Starting in July 2018 the ORCR was implemented in the IPRESS-DIRIS Lima Norte using the REFCON instrument that includes five processes, three of which occur in the IPRESS of destiny. Objective: To characterize the references of IPRESS I-4 whose destiny were DIRIS Lima Norte and time to appointment of the encounters. Methods: A cross- sectional study was carried-out from May to October 2019 including seven IPRESS I-4. References by age, sex and specialty were analyzed as well as time to appointment. Statistics for means and proportions were calculated using Stata v.16. Results: A total of 19,951 references from seven IPRESS were included in the analysis. The most common age group was 30-59 years (39.22%): women accounted for 67.04%. We excluded from the final analysis 2,714 references for not having information on time to appointment. Only 23.14% of referrals were accepted in less than 24...

Populations that live in poverty with restricted social mobility and limited access to health care services, such as the Shipibo-Konibo community of Cantagallo (Rimac), are at risk to get COVID-19. After the report of three fatalities due to COVID-19 in that community a multidisciplinary team involving the ministries of health, interior affairs, culture and the major of the Rimac district, the community of that district and NGOs did not allow the movement of persons in and out the community. The proportion of members of the community with positive IgM serological tests come down and those with positive IgG levels increased, suggesting reduced transmission or presence of mild- asymptomatic cases. The vulnerability of indigenous communities as reported here is a clear evidence of the need to have sustainable and articulated plans to protect these communities from devastating diseases such ...