Revista Peruana de Medicina de Experimental y Salud Publica最新文献

Objectives.: To evaluate whether there is an association between current major depressive episode (CMDE) and menstrual irregularities (MI), including amenorrhea, oligomenorrhea, or polymenorrhea, in Peruvian university students in 2024.

Materials and methods.: An observational, cross-sectional, and analytical study was conducted on students from a private university in Lima, Peru. The Patient Health Questionnaire 9 (PHQ-9) was used to identify a CMDE, and a survey with closed-ended questions was used to identify cases of MI. The measure of association was the prevalence ratio (PR), derived from Poisson regression models, both crude and adjusted for potential confounding factors.

Results.: A total of 250 women between 18 and 30 years of age participated (median age: 20 years, interquartile range from 19 to 21 years). 73.2% presented at least one MI (amenorrhea, oligomenorrhea, or polymenorrhea) and 70.8% had CMDE of any grade (29.2% mild and 41.6% moderate-severe). Compared to students without CMDE, the occurrence of any MI was more likely in those students with moderate-severe CMDE (aPR=1.33; 95% CI: 1.08-1.62; p=0.006), but was not different regarding those with mild CMDE (aPR=1.20; 95% CI: 0.95-1.5; p=0.112).

Conclusions.: MIs and CMDE are frequent in university students. Moderate-severe CMDE was associated with a higher risk of MI. Future longitudinal studies will allow for the establishment of temporality and other relevant aspects to assess a possible causal relationship between MI and CMDE, including the specific relationship with each type of MI.

Objective.: To explore how the Emberá communities of Chocó, Colombia, coexist with malaria, through the recognition of the meanings they construct about the disease, its treatment, and care.

Materials and methods.: This was an ethnographic study. Between October 2022 and November 2023, 250 hours of participant observation were conducted in six Emberá indigenous communities, and 25 interviews were conducted with community members, including authorities and Jaibaná. The data were analyzed according to Constructivist Grounded Theory, using NVIVO software.

Results.: The central category «Malaria: a disease that accompanies indigenous communities» emerged, supported by three subcategories: «Disease from the West,» which moves with people, can be prevented, and is always present; «The mosquito as the master of the disease,» which is controlled through training, cleanliness and hygiene, use of mosquito nets, and organic food; and «Health Care for Indigenous People with Malaria,» which begins with the Jaibaná, who controls the spirits that hinder the process and Western treatment.

Conclusions.: Communities perceive malaria as a Western disease and attribute its origin and transmission to mosquitoes, without recognizing humans as the main source of outbreaks. The Jaibaná plays a fundamental role in patient care, addressing spiritual conditions that complement Western treatment. Although the incorporation of ancestral practices into health care for Indigenous communities is recommended, this is done empirically and based on public demand.

Objective.: To understand the perception of the role of Community Health Workers (CHWs) as facilitators of the use of maternal health services in rural settings. Materials and methods. Semi-structured interviews were conducted with 11 CHWs assigned to the Paucara Health Center, selected by theoretical saturation sampling. Data were analyzed using a phenomenological approach, and constant comparison was used to inductively identify emerging themes.

Results.: The interviews revealed three categories of perceptions: 1. Accompaniment and monitoring: pregnancy identification, home visits, community awareness, transfers in emergency cases, and challenges such as lack of remuneration and community misunderstandings; 2. Cultural and institutional mediation: integration of traditional practices, respectful treatment, addressing cultural barriers; 3. Management: reporting the situation of pregnant women, training, and communal referral.

Conclusions.: CHWs perceive their roles as relevant in mitigating social, cultural, and structural barriers in maternal care. This study provides evidence for the design of public policies that can strengthen the recognition and sustainability of the CHWs' work, through an equitable and culturally sensitive maternal care model.

Marine sponges constitute a recognized source of metabolites with potential antibacterial activity. In the present study, the antibacterial activity of the marine sponge Suberites aff. latus from Ica, Peru, was evaluated. Lyophilized sponge samples were extracted using dichloromethane:methanol (1:1), and fractionated by solid-phase extraction into seven fractions (F1-F7), ranging from aqueous to organic polarity. The minimum inhibitory concentration was determined against Gram-positive/negative bacterial strains from the ATCC (American Type Culture Collection) collection. The results showed that the highest activity was observed in fraction F6 of specimen 01J against Klebsiella pneumoniae and Pseudomonas aeruginosa, as well as in fraction F3 of specimen 02J against K. pneumoniae. Qualitative chemical analysis revealed the presence of alkaloids and saponins in the samples. These findings highlight the potential of Suberites aff. latus from the Peruvian coast as a promising source of antibacterial compounds.

Objectives.: To identify Plasmodium vivax genotypes in the pregnant and non-pregnant population and explore their association with immune mediators.

Materials and methods.: Two cohorts of patients with uncomplicated vivax malaria were followed for 120 days in Puerto Libertador and Tierralta, Cordoba, Colombia: 41 pregnant women and 46 non-pregnant individuals, all treated with standard treatment. Parasite genotypes (microsatellites Pv3.27, Pv3.502, and Pv1.501) and the expression of host immune mediators (IL-13, IL-10, TNF-alpha, IFN-gamma, IL-8, TGF-beta, Fox-P3, PD-L1) were compared between primary and recurrent infections.

Results.: The frequency of recurrences was higher in pregnant women (41.6%) than in non-pregnant individuals (8.7%). Parasite genetic diversity was higher in pregnant women, although without exclusive alleles. Recurrences were genetically homologous (same alleles) in only 23% and 33% of cases in pregnant and non-pregnant individuals, respectively. Regarding immune mediators, only Fox-P3 expression varied significantly in pregnant women, with higher expression in the primary episode than in the recurrent one.

Conclusions.: Pregnant women are exposed to a high frequency of vivax malaria recurrences, with high parasite genetic variation, which may affect the development of effective protective immunity and favor adverse obstetric outcomes, both maternal and neonatal. These findings raise the need to strengthen and optimize prevention and treatment actions for vivax malaria during pregnancy.

Objective.: To examine the frequency of depressive symptoms, gender-based violence, and gender-based discrimination among transgender women (TGW) in Lima, Peru, during the COVID-19 pandemic.

Materials and methods.: Between May and July 2021, the non-governmental organization Socios En Salud conducted a cross-sectional study to assess depressive symptoms, gender-based discrimination and violence among TGW identified from a prior study database and peer referral. Descriptive statistics were used to report frequencies, and an exploratory bivariate analysis was performed to examine associations between depressive symptoms and participants´ characteristics, including experiences of discrimination and violence. Depressive symptoms were assessed using the Patient Health Questionnaire-9; gender-based discrimination and violence were measured using adopted instruments.

Results.: A total of 112 participants were included in the study. Most TGW reported depressive symptoms (81.2%), experiences of gender-based violence (83.8%), and experiences of gender-based discrimination (95.5%). The presence of depressive symptoms was associated with experiences of discrimination in healthcare settings (p < 0.046) and with experiences of violence (p < 0.046).

Conclusions.: A high frequency of depressive symptoms, as well as experiences of gender-based discrimination and violence, was observed among TGW in Lima, Peru, during the COVID-19 pandemic. In addition, significant associations were identified between these experiences and the presence of depressive symptoms. These findings are consistent with existing evidence on the mental health impact of the pandemic, but also suggest a disproportionate burden among TGW and highlight the urgent need to address the underlying contributing factors.

Objective.: To evaluate the energy contribution of ultra-processed foods (UPFs) and its association with social and demographic covariates in children between 6 and 35 months of age, based on national surveys conducted in 2008‒2010, 2015‒2016, and 2019.

Materials and methods.: The surveys used multistage stratified random samples. 24-hour recalls were applied on random days per participant, using the modified multiple-pass method, with the support of visual aids and scales. UPFs belonged to the Nova 4 group. Given the bimodal distribution, the covariates were analyzed using two models: a binomial model for the percentage of UPF consumers and a normal model for the average energy contribution, only among UPF consumers. The estimates and models were adjusted according to the sampling design.

Results.: 2887 children were included. UPFs contributed 27% (95% CI: 25 to 29) of the total energy intake and were consumed by 86% (84 to 89) of children. The main energy contribution from UPFs came from the milk and dairy products group (19% [17 to 20]) and cereals (5% [4 to 6]). The covariates associated with consumption were age, calendar quarter, and poverty. No associations were found with sex or the year of the survey.

Conclusions.: In children aged 6 to 35 months in Peru, UPFs provided an average of 27% of total energy and were consumed by 86%. The main sources were the milk and dairy products, and the cereals group. UPF consumption was associated with age, poverty, and the calendar quarter.

In 2024, a cross-sectional, quantitative, and descriptive study was conducted to molecularly identify resistance to organophosphates and carbamates in Aedes aegypti of different physiological ages in a cemetery in northern Peru. Female specimens were captured, taxonomically identified, their ovaries dissected, and the parity percentage calculated. Likewise, the legs of nulliparous, parous, and gravid females were dissected, DNA was extracted, and PCR was performed to detect the mutant ACEr gene associated with resistance to organophosphates and carbamates. A total of 218 (100%) females were captured, with a nulliparity index of 37,61% and a parity index of 62,39%, of which 13,23% of parous females were gravid at the time of capture. The ACEr gene was detected in all three physiological age groups. It is inferred that in the analyzed cemetery, there are Aedes aegypti populations carrying the genetic mutation conferring resistance to organophosphate and carbamate insecticides.