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BACKGROUND: Intimate partner violence (IPV) in Peru represents a significant public health challenge. IPV can influence women's reproductive and social behaviors, undermining fertility control, and exacerbating unintended pregnancies. Our objective was to assess the association between IPV and pregnancy intention among Peruvian women of reproductive age. METHODS: We conducted a secondary analysis of Peru's 2020 Demographic and Family Health Survey data. The independent variable in this study was IPV against women, which includes psychological IPV, sexual IPV, and physical IPV. If a respondent experienced any of these three forms of IPV, the IPV variable was labeled as "yes"; if none were present, it was labeled as "no". The dependent variable was pregnancy intention (no vs. yes). We utilized a generalized linear model (GLM) from the Poisson family with a log link function to assess the relationship between IPV occurrences (total and each IPV type) and pregnancy intention. We report crude and adjusted prevalence ratios (aPR) with 95% confidence intervals (95%CI). RESULTS: We analyzed data from 8466 women aged 15 to 49. The prevalence of any IPV was 49.6% (psychological IPV: 45.8%; physical IPV: 22.2%; and sexual IPV: 4.3%). Exposure to physical IPV (aPR: 1.05; 95% CI: 1.03-1.07), psychological IPV (aPR: 1.04; 95% CI: 1.02-1.06), and sexual IPV (aPR: 1.09; 95% CI: 1.04-1.13), as well as a history of any IPV (aPR: 1.05; 95% CI: 1.02-1.07), were associated with a higher probability of not intending to become pregnant. This association persisted after adjusting for confounders like age, marital status, educational attainment, education level of the child's father, place of residence, wealth, ethnicity, and parity. CONCLUSION: One in two Peruvian women reported experiencing IPV. An association was observed between IPV exposure and a higher probability of not holding an intention to become pregnant.

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ABSTRACT Objective: To identify predictors of stunting among children 0-24 months in Southeast Asia. Methods: This scoping review focused on articles with observational study design in English published from 2012 to 2023 from five international databases. The primary keyword used were: "stunting" OR "growth disorder" AND "newborn" AND "predict" AND "Southeast Asia". Results: Of the 27 articles selected for the final analysis there are thirteen predictors of stunting in seven Southeast Asia countries. The thirteen predictors include the child, mother, home, inadequate complementary feeding, inadequate breastfeeding, inadequate care, poor quality foods, food and water safety, infection, political economy, health and healthcare, water, sanitation, and environment, and social culture factor. Conclusion: All these predictors can lead to stunting in Southeast Asia. To prevent it, health service providers and other related sectors need to carry out health promotion and health prevention according to the predictors found.

RESUMO Objetivo: Identificar preditores de nanismo entre crianças de 0 a 24 meses no Sudeste Asiático. Métodos: Esta revisão de escopo se concentrou em artigos com desenho de estudo observacional em inglês publicados de 2012 a 2023 em cinco bases de dados internacionais. As palavras-chave primárias usadas foram: "stunting" (nanismo) OU "growth disorder" (distúrbio de crescimento) E "newborn" (recém-nascido) E "predict" (previsão) E "Southeast Asia" (Sudeste Asiático). Resultados: Dos 27 artigos selecionados para análise final, existem treze preditores de nanismo em sete países do Sudeste Asiático. Os treze preditores incluem a criança, a mãe, a casa, a alimentação complementar inadequada, a amamentação inadequada, os cuidados inadequados, os alimentos de má qualidade, a segurança alimentar e da água, a infeção, a economia política, a saúde e os cuidados de saúde, a água, o saneamento e o meio ambiente, e o fator cultura social. Conclusão: Todos estes preditores podem levar ao nanismo no Sudeste Asiático. Para preveni-lo, os prestadores de serviços de saúde e outros setores relacionados precisam realizar a promoção e a prevenção da saúde de acordo com os preditores encontrados.

RESUMEN Objetivo: Identificar indicadores de desnutrición crónica entre niños de 0 a 24 meses en el Sudeste Asiático. Métodos: Esta revisión de alcance se centró en artículos con diseño de estudio observacional publicados en inglés, entre los años 2012 y 2023 de cinco bases de datos internacionales. Las principales palabras clave utilizadas fueron: "stunting (Desnutrición crónica)" o "growth disorder (Desorden del crecimiento)", y "newborn (Recién nacido)", y "predict (Predecir)", y "Southeast Asia (Sudeste Asiático)". Resultados: De los 27 artículos seleccionados para el análisis final, se encontraron trece indicadores que influyen en la desnutrición crónica en siete países del Sudeste Asiático. Los trece indicadores incluyen el niño, la madre, el hogar, la alimentación inadequada complementaria, la lactancia materna inadecuada, la atención inadecuada, los alimentos de mala calidad, la seguridad de los alimentos y el agua, la infección, la economía política, la salud y la asistencia sanitaria, el agua, el saneamiento y el medio ambiente, y por último el factor sociocultural. Conclusión: Todos estos indicadores pueden provocar desnutrición crónica en niños del Sudeste Asiático. Para poder prevenirlo los prestadores de servicios de salud y otros sectores relacionados, necesitan realizar actividades de promoción y prevención de la salud de acuerdo con los indicadores encontrados en este artículo.

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ABSTRACT Objective: To analyze the spatiotemporal epidemiological dynamics of meningitis in Brazil, between 2010 and 2019. Methods: Descriptive ecological study with cases and deaths due to meningitis in Brazil (2010-2019) in the National Notifiable Diseases Information System (Sistema de Informações de Agravos de Notificação - SINAN). The following analyses were performed: (I) frequency analyses of cases and deaths, prevalence rates, mortality, lethality, Fisher's exact test, and chi-square test; (II) Prais-Winstein regression; and (III) Global, Local Moran's index, and Kernel density. Results: 182,126 cases of meningitis were reported in Brazil, of which 16,866 (9.26%) resulted in death, with prevalence rates of 9.03/100,000 inhabitants, mortality of 0.84/100,000 inhabitants, and lethality of 9.26%. There was a noted trend of decreasing prevalence rates (−9.5%, 95% confidence interval — 95%CI −13.92; −4.96, p<0.01) and mortality (−11.74%, 95%CI −13.92; −9.48, p<0.01), while lethality remained stable (−2.08%, 95%CI −4.9; 0.8; p<0.1941). The majority of cases were viral meningitis (45.7%), among 1-9 years old (32.2%), while the highest proportion of deaths was due to bacterial meningitis (68%), among 40-59 years old (26.3%). In the Moran and Kernel maps of prevalence and mortality rates, municipalities in the South, Southeast, and the capital of Pernambuco in the Northeast stood out with high rates; as for lethality, the North, Northeast, and Southeast coastal areas were highlighted. Conclusion: A decrease in meningitis cases and deaths was found in this study; however, the lethality rate was higher in areas with lower prevalence, emphasizing the need to enhance actions for identifying, monitoring, and providing health care for cases, as well as expanding vaccination coverage.

RESUMO Objetivo: Analisar a dinâmica epidemiológica espaçotemporal das meningites no Brasil, entre os anos de 2010 e 2019. Métodos: Estudo ecológico descritivo com os casos e óbitos por meningites no Brasil (2010-2019) no Sistema de Informações de Agravos de Notificação. Realizaram-se (I) análises de frequências dos casos e óbitos, taxas de prevalência, mortalidade, letalidade, testes de exato de Fisher e qui-quadrado; (II) regressão de Prais-Winsten; e (III) índice de Moran global, local e densidade de Kernel. Resultados: Notificaram-se 182.126 casos de meningites no Brasil, dos quais 16.866 (9,26%) evoluíram para óbito, com taxas de prevalência de 9,03/100.000/habitantes, mortalidade de 0,84/100.000/habitantes e letalidade de 9,26%. Destaca-se a tendência de decrescimento das taxas de prevalência (−9,5%, intervalo de confiança de 95% — IC95% −13,92; −4,96, p<0,01) e mortalidade (−11,74%, IC95% −13,92; −9,48, p<01,01), enquanto a letalidade se manteve estacionária (−2,08%, IC95% −4,9; 0,8; p<0,1941). A maioria dos casos foi de meningites virais (45,7%), entre 1 e 9 anos (32,2%), enquanto a maior parcela dos óbitos foi por meningites bacterianas (68%), entre 40 e 59 anos (26,3%). Nos mapas de Moran e Kernel das taxas de prevalência e mortalidade, destacaram-se com altas taxas os municípios do sul, sudeste e a capital de Pernambuco, no nordeste; já na letalidade, evidenciaram-se o norte, o nordeste e o litoral do sudeste. Conclusão: Encontrou-se decréscimo dos casos e óbitos por meningites neste estudo, entretanto a taxa de letalidade foi maior em áreas com menor prevalência, reforçando a necessidade do aprimoramento das ações de identificação, vigilância e assistência em saúde dos casos, bem como da ampliação da cobertura vacinal.

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ABSTRACT Objective: To longitudinally assess domestic violence (DV) during the postpartum period, identifying types, patterns and determinants of DV, according to mothers' reports in Fortaleza, Brazil. Methods: Data from the Iracema-COVID cohort study interviewed at home mothers who gave birth in the first wave of COVID-19, at 18 and 24 months after birth. Patterns of reported DV were classified as follows: no DV, interrupted DV, started DV and persistent DV. Adjusted multinomial logistic regressions were used to assess factors associated with persistent DV. Results: DV was reported by 19 and 24% of the mothers at 18 and 24 months postpartum, respectively, a 5 percentage points increase. Persistent DV was present in 11% of the households in the period. The most frequent forms of DV were verbal aggression, reported by 17-20% of the mothers at 18 and 24 months, respectively; drunkenness or use of drugs at home, present in 3-5% of the households; physical aggression, reported by 1.2-1.6% of the mothers. Households with two or more forms of DV increased from 2 to 12% in the period. Adjusted factors associated with persistent DV were maternal common mental disorder, family headed by the mother and head of family's poor schooling. Food insecurity was associated with starting DV. Conclusion: Prevalence of DV was considerably high in the postpartum period. DV prevention policies should rely on improving care to women's mental health; preventing food insecurity; and fostering the educational level of young people of both sexes.

RESUMO Objetivo: Avaliar a violência doméstica (VD) longitudinalmente no período pós-parto, identificando tipos, padrões e determinantes de VD, segundo relatos de mães em Fortaleza, Brasil. Métodos: O estudo de coorte Iracema-COVID entrevistou em casa mães que pariram na primeira onda de COVID-19, aos 18 e 24 meses após o parto. Os padrões de VD relatados foram classificados da seguinte forma: VD inexistente, VD interrompida, VD iniciada e VD persistente. Regressões logísticas multinomiais brutas e ajustadas com variância robusta foram utilizadas para avaliar os fatores associados à VD persistente. Resultados: A VD foi relatada por 19-24% das mães aos 18 e 24 meses pós-parto, respectivamente, mostrando um aumento de 5 pontos percentuais. Em 11% dos domicílios a VD persistente esteve presente no período. As formas de VD incluíram agressão verbal, relatada por 17-20% das mães; embriaguez ou uso de drogas em casa, presente em 3-5% das residências; agressão física, relatada por 1,2-1,6% das mães. Residências com duas ou mais formas de VD aumentaram de 2 para 12% no período. Fatores de risco ajustados associados à VD persistente foram: transtorno mental comum materno, família chefiada pela mãe e baixa escolaridade do chefe de família. Insegurança alimentar esteve associada à VD iniciada. Conclusão: A prevalência de VD foi consideravelmente alta no período pós-parto. Políticas de prevenção de VD devem se basear em intervenções que visem melhorar a atenção à saúde mental das mulheres; combater a insegurança alimentar; e promover o nível educacional de jovens de ambos os sexos.

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Introducción. Las tasas de éxito del tratamiento de la tuberculosis continúan siendo subóptimas. Objetivo. Identificar los factores asociados al tratamiento no exitoso para tuberculosis en pacientes con antecedentes de tratamiento para la tuberculosis. Materiales y métodos. Se realizó un estudio observacional retrospectivo, analítico, de cohorte de pacientes que reingresaron a un programa de micobacterias en Cali, Colombia. Se incluyeron mayores de 15 años con tuberculosis pulmonar entre el 2015 y el 2019 con antecedentes de tratamiento para la tuberculosis. Se excluyeron los pacientes con tuberculosis resistente. Resultados. Ingresaron 605 pacientes con antecedentes de tratamiento, 60 % por tratamiento inconcluso y 40 % por recaída. En comparación con los pacientes que reingresaron por recaída (ORa= 2,34; IC=1,62-3,38), las variables que explicaron de manera independiente el no tener éxito con el tratamiento para la tuberculosis al egreso fueron: estar en situación de calle (ORa = 2,45; IC = 1,54-3,89), ser farmacodependiente (ORa = 1,95; IC=1,24-3,05), tener coinfección tuberculosis/VIH (ORa = 1,69; IC =1,00- 2,86) o diabetes (ORa =1,89; IC=1,29-2,77), y el incumplimiento de un tratamiento previo por pérdida de seguimiento, abandono u otras causas. Las variables programáticas que favorecieron el éxito del tratamiento fueron la asesoría de la prueba voluntaria de VIH (p < 0,001) y la realización de la prueba de VIH (p < 0,001). Conclusión. Estar en situación de calle, ser farmacodependiente, tener coinfección de tuberculosis y VIH, o diabetes, así como el incumplimiento del tratamiento previo por pérdida del seguimiento, abandono o fracaso del mismo, dificultaron el éxito del tratamiento antituberculoso. En la primera atención al reingreso de los pacientes con tuberculosis se deben identificar y abordar estas características.

Introduction. The success rates in the treatment of tuberculosis are suboptimal. Objective. To identify associated factors with the lack of success of antituberculosis treatment in patients with a tuberculosis treatment history. Materials and methods. We performed a retrospective, analytical, observational, and cohort study of patients reentering the Mycobacterium program in Cali, Colombia. We included patients over 15 years old with pulmonary tuberculosis between 2015 and 2019 and a history of tuberculosis treatment. Patients with drug-resistant tuberculosis were excluded. Results. A total of 605 patients with a treatment history were included, 60% due to unfinished treatment and 40% due to relapse. Compared to patients reentering due to relapse (ORa=2.34, CI=1.62-3.38), the independent variables associated with treatment failure at discharge were homelessness (ORa=2.45, CI=1.54-3.89), substance dependence (ORa=1.95, CI=1.24-3.05), tuberculosis/HIV coinfection (ORa=1.69, CI=1.00-2.86), diabetes (ORa=1.89, CI=1.29-2.77), and unfinished previous tuberculosis treatment due to follow-up loss, abandonment, or other causes. Programmatic variables favoring treatment success were voluntary HIV testing counseling (p<0.001) and HIV testing (p<0.001). Conclusion. Homelessness, substance dependence, tuberculosis/HIV coinfection, diabetes, and incomplete previous treatment due to loss to follow-up, abandonment, or treatment failure hindered the success of antituberculosis. These characteristics should be identified and addressed during the initial care of patients reentering treatment for tuberculosis.

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Abstract Objective: To determine the prevalence of HIV in individuals by analyzing the influence of social determinants and sexual risk behaviors, in order to estimate the crude and adjusted risks of being HIV positive in the municipality of Solidaridad, state of Quintana Roo, Mexico. Method and Materials: A cross-sectional study was conducted in the municipality of Solidaridad, Quintana Roo, Mexico. Third and fourth generation HIV rapid tests were performed. Descriptive statistics, measures of association (OR and 95 % CI) and p value were calculated for each stratum. Logistic regression models were performed to determine the risk factors associated with being HIV positive in the tests. Results: The sample consisted of 4,800 people, of whom 3,030 were men (63.12%); the mean age was 32.6 years (SD 14.96). The variables included in the multivariate model for being HIV positive are: men who have sex with men with OR=61.20, age 30-39 years OR=1.72, having anal sex OR=2.21, and as a protective factor having health service OR =0.42. Conclusions: This study confirms already known social determinants such as being male and being in economically active age and sexual practices such as: having anal sex and men with men. Being entitled to health services was shown to be the only protective factor.

Resumen Objetivo: Determinar la prevalencia de VIH en personas analizando la influencia de los determinantes sociales y las conductas sexuales de riesgo, para estimar los riesgos crudos y ajustados para ser VIH positivo en el municipio Solidaridad, estado de Quintana Roo, México. Método y Materiales: Se realizó un estudio transversal en el municipio de Solidaridad, Quintana Roo, México. Se realizaron pruebas rápidas de VIH de tercera y cuarta generación. Se calcularon las estadísticas descriptivas, las medidas de asociación (OR e IC del 95 %) y el valor de p para cada estrato. Se realizaron modelos de regresión logística para determinar los factores de riesgo asociados con ser VIH positivo en las pruebas. Resultados: La muestra estuvo compuesta por 4,800 personas de las cuales; 3,030 hombres (63.12%); la edad promedio fue de 32.6 años (D.E. 14.96). Las variables incluidas en el modelo multivariado para ser VIH positivo son: hombres que tienen sexo con hombres con OR=61.20, edad 30-39 años OR=1.72, tener sexo anal OR=2.21, y como factor protector contar con servicio de salud OR =0.42. Conclusiones: Este estudio confirma determinantes sociales ya conocidos como el ser hombre y estar en edad económicamente activa y prácticas sexuales como: el tener sexo anal y hombres con hombres. Contar con derechohabiencia se muestra como único factor protector.

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Introducción: La automedicación es una práctica común para aliviar síntomas de diversas enfermedades, en la población infantil como la faringoamigdalitis y la rinofaringitis que son comunes en los centros de salud del Perú. Objetivo: Determinar los factores asociados a la automedicación en niños con enfermedades de vías respiratorias altas. Material y métodos: Estudio observacional transversal analítico. El tamaño muestral fue de 206 padres de familia que acudieron con sus hijos al servicio de emergencia. Se utilizó un cuestionario aprobado por Valenzuela m. Y el programa SPSS para hallar la frecuencia, análisis bivariado y análisis multivariado regresión logística de Poisson. Resultados: la prevalencia de automedicación en niños fue de 91,3%. Los padres que solo estudiaron primaria y secundaria tuvieron mayor probabilidad de automedicar a sus hijos RPa=1,22 (IC 95%: 1,01-1,40). Los primogénitos estuvieron protegidos ante la automedicación RPa=0,86 (IC 95% :0,76-0,97). Los padres que tenían un rango de edad entre 20 a 29 años obtuvieron RPa=1,04 (IC 95%: 0,96-1,13), los niños menores de 7 años, RPa=0,99 (IC 95%: 0,91-1,07) y los padres de familia que tenían 1 hijo RPa=1,04 (IC 95%:0,90-1,20). Conclusiones: El nivel educativo y el número de orden del hijo como ser el primogénito tuvieron asociación significativa con la automedicación en niños.

Introduction: self-medication is a common practice to alleviate symptoms of various diseases, in the child population such as pharyngitis and rhinopharyngitis that are common in health centers in Peru. Objective: to determine the factors associated with self-medication in children with upper respiratory tract diseases. Material and methods: analytical cross-sectional observational study. The sample size was 206 parents who went with their children to the emergency service. A questionnaire approved by Valenzuela m was used. And the SPSS program to find the frequency, the bivariate analysis and the multivariate analysis of Poisson logistic regression. Results: the prevalence of self-medication in children was 91,3%. Parents who only studied primary and secondary school were more likely to self-medicate their children PRa=1,22 (95% CI: 1,01-1,40). The first-born were protected from self-medication PRa=0,86 (95% CI: 0,76-0,97). Parents who were between 20 and 29 years of age obtained PRa=1,04 (95% CI: 0,96-1,13), children under 7 years old, PRa=0,99 (95% ci: 0,91-1,07) and parents of family that had 1 child PRa=1,04 (95% CI:0,90-1,20). Conclusions: the educational level and the order number of the child, such as being the first-born, had a significant association with self-medication in children.

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Malformações congênitas (MC) são alterações estruturais/funcionais que ocorrem no feto trazendo impacto socioeconômico e emocional. Estudo retrospectivo, documental, de abordagem quantitativa, com o objetivo de identificar a relação dos fatores de risco e perfil epidemiológico materno com a ocorrência de MC. Baseou-se na análise de 37 prontuários de gestantes em município da região metropolitana de Curitiba-PR, entre 2019 e 2021. Os achados revelaram um perfil: gestantes entre 18 e 36 anos, multíparas, obesas, com comorbidades, sem avaliação pré-concepcional. Os sistemas orgânicos mais acometidos foram o cardiovascular, o nervoso ou múltiplos sistemas. Identificou-se risco aumentado de malformações fetais em mulheres maiores de 25 anos, obesas, que utilizaram álcool ou tabaco. Embora uma causa única das MC nesse período e local não tenha sido identificada, estabeleceu-se associação entre fatores epidemiológicos maternos e características das malformações fetais, evidenciando necessidade de educação em saúde pré-concepcional

Congenital malformations (CM) are structural/functional alterations that occur in the fetus, leading to a socio-economic and emotional impact. This is a retrospective, documentary study with a quantitative approach aiming at identifying the relationship of risk factors and maternal epidemiological profile with the occurrence of CM. It was based on the analysis of 37 medical charts of pregnant women in a municipality in the metropolitan region of Curitiba-PR, between 2019 and 2021. The data revealed a profile: pregnant, multiparous, obese women between 18 and 36 years old, with comorbidities, with no preconception evaluation. The most affected organic systems were the cardiovascular and the nervous systems or multiple systems. An increased risk of fetal malformations was observed in obese women over 25 years old, who used alcohol or tobacco. Although a single cause of CM in that period and place has not been identified, an association was established between maternal epidemiological factors and characteristics of fetal malformations, highlighting the need for preconception health education.

Las malformaciones congénitas (MC) son alteraciones funcionales que ocurren en el feto, llevando consigo un impacto socioeconómico y emocional. Estudio retrospectivo, documental, con abordaje cuantitativo, con el objetivo de identificar la relación entre los factores de riesgo y el perfil epidemiológico materno con la ocurrencia de MC. Se basó en el análisis de 37 prontuarios de embarazadas del municipio de la región metropolitana de Curitiba-PR, entre 2019 y 2021. Los hallazgos revelaron un perfil: embarazadas entre 18 y 36 años, multíparas, obesas, con comorbilidades, sin evaluación preconcepcional. Los sistemas orgánicos más afectados fueron los sistemas cardiovascular, nervioso o múltiple. Se identificó un mayor riesgo de malformaciones fetales en mujeres mayores de 25 años, obesas, consumidoras de alcohol o tabaco. Aunque no se ha identificado una causa única de MC en ese período y lugar, se estableció una asociación entre los factores epidemiológicos maternos y las características de las malformaciones fetales, destacando la necesidad de la educación sanitaria previa a la concepción

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INTRODUCTION: Obesity and depression contribute to the global burden of economic cost, morbidity, and mortality. Nevertheless, not all people with obesity develop depression. OBJECTIVE: To determine the factors associated with depressive symptoms among people aged 15 or older with obesity from the National Demographic and Family Health Survey (ENDES in Spanish 2019-2021). METHODS: Cross-sectional analytical study. The outcome of interest was the presence of depressive symptoms, assessed using the Patient Health Questionnaire-9 (PHQ-9). Crude (cPR) and adjusted (aPR) prevalence ratios were estimated using GLM Poisson distribution with robust variance estimates. RESULTS: The prevalence of depression symptoms was 6.97%. In the multivariate analysis, a statistically significant association was found between depressive symptoms and female sex (PRa: 2.59; 95% CI 1.95-3.43); mountain region (PRa: 1.51; 95% CI 1.18-1.92); wealth index poor (PRa: 1.37; 95% CI 1.05-1.79, medium (PRa: 1.49; 95% CI 1.11-2.02), and rich (PRa: 1.65; 95% CI 1.21-2.26); daily tobacco use (PRa: 2.05, 95% CI 1.09-3.87); physical disability (PRa: 1.96, 95% CI 1.07-3.57); and a history of arterial hypertension (PRa: 2.05; 95% CI 1.63-2.55). CONCLUSION: There are several sociodemographic factors (such as being female and living in the Andean region) and individual factors (daily use of tobacco and history of hypertension) associated with depressive symptoms in Peruvian inhabitants aged 15 or older with obesity. In this study, the COVID-19 pandemic was associated with an increase in depressive symptoms.

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AIM: To evaluate the factors associated with alcohol abuse in the Peruvian population. METHODS: A secondary analysis was performed using data from the Demographic and Family Health Survey of Peru, 2019. We included 24 264 Peruvians between 18 and 59 years. For the analysis of association, the Poisson regression model with robust standard errors was used. Adjusted Prevalence Ratios (aPR) with their respective 95% confidence intervals (95% CI) were calculated. RESULTS: The prevalence of alcohol abuse was 5.2%. Having higher education (aPR:1.61; 95%CI:1.04-2.48), being widowed, separated or divorced (aPR:1.73; 95%CI:1.18-2.54), belonging to the third (aPR:1.70; 95%CI:1.12-2.60), fourth (aPR:2.08; 95%CI:1.33-3.23) or fifth socioeconomic quintile (aPR:2.16; 95%CI:1.33-3.50), being from the Sierra (aPR:1.45; 95%CI:1.12-1.87) or Selva (aPR:1.48; 95%CI:1.13-1.94), not having health insurance (aPR:1.25; 95%CI:1.04-1.50), being a current smoker (aPR:2.43; 95%CI:2.02-2.93) and having major depression (aPR:1.77; 95%CI:1.32-2.36) were associated with a higher prevalence of alcohol abuse. On the other hand being a middle-aged adult (aPR:0.73; 95%CI:0.60-0.88), female (aPR:0.16; 95%CI:0.12-0.22) and having started drinking alcohol after the age of 18 years (aPR:0.57; 95%CI:0.47-0.69) were associated with a lower prevalence. CONCLUSIONS: One in 20 Peruvians between 18 and 59 years had alcohol abuse. Age, gender, education level, marital status, socioeconomic level, region, age of first drink, smoking and depression were associated with alcohol abuse.

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Introducción: Los pacientes con el fenotipo delgado metabólicamente obeso (DMO) pueden presentar el mismo riesgo que los obesos clásicos para desarrollar enfermedades crónicas a largo plazo. No obstante, la prevalencia y los factores que se encuentran asociados este varía de acuerdo con la población estudiada. Objetivo: determinar la prevalencia y los factores se encuentran asociados al fenotipo DMO en el Perú. Métodos: Estudio analítico de corte transversal. Análisis secundario de la base de datos del estudio PERU MIGRANT. Los factores asociados que se consideraron fueron: edad (30-44 años, de 45-59 años, y 60 a más años), sexo, estado socioeconómico, nivel de educación, migración, tabaquismo, consumo de alcohol y nivel actividad física. Resultados: La prevalencia del fenotipo DMO fue de 32,23% (IC95% 27,61-37,10). En el análisis multivariable, el sexo masculino mostró 39% menor probabilidad de presentar el fenotipo DMO (PRa: 0,610; IC95% 0,428-0,869; p=0,006), en comparación con el sexo femenino. Mientras que, pertenecer a los grupos de edad entre 45-59 años y de 60 años a más presentó 110,5% (PRa: 2,105; IC95% 1,484-2,988; p<0,001) y 97,6% (PRa: 1,976; IC95% 1,270-3,075; p=0,003), respectivamente, mayor probabilidad de presentar DMO, en comparación con el grupo de 29-44 años. Conclusiones: El pertenecer al sexo femenino y a los grupos de edad de 45 a 59 y 60 años a más, aumentaron la probabilidad de presentar el fenotipo DMO. Se recomienda la realización de futuros estudios con prospectivos y con un tamaño de muestra mayor para confirmar dichos hallazgos, así como la inclusión de nuevas variables.

Introduction: Patients with the lean metabolically obese (BMD) phenotype may present the same risk as the classic obese for developing long-term chronic diseases. However, the prevalence and the factors that are associated with it vary according to the population studied. Objective: to determine the prevalence and the factors associated with the BMD phenotype in Peru. Methods: Cross-sectional analytical study. Secondary analysis of the PERU MIGRANT study database. The associated factors that were considered were: age (30-44 years, 45-59 years, and 60 years and over), sex, socioeconomic status, level of education, migration, smoking, alcohol consumption and level of physical activity. Results: The prevalence of the BMD phenotype was 32.23% (95% CI 27.61-37.10). In the multivariate analysis, the male sex showed a 39% lower probability of presenting the BMD phenotype (PRa: 0.610; 95% CI 0.428-0.869; p=0.006), compared to the female sex. While belonging to the age groups between 45-59 years and 60 years and over presented 110.5% (PRa: 2.105; 95% CI 1.484-2.988; p<0.001) and 97.6% (PRa: 1.976; CI95% 1.270-3.075; p=0.003), respectively, greater probability of presenting BMD, compared to the group of 29-44 years. Conclusions: Belonging to the female sex and to the age groups of 45 to 59 and 60 years or more, increased the probability of presenting the BMD phenotype. Future prospective studies with a larger sample size are recommended to confirm these findings, as well as the inclusion of new variables.

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Introducción: La Diabetes Mellitus tipo 2 es una enfermedad que representa un reto para la salud pública por su tendencia al crecimiento e impacto sobre todo en países en desarrollo. Objetivo: determinar los factores asociados a la no realización del cribado de diabetes mellitus tipo 2 según la encuesta demográfica y de salud familiar del año 2020 (ENDES-2020). Materiales y métodos: Estudio analítico transversal secundario de la ENDES-2020. Resultados: Las variables que mostraron asociación estadísticamente significativa para cribado de DM2 fueron: sexo masculino (PR=1,06, IC95% 1,02­1,10; p<0,001), edad entre 30 a 59 años (0,92; IC95% 0,89­0,95; p<0,001) y 60 años a más (PR=0,72; IC95% 0,65­0,79; p<0,001), educación primaria (PR=0,94, IC 95% 0,92 - 0,99; p<0,020), secundaria (PR=0,93; IC 95% 0,88­0,97; p=0,008) y superior (PR=0,86, IC 95% 0,85­0,94; p<0,001), ser pobre (PR=0,96, IC95% 0,92­0,99; p=0,016), medio (PR=0,93; IC95% 0,88 ­ 0,96; p=0,001), rico (PR=0,89; IC95% 0,84 ­ 0,94; p<0,001), muy rico (PR=0,81; IC95% 0,75­0,86; p<0,001), e hipertensión (PR=0,91; IC 95% 0,867­0,969; p=0,002). Discusión: El sexo masculino fue el único factor asociado a la no realización del cribado de diabetes mellitus tipo 2, mientras que, pertenecer a un grupo de edad mayor, tener hipertensión arterial, mayor nivel educativo y socioeconómico aumentó la posibilidad de realizarlo. Conclusión: Es imprescindible reforzar las estrategias de cribado en el primer nivel de atención, mediante la implementación de medidas de prevención.

Introduction: Type 2 Diabetes Mellitus (T2DM) is a disease that poses a challenge to public health due to its growth trend and impact, especially in developing countries. This study aimed to determine the factors associated with not being screened for T2DM according to the 2020 Demographic and Family Health Survey (ENDES-2020). Materials and Methods: Secondary, cross-sectional, analytical study using the ENDES-2020 data. Results: The variables that showed a statistically significant association for T2DM screening were the following: male sex (PR=1.06, 95% CI: 1.02­1.10; p<0.001), ages between 30 and 59 years (0.92, 95% CI: 0.89­0.95; p<0.001) and 60 years and older (PR=0.72, 95% CI: 0.65­0.79; p<0.001), primary education (PR=0.94, 95% CI: 0.92­0.99; p<0.020), secondary education (PR=0.93, 95% CI: 0.88­0.97; p=0.008) higher education (PR=0.86, 95% CI: 0.85­0.94; p<0.001), poor (PR=0.96, 95% CI: 0.92­0.99; p=0.016), middle income (PR=0.93, 95% CI: 0.88­0.96; p=0.001), rich (PR=0.89, 95% CI: 0.84­0.94; p<0.001), very rich (PR=0.81, 95% CI: 0.75­0.86; p<0.001), and hypertension (PR=0.91, 95% CI: 0.867­0.969; p=0.002). Discussion: Being male was the only factor associated with not being screened for T2DM, whereas belonging to an older age group, having arterial hypertension, and having higher education and socioeconomic levels increased the possibility of being screened. Conclusion: It is essential to strengthening screening strategies at the primary level of care by implementing preventive measures.

Introdução: A diabetes melito tipo 2 é uma doença que representa um desafio à saúde pública devido a sua crescente tendência e impacto, especialmente em países em desenvolvimento. O objetivo deste estudo foi determinar os fatores associados à não realização de triagem para diabetes mellitus tipo 2 de acordo com a Pesquisa Demográfica e de Saúde da Família 2020 (DHS-2020). Materiais e métodos: Estudo analítico transversal secundário do ENDES-2020. Resultados: As variáveis que mostraram associação estatisticamente significativa para a triagem DM2 foram: sexo masculino (PR=1,06, 95%CI 1,02-1,10, p<0,001), idade 30-59 anos (0,92, 95%CI 0,89-0,95, p<0,001) e 60 anos ou mais (PR=0,72, 95%CI 0,65-0,79, p<0,001), educação primária (PR=0,94, 95%CI 0,92-0,99, p<0,020), educação secundária (PR=0,93, 95%CI 0,88-0,97, p=0,008), e educação secundária superior (PR=0,93, 95%CI 0,88-0,97, p=0,008); p=0,008) e superior (PR=0,86, 95% CI 0,85-0,94; p<0,001), pobre (PR=0,96, 95% CI 0,92-0,99; p=0,016), médio (PR=0,93, 95% CI 0,88 - 0,96; p=0,001), rica (PR=0,89; 95%CI 0,84 - 0,94; p<0,001), muito rica (PR=0,81; 95%CI 0,75-0,86; p<0,001), e hipertensão (PR=0,91; 95%CI 0,867-0,969; p=0,002). Discussão: O sexo masculino foi o único fator associado com a não realização de triagem para diabetes mellitus tipo 2, enquanto pertencia a uma faixa etária mais velha, ter hipertensão, educação superior e status socioeconômico aumentou a probabilidade de triagem. Conclusão: É essencial reforçar as estratégias de triagem no nível da atenção primária através da implementação de medidas preventivas.

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Objetivo: Descrever o perfil clínico de indivíduos com Esclerose Lateral Amiotrófica (ELA) de um hospital de referência na cidade de Belo Horizonte, Brasil. Métodos: Trata-se de um estudo transversal retrospectivo com coleta de dados de prontuários eletrônicos de indivíduos com diagnóstico definido de ELA entre 2010 e 2020, no setor de referência em Distrofias Musculares de um hospital de uma capital brasileira. Resultados: Foram incluídos 103 indivíduos com ELA, com idade média de 60±12 anos, idade média de diagnóstico de 56±12 anos e tempo médio de evolução da doença de 3±3 anos. Além disso, 70% eram do sexo masculino, 88% com ELA esporádica, com envolvimento bulbar semelhante entre leve (32%), moderado (27%) e grave (28%), e com maior taxa de diagnóstico de 50 a 70 anos de idade. Conclusão: Os dados epidemiológicos deste estudo são muito semelhantes aos da literatura. No entanto, a heterogeneidade da doença, a complexidade do diagnóstico e a diversidade de formas que cada estudo traz para a doença, e principalmente a rápida progressão, dificultam a discussão de um quadro mais extenso. Traçar esse perfil é importante para uma clínica mais focada e um manejo mais adequado, e para isso são necessários mais estudos.

Objective: To describe the clinical profile of individuals with Amyotrophic Lateral Sclerosis (ALS) from a reference hospital in the city of Belo Horizonte, Brazil. Method: This is a retrospective cross-sectional study with data collection from electronic medical records of individuals with a defined diagnosis of ALS between 2010 and 2020, in the Muscular Dystrophies reference sector of a hospital in a Brazilian capital. Results: A total of 103 individuals with ALS were included, with a mean age of 60±12 years, mean diagnostic age 56±12 years, and mean time of disease progression of 3±3 years. Furthermore, 70% were male, 88% with sporadic ALS, with a similar bulbar involvement between mild (32%), moderate (27%) and severe (28%), and with a higher rate of diagnosis from 50 to 70 years of age. Conclusion: The epidemiological data from this study are very similar to those in the literature. However, the heterogeneity of the disease, the complexity of the diagnosis and the diversity of forms that each study brings to the disease, and especially the rapid progression, make a more extensive picture difficult to be discussed. Tracing this profile is important for a more focused clinic and a more adequate management, and for that, further studies are needed.

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Background: As of 7 January 2022, it is estimated that 5.5 million people worldwide have died from COVID-19. Although the full impact of SARS-CoV-2 (COVID-19) on healthcare systems worldwide is still unknown, we must consider the socio-economic impact. For instance, it has resulted in an 11% decrease in the GDP (Gross Domestic Product) in the European Union. We aim to provide valuable information for policymakers by analysing widely available epidemiological and socioeconomic indicators using Spanish data. Methods: Secondary analysis of routinely available data from various official data sources covering the period from 1 March 2020 to 31 March 2021. To measure the impact of COVID-19 in the population, a set of epidemiological and socioeconomic indicators were used. The interrelationships between these socioeconomic and epidemiological indicators were analysed using Pearson's correlation. Their behaviour was grouped according to their greater capacity to measure the impact of the pandemic and was compared to identify those that are more appropriate to monitor future health crises (primary outcome) using multivariate analysis of canonical correlation for estimating the correlation between indicators using different units of analysis. Results: Data from different time points were analysed. The excess of mortality was negatively correlated with the number of new companies created during the pandemic. The increase in COVID-19 cases was associated with the rise of unemployed workers. Neither GDP nor per capita debt was related to any epidemiological indicators considered in the annual analysis. The canonical models of socioeconomic and epidemiological indicators of each of the time periods analysed were statistically significant (0.80-0.91 p < 0.05). Conclusions: In conclusion, during the COVID-19 pandemic in Spain, excess mortality, incidence, lethality, and unemployment constituted the best group of indicators to measure the impact of the pandemic. These indicators, widely available, could provide valuable information to policymakers and higher management in future outbreaks.

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RESUMEN Introducción: El trasplante renal es la mejor opción disponible para el tratamiento de la insuficiencia renal crónica terminal. La determinación de marcadores humorales permite detectar y seguir la evolución del paciente trasplantado renal y la disfunción del injerto, así como sus diversas complicaciones. Objetivos: Relacionar el funcionamiento del trasplante renal realizado a pacientes con un grupo de marcadores humorales. Métodos: Se realizó una investigación descriptiva y de corte transversal en 85 pacientes trasplantados renales, previo consentimiento informado, los cuales constituían la totalidad de los pacientes del Servicio de trasplante renal, en el Hospital Universitario Clínico-Quirúrgico «Arnaldo Milián Castro¼, Santa Clara, Villa Clara, desde enero de 2015 a diciembre de 2017. Resultados: Predominaron pacientes del sexo masculino, de 40-59 años de edad. La principal enfermedad asociada fue la hipertensión arterial. Del total de trasplantados estaban con funcionabilidad 62 pacientes (72,94 %) y en ellos, fue significativo el aumento de los valores de hematocrito y albúmina, así como el valor medio de la creatinina sérica, ligeramente superior a los valores de referencia. Conclusiones: El rango de edad más frecuente fue de 40-59 años. Prevaleció el sexo masculino asociado con la hipertensión arterial. Predominó la funcionabilidad de los trasplantes realizados precozmente, con menor tiempo en diálisis. En los marcadores humorales la creatinina presentó una asociación significativa. Por otra parte, el hematocrito nunca se normalizó en los no funcionales. El conteo de Addis fue el examen que más modificación precoz sufrió ante cualquier alteración en la función renal.

ABSTRACT Introduction: renal transplantation is the best available option for the treatment of terminal chronic renal failure. The determination of humoral markers makes it possible to detect and follow the evolution of kidney transplant patients and graft dysfunction, as well as its various complications. Objectives: to relate the performance of kidney transplants performed in patients with a group of humoral markers. Methods: a descriptive and cross-sectional research was carried out in 85 kidney transplant patients, with prior informed consent, which constituted all the patients of the Kidney Transplant service from "Arnaldo Milián Castro" Clinical and Surgical University Hospital, Santa Clara, Villa Clara, between January 2015 and December 2017. Results: male patients aged 40-59 years old predominated. The main associated disease was arterial hypertension. A number of 62 patients from the total number of transplant recipients (72.94%) were functional and the increase in hematocrit and albumin values ​​was significant in them, as well as the mean value of serum creatinine was slightly higher than the reference values. Conclusions: the most frequent age range was 40-59 years. The male gender associated with arterial hypertension prevailed. The functionality of transplants performed early, with less time on dialysis, prevailed. Creatinine had a significant association in the humoral markers. On the other hand, the hematocrit never normalized in non-functional patients. The Addis count was the test that underwent the earliest changes in the event of any alteration in renal function.

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Objective: To identify the determinants of exclusive breastfeeding (EBF) among children under 6 months of age from three regions in the South and Grand'Anse Departments of Haiti. Methods: Data were pooled from three cross-sectional surveys conducted yearly from 2017 to 2019 with the guardians of 638 children under 6 months of age. A non-quantitative 24-hour dietary recall was used to assess EBF the day before the survey. Using unadjusted and adjusted prevalence ratios, associations were assessed between EBF and several explanatory factors: infant's age and sex; maternal age, educational attainment, mid-upper arm circumference (MUAC), dietary diversity, number of children under 5 years of age, responsibility for the main or secondary source of income of the household, initiation of breastfeeding within one hour, knowledge of EBF duration; household severe food insecurity, socioeconomic status, dependency ratio, region, and residential zone (urban/rural). Results: Prevalence of EBF was 68% in the study sample. From the fully adjusted model, prevalence of EBF was statistically significantly higher among younger infants, mothers with larger MUAC, who met or exceeded Minimum Dietary Diversity for Women (MDD-W), who initiated breastfeeding within one hour, who were knowledgeable of the recommendations for EBF duration, and living in the Jérémie region. Conclusions: The main determinants of EBF identified in this study attest to the importance of breastfeeding mothers' access to nutritious food for the practice and maintenance of EBF and the need for geographically equitable access to health services and education that support breastfeeding.

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INTRODUCTION: SARS-CoV-2 continues to have a high rate of contagion worldwide. The new variant of concern, Omicron, has mutations that decrease the effectiveness of vaccines and evade antibodies from previous infections resulting in a fourth wave of the pandemic. It was identified in Mexico in December 2021. METHODS: The Traveler's Preventive Care Clinic from the Faculty of Medicine UNAM at Mexico City International Airport has performed rapid antigen and PCR SARS CoV2 tests since January 2021 to comply with the new travel requirements. Demographic and clinical characteristics were collected from each passenger and the fourth wave of the pandemic in Mexico mainly caused by Omicron was analyzed in the travelers. RESULTS: A total of 5176 travelers attended the clinic between the second half of December 2021 and January 2022. Ten percent of all the tests performed were positive (13% of PCR and 9.3% of antigens, p = 0.001). Most of the SARS CoV2 positive cases were asymptomatic (78%), with a ratio of 3.5:1 over the symptomatic. By age groups, this ratio was higher for those under 20 years old (8.7:1). DISCUSSION: This study shows the rapid escalation of positivity that occurred in Mexico, detected in travelers, from the second half of December 2020 and throughout the month of January 2021. The incidence of COVID-19 was extremely high in travelers who were mostly asymptomatic for the period under study.

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RESUMEN Introducción: Los trabajadores de salud presentan alto riesgo de la COVID-19, hecho especialmente importante en el Perú que tiene una de los mayores índices de letalidad por esta pandemia. Objetivo: Identificar y comparar los determinantes de letalidad por la COVID-19 en trabajadores de salud del Perú, entre la primera y segunda olas. Material y Métodos: Análisis secundario de datos de la Sala situacional de trabajadores del sector salud de COVID-19, que incluyó 95 966 casos confirmados de la COVID-19 hasta el 21 de octubre de 2021. Se calculó el índice de letalidad, así como los odds ratio -y sus intervalos de confianza a 95 %- crudo y ajustado mediante regresión logística binaria. Resultados: 65,5 % fueron mujeres, de 41,2 (D.E.=11,1) años en promedio. El índice de letalidad fue mayor durante la segunda ola (2,1 % [IC95%=2,0-2,2] vs 2,6 % [IC95 %=2,5-2,8]). El sexo masculino (3,49 [IC95 %=3,09-3,95] en la primera ola y 2,65 [IC95 %=2,32-3,02] en la segunda ola), la edad ≥40 años (9,97 [IC95 %=8,19-12,13] en la primera ola y 10,77 [IC95 %=8,56-13,54] en la segunda ola), así como ser profesional de salud (1,14 [IC95 %=1,01-1,28] en la primera ola y 1,59 [IC95 %=1,39-1,82] en la segunda ola) determinaron la letalidad por la COVID-19 en ambas olas. Conclusiones: La letalidad fue mayor en la segunda ola y se asoció a determinantes individuales, geográficos y ocupacionales de los trabajadores de salud peruanos.

ABSTRACT Introduction: Healthcare workers are at high risk of COVID-19, a fact that is especially important in Peru which has one of the highest COVID-19 case fatality rates. Objective: To identify and compare the determinants of COVID-19 case fatality among healthcare workers in Peru between the first and second waves of the pandemic. Material and Methods: Secondary analysis of data from the COVID-19 Health Sector Workers Situation Room which included 95,966 confirmed cases of COVID-19 until October 21, 2021. Case fatality rate was calculated; crude and adjusted odds ratios with 95 % confidence intervals were obtained by applying binary logistic regression. Results: The results show that 65,5 % of the workers were female, aged 41,2 (S.D.=11,1) years on average. Case fatality rate was higher in the second wave. Male sex (3,49 [95 %CI=3,09-3,95] in the first wave (2,1 % [95 %CI=2,0-2,2] vs. 2,6 % [95 %CI=2,5-2,8]), and 2,65 [95 %CI=2,32-3,02] in the second wave), ≥40 years ofage (9,97 [95 %CI=8,19-12,13] in the first wave, and 10,77 [95 %CI=8,56-13,54] in the second wave), and healthcare professionals (1,14 [95 %CI=1,01-1,28] in the first wave, and 1,59 [95 %CI=1,39-1,82] in the second wave) were determinants for COVID-19 case fatality in both waves. Conclusions: COVID-19 case fatality was higher in the second wave, and was associated with individual, geographic and occupational determinants in Peruvian healthcare workers.

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La tuberculosis continúa siendo un problema de salud pública. Al respecto, se realizó un estudio no experimental de corte transversal, con el objetivo de caracterizar clínica y epidemiológica-mente el estado de la TB resistente a medicamentos de primera línea en la ciudad de Durán, desde enero 2015 hasta diciembre 2019. Los datos incluidos en los documentos de la matriz del programa de tuberculosis resistente. De 1111 casos nuevos de tuberculosis reportados en el cantón Durán durante el período estudiado, 45 de estos presentaron resistencia a medicamentos de primera línea. El 88,89% tuvo resistencia a rifampicina, el 33,33% de los pacientes se dispen-sarizaron en 2019. Los valores de chi cuadrado de Pearson no mostraron asociación estadística-mente significativa entre las variables investigadas (p>0,05). Entre los involucrados predominó el grupo de edades de 20 a 39 años, el sexo masculino, la tuberculosis pulmonar, infectados con VIH/sida, resistencia clasificada como primaria, los que abandonaron el seguimiento al trata-miento y la no manifestación de reacciones adversas a los medicamentos. No se observó mortali-dad entre los casos nuevos, predominando entre aquellos con recaída, el género masculino y los que tuvieron tuberculosis extrapulmonar.

Tuberculosis is a disease that continues to be a public health problem. In this regard, a non-expe-rimental cross-sectional study was carried out to characterize clinically and epidemiologically the status of TB resistant to first-line drugs in the city of Durán, from January 2015 to December 2019. The data included in the resistant tuberculosis program matrix documents. 1111 new cases of tuberculosis were reported in the Duran canton during the study period, 45 of these ones presented resistance to first-line drugs. 88.89% had rifampicin resistance, 33.33% of the patients were dispensed in 2019. Pearson's chi-square values did not show a statistically significant asso-ciation between the investigated variables (p> 0.05). Among the study population, it was predo-minated the age group between 20 and 39, male sex, pulmonary tuberculosis, infected with HIV / AIDS, resistance classified as primary, those who abandoned the follow-up to treatment and the non-manifestation of adverse drug reactions. No mortality was observed among new cases, predominantly among those ones with relapse, the male gender and those ones who had extra-pulmonary tuberculosis

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Objetivo: analisar a incidência da episiotomia e os fatores maternos e neonatais relacionados. Método: estudo transversal, retrospectivo, que analisou 11.809 prontuários de mulheres que evoluíram ao parto vaginal. Realizou-se o teste qui-quadrado para identificar os fatores relacionados (p<0,05). Resultados: a incidência da episiotomia foi 59,4%. Entre as mulheres que não sofreram episiotomia, 27,0% permaneceram com períneo íntegro e 13,5% tiveram laceração espontânea. Fatores maternos relacionados foram idade inferior a 19 anos, acompanhamento pré-natal adequado, primiparidade, dinâmica uterina presente, dilatação cervical entre 1 e 3cm, bolsa amniótica rota e trabalho de parto prolongado. Os fatores neonatais foram bebês a termo, peso ao nascer ≥2500g, Apgar ≥ 7, apresentação cefálica, intercorrências com o bebê e encaminhamento ao alojamento conjunto. Conclusão: a prática da episiotomia foi elevada, a qual deve ser desencorajada, com respeito a fisiologia do nascimento e a individualidade das mulheres, para o fortalecimento dos cuidados maternos.

Objective: to analyze the incidence of episiotomy and maternal and neonatal related factors. Method: cross-sectional, retrospective study in which 11,809 medical records of women who underwent vaginal delivery were analyzed. The chi-square test was performed to identify related factors (p<0.05). Results: the incidence of episiotomy was 59.4%. Among women who did not undergo episiotomy, 27.0% had intact perineum and 13.5% had spontaneous laceration. Maternal related factors were age less than 19 years, appropriate antenatal care, primiparity, presence of uterine dynamics, cervical dilation between 1 and 3 cm, ruptured amniotic sac, and prolonged labor. Neonatal factors were full-term babies, birth weight ≥2,500g, Apgar ≥7, cephalic presentation, complications with the baby and referral to rooming-in. Conclusion: the practice of episiotomy was high and should be discouraged. Respect for the physiology of birth and the individuality of women is necessary to strengthen maternal care.

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