Purpose: Globally, transgender women (TGW) experience wide-ranging barriers to health and care, with disproportionately high risks of infectious and chronic diseases. Yet, research on transgender populations' access to care in low- and middle-income countries remains limited, focused on human immunodeficiency virus (HIV) infection, and assesses TGW as a homogenous group. We analyzed morbidity and health service uptake patterns among TGW in Lima, Perú, to understand health outreach and service needs to inform targeting and design of community-level interventions. Methods: This cross-sectional study surveyed a convenience sample of 301 TGW in metropolitan Lima during September-October 2020. We report descriptive statistics and bivariable and multivariable regression model results as adjusted prevalence ratios (aPRs). Results: Health coverage and access to care were suboptimal. Less educat...

Objective: To report the characteristics of the implementation process of the video supervised treatment (VST) of patients with pulmonary tuberculosis in a first level health care center of the Social Security in Peru. Methods: An observational study was carried-out including patients enrolled from 18/09/2018 to 24/09/2019. Eight out of nine patients completed the VST, one patient was transferred to other institution before finishing treatment. One nurse trained at Partners in Health arranged the 727 video calls. Results: adherence to treatment was 100%. Conclusions: VST may be a useful alternative for patients with drug sensitive tuberculosis.

La interacción entre derecho y religión como dos modos de regulación de la conducta humana es algo que parece inevitable, pese a las pretensiones de mutua independencia. El devenir histórico de sistemas monopolísticos (monista o dualista) de los poderes espiritual y temporal a sistemas pluralistas lleva a una laicidad estatal, y el objetivo ha de ser el respeto de los derechos fundamentales de la persona, incluso la libertad religiosa, con repercusión pública. Aunque el Estado muchas veces no ha sido capaz de articular ese equilibrio, solo en el mutuo reconocimiento es viable la interacción de hechos sociales relevantes.

Objetivo: Evaluar el impacto de la capacitación en sexualidad a docentes secundarios del Cono Norte de la ciudad de Lima. Material y métodos: Se tomó un pre test y un post test para la evaluación. Se evalúo la capacitación de 4530 docentes; 45% hombres y 65% mujeres. Resultados: La calificación media del pre test fue de 12.5 ± 3.5; el 70.2% obtuvo nota ≤11 y el 29.8% desaprobó; luego de la capacitación en el post test la calificación media fue 16.9 ± 2.9; aprobando el 95.9%. Uno de los temas de capacitación fueron conocimientos sobre SIDA; la calificación media en el pre test, fue 18.4 ± 2.1, y en el post test, 19.2 ± 1.5, no encontrando diferencias significativas. En conocimientos sobre Enfermedades de Transmisión Sexual; en el pre test, el 35.52% de los encuestados no refirió ningún método para evitarlas, el 33.6% refirió solo a un concepto, el 26.4% refir...

Introducción: El número de pacientes con enfermedad renal en etapa terminal (ERT) en terapia de reemplazo renal, principalmente hemodiálisis, ha aumentado sustancialmente en todo el mundo. Las enfermedades crónicas no transmisibles que conllevan a ERT, como diabetes e hipertensión, son comunes en adultos mayores. La supervivencia de adultos mayores en hemodiálisis es pobre debido al efecto de varios factores incluyendo la edad, la atención tardía en nefrología y un inadecuado cuidado pre-hemodiálisis. Es importante comprender el patrón de mortalidad relacionado con la ERT en adultos mayores en nuestro país. Metodología: Se analizaron los pacientes adultos mayores con ERT en tratamiento con hemodiálisis, desde enero de 2012 hasta agosto 2017 en un hospital general en Perú. Se analizaron variables individuales y relacionadas con el sistema de salud, utilizando el modelo line...

Purpose: Globally, transgender women (TGW) experience wide-ranging barriers to health and care, with disproportionately high risks of infectious and chronic diseases. Yet, research on transgender populations' access to care in low- and middle-income countries remains limited, focused on human immunodeficiency virus (HIV) infection, and assesses TGW as a homogenous group. We analyzed morbidity and health service uptake patterns among TGW in Lima, Perú, to understand health outreach and service needs to inform targeting and design of community-level interventions. Methods: This cross-sectional study surveyed a convenience sample of 301 TGW in metropolitan Lima during September-October 2020. We report descriptive statistics and bivariable and multivariable regression model results as adjusted prevalence ratios (aPRs). Results: Health coverage and access to care were suboptimal. Less educat...

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Background: Few studies have explored a stepped care model for delivering mental health care to persons with tuberculosis (TB). Here, we evaluated depression screening and remote low-intensity mental health interventions for persons initiating TB treatment in Lima, Peru during the COVID-19 pandemic. Methods: We used the Patient Health Questionnaire 9 (PHQ-9) to screen participants for depressive symptoms (PHQ-9 ≥ 5). Participants with PHQ-9, 5–14 received remote Psychological First Aid (PFA) or Problem Management Plus (PM+). Participants were reevaluated 6 months after intervention completion. We then compared the change in median PHQ-9 scores before and after intervention completion. Those with PHQ-9 ≥ 15 were referred to higher-level care. Findings: We found that 62 (45.9%) of the 135 participants had PHQ-9 ≥ 5 at baseline. Then, 54 individuals with PHQ-9, 5–9 received PFA, o...

Background: Few studies have explored a stepped care model for delivering mental health care to persons with tuberculosis (TB). Here, we evaluated depression screening and remote lowintensity mental health interventions for persons initiating TB treatment in Lima, Peru during the COVID-19 pandemic. Methods: We used the Patient Health Questionnaire 9 (PHQ-9) to screen participants for depressive symptoms (PHQ-9 ≥ 5). Participants with PHQ-9, 5–14 received remote Psychological First Aid (PFA) or Problem Management Plus (PM+). Participants were reevaluated 6 months after intervention completion. Wethen compared the change in median PHQ-9 scores before and after intervention completion. Those with PHQ-9 ≥ 15 were referred to higherlevel care. Findings: We found that 62 (45.9%) of the 135 participants had PHQ-9 ≥ 5 at baseline. Then, 54 individuals with PHQ-9, 5–9 received PFA, of w...

We report severe acute respiratory syndrome coronavirus 2 antibody positivity among market and city bus depot workers in Lima, Peru. Among 1285 vendors from 8 markets, prevalence ranged from 27% to 73%. Among 488 workers from 3 city bus depots, prevalence ranged from 11% to 47%. Self-reported symptoms were infrequent.

Widely available and reliable testing for SARS-CoV-2 is essential for the public health response to the COVID-19 pandemic. We estimated the diagnostic performance of reverse transcription PCR (RT-PCR) performed on saliva and the SD Biosensor STANDARD Q antigen test performed on nasopharyngeal swab compared to the reference standard, nasopharyngeal swab (NP) RT-PCR. We enrolled participants living and/or seeking care in health facilities in North Lima, Peru from November 2020 to January 2021. Consenting participants underwent same-day RT-PCR on both saliva and nasopharyngeal swab specimens, antigen testing on a nasopharyngeal swab specimen, pulse oximetry, and standardized symptom assessment. We calculated sensitivity, specificity, and predictive values for the nasopharyngeal antigen and saliva RT-PCR compared to nasopharyngeal RT-PCR. Of 896 participants analyzed, 567 (63.3%) had acute s...

Background: Few studies have examined the burden of postacute sequelae of coronavirus disease 2019 (COVID-19) (PASC) in low- and middle-income countries. We sought to characterize PASC with self-reported questionnaires and clinical examinations of end-organ function in Lima, Peru. Methods: From January to July 2021, we recruited participants at least 8 weeks after COVID-19 diagnosis from a case registry in Lima, Peru. We evaluated participants for PASC with questionnaires, neuropsychiatric evaluations, chest X-ray, spirometry, electrocardiogram, and echocardiogram. We used multivariable models to identify risk factors for PASC. Results: We assessed 989 participants for PASC at a median 4.7 months after diagnosis. Clinically significant respiratory symptoms were reported by 68.3% of participants, particularly those who had been severely ill during acute COVID-19, and were associated with ...