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BACKGROUND: HIV disproportionately affects sexual minority men (SMM; eg, gay, bisexual, and other men who have sex with men) in Lima, Peru; epidemiological data estimate that 32% to 39% of new HIV infections occur among adult cisgender SMM within primary partnerships (ie, male couples). Most HIV prevention-care research in Lima, Peru, has focused on SMM as individuals and not couples. To help address this critical gap in prevention care, we developed Para Ti, Para Mí, Para Nosotros (P3): a couples-based, digital HIV serostatus-neutral intervention (DHI) for adult cisgender SMM couples in Lima, Peru. The P3 DHI is designed to facilitate couples with skill-building, communication, decision-making, and working together to form and adhere to a detailed prevention care plan that aligns with their explicit sexual agreement. The P3 DHI is theoretically informed, self-guided, directed, sequential, and fully automated. OBJECTIVE: This pilot randomized controlled trial (RCT) aims to examine the preliminary effects of P3 on couples' formation and adherence to a detailed prevention care plan containing evidence-based strategies that also aligns with their explicit sexual agreement over time. In addition, the feasibility of enrollment and retention and couples' acceptability of P3 will be assessed. METHODS: The research implements a prospective, 6-month pilot RCT with a 3-month delayed control condition. After baseline, 60 enrolled SMM couples will be randomized to 1 of 2 conditions. Couples randomized to the unmatched, delayed control condition will receive access to the P3 DHI to use during the last 3 months of the trial after the 3-month assessment. Couples randomized to the immediate intervention condition will immediately receive access to the P3 DHI for 6 months. Study assessments will occur at baseline and months 3 and 6. Descriptive, comparative, qualitative, and longitudinal analyses using generalized linear mixed-effect, multilevel, and actor-partner interdependence models will be conducted to address the specific aims. RESULTS: The 6-month pilot RCT is ongoing. Recruitment, enrollment, and data collection began in January 2023 and ended in April 2024. A total of 74 adult cisgender SMM couples met all inclusion criteria, provided consent, and were enrolled in the pilot RCT. Retention was 92% (68/74) at month 6. Data are currently being analyzed to address the 3 specific aims regarding feasibility, acceptability, and preliminary efficacy. CONCLUSIONS: Findings from this research will reveal whether couples deemed the P3 DHI to be acceptable. Findings will also highlight the preliminary efficacy of the P3 DHI on couples managing their vulnerability to HIV and other sexually transmitted infections (STIs) over time via alignment of their prevention-care plan and sexual agreement. Trial findings will help shape the future direction of the P3 DHI while addressing the existing gap in prevention and care services for couples in the local context. TRIAL REGISTRATION: ClinicalTrials.gov NCT05873855; https://clinicaltrials.gov/study/NCT05873855. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/63106.

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A partir de entrevistas y conversaciones a profundidad con cinco enfermeros técnicos de los pueblos Yine y Shipibo-Konibo que laboran en establecimientos de salud en la Amazonía de Ucayali en Perú, este estudio muestra que las prácticas desplegadas para atender a los enfermos con síntomas de Covid-19 hicieron uso de terapias y nociones biomédicas e indígenas. Dichas prácticas reflejaron su formación en salud intercultural y su capacidad para adecuar las normas establecidas por el Ministerio de Salud. En función de los síntomas observados en los pacientes, los enfermeros indígenas usaron una variedad de prácticas: vaporaciones, masajes, baños, infusiones y remedios. Las nociones de salud y enfermedad que los enfermeros técnicos indígenas comparten con sus pacientes fueron la base para interpretar el Covid-19 y estuvieron presentes en las atenciones brindadas. Esto se nutrió de la existencia de un sistema de cuidado familiar bastante articulado que fue tejiéndose y siendo negociado en función de los síntomas y las terapias aplicadas. Sus prácticas demuestran la creatividad en los pueblos indígenas. En ese sentido, el sector salud necesita repensar su mirada sobre la medicina indígena, a la que denomina "tradicional" y nos muestra la necesidad de repensar las ideas sobre adecuación de los servicios para la población indígena para colocar en el centro del debate el significado de interculturalidad en salud desde la perspectiva indígena.

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BACKGROUND: The purpose of scientific production is to synthesize and capture research for eventual publication. In Peru, scientific production at the undergraduate level is relatively limited. The purpose of this study was to identify the factors associated with scientific production conditions among dental students from the Peruvian capital. METHODS: This cross-sectional and analytical study evaluated 338 dental students from the Peruvian capital using a questionnaire composed of 15 questions on conditions for scientific production. Pearson's chi-square test and Fisher's exact test were used for bivariate analysis. To evaluate the influential variables, the adjusted Poisson regression model with robust variance using the adjusted prevalence ratio (APR) was employed. The significance level was p < 0.05. RESULTS: A total of 17.8% of the students carried out research studies, while 1.5% published scientific articles. Conditions for scientific production were considered unfavorable in 28.4% of the cases, while 50.6% were classified as somewhat favorable and 21% as favorable. Students who dedicated < 2 h and ≥ 2 h per week to research were 3.04 and 3.84 times more likely to have favourable conditions for scientific production, respectively, compared to those who had no time for it (APR = 3.04, 95% CI: 1.02-9.03 and APR = 3.84, 95% CI: 1.13-13.02; respectively). CONCLUSION: A minority of dental students reported favorable conditions for scientific production. On the other hand, students with more weekly time for research are more likely to have favourable conditions for scientific production compared to those with no time.

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Congenital heart diseases are the most common congenital malformations worldwide and represent one of the leading causes of neonatal death, in addition to the significant use of human and financial resources by health systems. The purpose of this document is to support the implementation of neonatal screening for critical congenital heart diseases using pulse oximetry according to the different geographical altitudes of Peru. This technology is widely used worldwide and has high sensitivity, specificity, and cost-effectiveness. At many latitudes, it has led to better survival in this group of patients and in the neonatal population in general since its use in the early detection of sepsis, pneumonia, and other conditions that affect the oxygenation of the newborn. Neonatal screening for critical congenital heart disease is applicable at all levels of healthcare at a national level, and its implementation must be a priority to improve neonatal health.

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Background: The objective of this study was to understand health care providers' perspectives regarding the facilitators of and barriers to the success of the former Pap and VIA-based cervical cancer program in Iquitos, Peru, using the Consolidated Framework for Implementation Research (CFIR) to inform the transition to the HPV screen-and-treat intervention. By exploring the pre-implementation organizational context, or inner setting, through the opinions of those who would implement the HPV-based intervention at the patient care level, this research lays the foundation to assess readiness before implementation and understand what's necessary to design contextually appropriate and sustainable interventions in LMIC settings. Methods: We conducted 19 semi-structured interviews with health professionals (12 nurse-midwives, 4 doctors, and 3 laboratory technicians) who administered the former Pap- and VIA-based cervical cancer EDT program. Results: Providers identified information gaps between the primary level of care, where cervical cancer screening occurs, and the hospital level of care, where diagnosis and treatment occurs. These gaps, which were caused in part by fragmented, antiquated, and overlapping data systems, resulted in the loss of patients between levels of care. Participants also noted a lack of trained personnel and basic materials. Some providers found their way around these gaps by facilitating informal information exchanges among providers to ensure women were not lost to follow-up. Conclusions: PPC relied on these findings and other data from INSPIRE Phase 1 to implement a HPV-based screen-and-treat program that dramatically increased screening and treatment; however, challenges remain regarding resources and sustainability related to HPV technology.

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OBJECTIVE: Research on factors that modify the intention to donate blood voluntarily in the general population in Peru is scarce, and most of it are focused on health science personnel. The aim of the present study was to estimate the factors associated with the intention to donate blood in patients attending an outpatient clinic in a hospital in northern Peru. METHODS: A prospective unpaired study of cases (n=185) and controls (n=185) was designed. A case was defined as a patient who responded "if I would voluntarily donate blood in the future" to the initial filter question. The response variable was intention to donate blood and the exposure variables were sex, age, marital status, educational level, employment status, monthly income, religion, donation practices, and knowledge about donation. In addition, the motivations for blood donation were explored. To identify the associated factors, crude odds ratios (ORc) were calculated by means of generalized linear models, using the Poisson family, log link function and robust models; then the variables that showed a significant statistical association were adjusted by multivariate analysis, adjusting for sociodemographic variables, and the adjusted odds ratios (ORa) were obtained. RESULTS: In the multivariate analysis, male sex (ORa=1.37), having a high monthly income (ORa=1.26), professing the catholic religion (ORa=5.27), having a higher score in the knowledge questionnaire (ORa=1.04), having previously donated (ORa=1.64) and having a family member who had previously donated (ORa=1.72) increased the probability of intention to donate blood. On the other hand, older age (ORa=0.97) decreased said probability. CONCLUSIONS: Several factors associated with the intention to donate blood are identified, most of which were similar to previous studies. It is highlighted that a high level of knowledge, as well as previous donation experiences, increase the intention to donate blood.

OBJECTIVE: Las investigaciones sobre factores que modifiquen la intención de donar sangre voluntariamente en población general en Perú son escasas, y la mayoría se centran en el personal de Ciencias de la Salud. El objetivo del presente estudio fue estimar los factores asociados a la intención de donación de sangre en pacientes que acudían a consulta externa de un hospital del norte peruano. METHODS: Se diseñó un estudio de casos (n=185) y controles (n= 185) prospectivo no pareado. Se definió como caso al paciente que respondía "si donaría voluntariamente sangre en el futuro" a la pregunta filtro inicial. La variable respuesta fue la intención de donación de sangre y las de exposición fueron sexo, edad, estado civil, grado de instrucción, situación laboral, ingresos mensuales, religión, prácticas sobre la donación y conocimientos sobre la donación. Adicionalmente se exploraron las motivaciones para la donación de sangre. Para identificar los factores asociados se calcularon odds ratio crudos (ORc) mediante modelos lineales generalizados, haciendo uso de la familia Poisson, función de enlace log y modelos robustos; luego, las variables que mostraron asociación estadística significativa se ajustaron mediante análisis multivariado, ajustándolas por las variables sociodemográficas, y se obtuvieron los odds ratio ajustados (ORa). RESULTS: En el análisis multivariado aumentaron la probabilidad de intención de donación de sangre ser de sexo masculino (ORa=1,37), tener ingresos mensuales altos (ORa=1,26), profesar la religión católica (ORa=5,27), tener una mayor puntuación en el cuestionario de conocimientos (ORa=1,04), haber donado previamente (ORa=1,64) y que un familiar hubiera donado previamente (ORa=1,72). Por otro lado, la edad más avanzada (ORa=0,97) disminuyó dicha probabilidad. CONCLUSIONS: Se identifican diversos factores asociados a la intención de donación de sangre. Se resalta que el nivel de conocimientos elevado, así como experiencias previas en donación, aumentan la intención de donar sangre.

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Background: Systematic reviews (SRs) worldwide suffer from methodological deficiencies, potentially biasing intervention decisions, and Peruvian SRs are no exception. Evaluating SRs led by Peruvian researchers is a crucial step to enhance quality and transparency in decision-making and to identify topics where SRs are either scarce or prioritized for research. Objective: To describe the characteristics and assess the methodological quality of SRs with Peruvian first authors. Methods: We conducted a scoping review within the Scopus database on January 5, 2023. We aimed to identify published SRs of interventions in which the first author had a Peruvian affiliation, published between 2013 and 2022. We evaluated the methodological quality of these SRs using the AMSTAR 2 tool. We assessed the factors associated with the AMSTAR 2 score using adjusted mean differences (aMD), including their 95 % confidence intervals (95 % CI). Results: We identified 95 eligible SRs, with a clear upward trend. SRs were primarily published in Q1 (43.2 %) and Q2 (23.2 %) journals, predominantly affiliated with institutions in Lima (90.5 %). Areas like infectious diseases (20.0 %) and dentistry (18.9 %) were most frequent. AMSTAR 2 assessments highlighted deficiencies, with few SRs reporting prior protocols (37.9 %), comprehensive search strategies (23.2 %), explanations for excluded studies (20.0 %), adequate descriptions of included studies (38.3 %), or funding sources (19.1 %). Notably, SRs in Q4 journals (aMD: -19.7, 95 % CI: -33.8 to -5.5) and those on surgical interventions (aMD: -22.6, 95 % CI: -34.7 to -10.4) had lower AMSTAR 2 scores. Conclusions: Although Peruvian-led SRs are increasingly being published, critical deficiencies are common, especially in reporting protocols, search strategies, study descriptions, and funding sources. Addressing these gaps is pivotal for enhancing the credibility and utility of these SRs in informing decision-making.

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Adolescent parents and their offspring experience worse health outcomes throughout the life course. While over 90% of adolescent births occur in low- and middle-income countries, data from many such countries are lacking, particularly from fathers. This qualitative study conducted in Lima, Peru characterises the experience of adolescent fathers and identifies potential intervention targets. Interviews with young fathers and the mothers of their children were coded and analysed using thematic analysis and a grounded theory approach. Factors impacting their experience included family support, changes in their relationship with their partner, gender dynamics, and financial pressure. The study identified family and couple conflict, gendered expectations, and the father's personal development as potential intervention targets. Further research is needed to develop interventions that effectively engage adolescent fathers in low- and middle-income countries such as Peru, and support their transition to fatherhood.

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RESUMEN Introducción: el índice de masa corporal y el perímetro abdominal son medidas antropométricas que podrían ser concordantes en la población peruana para el cribado de sobrepeso u obesidad. Objetivo: analizar la correlación y concordancia entre las pruebas de índice de masa corporal y perímetro abdominal para la detección de sobrepeso u obesidad en adultos peruanos. Metodología: estudio observacional, analítico y transversal basado en datos de la encuesta nacional demográfica de salud familiar. La población fue de 28960 adultos. Las variables fueron: índice de masa corporal y perímetro abdominal. Se utilizó la prueba V de Cramer, t de student, correlación de Spearman y kappa de Cohen. Resultados: hubo una asociación fuerte entre índice de masa corporal y perímetro abdominal en mujeres (V=0,701), moderada en hombres (V=0,632). En la prueba kappa de Cohen, ambas variables concordaron sustancialmente en mujeres (kappa=0,677) y moderadamente en hombres (kappa=0,580). Mediante el Odds Ratio, las mujeres con índice de masa corporal elevado tuvieron una probabilidad 97,22 veces mayor de perímetro abdominal elevado, mientras que en hombres con índice de masa corporal elevado fue 110,76 veces mayor. La correlación de Spearman fue muy alta y positiva en ambos sexos Conclusiones: el perímetro abdominal y el índice de masa corporal están asociados y correlacionados significativamente en adultos peruanos, presentaron una concordancia sustancial en mujeres y moderada en hombres. Se sugiere priorizar el uso del perímetro abdominal, debido a que distingue sobrepeso u obesidad según sexo, optimizándolo mediante la determinación de un punto de corte ajustado a la población peruana.

ABSTRACT Introduction: body mass index and abdominal perimeter are anthropometric measurements that could be concordant in the Peruvian population for screening for overweight or obesity. Objective: to analyze the correlation and agreement between body mass index and abdominal circumference tests for the detection of overweight or obesity in Peruvian adults. Methodology: observational, analytical and cross-sectional study based on data from the national demographic family health survey. The population was 28,960 adults. The variables were: body mass index and abdominal perimeter. Cramer's V test, student's t, Spearman's correlation and Cohen's kappa were used. Results: there was a strong association between body mass index and abdominal perimeter in women (V=0.701), moderate in men (V=0.632). In Cohen's kappa test, both variables agreed substantially in women (kappa=0.677) and moderately in men (kappa=0.580). Using the Odds Ratio, women with a high body mass index had a 97.22 times greater probability of having a high abdominal circumference, while in men with a high body mass index it was 110.76 times greater. The Spearman correlation was very high and positive in both sexes. Conclusions: abdominal circumference and body mass index are significantly associated and correlated in Peruvian adults; they presented substantial agreement in women and moderate agreement in men. It is suggested to prioritize the use of the abdominal perimeter, because it distinguishes overweight or obesity according to sex, optimizing it by determining a cut-off point adjusted to the Peruvian population.

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RESUMEN Objetivos. Analizar la evolución del COVID-19 en poblaciones rurales de Loreto y Ucayali en la etapa temprana de la pandemia. Materiales y métodos. Se realizó un estudio observacional longitudinal a nivel de comunidades basado en dos rondas de encuestas telefónicas con autoridades locales de más de 400 comunidades rurales indígenas y no-indígenas en Loreto y Ucayali, en julio y agosto de 2020, para recopilar información sobre casos y muertes por COVID-19 en sus comunidades, medidas de protección adoptadas y la recepción de asistencia estatal en la etapa temprana de la pandemia. Estadísticas descriptivas permiten evaluar la evolución de la pandemia después del brote inicial y comparar las tendencias de las dos regiones, así como entre poblaciones indígenas y no-indígenas. Resultados. En julio de 2020, el COVID-19 había llegado al 91,5% de las comunidades, aunque se reportaron muertes por COVID-19 en 13,0% de las comunidades, siendo la mortalidad rural mayor en Ucayali (0,111%) que en Loreto (0,047%) y en comunidades no-indígenas. Para agosto, la prevalencia disminuyó de 44,0% a 32,0% de comunidades, pero se volvió más frecuente en las comunidades indígenas, y aquellas en Ucayali. Viajar a la ciudad para recibir bonos estatales y las dificultades para mantener el distanciamiento social contribuyeron al contagio. Conclusiones. Los hallazgos mostraron la evolución del COVID-19 en comunidades rurales y señalan áreas importantes de atención en futuras políticas públicas, para la adopción de medidas de protección y reconsiderar estrategias para la distribución de asistencia ante pandemias futuras.

ABSTRACT Objectives. To analyze the evolution of COVID-19 in rural populations of Loreto and Ucayali in the early stage of the pandemic. Materials and methods. A community-level longitudinal observational study was conducted and based on two rounds of telephone surveys with local authorities of more than 400 indigenous and non-indigenous rural communities in Loreto and Ucayali, in July and August 2020. We collected information on cases and deaths by COVID-19 in their communities, protective measures adopted and if state assistance was received in the early stage of the pandemic. Descriptive statistics allowed us to evaluate the evolution of the pandemic after the initial outbreak and compare the trends of the two regions, as well as between indigenous and non-indigenous populations. Results. In July 2020, COVID-19 had reached 91.5% of the communities, although deaths from COVID-19 were reported in 13.0% of the communities, with rural mortality being higher in Ucayali (0.111%) than in Loreto (0.047%) and in non-indigenous communities. By August, prevalence decreased from 44.0% to 32.0% of communities, but became more frequent in indigenous communities, and those in Ucayali. Traveling to the city to receive state bonuses and difficulties maintaining social distancing contributed to the spread. Conclusions. Our findings show the evolution of COVID-19 in rural communities and point to important areas of attention in future public policies, for the adoption of protective measures and reconsidering strategies for the distribution of assistance in the face of future pandemics.

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RESUMEN El propósito del estudio fue describir las características clínicas, anatomopatológicas, tratamiento y supervivencia de los pacientes con cáncer de tiroides diferenciado. Se realizó un estudio de cohorte retrospectiva con datos de 150 pacientes de un hospital peruano entre los años 2010 al 2020. Se describieron las características y supervivencia (método de Kaplan-Meier). La media de edad fue 48,3 años, 130 (86,7%) fueron mujeres y el tipo histológico más frecuente fue el papilar 94,6%. El 74,2% tenían estadio TNM I, 70,7% tiroidectomía total y 68,7% recibió yodo radiactivo. La supervivencia global a los 5 años fue 89,3%, siendo menor en aquellos con estadio TNM IV y mayor en los que usaron yodo radiactivo. En conclusión, en un hospital de Cusco, el cáncer diferenciado de tiroides fue más frecuente en mujeres y la supervivencia fue menor en comparación con reportes de otros países.

ABSTRACT This study aimed at studying the clinical and anatomopathological characteristics, treatment and survival of patients with differentiated thyroid cancer. A retrospective cohort study was conducted with data from 150 patients from a Peruvian hospital between the years 2010 to 2020. Characteristics and survival (Kaplan-Meier method) were described. The mean age was 48.3 years, 130 participants (86.7%) were women and the most frequent histologic type was papillary 94.6%. Of the participants, 74.2% had TNM stage I, 70.7% had total thyroidectomy and 68.7% received radioactive iodine. Overall survival at 5 years was 89.3%, being lower in those with TNM stage IV and higher in those who used radioactive iodine. In conclusion, in a hospital in Cusco, differentiated thyroid cancer was more frequent in women and survival was lower compared to reports from other countries.

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The objective of the present study was to analyze the psychometric properties of a life satisfaction scale in older Peruvian adults using an exploratory graph analysis (EGA) approach. A total of 407 older adults aged between 60 and 95 years (M = 69.5; SD = 6.7) from three comprehensive elderly care centers (CIAMs) in Lima, Peru, were recruited. A non-probabilistic convenience sampling was used. The Satisfaction with Life Scale (SWLS) was analyzed using EGA with the Gaussian GLASSO model to assess its dimensionality and structural consistency. The relationship with other variables was analyzed using scales such as the GAD-7 and PHQ-9. The network structure of the SWLS indicates a single dimension. Additionally, network loadings (nodes) were examined, showing high values (>0.35) for most items except item 1, which had a moderate loading (>0.25). Structural reliability showed that a single dimension was identified 100% of the time. The post hoc CFA considering the unidimensional network structure obtained through EGA showed satisfactory fit (χ2/df = 3.48, CFI = 0.96, TLI = 0.92, SRMR = 0.02, RMSEA = 0.07 [90% CI 0.05, 0.08]). Finally, internal consistency reliability was acceptable (ω = 0.92). The SWLS measure is robust and consistent. These findings are a valuable reference for advancing research on aging in Peru, as they provide a practical, valid, and reliable measure.

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OBJECTIVE: This study aims to identify factors associated with excessive screen time among preschoolers in Lima, Peru. METHODS: Cross-sectional analysis from a 2019 panel study in Lima, Peru, was conducted focusing on women, aged 18 and above, who are mothers of 3- to 5-year-olds in mid-high and mid-low districts. There were two outcome variables: excessive TV and excessive electronic devices screen time, defined as ≥ 1 h of screen exposure for each one. Explored factors included the mother's age, education and wealth index and the children's age, sex, physical activity, day care attendance and ultra-processed food consumption. Crude (cPR) and adjusted prevalence ratios (aPR) were estimated for the association between associated factors and excessive screen time using the GLM Poisson of with a logarithmic link. RESULTS: Excessive TV screen time and electronic devices prevalence was 74% and 36.9%, respectively. For TV screen time, a high wealth index (aPR 1.13; 95%CI: 1.03-1.23) and children's age (aPR 1.18; 95%CI: 1.08-1.29 for 4 years, PR = 1.17; 95%CI: 1.07-1.28 for 5 years) were significant. For electronic devices, significant associations included mothers with more than 3 children (aPR 0.77; 95%CI: 0.62-0.96), being single (aPR 1.27; 95%CI: 1.01-1.58) and a high wealth index (aPR 1.38; 95%CI: 1.13-1.68). Furthermore, significant associations were found between excessive electronic device screen time and consumption of candies and chocolates (aPR 1.38; 95%CI: 1.08-1.77). CONCLUSIONS: Seven out of 10 preschool children exceeded the recommended television screen time. Certain characteristics of the children, their mothers and the family's socio-economic situation are related to excessive television screen time and excessive electronic device screen time.

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Phragmipedium kovachii is a species of orchid endemic to the Amazonas and San Martín regions. Unfortunately, its excessive extraction has made it a critically endangered species. In this study, we performed next-generation sequencing of P. kovachii (GenBank accession number OR348669) and assembled its complete chloroplast genome. The complete chloroplast genome of P. kovachii is A + T-rich (64.3%), measuring 152,918 bp in length. This plastid genome contains a total of 124 genes (77 protein-coding genes, 39 tRNAs, and eight rRNAs) and five pseudogenes, including a pair of inverted repeats (IRs) 25,116 bp in size and separated by a large single-copy (LSC) region of 89,216 bp and a small single-copy (SSC) region of 13,470 bp. This genome has a typical quadripartite organization following the structure of other Orchidaceae plastomes. Phylogenetic analyses revealed the close relationship between P. kovachii and P. besseae. This study contributes to the understanding of the phylogenetic relationships of the monophyletic group Cypripedioideae.

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OBJECTIVE: To estimate the association between disability and the demand for medical emergency care by citizens of Peru over the age of 18 years in 2019. METHODS: Cross-sectional analysis of secondary data from the national survey of budgeted programs (ENAPRES, in its Peruvian abbreviation) of 2019. Disabilities were surveyed based on the criteria of the Washington Group on Disability Statistics. Medical emergencies were queried using 2 questions referring to life-threatening situations. Sociodemographic covariables and variables related to certain medical emergencies were also analyzed as possible confounders. Poisson regression analysis was carried out and crude and adjusted prevalence ratios calculated. Calculations were performed on a complex sample of data from the ENAPRES 2019 survey. RESULTS: Data for 62 959 persons over the age of 18 years were included. Some type of disability was reported by 4.3% of the sample, and 8.7% reported a medical emergency during the past year. Persons with 3 or more disabilities were 2.97-fold more likely to have a medical emergency than persons without disabilities (prevalence ratio, 2.97 (95% CI, 2.28-3.87) after adjustment for multiple confounding variables. CONCLUSIONS: Disabled persons were more likely to have medical emergencies than persons without disabilities in Peru in 2019. The likelihood of medical emergencies was slightly higher in those with 3 or more disabilities.

OBJETIVO: Estimar la asociación entre la condición de discapacidad y la demanda de urgencias médicas en los ciudadanos peruanos mayores de 18 años durante el año 2019. METODO: Se realizó un estudio transversal analítico de datos secundarios de la Encuesta Nacional de Programas Presupuestales (ENAPRES) 2019. La discapacidad se determinó con las preguntas del grupo de Washington y la demanda de urgencias médicas se evaluó con dos preguntas referidas a situaciones que ponen en riesgo la vida de las personas. Se incluyeron covariables sociodemográficas y relacionadas con las urgencias médicas, como posibles confusores. Se llevó a cabo una regresión de Poisson y se estimaron razones de prevalencia (RP) crudas y ajustadas. Todos los cálculos se hicieron de acuerdo con el muestreo complejo de la ENAPRES 2019. RESULTADOS: Se incluyeron los datos de 62.959 personas mayores de 18 años. El 4,3% tenía algún tipo de discapacidad y el 8,7% tuvo una urgencia médica en el último año. Las personas con tres o más tipos de discapacidad tuvieron 2,97 veces más probabilidades de tener una urgencia médica, en comparación con las personas sin discapacidad [RP = 2,97 (IC 95%: 2,28-3,87)], ajustado por múltiples variables de confusión. CONCLUSIONES: En el Perú, durante el año 2019, las personas con discapacidad tuvieron más probabilidades de tener una urgencia médica en comparación con las personas sin discapacidad. Estas probabilidades fueron ligeramente mayores cuando las personas tenían tres o más discapacidades.

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BACKGROUND: Telemedicine-based interventions show promise in addressing mental health issues among rural populations, yet evidence regarding their impact among the health care workforce in these contexts remains limited. OBJECTIVE: This study aimed to evaluate the characteristics and the responses and perceptions of recently graduated physicians who work in rural areas of Peru as part of the Servicio Rural Urbano Marginal en Salud (Rural-Urban Marginal Health Service [SERUMS], in Spanish) toward a telehealth intervention to provide remote orientation and accompaniment in mental health. METHODS: A mixed methods study was carried out involving physicians who graduated from the Universidad Nacional Mayor de San Marcos and participated in the Mental Health Accompaniment Program (MHAP) from August 2022 to February 2023. This program included the assessment of mental health conditions via online forms, the dissemination of informational materials through a website, and, for those with moderate or high levels of mental health issues, the provision of personalized follow-up by trained personnel. Quantitative analysis explored the mental health issues identified among physicians, while qualitative analysis, using semistructured interviews, examined their perceptions of the services provided. RESULTS: Of 75 physicians initially enrolled to the MHAP, 30 (41.6%) opted to undergo assessment and use the services. The average age of the participants was 26.8 (SD 1.9) years, with 17 (56.7%) being female. About 11 (36.7%) reported have current or previous mental health issues, 17 (56.7%) indicating some level of depression, 14 (46.7%) indicated some level of anxiety, 5 (16.6%) presenting a suicidal risk, and 2 (6.7%) attempted suicide during the program. Physicians who did not use the program services reported a lack of advertising and related information, reliance on personal mental health resources, or neglect of symptoms. Those who used the program expressed a positive perception regarding the services, including evaluation and follow-up, although some faced challenges accessing the website. CONCLUSIONS: The MHAP has been effective in identifying and managing mental health problems among SERUMS physicians in rural Peru, although it faced challenges related to access and participation. The importance of mental health interventions in this context is highlighted, with recommendations to improve accessibility and promote self-care among participants.

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PURPOSE: To (1) describe secular trends in gross motor coordination (GMC) scores by sex and age; (2) investigate GMC trends adjusted for concomitant secular trends in height, weight, and overall physical fitness; and (3) examine trends in children's frequencies within different GMC categories. METHOD: The sample comprises 1562 Peruvian children (690 in 2009 and 872 in 2019), aged 6-11 years, from Junín (a high-altitude region). GMC was assessed with the KörperkoordinationsTest für Kinder. Physical fitness was assessed with handgrip strength, standing long jump, and shuttle-run test. Height and weight were measured with standardized protocols. Analysis of variance, covariance, and logistic regression were used. RESULTS: A negative secular trend in GMC (based on raw scores) for boys and girls aged 6-8 years was observed. However, a positive trend was observed at 11 years of age but only in boys. Finally, there were no significant changes in the likelihood of children having below-normal GMC from 2009 to 2019. CONCLUSIONS: Secular trends in GMC were negative in Peruvian children, especially at 6-8 years of age. Further, body size and physical fitness trends did not affect the negative secular trend. A high prevalence of children had below-normal GMC in both 2009 and 2019.

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BACKGROUND: During the pandemic in Peru, the COVIDA (Collaboration Network of Volunteer Brigade Members for the Investigation, Detection, and Primary Management of Community Cases Affected by COVID-19) project proposed an innovative way to provide telemonitoring and teleorientation to COVID-19 patients, led by health care student volunteers. However, it has not been described how this interaction is perceived from the patient's perspective and which factors increase their engagement with this service. OBJECTIVE: The aim of this study is to describe the perceptions of patients about COVIDA and identify factors associated with their engagement with this service. METHODS: A mixed methods study was conducted to evaluate perceptions of patients that participated in the COVIDA project. This telehealth intervention organized by the National University of San Marcos was implemented in Peru from August to December 2020. The service involved daily phone calls by volunteer students to monitor registered COVID-19 patients until the completion of the 14th day of the illness or if a warning sign was identified. The volunteers also provided teleorientation to address the patients' needs and concerns. Quantitative analysis was performed to describe the characteristics of the patients and to assess the factors related to their engagement with the service, which was defined by the percentage of participants who completed the follow-up according to their individual schedule. Qualitative analysis through semistructured interviews evaluated the patients' perceptions of the service regarding the aspects of communication, interaction, and technology. RESULTS: Of the 770 patients enrolled in COVIDA, 422 (55.7%) were female; the median age was 39 (IQR 28-52) years. During the monitoring, 380 patients (49.4%) developed symptoms, and 471 (61.2%) showed warning signs of COVID-19. The overall median for engagement was 93% (IQR 35.7%-100%). Among those patients who did not develop warning signs, engagement was associated with the presence of symptoms (OR 3.04, 95% CI 2.22-4.17), a positive COVID-19 test at the start of follow-up (OR 1.97, 95% CI 1.48-2.61), and the presence of comorbidities (OR 1.83, 95% CI 1.29-2.59). Patients reported that the volunteers provided clear and valuable information and emotional support. Communication via phone calls took place smoothly and without interruptions. CONCLUSIONS: COVIDA represents a well-accepted and well-perceived alternative model for student volunteers to provide telemonitoring, teleorientation, and emotional support to patients with COVID-19 in the context of overwhelmed demand for health care services. The deployment of this kind of intervention should be prioritized among patients with symptoms and comorbidities, as they show more engagement with these services.

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Fort Sherman virus (FSV) was isolated in Panama in 1985 from a US soldier. We report a case of human FSV infection in a febrile patient from northern coastal Peru in 2020. FSV infections spanning ≈35 years and a distance of 2,000 km warrant diagnostics, genomic surveillance, and investigation of transmission cycles.

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BACKGROUND: Moral injury is prevalent among health care professionals, especially nurses. It can have negative personal consequences for clinicians, and indirectly impact the quality of patient care. Although nurses around the world experienced moral injury during the pandemic, it will continue to be a professional challenge. Thus, this study aimed to determine the psychometric properties of a scale measuring moral injury translated into Spanish. METHODS: A methodological study with a cross-sectional approach was conducted. After translating the Moral Injury Symptom Scale for Healthcare Professionals (MISS-HP) into Peruvian Spanish (MISS-HP-S) using International Test Commission methods, data were collected using online survey methods from a sample of 720 Peruvian nurses. Analytical methods included exploratory and confirmatory factor analysis, and invariance by age were examined. The corrected homogeneity index, ordinal alpha, and McDonald's omega allowed the evaluation of internal reliability. RESULTS: Findings from this sample of nurses who were mostly female (92%), from coastal Peru (57%), and averaged 39 (± 11) years of age, provided support for the validity and reliability of the MISS-HP-S. Structural validity was endorsed by findings indicating consistent factorial structure and adequate invariance among different age groups. In this study, three factors were observed: guilt/shame, condemnation, and spiritual strength. Internal consistency values included an ordinal alpha of 0.795 and McDonald's omega of 0.835. CONCLUSION: These findings differ from those reported from previous studies in other cultural contexts, suggesting the influence of cultural and sample-specific factors in the perception of moral injury among Peruvian nurses. Because this evidence supports the validity of the MISS-HP-S, it can be used in professional practice and in future research to identify and address situations that contribute to nurse moral injury.

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