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Background: The growing threat from pre-extensively drug-resistant tuberculosis (pre-XDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) poses a major public health concern in Latin America and the Caribbean (LAC). Therefore, this study aimed to summarize the available evidence on the prevalence of pre-XDR-TB and XDR-TB among patients with multidrug-resistant tuberculosis in LAC. Methods: A systematic review was conducted in the following databases on June 3, 2023: PubMed, Scopus, Ovid Medline, Web of Science, Scielo and LILACS. We estimated pooled proportions using a random effects model (Dersimonian and Laird). The 95% confidence intervals (95% CI) were calculated using the binomial exact method (Clopper-Pearson Method). Subgroup (by time period and country) and sensitivity analyses were performed. Results: Twenty-nine studies were eligible for qualitative synthesis and 27 for...

Objective: This scoping review aimed to describe studies that evaluate the management of cryptococcal meningitis (CM) using cerebrospinal fluid (CSF) shunts, types of shunts used, and clinically relevant patient outcomes. Methods: We searched in the following databases: PubMed, Web of Science/Core collection, Embase, the Cochrane Library, and clinicaltrials.gov on 1 April 2022. We included two-arm and one-arm cohort studies that evaluated clinically relevant patient outcomes. Case reports were used to describe the type of CSF shunts used and the rationale behind its selection. The selection and extraction processes were independently performed by two authors. Results: This study included 20 cohort studies and 26 case reports. Only seven cohort studies compared two groups. Ventriculoperitoneal shunt was the most commonly used type of shunt (82.1%). The main indications for placing a shunt...

Neurobrucellosis, caused by Brucella species, is a zoonotic infection that may involve the central nervous system. Although uncommon, it can manifest as a solitary intracranial mass. We report a case of neurobrucellosis in a 25-year-old woman from Peru who presented with headache, weight loss, and right-side hemiparesis and paresthesia. A contrast-enhanced magnetic resonance imaging scan revealed an intracerebral mass in the left temporal lobe. Serum testing subsequently were positive. Brain biopsy demonstrated non-necrotizing granulomas without malignant cells. Neurobrucellosis should be considered in the differential diagnosis of brain space occupying lesions in endemic countries. Copyright

Objective: To evaluate the factors associated with the intention to participate in COVID-19 vaccine clinical trials in the Peruvian population. Methods: Cross-sectional study and secondary analysis of a database that involved Peruvian population during September 2020. The Poisson regression model was used to estimate the associated factors. Results: Data from 3231 individuals were analyzed, 44.1% of whom intended to participate in COVID-19 vaccine clinical trials. Factors associated with the outcome were being male (RPa: 1.25; 95% CI: 1.15–1.35), being from the highlands region (RPa: 1.18; 95% CI: 1.09–1.28) or jungle (RPa: 1.30; 95% CI: 1.15–1.47), having a relative that is a healthcare professional (PRa: 1.16; 95% CI: 1.06–1.28), using a medical source of information (PRa: 1.28; 95% CI: 1.17–1.41), and trusting in the possible effectiveness of vaccines (PRa: 1.40; 95% CI: 1.2...

Latin America has reported a 9% increase in new HIV infections from 2010 to 2023. Pre-exposure prophylaxis (PrEP) is a crucial biomedical intervention for preventing HIV transmission. Currently, several antiretroviral drugs, in various forms of administration, have demonstrated high efficacy and effectiveness to protect against HIV. Among the oral drugs, we have emtricitabine/te-nofovir and emtricitabine/tenofovir alafenamide, while alternative options include the dapivirine vaginal ring, injectable drugs such as Cabotegravir, and the most recently studied Lenacapavir. Despite their high efficacy and effectiveness, implementing PrEP in Latin America has been challenging throughout the region. Although some countries such as Brazil, Mexico, and Colombia have shown progress in increasing the number of users, there is a significant gap between these countries and others where PrEP access re...

The objective of this study was to evaluate the knowledge level and perception of dengue fever management among Peruvian physicians and to determine the factors associated with higher knowledge.We conducted an analytical cross-sectional study based on an online survey. To evaluate the factors associated with a high level of knowledge ($70% of correct answers), we used crude (cPR) and adjusted (aPR) prevalence ratios by the Poisson regression model. Of 359 respondents (median age: 33 years; male: 56.5%), 78.8% achieved a high level of knowledge. Multivariable analysis showed an independent association with having read the Peruvian clinical practice guidelines for dengue management (aPR: 1.29; 95% CI: 1.12–1.49), having experience in treating patients (aPR: 1.32; 95% CI: 1.03–1.68), and having treated cases frequently (aPR: 1.22; 95% CI: 1.02–1.46). Residing in the eastern macroregio...

Introduction: Due to the high incidence of mpox in Peru and the poor knowledge about this disease among healthcare workers in non-endemic countries, it is crucial to determine the knowledge status of Peruvian physicians. Methodology: We conducted an analytical cross-sectional study based on an online survey from August to September 2022. Physicians who had a medical license and lived and practiced medicine in Peru were included. To evaluate the factors associated with a higher level of knowledge, we used crude (cPR) and adjusted (aPR) prevalence ratios with 95% confidence intervals (95% CI) using Poisson regression. Results: We included 463 physicians. The mean age was 36.6 (SD: 10.3) years, and most were male (58.1%). Regarding knowledge, the median knowledge score was 14 [IQR: 13 to 15] out of 17 points. In terms of knowledge gaps, only 60.7% of the participants knew that there was an ...