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Although several Latin American countries have 70% antenatal care coverage, the proportion of human immunodeficiency virus (HIV) testing of Peruvian pregnant women and the socioeconomic inequalities of this preventive measure are unknown. This study aimed to determine socioeconomic inequalities and quantify the contribution of contextual and compositional factors on HIV testing during prenatal care in Peru. A cross-sectional study of the 2021 Demographic and Family Health Survey data was conducted. The outcome variable was HIV testing of pregnant women during prenatal care. An analysis of inequalities was performed including the determination of concentration curves and a decomposition analysis of concentration indices. Of a total of 17521 women aged 15 to 49 years, 91.4% had been tested for HIV during prenatal care. The concentration curves showed that prenatal HIV testing was concentrated among richer women, while the decomposition analysis determined that the main contributors to inequality were having a higher education, residing in an urban area, and in the highlands, belonging to the wealthy quintile, and being exposed to television and newspapers. Strategies focused on improving access, promotion and restructuring of prevention of mother-to-child transmission measures should be prioritized. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic inequalities in the population influence access to health services and constitute a challenge for health systems, especially in low- and middle-income countries. In Peru, an increase in the use of medical services has been estimated; however, the study of inequalities in the use of medical services is limited. Therefore, the objective of this research was to analyze and decompose socioeconomic inequalities in the use of medical consultation services in Peru. Methods: A cross-sectional analytical study was conducted using data from the National Household Survey 2019. The outcome variable was the use of a consultation attended by a physician in the last 4 weeks in persons who presented symptom or discomfort, illness, relapse of chronic disease and/or accident. Concentration curves and Erreygers concentration indices were used to determine socioeconomic inequalities, and a generalized linear regression model was used for the decomposition analysis of inequalities. Results: A total of 52,715 persons were included in the study. The frequency of medical consultation was 25.4% (95% confidence interval: 24.8 − 26.1%). In the inequality analysis, it was found that the use of medical consultations was concentrated among the wealthiest individuals. The main contributing factors were having another type of health insurance (social health insurance [EsSalud], private health insurance, health provider, the Armed Forces, and the Police), residing in an urban area, belonging to the richest wealth quintile, having a chronic disease, and residing in the highlands of Peru. Conclusions: Based on our findings, government institutions seeking to achieve equitable access to health services should consider the main factors contributing to this inequality in the formulation of strategies to lessen the negative impact of inadequate disease control in the population. [ABSTRACT FROM AUTHOR]

Binge drinking and suicidal ideation are public health problems that have consequences on the well-being of Peruvian adolescents. This study aimed to evaluate the relationship between binge drinking and suicidal ideation in Peruvian adolescents. A secondary data analysis of the health questionnaire of the Demographic and Family Health Surveys from 2013 to 2019 was performed. The outcome variable was suicidal ideation in the last 14 days, assessed with one of the Patient Health Questionnaire (PHQ-9) questions, while the independent variable was binge drinking in the last 30 days. Generalized linear models of the Poisson family with logarithmic link (crude and adjusted) were used to assess the association of interest. Data from a total of 11,609 participants were analyzed. The pooled prevalence of suicidal ideation was 8.5 % (95 % confidence interval [CI]: 7.8–9.2), and that of binge drinking was 5.8 % (95 % CI: 5.2–6.5). An association was found between binge drinking and suicidal ideation in the adjusted analysis (adjusted prevalence ratio: 2.95; 95 % CI: 1.69–3.09). The cross-sectional design of the study does not allow for establishing a causal relationship. Between 2013 and 2019, nine out of every 100 Peruvian adolescents had suicidal ideation, and six out of every 100 adolescents had binge drinking. An association was found between both risk behaviors in Peruvian adolescents. • Suicidal ideation is a health problem affecting 9 % of Peruvian adolescents. • Binge drinking is a social and health problem that affects 6 % of Peruvian adolescents. • Our study found an association between both problems in Peruvian adolescents. • Identification of binge drinking should be a mandatory criterion in mental health assessment. [ABSTRACT FROM AUTHOR]

• Previous studies have established that in high-altitude regions there is a higher prevalence of depression. • An increase in meters above sea level of residence was positively and significantly associated with the depressive symptoms score. • This relationship is also observed according to the sex, age, number of comorbidities, marital status, area of residence, current smoking status, and pattern of alcohol consumption. • For the sensitivity analysis, altitude having no significant effect on the low scores (p10) of depressive symptoms, and the high scores of depressive symptoms are associated with the high altitude. In high altitude regions, people experience biological, inflammatory and brain structure changes that increase the risk of depressive symptoms. The aim of this study was to determine the association between altitude and depressive symptoms in the Peruvian population, adjusting by demographic, socioeconomic and exposure to health risk factors. We performed a cross-sectional analytical study of data collected annually by the Demographic and Family Health Survey during the period 2013–2020. The presence of depressive symptoms during the last 14 days prior to the survey were measured using scores obtained from the Patient Health Questionnaire-9 (PHQ-9). A generalized linear model (GLM) of gamma family and log link function was used to report the crude and adjusted β coefficients. A quantile regression model was performed as a sensitivity analysis. Data from a total of 215,409 participants were included. After adjusting for demographic, socioeconomic and health risk exposures, the GLM showed that an increase in every 100 m of altitude of residence was positively and significantly associated with the depressive symptoms score (β=0•01 [95% confidence interval: 0•01–0•01]). The length of residence in high altitude areas of the population included cannot be established, requiring future research to determine if the results of the present study are similar in native people or permanent residents of high altitude regions. Altitude was positively associated with depressive symptom scores. Our results will allow the development of mental health interventions based on factors that increase the likelihood of depressive symptoms in high-altitudes. [ABSTRACT FROM AUTHOR]

Background: In high altitude regions, people experience biological, inflammatory and brain structure changes that increase the risk of depressive symptoms. The aim of this study was to determine the association between altitude and depressive symptoms in the Peruvian population, adjusting by demographic, socioeconomic and exposure to health risk factors.Methods: We performed a cross-sectional analytical study of data collected annually by the Demographic and Family Health Survey during the period 2013-2020. The presence of depressive symptoms during the last 14 days prior to the survey were measured using scores obtained from the Patient Health Questionnaire-9 (PHQ-9). A generalized linear model (GLM) of gamma family and log link function was used to report the crude and adjusted β coefficients. A quantile regression model was performed as a sensitivity analysis.Results: Data from a total of 215,409 participants were included. After adjusting for demographic, socioeconomic and health risk exposures, the GLM showed that an increase in every 100 m of altitude of residence was positively and significantly associated with the depressive symptoms score (β=0•01 [95% confidence interval: 0•01-0•01]).Limitations: The length of residence in high altitude areas of the population included cannot be established, requiring future research to determine if the results of the present study are similar in native people or permanent residents of high altitude regions.Conclusions: Altitude was positively associated with depressive symptom scores. Our results will allow the development of mental health interventions based on factors that increase the likelihood of depressive symptoms in high-altitudes. [ABSTRACT FROM AUTHOR]

Objective: Iodine deficiency is a public health problem, especially in Peru, where it affects women of childbearing age and school-age children. The objective of the study was to conduct a household-level analysis of the factors associated with the consumption of table salt with inadequate amounts of iodine in Peru. Design: Analytical cross-sectional study using Peruvian household-level data from the Demographic and Family Health Survey. Table salt iodine concentrations were considered as the dependent variable ('inadequate' with iodine levels <30 PPM and 'adequate' with levels ≥30 PPM). The association between iodine concentrations in salt and independent variables was evaluated using crude and adjusted log-binomial regression models. Setting: Peru. Participants: A total of 25 007 households were included. Results: In Peru, 21·8 % households had inadequate table salt iodine concentrations. Belonging to the poorer and poorest wealth index, living in the Highlands natural region, and living with women of childbearing age with native mother tongue were identified as factors associated with inadequate iodine concentrations in table salt. Conclusions: There is an urgent need to ensure that table salt with adequate iodine concentrations is available for poor populations, residents of the Highlands and households with ethnic presence. Likewise, it is necessary to promote good storage practices, greater regulation/law enforcement and better monitoring of the companies that manufacture or sell this product. Furthermore, the population needs to be informed of the disorders associated with iodine deficiency. [ABSTRACT FROM AUTHOR]

Background: To date, the factors associated with the presence of depression or depressive symptoms in the Peruvian population have not been described. This study aimed to determine the prevalence of clinically relevant depressive symptoms in the Peruvian population and its associated factors.Methods: A cross-sectional analytical study of secondary data from 2018 Demographic and Family Health Survey was conducted. The survey database includes 31,996 participants over 18 years of age. The dependent variable of the analysis was the presence of depression during the 14 days before the survey measured by the Patient Health Questionnaire (PHQ-9). Factors associated with the presence of depression were estimated with a proportional odds logistic regression model.Results: The overall prevalence of clinically relevant depressive symptoms was 6.4% (moderate and severe symptomatology in 3.9% [95% CI: 3.6-4.3] and 2.5% [95% CI: 2.2-2.7], respectively). Being a woman, belonging to the age groups of 45 to 64 years or 65 or older, living in the Andean region, and having high blood pressure or diabetes mellitus or some disability increased the probability of having clinically relevant depressive symptoms.Limitations: The use of the PHQ-9 tool to assess depressive symptomatology limits the evaluation to a period of two weeks before the survey, requiring further study for diagnosis confirmation.Conclusion: Six out of 100 Peruvians presented moderate to severe clinically relevant depressive symptoms in 2018. Strategies for depression should contemplate population subgroups , such as women and patients with chronic diseases and disabilities. [ABSTRACT FROM AUTHOR]

Objective. To estimate the prevalence and determine the factors associated with the non-utilization of healthcare facilities (NUHCF) among adult Venezuelan migrants in Peru. Materials and Methods. An analytical cross-sectional study of the "Survey of the Venezuelan Population Residing in Peru" 2018. We calculated the proportion of immigrants with NUHCF (immigrants with some symptom or malaise, illness, relapse of chronic illness, accident and discomfort, or other problem such as depression, fear, anger, anxiety, and stress, and who did not consider that it was serious or that they needed to visit a healthcare facility). Raw and adjusted (PRa) prevalence ratios (PR) for presenting NUHCF were estimated using generalized linear models. Results. The study included 2,144 Venezuelan migrants: 57.2% presented NUHCF, reporting reasons such as: not having money (64.5%), lack of health insurance (24.3%), self-medication (12.8%), and not having time (8.4%). Living in Arequipa (PRa: 0.69; 95% CI: 0.57-0.83) or Trujillo (PRa: 0.87; 95% CI: 0.76-0.99), suffering from a chronic disease (PRa: 0.83; 95% CI: 0.71-0.97), and being enrolled in the Seguro Integral de Salud (SIS) insurance (PRa: 0.28; 95% CI: 0.13-0.61) was associated with a lower probability of NUHCF. Belonging to an age group under 60 years was associated with a higher probability of NUHCF. Conclusions. One out of two Venezuelan migrants in Peru presents NUHCF. Having SIS increases the likelihood of Venezuelan migrants in Peruvian territory seeking medical attention. Increasing public health insurance for this population, which is currently low, could increase the utilization of health services. [ABSTRACT FROM AUTHOR]

Objectives. To identify the prevalence and factors associated with the use of oral health services in Peruvian older adults (OA) during 2018. Materials and Methods. Secondary analysis of data on 4,874 Peruvian OAs from the Demographic and Family Health Survey (ENDES) carried out in 2018. The use of oral health services was considered (yes/no) based on the six months prior to the application of the survey as a dependent variable. The independent variables were sex, age, area of residence, educational level, marital status, geographical domain, physical limitation, health insurance, spoken language, and welfare index quintile. A descriptive analysis was performed using absolute frequencies and weighted proportions, and a multivariate analysis using generalized linear models (Poisson regression). Results. From the total of OAs, 52.6% were women, 52.9% belonged to the 60-69 age group, 77% belonged to the urban area, and 81.1% had a health insurance. The prevalence of the use of dental care services in the last six months was 24.9%. Multivariate analysis found association with area of residence (p<0.001), higher educational level (p=0.001), health insurance affiliation (p<0.001), geographic domain (p=0.019), and all welfare index quintiles (p<0.001). Conclusions. The prevalence of the use of dental care services in OAs was low, and its associated factors were the area of residence, educational level, health insurance, geographic domain, and welfare index quintiles. [ABSTRACT FROM AUTHOR]

Objective. To estimate the proportion of Peruvian women who received quality prenatal care (PNC) for their last childbirth in the last five years and to determine its associated factors. Materials and Methods. Analytical cross-sectional study of the 2017 Demographic and Family Health Survey. The proportion of quality PNC was calculated based on the number of PNC control visits. Bivariate and adjusted prevalence ratios (PRa) of quality PNC were estimated. Results. Data from 18,156 women were analyzed; 56.1% received quality PNC. Receiving more PNC visits increased the likelihood of receiving quality PNC (49.6% and 59.9% for six and eight control visits, respectively). Being from the highlands (PRa=0.85; 95% CI: 0.80-0.91), living in rural areas (PRa=0.94; 95% CI: 0.89-0.99), and belonging to a native ethnic group (PRa=0.72; 95% CI: 0.66-0.79) was associated with a lower likelihood of receiving quality PNC. Having completed high-school (PRa=1.16; 95% CI: 1.10-1.22) and higher education (PRa=1.15; 95% CI: 1.07-1.23), being from the 2nd wealth quintile (PRa=1.15; 95% CI: 1.08-1.22), 3rd quintile (PRa=1.18; 95% CI: 1.09-1.27), 4th quintile (PRa=1.16; 95% CI: 1.07-1.26), and 5th quintile (PRa=1.16; 95% CI: 1.05-1.28); being from the rest of the Coast (PRa=1.06; 95% CI: 1.00-1.12) and Jungle (PRa=1.31; 95% CI: 1.24-1.39); being enrolled in health insurance (PRa=1.24; 95% CI: 1.18-1.30); birth order 2-3 (PRa=1.10; 95% CI: 1.06-1.15) or ≥4 (PRa=1.20; 95% CI: 1.14-1.27), and having received PNC in the first trimester (PRa=1.20, 95% CI: 1.14-1.26) was related to an increased likelihood of receiving quality PNC. Conclusions. Four out of ten women did not receive quality PNC, especially in women of native ethnicity or residents of the highlands or rural areas, groups that would require prioritization in maternal health strategies. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a global health problem and a violation of individual rights. The objective of this study was to assess the association between physical child abuse and current IPV in women of childbearing age in Peru. An analytical cross-sectional analysis of the data from the 2019 Demographic and Family Health Survey was carried out. IPV was constituted by emotional, physical and sexual violence, while physical child abuse was constructed from variables related to physical punishment that women of childbearing age experienced during childhood. Poisson's family generalized linear models were used for the crude and adjusted analyses to determine the association between physical child abuse and IPV. Data from a total of 21,518 women of childbearing age were included. 67.1% of women experienced physical abuse in childhood, while 57.7% experienced intimate partner violence. After adjusting for the characteristics of the woman, the partner or husband, marriage or relationship and the home, it was observed that having experienced physical abuse during childhood increased the probability of experiencing emotional (adjusted prevalence ratio [aPR] 1.15; 95% confidence interval [CI]: 1.09-1.21), physical (aPR 1.33; 95% CI: 1.20-1.47), sexual (aPR 1.57; 95% CI: 1.26-1.96) and any type of violence (aPR 1.15; 95% CI: 1.09-1.21) in adulthood. In conclusion, physical abuse during childhood is a public health issue in Peru. This study shows that women aged 15 to 49 who experienced physical abuse in childhood are more likely to experience intimate partner violence. [ABSTRACT FROM AUTHOR]

Objective: To determine the association between type 2 diabetes mellitus and cataracts in Peruvian adults over 50 years of age. Methods: Cross-sectional analytical observational study corresponding to the secondary analysis of the 2019 Encuesta Demográfica y de Salud Familiar database. Type 2 diabetes mellitus was considered an independent variable and cataract as a dependent variable. A descriptive analysis was performed using absolute frequencies and weighted proportions, as well as a multivariate analysis using generalized linear models of the Poisson family with logarithmic link function to estimate prevalence ratios on the association between diabetes and cataracts. Results: Data from a total of 8,775 Peruvian adults over 50 years of age were analyzed, of whom 1,322 self-reported a diagnosis of cataract. Of the total respondents, 9.2% reported having been diagnosed with diabetes mellitus and 16.7% with cataracts. The crude model (p<0.001) and the adjusted models 1 (p=0.007) and 2 (p=0.029) found an association between having diabetes mellitus and having cataracts. Conclusion: Two out of ten adults aged 50 years old and older in Peru had cataracts. There was an association between having diabetes and the presence of cataracts in the Peruvian population. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence and socio-economic inequalities in adequate consumption of fruits and vegetables in Peru between 2014 and 2019.Design: Analytical cross-sectional study. The outcome variable was adequate consumption of fruits and vegetables, defined as the consumption of five or more servings of fruits and vegetables per d (yes/no). We used concentration curves and Erreygers concentration index to describe socio-economic inequalities and a microeconometric approach to determine the contribution of each variable to inequality.Setting: Peru.Participants: Data from Peruvians aged 18 years or older collected by the Demographic and Family Health Survey.Results: The prevalence of adequate fruit and vegetable consumption did not change between 2014 (10·7 %; 95 % CI (10·0, 11·4)) and 2019 (11 %; 95 % CI (10·4, 11·7)). We found socio-economic inequalities in the adequate consumption of fruits and vegetables, with wealthier individuals having a higher prevalence of adequate consumption compared to poorer individuals in 2014 (19·2 % v. 3·5 %) and 2019 (18·6 % v. 4·7 %). The decomposition analysis found that education, urban areas and being wealthy were the main factors associated with socio-economic inequality in adequate fruit and vegetable consumption, being structural problems of society.Conclusion: Despite the current regulations on healthy eating in Peru, adequate consumption of fruits and vegetables remains low, and there are socio-economic inequalities between the poorest and wealthiest individuals. Our findings suggest that more efforts are needed to increase the intake and assess the disparities in adequate fruit and vegetable consumption. [ABSTRACT FROM AUTHOR]

Determine the bibliometric characteristics of scientific articles that address the subject of neurosurgery in Latin America and the Caribbean. A bibliographic search of original articles published in the Web of Science database up to 2021 was performed, without language restrictions. The terms included in the search strategy were Neurosurgery, neurosurgical procedures, and neurological surgical procedure. Articles according to the inclusion criteria in the Rayyan application were included. Subsequently, a quantitative bibliometric analysis was carried out with the bibliometrix package in R and VOSviewer. We identified 882 articles published in 271 journals. The first publication was in 2006, the highest number of publications was in 2021, the annual percentage growth rate was 25.9, and the average number of citations per document was 11.2. The author with the highest number of publications was Teixeira MJ (41 articles), and the University of Sao Paulo had the highest number of articles on this topic. WORLD NEUROSURGERY was the journal with the most publications (120 articles), and the study by Carney et al (2017) was the most cited (1175 citations). The country of corresponding authors with the most publications and the greatest number of total citations was Brazil. Surgery, and Management were the most used keywords plus; however, in the most recent articles Simulation and Guidelines were used. In the past decade, there has been an increase in articles on neurosurgery in Latin America and the Caribbean. Scientific production in neurosurgery must continue to increase in order to promote evidence-based medicine. [ABSTRACT FROM AUTHOR]

To determine the factors associated with the homicide profile of the prison population in Peru. A cross-sectional analytical study was conducted on the data of inmates surveyed in the First National Prison Population Census of 2016. The dependent variable was committing intentional homicide which was constructed from the Peruvian Penal Code and the International Classification of Crime for statistical purposes. To determine the factors associated with the homicide profile, a generalized linear model of the Poisson family with logarithmic link function was used and crude and adjusted prevalence ratios were estimated. A total of 57,866 inmates were included, of whom 6.60% had committed intentional homicide. In addition, some sociodemographic, mental health, social and family environments, and crime characteristics we found to increase the probability of inmates committing intentional homicide. Almost 7 out of 100 inmates committed intentional homicide. Although our findings are based on a prison population, the associated factors reported in our study could be useful for the implementation of strategies to reduce the homicide rate in Peru and for judicial decision-making. [ABSTRACT FROM AUTHOR]

Background: Myocardial infarction (MI) is the most prevalent cardiovascular disease globally and is considered a public health problem. In Peru, MI is the second leading cause of death at the national level, with a mortality rate that exceeds 10% in the hospital setting. The study aims to determine the clinical and epidemiological characteristics of ST-segment elevation myocardial infarction (STEMI) in tertiary care facilities belonging to the Peruvian public health system. Methods and analysis: This will be a prospective, observational, multicenter study, with baseline and two follow-up assessments: at admission to the health service, and 30 days and 12 months after admission. This multicenter study will be conducted in 27 hospitals located in the main cities of Peru. The patients included in the study will be over 18 years of age, of either sex, and will have been admitted to the health facility with a diagnosis of acute coronary syndrome with ST-segment elevation. The Kaplan-Meier method will be used to estimate the cumulative in-hospital mortality of patients at 30 days and 12 months of follow-up, and the log-rank test will be used to evaluate the differences between the survival curves between reperfused and non-reperfused patients. Subsequently, to evaluate the risk factors for successful reperfusion and cardiovascular adverse events, generalized linear models of the binomial family with log link function will be used to estimate the bivariate and multivariate relative risk (RR) with their respective 95% confidence intervals. This project was approved by the Ethics and Research Committee of the National Cardiovascular Institute (Instituto Nacional Cardiovascular "Carlos Alberto Peschiera Carrillo"—INCOR [in Spanish]; Approval report 21/2019-CEI). Discussion: Among the strengths, the observational design will allow the inclusion of a large sample of patients, which will significantly contribute to the knowledge base on STEMI in Peru. It should be noted that this study is the first to examine the clinical-epidemiological characteristics of STEMI in high-resolution hospital centers in Peru with follow-up one year after the event, providing knowledge of these observable characteristics in daily clinical routine. Likewise, the multicenter nature of the study will increase the external validity of the findings. In terms of limitations, the observational design of the study can only describe associations and not causality. Furthermore, since data from medical records will be used, there could be imprecision in the data. [ABSTRACT FROM AUTHOR]

Objective: To determine the optimal anthropometric cut-off points for predicting the likelihood ratios of hypertension and diabetes in the Peruvian population. Design: A cross-sectional study was performed to establish cut-off values for body mass index (BMI), waist circumference (WC), waist:height ratio (WHtR) and Conicity index (C-index) associated with increased risk of hypertension and diabetes. Youden's index (YIndex), area under the curve (AUC), sensitivity and specificity were calculated. Setting: Peruvian households. Participants: Peruvian population over the age of 18 years. Results: A total of 31 553 subjects were included, 57 % being women. Among the women, 53·06 % belonged to the 25- to 44-year-old age group [mean age: 41·66 in men and 40·02 in women]. The mean BMI, WHtR and C-index values were higher in women 27·49, 0·61, 1·30, respectively, while the mean WC value was higher in men 92·12 cm (sd ± 11·28). The best predictors of hypertension in men were the WHtR (AUC = 0·64) and the C-index (AUC = 0·64) with an optimal cut-off point of 0·57 (YIndex = 0·284) and 1·301 (YIndex = 0·284), respectively. Women showed an AUC of 0·63 and 0·61 in the WHtR and C-index, respectively, with an optimal cut-off of 0·61 (YIndex = 0·236) and 1·323 (YIndex = 0·225). The best predictor for diabetes was the C-index: with an AUC = 0·67 and an optimal cut-off of 1·337 (YIndex = 0·346) for men and an AUC = 0·66 and optimal cut-off of 1·313 (YIndex = 0·319) for women. Conclusions: Our findings show that in Peruvian adults, the WHtR and the C-index have the strongest association with hypertension in both sexes. Likewise, the C-index had the strongest association with diabetes. [ABSTRACT FROM AUTHOR]

Background: To estimate the impact of stunting on the development of effective verbal communication (EVC) in children aged 24 to 36 months. Methods: We conducted a retrospective, quasi-experimental study design using data from 4452 children between 24 and 36 months of age available in the Early Childhood Development (ECD) section of the Demographic and Family Health Survey (ENDES) 2019 survey. Achievement of EVC was considered as the dependent variable. After propensity score matching analysis, a total 601 children were included in the exposed (children with stunting) and 3848 in the unexposed group (children without stunting). The psmatch2 Stata software command was used to estimate the impact of stunting on EVC with a level of 5% for significance. Results: The EVC indicator was achieved by 57.4% of the children between 24 and 36 months of age evaluated, while the prevalence of stunting in this population was 14%. The evaluation of impact showed that the group exposed to stunting was 8% less likely to show EVC compared to the unexposed group (ATT -0.08; 95% CI -0.106 to -0.054; p<0.001). Conclusions: The presence of stunting was found to have a significant impact on the propensity to show EVC in Peruvian children between 24 and 36 months of age. Strengthening of strategies for reducing malnutrition in vulnerable areas, as well as those directly affecting EVC is a priority for diminishing gaps in the achievement of this indicator in our country. [ABSTRACT FROM AUTHOR]

Objectives: To determine the association between Peruvian women's autonomy and place of delivery. Methods: An analytical cross-sectional study of secondary data from the Demographic and Family Health Survey 2019 was carried out. The dependent variable was institutionalized childbirth, and the independent variable was women's autonomy. Likewise, the association between women's autonomy and institutionalized childbirth was evaluated using Poisson family generalized linear models with logarithmic link function, and crude (PR) and adjusted prevalence ratios (aPR) with their respective 95% confidence interval (CI) were estimated. Results: The analysis included 15,334 women aged 15–49 years. It was found that a high proportion of women had a low level of autonomy (42.6%; 95% CI: 41.5–43.7), while 92.1% (95% CI: 91.3–92.9) had institutionalized childbirth. Moderate (PR: 1.10; 95% CI: 1.08–1.12) and high (PR: 1.13; 95% CI: 1.12–1.15) levels of women's autonomy were found to be associated with institutionalized childbirth, and the same association was found in the adjusted analysis. Conclusion: Being a woman with a higher level of autonomy was related to a higher prevalence of institutionalized childbirth. Therefore, as decision-making is a multifactorial characteristic, it is necessary to study in depth the determinants of non-institutionalized childbirth in women with less autonomy. Significance: What is already known on this subject? Women's autonomy is a strategy to improve health conditions and various socioeconomic aspects of women's lives and their environment. Several studies have found that women with high autonomy are positively associated with their health and access to maternal health services, such as institutionalized childbirth. What this study adds? This study found that Peruvian women with a high level of autonomy were more likely to have an institutionalized childbirth. This finding can contribute to government institutions to guide the strategies already in place to improve various aspects of women's lives and enhance their autonomy. [ABSTRACT FROM AUTHOR]

Aim: To estimate the prevalence of hepatitis C virus (HCV) infection in patients with end-stage renal disease (ESRD) undergoing hemodialysis in Latin America and the Caribbean (LAC). Materials and methods: Observational studies published in Spanish, Portuguese, and English language by November 25, 2021, in PubMed, Embase, Web of Science, Scopus, SciELO, and LILACS were selected by two reviewers according to predefined eligibility criteria. Study quality was assessed using the US National Heart, Lung and Blood Institute tool for observational cohort and cross-sectional studies. A meta-analysis of proportions was performed using a random-effects model based on the DerSimonian and Laird method, using R. PROSPERO N°: CRD42018107403. Results: A total of 20 studies were included in the narrative synthesis (15 from Brazil, two from Cuba, two from Argentina, and one from Peru). Only 17 studies were included in the meta-analysis (13 from Brazil, two from Argentina, one from Cuba, and one from Peru). The overall prevalence of HCV in ESRD patients undergoing hemodialysis in LAC was 11.3% (95% confidence interval [CI]: 8.9% - 13.9%; I2: 99 %). In Brazil and Argentina, the prevalence was 6% and 26.1%, respectively. Prevalence after excluding poor-quality studies was 10.7%. Conclusion: The prevalence of HCV in ESRD patients undergoing hemodialysis in LAC was 11.3%. The implementation of infection control measures in hemodialysis centers in LAC is required. It is also necessary to increase the number of studies on the subject in the ESRD population in most LAC countries. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to determine the prevalence of depression or depressive symptoms in people residing in high-altitude regions.Methods: Eleven databases were searched for studies on depression and depressive symptoms: PubMed, ISI Web of Science, CINAHL, Embase, Scopus, PsycINFO, Psychology and Behavioral Sciences Collection, Psychology Database, Academic Search Ultimate, SciELO and LILACS. Systematic review and meta-analysis were performed based on the inclusion of these articles measuring the prevalence of depressive symptoms in people living at high altitude (≥1500 m above sea level [masl]). The protocol was registered in PROSPERO (CRD42021271069).Results: Eight articles with >40,000 participants from 4 different countries were included. Among the samples treated, the combined prevalence of depressive symptoms was 17.9 % (I2: 99 %) and the only estimate by subpopulation at the country level was possible for China, with >36,000 participants, being 28.7 % (I2: 4 %).Limitations: Considerable heterogeneity was reported in the estimation of overall prevalence due to the quality of the studies and the instruments used to screen for depressive symptoms.Conclusion: Almost two out of every 10 people living at high-altitude regions suffer from depressive symptoms. Therefore, it is necessary to adapt interventions to this condition and further research in the field is required. [ABSTRACT FROM AUTHOR]