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Objectives: To estimate the prevalence and factors associated with COVID-19 vaccination intention (VI) in Peru. Materials and methods: Analytical cross-sectional study using the survey conducted by the University of Maryland, USA, on Facebook. The dependent variable is VI. Crude and adjusted prevalence ratios (PR) were calculated, with their 95% confidence intervals (95%CI) using generalized linear models of the Poisson family, to evaluate the association of sociodemographic variables, compliance with community mitigation strategies, symptoms of COVID-19, mental health and acceptance of vaccination before the recommendation (AVR) by various actors and health authorities, with the ITV. Results: Data from 17,162 adults were analyzed. The overall prevalence of VI was 74.9%. A lower prevalence of VI was associated with the female sex (PR=0.95; 95%CI:0.94-0.97), living in a town (PR=0.95; 95%CI:0.91-0.99) or village or other rural area (PR=0.90; 95%CI:0.86-0.93) and the AVR of politicians (PR=0.89; 95%CI:0.87-0.92). Conversely, having COVID-19 symptoms (PR=1.06; 95%CI:1.03-1.09), economic insecurity (PR=1.04; 95%CI:1.01-1.06), fears of becoming seriously ill or that a family member becomes seriously ill from COVID-19 (PR=1.49; 95%CI:1.36-1.64) and the AVR of family and friends (PR=1.10; 95%CI: 1.08-1.12), healthcare workers (PR=1.29; 95%CI: 1.26-1.32), World Health Organization (PR=1.34; 95%CI: 1.29-1.40) and government officials (PR=1.18; 95%CI: 1.15-1.22) was associated with a higher prevalence of VI. Conclusions: Three-quarters of the respondents had VI. There are potentially modifiable factors that could improve vaccine acceptance.

Abstract COVID‐19 has been associated with several neurological complications. We presented a case of Bell's palsy as a possible neurological complication of COVID‐19 infection. Further research should be conducted to clarify the association, correlation, or causality between COVID‐19 and neuroimmunological diseases.

Objetivos. Evaluar la relación entre el índice de desarrollo humano (IDH) y la incidencia de tuberculosis (TB) en 165 países del mundo en el período 2005-2011. Materiales y métodos. Se realizó un estudio ecológico para el cual el IDH se obtuvo de la base de datos del Fondo de Naciones Unidas para el Desarrollo (PNUD) y la incidencia de TB del Programa Alto a la TB de la Organización Mundial de la Salud (OMS). Se evaluó la variación anual de las variables y se realizaron modelos de regresión no lineales (exponencial). Resultados. Al analizar los datos con los modelos de regresión no lineal, se observó que los países con mayores tasas de incidencia de TB fueron aquellos con menores valores de IDH, siendo significativa su asociación (p

Objetivos. Evaluar las diferencias entre el valor de hemoglobina observada y el valor estimado a partir del hematocrito en el marco del Segundo Estudio Nacional de Crecimiento y Desarrollo Humano de la Población Venezolana (SENACREDH) en el eje centro norte costero del país. Materiales y métodos. Por medio de un muestreo probabilístico multietápico por conglomerados se seleccionó un total de 6004 sujetos que representan 7 286 781 habitantes del eje Centro Norte Costero (Vargas, Carabobo, Distrito Capital, Aragua y Miranda). Se compararon medias de la hemoglobina observada y hemoglobina estimada (hematocrito/3), usando la prueba t para muestras relacionadas. Se realizaron regresiones lineales entre hemoglobina observada y hematocrito. Resultados. Se observó que el promedio de las diferencias entre la asignadas a la hemoglobina observada y la estimada por el hematocrito fue de -0,3446 ± 0,0002 (pObjectives. To evaluate the differences between the observed hemoglobin levels and those estimated based on hematocrit in the context of the 2nd National Study of Human Growth and Development of the Venezuelan Population (SENACREDH). Materials and methods. 6,004 individuals were chosen by a probabilistic multistage cluster sampling representing 7,286,781 inhabitants from North Central Coastal area (Vargas, Carabobo, Capital District, Aragua and Miranda). Means of observed and estimated hemoglobin (hematocrit/3) were compared, using t test for related samples and linear regression. Results. Mean difference between the values of observed and estimated hemoglobin was -0.3446 ±0.0002 (p

Objetivos. Evaluar las posibles asociaciones entre el índice de desarrollo humano (IDH) y sus componentes, y la incidencia de Leishmaniosis cutánea (LC) en cuatro estados endémicos de Venezuela (Mérida, Trujillo, Lara y Sucre) en el período 1994 al 2003. Materiales y métodos. La data socioeconómica (clasificada de acuerdo al Banco Mundial) se obtuvo del Instituto Nacional de Estadística y la epidemiológica del Ministerio de Salud, ambos de Venezuela. Para este estudio ecológico se evaluó la variación anual de las variables y se realizó modelos de regresión. Resultados. El IDH varió en el período, de 0,6746 en 1994 a 0,8144 en 2003 (p=0,90), asimismo, se observó un aumento de la incidencia acumulada de Leishmaniosis, en especial del año 1998 (7,3 casos/100 000 hab) a 1999 (11,3 casos/100 000 hab). Al analizar con los modelos de regresión lineal, se observó que la relación entre las variables epidemiológicas y sociales era diferente a nivel de los Estados evaluados. Para Mérida y Trujillo se observó un descenso significativo de la incidencia de LC con relación al aumento del porcentaje de alfabetización (pObjectives. Assess potential relationships between the Human Development Index (HDI) and its components and the incidence of cutaneous leishmaniasis (CL) in four endemic States of Venezuela (Mérida, Trujillo, Lara and Sucre) in the period 1994-2003. Material and methods. Socioeconomical data (classified according the World Bank) was obtained from the National Institute of Statistics, and the epidemiological data from the Ministry of Health, both from Venezuela. For this ecological study the annual variation of the variables was assessed and also regression models were done. Results. The HDI varied in the period from 0.6746 in 1994 to 0.8144 in 2003 (p=0.90). During this time an increase in the cumulative incidence of Leishmaniasis was observed, particularly from 1998 (7.3 cases/100,000 pop) to 1999 (11.3 cases/100,000 pop). Analyzing the linear regression models, it was observed that the relationship between epidemiological and social variables was different at States levels. For Mérida and Trujillo it was observed a significant decrease in the CL regard to the increase of literacy (p

La malaria continúa siendo un grave problema de salud pública mundial, ya no sólo en países endémicos, sino comenzando a representar un dilema médico en países distantes por la llegada de casos importados. Ahora bien, aun cuando en términos de las disciplinas médicas convencionales se ha publicado muchos estudios clínico-epidemiológicos y reportes de caso, los aspectos sociales, que parecerían obvios en el contexto de la malaria importada por supeditarse a la migración de la población, no han sido exhaustivamente explorados en relación con este fenómeno. Por estas razones, en esta revisión se analiza los aspectos sociales relacionados con el fenómeno de la malaria importada con énfasis al contexto epidemiológico de América Latina.

Objetivos: Analizar la importancia de la parasitemia, su relación con los valores de hemoglobina y anemia en niños internados con malaria por Plasmodium falciparum no complicada, y su potencial uso como variable en la predicción de la hemoglobina y la anemia. Materiales y Métodos: Se realizó un estudio clínico epidemiológico en el Hospital de Nzega, provincia de Tabora, Tanzania entre el 2001-2005, haciendo el diagnóstico con gota gruesa y extendido para investigar la presencia de hemoparásitos. Resultados: En el período de estudio fueron evaluados 165 pacientes con una edad media de 4,1 años (61,2%

Objetivos: Demostrar la presencia de asociación entre las variaciones climáticas (variables macro y microclimáticas) con los casos de dengue en el Hospital Pérez de León (HPL) de Caracas, Venezuela, en el período 1998-2004. Materiales y métodos: Se recolectó el registro mensual de los casos confirmados de dengue del Servicio de Epidemiología del HPL. Los datos microclimáticos se obtuvieron del Servicio de Meteorología de la Fuerza Aérea Venezolana, las precipitaciones se expresaron en mm de lluvia al mes y la temperatura máxima y mínima extrema de cada mes. Se usaron como índices climáticos el NAO, SOI, ONI de acuerdo con la clasificación de la NOAA, se clasificó en años El Niño y No El Niño (neutrales y La Niña). Para encontrar las asociaciones se usaron modelos de regresión lineal. Resultados: Para el periodo estudiado se registraron un total de 2187 casos confirmados de dengue, media anual de 267,86 casos (±371,21). El 2000 fue el año con mayor número de casos (hasta 214 casos/ mes), correspondiendo climáticamente con el fenómeno de La Niña. Se observó mayor número de casos durante los años No El Niño (1999, 2000, 2001, 2004) (60,26% más que la media) en comparación con los años El Niño (1998, 2002, 2003) donde se observó disminución en comparación con la media (-67,56%) (c 2 =21,76; p

Los recientes avances en la comprensión del ambiente en el cual ocurre la transmisión de muchas enfermedades infecciosas de importancia en salud pública en particular las transmitidas por vectores, ha permitido generar una serie de conceptos y herramientas que están modificando el abordaje de los problemas complejos en salud pública. Así, la ecoepidemiología y más recientemente la epidemiología satelital, brindan un potencial de opciones que se traducen en visiones más integradas de las enfermedades y nuevas posibilidades para prevenirlas y controlarlas. La presente revisión refleja los conceptos en evolución vinculados con estas nuevas ramas de la epidemiología y la salud pública.

Summary: Background: Autochthonous transmission of Zika virus (ZIKV) has been reported in 87 countries since 2015. Although most infections are mild, there is risk of Guillain-Barré syndrome and adverse pregnancy outcomes. Vaccines are urgently needed to prevent Zika, but sufficient understanding of humoral responses and tools to assess ZIKV-specific immunity are lacking. Methods: We developed a blockade-of-binding (BOB) ELISA using A9E and G9E, two strongly neutralising ZIKV-specific monoclonal antibodies, which do not react with dengue virus. Receiver operating characteristic curve analysis assessed A9E and G9E BOB serodiagnostic performance. BOB was then applied to samples from a surveillance cohort in Risaralda, Colombia, and phase 1 ZIKV vaccine trial samples, comparing results against traditional serologic tests. Findings: In the validation sample set (n = 120), A9E BOB has a sensitivity of 93.5% (95% CI: 79.3, 98.9) and specificity 97.8 (95% CI: 92.2, 99.6). G9E BOB had a sensitivity of 100% (95% CI: 89.0, 100.0) and specificity 100% (95% CI: 95.9, 100). Serum from natural infections consistently tested positive in these assays for up to one year, and reactivity tracks well with ZIKV infection status among sera from endemic areas with complicated flavivirus exposures. Interestingly, a leading ZIKV vaccine candidate elicited minimal BOB reactivity despite generating neutralising antibody responses. Interpretation: In conclusion, A9E and G9E BOB assays are sensitive and specific assays for detecting antibodies elicited by recent or remote ZIKV infections. Given the additional ability of these BOB assays to detect immune responses that target different epitopes, further development of these assays is well justified for applications including flavivirus surveillance, translational vaccinology research and as potential serologic correlates of protective immunity against Zika. Funding: R21 AI129532 (PI: S. Becker-Dreps), CDC BAA 2017-N-18041 (PI: A. M. de Silva), Thrasher Fund (PI: M. H. Collins), K22 AI137306 (PI: M. H. Collins).

Introduction: The advancement of technology has made the cell phone a fundamental part of daily life and a potential carrier of bacteria. Objective: To evaluate the factors associated with the presence of gram-negative bacteria in the cell phones of the merchants of the main market of the city of Huanuco, Peru. Methods: A cross-sectional study was carried out. The sample consisted of 116 merchants and was obtained by stratified probabilistic sampling. Samples of their cell phones were taken and cultured manually, and sensitivity was determined with antibiogram discs. The instrument was the validated collection card (81%). Stata v.16 software was used for the analysis, using chi-square and Mann Whitney U. Results: 17.2% of the cell phones had growth of Gram-negative bacteria. The bivariate analysis with this variable found that sex, type of cell phone and the longest time of use during working hours were statistically associated (p< 0.05). Conclusions: The female gender, having a cell phone with a keyboard and the highest frequency of use are variables associated with the colonization of gram-negative germs in cell phones of vendors in the Huanuco, Peru market.

BackgroundThe Latin American and Caribbean (LAC) region has been one of the regions most affected by the COVID-19 pandemic, with countries presenting some of the highest numbers of cases and deaths from this disease in the world. Despite this, vaccination intention is not homogeneous in the region, and no study has evaluated the influence of the mass media on vaccination intention. The objective of this study was to evaluate the association between the use of mass media to learn about COVID-19 and the non-intention of vaccination against COVID-19 in LAC countries.MethodsAn analysis of secondary data from a Massachusetts Institute of Technology (MIT) survey was conducted in collaboration with Facebook on people's beliefs, behaviors, and norms regarding COVID-19. Crude and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95%CI) were calculated to evaluate the association between the use of mass media and non-vaccination intention using generalized linear models of the Poisson family with logarithmic link.ResultsA total of 350,322 Facebook users over the age of 18 from LAC countries were included. 50.0% were men, 28.4% were between 18 and 30 years old, 41.4% had a high school education level, 86.1% lived in the city and 34.4% reported good health condition. The prevalence of using the mass media to learn about COVID-19 was mostly through mixed media (65.8%). The non-intention of vaccination was 10.8%. A higher prevalence of not intending to be vaccinated against COVID-19 was found in those who used traditional media (aPR = 1.36; 95%CI: 1.29–1.44; p < 0.001) and digital media (aPR = 1.70; 95%CI: 1.24–2.33; p = 0.003) compared to those using mixed media.ConclusionWe found an association between the type of mass media used to learn about COVID-19 and the non-intention of vaccination. The use of only traditional or digital information sources were associated with a higher probability of non-intention to vaccinate compared to the use of both sources.

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.

Introduction: Coronavirus disease 2019 (COVID-19) fatal outcomes have been associated with multiple cardiovascular risk factors. In new epidemic areas, such as Latin America, there is a lack of studies about this. Objectives: To evaluate demographic data, signs and symptoms during emergency arrival, prevalence of cardiovascular risk factors, laboratory and ECG findings and their influence in mortality, in a retrospective cohort of patients in a national reference hospital of Lima, Peru. Methods: Review the clinical records of the patients attended at Hospital Rebagliati Hospital during March 6th and April 30th, 2020, using rRT-PCR was used for the detection of the RNA of SARS-CoV-2 following the protocol Charité, Berlin, Germany, from nasopharyngeal swabs at the National Institute of Health. Bivariate analysis and multivariate analysis using logistic regression was done. Values of p < 0.05 were considered significant for all analyses. Results: One hundred six hospitalized patients were evaluated. The mean age of patients was 61.58 years (SD 16.81). Cardiovascular risk factors among them were hypertension (46.2%), diabetes (28.3%), and obesity (28.3%), among others. Fifty-six patients died (52.8%). Mortality associated factors at the multivariate analysis were arterial hypertension (OR=1.343, 95% 1.089-1.667), myocardial injury (OR=1.303, 95% 1.031-1.642), and mechanical ventilation (OR 1.262, 95% 1.034-1.665), as associated factors. Conclusion: Cardiovascular risk factors and cardiovascular signs or symptoms are common during emergency arrival in patients with COVID-19. Arterial hypertension, myocardial injury and mechanical ventilation were associated with mortality in multivariate analysis, as observed in other regions of the world.

Congenital toxoplasmosis continues to be a public health threat. Even existing guidelines, publicly known, its implementation and lack of appropriate interpretation of serological tests in pregnancy is often observed. This leds to failure in opportunities for positive and known interventions to decrease the fetal risk due to Toxoplasma gondii infection. We reported herein a case series, with variable neurological and systemic compromise (respiratory distress, hepatosplenomegaly, enterocolitis, brain calcifications, thrombocytopenia, ascites, shock), even fatal, calling for awareness about the fact that despite the Zika epidemics in 2015-2016 in Brazil, Colombia and other countries, precisely toxoplasmosis, is a differential diagnosis still prevalent in these territories, that can leds to severe consequences, with neurological disability and risk of ocular damage, even lately. Additionally, with varieties of T. gondii with more aggressive patterns in Latin America, which make worse those cases, including also a higher risk of death.

To the Editor, The article of Krutikov and Manson1 was interesting. However, no comment was made on the impact and related clinical epidemiology of the chikungunya virus (CHIKV) infection during the 2014–2015 epidemics in Latin America, the most recent area affected by CHIKV. ...

Desde hace un par de décadas y más aun en los últimos cinco años, se ha desarrollado un gran número de estudios que demuestran la actividad tripanocida de diversas drogas, algunas nuevas, muchas viejas, lo cual aunado al conocimiento acerca de la persistencia parasitaria de Trypanosoma cruzi en tejido miocárdico, entre otros, durante las fases crónicas de la enfermedad, permiten hacer patente que existe un nuevo paradigma, nuevas aproximacio-nes al manejo terapéutico del paciente con enfermedad de Chagas. En el presente artículo se revisan las principales bases que sustentan dichas perspectivas terapéuticas en la tripanosomiasis americana.

Objetivos: Describir los posibles impactos de El Niño Southern Oscillation (ENSO) sobre la leishmaniosis cutánea (LC) en Sucre, Venezuela en el período 1994-2003. Materiales y Métodos: La data climática se obtuvo de sistemas remotos y fue clasificada de acuerdo con la National Oceanographic and Atmospheric Administration (NOAA) en periodos El Niño, Neutral o La Niña, usando el Southern Oscillation Index (SOI) como indicador de variabilidad. Los datos de LC fueron obtenidos de la Gerencia de Saneamiento Ambiental en Sucre. Se realizaron comparaciones de las variaciones anuales y desviaciones de las tendencias medias, entre la incidencia de LC y variabilidad climática, así como modelos de regresión. Resultados: Se registraron entre 1994 -2003 en Sucre 2212 casos de LC. Se observaron tres fases importantes de El Niño: 1994-1995, 1997-1998 y 2001-2003, la más relevante correspondió a 1997-1998, que fue seguido de un periodo frío y lluvioso en 1999 (La Niña). Durante 1999/2000, se registraron 360 casos de LC en Sucre, con importante variabilidad intraanual, se observó un incremento en 66,7% de los casos de LC (F=10,06, p=0,0051) asociado a la presencia de La Niña débil (poco frío y lluvioso). Los modelos mostraron que a mayores valores del SOI menor incidencia de LC (r 2 =0,3308, p=0,0504). El incremento sobre la tendencia media de las precipitaciones se asoció con incrementos sobre las tendencias de la LC durante 1994-2003 (p=0,0358). Conclusiones: Estos datos reflejan la importancia del ENSO sobre la incidencia de la LC, abriendo una nueva línea de investigación con posible impacto en la predicción y monitoreo con relevancia en salud pública.

Objetivos. Evaluar la relación entre el índice de desarrollo humano (IDH) y la incidencia de tuberculosis (TB) en 165 países del mundo en el período 2005-2011. Materiales y métodos. Se realizó un estudio ecológico para el cual el IDH se obtuvo de la base de datos del Fondo de Naciones Unidas para el Desarrollo (PNUD) y la incidencia de TB del Programa Alto a la TB de la Organización Mundial de la Salud (OMS). Se evaluó la variación anual de las variables y se realizaron modelos de regresión no lineales (exponencial). Resultados. Al analizar los datos con los modelos de regresión no lineal, se observó que los países con mayores tasas de incidencia de TB fueron aquellos con menores valores de IDH, siendo significativa su asociación (p