was associated with UNAV seropositivity. Our results suggest that alphavirus infection in this region is common, but we highlight the high UNAV seroprevalence found and corroborate the low MADV prevalence reported in this region. Furthermore, MAYV-neutralizing antibodies were also detected in stored samples from wild animals (18%) hunted by Nueva Esperanza inhabitants and another mestizo community located close to Iquitos. Further serological surveys of VEE complex alphaviruses, UNAV, and MADV in wild animals and assessing the ability of the MAYV seropositive species to transmit the virus will be relevant.
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Affiliation(s)
| | | | - Emmanuel Serrano
- Universitá di Torino, Torino, Italy.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Yaneth Pittí
- Gorgas Memorial Institute of Health Studies, Panama City, Panama
| | | | - Gregorio Mentaberre
- Universitat de Lleida, Lleida, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | - Pedro Mayor
- Universitat Autònoma de Barcelona, Barcelona, Spain
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26
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Chávez-Zárate A, Maguiña JL, Quichiz-Lara AD, Zapata-Fajardo PE, Mayta-Tristán P. Correction: Relationship between stunting in children 6 to 36 months of age and maternal employment status in Peru: A sub-analysis of the Peruvian Demographic and Health Survey. PLoS One 2019; 14:e0217252. [PMID: 31185021 PMCID: PMC6559626 DOI: 10.1371/journal.pone.0217252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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27
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Altuna-Venegas S, Aliaga-Vega R, Maguiña JL, Parodi JF, Runzer-Colmenares FM. Risk of community-acquired pneumonia in older adults with sarcopenia of a hospital from Callao, Peru 2010–2015. Arch Gerontol Geriatr 2019; 82:100-105. [DOI: 10.1016/j.archger.2019.01.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/10/2019] [Accepted: 01/19/2019] [Indexed: 12/13/2022]
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28
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Chávez-Zárate A, Maguiña JL, Quichiz-Lara AD, Zapata-Fajardo PE, Mayta-Tristán P. Relationship between stunting in children 6 to 36 months of age and maternal employment status in Peru: A sub-analysis of the Peruvian Demographic and Health Survey. PLoS One 2019; 14:e0212164. [PMID: 30943197 PMCID: PMC6447236 DOI: 10.1371/journal.pone.0212164] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 01/29/2019] [Indexed: 11/18/2022] Open
Abstract
Objectives This study aimed to determine the relationship between stunting in children 6 to 36 months old and maternal employment status in Peru. Methods A secondary data analysis was conducted using information from the Demographic and Health Survey (DHS) in Peru. We used a representative sample of 4637 mother-child binomials to determine the association between stunting in children 6 to 36 months of age and the employment status of their mothers. Results The prevalence of stunting among children was 15.9% (95% CI: 13.9–16.7). The prevalence of working mothers was 63.7%. No association was found between maternal employment status and the presence of stunting in children [prevalence ratio (PR) = 1.04; 95% confidence interval (95% CI): 0.9 to 1.2; p = 0.627). However, on multivariate analysis we found that the prevalence of stunting was significantly higher among children of mothers performing unpaid work (12.4%) (PR = 1.38; 95% CI: 1.2–1.6; p < 0.001) compared with those of paid working mothers. Conclusion No significant association was found between maternal employment status and the presence of stunting in children 6 to 36 months of age. However, children of mothers doing unpaid work are at higher risk of stunting. These findings support the implementation of educational programs and labour policies to reduce the prevalence of stunting among children.
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Affiliation(s)
- Airin Chávez-Zárate
- Escuela de Nutrición y Dietética, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
- * E-mail: (AC); (PM)
| | - Jorge L. Maguiña
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima Perú
| | | | | | - Percy Mayta-Tristán
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima Perú
- * E-mail: (AC); (PM)
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29
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Rommel Diaz F, Rojas-Luna D, Maguiña JL. Missing asthma patients in epidemiologic survey? J Asthma 2019; 57:228-229. [PMID: 30656999 DOI: 10.1080/02770903.2019.1565767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- F Rommel Diaz
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - D Rojas-Luna
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Jorge L Maguiña
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
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30
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Salazar-De La Cuba AL, Ardiles-Paredes DF, Araujo-Castillo RV, Maguiña JL. High prevalence of self-reported tuberculosis and associated factors in a nation-wide census among prison inmates in Peru. Trop Med Int Health 2018; 24:328-338. [PMID: 30589977 DOI: 10.1111/tmi.13199] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 11/29/2022]
Abstract
OBJECTIVE To estimate the prevalence of self-reported tuberculosis TB diagnosed at Peruvian correctional facilities (CFs), and their associated factors. METHODS Cross-sectional study based on secondary analysis of the National Census held in all Peruvian CFs in 2016. Outcome was defined as self-reported TB diagnosed by a healthcare professional intra-penitentiary. A descriptive bivariate analysis was carried out, followed by multivariate analysis using Poisson regression in order to calculate the adjusted prevalence ratios (PRa). Additionally, a mixed effects multilevel model adjusted by CFs as clusters was performed. RESULTS Of 77 086 prison inmates in 66 CFs participated in the original census, of which 69 890 were included. Of these, 1754 self-reported TB diagnosed intra-penitentiary, yielding a prevalence of 2510/100 000 PDL. In the final model, self-reported TB was associated with younger age, male gender, lower educational level, not having a stable partner, having prison readmissions and having relatives in prison. There was also strong association with HIV/AIDS (PRa 2.77; 1.84-4.18), STIs (PRa 2.13; 1.46-3.10), DM (PRa 1.99; 1.59-2.50) and recreational drugs use (PRa 1.41; 1.23-1.61). The mixed model showed significant variance for belonging to different CFs (2.13; 1.02-4.44) and CF overcrowding (3.25; 1.37-7.71). CONCLUSIONS Self-reported TB prevalence found was higher than reported by other lower/lower-middle income countries. Demographic factors, individual clinical features and overcrowding increases the likelihood of self-reported TB.
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Affiliation(s)
| | | | - Roger V Araujo-Castillo
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Instituto de Evaluacion de Tecnologías en Salud e Investigación, ESSALUD, Lima, Peru
| | - Jorge L Maguiña
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Research Unit on Emerging Diseases and Climate Change, Universidad Peruana Cayetano Heredia, Lima, Peru
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Villena FE, Gomez-Puerta LA, Jhonston EJ, Del Alcazar OM, Maguiña JL, Albujar C, Laguna-Torres VA, Recuenco SE, Ballard SB, Ampuero JS. First Report of Trypanosoma cruzi Infection in Salivary Gland of Bats from the Peruvian Amazon. Am J Trop Med Hyg 2018; 99:723-728. [PMID: 30014825 PMCID: PMC6169177 DOI: 10.4269/ajtmh.17-0816] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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] [Indexed: 11/07/2022] Open
Abstract
In the Americas, 8 million people are infected with Chagas disease, and an additional 90 million people are at risk for infection. Little is known about the role bats play in the sylvatic transmission cycle of Trypanosoma cruzi, the parasite causing Chagas disease. Here, we captured bats in the villages of Palmiche, Pachacutec, Nuevo San Martin, and Mayuriaga located in the Datem del Marañon Province in Loreto, Peru. Venous blood samples were collected by cardiac puncture or from the upper extremities, and trypanosomatids were identified by microscopy and molecularly. We collected blood samples from 121 bats on filter paper for molecular studies and 111 slides for microscopic examination of thin and thick blood smears from 16 different bat species. The prevalence of trypanosomatids in all bats species was 34.7% (42/121) and the prevalence of T. cruzi was 4.1% (5/121). In hematophagous bat species, the prevalence of trypanosomatids and T. cruzi was 36.9% (27/73) and 2.7% (2/73), respectively. In non-hematophagous bats, the prevalences of trypanosomatids and T. cruzi were 31.2% (15/48) and 6.2% (3/48), respectively. Also, we confirm the presence of T. cruzi in salivary glands of hematophagous bats Diaemus youngi. These results suggest a sylvatic cycle of trypanosomatid transmission in which bats may harbor infectious T. cruzi parasites that could be transmitted to humans via hematophagous bat bites or salivary contamination by non-hematophagous bats of vegetables consumed by humans.
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Affiliation(s)
- Fredy E Villena
- U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru
| | - Luis A Gomez-Puerta
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru.,U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru
| | - Erik J Jhonston
- Facultad de Medicina de la Universidad Nacional de la Amazonia Peruana, Loreto, Peru
| | - O Melisa Del Alcazar
- Departamento de Mastozoología, Museo de Historia Natural, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Jorge L Maguiña
- U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru
| | | | - V Alberto Laguna-Torres
- Instituto de Medicina Tropical Daniel A. Carrión, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Sergio E Recuenco
- Departamento de Medicina Preventiva y Salud Pública, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | - Julia S Ampuero
- U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru
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Wolniczak I, Cáceres-DelAguila JA, Maguiña JL, Bernabe-Ortiz A. Fruits and vegetables consumption and depressive symptoms: A population-based study in Peru. PLoS One 2017; 12:e0186379. [PMID: 29023513 PMCID: PMC5638500 DOI: 10.1371/journal.pone.0186379] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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: 06/20/2017] [Accepted: 09/30/2017] [Indexed: 12/18/2022] Open
Abstract
Objectives Among different factors, diet patterns seem to be related to depression. The aim of this study was to evaluate the association between the consumption of fruits and/or vegetables and depressive symptoms. Methodology/Principal findings A secondary data analysis was conducted using information from a population-based survey from 25 regions from Peru. The outcome was the presence of depressive symptoms according to the Patient Health Questionnaire (cutoff ≥15 to define major depressive syndrome); whereas the exposure was the self-reported consumption of fruits and/or vegetables (in tertiles and using WHO recommendation ≥5 servings/day). The association of interest was evaluated using Poisson regression models controlling for the complex-sample survey design and potential confounders. Data from 25,901 participants were analyzed, mean age 44.2 (SD: 17.7) and 13,944 (54.0%) women. Only 910 (3.8%; 95%CI: 3.5%–4.2%) individuals reported consuming ≥5 servings of fruits and/or vegetables/day; whereas 819 (2.8%; 95%CI: 2.5%–3.1%) had depressive symptoms. Those in the lowest tertile of fruits and/or vegetables consumption had greater prevalence of depressive symptoms (PR = 1.88; 95%CI: 1.39–2.55) than those in the highest tertile. This association was stronger with fruits (PR = 1.92; 95%CI: 1.46–2.53) than vegetables (PR = 1.42; 95%CI: 1.05–1.93) alone. Conclusions An inverse relationship between consumption of fruits and/or vegetables and depressive symptoms is reported. Less than 5% of subjects reported consuming the amount of fruits and vegetables recommended by the WHO. There is a need to implement strategies to promote better diet patterns with potential impact on mental health.
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Affiliation(s)
- Isabella Wolniczak
- School of Medicine, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas–UPC, Lima, Perú
| | - José A. Cáceres-DelAguila
- School of Medicine, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas–UPC, Lima, Perú
| | - Jorge L. Maguiña
- School of Medicine, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas–UPC, Lima, Perú
| | - Antonio Bernabe-Ortiz
- School of Medicine, Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas–UPC, Lima, Perú
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Perú
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
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Carnero AM, Mayta-Tristan P, Konda KA, Mezones-Holguin E, Bernabe-Ortiz A, Alvarado GF, Canelo-Aybar C, Maguiña JL, Segura ER, Quispe AM, Smith ES, Bayer AM, Lescano AG. Plagiarism, Cheating and Research Integrity: Case Studies from a Masters Program in Peru. Sci Eng Ethics 2017; 23:1183-1197. [PMID: 27848191 PMCID: PMC5432416 DOI: 10.1007/s11948-016-9820-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 09/05/2016] [Indexed: 06/06/2023]
Abstract
Plagiarism is a serious, yet widespread type of research misconduct, and is often neglected in developing countries. Despite its far-reaching implications, plagiarism is poorly acknowledged and discussed in the academic setting, and insufficient evidence exists in Latin America and developing countries to inform the development of preventive strategies. In this context, we present a longitudinal case study of seven instances of plagiarism and cheating arising in four consecutive classes (2011-2014) of an Epidemiology Masters program in Lima, Peru, and describes the implementation and outcomes of a multifaceted, "zero-tolerance" policy aimed at introducing research integrity. Two cases involved cheating in graded assignments, and five cases correspond to plagiarism in the thesis protocol. Cases revealed poor awareness of high tolerance to plagiarism, poor academic performance, and widespread writing deficiencies, compensated with patchwriting and copy-pasting. Depending on the events' severity, penalties included course failure (6/7) and separation from the program (3/7). Students at fault did not engage in further plagiarism. Between 2011 and 2013, the Masters program sequentially introduced a preventive policy consisting of: (i) intensified research integrity and scientific writing education, (ii) a stepwise, cumulative writing process; (iii) honor codes; (iv) active search for plagiarism in all academic products; and (v) a "zero-tolerance" policy in response to documented cases. No cases were detected in 2014. In conclusion, plagiarism seems to be widespread in resource-limited settings and a greater response with educational and zero-tolerance components is needed to prevent it.
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Affiliation(s)
- Andres M Carnero
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Percy Mayta-Tristan
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Kelika A Konda
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Edward Mezones-Holguin
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Antonio Bernabe-Ortiz
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- CRONICAS, Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - German F Alvarado
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carlos Canelo-Aybar
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jorge L Maguiña
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Parasitology, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru
| | - Eddy R Segura
- School of Medicine, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Antonio M Quispe
- Department of Parasitology, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Edward S Smith
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Parasitology, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru
- School of Medicine, Universidad San Martin de Porres, Lima, Peru
| | - Angela M Bayer
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Andres G Lescano
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
- Department of Parasitology, U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru.
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Park H, Konda KA, Roberts CP, Maguiña JL, Leon SR, Clark JL, Coates TJ, Caceres CF, Klausner JD. Risk Factors Associated with Incident Syphilis in a Cohort of High-Risk Men in Peru. PLoS One 2016; 11:e0162156. [PMID: 27602569 PMCID: PMC5014407 DOI: 10.1371/journal.pone.0162156] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 09/21/2015] [Accepted: 08/18/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Syphilis is concentrated among high-risk groups, but the epidemiology of syphilis reinfection is poorly understood. We characterized factors associated with syphilis incidence, including reinfection, in a high-risk cohort in Peru. METHODS Participants in the NIMH CPOL trial were assessed at baseline and 2 annual visits with HIV/STI testing and behavioral surveys. Participants diagnosed with syphilis also attended 4- and 9-month visits. All participants underwent syphilis testing with RPR screening and TPPA confirmation. Antibiotic treatment was provided according to CDC guidelines. Reinfection was defined as a 4-fold titer increase or recurrence of seroreactivity after successful treatment with subsequent negative RPR titers. The longitudinal analysis used a Possion generalized estimating equations model with backward selection of variables in the final model (criteria P <0.02). RESULTS Of 2,709 participants, 191 (7.05%) were RPR-reactive (median 1:8, range 1:1-1:1024) with TPPA confirmation. There were 119 total cases of incident syphilis, which included both reinfection and first-time incident cases. In the bivariate analysis, the oldest 2 quartiles of age (incidence ratio (IR) 3.84; P <0.001 and IR 8.15; P <0.001) and being MSM/TW (IR 6.48; P <0.001) were associated with higher risk of incident syphilis infection. Of the sexual risk behaviors, older age of sexual debut (IR 12.53; P <0.001), not being in a stable partnership (IR 1.56, P = 0.035), higher number of sex partners (IR 3.01; P <0.001), unprotected sex in the past 3 months (IR 0.56; P = 0.003), HIV infection at baseline (IR 3.98; P <0.001) and incident HIV infection during the study period (IR 6.26; P = 0.003) were all associated with incident syphilis. In the multivariable analysis, older age group (adjusted incidence ratio (aIR) 6.18; P <0.001), men reporting having sex with a man (aIR 4.63; P <0.001), and incident HIV infection (aIR 4.48; P = 0.008) were significantly associated. CONCLUSIONS We report a high rate of syphilis reinfection among high-risk men who have evidence of previous syphilis infection. Our findings highlight the close relationship between HIV incidence with both incident syphilis and syphilis reinfection. Further studies on syphilis reinfection are needed to understand patterns of syphilis reinfection and new strategies beyond periodic testing of high-risk individuals based on HIV status are needed.
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Affiliation(s)
- Hayoung Park
- UCLA David Geffen School of Medicine Program in Global Health, Los Angeles, CA, United States of America
| | - Kelika A. Konda
- UCLA David Geffen School of Medicine Program in Global Health, Los Angeles, CA, United States of America
- Universidad Peruana Cayetano Heredia, Unidad de Salud, Sexualidad y Desarrollo Humano, Lima, Peru
| | - Chelsea P. Roberts
- UCLA David Geffen School of Medicine Program in Global Health, Los Angeles, CA, United States of America
| | - Jorge L. Maguiña
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Segundo R. Leon
- Universidad Peruana Cayetano Heredia, Unidad de Salud, Sexualidad y Desarrollo Humano, Lima, Peru
| | - Jesse L. Clark
- UCLA David Geffen School of Medicine Program in Global Health, Los Angeles, CA, United States of America
| | - Thomas J. Coates
- UCLA David Geffen School of Medicine Program in Global Health, Los Angeles, CA, United States of America
| | - Carlos F. Caceres
- Universidad Peruana Cayetano Heredia, Unidad de Salud, Sexualidad y Desarrollo Humano, Lima, Peru
| | - Jeffrey D. Klausner
- UCLA David Geffen School of Medicine Program in Global Health, Los Angeles, CA, United States of America
- * E-mail:
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Maguiña JL, Konda KA, Leon SR, Lescano AG, Clark JL, Hall ER, Klausner JD, Coates TJ, Caceres CF. Relationship between alcohol consumption prior to sex, unprotected sex and prevalence of STI/HIV among socially marginalized men in three coastal cities of Peru. AIDS Behav 2013; 17:1724-33. [PMID: 23054035 DOI: 10.1007/s10461-012-0310-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This article presents data about the relationship between alcohol consumption prior to sex and unprotected sex and the prevalence of at least one sexually transmitted infection (STI) including HIV among socially marginalized men in three coastal Peruvians cities. During an epidemiological survey with 2,146 men, we assessed their STI prevalence, frequency of alcohol consumption prior to sex, unprotected sex and other sexual risk behaviors. The overall prevalence of at least one STI/HIV was 8.5 % (95 % CI 7.3-9.7), the prevalence of unprotected sex was 79.1 % (95 % CI 77.8-80.3) and alcohol consumption prior to sex with any of the last five sex partners in the previous 6 months was 68.9 % (95 % CI 66.9-70.9). Bivariate and multivariate analysis showed that alcohol consumption of participants or their partners prior to sex were associated with the prevalence of at least one STI, adjusted Prevalence Ratio (aPR) = 1.3 (95 % CI 1.01-1.68). Unprotected sex was significantly associated with alcohol consumption prior to sex when both partners used alcohol, aPR = 1.15 (95 % CI 1.10-1.20) or when either one of them used alcohol aPR = 1.14 (95 % CI 1.09-1.18). These findings concur with previous literature suggesting a relationship between alcohol consumption prior to sex and STI and HIV. These data improve our understanding of this relationship in this context and could be used to enhance STI and HIV prevention strategies for socially marginalized men in Peru.
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