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Incarceration and TB: the epidemic beyond prison walls. BMJ Glob Health 2024; 9:e014722. [PMID: 38382977 PMCID: PMC10882329 DOI: 10.1136/bmjgh-2023-014722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/06/2023] [Indexed: 02/23/2024] Open
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Mental health issues and psychological risk factors among Paraguayan healthcare workers during the COVID-19 pandemic. J Ment Health 2023; 32:1065-1072. [PMID: 34586935 DOI: 10.1080/09638237.2021.1979494] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/13/2021] [Accepted: 08/29/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND There is an increasing concern regarding the mental health of healthcare workers during the COVID-19 pandemic. AIMS This study aimed to assess the psychological impact of the COVID-19 exposure among Paraguayan healthcare workers. METHODS A cross-sectional descriptive study has been carried out in five hospitals of Paraguay. Demographic and occupational exposure to COVID-19 were collected through a short questionnaire. Mental health status was assessed with the GAD-7, the PHQ-9, and the PCL-C. Logistic regression was used to determine psychological risk factors. RESULTS 432 participants were surveyed. 218 (50.46%) were physicians. The prevalence of symptoms of anxiety, depression and PTSD was 48.15, 41.90, and 5.79%, respectively. There were no significant differences in anxiety (128 [29.63%] vs. 80 [18.52%]; p = 0.3303), depression (102 [23.61%] vs. 79 [18.29%]; p = 0.6703), or PTSD (14 [3.24%] vs. 11 [2.55%]; p = 0.8074) between frontline versus second-line workers. Main risk factors associated with psychological distress included work experience <5 years for depression and a COVID-19 positive diagnosis or having family/friends with a COVID-19 positive diagnosis for PTSD. CONCLUSIONS Paraguayan healthcare workers reported high prevalence of anxiety, depression, and a low prevalence of PTSD. A positive diagnosis of COVID-19 and work experience <5 years are important psychological risk factors.
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The Chikungunya anxiety scale (CHIKAS): Development, validation, and relationship between its items and illness-related factors. Ind Psychiatry J 2023; 32:S117-S126. [PMID: 38370942 PMCID: PMC10871425 DOI: 10.4103/ipj.ipj_210_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/10/2023] [Accepted: 08/29/2023] [Indexed: 02/20/2024] Open
Abstract
Background Paraguay has recently experienced an exponential increase in chikungunya cases, leading to psychological distress, particularly anxiety. Aim To develop and validate the Chikungunya Anxiety Scale (CHIKAS). Materials and Methods An initial scale of 18 items was used, which was subjected to validation by expert judgment to obtain 14 items. To determine construct validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) have been employed, and internal and convergent validity were determined. Demographic, socioeconomic, and health status data were also collected. Results The study included 974 participants. The final scale consisted of 12 items with evidence of a two-factor model (psychological and physical). The internal validity was good (McDonald's omega = 0.882). The CFA showed good adjustment indices. Regarding participant characteristics, a relationship was found between anxiety due to chikungunya and gender, employment, mental diagnosis, medication use, and chikungunya infection. Conclusion The final 12-item CHIKAS had strong psychometric properties and was a two-factor model.
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Prioritizing persons deprived of liberty in global guidelines for tuberculosis preventive treatment. PLoS Med 2023; 20:e1004288. [PMID: 37788448 PMCID: PMC10547494 DOI: 10.1371/journal.pmed.1004288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
In this Policy Forum piece, Aditya Narayan and colleagues discuss the challenges and opportunities for tuberculosis preventive treatment in carceral settings.
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Intergenerational sex and early sexual debut are associated with HIV infection among transgender women in Paraguay. HIV Med 2023; 24:990-999. [PMID: 37128161 PMCID: PMC10792994 DOI: 10.1111/hiv.13496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/22/2023] [Indexed: 05/03/2023]
Abstract
INTRODUCTION HIV prevalence among transgender women is high worldwide. The objectives of the present study were to estimate the current prevalence of HIV and identify factors associated with high HIV burden among transgender women in Paraguay. METHODS Transgender women aged ≥15 years in four regions of Paraguay were recruited by Starfish sampling between February and March 2021. RESULTS In total, 322 transgender women were included. Mean age was 31 years (range 15-67), and 102 had positive HIV test results (31.7%, 95% confidence interval [CI] 26.6-37.1). In multivariable analysis, factors associated with HIV infection were age at first intercourse ≤17 years (adjusted odds ratio [aOR] 5.47; 95% CI 1.05-28.42), >10 years difference in age with the last sexual partner (aOR 1.60; 95% CI 1.04-2.46), substance use (mostly cocaine) (aOR 3.00; 95% CI 1.47-6.12), higher risk perception (aOR 3.08; 95% CI 1.53-6.17), not testing for HIV (aOR 1.23; 95% CI 1.09-1.39), and accessed by a peer educator (aOR 3.86; 95% CI 1.77-8.38). CONCLUSIONS Sexual debut as a minor and a large age difference with sexual partners are associated with high burden of HIV among transgender women in Paraguay. Our study corroborates the finding of cocaine use during sex as a risk factor for HIV. Prevention programmes must address structural and social vulnerabilities to stem the tragically high burden of HIV among transgender women.
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An evaluation of the safety and immunogenicity of MVC-COV1901: Results of an interim analysis of a phase III, parallel group, randomized, double-blind, active-controlled immunobridging study in Paraguay. Vaccine 2023; 41:109-118. [PMID: 36404171 PMCID: PMC9671637 DOI: 10.1016/j.vaccine.2022.10.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Data from previous studies of the MVC-COV1901 vaccine, a subunit vaccine against SARS-CoV-2 based on the stable prefusion spike protein (S-2P) adjuvanted with CpG 1018 adjuvant and aluminum hydroxide, suggest that the vaccine is generally safe and elicits a good immune response in healthy adults and adolescents. By comparing with AZD1222, this study adds to the findings from previous trials and further evaluates the breadth of protection offered by MVC-COV1901. METHODS In this phase 3, parallel group, randomized, double-blind, active-controlled trial conducted in 2 sites in Paraguay, we assigned adults aged 18-91 years in a 1:1 ratio to receive intramuscular doses of MVC-COV1901 or AZD1222 administered as scheduled in the clinical trial. Serum samples were collected on the day of vaccination and 14 days after the second dose. Primary and secondary safety and immunogenicity endpoints were assessed. In addition, other outcomes investigated were cross-reactive immunity against the Omicron strain and the induction of IgG subclasses. RESULTS A total of 1,030 participants underwent randomization. Safety data was derived from this set while primary immunogenicity data involved a per-protocol immunogenicity (PPI) subset including 225 participants. Among the participants, 58% are seropositive at baseline. When compared against AZD1222, MVC-COV1901 exhibited superiority in terms of neutralizing antibody titers and non-inferiority in terms of seroconversion rates. Reactogenicity was generally mild and no serious adverse event was attributable to MVC-COV1901. Both vaccines have a Th1-biased response predominated by the production of IgG1 and IgG3 subclasses. Omicron-neutralizing titers were 44.5 times lower compared to wildtype-neutralizing titers among seronegative individuals at baseline. This fold-reduction was 3.0 times among the seropositive. CONCLUSION Safety and immunogenicity data of MVC-COV1901 from the study in Paraguay confirm previous results. The previous infection coupled with vaccination of this vaccine may offer protection against the Omicron strain though its durability is still unknown.
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Surveillance of drug resistance of Mycobacterium tuberculosis in Paraguay, 2014 to 2017. ANALES DE LA FACULTAD DE CIENCIAS MÉDICAS (ASUNCIÓN) 2022. [DOI: 10.18004/anales/2022.055.03.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Deficiencias de cobre, hierro y zinc en niños menores de 5 años. PEDIATRÍA (ASUNCIÓN) 2022. [DOI: 10.31698/ped.49032022005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Introducción: La determinación de niveles séricos de micronutrientes de los niños menores de 5 años, es un requerimiento básico para establecer la prevalencia de deficiencias nutricionales de la población infantil y es una estrategia útil para incentivar a Salud Pública para que tome medidas en cuanto a aplicación y/o modificación de las Políticas Alimentarias Nacionales.
Objetivo: Determinar los niveles séricos de cobre, hierro y zinc en niños paraguayos menores de 5 años.
Materiales y Métodos: Estudio observacional, descriptivo y de corte transversal. Se procesaron las muestras de sangre de 1.441 niños menores de 5 años de edad que provenían de los Departamentos de Alto Paraná, Caaguazú, Central y de la capital de Paraguay. Se realizaron hemogramas y se determinaron las concentraciones séricas de albúmina, cobre, ferritina y zinc, de todas las muestras.
Resultados: Los niños tuvieron una edad promedio de 3 años y 3 meses, fueron 52,74% de sexo masculino y 47,26% de sexo femenino. La prevalencia de anemia fue de 45,25% y la prevalencia de hipoalbuminemia fue de 20,65%. Se detectaron deficiencias de cobre en 14,03%, de ferritina en 6,98% y de zinc en 43,62%, de los niños.
Conclusión: Los resultados de este estudio avalan la necesidad de ampliar la cobertura del Programa Alimentario Nutricional Integral (PANI), de plantearse si se deben ajustar las cantidades de minerales y vitaminas de la fórmula nutricional del Programa y de mejorar el seguimiento de los controles prenatales de las madres.
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Factores asociados a la mortalidad por tuberculosis en indígenas en Paraguay, 2014 a 2019. Rev Chilena Infectol 2022. [DOI: 10.4067/s0716-10182022000500535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
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Case Series of Leishmaniasis Detected in Health Centers in the Department of Caaguazu, Paraguay in 2019. REVISTA DEL INSTITUTO DE MEDICINA TROPICAL 2021. [DOI: 10.18004/imt/2021.16.1.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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[Clinical-epidemiological characterization of patients with tuberculosis in the Department of Caaguazú, Paraguay. 2014-2017]. Rev Chilena Infectol 2021; 37:750-755. [PMID: 33844816 DOI: 10.4067/s0716-10182020000600750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 11/11/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) is one of the ten leading causes of death worldwide. AIM To characterize the clinical and epidemiological point of view of TB cases reported in the Department of Caaguazú-Paraguay, from 2014 to 2017. METHODS Observational, descriptive, retrospective study; Population: 659 cases of TB registered in the National Tuberculosis Control Program (NTCP); variables: age, sex, population group, type of TB, TB/HIV coinfection. We procesed database in Excel 2016 © using Stata 14.0®. RESULTS 63.3% were of male gender, average age: 35.8 years, 39.6% were indigenous and 85.4% were liberty deprived persons known as inmates (LDP), 89.6% had pulmonary TB and 2,4% had TB/HIV coinfection. Incidence rate exceed 21.6/100,000 inhabitants in 2014. Indigenous incidence was 76.5/100,000 inhabitants in 2017, LDP incidence was 2,272.1/ 100,000 inhabitants in 2017. CONCLUSION The incidence of TB in the Department of Caaguazú is low, mainly affecting men, while TB incidence in indigenous people and LDP was high.
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Diseño de un estudio comunitario randomizado controlado multi-componente para prevención de obesidad en niños escolares: Protocolo de investigación. REVISTA ESPAÑOLA DE NUTRICIÓN HUMANA Y DIETÉTICA 2020. [DOI: 10.14306/renhyd.24.4.1024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introducción: el objetivo fue diseñar un estudio comunitario randomizado controlado multi-componente y evaluar su efecto en la prevención de obesidad en escolares del departamento de Caaguazú, Paraguay.Material y métodos: Diseño: ensayo comunitario randomizado controlado. Lugar: 16 escuelas públicas y privadas del área urbana y rural del Departamento de Caaguazú, Paraguay. Participantes e intervención: 16 escuelas serán asignadas aleatoriamente a dos grupos. Grupo intervención, recibirán un programa de educación nutricional y actividad física en el entorno escolar durante 6 meses. Grupo control, recibirán 3 charlas educativas en el mismo periodo. Medición de las principales variables: primaria (espesor de pliegues cutáneos), secundarias (z índice de masa corporal, conocimientos nutricionales, consumo de frutas y verduras, nivel de actividad física) y variables demográficas (sexo, edad, zona de residencia). Todas las variables serán medidas en la línea base y al final del estudio, utilizando herramientas calibradas, cuestionarios validados y protocolos de procedimiento. Análisis: se utilizará estadística descriptiva, además de los test t Student y chi2 para establecer diferencias. Se correrán modelos de regresión lineal y logística crudos y ajustados.Ética y diseminación: el protocolo de estudio ha sido evaluado y aprobado por el Comité de Ética en Investigación de la Universidad Nacional de Caaguazú. Se utilizarán consentimientos informados institucionales (escuelas) e individuales (padres) y asentimiento de los niños.
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Prevalencia y factores de riesgo para sífilis en población indígena masculina de Paraguay, 2017. SALUD PUBLICA DE MEXICO 2020; 63:21-26. [PMID: 33984207 DOI: 10.21149/11742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/23/2020] [Indexed: 11/06/2022] Open
Abstract
Objetivo. Determinar la prevalencia y los factores de riesgo para sífilis en población indígena masculina de Paraguay durante el año 2017. Material y métodos. Se realizó un estudio observacional, descriptivo, con muestro probabilístico, estratificado y multietápico. Fueron incluidos indígenas de sexo masculino, mayores de 15 años de edad, de cinco familias lingüísticas residentes en Paraguay durante el periodo de estudio. Resultados. La prevalencia de sífilis en hombres de la población indígena de Paraguay fue de 4.50%. Los indígenas que tenían entre 15 y 20 años tuvieron 2.70 probabilidades de presentar sífilis. Asimismo, los participantes que reportaron múltiples parejas en el último año, sexo transaccional y consumir alcohol en la última relación sexual tuvieron 2.69, 3.06 ym 2.16 veces la probabilidad de presentar sífilis, respectivamente. Conclusiones. Se encontró una prevalencia moderada de sífilis en la población indígena masculina. La prevalencia fue de dos veces más para aquéllos que tenían más de dos parejas sexuales, sexo transaccional y que involucraban alcohol durante la práctica sexual.
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Psychological impact of COVID-19 pandemic among healthcare workers in Paraguay: A descriptive and preliminary study. MEDICINA CLÍNICA Y SOCIAL 2020. [DOI: 10.52379/mcs.v4i3.156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Introduction: Healthcare workers exposed to SARS-CoV-2 are vulnerable to psychological distress. The goal of this study is to evaluate the psychological impact of exposure to the SARS-CoV-2 among healthcare workers in Paraguay. Methodology: A descriptive cross-sectional study was carried out in 5 tertiary hospitals in the Central, San Pedro and Caaguazú Departments of Paraguay during the COVID-19 pandemic from April to June 2020. The pilot study included 125 healthcare workers as participants, 25 for each hospital. Demographic data and occupational exposure data were collected with an ad-hoc questionnaire. Symptoms of depression and anxiety were evaluated employing the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder scale-7. The prevalence of post-traumatic stress was determined using the Post-Traumatic Stress Disorder Check List-C. Results: Of the 125 participants, 68 (54.8%) were doctors, 37 (29.8) nurses, 7 (5.6%) biochemists, 3 (2.4%) obstetricians, and 9 (7.3%) other healthcare workers. Most participants were females (86 [68.8%]), with an average age of 33.8 years (SD ± 7.4), single (71 [56.8%]), with a postgraduate educational level (83 [66.4%]), and reporting a junior level of work experience (52 [41.6%]). A total of 71 (57.3%) were classified as high-risk healthcare workers after exposure to SARS-CoV-2. 61 (48.8%) of participants presented symptoms of depression, and 68 (54.4%) presented symptoms of anxiety. A small group reported symptoms of post-traumatic stress (9 [7.2%]). Conclusion: Healthcare workers in Paraguay reported a significant prevalence of depressive and anxious symptoms during the COVID-19 pandemic. These findings lend support to the idea that healthcare workers are vulnerable to psychological distress and that they may require specific mental health interventions.
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Uso de antibióticos en el Hospital General del Departamento de San Pedro – Paraguay. MEDICINA CLÍNICA Y SOCIAL 2020. [DOI: 10.52379/mcs.v4i2.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Introducción: Los antibióticos han constituido la herramienta más eficaz para la lucha contra enfermedades infecciosas y trasmisibles. Sin embargo, en los últimos tiempos su efectividad se ha visto afectada por la resistencia antimicrobiana, que a su vez es determinada en gran medida por el uso apropiado o inapropiado de antibióticos. Objetivo: Determinar la frecuencia puntual de uso de antibióticos en el Hospital General del Departamento de San Pedro Paraguay - Corea en el 2019. Metodología: Estudio observacional, descriptivo sobre el uso de antibióticos. Se incluyeron pacientes hospitalizados del 26 al 29 de agosto 2019. Se evaluó el motivo de indicación, clase de antibiótico y cumplimiento de guías terapéuticas. Los datos fueron cargados y analizados en la plataforma RedCap. Resultados: Fueron incluidos 62 pacientes. El 53,23 % de los pacientes fueron del sexo femenino, de 21 a 27 años en un 19,35 %. La frecuencia puntual de uso de antibióticos fue del 91,94 %, de los cuales 38,60 % fue para una profilaxis y 61,40 % para uso terapéutico. El diagnóstico más frecuente fue neumonía (31,43%) y el prescriptor más frecuente fue el médico responsable (85,48%). Entre los casos terapéuticos, se observó que el 94,29 % fue de uso empírico. Las familias de antibióticos empleados con mayor frecuencia fueron: cefalosporina de primera y tercera generación 25,64 %. Se observó un 52,63 % de uso no adecuado de antibióticos. Conclusión: Se ha destacado la elevada frecuencia de uso de antimicrobianos y una importante proporción de uso inadecuado en el Hospital General Paraguay-Korea. Es importante establecer los programas de optimización de uso de antimicrobianos y fortalecer los comités de infecciones asociadas al cuidado de la salud. Palabras clave: Profilaxis Antibiótica; Farmacorresistencia Microbiana; automedicación
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Conocimientos, actitudes y prácticas sobre salud sexual y reproductiva en estudiantes del nivel medio de centros educativos del distrito de R. I. 3 Corrales, 2018. MEDICINA CLÍNICA Y SOCIAL 2020. [DOI: 10.52379/mcs.v4i1.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Introducción: Durante la adolescencia se despierta el interés sexual debido a los diversos cambios. Es el momento oportuno para fomentar conductas adecuadas sobre salud sexual y reproductiva, para así posteriormente disfrutar de una vida sexual segura y responsable. Objetivo: Determinar los conocimientos, actitudes y prácticas sobre salud sexual y reproductiva en estudiantes del nivel medio de centros educativos del Distrito de R. I. 3 Corrales, durante el año 2018. Metodología: Se realizó un estudio observacional, descriptivo de corte transversal. Fueron incluidos la totalidad de los estudiantes del primer al tercer curso de cuatro colegios del Distrito de R.I. 3 Corrales del Departamento de Caaguazú, durante el mes de setiembre del 2018. Para la recolección de los datos se utilizó el “Cuestionario de Conocimientos, Actitudes y Prácticas sobre Salud Sexual y VIH/Sida en Niños, Niñas y Adolescentes de las comunidades de Dajabón (República Dominicana) y Wanament (Haití)”. Resultados: La población conformada por 200 estudiantes. La mediana de la edad de los que ingresaron al estudio fue de 16 años, 52% femenino, 54,77% refieren haber tenido relaciones sexuales, 71,94% conoce el preservativo y 47% de ellos lo utilizaron en el primer contacto sexual. El conocimiento fue bajo en un 48%, la actitud desfavorable en un 56% y las prácticas incorrectas en un 54% de los casos. Conclusión: El conocimiento global fue bajo, las actitudes desfavorables y las practicas incorrectas en la mayoría de los casos.
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Prevalencia de sífilis y características del comportamiento de los jóvenes indígenas del Paraguay, 2016. MEMORIAS DEL INSTITUTO DE INVESTIGACIONES EN CIENCIAS DE LA SALUD 2018. [DOI: 10.18004/mem.iics/1812-9528/2018.016(03)51-057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Condiciones higiénico-sanitarias basadas en las cinco claves de la OMS de los servicios de alimentación de hospitales del departamento de Caaguazú, Paraguay. MEMORIAS DEL INSTITUTO DE INVESTIGACIONES EN CIENCIAS DE LA SALUD 2018. [DOI: 10.18004/mem.iics/1812-9528/2018.016(02)21-031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Good Manufacturing Practices and Risk Factors During the Handling of Foods in the Municipal Markets of the Department of Caaguazú (2015-2016). REVISTA DEL INSTITUTO DE MEDICINA TROPICAL 2017. [DOI: 10.18004/imt/201712231-37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Risk Factors Associated with Neonatal Mortality in the Neonatology Service of the Regional Hospital of Coronel Oviedo Dr. Jose Angel Samudio, Period 2013- 2014. REVISTA DEL INSTITUTO DE MEDICINA TROPICAL 2016. [DOI: 10.18004/imt/201611122-34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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P3.179 Prevalence of HIV and Syphilis and Social Behaviour Characteristics of Native Populations in Three Geographical Areas of Paraguay - 2011. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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