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RESUMEN Introducción. La depresión en la población adulta mayor es un asunto de salud pública y escasos estudios analizan su distribución según áreas geográficas. Objetivos. Describir la distribución geoespacial y factores asociados del síndrome depresivo (SD) en adultos mayores peruanos según la ENDES 2018 al 2020. Métodos. Estudio transversal y de tipo analítico a partir de los datos de las encuestas nacionales, las cuales emplearon la escala PHQ-9 para medir el SD. Se utilizó la prueba Chi cuadrado de Pearson, regresión logística multivariada y OR con un p valor <0,05. Resultados. La prevalencia del SD en el año 2018 fue de 12,9%; 13,3% en 2019 y 10,8% en 2020. Los factores asociados al SD fueron: ser mujer, vivir en la pobreza. Bajo nivel de instrucción, residir en el área rural, proceder de la sierra y selva, vivir solo y tener 75 o más años de edad. El análisis geoespacial evidenció que el SD se concentra en departamentos de la sierra como Huancavelica, Puno, Ayacucho, Apurímac y por el norte, Ancash y Cajamarca. Conclusiones. Las políticas públicas dirigidas a la reducción del SD deben focalizarse en las mujeres, mayores de 75 años, quienes viven en área rural y fundamentalmente a los que viven en los departamentos identificados con la mayor prevalencia.
ABSTRACT Introduction. Depression in the elderly population is a public health issue and few studies analyze its distribution according to geographic areas. Objectives. To describe the geospatial distribution and associated factors of depressive syndrome (DS) in Peruvian older adults according to ENDES 2018 to 2020. Methods. Crosssectional and analytical study based on data from national surveys, which used the PHQ-9 scale to measure DS. The analysis used Pearson's Chi square test and multivariate logistic regression and OR with p < 0,05. Results. The prevalence of DS in 2018 was 12.9%; 13.3% in 2019 and 10.8% in 2020. The factors associated with DS were: being a woman, living in poverty, having secondary education, residing in rural areas, coming from the mountains and jungle, living alone and being 75 years of age or older. The geospatial analysis shows that the SD is concentrated in five departments: the coast (Lima, La Libertad, Piura) and the southern highlands (Puno, Arequipa). Conclusions. Public policies aimed at reducing DS should focus on women, older than 75 years and those who live in rural areas and fundamentally those who live in the departments identified as having the highest prevalence.
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RESUMEN Introducción. La victimización escolar es un problema vigente en el Perú. El enfoque de género en el análisis de sus características permitirá adaptar estrategias de intervención diferenciadas. Objetivo. Determinar los factores de riesgo de victimización según enfoque de género en adolescentes escolares de las ciudades de Huamanga y Sicuani. Diseño. Estudio observacional transversal analítico. Participantes. 1160 alumnos de primero a quinto de secundaria de dos colegios (privado y público) en Huamanga y Sicuani. Intervención. Encuesta validada para identificar víctimas de bullying. Análisis. Descriptivo, chi-cuadrado, OR (IC95%) y análisis multivariado de regresión logística. Se utilizó SPSS v. 15. Principales medidas de resultados. Porcentaje y factores de riesgo de victimización escolar. Resultados. El 37,3% de estudiantes fueron victimizados. En varones, "ha presenciado algún acto violento" 1,72 (1,122 - 2,636); en mujeres "vivir con uno de los padres" 1,682 (1,072 - 2,641); en "Huamanga" 1,767 (1,119 - 2,790); en ambos sexos "tener algún defecto físico" y "padres reaccionan con violencia cuando se portan mal" fueron los factores de riesgo más importantes. Formas de victimización más reportadas en ambos sexos fueron "te pusieron apodos" y "has sido discriminado". Predominó en varones, las formas directas como "te llamaron homosexual" y "has sido golpeado"; y en mujeres las indirectas. Conclusiones. La victimización escolar es problema importante. En mujeres estuvo asociada con características individuales y familiares; y en varones con la seguridad escolar. Las formas directas de victimización se relacionaron con varones.
ABSTRACT Introduction. School victimization is a current problem in Peru. Gender approach in analysis allows the adaptation of differentiated intervention strategies. Objective. To determine the risk factors for victimization according to gender approach in school adolescents from cities of Huamanga and Sicuani. Design. Analytical cross-sectional observational. Participants. 1160 students from first to fifth grade from two schools (private and public) in Huamanga and Sicuani. Intervention. Validated survey to identify victims of bullying. Analysis. Desciptive, chi-square, OR (95% CI) and multivariate logistic regression analysis. The SPSS vs. 15 program was used. Main outcome measures. Percentage and risk factors for school victimization. Results. 37.3% of students were found victims. In male gender, "has witnessed a violent act" 1.72 (1.122 - 2.636); in female gender "to live with one of parent" 1.682 (1.072 - 2.641); "live in Huamanga" 1.767 (1.119 - 2.790); and in both genders "having a physical defect" and "parents react with violence when they misbehave" were the most important risk factors. The most reported forms of victimization in both genders were "they gave you nicknames" and "you have been discriminated against". Direct forms such as "they called you homosexual" and "you have been beaten" prevailed in men, and indirect forms in women. Conclusions. The school victimization is an important problem. In female gender is related to individual and family characteristics and in male gender to school safety. The direct forms of victimization are related to male gender.
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BACKGROUND: Tuberculosis (TB) prevention through the use of preventive treatment is a critical activity in the elimination of TB. In multiple settings, limited staffing has been identified as a barrier to managing preventive treatment for TB contacts. This study aims to determine how health center staffing, service type, and TB caseload affects implementation of isoniazid preventive therapy (IPT) for TB contacts in southern Lima. METHODS: We conducted an ecological study in 2019 in southern Lima, Peru. Through the review of medical records, we identified contacts of TB patients who initiated IPT during 2016-2018, and who were 0-19 years old, the age group eligible for IPT according to Peruvian guidelines. We assessed bivariate associations between health center characteristics (numbers of physicians and nurses, types of services available, annual TB caseload) and IPT initiation and completion using binomial logistic regression. RESULTS: Among 977 contacts, 69% took more than a week to start IPT and 41% did not complete IPT. For those who successfully completed IPT, 58% did not complete full medical follow-up. There was no significant difference in IPT completion or adherence based on whether health centers had more physicians and nurses, more comprehensive services, or higher TB caseloads. Among contacts, female sex was associated with delay in initiating IPT (P = 0.005), age 5-19 years old was associated with completion of IPT (P = 0.025) and age < 5 years old was associated with completion of clinical evaluations (P = 0.041). CONCLUSIONS: There are significant gaps in IPT implementation in health centers of southern Lima, Peru, but insufficient staffing of health centers may not be responsible. Further research is needed to identify how IPT implementation can be improved, potentially through improving staff training or monitoring and supervision.