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INTRODUCTION: Peru's health infrastructures, particularly hospitals, are exposed to disaster threats of different natures. Traditionally, earthquakes have been the main disaster in terms of physical and structural vulnerability, but the coronavirus disease 2019 (COVID-19) pandemic has also shown their functional vulnerability. Public hospitals in Lima are very different in terms of year constructed, type of construction, and number of floors, making them highly vulnerable to earthquakes. In addition, they are subject to a high demand for care daily. Therefore, if a major earthquake were to occur in Lima, the hospitals would not have the capacity to respond to the high demand. OBJECTIVE: The aim of this study was to analyze the Hospital Safety Index (HSI) in hospitals in Lima (Peru). MATERIALS AND METHODS: This was a cross-sectional observational study of 18 state-run hospitals that met the inclusion criteria; open access data were collected for the indicators proposed by the Pan American Health Organization (PAHO) Version 1. Associations between variables were calculated using the chi-square test, considering a confidence level of 95%. A P value less than .05 was considered to determine statistical significance. RESULTS: The average bed occupancy rate was 90%, the average age was 70 years, on average had one bed per 25,126 inhabitants, and HSI average score was 0.36 with a vulnerability of 0.63. No association was found between HSI and hospital characteristics. CONCLUSION: Most of the hospitals were considered Category C in earthquake and disaster safety, and only one hospital was Category A. The hospital situation needs to be clarified, and the specific deficiencies of each institution need to be identified and addressed according to their own characteristics and context.
Assuntos
COVID-19 , Planejamento em Desastres , Desastres , Humanos , Idoso , Peru/epidemiologia , Hospitais Estaduais , Estudos Transversais , COVID-19/epidemiologia , HospitaisRESUMO
BACKGROUND: Complex emergencies are situations of violence, nutritional insecurity and population displacement of increasing frequency and intensity which pose a serious public health problem to the affected populations. Communicable diseases, especially waterborne diseases as cholera, cause up to 75% of morbidity and mortality in complex emergencies. The objective is to analyze the cholera epidemics in complex emergencies and cholera risk factors associated with the emergency. METHODS: This descriptive study analyzes cholera epidemics in complex emergencies in affected countries between 2000 and 2011 by reviewing the information formally published and unpublished reports from field organizations and aid agencies. Indicators of incidence, mortality and case-fatality were used. RESULTS: The mean annual incidence of cholera in areas of complex emergency was 1.2 per 1,000 population (95% CI = 0.5 to 1.9) and the average fatality of epidemics was 4.08% (95% CI = 3.3 to 4.86). CONCLUSIONS: In the cases studied the following specific risk factors of complex emergencies are present and amplify the impacts of cholera: serious deficiencies in water and sanitation, over-crowding, weak health system, lack of previous immunity of the affected population and introduction or reintroduction of causative agent.