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1. National health examination surveys; a source of critical data/Enquetes nationales de sante par examen: une source de donnees essentielles/Encuestas nacionales de salud: una fuente de datos fundamentals

Author

Margozzini, Paula, Tolonen, Hanna, Bernabe-Ortiz, Antonio, Cuschieri, Sarah, Donfrancesco, Chiara, Palmieri, Luigi, Sanchez-Romero, Luz Maria, Mindell, Jennifer S., and Oyebode, Oyinlola

Subjects
Physical diagnosis -- Usage -- Evaluation, Health surveys -- Methods -- Evaluation, Periodic health examinations -- Usage -- Evaluation, Medical screening -- Usage -- Evaluation, Health
Abstract

The aim of this paper is to contribute technical arguments to the debate about the importance of health examination surveys and their continued use during the post-pandemic health financing crisis, and in the context of a technological innovation boom that offers new ways of collecting and analysing individual health data (e.g. artificial intelligence). Technical considerations demonstrate that health examination surveys make an irreplaceable contribution to the local availability of primary health data that can be used in a range of further studies (e.g. normative, burden-of-disease, care cascade, cost and policy impact studies) essential for informing several phases of the health planning cycle (e.g. surveillance, prioritization, resource mobilization and policy development). Examples of the use of health examination survey data in the World Health Organization (WHO) European Region (i.e. Finland, Italy, Malta and the United Kingdom of Great Britain and Northern Ireland) and the WHO Region of the Americas (i.e. Chile, Mexico, Peru and the United States of America) are presented, and reasons why health provider-led data cannot replace health examination survey data are discussed (e.g. underestimation of morbidity and susceptibility to bias). In addition, the importance of having nationally representative random samples of the general population is highlighted and we argue that health examination surveys make a critical contribution to external quality control for a country's health system by increasing the transparency and accountability of health spending. Finally, we consider future technological advances that can improve survey fieldwork and suggest ways of ensuring health examination surveys are sustainable in low-resource settings. Cet article a pour objet d'apporter des arguments techniques au debat sur l'importance des enquetes de sante par examen et sur leur utilisation continue pendant la crise post-pandemique du financement de la sante et dans le contexte d'un essor de l'innovation technologique qui offre de nouvelles facons de collecter et d'analyser les donnees individuelles sur la sante (comme l'intelligence artificielle). Les considerations techniques demontrent que les enquetes de sante par examen apportent une contribution irremplacable a la disponibilite locale de donnees de sante primaires qui peuvent servir dans une serie detudes complementaires (telles que des etudes normatives, sur la charge de morbidite, la cascade des soins, les couts et l'impact des politiques). Ces etudes sont essentielles pour renseigner plusieurs phases du cycle de planification sanitaire (par exemple: surveillance, priorisation, mobilisation de ressources et elaboration de politiques). Cet article presente des exemples d'utilisation des donnees d'enquetes de sante par examen dans la Region OMS de l'Europe (Finlande, Italie, Malte et Royaume-Uni de Grande-Bretagne et d'Irlande du Nord) et dans la Region OMS des Ameriques (Chili, Etats-Unis d'Amerique, Mexique et Perou) et aborde les raisons pour lesquelles les donnees fournies par les prestataires de soins de sante ne peuvent pas remplacer les donnees d'enquetes de sante par examen (par exemple la sous-estimation de la morbidite et la vulnerabilite aux biais). En outre, il soulignet l'importance de disposer d'echantillons aleatoires representatifs de la population generale au niveau national, et nous soutenons que les enquetes de sante par examen apportent une contribution essentielle au controle externe de la qualite du systeme de sante d'un pays en renforcant la transparence des depenses de sante et l'obligation de rendre des comptes a leur sujet. Enfin, nous envisageons les futures avancees technologiques susceptibles d'ameliorer le travail d'enquete sur le terrain et suggerons des moyens d'assurer la viabilite des enquetes de sante par examen dans les environnements a faibles ressources. El objetivo de este articulo es aportar argumentos tecnicos al debate sobre la importancia de las encuestas de salud y su uso continuado durante la crisis de financiacion sanitaria pospandemica y en el contexto de un auge de la innovacion tecnologica que ofrece nuevas formas de recopilar y analizar datos sanitarios individuales (por ejemplo, la inteligencia artificial). Las consideraciones tecnicas demuestran que las encuestas de salud contribuyen de manera insustituible a la disponibilidad local de datos sanitarios primarios que pueden utilizarse en toda una serie de estudios posteriores (por ejemplo, estudios normativos, de carga de morbilidad, de cascada asistencial, de costes y de impacto de las politicas) esenciales para fundamentar varias fases del ciclo de planificacion sanitaria (por ejemplo, vigilancia, establecimiento de prioridades, movilizacion de recursos y elaboracion de politicas). Se presentan ejemplos del uso de los datos de las encuestas de salud en la Region Europea de la Organizacion Mundial de la Salud (Finlandia, Italia, Malta y el Reino Unido de Gran Bretana e Irlanda del Norte) y en la Region de las Americas de la OMS (Chile, Estados Unidos de America, Mexico y Peru) y se analizan las razones por las que los datos obtenidos por los proveedores sanitarios no pueden sustituir a los de las encuestas de salud (por ejemplo, la subestimacion de la morbilidad y la posibilidad de sesgo). Ademas, se destaca la importancia de contar con muestras aleatorias representativas de la poblacion general a escala nacional y se argumenta que las encuestas de salud contribuyen de forma decisiva al control de calidad externo del sistema sanitario de un pais, al aumentar la transparencia y la rendicion de cuentas del gasto sanitario. Por ultimo, se examinan los futuros avances tecnologicos que pueden mejorar el trabajo de campo de las encuestas y se sugieren metodos para garantizar que las encuestas de salud sean sostenibles en entornos con pocos recursos., Introduction National health examination surveys have been developed to gather important information that cannot be obtained from other sources. In these surveys, trained field staff take objective, biophysical measurements (e.g. [...]

Published
2024
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3. Association between type 2 diabetes and periodontitis: a population-based study in the North Peru [version 3; peer review: 2 approved]

Author

Marcela Mayta-Mayorga, Victoria Guerra-Rodríguez, and Antonio Bernabe-Ortiz

Subjects
Periodontitis, periodontal disease, type 2 diabetes mellitus, prediabetic state., eng, Medicine, Science
Abstract

Background Periodontitis, one of the most common forms of periodontal disease, has been linked to several cardiovascular factors including metabolic syndrome and inflammatory processes. This study aimed to determine the association between type 2 diabetes mellitus (T2DM) and periodontitis in a representative sample of individuals in the north of Peru. Materials and methods Secondary data analysis using information of a population-based survey, enrolling subjects aged 35 to 69 years. The outcome was periodontitis, evaluated using a self-reported and validated 8-item questionnaire (≥5 points compatible with severe periodontitis), whereas the exposure was the presence of T2DM, evaluated using results of oral glucose tolerance test and categorized into two different forms: (a) normoglycemic, prediabetes, and T2DM, and (b) without T2DM, with T2DM and

Published
2024
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4. Association between type 2 diabetes and periodontitis: a population-based study in the North Peru [version 2; peer review: 2 approved]

Author

Marcela Mayta-Mayorga, Victoria Guerra-Rodríguez, and Antonio Bernabe-Ortiz

Subjects
Periodontitis, periodontal disease, type 2 diabetes mellitus, prediabetic state., eng, Medicine, Science
Abstract

Background Periodontitis, one of the most common forms of periodontal disease, has been linked to several cardiovascular factors including metabolic syndrome and inflammatory processes. This study aimed to determine the association between type 2 diabetes mellitus (T2DM) and periodontitis in a representative sample of individuals in the north of Peru. Materials and methods Secondary data analysis using information of a population-based survey, enrolling subjects aged 35 to 69 years. The outcome was periodontitis, evaluated using a self-reported and validated 8-item questionnaire, whereas the exposure was the presence of T2DM, evaluated using results of oral glucose tolerance test and categorized into two different forms: (a) normoglycemic, prediabetes, and T2DM, and (b) without T2DM, with T2DM and

Published
2024
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5. Association between stressful life events and depression, anxiety, and quality of life among urban adolescents and young adults in Latin America

Author

Francisco Diez-Canseco, Adriana Carbonel, Antonio Bernabe-Ortiz, Natividad Olivar, Carlos Gómez-Restrepo, Mauricio Toyama, José Miguel Uribe-Restrepo, Luis Ignacio Brusco, Liliana Hidalgo-Padilla, Daniela Ramirez-Meneses, Fernando Luis Carbonetti, Karen Ariza-Salazar, Diliniya Stanislaus Sureshkumar, Catherine Fung, and Stefan Priebe

Subjects
stressful life events, depression, anxiety, quality of life, youth, Latin America, Psychology, BF1-990
Abstract

BackgroundLatin American youth have a high prevalence of mental health disorders and face major socioeconomic and public safety problems. This study assesses the association between stressful life events (SLEs) and depression, anxiety, and quality of life among adolescents and young adults from deprived neighbourhoods of Latin America.MethodsThe sample consisted of 2,402 participants, between adolescents (15–16 years) and young adults (20–24 years), from Bogotá (Colombia), Buenos Aires (Argentina), and Lima (Peru), assessed in 2021–2022 and recruited in education and community settings and social media. We evaluated the most frequent recent and distant SLEs (occurred in the previous year and more than a year ago, respectively), the relationship between SLEs and severity of depression (PHQ-8), anxiety (GAD-7), and quality of life (MANSA), and we tested for differences by gender and age group.ResultsThe most common recent and distant SLEs were related to public safety issues and financial distress. Accidents and school suspensions were more frequent among men, and sexual harassment and bullying among women. Every additional reported recent SLE increased the odds of mild, moderate, and severe depression (18, 17, and 25%, respectively) and anxiety (10, 17, and 21%, respectively) symptoms. Similar trends were found with distant SLEs and depression (8, 9, and 11% for mild, moderate, and severe symptoms, respectively) and anxiety (9, 11, and 12%, respectively). Furthermore, a higher number of recent and distant SLEs were associated with lower quality of life (β = −0.05, p

Published
2024
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6. Estimating the prevalence, factors, and conditions associated with Parkinson disease: a population-based study in Peru

Author

Antonio Bernabe-Ortiz and Rodrigo M. Carrillo-Larco

Subjects
Parkinson Disease, Depression, Anxiety, Cognitive Dysfunction, Quality of Life, Medicine, Public aspects of medicine, RA1-1270
Abstract

Abstract: This study aimed to estimate the population-based Parkinson disease prevalence, and to explore potentially associated factors and conditions. A population-based survey was conducted in Northern Peru. Symptoms compatible with Parkinson’s were defined using a validated Spanish questionnaire (≥ 42 points suggest Parkinson’s). Potential factors (e.g., age, sex, etc.) and clinical conditions (e.g., depressive symptoms, perceived stress, etc.) associated with Parkinson’s were assessed. In total, 1,609 subjects were included, mean age of participants was 48.2 (SD: 10.6), and 810 (50.3%) were women. Parkinson’s prevalence was 1.6% (95%CI: 1.0; 2.4). Those aged ≥ 55 years, and those who reported using wood as fuel for household cooking had a Parkinson’s prevalence from 3.5 to 4 times greater than those who did not. The presence of depressive symptoms, anxiety symptoms, perceived stress, poor sleep quality, and cognitive impairment was more common among those with Parkinson’s, and quality of life in these participants was lower than those without Parkinson’s. In conclusion, 1.6% of the population shows symptoms compatible with Parkinson’s. Age and use of wood for household cooking were factors associated with Parkinson’s. Several mental health conditions and lower quality of life were more frequent among those with Parkinson’s. Appropriate strategies are required to detect, prevent, and manage Parkinson’s cases.

Published
2024
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7. Eligibility for obesity management in Peru: Analysis of National Health Surveys from 2014 to 2022 [version 4; peer review: 2 approved]

Author

Antonio Bernabe-Ortiz and Rodrigo M. Carrillo-Larco

Subjects
adiposity, body mass index, anthropometrics, treatment, Peru, eng, Medicine, Science
Abstract

Background The prevalence of overweight and obesity has increased fastest in low- and middle-income countries in the last decades. Together with this rising prevalence, pharmacological and surgical interventions for obesity have emerged. How many people need these treatments is unknown. We quantified the prevalence of people in need of pharmacological and surgical treatment for obesity in Peru between 2014 and 2022. Methods Repeated cross-sectional analysis of national health surveys in Peru was conducted. Eligibility for pharmacological treatment for obesity was: body mass index (BMI) ≥30 kg/m2 or BMI ≥27 kg/m2 alongside type 2 diabetes or hypertension (self-reported). Eligibility for bariatric surgery were BMI ≥40 kg/m2 or BMI between 35 to 39.9 kg/m2 linked to weight-related health problems. We used Poisson regressions to identify associated factors with eligibility for obesity management. Results Across years, 260,131 people (mean age 44.0 and 54.5% were women) were studied, 66,629 (27.7%; 95% CI: 27.4% - 28.1%) were eligible for obesity medication, and 5,263 (2.5%; 95% CI: 2.4% - 2.6%) were eligible for bariatric surgery. Female sex, older age, higher socioeconomic level and study year were associated with higher probability of eligibility for both obesity medication and bariatric surgery. Conclusions Eligibility for obesity management has increased over time in Peru. There is a need to strengthen policies to tackle overweight and obesity in Peru, acknowledging that some individuals may benefit from pharmacological and surgical interventions.

Published
2024
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8. Intestinal microbiota dataset revealed by high-throughput sequencing of 16S rRNA in children with anemia in southern Peru

Author

Jani Pacheco-Aranibar, Karla Diaz-Rodriguez, Rosemary Zapana-Begazo, Steven Criollo-Arteaga, Jose A. Villanueva-Salas, and Julio C. Bernabe-Ortiz

Subjects
16S rRNA, Intestinal microbiota, Children with anemia, Metagenomics, Next-generation sequencing, Computer applications to medicine. Medical informatics, R858-859.7, Science (General), Q1-390
Abstract

Anemia is the most common hematological disorder affecting humans. In Peru, anemia is a pressing issue that present the most significant concern due to its adverse effects, such as delayed growth and psychomotor development, in addition to a deficiency in cognitive development. Anemia is a significant public health issue in Peru, which has one of the highest prevalence rates in infants in the Latin American and Caribbean (LAC) region, affecting approximately 43.6 % of children under three years nationally as of 2017, with rural areas experiencing a higher prevalence of approximately 53.3 %. In 2019, the prevalence was highest in the Sierra (48.8 %) and Selva regions (44.6 %), whereas the coast had a lower rate of 33.9 % in children under 36 months.Although the composition of the gut microbiota is relatively well described in children, there is little information on the identification of the microbiota in iron-deficiency anemia. There is evidence that diseases or health conditions can change the microbiota, or vice versa. This study aimed to identify the microbiota in children with anemia who did not recover after iron treatment. In a previous study, we found that the phylum Actinobacteria was predominant in the microbiota of children with anemia. These data will be useful for understanding the functionality of the most important bacteria found in each group at the genus or species level, especially the metabolic pathways in which they participate and their links with iron metabolism.Microbial composition data were obtained through next-generation 16S rRNA sequencing (NGS) of stool samples from children with anemia in southern Peru. Numerous studies have underscored the importance of early symbiotic development in infant health and its long-term impact on health. From infancy, modulation of the gut microbiota can promote long-term health. According to the National Institute of Health (NIH), iron-deficiency anemia may cause serious complications, such as fatigue, headaches, restless legs syndrome, heart problems, pregnancy complications, and developmental delays in children. The development of the gut microbiota is regulated by a complex interplay between host and environmental factors. The bidirectional link between the gut microbiota and anemia plays an important role in tracking the gut microbiota and will be useful in understanding the composition of the intestinal microbiota and its implications in anemia, which has now become a public health problem. Our previous study investigated the microbial composition in children with iron-deficiency anemia and revealed the presence of several bacterial groups, including Proteobacteria, Actinobacteria, Firmicutes, and Chloroflexi.In addition, these data may be useful for investigating the association between the intestinal microbiota of children with persistent anemia and those who have recovered.

Published
2024
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9. Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants

Author

Zhou, Bin, Rayner, Archie W, Gregg, Edward W, Sheffer, Kate E, Carrillo-Larco, Rodrigo M, Bennett, James E, Shaw, Jonathan E, Paciorek, Christopher J, Singleton, Rosie K, Barradas Pires, Ana, Stevens, Gretchen A, Danaei, Goodarz, Lhoste, Victor PF, Phelps, Nowell H, Heap, Rachel A, Jain, Lakshya, D'Ailhaud De Brisis, Yse, Galeazzi, Agnese, Kengne, Andre P, Mishra, Anu, Ikeda, Nayu, Lin, Hsien-Ho, Aguilar-Salinas, Carlos A, Anjana, Ranjit Mohan, Ben Romdhane, Habiba, Davletov, Kairat, Ganapathy, Shubash, Heidemann, Christin, Khader, Yousef Saleh, Khang, Young-Ho, Laxmaiah, Avula, Mbanya, Jean Claude N, Mohan, Viswanathan, Narayan, KM Venkat, Pavkov, Meda E, Sobngwi, Eugène, Wade, Alisha N, Younger-Coleman, Novie O, Zdrojewski, Tomasz, Abarca-Gómez, Leandra, Abbasi-Kangevari, Mohsen, Abdul Rahim, Hanan F, Abu-Rmeileh, Niveen M, Adambekov, Shalkar, Adams, Robert J, Aekplakorn, Wichai, Afzal, Shoaib, Agdeppa, Imelda A, Aghazadeh-Attari, Javad, Agyemang, Charles, Ahmad, Noor Ani, Ahmadi, Ali, Ahmadi, Naser, Ahmadi, Nastaran, Ahmed, Soheir H, Ahrens, Wolfgang, Ajlouni, Kamel, Al-Hamli, Sarah F, Al-Hinai, Halima, Al-Lawati, Jawad A, Al Asfoor, Deena, Alarouj, Monira, AlBuhairan, Fadia, AlDhukair, Shahla, Ali, Mohamed M, Ali, Mohammed K, Alieva, Anna V, Alinezhad, Farbod, Alkandari, Abdullah, Alkerwi, Ala'a, Aly, Eman, Amarapurkar, Deepak N, Andersen, Lars Bo, Anderssen, Sigmund A, Andrade, Dolores S, Ansari-Moghaddam, Alireza, Aounallah-Skhiri, Hajer, Araújo, Joana, Aris, Tahir, Arku, Raphael E, Arlappa, Nimmathota, Aryal, Krishna K, Aspelund, Thor, Assah, Felix K, Assembekov, Batyrbek, Au Yeung, Shiu Lun, Auvinen, Juha, Avdičová, Mária, Azad, Kishwar, Azevedo, Ana, Azimi-Nezhad, Mohsen, Azizi, Fereidoun, Bacopoulou, Flora, Balakrishna, Nagalla, Balanova, Yulia, Bamoshmoosh, Mohamed, Banach, Maciej, Bandosz, Piotr, Banegas, José R, Barbagallo, Carlo M, Barcelo, Alberto, Baretić, Maja, Barrera, Lena, Barreto, Marta, Basit, Abdul, Batieha, Anwar M, Batista, Aline P, Baur, Louise A, Belavendra, Antonisamy, Benedek, Theodora, Benet, Mikhail, Benzeval, Michaela, Berkinbayev, Salim, Bernabe-Ortiz, Antonio, Berrios Carrasola, Ximena, Bettiol, Heloísa, Beybey, Augustin F, Bhargava, Santosh K, Bi, Yufang, Bika Lele, Elysée Claude, Bikbov, Mukharram M, Bista, Bihungum, Bjerregaard, Peter, Bjertness, Espen, Bjertness, Marius B, Björkelund, Cecilia, Bloch, Katia V, Blokstra, Anneke, Bobak, Martin, Boehm, Bernhard O, Boggia, Jose G, Boissonnet, Carlos P, Bojesen, Stig E, Bonaccio, Marialaura, Bonilla-Vargas, Alice, Borghs, Herman, Botomba, Steve, Bovet, Pascal, Brajkovich, Imperia, Brenner, Hermann, Brewster, Lizzy M, Brian, Garry R, Briceño, Yajaira, Brito, Miguel, Bueno, Gloria, Bugge, Anna, Buntinx, Frank, Cabrera de León, Antonio, Caixeta, Roberta B, Can, Günay, Cândido, Ana Paula C, Capanzana, Mario V, Čapková, Naděžda, Capuano, Eduardo, Capuano, Rocco, Capuano, Vincenzo, Cardoso, Viviane C, Carlsson, Axel C, Casanueva, Felipe F, Censi, Laura, Cervantes–Loaiza, Marvin, Chadjigeorgiou, Charalambos A, Chamnan, Parinya, Chamukuttan, Snehalatha, Chan, Queenie, Charchar, Fadi J, Chaturvedi, Nish, Chen, Chien-Jen, Chen, Huashuai, Chen, Long-Sheng, Cheng, Ching-Yu, Cheraghian, Bahman, Chetrit, Angela, Chiou, Shu-Ti, Chirlaque, María-Dolores, Chudek, Jerzy, Cifkova, Renata, Cirillo, Massimo, Claessens, Frank, Clarke, Janine, Cohen, Emmanuel, Concin, Hans, Cooper, Cyrus, Cosmin, Cojocaru R, Costanzo, Simona, Cowan, Melanie J, Cowell, Chris, Crampin, Amelia C, Crujeiras, Ana B, Cruz, Juan J, Cureau, Felipe V, Cuschieri, Sarah, D'Arrigo, Graziella, d'Orsi, Eleonora, da Silva-Ferreira, Haroldo, Dallongeville, Jean, Damasceno, Albertino, Dankner, Rachel, Dastgiri, Saeed, Dauchet, Luc, De Curtis, Amalia, de Gaetano, Giovanni, De Henauw, Stefaan, De Ridder, David, Deepa, Mohan, DeGennaro, Vincent Jr, Demarest, Stefaan, Dennison, Elaine, Deschamps, Valérie, Dhimal, Meghnath, Dika, Zivka, Djalalinia, Shirin, Donfrancesco, Chiara, Dorobantu, Maria, Dragano, Nico, Drygas, Wojciech, Du, Shufa, Du, Yong, Duante, Charmaine A, Duboz, Priscilla, Duda, Rosemary B, Dushpanova, Anar, Dzerve, Vilnis, Dziankowska-Zaborszczyk, Elzbieta, Ebrahimi, Narges, Eddie, Ricky, Eftekhar, Ebrahim, Efthymiou, Vasiliki, Egbagbe, Eruke E, Eggertsen, Robert, Eghtesad, Sareh, Ejembi, Clara Ladi, El-Khateeb, Mohammad, El Ati, Jalila, Eldemire-Shearer, Denise, Elosua, Roberto, Enang, Ofem, Erasmus, Rajiv T, Erem, Cihangir, Ergor, Gul, Eriksen, Louise, Eriksson, Johan G, Esmaeili, Ali, Evans, Roger G, Fagherazzi, Guy, Fahimfar, Noushin, Fakhradiyev, Ildar, Fakhretdinova, Albina A, Fall, Caroline H, Faramarzi, Elnaz, Farjam, Mojtaba, Farzadfar, Farshad, Farzi, Yosef, Fattahi, Mohammad Reza, Fawwad, Asher, Felix-Redondo, Francisco J, Ferguson, Trevor S, Fernández-Bergés, Daniel, Fernando, Desha R, Ferrao, Thomas, Ferrari, Marika, Ferrario, Marco M, Ferreccio, Catterina, Ferrer, Eldridge, Feskens, Edith JM, Fink, Günther, Flood, David, Forsner, Maria, Fosse-Edorh, Sandrine, Fottrell, Edward F, Fouad, Heba M, Francis, Damian K, Frontera, Guillermo, Fujiati, Isti I, Fumihiko, Matsuda, Furusawa, Takuro, Gaciong, Zbigniew, Galvano, Fabio, Garnett, Sarah P, Gaspoz, Jean-Michel, Gasull, Magda, Gazzinelli, Andrea, Gehring, Ulrike, Ghaderi, Ebrahim, Ghamari, Seyyed-Hadi, Ghanbari, Ali, Ghasemi, Erfan, Gheorghe-Fronea, Oana-Florentina, Ghimire, Anup, Gialluisi, Alessandro, Giampaoli, Simona, Gianfagna, Francesco, Gill, Tiffany K, Giovannelli, Jonathan, Gironella, Glen, Giwercman, Aleksander, Goldberg, Marcel, Goltzman, David, Gomula, Aleksandra, Gonçalves, Helen, Gonçalves, Mauer, Gonzalez-Chica, David A, Gonzalez-Gross, Marcela, González-Rivas, Juan P, Gonzalez, Angel R, Goto, Atsushi, Gottrand, Frederic, Grafnetter, Dušan, Grammatikopoulou, Maria G, Grant, Andriene, Grimsgaard, Anne Sameline, Grodzicki, Tomasz, Grøntved, Anders, Grosso, Giuseppe, Gu, Dongfeng, Gudnason, Vilmundur, Guerrero, Ramiro, Guessous, Idris, Gujral, Unjali P, Gupta, Rajeev, Gutierrez, Laura, Gwee, Xinyi, Ha, Seongjun, Haghshenas, Rosa, Hakimi, Hamid, Hambleton, Ian R, Hamzeh, Behrooz, Hange, Dominique, Hantunen, Sari, Hao, Jie, Harooni, Javad, Hashemi-Shahri, Seyed Mohammad, Hata, Jun, Hayes, Alison J, He, Jiang, Henrique, Rafael dos Santos, Henriques, Ana, Herrala, Sauli, Herzig, Karl-Heinz, Heshmat, Ramin, Hill, Allan G, Ho, Sai Yin, Holdsworth, Michelle, Homayounfar, Reza, Hopman, Wilma M, Horimoto, Andrea RVR, Hormiga, Claudia, Horta, Bernardo L, Houti, Leila, Howitt, Christina, Htay, Thein Thein, Htet, Aung Soe, Htike, Maung Maung Than, Huerta, José María, Huhtaniemi, Ilpo Tapani, Huiart, Laetitia, Huisman, Martijn, Hunsberger, Monica, Husseini, Abdullatif, Huybrechts, Inge, Iacoviello, Licia, Iakupova, Ellina M, Iannone, Anna G, Ibrahim Wong, Norazizah, Ijoma, Chinwuba, Irazola, Vilma E, Ishida, Takafumi, Islam, Sheikh Mohammed Shariful, Islek, Duygu, Ittermann, Till, Iwasaki, Masanori, Jääskeläinen, Tuija, Jacobs, Jeremy M, Jaddou, Hashem Y, Jadoul, Michel, Jallow, Bakary, James, Kenneth, Jamil, Kazi M, Janus, Edward, Jarvelin, Marjo-Riitta, Jasienska, Grazyna, Jelaković, Ana, Jelaković, Bojan, Jennings, Garry, Jha, Anjani Kumar, Jibo, AM, Jimenez, Ramon O, Jöckel, Karl-Heinz, Jokelainen, Jari J, Jonas, Jost B, Josipović, Josipa, Joukar, Farahnaz, Jóźwiak, Jacek, Kafatos, Anthony, Kajantie, Eero O, Kalmatayeva, Zhanna, Kalter-Leibovici, Ofra, Karakosta, Argyro, Karki, Khem B, Katibeh, Marzieh, Katulanda, Prasad, Kauhanen, Jussi, Kazakbaeva, Gyulli M, Kaze, François F, Ke, Calvin, Keinänen-Kiukaanniemi, Sirkka, Kelishadi, Roya, Keramati, Maryam, Kersting, Mathilde, Khalagi, Kazem, Khaledifar, Arsalan, Khalili, Davood, Kheiri, Bahareh, Kheradmand, Motahareh, Khosravi Farsani, Alireza, Kiechl-Kohlendorfer, Ursula, Kiechl, Sophia J, Kiechl, Stefan, Kim, Hyeon Chang, Kingston, Andrew, Klakk, Heidi, Klanova, Jana, Knoflach, Michael, Kolsteren, Patrick, König, Jürgen, Korpelainen, Raija, Korrovits, Paul, Kos, Jelena, Koskinen, Seppo, Kowlessur, Sudhir, Koziel, Slawomir, Kratzer, Wolfgang, Kriemler, Susi, Kristensen, Peter Lund, Krokstad, Steinar, Kromhout, Daan, Kubinova, Ruzena, Kujala, Urho M, Kulimbet, Mukhtar, Kulothungan, Vaitheeswaran, Kumari, Meena, Kutsenko, Vladimir, Kyobutungi, Catherine, La, Quang Ngoc, Laatikainen, Tiina, Labadarios, Demetre, Lachat, Carl, Laid, Youcef, Lall, Lachmie, Langsted, Anne, Lankila, Tiina, Lanska, Vera, Lappas, Georg, Larijani, Bagher, Latt, Tint Swe, Laurenzi, Martino, Le Coroller, Gwenaëlle, Lee, Jeannette, Lehtimäki, Terho, Lemogoum, Daniel, Leung, Gabriel M, Lim, Charlie, Lim, Wei-Yen, Lima-Costa, M Fernanda, Lin, Yi-Jing, Lind, Lars, Lissner, Lauren, Liu, Liping, Liu, Xiaotian, Lo, Wei-Cheng, Loit, Helle-Mai, Lopez-Garcia, Esther, Lopez, Tania, Lozano, José Eugenio, Luksiene, Dalia, Lundqvist, Annamari, Lunet, Nuno, Lung, Thomas, Lustigová, Michala, Ma, Guansheng, Machado-Coelho, George LL, Machado-Rodrigues, Aristides M, Macia, Enguerran, Macieira, Luisa M, Madar, 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Schmidt, Carsten O, Schnohr, Peter, Schooling, Catherine Mary, Schöttker, Ben, Schramm, Sara, Sebert, Sylvain, Sedaghattalab, Moslem, Sein, Aye Aye, Sen, Abhijit, Sepanlou, Sadaf G, Servais, Jennifer, Sewpaul, Ronel, Shalnova, Svetlana, Shamshirgaran, Seyed Morteza, Shanthirani, Coimbatore Subramaniam, Sharafkhah, Maryam, Sharma, Sanjib K, Sharman, Almaz, Shayanrad, Amaneh, Shayesteh, Ali Akbar, Shibuya, Kenji, Shimizu-Furusawa, Hana, Shiri, Rahman, Shoranov, Marat, Shrestha, Namuna, Si-Ramlee, Khairil, Siani, Alfonso, Siedner, Mark J, Silva, Diego Augusto Santos, Sim, Xueling, Simon, Mary, Simons, Judith, Simons, Leon A, Sjöström, Michael, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemysław, Smeeth, Liam, Söderberg, Stefan, Soemantri, Agustinus, Solfrizzi, Vincenzo, Somi, Mohammad Hossein, Soumaré, Aïcha, Sousa-Poza, Alfonso, Sousa-Uva, Mafalda, Sparrenberger, Karen, Staessen, Jan A, Stang, Andreas, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D, 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Uusitalo, Hannu MT, Valdivia, Gonzalo, Valvi, Damaskini, van Dam, Rob M, van den Born, Bert-Jan, Van der Heyden, Johan, Van Minh, Hoang, van Rossem, Lenie, Van Schoor, Natasja M, van Valkengoed, Irene GM, Vanderschueren, Dirk, Vanuzzo, Diego, Varbo, Anette, Vasan, Senthil K, Vega, Tomas, Veidebaum, Toomas, Velasquez-Melendez, Gustavo, Verdot, Charlotte, Veronesi, Giovanni, Verstraeten, Roosmarijn, Victora, Cesar G, Viet, Lucie, Villarroel, Luis, Vioque, Jesus, Virtanen, Jyrki K, Viswanathan, Bharathi, Vollenweider, Peter, Voutilainen, Ari, Vrijheid, Martine, Walton, Janette, Wan Bebakar, Wan Mohamad, Wan Mohamud, Wan Nazaimoon, Wang, Chongjian, Wang, Huijun, Wang, Ningli, Wang, Qian, Wang, Weiqing, Wang, Ya Xing, Wang, Yi-Ren, Wang, Ying-Wei, Wannamethee, S Goya, Webster-Kerr, Karen, Wedderkopp, Niels, Wei, Wenbin, Westbury, Leo D, Whincup, Peter H, Widhalm, Kurt, Widyahening, Indah S, Więcek, Andrzej, Wijemunige, Nilmini, Wilks, Rainford J, Willeit, Karin, Willeit, Peter, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Emily B, Woodward, Mark, Wu, Chao-Chun, Wu, Frederick C, Xu, Haiquan, Xu, Liang, Xu, Yu, Yaacob, Nor Azwany, Yan, Li, Yan, Weili, Yasuharu, Tabara, Yeh, Chao-Yu, Yoosefi, Moein, Yoshihara, Akihiro, You, San-Lin, Yu, Yu-Ling, Yusoff, Ahmad Faudzi, Zainuddin, Ahmad A, Zamani, Farhad, Zambon, Sabina, Zampelas, Antonis, Zargar, Abdul Hamid, Zaw, Ko Ko, Zeljkovic Vrkic, Tajana, Zeng, Yi, Zhang, Bing, Zhang, Lei, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Ming-Hui, Zhao, Wenhua, Zholdin, Bekbolat, Zimmet, Paul, Zins, Marie, Zitt, Emanuel, Zoghlami, Nada, Zuñiga Cisneros, Julio, and Ezzati, Majid

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2024
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10. Co-creation process of an intervention to implement a multiparameter point-of-care testing device in a primary healthcare setting for non-communicable diseases in Peru

Author

Leonardo Albitres-Flores, Silvana Perez-Leon, Antonio Bernabe-Ortiz, Janeth Tenorio-Mucha, Maria Kathia Cardenas, Beatrice Vetter, Elvis Safary, Ricardo Gamboa, Vicente Cordova, Reena Gupta, Andrew Moran, David Beran, and María Lazo-Porras

Subjects
Point-of-care testing, Community-based Participatory Research, Primary Health Care, Noncommunicable diseases, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Point-of-care testing (POCT) devices are diagnostic tools that can provide quick and accurate results within minutes, making them suitable for diagnosing non-communicable diseases (NCDs). However, these devices are not widely implemented in healthcare systems and for this reason is relevant to understand the implementation process. Aim To describe the process and define a strategy to implement a multiparameter POCT device for diagnosing and managing NCDs in one region of Peru. Methods A descriptive and non-experimental study, using the participatory methodologies of co-creation process. It was conducted in one region of Peru (Tumbes) to design an intervention for implementing a multiparameter POCT device. Two co-creation sessions were conducted involving five groups: community members, primary healthcare workers, these groups in both rural and urban settings, and regional decision-makers. These sessions included activities to understand patient journeys in receiving care for NCDs, identify facilitators and barriers to POCT devices usage, and define an implementation strategy for POCT devices in both rural and urban settings of Tumbes. The research team analysed the data and summarized key topics for discussion after each session. Results A total of 78 participants were enrolled across the five groups. Among community members: 22.2% had only diabetes, 24.1% had only hypertension, and 18.5% had both diagnoses. In the patient journey, community members mentioned that it took at least three days to receive a diagnosis and treatment for an NCD. Most of the participants agreed that the POCT devices would be beneficial for their communities, but they also identified some concerns. The strategy for POCT devices implementation included healthcare workers training, POCT devices must be placed in the laboratory area and must be able to perform tests for glucose, glycated haemoglobin, cholesterol, and creatinine. Advertising about POCT devices should be displayed at the healthcare centres and the municipality using billboards and flyers. Conclusions The co-creation process was useful to develop strategies for the implementation of multiparameter POCT devices for NCDs, involving the participation of different groups of stakeholders guided by moderators in both, rural and urban, settings in Peru.

Published
2024
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11. General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants

Author

Zhou, Bin, Bennett, James E, Wickham, Aidan P, Singleton, Rosie K, Mishra, Anu, Carrillo-Larco, Rodrigo M, Ikeda, Nayu, Jain, Lakshya, Barradas-Pires, Ana, Heap, Rachel A, Lhoste, Victor PF, Sheffer, Kate E, Phelps, Nowell H, Rayner, Archie W, Gregg, Edward W, Woodward, Mark, Stevens, Gretchen A, Iurilli, Maria LC, Danaei, Goodarz, Di Cesare, Mariachiara, Aguilar-Salinas, Carlos A, Ahmad, Noor Ani, Bovet, Pascal, Chen, Zhengming, Damasceno, Albertino, Filippi, Sarah L, Janszky, Imre, Kengne, Andre P, Khang, Young-Ho, Khunti, Kamlesh, Laxmaiah, Avula, Lim, Lee-Ling, Lissner, Lauren, Margozzini, Paula, Mbanya, Jean Claude N, McGarvey, Stephen T, Shaw, Jonathan E, Söderberg, Stefan, Soto-Mota, Luis Adrián, Wang, Junyang, Zaccardi, Francesco, Abarca-Gómez, Leandra, Abbasi-Kangevari, Mohsen, Abdrakhmanova, Shynar, Abdul Ghaffar, Suhaila, Abdul Rahim, Hanan F, Abdurrahmonova, Zulfiya, Abu-Rmeileh, Niveen M, Acosta-Cazares, Benjamin, Adam, Ishag, Adamczyk, Marzena, Aekplakorn, Wichai, Agdeppa, Imelda A, Aghazadeh-Attari, Javad, Agyemang, Charles, Ahmad, Mohamad Hasnan, Ahmadi, Ali, Ahmadi, Naser, Ahmadi, Nastaran, Ahmed, Soheir H, Ahrens, Wolfgang, Aitmurzaeva, Gulmira, Ajlouni, Kamel, Al-Hazzaa, Hazzaa M, Al-Hinai, Halima, Al-Lawati, Jawad A, Al-Raddadi, Rajaa, Al Asfoor, Deena, Al Hourani, Huda M, Alarouj, Monira, AlBuhairan, Fadia, AlDhukair, Shahla, Ali, Mohamed M, Alieva, Anna V, Alkandari, Abdullah, Alkhatib, Buthaina M, Aly, Eman, Amarapurkar, Deepak N, Amiano Etxezarreta, Pilar, Amougou, Norbert, Andersen, Lars Bo, Anderssen, Sigmund A, Androutsos, Odysseas, Anjana, Ranjit Mohan, Ansari-Moghaddam, Alireza, Anufrieva, Elena, Aounallah-Skhiri, Hajer, Aris, Tahir, Arku, Raphael E, Arlappa, Nimmathota, Aryal, Krishna K, Assah, Felix K, Assembekov, Batyrbek, Assunção, Maria Cecília F, Auvinen, Juha, Avdičová, Mária, Azad, Kishwar, Azevedo, Ana, Azimi-Nezhad, Mohsen, Azizi, Fereidoun, Bacopoulou, Flora, Bahijri, Suhad, Bajramovic, Izet, Balakrishna, Nagalla, Bamoshmoosh, Mohamed, Banach, Maciej, Bandosz, Piotr, Banegas, José R, Baran, Rafał, Barbagallo, Carlo M, Barbosa Filho, Valter, Barceló, Alberto, Baretić, Maja, Barnoya, Joaquin, Barrera, Lena, Barros, Aluisio JD, Barros, Mauro Virgílio Gomes, Basit, Abdul, Bastos, Joao Luiz, Batieha, Anwar M, Batista, Aline P, Batista, Rosangela L, Battakova, Zhamilya, Baur, Louise A, Bayauli, Pascal M, Bel-Serrat, Silvia, Belavendra, Antonisamy, Ben Romdhane, Habiba, Benedek, Theodora, Benedics, Judith, Benet, Mikhail, Benitez Rolandi, Gilda Estela, Benzeval, Michaela, Bere, Elling, Berger, Nicolas, Bergh, Ingunn Holden, Berkinbayev, Salim, Bernabe-Ortiz, Antonio, Bettiol, Heloísa, Beybey, Augustin F, Bezerra, Jorge, Bhagyalaxmi, Aroor, Bhargava, Santosh K, Bika Lele, Elysée Claude, Bikbov, Mukharram M, Bista, Bihungum, Bjelica, Dusko J, Bjerregaard, Peter, Bjertness, Espen, Bjertness, Marius B, Björkelund, Cecilia, Bloch, Katia V, Blokstra, Anneke, Bo, Simona, Bobak, Martin, Boddy, Lynne M, Boehm, 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Marjolein, Viswanathan, Bharathi, Vladulescu, Mihaela, Völzke, Henry, Voutilainen, Ari, Vrijheid, Martine, Wade, Alisha N, Wan Bebakar, Wan Mohamad, Wan Mohamud, Wan Nazaimoon, Wanderley Júnior, Rildo de Souza, Wang, Chongjian, Wang, Huijun, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nicholas, Wartha, Olivia, Weber, Adelheid, Webster-Kerr, Karen, Wedderkopp, Niels, Weghuber, Daniel, Wei, Wenbin, Westbury, Leo, Whincup, Peter H, Wickramasinghe, Kremlin, Widhalm, Kurt, Widyahening, Indah S, Więcek, Andrzej, Wilks, Rainford J, Willeit, Karin, Willeit, Peter, Williams, Julianne, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Emily B, Wu, Frederick C, Wyszyńska, Justyna, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yan, Li, Yan, Weili, Yang, Yang, Yépez García, Martha, Yoosefi, Moein, Yoshihara, Akihiro, Younger-Coleman, Novie O, Yu, Yu-Ling, Yu, Yunjiang, Yusoff, Ahmad Faudzi, Zafiropulos, Vassilis, Zainuddin, Ahmad A, Zamani, Farhad, Zambon, Sabina, Zampelas, Antonis, Zapata, Maria Elisa, Zaw, Ko Ko, Zdrojewski, Tomasz, Żegleń, Magdalena, Zejglicova, Kristyna, Zeljkovic Vrkic, Tajana, Zhang, Bing, Zhang, Zhen-Yu, Zhecheva, Yanitsa V, Zholdin, Bekbolat, Zimmet, Paul, Zins, Marie, Zuñiga Cisneros, Julio, Zuziak, Monika, and Ezzati, Majid

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2024
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12. Differences in SARS-COV-2 seroprevalence in the population of Cusco, Peru

Author

Charles Huamaní, Fátima Concha-Velasco, Lucio Velásquez, María K. Antich, Johar Cassa, Kevin Palacios, Luz Bernable-Villasante, Guido Giraldo-Alencastre, Eduarda Benites-Calderon, Sebastian Mendieta-Nuñez, Heber Quispe-Jihuallanca, Matilde Quispe-Yana, Karla Zavala-Vargas, Liesbeth Hinojosa-Florez, Javier Ramírez-Escobar, Juan Spelucin-Runciman, and Antonio Bernabe-Ortiz

Subjects
Seroprevalence, SARS-CoV-2, COVID-19, Infectious and parasitic diseases, RC109-216
Abstract

Background: The spread of the coronavirus disease 2019 (COVID-19) in Peru has been reported at the regional level, few studies have evaluated its spread at the provincial level, in which the mechanisms could be different. Methods: We conducted an analytical, cross-sectional, multistage observational population study to assess the seroprevalence of SARS-COV-2 at the provincial and urban/rural levels in a high-altitude setting. The sampling unit was the household, including a randomly selected family member. Sampling was performed using a data collection sheet on clinical and epidemiological variables. Chemiluminescence tests were used to detect total anti-SARS-COV-2 antibodies (IgG and IgM simultaneously). The percentages were adjusted to the sampling design. Results: The overall prevalence in the region of Cusco was 25.9%, with considerably different prevalence between the 13 provinces (from 15.9% in Acomayo to 40.1% in Canchis) and between rural (21.1%) and urban (31.7%) areas. In multivariable model, living in a rural area was a protective factor (adjusted prevalence ratio [aPR], 0.68; 95% confidence interval [CI], 0.61–0.76). Conclusions: Geographic diversity and population density determine different prevalence rates, typically lower in rural areas, possibly due to natural social distancing or limited interaction with people at risk.

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2024
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13. Differences in SARS-COV-2 seroprevalence in the population of Cusco, Peru

Author

Huamaní, Charles, Concha-Velasco, Fátima, Velásquez, Lucio, Antich, María K., Cassa, Johar, Palacios, Kevin, Bernable-Villasante, Luz, Giraldo-Alencastre, Guido, Benites-Calderon, Eduarda, Mendieta-Nuñez, Sebastian, Quispe-Jihuallanca, Heber, Quispe-Yana, Matilde, Zavala-Vargas, Karla, Hinojosa-Florez, Liesbeth, Ramírez-Escobar, Javier, Spelucin-Runciman, Juan, and Bernabe-Ortiz, Antonio

Published
2024
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16. Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Author

Phelps, Nowell H, Singleton, Rosie K, Zhou, Bin, Heap, Rachel A, Mishra, Anu, Bennett, James E, Paciorek, Christopher J, Lhoste, Victor PF, Carrillo-Larco, Rodrigo M, Stevens, Gretchen A, Rodriguez-Martinez, Andrea, Bixby, Honor, Bentham, James, Di Cesare, Mariachiara, Danaei, Goodarz, Rayner, Archie W, Barradas-Pires, Ana, Cowan, Melanie J, Savin, Stefan, Riley, Leanne M, Aguilar-Salinas, Carlos A, Baker, Jennifer L, Barkat, Amina, Bhutta, Zulfiqar A, Branca, Francesco, Caixeta, Roberta B, Cuschieri, Sarah, Farzadfar, Farshad, Ganapathy, Shubash, Ikeda, Nayu, Iotova, Violeta, Kengne, Andre P, Khang, Young-Ho, Laxmaiah, Avula, Lin, Hsien-Ho, Ma, Jun, Mbanya, Jean Claude N, Miranda, J Jaime, Pradeepa, Rajendra, Rodríguez-Artalejo, Fernando, Sorić, Maroje, Turley, Maria, Wang, Limin, Webster-Kerr, Karen, Aarestrup, Julie, Abarca-Gómez, Leandra, Abbasi-Kangevari, Mohsen, Abdeen, Ziad A, Abdrakhmanova, Shynar, Abdul Ghaffar, Suhaila, Abdul Rahim, Hanan F, Abdurrahmonova, Zulfiya, Abu-Rmeileh, Niveen M, Abubakar Garba, Jamila, Acosta-Cazares, Benjamin, Adam, Ishag, Adamczyk, Marzena, Adams, Robert J, Adu-Afarwuah, Seth, Aekplakorn, Wichai, Afsana, Kaosar, Afzal, Shoaib, Agbor, Valirie N, Agdeppa, Imelda A, Aghazadeh-Attari, Javad, Ågren, Åsa, Aguenaou, Hassan, Agyemang, Charles, Ahmad, Mohamad Hasnan, Ahmad, Noor Ani, Ahmadi, Ali, Ahmadi, Naser, Ahmadi, Nastaran, Ahmed, Imran, Ahmed, Soheir H, Ahrens, Wolfgang, Aitmurzaeva, Gulmira, Ajlouni, Kamel, Al-Hazzaa, Hazzaa M, Al-Hinai, Halima, Al-Lahou, Badreya, Al-Lawati, Jawad A, Al-Raddadi, Rajaa, Al Asfoor, Deena, Al Hourani, Huda M, Al Qaoud, Nawal M, Alarouj, Monira, AlBuhairan, Fadia, AlDhukair, Shahla, Aldwairji, Maryam A, Alexius, Sylvia, Ali, Mohamed M, Alieva, Anna V, Alkandari, Abdullah, Alkerwi, Ala'a, Alkhatib, Buthaina M, Allin, Kristine, Alomary, Shaker A, Alomirah, Husam F, Alshangiti, Arwa M, Alvarez-Pedrerol, Mar, Aly, Eman, Amarapurkar, Deepak N, Amiano Etxezarreta, Pilar, Amoah, John, Amougou, 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Alireza, Safarpour, Ali Reza, Safi, Sare, Safiri, Saeid, Saghi, Mohammad Hossien, Saidi, Olfa, Saieva, Calogero, Sakata, Satoko, Saki, Nader, Šalaj, Sanja, Salanave, Benoit, Salazar Martinez, Eduardo, Salhanova, Akkumis, Salmerón, Diego, Salomaa, Veikko, Salonen, Jukka T, Salvetti, Massimo, Samoutian, Margarita, Sánchez-Abanto, Jose, Sánchez Rodríguez, Inés, Sandjaja, Sans, Susana, Santa-Marina, Loreto, Santacruz, Ethel, Santos, Diana A, Santos, Ina S, Santos, Lèlita C, Santos, Maria Paula, Santos, Osvaldo, Santos, Rute, Santos, Tamara R, Saramies, Jouko L, Sardinha, Luis B, Sarrafzadegan, Nizal, Sathish, Thirunavukkarasu, Saum, Kai-Uwe, Savva, Savvas, Savy, Mathilde, Sawada, Norie, Sbaraini, Mariana, Scazufca, Marcia, Schaan, Beatriz D, Schaffrath Rosario, Angelika, Schargrodsky, Herman, Schienkiewitz, Anja, Schindler, Karin, Schipf, Sabine, Schmidt, Börge, Schmidt, Carsten O, Schmidt, Ida Maria, Schneider, Andrea, Schnohr, Peter, Schöttker, Ben, Schramm, Sara, Schramm, Stine, Schröder, Helmut, Schultsz, Constance, Schultz, Gry, Schulze, Matthias B, Schutte, Aletta E, Sebert, Sylvain, Sedaghattalab, Moslem, Selamat, Rusidah, Sember, Vedrana, Sen, Abhijit, Senbanjo, Idowu O, Sepanlou, Sadaf G, Sequera, Guillermo, Serra-Majem, Luis, Servais, Jennifer, Ševčíková, Ľudmila, Sewpaul, Ronel, Shalnova, Svetlana, Shamah-Levy, Teresa, Shamshirgaran, Seyed Morteza, Shanthirani, Coimbatore Subramaniam, Sharafkhah, Maryam, Sharma, Sanjib K, Sharman, Almaz, Shaw, Jonathan E, Shayanrad, Amaneh, Shayesteh, Ali Akbar, Shengelia, Lela, Shi, Zumin, Shibuya, Kenji, Shimizu-Furusawa, Hana, Shimony, Tal, Shiri, Rahman, Shrestha, Namuna, Si-Ramlee, Khairil, Siani, Alfonso, Siantar, Rosalynn, Sibai, Abla M, Sidossis, Labros S, Silitrari, Natalia, Silva, Antonio M, Silva, Caroline Ramos de Moura, Silva, Diego Augusto Santos, Silva, Kelly Samara, Sim, Xueling, Simon, Mary, Simons, Judith, Simons, Leon A, Sjöberg, Agneta, Sjöström, Michael, Skoblina, Elena V, Skoblina, Natalia A, 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Valkengoed, Irene GM, Vanderschueren, Dirk, Vanuzzo, Diego, Varbo, Anette, Varela-Moreiras, Gregorio, Vargas, Luz Nayibe, Varona-Pérez, Patricia, Vasan, Senthil K, Vasques, Daniel G, Vatasescu, Radu, Vega, Tomas, Veidebaum, Toomas, Velasquez-Melendez, Gustavo, Velika, Biruta, Verloigne, Maïté, Veronesi, Giovanni, Verschuren, WM Monique, Victora, Cesar G, Viegi, Giovanni, Viet, Lucie, Vik, Frøydis N, Vilar, Monica, Villalpando, Salvador, Vioque, Jesus, Viriyautsahakul, Napaphan, Virtanen, Jyrki K, Visser, Marjolein, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vladulescu, Mihaela, Vlasoff, Tiina, Vocanec, Dorja, Vollenweider, Peter, Völzke, Henry, Vourli, Georgia, Voutilainen, Ari, Vrijheid, Martine, Vrijkotte, Tanja GM, Vuletić, Silvije, Wade, Alisha N, Waldhör, Thomas, Walton, Janette, Wambiya, Elvis OA, Wan Bebakar, Wan Mohamad, Wan Mohamud, Wan Nazaimoon, Wanderley Júnior, Rildo de Souza, Wang, Chongjian, Wang, Huijun, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nicholas, Wartha, Olivia, Weber, Adelheid, Wedderkopp, Niels, Weghuber, Daniel, Wei, Wenbin, Weres, Aneta, Werner, Bo, Westbury, Leo D, Whincup, Peter H, Wichstrøm, Lars, Wickramasinghe, Kremlin, Widhalm, Kurt, Widyahening, Indah S, Więcek, Andrzej, Wild, Philipp S, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Julianne, Wilsgaard, Tom, Wirth, James P, Wojtyniak, Bogdan, Woldeyohannes, Meseret, Wolf, Kathrin, Wong-McClure, Roy A, Wong, Andrew, Wong, Emily B, Wong, Jyh Eiin, Wong, Tien Yin, Woo, Jean, Woodward, Mark, Wu, Frederick C, Wu, Hon-Yen, Wu, Jianfeng, Wu, Li Juan, Wu, Shouling, Wyszyńska, Justyna, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yamborisut, Uruwan, Yan, Li, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yardim, Nazan, Yasuharu, Tabara, Yépez García, Martha, Yiallouros, Panayiotis K, Yngve, Agneta, Yoosefi, Moein, Yoshihara, Akihiro, Yotov, Yoto, You, Qi Sheng, You, San-Lin, Younger-Coleman, Novie O, Yu, Yu-Ling, Yu, Yunjiang, Yusof, Safiah Md, Yusoff, Ahmad Faudzi, Zaccagni, Luciana, Zafiropulos, Vassilis, Zainuddin, Ahmad A, Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antonis, Zamrazilová, Hana, Zapata, Maria Elisa, Zargar, Abdul Hamid, Zaw, Ko Ko, Zayed, Ayman A, Zdrojewski, Tomasz, Żegleń, Magdalena, Zejglicova, Kristyna, Zeljkovic Vrkic, Tajana, Zeng, Yi, Zentai, Andrea, Zhang, Bing, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhao, Wenhua, Zhecheva, Yanitsa V, Zhen, Shiqi, Zheng, Wei, Zheng, Yingfeng, Zholdin, Bekbolat, Zhou, Maigeng, Zhu, Dan, Zimmet, Paul, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Zoghlami, Nada, Zuñiga Cisneros, Julio, Zuziak, Monika, and Ezzati, Majid

Published
2024
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17. Prevalence, trends, and factors associated with hypertensive crisis among Peruvian adults

Author

Victor Calderon-Ocon, Fiorella Cueva-Peredo, and Antonio Bernabe-Ortiz

Subjects
Hypertension, Hypertensive Crisis, Prevalence, Health Survey, Medicine, Public aspects of medicine, RA1-1270
Abstract

There are few studies focused on the epidemiology of hypertensive crisis at the population level in resource-constrained settings. This study aimed to determine the prevalence and trends over time of hypertensive crisis, as well as the factors associated with this condition among adults. A secondary data analysis was carried out using the Peruvian Demographic and Family Health Survey (ENDES). Hypertensive crisis was defined based on the presence of systolic (≥ 180mmHg) or diastolic (≥ 110mmHg) blood pressure, regardless of previous diagnosis or medication use. The factors associated with our outcome were evaluated using multinomial logistic regression, and the trend of hypertensive crisis was evaluated using the Cochrane-Armitage test. Data from 260,167 participants were analyzed, with a mean age of 44.2 (SD: 16.9) years and 55.5% were women. Hypertension prevalence was 23% (95%CI: 22.7-23.4) and, among them, 5.7% (95%CI: 5.4-5.9) had hypertensive crisis, with an overall prevalence of 1.5% (95%CI: 1.4-1.6). From 2014 to 2022, a significant decrease in the prevalence of hypertensive crisis was observed, from 1.7% in 2014 to 1.4% in 2022 (p = 0.001). In the multivariable model, males, increasing age, living in urban areas, high body mass index, and self-reported type 2 diabetes were positively associated with hypertensive crisis, whereas higher educational level, socioeconomic status, and high altitude were inversely associated. There is a need to improve strategies for the diagnosis, treatment, and control of hypertension, especially hypertensive crisis.

Published
2024
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18. Diabetes Management in Latin America

Author

Carrillo-Larco, Rodrigo M., Bracco, Paula A., Bernabe-Ortiz, Antonio, Lazo-Porras, Maria, Zafra-Tanaka, Jessica H., Tenorio-Mucha, Janeth, Bello-Chavolla, Omar Yaxmehen, Beran, David, and Rodriguez-Saldana, Joel, editor

Published
2023
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23. Association between total available nutritional quality and food expenditure in Peruvian households, 2019-2020

Author

Karen Bonilla-Aguilar and Antonio Bernabe-Ortiz

Subjects
Nutritional Quality, Expenditure, Family Characteristics, Diet Surveys, Medicine, Public aspects of medicine, RA1-1270
Abstract

Abstract: Evidence points to a direct relationship between nutritional quality and food expenditure. However, food expenditure is highly susceptible to changes, and nutritional quality of household food presents limited evidence. The aim of this study was to assess the relationship between nutritional quality available and total food expenditure in Peruvian households, and whether there were differences by area (urban and rural) and between years of the COVID-19 pandemic. For this, we used Peru’s National Household Survey (ENAHO) from 2019 and 2020. We assessed total food expenditure in US dollars per day, whereas household nutritional quality available was assessed based on dietary diversity and compliance with the household calorie requirements, percentage of food expenditure, and potential confounders. We used the Student’s t-test, analysis of variance (ANOVA), linear regression, and the Wald test to assess the interaction effect. Households with adequate total/partial nutritional quality available by area were found to spend, on average, USD 2.00 more in urban than in rural areas and, by year, they presented 7.1% more percentage of food expenditure in 2020 than in 2019. Despite associations existing between nutritional quality available and total food expenditure by year and study area, the effect modification was only present by study area. In multivariable model, households with adequate total/partial nutritional quality available consistently presented a lower total food expenditure by year, with a lower total food expenditure in urban areas. An inverse relationship was found between nutritional quality available and total food expenditure, in contrast to the direct relationship of studies assessing dietary cost and nutritional quality. Our results reflect the nutritional deficit in the food purchases of Peruvian households.

Published
2023
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26. Asociación entre el consumo de ciertos alimentos y síntomas depresivos en adultos mayores

Author

Antonio Bernabe-Ortiz, Paola J. Sabelino-Francia, and Samantha N. Avendaño-Gómez

Subjects
Depresión, Anciano, Pobreza, Clase social, dieta, Nutrition. Foods and food supply, TX341-641, Nutritional diseases. Deficiency diseases, RC620-627
Abstract

Introducción: Se vienen dando cambios en la alimentación en los países en vías de desarrollo como parte de la transición nutricional. Estos podrían afectar el consumo de ciertos grupos de alimentos y por lo tanto la salud mental, especialmente en los adultos mayores. El objetivo fue evaluar si existe asociación entre el consumo de ciertos grupos de alimentos (lácteos, huevos y menestras, carne, aves de corral o pescado, y frutas y/o verduras) y la presencia de síntomas depresivos en adultos mayores de pobreza y pobreza extrema en el Perú. Metodología: Análisis secundario de un estudio de base poblacional (Encuesta de Salud y Bienestar del Adulto Mayor, en Perú) realizada en el 2012. La variable desenlace fue la presencia de síntomas depresivos, mientras que la exposición fue la frecuencia de consumo de ciertos grupos de alimentos: lácteos; huevos y menestras; carne, aves de corral o pescado; y frutas y/o verduras. Se usó modelos de regresión de Poisson, reportándose razones de prevalencia (RP) e intervalos de confianza al 95% (IC95%). Resultados: Un total de 4214 registros fueron analizados, edad promedio de 71,2 (DE: 4,4) años, 54,2% de varones, y 61,4% de zona rural. Un total de 1621 (38,6%; IC95%: 37,1%-40,1%) adultos mayores presentaron síntomas depresivos. En modelo multivariable, la frecuencia de síntomas depresivos fue un 41% superior (IC95%: 30%-54%) entre los que no consumían huevos y menestras al menos una vez a la semana. Similarmente, se encontró asociación en aquellos que reportaron no consumir carne, aves de corral o pescado al menos tres veces por semana (18%; IC95%: 9%-28%) y los que no consumieron frutas y/o verduras al menos dos veces al día (15%; IC95%: 6%-24%). Conclusión: Este estudio evidenció que el consumo de frutas y/o verduras, aves de corral o pescado, huevos y menestras están relacionados de manera inversa con la presencia de síntomas depresivos en el adulto mayor

Published
2023
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27. Implementation of a salt substitute intervention using social marketing in resourced-limited communities in Peru: a process evaluation study

Author

María Lazo-Porras, Adela Del Valle, David Beran, Maria Amalia Pesantes, Silvana Perez-Leon, Vilarmina Ponce-Lucero, Antonio Bernabe-Ortiz, María Kathia Cárdenas, François Chappuis, Pablo Perel, J. Jaime Miranda, and Francisco Diez-Canseco

Subjects
process evaluation, salt replacement, context, acceptability, fidelity, low- and middle-income countries, Public aspects of medicine, RA1-1270
Abstract

ObjectiveThis study aimed to conduct a process evaluation of a salt substitute trial conducted in Peru.MethodsThrough semi-structured interviews of intervention participants, we documented and analyzed process evaluation variables as defined by the Medical Research Council Framework. This study was a stepped wedge trial conducted in Tumbes, Peru in 2014. The intervention was a community-wide replacement of regular salt (100% sodium) with “Salt Liz” (75% sodium and 25% potassium) using social marketing strategies to promote the adoption and continued use of the salt substitute in daily life. The components of the social marketing campaign included entertainment educational activities and local product promoters (“Amigas de Liz”). Another component of the intervention was the Salt Liz spoon to help guide the amount of salt that families should consume. The process evaluation variables measured were the context, mechanism of action, and implementation outcomes (acceptability, fidelity and adoption, perceptions, and feedback).ResultsIn total, 60 women were interviewed, 20 with hypertension and 40 without hypertension. Regarding context, common characteristics across the four villages included residents who primarily ate their meals at home and women who were responsible for household food preparation. As the mechanism of action, most participants did not notice a difference in the flavor between regular salt and Salt Liz; those that did notice a difference took around 2 weeks to become accustomed to the taste of the salt substitute. In terms of implementation outcomes, the Salt Liz was accepted by villagers and factors explaining this acceptability included that it was perceived as a “high quality” salt and as having a positive effect on one's health. Participants recognized that the Salt Liz is healthier than regular salt and that it can help prevent or control hypertension. However, most participants could not accurately recall how the compositions of the Salt Liz and regular salt differed and the role they play in hypertension. Although the use of the Salt Liz was far-reaching at the community level, the use of the Salt Liz spoon was poor. Educational entertainment activities were well-received, and most participants enjoyed them despite not always being active participants but rather sideline observers.ConclusionThis process evaluation identifies key intervention components that enabled a successful trial. Seeking and incorporating feedback from the target population helps deepen the understanding of contextual factors that influence an intervention's success. Furthermore, feedback received can aid the development of the intervention product. Some factors that can be improved for future interventions are acknowledged.Clinical trial registrationNCT01960972.

Published
2023
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29. Association between stressful life events and depression, anxiety, and quality of life among urban adolescents and young adults in Latin America.

Author

Diez-Canseco, Francisco, Carbonel, Adriana, Bernabe-Ortiz, Antonio, Olivar, Natividad, Gómez-Restrepo, Carlos, Toyama, Mauricio, Uribe-Restrepo, José Miguel, Brusco, Luis Ignacio, Hidalgo-Padilla, Liliana, Ramirez-Meneses, Daniela, Carbonetti, Fernando Luis, Ariza-Salazar, Karen, Sureshkumar, Diliniya Stanislaus, Fung, Catherine, and Priebe, Stefan

Subjects
LIFE change events, LATIN Americans, MENTAL illness, QUALITY of life, PSYCHOLOGICAL distress, YOUNG adults
Abstract

Background: Latin American youth have a high prevalence of mental health disorders and face major socioeconomic and public safety problems. This study assesses the association between stressful life events (SLEs) and depression, anxiety, and quality of life among adolescents and young adults from deprived neighbourhoods of Latin America. Methods: The sample consisted of 2,402 participants, between adolescents (15–16 years) and young adults (20–24 years), from Bogotá (Colombia), Buenos Aires (Argentina), and Lima (Peru), assessed in 2021–2022 and recruited in education and community settings and social media. We evaluated the most frequent recent and distant SLEs (occurred in the previous year and more than a year ago, respectively), the relationship between SLEs and severity of depression (PHQ-8), anxiety (GAD-7), and quality of life (MANSA), and we tested for differences by gender and age group. Results: The most common recent and distant SLEs were related to public safety issues and financial distress. Accidents and school suspensions were more frequent among men, and sexual harassment and bullying among women. Every additional reported recent SLE increased the odds of mild, moderate, and severe depression (18, 17, and 25%, respectively) and anxiety (10, 17, and 21%, respectively) symptoms. Similar trends were found with distant SLEs and depression (8, 9, and 11% for mild, moderate, and severe symptoms, respectively) and anxiety (9, 11, and 12%, respectively). Furthermore, a higher number of recent and distant SLEs were associated with lower quality of life (β = −0.05, p < 0.001, 95% CI [−0.06, −0.04] and β = −0.04, p < 0.001, 95% CI [−0.05, −0.03], respectively). The relationship between mental distress and quality of life of recent SLEs seems stronger than the one from distant SLEs, and recent SLEs may have a higher impact on adolescents' mental health compared with young adults. Conclusion: Both recent and distant SLEs are related to mental distress and quality of life. Policies and programmes should aim to enhance public and health safety, as well as improve individual, family, and community protective factors that could mitigate the effect of SLEs on Latin American youth. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Peru – Progress in health and sciences in 200 years of independence

Author

Carrillo-Larco, Rodrigo M., Guzman-Vilca, Wilmer Cristobal, Leon-Velarde, Fabiola, Bernabe-Ortiz, Antonio, Jimenez, M. Michelle, Penny, Mary E., Gianella, Camila, Leguía, Mariana, Tsukayama, Pablo, Hartinger, Stella M., Lescano, Andres G., Cuba-Fuentes, María Sofía, Cutipé, Yuri, Diez-Canseco, Francisco, Mendoza, Walter, Ugarte-Gil, Cesar, Valdivia-Gago, Andrea, Zavaleta-Cortijo, Carol, and Miranda, J. Jaime

Published
2022
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32. Second-hand smoke exposure in adolescents in Latin America and the Caribbean: a pooled analysisResearch in context

Author

Antonio Bernabe-Ortiz and Rodrigo M. Carrillo-Larco

Subjects
Second-hand smoking, Tobacco smoke pollution, Smoke-free environment, Adolescents, Public aspects of medicine, RA1-1270
Abstract

Summary: Background: Second-hand smoke exposure is prevalent amongst adolescents, despite of being a preventable risk factor associated with unfavourable outcomes. The distribution of this risk factor varies by underlying determinants and public health officers need contemporary evidence to update policies. Using the most recent data available from adolescents in Latin America and the Caribbean (LAC), we described the prevalence of second-hand smoking. Methods: Pooled analysis of Global School-based Student Health (GSHS) surveys conducted from 2010 to 2018 was conducted. Two indicators were analysed based on information from the 7 days prior to the survey: a) any exposure to second-hand smoking (0 vs ≥1 days of exposure); and b) daily exposure (

Published
2023
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33. Mean systolic blood pressure above the control threshold in people with treated uncontrolled hypertension: a pooled, cross-sectional analysis of 55 national health surveysResearch in context

Author

Rodrigo M. Carrillo-Larco, Wilmer Cristobal Guzman-Vilca, Xiaolin Xu, and Antonio Bernabe-Ortiz

Subjects
Hypertension, Noncommunicable diseases, Global health, Health metrics, Medicine (General), R5-920
Abstract

Summary: Background: The hypertension care cascade has been characterized worldwide, yet it has not been quantified how far above the blood pressure control threshold people with uncontrolled treated hypertension are. We summarized the mean systolic blood pressure (SBP; mmHg) in people treated for hypertension but SBP not 130/80 mmHg were included. We quantified the mean SBP overall and by socio-demographic (sex, age, urban/rural location, education) and cardiometabolic (current smoking, self-reported diabetes) risk factors. Findings: The lowest SBP was observed in Kuwait (146.6; 95% CI: 143.8–149.4 mmHg) and the highest in Libya (171.9; 95% CI: 167.8–176.0 mmHg). In 29 countries, the SBP was higher in men, and SBP tended to be higher in older groups except in six countries. In 17 countries, the SBP was higher in rural than in urban sites, for example in Turkmenistan the SBP was 162.3 (95% CI: 158.4–166.2) mmHg in rural versus 151.6 (95% CI: 148.7–154.4) mmHg in urban areas. In 25 countries, the SBP was higher in adults with no education, for example in Benin the SBP in people without formal education was 175.3 (95% CI: 168.8–181.9) mmHg versus 156.4 (95% CI: 148.8–164.0) mmHg in people with higher education. Interpretation: Stronger interventions to improve and secure access to effective management are needed in most countries and specific groups, to reach hypertension control in people with hypertension already receiving antihypertensive medication. Funding: The Wellcome Trust International Training Fellowship (214185/Z/18/Z).

Published
2023
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35. Primary stroke prevention worldwide: translating evidence into action

Author

Abanto, Carlos, Abera, Semaw Ferede, Addissie, Adamu, Adebayo, Oluwadamilola, Adeleye, Amos Olufemi, Adilbekov, Yerzhan, Adilbekova, Bibigul, Adoukonou, Thierry Armel, Aguiar de Sousa, Diana, Ajagbe, Temitope, Akhmetzhanova, Zauresh, Akpalu, Albert, Álvarez Ahlgren, Jhon, Ameriso, Sebastián, Andonova, Silva, Awoniyi, Foloruso Emmanuel, Bakhiet, Moiz, Barboza, Miguel, Basri, Hamidon, Bath, Philip, Bello, Olamide, Bereczki, Dániel, Beretta, Simone, Berkowitz, Aaron, Bernabé-Ortiz, Antonio, Bernhardt, Julie, Berzina, Guna, Bisharyan, Mher, Bovet, Pascal, Budincevic, Hrvoje, Cadilhac, Dominique, Caso, Valeria, Chen, Christopher, Chin, Jerome, Chwojnicki, Kamil, Conforto, Adriana, Cruz, Vitor Tedim, D'Amelio, Marco, Danielyan, Kristine, Davis, Stephen, Demarin, Vida, Dempsey, Robert, Dichgans, Martin, Dokova, Klara, Donnan, Geoffrey, Elkind, Mitchell S., Endres, Matthias, Fischer, Urs, Gankpé, Fortuné, Gaye Saavedra, Andrés, Gil, Artyom, Giroud, Maurice, Gnedovskaya, Elena, Hachinski, Vladimir, Hafdi, Melanie, Hamadeh, Randah, Hamzat, T. Kolapo, Hankey, Graeme, Heldner, Mirjam, Ibrahim, Etedal Ahmed, Ibrahim, Norlinah Mohamed, Inoue, Manabu, Jee, Sungju, Jeng, Jiann-Shing, Kalkonde, Yogesh, Kamenova, Saltanat, Karaszewski, Bartosz, Kelly, Peter, Khan, Taskeen, Kiechl, Stefan, Kondybayeva, Aida, Kõrv, Janika, Kravchenko, Michael, Krishnamurthi, Rita V., Kruja, Jera, Lakkhanaloet, Mongkol, Langhorne, Peter, Lavados, Pablo M., Law, Zhe Kang, Lawal, Abisola, Lazo-Porras, Maria, Lebedynets, Dmytro, Lee, Tsong-Hai, Leung, Thomas, Liebeskind, David S., Lindsay, Patrice, López-Jaramillo, Patricio, Lotufo, Paulo Andrade, Machline-Carrion, Julia, Makanjuola, Akintomiwa, Markus, Hugh Stephen, Marquez-Romero, Juan Manuel, Medina, Marco, Medukhanova, Sabina, Mehndiratta, Man Mohan, Merkin, Alexandr, Mirrakhimov, Erkin, Mohl, Stephanie, Moscoso-Porras, Miguel, Müller-Stierlin, Annabel, Murphy, Sean, Musa, Kamarul Imran, Nasreldein, Ahmed, Nogueira, Raul Gomes, Nolte, Christian, Noubiap, Jean Jacques, Novarro-Escudero, Nelson, Ogun, Yomi, Oguntoye, Richard Ayobami, Oraby, Mohammed Ibrahim, Osundina, Morenike, Ovbiagele, Bruce, Orken, Dilek Necioglu, Ozdemir, Atilla Özcan, Ozturk, Serefnur, Paccot, Melanie, Phromjai, Jurairat, Piradov, Piradov, Platz, Thomas, Potpara, Tatjana, Ranta, Annemarei, Rathore, Farooq, Richard, Edo, Sacco, Ralph L., Sahathevan, Ramesh, Santos Carquín, Irving, Saposnik, Gustavo, Sarfo, Fred Stephen, Sharma, Mike, Sheth, Kevin, Shobhana, A., Suwanwela, Nijasri, Svyato, Irina, Sylaja, P.N., Tao, Xuanchen, Thakur, Kiran T., Toni, Danilo, Topcuoglu, Mehmet Akif, Torales, Julio, Towfighi, Amytis, Truelsen, Thomas Clement, Tsiskaridze, Alexander, Tulloch-Reid, Marshall, Useche, Nicolás, Vanacker, Peter, Vassilopoulou, Sophia, Vukorepa, Gorana, Vuletic, Vladimira, Wahab, Kolawole W., Wang, Wenzhi, Wijeratne, Tissa, Wolfe, Charles, Yifru, Yared Mamushet, Yock-Corrales, Adriana, Yonemoto, Naohiro, Yperzeele, Laetitia, Zhang, Puhong, Owolabi, Mayowa O, Thrift, Amanda G, Mahal, Ajay, Ishida, Marie, Martins, Sheila, Johnson, Walter D, Pandian, Jeyaraj, Abd-Allah, Foad, Yaria, Joseph, Phan, Hoang T, Roth, Greg, Gall, Seana L, Beare, Richard, Phan, Thanh G, Mikulik, Robert, Akinyemi, Rufus O, Norrving, Bo, Brainin, Michael, and Feigin, Valery L

Published
2022
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37. Blood-free risk scores and neuropathy assessment tools to detect undiagnosed type 2 diabetes in Peru

Author

Bernabe Ortiz, A., Smeeth, L., and Perel, P.

Subjects
616.4
Abstract

The prevalence of type 2 diabetes mellitus is rising, especially in low- and middle-income countries, where the situation is worsened because around half of cases are unaware of the disease. Universal screening utilizing blood markers can be challenging in resource-constrained settings. The identification of these individuals can be potentially addressed using risk scores and neuropathy assessment tools. This study aimed to assess the diagnostic accuracy of the FINDRISC, a blood-free risk score, three neuropathy assessment tools (EZSCAN, pupillometer, and biothesiometer), alone and in combination. A population-based study was conducted enrolling a sex-stratified random sample of participants from Tumbes, a semiurban area in the north of Peru. Undiagnosed T2DM was the outcome, defined using WHO OGTT thresholds. Diagnostic accuracy of the FINDRISC and neuropathy tools was evaluated using the area under the ROC curve (aROC) and respective 95% confidence intervals (95%CI). Data from 1609 participants were analysed, mean age 48.2 (SD: 10.6) years, 810 (50.3%) females. A total of 176 (10.9%) individuals had T2DM, and only 71 (4.7%) had undiagnosed T2DM. The diagnostic accuracy of the FINDRISC was aROC = 0.69 (95% CI: 0.64–0.74), with a sensitivity of 69% and specificity of 67%. Among devices, the EZSCAN (aROC = 0.59; 95%CI: 0.53–0.66; sensitivity of 59% and specificity of 54%) and biothesiometer in the third metatarsal head (aROC = 0.60; 95%CI: 0.53–0.67; sensitivity of 31% and specificity of 85%) performed best. A combination of the FINDRISC and the biothesiometer had the best diagnostic accuracy, with a similar aROC of FINDRISC alone (AROC = 0.69; 95%CI: 0.68–0.78), with a sensitivity of 79% and a specificity of 59%. Our results confirm that combination of the FINDRISC and biothesiometer can improve diagnostic accuracy of the FINDRISC and biothesiometer alone, increasing sensitivity without affecting specificity or the area under the ROC curve.

Published
2018
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38. Second-hand smoking, hypertension and cardiovascular risk: findings from Peru

Author

Antonio Bernabe-Ortiz and Rodrigo M. Carrillo-Larco

Subjects
Second-hand smoking, Hypertension, Cardiovascular risk, Peru, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background Second-hand smoking has not been detailedly studied in Peru, where smoking is prohibited in all indoor workplaces, public places, and public transportation. Second-hand smoke exposure may occur at home or any other places. This study aimed to estimate the prevalence of second-hand smoking and assess its association with hypertension and cardiovascular risk in Peru. Materials and methods Secondary analysis of a nationally-representative population-based survey including individuals aged 18–59 years. There were two outcomes: hypertension and 10-year cardiovascular risk using the Framingham and the 2019 World Health Organization (WHO) risk scores. The exposure was self-reported second-hand smoking during the 7 days before the survey. The association between second-hand smoking and hypertension was quantified with Poisson models reporting prevalence ratio (PR) and 95% confidence interval (95% CI); the association between second-hand smoking and cardiovascular risk was quantified with linear regressions reporting coefficients and their 95% CI. Results Data from 897 individuals, mean age: 38.2 (SD: 11.8) years, and 499 (55.7%) females, were analyzed, with 8.7% subjects reporting second-hand smoking at home and 8.3% at work or any other place. Thus, 144 (15.5%; 95% CI: 12.8%-18.6%) subjects reported any second-hand smoking. In multivariable model second-hand smoking was associated with hypertension (PR = 2.42; 95% CI: 1.25–4.67), and with 1.2% higher Framingham cardiovascular risk, and 0.2% higher 2019 WHO risk score. Conclusions There is an association between second-hand smoking and hypertension as well as with cardiovascular risk, and 15% of adults reported second-hand smoke exposure overall with half of them exposed at home. There is a need to guarantee smoking-free places to reduce cardiovascular risk.

Published
2021
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39. Aggregation and combination of cardiovascular risk factors and their association with 10-year all-cause mortality: the PERU MIGRANT Study

Author

Janina Bazalar-Palacios, J. Jaime Miranda, Rodrigo M. Carrillo-Larco, Robert H. Gilman, Liam Smeeth, and Antonio Bernabe-Ortiz

Subjects
Survival, Comorbidity, Prospective studies (MeSH NLM), Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Objective To estimate the association between the aggregation and pair-wise combination of selected cardiovascular risk factors (CVRF) and 10-year all-cause mortality. Methods Secondary data analysis of the PERU MIGRANT study, a prospective population-based cohort. Ten-year all-cause mortality was determined for participants originally enrolled in the PERU MIGRANT Study (baseline in 2007) through the National Registry of Identification and Civil Status. The CVRF included hypertension, type 2 diabetes mellitus, hypercholesterolemia, and overweight/obesity. Exposures were composed of both the aggregation of the selected CVRF (one, two, and three or more CVRF) and pair-wise combinations of CVRF. Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (95% CI). Findings Of the 989 participants evaluated at baseline, 976 (98.8%) had information about vital status at 10 years of follow-up (9992.63 person-years), and 63 deaths were recorded. In the multivariable model, adjusting for sociodemographic and lifestyle variables, participants with two CVRF (HR: 2.48, 95% CI: 1.03–5.99), and those with three or more CVRF (HR: 3.93, 95% CI: 1.21–12.74) had higher all-cause mortality risk, compared to those without any CVRF. The pair-wise combinations associated with the highest risk of all-cause mortality, compared to those without such comorbidities, were hypertension with type 2 diabetes (HR: 11.67, 95% CI: 3.67–37.10), and hypertension with overweight/obesity (HR: 2.76, 95% CI: 1.18–6.71). Conclusions The aggregation of two or more CVRF and the combination of hypertension with type 2 diabetes or overweight/obesity were associated with an increased risk of 10-year all-cause mortality. These risk profiles will inform primary and secondary prevention strategies to delay mortality from cardiovascular risk factors.

Published
2021
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40. Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies

Author

Carrillo-Larco, Rodrigo M., Stern, Dalia, Hambleton, Ian R., Hennis, Anselm, Cesare, Mariachiara Di, Lotufo, Paulo, Ferreccio, Catterina, Irazola, Vilma, Perel, Pablo, Gregg, Edward W, Miranda, J. Jaime, Ezzati, Majid, Danaei, Goodarz, Aguilar-Salinas, Carlos A, Alvarez-Váz, Ramón, Amadio, Marselle B, Baccino, Cecilia, Bambs, Claudia, Bastos, João Luiz, Beckles, Gloria, Bernabe-Ortiz, Antonio, Bernardo, Carla DO, Bloch, Katia V., Blümel, Juan E., Boggia, Jose G., Borges, Pollyanna K., Bravo, Miguel, Brenes-Camacho, Gilbert, Carbajal, Horacio A, Rascon, Maria S. Castillo, Ceballos, Blanca H., Colpani, Veronica, Cooper, Jackie A, Cortes, Sandra, Cortes-Valencia, Adrian, Cunha, Roberto S, d'Orsi, Eleonora, Dow, William H, Espeche, Walter G, Fuchs, Flavio D., Fuchs, Sandra C., Gimeno, Suely GA, Gomez-Velasco, Donaji, Gonzalez-Chica, David A, Gonzalez-Villalpando, Clicerio, Gonzalez-Villalpando, María-Elena, Grazioli, Gonzalo, Guerra, Ricardo O., Gutierrez, Laura, Herkenhoff, Fernando L, Horimoto, Andrea RVR, Huidobro, Andrea, Koch, Elard, Lajous, Martin, Lima-Costa, Maria Fernanda, Lopez-Ridaura, Ruy, Maciel, Alvaro CC, Manrique-Espinoza, Betty S, Marques, Larissa P, Mill, Jose G, Moreira, Leila B, Muñoz, Oscar M, Ono, Lariane M, Oppermann, Karen, Paiva, Karina M., Peixoto, Sergio V., Pereira, Alexandre C., Peres, Karen G., Peres, Marco A., Ramírez-Palacios, Paula, Rech, Cassiano R, Rivera-Paredez, Berenice, Rodriguez, Nohora I, Rojas-Martinez, Rosalba, Rosero-Bixby, Luis, Rubinstein, Adolfo, Ruiz-Morales, Alvaro, Salazar, Martin R, Salinas-Rodriguez, Aaron, Salmerón, Jorge, Sanchez, Ramon A, Silva, Nelson AS, Silva, Thiago LN, Smeeth, Liam, Spritzer, Poli M, Tartaglione, Fiorella, Tartaglione, Jorge, and Velázquez-Cruz, Rafael

Published
2021
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41. Determination of Sarcocystis lamacanis microcysts in the cardiac muscle of alpacas (Vicugna pacos) and their correlation with troponin cTnI. A study performed in the high Andean region of southern Peru

Author

Fernando Fernandez-F, Roxana Gutiérrez-A, Víctor Pacheco-S, José Chirinos-T, Daniel Marcelo Lombardo, Luis V.M. Olivera, Julio Cesar Bernabe-Ortiz, and Patricia López-Casaperalta

Subjects
Sarcocystis lamacanis, Vicugna pacos, Microcysts, Troponin cTnI, Cardiac muscles, Veterinary medicine, SF600-1100
Abstract

The breeding of alpaca (Vicugna pacos) is one of the most important economic activities in the high Andean areas of Peru. The commercialization of products derived from alpaca represents more than 80% of the income of high-Andean families. However, the infestation of parasites such as Sarcocystis lamacanis in the alpacas causes economic losses that deteriorate the already diminished quality of life of the alpaca breeder. The search for biomarkers that allow the early detection of these parasites is one of the most critical challenges in Peru, a country with the largest population of alpacas worldwide. This work aimed to analyze and quantify the microcysts formed by the parasite and relate them to the troponin cTnI level in the blood serum. Troponins are proteins secreted when there is damage to the cardiac muscle. 60 blood and cardiac tissue samples were collected from Tisco and La Raya slaughterhouses, localities of Caylloma Province in Arequipa, and Chucuito District in Puno, both regions in southern Peru. The cardiac muscle samples were processed with the routine histology technique and stained with hematoxylin and eosin. In addition, serum samples were processed with the ELISA and immunochromatography methods for troponin cTnI. Results were 100% positive for the presence of Sarcocystis lamacanis microcysts in all cardiac muscle samples. The average microcyst quantification per field of 100x were 3.5 and 5.7 for the Tisco and La Raya samples. In addition, several microscopic lesions were observed in the cardiac muscles: microcyst infiltration between muscle fibers, basophilic microcysts with a thick outer membrane and bradyzoites inside, and tissue displacement. On the other hand, all serum blood samples were negative for troponin cTnI, with both methods, ELISA and immunochromatography. For results, we infer troponin cTnI do not can be used as a biomarker for heart damage caused by Sarcocystis lamacanis parasite in alpacas.

Published
2022
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42. Agreement between the laboratory-based and non-laboratory-based WHO cardiovascular risk charts: a cross-sectional analysis of a national health survey in Peru

Author

Antonio Bernabe-Ortiz, Rodrigo M Carrillo-Larco, Wilmer Cristobal Guzman-Vilca, Gustavo A Quispe-Villegas, and Fritz Fidel Váscones Román

Subjects
Medicine
Abstract

Objective To determine the agreement between the cardiovascular disease (CVD) risk predictions computed with the WHO non-laboratory-based model and laboratory-based model in a nationally representative sample of Peruvian adults.Design Cross-sectional analysis of a national health survey.Methods Absolute CVD risk was computed with the 2019 WHO laboratory-based and non-laboratory-based models. The risk predictions from both models were compared with Bland-Altman plots, Lin’s concordance coefficient correlation (LCCC), and kappa statistics, stratified by sex, age, body mass index categories, smoking and diabetes status.Results 663 people aged 30–59 years were included in the analysis. Overall, there were no substantial differences between the mean CVD risk computed with the laboratory-based model 2.0% (95% CI 1.8% to 2.2%) and the non-laboratory-based model 2.0% (95% CI 1.8% to 2.1%). In the Bland-Altman plots, the limits of agreement were the widest among people with diabetes (−0.21; 4.37) compared with people without diabetes (−1.17; 0.95). The lowest agreement as per the LCCC was also seen in people with diabetes (0.74 (95% CI 0.63 to 0.82)), the same was observed with the kappa statistic (kappa=0.36). In general, agreement between the scores was appropriate in terms of clinical significance.Conclusions The absolute cardiovascular predicted risk was similar between the laboratory-based and non-laboratory-based 2019 WHO cardiovascular risk models. Pending validation from longitudinal studies, the non-laboratory-based model (instead of the laboratory-based) could be used when assessing CVD risk in Peruvian population.

Published
2022
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43. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Author

Zhou, Bin, Carrillo-Larco, Rodrigo M, Danaei, Goodarz, Riley, Leanne M, Paciorek, Christopher J, Stevens, Gretchen A, Gregg, Edward W, Bennett, James E, Solomon, Bethlehem, Singleton, Rosie K, Sophiea, Marisa K, Iurilli, Maria LC, Lhoste, Victor PF, Cowan, Melanie J, Savin, Stefan, Woodward, Mark, Balanova, Yulia, Cifkova, Renata, Damasceno, Albertino, Elliott, Paul, Farzadfar, Farshad, He, Jiang, Ikeda, Nayu, Kengne, Andre P, Khang, Young-Ho, Kim, Hyeon Chang, Laxmaiah, Avula, Lin, Hsien-Ho, Margozzini Maira, Paula, Miranda, J Jaime, Neuhauser, Hannelore, Sundström, Johan, Varghese, Cherian, Widyahening, Indah S, Zdrojewski, Tomasz, Abarca-Gómez, Leandra, Abdeen, Ziad A, Abdul Rahim, Hanan F, Abu-Rmeileh, Niveen M, Acosta-Cazares, Benjamin, Adams, Robert J, Aekplakorn, Wichai, Afsana, Kaosar, Afzal, Shoaib, Agdeppa, Imelda A, Aghazadeh-Attari, Javad, Aguilar-Salinas, Carlos A, Agyemang, Charles, Ahmad, Noor Ani, Ahmadi, Ali, Ahmadi, Naser, Ahmadi, Nastaran, Ahmadizar, Fariba, Ahmed, Soheir H, Ahrens, Wolfgang, Ajlouni, Kamel, Al-Raddadi, Rajaa, Alarouj, Monira, AlBuhairan, Fadia, AlDhukair, Shahla, Ali, Mohamed M, Alkandari, Abdullah, Alkerwi, Ala'a, Allin, Kristine, Aly, Eman, Amarapurkar, Deepak N, Amougou, Norbert, Amouyel, Philippe, Andersen, Lars Bo, Anderssen, Sigmund A, Anjana, Ranjit Mohan, Ansari-Moghaddam, Alireza, Ansong, Daniel, Aounallah-Skhiri, Hajer, Araújo, Joana, Ariansen, Inger, Aris, Tahir, Arku, Raphael E, Arlappa, Nimmathota, Aryal, Krishna K, Aspelund, Thor, Assah, Felix K, Assunção, Maria Cecília F, Auvinen, Juha, Avdićová, Mária, Azevedo, Ana, Azimi-Nezhad, Mohsen, Azizi, Fereidoun, Azmin, Mehrdad, Babu, Bontha V, Bahijri, Suhad, Balakrishna, Nagalla, Bamoshmoosh, Mohamed, Banach, Maciej, Banadinović, Maja, Bandosz, Piotr, Banegas, José R, Baran, Joanna, Barbagallo, Carlo M, Barceló, Alberto, Barkat, Amina, Barreto, Marta, Barros, Aluisio JD, Barros, Mauro Virgílio Gomes, Bartosiewicz, Anna, Basit, Abdul, Bastos, Joao Luiz D, Bata, Iqbal, Batieha, Anwar M, Batyrbek, Assembekov, Baur, Louise A, Beaglehole, Robert, Belavendra, Antonisamy, Ben Romdhane, Habiba, Benet, Mikhail, Benson, Lowell S, Berkinbayev, Salim, Bernabe-Ortiz, Antonio, Bernotiene, Gailute, Bettiol, Heloísa, Bezerra, Jorge, Bhagyalaxmi, Aroor, Bhargava, Santosh K, Bia, Daniel, Biasch, Katia, Bika Lele, Elysée Claude, Bikbov, Mukharram M, Bista, Bihungum, Bjerregaard, Peter, Bjertness, Espen, Bjertness, Marius B, Björkelund, Cecilia, Bloch, Katia V, Blokstra, Anneke, Bo, Simona, Bobak, Martin, Boeing, Heiner, Boggia, Jose G, Boissonnet, Carlos P, Bojesen, Stig E, Bongard, Vanina, Bonilla-Vargas, Alice, Bopp, Matthias, Borghs, Herman, Bovet, Pascal, Boyer, Christopher B, Braeckman, Lutgart, Brajkovich, Imperia, Branca, Francesco, Breckenkamp, Juergen, Brenner, Hermann, Brewster, Lizzy M, Briceño, Yajaira, Brito, Miguel, Bruno, Graziella, Bueno-de-Mesquita, H Bas, Bueno, Gloria, Bugge, Anna, Burns, Con, Bursztyn, Michael, Cabrera de León, Antonio, Cacciottolo, Joseph, Cameron, Christine, Can, Günay, Cândido, Ana Paula C, Capanzana, Mario V, Čapková, Naděžda, Capuano, Eduardo, Capuano, Vincenzo, Cardoso, Viviane C, Carlsson, Axel C, Carvalho, Joana, Casanueva, Felipe F, Censi, Laura, Cervantes-Loaiza, Marvin, Chadjigeorgiou, Charalambos A, Chamukuttan, Snehalatha, Chan, Angelique W, Chan, Queenie, Chaturvedi, Himanshu K, Chaturvedi, Nish, Chee, Miao Li, Chen, Chien-Jen, Chen, Fangfang, Chen, Huashuai, Chen, Shuohua, Chen, Zhengming, Cheng, Ching-Yu, Cheraghian, Bahman, Cherkaoui Dekkaki, Imane, Chetrit, Angela, Chien, Kuo-Liong, Chiolero, Arnaud, Chiou, Shu-Ti, Chirita-Emandi, Adela, Chirlaque, María-Dolores, Cho, Belong, Christensen, Kaare, Christofaro, Diego G, Chudek, Jerzy, Cinteza, Eliza, Claessens, Frank, Clarke, Janine, Clays, Els, Cohen, Emmanuel, Concin, Hans, Cooper, Cyrus, Coppinger, Tara C, Costanzo, Simona, Cottel, Dominique, Cowell, Chris, Craig, Cora L, Crampin, Amelia C, Crujeiras, Ana B, Cruz, Juan J, Csilla, Semánová, Cui, Liufu, Cureau, Felipe V, Cuschieri, Sarah, D'Arrigo, Graziella, d'Orsi, Eleonora, Dallongeville, Jean, Dankner, Rachel, Dantoft, Thomas M, Dauchet, Luc, Davletov, Kairat, De Backer, Guy, De Bacquer, Dirk, De Curtis, Amalia, de Gaetano, Giovanni, De Henauw, Stefaan, de Oliveira, Paula Duarte, De Ridder, David, De Smedt, Delphine, Deepa, Mohan, Deev, Alexander D, DeGennaro, Vincent Jr, Delisle, Hélène, Demarest, Stefaan, Dennison, Elaine, Deschamps, Valérie, Dhimal, Meghnath, Di Castelnuovo, Augusto F, Dias-da-Costa, Juvenal Soares, Diaz, Alejandro, Dickerson, Ty T, Dika, Zivka, Djalalinia, Shirin, Do, Ha TP, Dobson, Annette J, Donfrancesco, Chiara, Donoso, Silvana P, Döring, Angela, Dorobantu, Maria, Dörr, Marcus, Doua, Kouamelan, Dragano, Nico, Drygas, Wojciech, Duante, Charmaine A, Duboz, Priscilla, Duda, Rosemary B, Dulskiene, Virginija, Dushpanova, Anar, Džakula, Aleksandar, Dzerve, Vilnis, Dziankowska-Zaborszczyk, Elzbieta, Eddie, Ricky, Eftekhar, Ebrahim, Eggertsen, Robert, Eghtesad, Sareh, Eiben, Gabriele, Ekelund, Ulf, El-Khateeb, Mohammad, El Ati, Jalila, Eldemire-Shearer, Denise, Eliasen, Marie, Elosua, Roberto, Erasmus, Rajiv T, Erbel, Raimund, Erem, Cihangir, Eriksen, Louise, Eriksson, Johan G, Escobedo-de la Peña, Jorge, Eslami, Saeid, Esmaeili, Ali, Evans, Alun, Faeh, David, Fakhretdinova, Albina A, Fall, Caroline H, Faramarzi, Elnaz, Farjam, Mojtaba, Fattahi, Mohammad Reza, Fawwad, Asher, Felix-Redondo, Francisco J, Felix, Stephan B, Ferguson, Trevor S, Fernandes, Romulo A, Fernández-Bergés, Daniel, Ferrante, Daniel, Ferrao, Thomas, Ferrari, Marika, Ferrario, Marco M, Ferreccio, Catterina, Ferreira, Haroldo S, Ferrer, Eldridge, Ferrieres, Jean, Figueiró, Thamara Hubler, Fink, Günther, Fischer, Krista, Foo, Leng Huat, Forsner, Maria, Fouad, Heba M, Francis, Damian K, Franco, Maria do Carmo, Frikke-Schmidt, Ruth, Frontera, Guillermo, Fuchs, Flavio D, Fuchs, Sandra C, Fujita, Yuki, Fumihiko, Matsuda, Furdela, Viktoriya, Furer, Ariel, Furusawa, Takuro, Gaciong, Zbigniew, Galbarczyk, Andrzej, Galenkamp, Henrike, Galvano, Fabio, Gao, Jingli, Gao, Pei, Garcia-de-la-Hera, Manoli, Garcia, Pablo, Gareta, Dickman, Garnett, Sarah P, Gaspoz, Jean-Michel, Gasull, Magda, Gazzinelli, Andrea, Gehring, Ulrike, Geleijnse, Johanna M, George, Ronnie, Ghanbari, Ali, Ghasemi, Erfan, Gheorghe-Fronea, Oana-Florentina, Ghimire, Anup, Gialluisi, Alessandro, Giampaoli, Simona, Gieger, Christian, Gill, Tiffany K, Giovannelli, Jonathan, Gironella, Glen, Giwercman, Aleksander, Gkiouras, Konstantinos, Goldberg, Marcel, Goldsmith, Rebecca A, Gomez, Luis F, Gomula, Aleksandra, Gonçalves, Helen, Gonçalves, Mauer, Gonçalves Cordeiro da Silva, Bruna, Gonzalez-Chica, David A, Gonzalez-Gross, Marcela, González-Rivas, Juan P, González-Villalpando, Clicerio, González-Villalpando, María-Elena, Gonzalez, Angel R, Gorbea, Mariano Bonet, Gottrand, Frederic, Graff-Iversen, Sidsel, Grafnetter, Dušan, Grajda, Aneta, Grammatikopoulou, Maria G, Gregor, Ronald D, Grodzicki, Tomasz, Grosso, Giuseppe, Gruden, Gabriella, Gu, Dongfeng, Guan, Ong Peng, Gudmundsson, Elias F, Gudnason, Vilmundur, Guerrero, Ramiro, Guessous, Idris, Guimaraes, Andre L, Gulliford, Martin C, Gunnlaugsdottir, Johanna, Gunter, Marc J, Gupta, Prakash C, Gupta, Rajeev, Gureje, Oye, Gurzkowska, Beata, Gutierrez, Laura, Gutzwiller, Felix, Ha, Seongjun, Hadaegh, Farzad, Haghshenas, Rosa, Hakimi, Hamid, Halkjær, Jytte, Hambleton, Ian R, Hamzeh, Behrooz, Hange, Dominique, Hanif, Abu AM, Hantunen, Sari, Hao, Jie, Hardman, Carla Menêses, Hari Kumar, Rachakulla, Hashemi-Shahri, Seyed Mohammad, Hata, Jun, Haugsgjerd, Teresa, Hayes, Alison J, He, Yuna, Heier, Margit, Hendriks, Marleen Elisabeth, Henrique, Rafael dos Santos, Henriques, Ana, Hernandez Cadena, Leticia, Herqutanto, Herrala, Sauli, Heshmat, Ramin, Hill, Allan G, Ho, Sai Yin, Ho, Suzanne C, Hobbs, Michael, Holdsworth, Michelle, Homayounfar, Reza, Horasan Dinc, Gonul, Horimoto, Andrea RVR, Hormiga, Claudia M, Horta, Bernardo L, Houti, Leila, Howitt, Christina, Htay, Thein Thein, Htet, Aung Soe, Htike, Maung Maung Than, Hu, Yonghua, Huerta, José María, Huhtaniemi, Ilpo Tapani, Huiart, Laetitia, Huisman, Martijn, Husseini, Abdullatif S, Huybrechts, Inge, Hwalla, Nahla, Iacoviello, Licia, Iannone, Anna G, Ibrahim, Mohsen M, Ibrahim Wong, Norazizah, Ikram, M Arfan, Iotova, Violeta, Irazola, Vilma E, Ishida, Takafumi, Isiguzo, Godsent C, Islam, Muhammad, Islam, Sheikh Mohammed Shariful, Iwasaki, Masanori, Jackson, Rod T, Jacobs, Jeremy M, Jaddou, Hashem Y, Jafar, Tazeen, James, Kenneth, Jamrozik, Konrad, Janszky, Imre, Janus, Edward, Jarvelin, Marjo-Riitta, Jasienska, Grazyna, Jelaković, Ana, Jelaković, Bojan, Jennings, Garry, Jha, Anjani Kumar, Jiang, Chao Qiang, Jimenez, Ramon O, Jöckel, Karl-Heinz, Joffres, Michel, Johansson, Mattias, Jokelainen, Jari J, Jonas, Jost B, Jørgensen, Torben, Joshi, Pradeep, Joukar, Farahnaz, Jóżwiak, Jacek, Juolevi, Anne, Jurak, Gregor, Jureša, Vesna, Kaaks, Rudolf, Kafatos, Anthony, Kajantie, Eero O, Kalmatayeva, Zhanna, Kalpourtzi, Natasa, Kalter-Leibovici, Ofra, Kampmann, Freja B, Kannan, Srinivasan, Karaglani, Eva, Kårhus, Line L, Karki, Khem B, Katibeh, Marzieh, Katz, Joanne, Kauhanen, Jussi, Kaur, Prabhdeep, Kavousi, Maryam, Kazakbaeva, Gyulli M, Keil, Ulrich, Keinan Boker, Lital, Keinänen-Kiukaanniemi, Sirkka, Kelishadi, Roya, Kemper, Han CG, Keramati, Maryam, Kerimkulova, Alina, Kersting, Mathilde, Key, Timothy, Khader, Yousef Saleh, Khalili, Davood, Khaw, Kay-Tee, Kheiri, Bahareh, Kheradmand, Motahareh, Khosravi, Alireza, Kiechl-Kohlendorfer, Ursula, Kiechl, Stefan, Killewo, Japhet, Kim, Dong Wook, Kim, Jeongseon, Klakk, Heidi, Klimek, Magdalena, Klumbiene, Jurate, Knoflach, Michael, Kolle, Elin, Kolsteren, Patrick, Kontto, Jukka P, Korpelainen, Raija, Korrovits, Paul, Kos, Jelena, Koskinen, Seppo, Kouda, Katsuyasu, Kowlessur, Sudhir, Koziel, Slawomir, Kratenova, Jana, Kriaucioniene, Vilma, Kristensen, Peter Lund, Krokstad, Steiner, Kromhout, Daan, Kruger, Herculina S, Kubinova, Ruzena, Kuciene, Renata, Kujala, Urho M, Kulaga, Zbigniew, Kumar, R Krishna, Kurjata, Pawel, Kusuma, Yadlapalli S, Kutsenko, Vladimir, Kuulasmaa, Kari, Kyobutungi, Catherine, Laatikainen, Tiina, Lachat, Carl, Laid, Youcef, Lam, Tai Hing, Landrove, Orlando, Lanska, Vera, Lappas, Georg, Larijani, Bagher, Latt, Tint Swe, Le Coroller, Gwenaëlle, Le Nguyen Bao, Khanh, Le, Tuyen D, Lee, Jeannette, Lee, Jeonghee, Lehmann, Nils, Lehtimäki, Terho, Lemogoum, Daniel, Levitt, Naomi S, Li, Yanping, Lilly, Christa L, Lim, Wei-Yen, Lima-Costa, M Fernanda, Lin, Xu, Lin, Yi-Ting, Lind, Lars, Lingam, Vijaya, Linneberg, Allan, Lissner, Lauren, Litwin, Mieczyslaw, Lo, Wei-Cheng, Loit, Helle-Mai, Lopez-Garcia, Esther, Lopez, Tania, Lotufo, Paulo A, Lozano, José Eugenio, Lukačević Lovrenčić, Iva, Lukrafka, Janice L, Luksiene, Dalia, Lundqvist, Annamari, Lundqvist, Robert, Lunet, Nuno, Lustigová, Michala, Luszczki, Edyta, Ma, Guansheng, Ma, Jun, Machado-Coelho, George LL, Machado-Rodrigues, Aristides M, Macia, Enguerran, Macieira, Luisa M, Madar, Ahmed A, Maggi, Stefania, Magliano, Dianna J, Magriplis, Emmanuella, Mahasampath, Gowri, Maire, Bernard, Majer, Marjeta, Makdisse, Marcia, Malekzadeh, Fatemeh, Malekzadeh, Reza, Malhotra, Rahul, Mallikharjuna Rao, Kodavanti, Malyutina, Sofia K, Maniego, Lynell V, Manios, Yannis, Mann, Jim I, Mansour-Ghanaei, Fariborz, Manzato, Enzo, Marcil, Anie, Mårild, Staffan B, Marinović Glavić, Mihalea, Marques-Vidal, Pedro, Marques, Larissa Pruner, Marrugat, Jaume, Martorell, Reynaldo, Mascarenhas, Luis P, Matasin, Marija, Mathiesen, Ellisiv B, Mathur, Prashant, Matijasevich, Alicia, Matlosz, Piotr, Matsha, Tandi E, Mavrogianni, Christina, Mbanya, Jean Claude N, Mc Donald Posso, Anselmo J, McFarlane, Shelly R, McGarvey, Stephen T, McLachlan, Stela, McLean, Rachael M, McLean, Scott B, McNulty, Breige A, Mediene Benchekor, Sounnia, Medzioniene, Jurate, Mehdipour, Parinaz, Mehlig, Kirsten, Mehrparvar, Amir Houshang, Meirhaeghe, Aline, Meisinger, Christa, Mendoza Montano, Carlos, Menezes, Ana Maria B, Menon, Geetha R, Mereke, Alibek, Meshram, Indrapal I, Metspalu, Andres, Meyer, Haakon E, Mi, Jie, Michels, Nathalie, Mikkel, Kairit, Milkowska, Karolina, Miller, Jody C, Minderico, Cláudia S, Mini, GK, Mirjalili, Mohammad Reza, Mirrakhimov, Erkin, Mišigoj-Duraković, Marjeta, Modesti, Pietro A, Moghaddam, Sahar Saeedi, Mohajer, Bahram, Mohamed, Mostafa K, Mohamed, Shukri F, Mohammad, Kazem, Mohammadi, Mohammad Reza, Mohammadi, Zahra, Mohammadifard, Noushin, Mohammadpourhodki, Reza, Mohan, Viswanathan, Mohanna, Salim, Mohd Yusoff, Muhammad Fadhli, Mohebbi, Iraj, Mohebi, Farnam, Moitry, Marie, Møllehave, Line T, Molnár, Dénes, Momenan, Amirabbas, Mondo, Charles K, Monterrubio-Flores, Eric, Monyeki, Kotsedi Daniel K, Moon, Jin Soo, Moosazadeh, Mahmood, Moreira, Leila B, Morejon, Alain, Moreno, Luis A, Morgan, Karen, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mostafavi, Seyed-Ali, 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Charles, Soumaré, Aïcha, Sparboe-Nilsen, Bente, Sparrenberger, Karen, Staessen, Jan A, Starc, Gregor, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Stieber, Jutta, Stöckl, Doris, Stocks, Tanja, Stokwiszewski, Jakub, Stronks, Karien, Strufaldi, Maria Wany, Suka, Machi, Sun, Chien-An, Sung, Yn-Tz, Suriyawongpaisal, Paibul, Sy, Rody G, Syddall, Holly E, Sylva, René Charles, Szklo, Moyses, Tai, E Shyong, Tammesoo, Mari-Liis, Tamosiunas, Abdonas, Tan, Eng Joo, Tang, Xun, Tanser, Frank, Tao, Yong, Tarawneh, Mohammed Rasoul, Tarqui-Mamani, Carolina B, Taylor, Anne, Taylor, Julie, Tebar, William R, Tell, Grethe S, Tello, Tania, Tham, Yih Chung, Thankappan, KR, Theobald, Holger, Theodoridis, Xenophon, Thijs, Lutgarde, Thinggaard, Mikael, Thomas, Nihal, Thorand, Barbara, Thuesen, Betina H, Timmermans, Erik J, Tjandrarini, Dwi H, Tjonneland, Anne, Toft, Ulla, Tolonen, Hanna K, Tolstrup, Janne S, Topbas, Murat, Topór-Madry, Roman, Tormo, María José, Tornaritis, Michael J, Torrent, Maties, Torres-Collado, Laura, Touloumi, Giota, Traissac, Pierre, Triantafyllou, Areti, Trichopoulos, Dimitrios, Trichopoulou, Antonia, Trinh, Oanh TH, Trivedi, Atul, Tshepo, Lechaba, Tsugane, Shoichiro, Tuliakova, Azaliia M, Tulloch-Reid, Marshall K, Tullu, Fikru, Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Turley, Maria L, Twig, Gilad, Tynelius, Per, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice, Ulmer, Hanno, Uusitalo, Hannu MT, Valdivia, Gonzalo, Valvi, Damaskini, van Dam, Rob M, van den Born, Bert-Jan, Van der Heyden, Johan, van der Schouw, Yvonne T, Van Herck, Koen, Van Minh, Hoang, Van Schoor, Natasja M, van Valkengoed, Irene GM, van Zutphen, Elisabeth M, Vanderschueren, Dirk, Vanuzzo, Diego, Varbo, Anette, Vasan, Senthil K, Vega, Tomas, Veidebaum, Toomas, Velasquez-Melendez, Gustavo, Veronesi, Giovanni, Verschuren, WM Monique, Verstraeten, Roosmarijn, Victora, Cesar G, Viet, Lucie, Villalpando, Salvador, Vineis, Paolo, Vioque, Jesus, Virtanen, Jyrki K, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vlasoff, Tiina, Vollenweider, Peter, Voutilainen, Ari, Wade, Alisha N, Walton, Janette, Wambiya, Elvis OA, Wan Bebakar, Wan Mohamad, Wan Mohamud, Wan Nazaimoon, Wanderley Júnior, Rildo de Souza, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nicholas, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H, Widhalm, Kurt, Wiecek, Andrzej, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Emmanuel A, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Tien Yin, Woo, Jean, Wu, Frederick C, Wu, Shouling, Wyszynska, Justyna, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K, Yoosefi, Moein, Yoshihara, Akihiro, You, San-Lin, Younger-Coleman, Novie O, Yusoff, Ahmad Faudzi, Zainuddin, Ahmad A, Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antonis, Zapata, Maria Elisa, Zaw, Ko Ko, Zejglicova, Kristyna, Zeljkovic Vrkic, Tajana, Zeng, Yi, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhen, Shiqi, Zheng, Yingfeng, Zholdin, Bekbolat, Zhu, Dan, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Zoghlami, Nada, Zuñiga Cisneros, Julio, and Ezzati, Majid

Published
2021
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46. Quality of stroke guidelines in low- and middle-income countries: a systematic review/Qualite des directives de prise en charge des AVC dans les pays a faible et moyen revenu: revue systematique/Calidad de las directrices sobre accidentes cerebrovasculares en paises con ingresos bajos y medios: una revision sistematica

Author

Yaria, Joseph, Gil, Artyom, Makanjuola, Akintomiwa, Oguntoye, Richard, Miranda, J.Jaime, Lazo-Porras, Maria, Zhang, Puhong, Tao, Xuanchen, Ahlgren, Jhon Alvarez, Bernabe-Ortiz, Antonio, Moscoso-Porras, Miguel, Malaga, German, Svyato, Irina, Osundina, Morenike, Gianella, Camila, Bello, Olamide, Lawal, Abisola, Temitope, Ajagbe, Adebayo, Oluwadamilola, Lakkhanaloet, Monkol, Brainin, Michael, Johnson, Walter, Thrift, Amanda G., Phromjai, Jurairat, Mueller-Stierlin, Annabel S., Perone, Sigiriya Aebischer, Varghese, Cherian, Feiginq, Valery, and Owolabi, Mayowa O.

Subjects
Stroke (Disease) -- Analysis, Practice guidelines (Medicine) -- Analysis, Medical societies -- Analysis, Medical advice systems -- Analysis, Health, World Health Organization
Abstract

Objective To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and middle-income countries. Methods We systematically searched medical databases and websites of medical societies and contacted international organizations. Country-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation). We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of guidelines and plans for dissemination to target audiences. Findings We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries. Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development; breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines encompassed detailed implementation plans and socioeconomic considerations. Conclusion Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions. Objectif Identifier les lacunes presentes dans les directives nationales de prise en charge des accidents vasculaires cerebraux (AVC), ainsi que la maniere de les combler afin d'ameliorer la qualite des soins dans les pays a faible et moyen revenu. Methodes Nous avons analyse systematiquement une serie de bases de donnees medicales et sites Internet de societes medicales. Nous avons egalement contacte des organismes internationaux. Toutes les directives nationales de prevention et de prise en charge des AVC, publiees dans n'importe quelle langue entre 2010 et 2020, etaient admises dans cette analyse. Nous avons examine chaque directive incluse a la recherche de quatre composants cles de la prise en charge des AVC (surveillance, prevention, soins intensifs et reeducation). Enfin, nous avons evalue le degre de conformite avec les huit standards de l'Institut de medecine pour les directives de pratique clinique, mais aussi la facilite avec laquelle ces directives etaient appliquees et la maniere dont elles etaient censees etre diffusees aupres du public cible. Resultats Nous avons etudie 108 directives retenues provenant de 47 pays dont quatre a faible revenu, 24 a moyen revenu et 19 a haut revenu. Globalement, le nombre de directives concernant la prevention primaire des AVC etait moins eleve que d'autres volets de soins, et aucune ne recommandait une surveillance. Les directives relatives aux AVC dans les pays a faible et moyen revenu ne repondaient pas aux exigences en matiere de developpement des directives; d'etendue du public cible; d'integration des quatre composants de prise en charge des AVC; ni d'adaptation au contexte socioeconomique. La transparence des directives nationales etait moins souvent assuree dans les pays a faible et moyen revenu que dans les pays a haut revenu. Moins d'un quart des directives comportaient des plans de mise en oeuvre detailles et des considerations economiques. Conclusion Les directives relatives a la prise en charge des AVC dans les pays a faible et moyen revenu doivent etre renforcees avec le concours d'une plus large categorie de prestataires et d'acteurs du secteur de la sante. Elles doivent en outre prevoir une gamme complete d'interventions transposables sur le terrain et adaptees au contexte. Objetivo Identificar las lagunas en las directrices nacionales sobre accidentes cerebrovasculares que podrian subsanarse para mejorar la calidad de los servicios de atencion a los accidentes cerebrovasculares en los paises con ingresos bajos y medios. Metodos Se realizaron busquedas sistematicas en bases de datos medicas y sitios web de sociedades medicas y se contacto con organizaciones internacionales. Se incluyeron las directrices especificas de cada pais sobre la atencion y el control de los accidentes cerebrovasculares en cualquier idioma, publicadas entre 2010 y 2020. Se reviso cada directriz incluida para la cobertura de cuatro componentes clave de los servicios por ataques cerebrovasculares (vigilancia, prevencion, atencion aguda y rehabilitacion). Tambien se evaluo el cumplimiento de los ocho estandares del Instituto de Medicina para las guias de practica clinica, la facilidad de implementacion de las directrices y los planes de difusion al publico objetivo. Resultados Se revisaron 108 directrices elegibles de 47 paises, incluyendo cuatro de bajos ingresos, 24 de medianos ingresos y 19 de altos ingresos. Globalmente, la prevencion primaria de los ataques cerebrovasculares estaba cubierta en menos directrices que otros componentes de la atencion medica, y ninguna recomendaba la vigilancia. Las directrices sobre ataques cerebrovasculares en los paises de ingresos bajos y medios no cumplian con los estandares requeridos para el desarrollo de directrices; la amplitud del publico objetivo; la cobertura de los cuatro componentes de los servicios de ataques cerebrovasculares; ni la adaptacion al contexto socioeconomico. El numero de directrices de los paises de ingresos bajos y medios que demostraron ser transparentes fue menor que el de los paises de ingresos altos. Menos de una cuarta parte de las directrices incluian planes de aplicacion detallados y consideraciones socioeconomicas. Conclusion Las directrices sobre los ataques cerebrovasculares en los paises de ingresos bajos y medios deben elaborarse en colaboracion con una categoria mas amplia de proveedores de servicios sanitarios y partes interesadas, con un espectro completo de intervenciones traducibles y adecuadas al contexto., Introduction Stroke is the second leading cause of death and disability globally, with evidence of an increasing incidence of stroke among young adults. (1-3) The burden of stroke is increasing [...]

Published
2021
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50. Urbanization, Altitude and Cardiovascular Risk

Author

Antonio Bernabe-Ortiz and Rodrigo M. Carrillo-Larco

Subjects
cardiovascular disease, cardiovascular risk, altitude, urbanization, peru, Diseases of the circulatory (Cardiovascular) system, RC666-701, Public aspects of medicine, RA1-1270
Abstract

Background: There is limited information regarding the variation of the cardiovascular (CV) risk, that combines multiple risk factors in one metric, according to urbanization and altitude. Objective: To assess and disentangle the potential association between urbanization and altitude with absolute CV risk using Peruvian nationally representative surveys. Methods: Pooled analysis of Peruvian Demographic Health Surveys (from 2014 to 2020), including subjects aged between 40 and 74 years, was conducted. The outcome of interest was the 10-year predicted absolute CV risk based on the non-laboratory version of the World Health Organization (WHO) and split into

Published
2022
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