Partner- and partnership-related risk factors for preterm birth among low-income women in Lima,Peru

A woman's partner and the characteristics of their partnership can play an important role in the health of her pregnancy. Yet, with the notable exception of intimate partner violence, there has been little previous research addressing the associations between partner- or partnership-related factors and birth outcomes. This analysis tested the hypothesis that risk factors related specifically to partner or partnership characteristics increased the risk for preterm birth. Between 2003 and 2005, a total of 580 preterm cases (20–36 weeks gestational age at delivery) and 633 term controls (≥37 weeks) were selected from women delivering at an obstetric hospital in Lima, Peru. Each woman completed a confidential, structured interview and provided biological specimens within 48 h after delivery. Multivariable logistic regression was used to assess associations between partner and partnership characteristics and preterm birth. After adjustment for behavioral, demographic, and obstetric risk factors, ever having had a partner with a history of drug use (aOR = 1.91, 95% CI 1.22–2.99), ever having had anal sex (aOR = 1.40, 95% CI 1.07–1.84), having a current partner with a history of visiting prostitutes (aOR = 1.69, 95% CI 1.22–2.33), and perceiving one's current partner as a “womanizer” (aOR = 1.34, 95% CI 1.02–1.77) were significantly associated with an elevated risk of preterm birth when tested in separate models. These four factors were then used to create a composite partnership risk score, which showed an increasing dose-response relationship with preterm birth risk (per additional partner risk factor: aOR = 1.31, 95% CI 1.16–1.49). These results highlight the importance of considering a broader set of risk factors for preterm birth, specifically those related to a woman's partner and partnership characteristics. Further research could clarify the specific mechanisms through which these partner and partnership characteristics may increase the risk of preterm birth.     

Patch test reactions in atopic patients

Patch testing was carried out in 851 atopic patients; 181 atopic dermatitis (AD) patients were additionally tested with 50% dilutions of the test substances. The occurrence of allergic and irritant reactions was frequent, being 57% and 33% for AD patients aged 28-41 years and 19-27 years, respectively. Among age-matched allergic rhinitis (AR)/allergic conjunctivitis (AC) or asthma (A) patients, the number of allergic reactions varied from 25 to 30%, and for irritant reactions was 24%. In all groups, nickel, fragrance-mix, balsam of Peru and neomycin were the commonest allergens. Contact allergy to ingredients of topical medicaments was common among AD patients and patients with severe and long-lasting dermatitis were most frequently sensitized. However, sensitivity to multiple substances was not common among those patients. The number of irritant reactions was considerable, but 50% dilution of the test substances did not solve the problem.     

Diferencias en la nota del ENAM y el promedio ponderado universitario en postulantes al servicio rural peruano, 2008-2015

Introduction

The Rural and Urban Marginal Health Service (SERUMS) is a mandatory program at the end of the medical career in Peru. The promotional grade point average (PPP) and the national medical examination (ENAM) grades are used when awarding places.

Advances in cocaine signature methodology: Alkaloid and isotope profiles of coca grown in Puno,Peru

Drug Enforcement Administration's (DEA) Cocaine Signature Program previously identified 19 coca-growing regions within South America and developed methodology to geo-source cocaine using a combination of trace cocaine alkaloids, stable isotopes, and multivariate statistics. Twenty-nine coca leaf samples collected in 2016 and 2019 from a previously unanalyzed coca-growing region located in Puno, Peru, were analyzed with this methodology. Trace cocaine alkaloids and stable isotopes were compared with other Peruvian regions. Minor differences were observed in the extracted cocaine alkaloid profiles when compared with samples collected from the Ucayali-Huallaga Valley and Cusco-Apurimac regions while the stable isotopes of δ²H (−177.1‰) and δ¹⁸O (23.8‰) were enriched. Puno's alkaloid and stable isotope results are presented in this publication to assist forensic laboratories and enhance their cocaine geo-sourcing capabilities.     

Residual Infestation and Recolonization during Urban Triatoma infestans Bug Control Campaign,Peru

Chagas disease vector control campaigns are being conducted in Latin America, but little is known about medium-term or long-term effectiveness of these efforts, especially in urban areas. After analyzing entomologic data for 56,491 households during the treatment phase of a Triatoma infestans bug control campaign in Arequipa, Peru, during 2003–2011, we estimated that 97.1% of residual infestations are attributable to untreated households. Multivariate models for the surveillance phase of the campaign obtained during 2009–2012 confirm that nonparticipation in the initial treatment phase is a major risk factor (odds ratio [OR] 21.5, 95% CI 3.35–138). Infestation during surveillance also increased over time (OR 1.55, 95% CI 1.15–2.09 per year). In addition, we observed a negative interaction between nonparticipation and time (OR 0.73, 95% CI 0.53–0.99), suggesting that recolonization by vectors progressively dilutes risk associated with nonparticipation. Although the treatment phase was effective, recolonization in untreated households threatens the long-term success of vector control.     

Preventing dengue through mobile phones: Evidence from a field experiment in Peru

Dengue is the most rapidly spreading mosquito-borne viral disease in the world (WHO, 2009). During the last two decades, the dramatic rise in the number of dengue infections has been particularly evident in Latin American and the Caribbean countries. This paper examines the experimental evidence of the effectiveness of mobile phone technology in improving households’ health preventive behavior in dengue-endemic areas. The main results suggest that repeated exposure to health information encourages households’ uptake of preventive measures against dengue. As a result, the Breteau Index in treatment households, an objective measure of dengue risk transmission, is 0.10 standard deviations below the mean of the control group, which shows a reduction in the number of containers per household that test positive for dengue larvae.The estimates also show marginally significant effects of the intervention on self-reported dengue symptoms. Moreover, we use a multiple treatment framework that randomly assigns households to one of the four treatment groups in order to analyze the impacts of framing on health behavior. Different variants emphasized information on monetary and non-monetary benefits and costs. The main results show no statistical differences among treatment groups.     

Depression among Peruvian adults with hypertension and diabetes: Analysis of a national survey

Background and aimsHypertension and diabetes are global health problems with an incidence that is rapidly increasing worldwide. Depression is the most frequent mental health co-morbidity and is considered an important risk factor for the development of both diseases. This study aimed to determine the prevalence and factors associated with depression among Peruvian adults with hypertension and diabetes.MethodsWe performed a secondary analysis of the 2017 Peru Demographic and Family Health Survey, using data from 10,566 adults aged 40 and older. The main outcome was depression assessed with the Patient Health Questionnaire-9 (PHQ-9). Other important variables were the diagnosis of hypertension or diabetes, sex, age, level of education, geographical region, wealth index, daily smoking, harmful alcohol consumption and physical disability.ResultsThe overall prevalence of depression was 23.15% (CI 95%: 21.42%–24.88%) and among adults with hypertension and diabetes it was 34.96% (CI 95%: 29.33%–40.59%) and 35.56% (CI 95%: 24.49%–46.63%), respectively. Whereas the prevalence of depression among adults with type 2 diabetes mellitus (T2DM) was higher in the physical disability group (PRa: 1.28; CI 95%: 1.12–1.45), the prevalence of depression among adults with hypertension was higher in the female group (PRa: 1.36; CI 95%: 1.20–1.54) and among those with harmful alcohol consumption (PRa: 1.50; CI 95%: 1.01–2.24).ConclusionPeru has a considerable burden of depression in the hypertensive and diabetic populations. While the variables positively associated with depression in hypertensive adults were female gender and harmful alcohol consumption, in adults with diabetes it was the presence of physical disability.     

Heterogeneous motivations for coca growing: The case of an indigenous Aymara community in Peru

Coca is a native bush from the Amazon rainforest from which cocaine is extracted. Growing coca is a profitable activity; however, not all farmers located in the coca-supply areas do so. Little is known about farmers’ motivations for the decision to grow coca and if so, how much to grow. This article evaluates the influence of monetary and non-monetary factors on these decisions. The study is based on a survey of 496 households in an indigenous Aymara community in Peru. The results suggest, for example, that farmers are more likely to cultivate coca when their plots are characterized by flatter agricultural slopes and when in debt. In relation to the scale of coca cultivation, farmers can be classified into two groups. The larger group (73 percent) grows a high number of coca bushes when facing economic hardship; farmers in the second group (27 percent) seem to be more motivated by the potential profits from coca production relative to coffee, the alternative crop in the area. Therefore, the results support the common notion that farmers cultivate coca in accordance with economic need. Nonetheless, non-economic factors also influence the number of coca bushes cultivated and offer an additional opportunity to reduce coca cultivation if explicitly considered in drug-control policies. This research also discusses potential farmers’ responses to different coca-growing reduction strategies. Common drug-control policies such as organic coffee certification, road construction, and education have mixed effects on coca cultivation, depending on the type of coca grower. As such, farmers’ motivations are heterogeneous and the design of effective drug-control policies needs to reflect this.