Search

To identify the associated factors and assess the inequalities of full vaccination coverage (FVC) among Peruvian infants aged 12-23 months during the COVID-19 pandemic in a nationally representative sample.We carried out a population-based cross-sectional study based on a secondary data analysis using the 2021 Peruvian Demographic Health Survey (DHS) in infants aged 12 to 23 months. The sampling design was probabilistic, multistage, stratified, and independent at both departmental and area of residence levels. FVC was defined according to the WHO definition. We performed generalized linear models (GLM) Poisson family log link function to estimate crude (aPR) and adjusted prevalence ratios (aPR). Also, for inequality assessment, we calculated the concentration curve (CC), concentration index (CI), and Erreygers normalized concentration index (ECI).We included 4,189 infants in our analysis. Nationwide, the prevalence of FVC was 66.19% (95% CI: 64.33-68). Being younger, having a mother with no education or primary education, belonging to a large family, having no access to mass media, having had six or fewer ANC visits, and having a mother whose age was under 20 at first delivery were inversely associated with FVC. Meanwhile, living in the Highlands or on the rest of the coast, and living in rural areas were directly associated with FVC. We found a pro-rich inequality in FVC based on wealth-ranked households (CI: 0.0066; ECI: 0.0175).FVC has dropped among Peruvian infants aged between 12 and 23 months. There were several factors associated with FVC. It was more concentrated among the better-off infants, although in low magnitude.

Background and Aims. Biomarkers are necessary to stratify the risk of diabetic foot ulcers (DFUs). This systematic review and meta-analysis aimed to evaluate the association between the lipid profile and apolipoproteins with the risk of DFU. Methods. A systematic search was conducted in PubMed, Scopus, Cochrane Library, and Web of Science among adult patients. Cohort and case-control studies were included. Random-effects models were used for meta-analyses, and the effects were expressed as odds ratio (OR) and their 95% confidence intervals (CIs). We evaluated publication bias through Egger’s test and funnel plot. Results. A total of 12 cohort studies and 26 case-control studies were included, with 17076 patients. We found that the higher values of total cholesterol (TC), low-density lipoprotein (LDL), triglycerides, and lipoprotein(a) (Lp(a)) were associated with a higher risk of developing DFU (OR: 1.47, OR: 1.47, OR: 1.5, OR: 1.85, respectively). Otherwise, the lower values of HDL were associated with a higher risk of developing DFU (OR: 0.49). Publication bias was not found for associations between TC, HDL, LDL, or TG and the risk of DFU. Conclusions. The high values of LDL, TC, TG, and Lp(a) and low values of HDL are associated with a higher risk of developing DFU. Furthermore, we did not find a significant association for VLDL, ApoA1, ApoB, and ApoB/ApoA1 ratio.

We conducted a secondary data analysis based on the 2014, 2015, and 2016 Demographic and Health Surveys to determine the association between intimate partner violence (IPV) and depressive symptoms in Peruvian women aged 15–45 years. Depressive symptoms were assessed through the PHQ-9, while IPV was assessed through the CTS-2. A total of 24,099 subjects were included. The prevalence of depressive symptoms and IPV was 6.98% and 64.72%, respectively. Victims of IPV were 2.47 times more likely to have depressive symptoms compared to those who were never assaulted. In conclusion, there is a strong association between IPV and depressive symptoms.

Purpose Depression has become a major health concern, particularly in developing countries. This disorder is highly prevalent among certain vulnerable populations, such as prisoners. In Peru, prisons are overcrowded, and the health of prisoners is neglected. Thus, this study aims to estimate the prevalence of depression diagnosed during incarceration in male inmates from all Peruvian prisons and assess its associated factors. Design/methodology/approach A cross-sectional study was conducted based on the secondary data analysis of the National Census of Prison Population 2016 in Peru. This study included records of prisoners who reported whether they were diagnosed with depression by a health-care professional after admission into the prisons. Descriptive, bivariate and multivariable analyses were performed. Findings Of the 63,312 prisoners included in this study, 1,007 reported an in-prison diagnosis of depression by a health-care professional, which represents a prevalence of 1.59%. Substance use disorder (adjusted prevalence ratio [aPR] 3.10; 95% confidence interval [CI]: 1.91–5.03), hypertension (aPR 7.20; 95% CI: 6.28–8.24) and previous discrimination (aPR 1.97; 95% CI: 1.62–2.40) were strongly associated with depression, even when adjusting for multiple confounders. Other directly associated variables were, for example, violence during childhood, infrequent visits in prison and diabetes. Originality/value The right of prisoners to adequate health care is being neglected in Peru. Mental health is a cornerstone of health quality. Acknowledging which factors are associated with depression in prison is important to implement strategies to improve the mental health of prisoners.

Objective: To evaluate the psychometric properties of the Spanish version of Jenkins Sleep Scale with 4 items (JSS-4) of the Peruvian health system's (PHS) nurses and physicians. Methods: We carried out a psychometric study based on secondary analysis in a sample from a nationally representative survey that used acomplex sampling design. The participants were physicians and nurses aged 18–65 years, working in PHS private and public facilities, who have fulfilled all JSS-4 items. We performed a confirmatory factor analysis. Reliability was evaluated via two estimates - classic alpha (α) and categorical omega (ω) coefficients. Also, we tested the invariance across groups of variables. The convergent validity was evaluated based on the relation between JSS-4 and PHQ-2 using Pearson's correlation coefficient and effect size (Cohen's d). Also, we designed normative values based on percentiles. Results: We included 2100 physicians and 2826 nurses in the analysis. We observed that the unidimensional model has adequate goodness-of-fit indices and values of α and ω coefficients. No measurement invariance was found between the groups of professionals and age groups; however, invariance was achieved between sex, monthly income, work-related illness, and chronic illness groups. Regarding the relation with other variables, the JSS-4 has a small correlation with PHQ-2. Also, profession and age-specific normative values were proposed. Conclusion: JSS-4 Spanish version has adequate psychometric properties in PHS nurses and physicians. Revisión por pares

RESUMEN Objetivo: Determinar los factores sociodemográficos y nutricionales asociados a la anemia en niños de 1 a 5 años de Perú según la Encuesta Nacional Demográfica y de Salud Familiar (DHS, por sus siglas en inglés Demographic and Health Survey). Metodología: Para determinar los posibles factores sociodemográficos y nutricionales asociados a la anemia, se hizo un subanálisis de la DHS 2017, tomando en cuenta un intervalo de confianza del 95% y considerando los parámetros de complejidad de la encuesta. Se describieron las frecuencias relativas en el análisis univariado. Para el análisis bivariado se empleó el test de chi cuadrado para las variables categóricas y t-Student para las variables continuas. Para el modelo de regresión múltiple, se realizó una regresión de Poisson cruda y ajustada con el método de selección de variables tipo backward. Principales resultados: La prevalencia de anemia fue de 38.5%. Los factores independientemente asociados fueron quintil de riqueza bajo (RP(a): 1,23; IC95%: 1,0-1,4), ningún grado de instrucción o grado de instrucción primaria de la madre (RP(a): 1,25; IC95%: 1,0-1,5), edad de la madre menor de 19 años (RP(a): 1,34; IC95%: 1,1-1,7), lugar del parto no institucionalizado (RP(a): 1,24; IC95%: 1,1-1,5), no consumo de antiparasitarios (RP(a): 1,13; IC95%:1,0-1,3) y altitud mayor o igual a 4000 msnm (RP(a): 1,45; IC95%: 1,2-1,8). Conclusiones: La prevalencia de anemia en niños de 1 a 5 años en el 2017 fue moderada. Existen factores sociodemográficos y nutricionales asociados a dicha condición.

Resumen Objetivos: Determinar la asociación entre los factores sociodemográficos y reproductivos con la fecundidad adicional no deseada (FAND) en el Perú. Materiales y métodos: Se realizó un estudio observacional, analítico transversal, a partir de la Encuesta Demográfica y de Salud Familiar (ENDES) 2018 en el Perú. La FAND es una variable que se creó a partir de la diferencia numérica entre la fecundidad obtenida y la fecundidad deseada. La variable FAND, se creó a partir de la diferencia numérica entre la fecundidad obtenida y la fecundidad deseada y se agrupó en dos categorías donde la diferencia numérica positiva correspondió a la presencia de FAND. Se realizó una regresión de Poisson, tanto cruda como ajustada. Resultados: Se analizaron los datos de 6944 mujeres entre 40 y 49 años, con una edad promedio de 44,3 años. Se halló una prevalencia de FAND de 72,5% (IC95%: 70,4%-74,4%). En el modelo ajustado, se observó que pertenecer al quintil superior de riqueza (RPa 0,80; IC95%: 0,69-0,93) disminuía la probabilidad de FAND con respecto al quintil intermedio. Por otro lado, provenir del ámbito rural (RPa 1,07; IC95%: 1,01-1,14), aumenta la probabilidad de FAND con respecto al provenir del ámbito urbano. Conclusiones: La prevalencia de FAND en mujeres peruanas de 40 a 49 años que participaron de la ENDES 2018 es alta. Provenir del área rural aumenta la probabilidad de FAND; y pertenecer al quintil superior de riqueza, la disminuye. Abstract Objectives: To determine the association between sociodemographic and reproductive factors with unwanted additional fertility (UAF) in Peru. Materials and methods: We carried out an observational, cross-sectional analytical study based on the 2018 Demographic and Family Health Survey (DHS) in Peru. The UAF variable was defined as the numerical difference between the general fertility rate and the total fertility rate. This variable was divided into 2 categories, UAF was considered when the numerical difference was positive. The Poisson regression was used, both crude and adjusted. Results: We analyzed data from 6,944 women with an average age of 44.3 years (range, 40 to 49). The prevalence of UAF was found to be 72.5% (95% CI: 70.4%-74.4%). In the adjusted model, patients in the top wealth quintile (aPR 0.80; 95% CI: 0.69-0.93) were found to have a lower probability of having unwanted pregnancies when compared to those in the middle quintile. On the other hand, patients from rural areas (aPR 1.07; 95% CI: 1.01-1.14) had a higher probability of having unwanted pregnancies when compared to those from urban áreas. Conclusions: The prevalence of UAF in Peruvian women between 40 and 49 years old who participated in the 2018 DHS is high. Patients from rural areas have a higher probability of having unwanted pregnancies, and those in the top wealth quintile have a lower probability.

La rabia es una infección zoonotica de amplia distribución en países en vías de desarrollo que es causada por un rhabdovirus de ARN. En Perú esta infección se distribuye en mayor porcentaje en regiones vulnerables como Loreto y Puno. Es por ello que es fundamental conocer su mecanismo de acción molecular y así tomar acciones adecuadas para su prevención. Si bien es cierto dichos mecanismos moleculares resultan complejos, en estos últimos años se está dilucidando cuales son los sistemas comprometidos (sistema nervioso y periférico), receptores implicados (nicotínicos, mGluR2, etc.), neurotransmisores (acetilcolina, glutamato, GABA, etc.) y respuesta inmunológica comprometida. La prevención es clave para evitar la propagación y secuelas de esta enfermedad. Así, la prevención primaria o secundaria, las inmunizaciones activa o pasiva y, sobre todo, el conocimiento de la población sobre la “triada preventiva” han demostrado tener efectos beneficiosos. El objetivo de esta revisión es discutir los aspectos epidemiológicos, moleculares y de prevención sobre la rabia, contribuyendo así a su comprensión holística. Palabras claves: Rabia, zoonótica, transporte axonal, inmunización.

Marijuana is the most widely used illicit drug in the world, especially among young people. This study is relevant to policy makers because it expands the knowledge regarding drug use in vulnerable youth, allowing health authorities to reduce marijuana consumption via educational, family, and governmental strategies and policies. The objective of this study was to determine the prevalence of frequent marijuana consumption and its associated factors in young people before admission to juvenile detention centers in Peru. The data was taken from the 2016 National Population Census of the Youth Diagnostic and Rehabilitation Centers in Peru. The final sample was made up of 1,848 people with ages between 14 and 22 years old, with a median age of 17 (95.6% males). The variable frequent marijuana consumption was defined as the use of marijuana at least once a week, prior to entering the center. The main factors associated with frequent marijuana use were male sex, running away from home before the age of 15, physical abuse during childhood, having a family member who consumed alcohol or drugs frequently, and the presence of criminal gangs in the housing area. Additionally, it was found that living with parents up to a specific critical age decreases the probability of frequent use of marijuana in young people. These results could aid the development of strategies and public policies that help prevent the consumption of marijuana and other drugs from an early age.La marihuana es la droga ilícita más consumida en el mundo, especialmente entre jóvenes. El presente estudio es relevante para la toma de decisiones en salud porque expande el conocimiento sobre el uso de drogas en la juventud vulnerable y permite a las autoridades sanitarias reducir el consumo de marihuana mediante estrategias educativas, familiares y gubernamentales. El objetivo de este estudio fue determinar la prevalencia del consumo frecuente de marihuana y sus factores asociados en jóvenes antes de su ingreso a centros juveniles de diagnóstico y rehabilitación en Perú. Los datos fueron tomados del Censo Nacional de Población en los Centros Juveniles de Diagnóstico y Rehabilitación del año 2016 en Perú. La muestra final estuvo compuesta por 1848 personas entre 14 y 22 años, con una mediana de edad de 17 años (95,6 % hombres). La variable consumo frecuente de marihuana fue definida como el consumo de marihuana de al menos una vez por semana por parte de los jóvenes, previo a su ingreso al centro. Los principales factores asociados al consumo frecuente de marihuana fueron el sexo masculino, huir de casa antes de los 15 años, haber sufrido abuso físico durante la infancia, tener un miembro de la familia que consuma alcohol o drogas frecuentemente y la presencia de pandillas criminales en la zona residencial. Asimismo, se halló que vivir con los padres hasta cierta edad crítica disminuye la probabilidad de consumo frecuente de marihuana en jóvenes. Estos resultados podrían ayudar a desarrollar estrategias y políticas públicas que ayuden a prevenir el consumo de marihuana y otras drogas desde edades tempranas.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. Carta al editor. Revisión por pares

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. Methods: We conducted a systematic review and meta-analysis. Observational studies that reported the association between baseline NLR values (i.e. 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 (OR) and their 95% confidence intervals (CI). Small study effects were assessed with the Egger’s test. Results: Twenty studies, 19 cohorts and one case-control were included. An increase of one unit of NLR was associated with a higher odds of COVID-19 severity (OR 6.6, 95% CI: 4.71 - 7.19; p

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. Objective: To evaluate the safety and tolerability of an oral herbal supplement containing glucosinolates, phytosterols, and citrus flavonoids (Warmi®, Lima Perú;) in otherwise healthy adult women. Methods: This was a phase-I, randomized parallel three arms, double-blinded, and a placebo-controlled clinical trial. A total of 55 participants aged 18-40 were randomly assigned to one of three groups to receive for three months: (1) an oral herbal supplement of 1650 mg/day; (2) an oral herbal supplement of 3300 mg/day; or (3) an oral placebo 3300 mg/day. The primary endpoints were oral safety and tolerability of the supplement. The secondary endpoint was its effect on vital functions, anthropometrics, and laboratory tests. We used an exploratory approach by covariance analysis (ANCOVA) adjusted for the variables’ baseline value for the secondary outcomes. Results: All women completed three months of follow-up, reporting no side effects. Our exploratory analysis revealed that treatment with the herbal supplement of 1650 mg/day was associated with increased glucose and uric acid levels. In comparison, the herbal supplement 3300 mg/day was associated with reduced breathing rate, increased basal temperature, and systolic blood pressure, both compared to the placebo group. However, despite significant differences, none of these was clinically significant. Conclusion: The oral herbal supplement had a favorable safety and tolerability profile in studied women. There is a need to study its potential as an option to treat menopausal symptoms. Revisión por pares

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

We have read with interest the short communication published by Segovia-Juarez et al., 2020 in Respiratory Physiology & Neurobiology establishing that high altitude reduces the infection rate of COVID-19 but not the case fatality rate in the Peruvian setting. We support this hypothesis, however there could be an important number of under registered deaths on account of a low rate of diagnostic tests performed per inhabitant and mostly in symptomatic patients (Pasquariello and Stranges, 2020). Revisión por pares

To determine the association between sociodemographic and reproductive factors with unwanted additional fertility (UAF) in Peru.We carried out an observational, cross-sectional analytical study based on the 2018 Demographic and Family Health Survey (DHS) in Peru. The UAF variable was defined as the numerical difference between the general fertility rate and the total fertility rate. This variable was divided into 2 categories, UAF was considered when the numerical difference was positive. The Poisson regression was used, both crude and adjusted.We analyzed data from 6,944 women with an average age of 44.3 years (range, 40 to 49). The prevalence of UAF was found to be 72.5% (95% CI: 70.4%-74.4%). In the adjusted model, patients in the top wealth quintile (aPR 0.80; 95% CI: 0.69-0.93) were found to have a lower probability of having unwanted pregnancies when compared to those in the middle quintile. On the other hand, patients from rural areas (aPR 1.07; 95% CI: 1.01-1.14) had a higher probability of having unwanted pregnancies when compared to those from urban áreas.The prevalence of UAF in Peruvian women between 40 and 49 years old who participated in the 2018 DHS is high. Patients from rural areas have a higher probability of having unwanted pregnancies, and those in the top wealth quintile have a lower probability.Determinar la asociación entre los factores sociodemográficos y reproductivos con la fecundidad adicional no deseada (FAND) en el Perú.Se realizó un estudio observacional, analítico transversal, a partir de la Encuesta Demográfica y de Salud Familiar (ENDES) 2018 en el Perú. La FAND es una variable que se creó a partir de la diferencia numérica entre la fecundidad obtenida y la fecundidad deseada. La variable FAND, se creó a partir de la diferencia numérica entre la fecundidad obtenida y la fecundidad deseada y se agrupó en dos categorías donde la diferencia numérica positiva correspondió a la presencia de FAND. Se realizó una regresión de Poisson, tanto cruda como ajustada.Se analizaron los datos de 6944 mujeres entre 40 y 49 años, con una edad promedio de 44,3 años. Se halló una prevalencia de FAND de 72,5% (IC95%: 70,4%-74,4%). En el modelo ajustado, se observó que pertenecer al quintil superior de riqueza (RPa 0,80; IC95%: 0,69-0,93) disminuía la probabilidad de FAND con respecto al quintil intermedio. Por otro lado, provenir del ámbito rural (RPa 1,07; IC95%: 1,01-1,14), aumenta la probabilidad de FAND con respecto al provenir del ámbito urbano.La prevalencia de FAND en mujeres peruanas de 40 a 49 años que participaron de la ENDES 2018 es alta. Provenir del área rural aumenta la probabilidad de FAND; y pertenecer al quintil superior de riqueza, la disminuye.

Background: COVID-19 is a condition caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing a systemic inflammatory response and respiratory failure. Patients with acute leukemia are presumed to be at the highest risk among all cancer patients, given their state of severe immunosuppression from both the disease and aggressive therapy. Therefore, we aimed to determine if COVID-19 increases the early-mortality risk of ALL patients during the induction phase. Methods: We conducted a retrospective cohort study by reviewing medical records of newly diagnosed ALL patients between March 2020 and September 2020 at a single Peruvian institution (INEN, Lima-Peru). We included patients older than 14 years, with the initial intent of intensive treatment. The proposed protocol was the CALGB10403 with asparaginase modification. COVID-19 was determined by a +ve nasopharyngeal SARS-CoV-2 RT-PCR or serology. The outcomes were 30-day and 60-day mortality and treatment response at the end of induction. Results: Of 63 patients with ALL in induction therapy, 22 (35%) had COVID-19, and 41 (65%) did not. Overall, the median age was 30 (IQR 21 - 42), and 59% were males. Table 1 shows that age, sex, ALL subtype, and laboratory characteristics had a similar distribution between both groups. The mortality rate of ALL patients with COVID-19 was non-statistically different from non-COVID-19 patients at 30 (23% versus 12%, p=0.466) and 60 days (32% versus 20%, p=0.434). Multivariate logistic regression did not find a significant association between COVID-19 and complete treatment response (aOR: 0.44, 95% CI: 0.02-4.54). Similarly, patients with COVID-19 did not had an increased mortality risk at 30 days (aHR: 2.37, 95% CI: 0.64-8.75) and 60 days (aHR: 1.98, 95% CI: 0.7-5.64). Conclusion: In our cohort, COVID-19 did not increase the risk of early death in newly diagnosed patients with ALL. Table 1.Characteristics of patients with ALLOverallCOVID-19 NegativeCOVID-19 positivep-value*n=63n=41n=22Age (years)**33 ±1532 ±1635 ±130.377Sex Male37 (59%)25 (61%)12 (55%)0.821 Female23 (41%)16 (39%)10 (45%)Type B-ALL56 (86%)36 (88%)18 (72%)0.787 T-ALL9 (14%)5 (12%)4 (18%)B-ALL subtype NOS42 (78%)29 (81%)13 (72%)0.873 E2A/PBX12 (4%)1 (3%)1 (6%) MLL/AF42 (4%)1 (3%)1 (6%) TEL/AML1 (2%)1 (3%)0 (0%) BCR/ABL5 (8%)3 (7%)2 (10%) Unknown2 (4%)1 (3%)1 (6%)DHL (U/L)655 ±854719 ±988536 ±5230.422D-dimer (ng/mL)4539 ±59085319 ±70293164 ±27290.184Leucocytes (x103µL)38 ±10044 ±11927 ±490.528Hemoglobin (g/dL) †9 (7-14)9 (7-11)10 (7-54)0.475CNS Infiltration11 (17%)8 (20%)3 (14%)0.812ECOG>32 (3%)1 (2%)1 (5%)Complete Response43 (68%)28 (68%)15 (68%)0.896Minimal Residual Disease29 (46%)20 (49%)9 (41%)0.8330-day mortality10 (16%)5 (12%)5 (23%)0.46660-day mortality15 (24%)8 (20%)7 (32%)0.434*Univariate Cox regression.**Mean (standard deviation)†Median (Interquartile range) Citation Format: Daniel J. Enriquez-Vera, Ali Al-kassab-Cordova, Lizbeth Lachira-Yparraguirre, Gustavo Sandival-Ampuero, Bryan Valcarcel, Cesar Samanez, Juan Haro-Varas, Shirley Quintana-Truyenque, Luis Malpica, Henry Gomez-Leonidas, Tatiana Vidaurre-Rojas. Early death in acute lymphoblastic leukemia during COVID-19 pandemic: A single institution cohort study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 721.

Background: Acute myeloid leukemia (AML) is a highly heterogeneous disease with new cases commonly diagnosed in the elderly population. Despite advances in AML therapy, disease outcomes remain poor. Between 2010 and 2016, the reported 5-year overall survival in the U.S. was 28.7% (Source: NCI SEER 13 statistics). National based registries are vital to monitor the incidence, outcome and survivorship of AML patients. Therefore, we aim to explore the incidence and outcome of AML patients managed at the National Cancer Institute in Peru over the past decade. Methods: We conducted a retrospective analysis of all newly diagnosed AML patients seen at the National Cancer Institute (INEN) in Lima-Peru between January 2008 to December 2018. The INEN is the major governmental leukemia center providing care for about 60% of newly diagnosed AML patients in Peru. Patient eligibility screening was performed using the Flow Cytometry Core Lab Registry. We excluded patients with acute promyelocytic leukemia. Demographic and clinical characteristics were obtained from medical records. Place of birth and death records were confirmed using the Peruvian National Registry of Identification and Civil Status (RENIEC). Survival analysis was performed using Kaplan Meier and Log-rank tests. The cumulative 11-year AML incidence rate was calculated and plotted using a choropleth map of Peru. Results: A total of 1,499 newly diagnosed AML cases were identified and had sufficient data for analysis. Median age at diagnosis was 44 years (range: 0-92) with a female:male ratio of 0.9:1. Clinical characteristics and outcome are presented in Table 1. Twenty-two percent (n=324) of patients were older than 65 years-old at the time of diagnosis. Most patients (n=926, 62%) came from the coastal region of Peru, followed by the mountains (30%) and the rainforest (8%). The cumulative 11-year incidence rate according to geographical location is shown in Figure 1. Overall, the Peruvian hospital-based cumulative incidence rate was 4.79 AML cases per 100,000 habitants, with the highest incidence rate observed in Piura (a coastal city in Northern Peru) with 38 AML cases per 100,000 habitants. At a median follow up of 68 months, the global 5-year overall survival (OS) rate of AML cases seen in Peru was 16%. Worse survival rates were found in patients aged 66 years and older (5-year OS 3%, median survival time [MST] 2 months, p Conclusions: This is the first study describing the incidence and outcome of AML patients in Peru. In this large contemporary cohort, we found a cumulative 11-year incidence rate of 4.79 AML cases per 100,000 habitants, with an alarming high incidence of AML cases observed in the city of Piura which needs further epidemiological evaluation. Despite improvements in supportive care in the contemporary era, our inpatient mortality for adult patients with AML remains high particularly among older patients. Further analyses are warranted to examine predictors of AML-related deaths in Peru and to develop strategies that improve patient outcomes. Disclosures No relevant conflicts of interest to declare.

Marijuana is the most widely used illicit drug in the world, especially among young people. This study is relevant to policy makers because it expands the knowledge regarding drug use in vulnerable youth, allowing health authorities to reduce marijuana consumption via educational, family, and governmental strategies and policies. The objective of this study was to determine the prevalence of frequent marijuana consumption and its associated factors in young people before admission to juvenile detention centers in Peru. The data was taken from the 2016 National Population Census of the Youth Diagnostic and Rehabilitation Centers in Peru. The final sample was made up of 1,848 people with ages between 14 and 22 years old, with a median age of 17 (95.6% males). The variable frequent marijuana consumption was defined as the use of marijuana at least once a week, prior to entering the center. The main factors associated with frequent marijuana use were male sex, running away from home before the age of 15, physical abuse during childhood, having a family member who consumed alcohol or drugs frequently, and the presence of criminal gangs in the housing area. Additionally, it was found that living with parents up to a specific critical age decreases the probability of frequent use of marijuana in young people. These results could aid the development of strategies and public policies that help prevent the consumption of marijuana and other drugs from an early age.