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BACKGROUND: During 2021, Peru started the vaccination against SARS-CoV-2 using the BBIBP-CorV inactivated virus vaccine for health care workers (HCW). We aim to evaluate the effectiveness of the BBIBP-CorV vaccine to prevent SARS-CoV-2 infection and deaths among HCWs. METHODS: Retrospective cohort study, from February 9 to June 30, 2021, using national registries of health care workers, laboratory tests for SARS-CoV-2 and deaths. We calculated the vaccine effectiveness for preventing laboratory-confirmed SARS-CoV-2 infection, COVID-19-mortality, and all-cause mortality among partially immunized and fully immunized HCWs. An extension of Cox proportional hazards regression was used to model the mortality results, and Poisson regression was used to model SARS-CoV-2 infection. RESULTS: The study included 606,772 eligible HCWs, the mean age was 40 (IQR: 33.0, 51.0). In fully immunized HCW, the effectiveness for preventing all-cause mortality was 83.6 (95% CI: 80.2 to 86.4), 88.7 (95% CI: 85.1 to 91.4) for preventing COVID-19 mortality, and 40.3 (95% CI 38.9 to 41.6) for preventing SARS-CoV-2 infection. CONCLUSION: The BBIBP-CorV vaccine showed high levels of effectiveness for preventing all-cause and COVID-19 deaths among fully immunized HCW. These results were consistent within different subgroups and sensitivity analyses. However, the effectiveness for preventing infection was suboptimal in this particular setting.

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BACKGROUND: Studies have reported evidence about the effectiveness of a third dose with BNT162b2 for preventing hospitalization and death by COVID-19. However, there is little evidence regarding other primary vaccine schedules such as BBIBP-CorV and ChAdOx1-S. We estimated the relative vaccine effectiveness (RVE) of the booster dose versus the primary regimens of COVID-19 vaccines based on BBIBP-CorV, ChAdOx1-S, or BNT162b2 for preventing death during the Omicron wave in Peruvian adult people. METHODS: We carried out a nested case-control study with a risk set sampling of controls using data from Peru between December 20, 2021, and February 20, 2022 (during the Omicron wave). Data on vaccination, COVID-19 tests and deaths were collected from national surveillance databases. We performed conditional logistic regression models to estimate the RVE on the adult population. In addition, we executed sub-group analysis per age group (18 to 59 years, and 60 years or more) and per primary regime (based on BNT162b2, BBIBP-CorV, or ChAdOx1-S). RESULTS: Of the 11,188,332 people eligible to enter the study 1,974 met the case definition (death from COVID-19) and were matched to 9,183 controls. The overall RVE of a third dose to prevent death was 87.2% (84.2%-89.7%), which varied according to the primary regime (87.3% for BNT162b2, 82.0% for BBIPB-CorV-2, and 79.5% for ChAdOx-S). In older adults, the RVE was 87.1%, without significant variations according to the primary regime (86.1% for BNT162b2, 86.1 for BBIBP-CorV, and 82% for ChAdOx-S). CONCLUSIONS: The booster) dose of vaccine against COVID-19 had a high RVE for preventing death by COVID-19 in the Peruvian population in all primary regimes of vaccines during the Omicron wave. This effect was consistent in people over 60 years of age, the group most vulnerable to die from this infection.

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Herd immunity is considered to be a relevant aspect of COVID-19 epidemiology. In this regard, seroprevalence studies are essential for understanding how far countries and regions are from that potential point. This study analyzed seroprevalence data in nine studies from South America, which is a region that has been badly affected by COVID-19. Seroprevalence values ​​were high, with percentages up to 70.0% (95% CI 67.0-73.4%) in Iquitos, Peru. A meta-analysis of such data enabled a pooled seroprevalence to be obtained, estimated at 33.6% (95% CI 28.6-38.5%). Despite this, the COVID-19 pandemic in South America continues to significantly affect countries such as Brazil, Colombia, and Peru.

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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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The aim of this study was to describe the frequency of migration to study medicine in Peru. We con ducted a secondary data analysis of the Red-LIRHUS study (2011-2012). We included 3 680 Peruvian students. Approximately, 23.2% migrated for medical school. Less than 1% were international migrants. We found a higher proportion of migrant students in Universities outside of Lima than in Universities in Lima (27.1% vs. 15.8%). There was also a higher proportion of migrants in private universities (28.3% vs. 16.0%) Migrant students were more likely to live alone (27.4% vs. 6.4%) and to report having failed a module/course (51.0% vs. 38.6%) compared to non-migrant students. It is necessary to evaluate potential interventions for the preservation of the well-being of people who migrate for their medical training.

Con el objetivo de caracterizar el perfil del estudiante de medicina migrante de primer y quinto año de 32 escuelas de medicina del Perú, se realizó un análisis secundario del estudio Red-LIRHUS (2011-2012). De los 3680 estudiantes peruanos incluidos, uno de cada cuatro (23,2%) fueron migrantes. Menos de 1% fueron migrantes internacionales. Hubo mayor proporción de estudiantes migrantes en universidades de provincias que en universidades de Lima (27,1% vs. 15,8%). Asimismo, hubo mayor proporción de migrantes en universidades privadas (28,3% vs. 16,0%). Los estudiantes migrantes tenían mayor proba bilidad de vivir solos (37,4% vs. 6,4%) y de haber desaprobado cursos (51,0% vs. 38,6%) en comparación con los estudiantes no migrantes. Es necesario evaluar potenciales intervenciones para la preservación del bienestar de las personas que migran para su formación médica.

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BACKGROUND: Research is an important undergraduate competence for physicians. However, few studies have assessed the scientific production of medical students in Latin-America. Thus, this study had the objective to assess the rate and characteristics of research publications by undergraduate medical students in 2016, in Lima, Peru. METHODS: This cross-sectional study included all the students of the eight medical schools in Lima (Peru). The medical students included were collected from the registry of the National Medical Examination (taken during their last year of undergraduate studies) in 2016. To evaluate their research publications, systematic searches were performed in Google Scholar and PubMed during August 2018. RESULTS: We studied data from 1241 medical students (54.2% females) from eight medical schools. 173 (13.9%) students published at least one paper, 102 (8.2%) published at least one original paper, and 30 (2.4%) published at least one original paper in PubMed-Indexed journals. We registered a total of 174 papers authored by medical students, of which 98 (56.3%) were published in Peruvian journals, 128 (73.6%) were published in Spanish, 90 (51.7%) had a medical student as the first author, and 43 (24.7%) had a medical student as the corresponding author. The percentage of students with at least one publication was very heterogeneous across the eight medical schools evaluated (63.6%, 21.4%, 16.8%, 15.1%, 8.2%, 2.0%, 1.9%, and 0.0%). CONCLUSION: Among medical students in Lima, one out of seven had published at least one paper, one out of 12 had published at least one original paper, and one out of 40 had published at least one original paper in PubMed-Indexed journals. Scientific production was very heterogeneous across medical schools.

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Resumen Introducción: los trastornos alimentarios (anorexia y bulimia) han aumentado en todo el mundo y en todo el país. Antes del desarrollo de este trastorno, la actual insatisfacción corporal de los adolescentes, cuyo estudio a través del "Modelo de influencia tripartita" nos da tres presiones principales: la presión de los padres, los medios y los compañeros. Factores que se estudian a través de SATAQ-4. Realizamos un estudio para validar la versión peruana de SATAQ-4 "Actitudes socioculturales hacia el cuestionario de apariencia-4". Métodos: se realizó un estudio transversal en 2015. Se comenzó adaptando culturalmente la prueba. Posteriormente, la validez se determinó a través de la validez del constructo y la confiabilidad a través de la evaluación de consistencia interna y la confiabilidad intraobservador (prueba- volver a probar). Resultados: Obtuvimos un instrumento adaptado culturalmente que presentó una media mayor que 3 en el método Delphi, una correlación intraclase igual a 0,83 y una consistencia interna (alfa de Cronbach) de 0,90. El análisis factorial confirmatorio apoyó la estructura original de cinco factores y el análisis de validez convergente (r Pearson) cuando se comparó con BSQ una correlación de 0,70. Conclusiones: El instrumento mide adecuadamente el constructo para el cual fue creado y puede aplicarse en el entorno universitario peruano.

Introduction: Eating disorders (anorexia and bulimia) have been increasing worldwide and nationally. Prior to the development of this disorder, adolescents' present body dissatisfaction, whose study through the "Tripartite Influence Model" gives us three main pressures: Pressure from parents, media and peers. Factors that are studied through SATAQ-4. We conduct a study to validate the Peruvian version of SATAQ-4 "Sociocultural Attitudes Toward Appearance Questionnaire-4". Methods: A cross-sectional study was carried out in 2015. It was started by culturally adapting the test. Subsequently, validity was determined through the validity of the construct, and reliability through internal consistency assessment and intra-observer reliability (test-retest). Results: We obtained a culturally adapted instrument which presented a mean greater than 3 in the Delphi method, an intraclass correlation equal to 0.83 and an internal consistency (Cronbach alpha) of 0.90. The confirmatory factor analysis supported the original five-factor structure and the convergent validity analysis (r Pearson) when compared with BSQ a correlation of 0.70. Conclusions: The instrument adequately measures the construct for which it was created and can be applied in the Peruvian university environment.

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RESUMEN Con el objetivo de caracterizar el perfil del estudiante de medicina migrante de primer y quinto año de 32 escuelas de medicina del Perú, se realizó un análisis secundario del estudio Red-LIRHUS (2011-2012). De los 3680 estudiantes peruanos incluidos, uno de cada cuatro (23,2%) fueron migrantes. Menos de 1% fueron migrantes internacionales. Hubo mayor proporción de estudiantes migrantes en universidades de provincias que en universidades de Lima (27,1% vs. 15,8%). Asimismo, hubo mayor proporción de migrantes en universidades privadas (28,3% vs. 16,0%). Los estudiantes migrantes tenían mayor proba bilidad de vivir solos (37,4% vs. 6,4%) y de haber desaprobado cursos (51,0% vs. 38,6%) en comparación con los estudiantes no migrantes. Es necesario evaluar potenciales intervenciones para la preservación del bienestar de las personas que migran para su formación médica.

ABSTRACT The aim of this study was to describe the frequency of migration to study medicine in Peru. We con ducted a secondary data analysis of the Red-LIRHUS study (2011-2012). We included 3 680 Peruvian students. Approximately, 23.2% migrated for medical school. Less than 1% were international migrants. We found a higher proportion of migrant students in Universities outside of Lima than in Universities in Lima (27.1% vs. 15.8%). There was also a higher proportion of migrants in private universities (28.3% vs. 16.0%) Migrant students were more likely to live alone (27.4% vs. 6.4%) and to report having failed a module/course (51.0% vs. 38.6%) compared to non-migrant students. It is necessary to evaluate potential interventions for the preservation of the well-being of people who migrate for their medical training.

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AIM: To assess if there is an association between sitting time and obesity among adult Peruvian population, using three different anthropometric measurements. METHODS: A secondary analysis using data from a population-based study, the National Household Survey (ENAHO, in Spanish), was conducted enrolling adults aged ≥18 years from the 25 regions of Peru using a multistage random sampling technique. The outcome of interest was obesity, determined by body mass index (BMI > 30 kg/m2 ), waist circumference (WC > 80 and >90 cm in women and men, respectively) and waist to height ratio (WHR > 0.5); while the exposure was sitting time, measured using the last domain of the International Physical Activity Questionnaire and then categorised in <4 hours/day, 4 to <8 hours/day and 8+ hours/day. Associations were estimated using Poisson regression models, reporting prevalence ratios (PRs) and their respective 95% CI. RESULTS: Data from 8587 subjects were analysed; mean age was 38.4 (SD: 13.5) and 53.6% were females. The prevalence of obesity was 16.3% (95% CI: 15.2-17.5%) by BMI, 58.5% (95% CI: 56.9-60.0%) by WC, and 78.0% (95% CI: 76.5-79.3%) by WHR. In the multivariable model, subjects reporting a sitting time of 8+ hours/day were more likely to be obese than those reporting <4 hours/day according to BMI (PR: 1.38; 95% CI: 1.15-1.65), WC (PR: 1.20; 95% CI: 1.12-1.28) and WHR (PR: 1.05; 95% CI: 1.01-1.10). CONCLUSIONS: Subjects with greater sitting time were more likely to be obese, and this association was evident with three different anthropometric indicators. Findings suggest the need of generating public health actions to reduce sedentary behaviour.

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Background: The doctor-patient relationship may be affected by the indiscriminate use of social media platforms. The aim of this study was to evaluate the content of the photos posted on medical students' Facebook accounts to determine whether they have posted private patient information and compare this to their self-reported behavior of posting such photos. Methods: We performed a cross-sectional study of medical students from a Peruvian private university. With their permission, we reviewed their Facebook accounts for the publication of photos or documents that included private patient information (face, name, diagnosis, medical exams). Those who allowed access to their Facebook accounts were also asked to complete an online survey. We assessed variables related to sociodemographic aspects, self reported Facebook use, and what type of private patient information they posted. Results: A total of 160/220 students joined the study, 59% were women, mean age: 20 years. 25.7% self-reported having posted private patient information in their Facebook profiles but we found such information on 33.1% of the students' pages. Of the pages where private patient information was found, in 94% of cases, the patients' faces were identifiable, and in 7.6%, the patients' real names appeared. However, only half of the students believed that the information in their Facebook post might affect or influence the doctor-patient relationship. Association with narcissism, gender, and account privacy was not found. Having uploaded more than 250 photos (OR:2.90; CI95%:1.14-7.39) and posting photos tagged with the location of a hospital (OR:4.02; CI95%:1.36-11.9) were associated with having posted photos containing private patient information. Conclusion: One out of three of medical students posted patients' private information on their personal Facebook profiles. Development, dissemination, and implementation of guidelines related to ethics in social media platforms are needed.

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[This corrects the article DOI: 10.1371/journal.pone.0212164.].

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The new university law 30220 of 2014 introduced the mandatory institutional licensing of all Peruvian universities by the National Superintendence of Higher University Education (SUNEDU, in Spanish). The first undergraduate program to go through this process will be medicine. The licensing of medical programs is necessary to ensure that the conditions in which the program is taught in Peru are adequate, with a high probability of closing some medical schools. Once a medical school has demonstrated that it meets the basic conditions of quality, a qualitative and quantitative evaluation is carried out that includes three criteria: scientific production in the Web of Science, impact measured through the H index, and results of the national medical exam, to determine the years of licensing. This article evaluates the quantitative indicators linked to research using Web of Science and Scopus, in addition to making technical and methodological revisions of them. Suggestions for the other indicators are also covered by this article.

La nueva ley universitaria 30220 del 2014 creó la obligatoriedad del licenciamiento institucional de todas las universidades peruanas a cargo de la Superintendencia Nacional de Educación Superior Universitaria - SUNEDU, el primer programa de pregrado en pasar por el mismo proceso será medicina. El licenciamiento de programas de medicina es necesario para garantizar que las condiciones en que se imparte la carrera en el Perú son las adecuadas, con la alta posibilidad de cierre de algunas escuelas de medicina. Una vez que una escuela de medicina haya demostrado que cumple con las condiciones básicas de calidad, se realiza una evaluación cualitativa y una cuantitativa que incluye tres criterios: producción científica en Web of Science, impacto medido a través del índice H, y resultados del examen nacional de medicina, para determinar los años de licenciamiento. Este artículo realiza una evaluación de los indicadores cuantitativos vinculados a investigación usando Web of Science y Scopus, además de hacer revisiones técnicas y metodológicas de los mismos; así como sugerencias para los otros indicadores.

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OBJECTIVES: This study aimed to determine the relationship between stunting in children 6 to 36 months old and maternal employment status in Peru. METHODS: A secondary data analysis was conducted using information from the Demographic and Health Survey (DHS) in Peru. We used a representative sample of 4637 mother-child binomials to determine the association between stunting in children 6 to 36 months of age and the employment status of their mothers. RESULTS: The prevalence of stunting among children was 15.9% (95% CI: 13.9-16.7). The prevalence of working mothers was 63.7%. No association was found between maternal employment status and the presence of stunting in children [prevalence ratio (PR) = 1.04; 95% confidence interval (95% CI): 0.9 to 1.2; p = 0.627). However, on multivariate analysis we found that the prevalence of stunting was significantly higher among children of mothers performing unpaid work (12.4%) (PR = 1.38; 95% CI: 1.2-1.6; p < 0.001) compared with those of paid working mothers. CONCLUSION: No significant association was found between maternal employment status and the presence of stunting in children 6 to 36 months of age. However, children of mothers doing unpaid work are at higher risk of stunting. These findings support the implementation of educational programs and labour policies to reduce the prevalence of stunting among children.

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