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Purpose: To identify the frequency of anemia in pregnant women at different geographical altitudes in the Arequipa region of Peru. Methods: A quantitative, descriptive, and retrospective study was carried out. The study population consisted of 35,725 pregnant women living in the Arequipa Region at different altitudes. Data on age, gestational age, weight, height, province of residence, altitude, hemoglobin were collected. Results: Using World Health Organization altitude adjusted hemoglobin values, anemia prevalence in pregnant women between 2018-2019 was 13.7 percent in the Arequipa Region, while using unadjusted hemoglobin, the overall prevalence was 4.1 percent. When analyzed by altitudes, the frequency of anemia was 9.77 percent below 1 000 m 13.1 percent between 1 000-1 999 m, 13.1 percent between 2.000-2.999 m, 31.5 percent between 3.000-3.999 and 47.1 percent between 4.000-4.999. Nevertheless, when using unadjusted hemoglobin values rates were 6.67 percent for the 1.000-1.999 range, 2.39 percent for ranges between 2.000-2.999 m and 3.000-3.999 m, and 5.19 percent for altitudes above 4.000 m. Conclusions: There is a directly proportional correlation in the prevalence of anemia in pregnant women and higher altitude (p<0.01) as well as levels of anemia during the last trimester of pregnancy. Adjusting the hemoglobin values by altitude results in triple the prevalence of anemia. A throughout revision of the suitability of current guidelines to diagnose and prevent anemia at high altitude is recommended (AU)

Objetivo: Identificar la frecuencia de anemia en gestantes de diferentes altitudes geográficas en la región Arequipa, Perú. Métodos: Se realizó un estudio cuantitativo, descriptivo y retrospectivo. La población de estudio estuvo constituida por 35 725 gestantes residentes en la Región Arequipa a diferentes altitudes. Se recogieron datos de edad, edad gestacional, peso, talla, provincia de residencia, altitud, hemoglobina. Resultados: Utilizando los valores de hemoglobina ajustados por altitud de la Organización Mundial de la Salud, la prevalencia de anemia en gestantes entre 2018-2019 fue de 13,7 por ciento en la Región Arequipa, mientras que utilizando la hemoglobina no ajustada, la prevalencia global fue de 4,1 por ciento. Al analizar por altitudes, la frecuencia de anemia fue de 9,77 por ciento por debajo de 1 000 m 13,1 por ciento entre 1 000-1 999 m, 13,1 por ciento entre 2 000-2 999 m, 31,5 por ciento entre 3 000-3 999 y 47,1 por ciento entre 4 000-4 999. Sin embargo, cuando se utilizaron valores de hemoglobina no ajustados, las tasas fueron del 6,67 por ciento para el intervalo de 1 000-1 999, del 2,39 por ciento para los intervalos entre 2 000-2 999 m y 3 000-3 999 m, y del 5,19 por ciento para altitudes superiores a 4 000 m. Conclusiones: Existe una correlación directamente proporcional en la prevalencia de anemia en embarazadas y mayor altitud (p<0,01), así como niveles de anemia durante el último trimestre del embarazo. Ajustando los valores de hemoglobina por la altitud se triplica la prevalencia de anemia. Se recomienda una revisión en profundidad de la idoneidad de las directrices actuales para diagnosticar y prevenir la anemia a gran altitud(AU)

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BACKGROUND: The COVID-19 pandemic is an unprecedented challenge to health systems that has revealed shortcomings and increased unmet demands. Such situations might exacerbate workplace violence (WPV) against physicians, as has been reported in several parts of the world. METHODS: To identify the frequency and characteristics of WPV suffered by physicians attending COVID-19 patients in Peru, a descriptive, cross-sectional study was conducted with an online survey of 200 physicians. RESULTS: Of the survey respondents, 84.5% had suffered some type of WPV; 97.6% of these suffered nonphysical violence. Suffering more than one incident of violence was reported by 75.7% of respondents. The primary aggressor was a patient's family member or caregiver. Violence occurred most frequently in critical areas inside the health service facility, such as COVID-19 triage, tents, and hospital units, although it also occurred during teleconsultations. Multiple shortcomings of the health services were perceived as the main trigger of violence. Being a female physician (odds ratio [OR] = 2.48, 95% confidence interval [CI] = 1.06-5.83) and working in a COVID-19 ICU (OR = 5.84, 95% CI = 1.60-21.28) were the main factors associated with WPV. CONCLUSION: Violence against physicians attending COVID-19 patients in Peru is common. The perceived factors that contribute most to violence are linked to deficiencies in health services.

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