Editados por otras instituciones
https://hdl.handle.net/20.500.12866/1319
2024-03-29T15:54:48ZDiscapacidad funcional en pacientes con fibromialgia en un hospital en Lima, Perú
https://hdl.handle.net/20.500.12866/14733
Discapacidad funcional en pacientes con fibromialgia en un hospital en Lima, Perú
Reátegui Arrue, Willman Arian; Ríos Lopez, Samuel Francisco; Cachay Cruzado, Jorge Andres; Huamanchumo Guzman, Roberto Miguel; Loza Munarriz, Cesar Antonio; Olivera García, Anapaula; Nestares Luna, Kim Leslie; Arévalo Flores, Jorge Martín
Background: Fibromyalgia is a rheumatological disorder characterized by generalized pain of imprecise localization that mainly affects women. It is associated with fatigue, anxiety, depression, and functional capacity is greatly affected by the coexistence of these disorders. Methods: It is a series of cross-sectional cases, using secondary data from 126 patients with fibromyalgia who attended the outpatient clinic of a hospital at Lima at the rheumatology service during February 2020.We try to determine the frequency of functional disability and explore associated factors in patients diagnosed with fibromyalgia with or without depression. Functional capacity and the presence of depressive symptoms were measure by validated scales. A multivariate multiple logistic regression analysis was performed to assess whether depression is an independent risk factor for disability. Results: The age had a median of 53.5 (IQR: 46-60) years, 122 participants were women. In addition, 42 (33.33%) patients had depression and 76 (60.32%) patients had functional disability. In the multivariate analysis, it was found that depression is an independent risk factor for functional disability after adjusting for diabetes, presence of 3 or more comorbidities, intensity of fatigue and associated symptoms [OR 3.09 (1.24 - 7.70); p: 0.015]. Conclusions: Depression is an independent factor for functional incapacity in patients with fibromyalgia.; Introducción: La fibromialgia es un trastorno reumatológico caracterizado por dolor generalizado de localización imprecisa que afecta principalmente a mujeres. Se asocia a fatiga, ansiedad, depresión y la capacidad funcional de estos pacientes se ve afectada por la coexistencia de dichos trastornos. Métodos: Serie de casos de corte transversal con uso de datos secundarios de 126 pacientes con fibromialgia que acudieron a consultorio externo del servicio de reumatología de un hospital en Lima durante febrero de 2020. Se buscó determinar la frecuencia de discapacidad funcional y explorar factores asociados en pacientes con diagnóstico de fibromialgia con o sin depresión. La capacidad funcional y la presencia de síntomas depresivos fueron medidas mediante uso de escalas validadas. Se realizó un análisis multivariado de regresión logística múltiple para valorar si la depresión es un factor de riego independiente de discapacidad. Resultados: La edad tuvo una mediana de 53,5 (RIQ: 46-60) años y 122 participantes eran mujeres, además 42 (33,33%) pacientes presentaban depresión y 76 (60,32%) presentaban discapacidad funcional. En el análisis multivariado, se encontró que la depresión es un factor de riesgo independiente de discapacidad funcional luego de ajustar a diabetes, presencia de 3 o más comorbilidades, intensidad de fatiga y síntomas asociados [OR de 3.09 (1.24 – 7.70); p: 0.015]. Conclusiones: La depresión es un factor independiente para discapacidad funcional en pacientes con fibromialgia.
2023-01-01T00:00:00ZEl tamaño del empaque de la galletas ultraprocesadas evita que lleven octógonos a pesar de tener alto contenido de azúcar y grasas saturadas
https://hdl.handle.net/20.500.12866/14736
El tamaño del empaque de la galletas ultraprocesadas evita que lleven octógonos a pesar de tener alto contenido de azúcar y grasas saturadas
Meza Hernandez, Mayra Milagros; Yabiku Soto, Kiomi Denisse; Saavedra Garcia, Lorena Maria; Diez-Canseco Montero, Francisco
The regulation of the “Law for the Promotion of Healthy Eating for Children and Adolescents” (Law No. 30021) indicates that processed and ultra-processed foods and beverages that exceed the parameters for sugar content, saturated fat, sodium, and contain trans fats, must carry a frontal advertising warning (octagon). The purpose of the octagons is to inform the population about the high content of these nutrients, so that they can make healthier choices when purchasing food...; La reglamentación de la «Ley de promoción de la alimentación saludable para niños, niñas y adolescentes» (Ley N.º 30021) indica que las bebidas y alimentos procesados y ultraprocesados que sobrepasan los parámetros para el contenido de azúcar, grasas saturadas, sodio, y contienen grasas trans, deben llevar una advertencia publicitaria frontal (octógono). Los octógonos tienen la finalidad de informar a la población sobre el alto contenido de dichos nutrientes, para que puedan tomar decisiones más saludables al momento de adquirir sus alimentos...
2023-01-01T00:00:00ZDesarrollo y validación de un método de suspensión basado en células vero par a la detección del virus Zika
https://hdl.handle.net/20.500.12866/14734
Desarrollo y validación de un método de suspensión basado en células vero par a la detección del virus Zika
Popuche, Dina; Huaman, Alfredo; Loyola Sosa, Steev Orlando; Silva, María; Jenkins, Sarah A.; Guevara, Carolina
OBJECTIVE.: To develop and validate a cell suspension method using Vero 76 cells for culturing Zika virus (ZIKV) based on infection of detached freshly seeded cells. MATERIAL AND METHODS.: Three different multiplicities of infection of ZIKV were used to develop and compare this novel method to the standard confluent cell monolayer method. In addition, we preliminary validated the cell suspension method using well-characterized ZIKV positive and negative clinical samples. The standard confluent cell monolayer method was used as the reference method, and viral isolation was confirmed by a ZIKV-specific RT-PCR. The sensitivity and its 95% confidence intervals for the cell suspension method were estimated. Also, a technical comparison of the cell suspension method against the cell monolayer method was performed. RESULTS.: Our findings suggested that both the viral load and replication of ZIKV were comparable between both monolayer- and suspension-infection methods. Although both methods were suitable for culturing and isolating ZIKV, the cell suspension method was easier, cheaper, and quicker as well as a sensitive isolation technique. The cell suspension method was significantly more sensitive in detecting Zika in inconclusive cases by RT-PCR, with a fourfold increase compared to the confluent cell monolayer method. CONCLUSION.: The cell suspension method has the potential to be an effective method for cultivating and isolating ZIKV and its application is potentially useful in both research and clinical settings.; OBJETIVO: Desarrollar y validar un método de suspensión celular utilizando células Vero 76 para el cultivo del virus Zika (ZIKV) basado en la infección de células recién sembradas no adheridas. MATERIAL Y MÉTODOS: . Se utilizaron tres multiplicidades de infección diferentes del ZIKV para desarrollar y comparar este novedoso método con el método estándar de monocapa de células confluentes. Además, validamos preliminarmente el método de suspensión utilizando muestras clínicas caracterizadas como positivas o negativas para el ZIKV. El método estándar de monocapa se utilizó como método de referencia, y el aislamiento viral se confirmó mediante un RT-PCR específico del ZIKV. Se estimó la sensibilidad e intervalos de confianza del 95% para el método de suspensión. Asimismo, se realizó una comparación técnica del método de suspensión contra el método de monocapa. RESULTADOS: . Nuestros hallazgos sugieren que tanto la carga viral como la replicación del ZIKV fueron comparables entre los métodos de infección en monocapa y en suspensión. Aunque ambos métodos fueron adecuados para cultivar y aislar el ZIKV, el método de suspensión se caracterizó por ser más fácil, barato y rápido, así como una técnica de aislamiento sensible. En comparación con el método de monocapa, el método de suspensión fue cuatro veces más sensible en la detección del ZIKV en casos inconclusos por RT-PCR. CONCLUSIONES: . El método de suspensión tiene el potencial de ser un método eficaz para cultivar y aislar el ZIKV y su uso es potencialmente útil tanto en la investigación como en entornos clínicos.
2023-01-01T00:00:00ZExperiencias de usarios y familiares sobre la atención recibida en centros de salud metal comunitaria de Lima y Callao durante la pandemia de la COVID-19
https://hdl.handle.net/20.500.12866/14735
Experiencias de usarios y familiares sobre la atención recibida en centros de salud metal comunitaria de Lima y Callao durante la pandemia de la COVID-19
Cusihuaman Lope, Noelia Margarita; Vilela Estrada, Ana Lucía; Cavero Huapaya, Victoria María; Villarreal-Zegarra, David; Diez-Canseco Montero, Francisco
OBJECTIVE.: To understand the experiences of new and continuing users of Community Mental Health Centers (CMHC) of Lima and Callao, and their relatives, regarding the mental health care they received during the COVID-19 pandemic. MATERIALS AND METHODS.: Qualitative study conducted between September 2021 and February 2022, in which we interviewed 24 users and family members who interacted with the services provided by three CMHCs in Lima and one in Callao during the COVID-19 pandemic. We carried out a thematic analysis of the transcribed interviews. RESULTS.: Participants perceived that the pandemic exacerbated the symptoms of people with mental health problems. During the pandemic, mental health care relied on the use of technology, mainly telephone calls, which were used to monitor the emotional state and pharmacological treatment of users, as well as to schedule and remember appointments. The users emphasized that frequent telephone calls made them feel accompanied and highlighted the commitment of the CMHC workers. Among the difficulties, they reported an increase in the demand for care, problems in accessing video calls, and low quality in virtual care. CONCLUSIONS.: COVID-19 had an emotional impact on people with mental health problems; in turn, CMHC services were affected by the type of care (face-to-face or virtual), resources, frequency, time and quality of care, finding limitations and benefits in the use of technology.; OBJETIVOS.: Comprender las experiencias de usuarios nuevos y continuadores de los Centros de Salud Mental Comunitaria (CSMC) de Lima y Callao, y de sus familiares, en relación a la atención en salud mental que recibieron durante la pandemia de la COVID-19. MATERIALES Y MÉTODOS.: Estudio cualitativo realizado entre septiembre del 2021 y febrero del 2022, en el que se entrevistó a 24 usuarios y familiares que interactuaron con los servicios brindados por tres CSMC de Lima y uno del Callao, durante la pandemia de la COVID-19. Se realizó un análisis temático de las entrevistas transcritas. RESULTADOS.: Los informantes percibieron que la pandemia exacerbó los síntomas de las personas con problemas de salud mental. Durante la pandemia, las atenciones de salud mental se apoyaron en el uso de tecnología, principalmente de llamadas telefónicas, las que sirvieron para monitorear el estado emocional y el tratamiento farmacológico de los usuarios, así como para programar y recordar citas. Los usuarios destacan que las llamadas telefónicas frecuentes les hicieron sentirse acompañados y resaltan el compromiso de los trabajadores de los CSMC. Como dificultades, reportan el incremento en la demanda de atención, problemas para acceder a videollamadas, y menor calidad en las atenciones virtuales. CONCLUSIONES.: La COVID-19 impactó emocionalmente a las personas con problemas de salud mental, a su vez, los servicios de los CSMC vieron afectada la modalidad (presencial o virtual), recursos, frecuencia, tiempo y calidad de la atención, encontrando limitaciones y beneficios en el uso de la tecnología.
2023-01-01T00:00:00ZToothbrushing and Access to Dental Services in Peruvian Children
https://hdl.handle.net/20.500.12866/14732
Toothbrushing and Access to Dental Services in Peruvian Children
Hadad Arrascue, Natalie Luz Gabriela; Garcés Elías, María Claudia; Chirinos Caceres, Jesus Lorenzo
Objective. The aim was to determine the association between access to dental services and toothbrushing in Peruvian children under 12 years old. Methods. This was a cross-sectional study with a population of 2021 database of the Demographic and Family Health Survey. Records of children under 12 years old who provided answers about their toothbrushing were included. Variables were evaluated descriptively and followed by a bivariate analysis; multivariate tests were performed using Poisson regression with a multilevel regression analysis. Results. General toothbrushing was 96.32% (n = 34 198), and daily toothbrushing was 88.05% (n = 28 444). Access to dental services was associated with general toothbrushing (aPR: 1.18; 95% CI: 1.14-1.22; P <.001), daily toothbrushing (aPR: 1.08; 95% CI: 1.04-1.12; P <.001) and minimum toothbrushing 2 times a day (aPR: 1.12; 95% CI: 1.07-1.17; P <.001). Conclusion. Access to dental services was associated with general toothbrushing, daily toothbrushing and toothbrushing at least twice a day.
2023-01-01T00:00:00ZThe complete mitochondrial genome of the lowland paca (Cuniculus paca) and its phylogenetic relationship with other New World hystricognath rodents
https://hdl.handle.net/20.500.12866/14730
The complete mitochondrial genome of the lowland paca (Cuniculus paca) and its phylogenetic relationship with other New World hystricognath rodents
Li, J.; Mayor, P.; Santolalla Robles, Meddly Leslye; Greenwood, A.D.
The lowland paca (Cuniculus paca) is a nocturnal, widespread, and solitary large-sized rodent in the family Cuniculidae, and one of the most frequently hunted mammals in the Neotropical forests of Latin America. We assembled the first complete mitochondrial genome of lowland paca using three closely related hystricognath species as reference sequences. The mitochondrial genome is 16,770 basepairs (bp) in length, with similar characteristics of vertebrate mitochondrial genomes. We performed phylogenetic analyses using 26 mitochondrial genome of hystricognath species based on thirteen protein-coding genes. The result confirms the taxonomical placement among the New World hystricognath rodents with high support. The placement is consistent with previous phylogenetic studies based on individual mitochondrial and nuclear genes. The current study improves the phylogenic resolution of hystricognath rodents.
2023-01-01T00:00:00ZThe Lancet Diabetes & Endocrinology Commission on type 1 diabetes: looking back to move forward.
https://hdl.handle.net/20.500.12866/14731
The Lancet Diabetes & Endocrinology Commission on type 1 diabetes: looking back to move forward.
Beran, David; Koch, Marta; Ajmal, Sana; de Beaufort, Carine; Ramaiya, Kaushik; Zafra-Tanaka, Jessica Hanae; Atkinson, Mark
Kofi Annan, former UN Secretary General and Nobel Prize winner, was noted for his many words of wisdom, including: “One has to learn from history. Quite frankly, it is almost impossible to have a sense of vision without a sense of history. If history is learned, then it doesn’t have to repeat itself over generations.”...
2023-01-01T00:00:00ZStreptococcus pneumoniae serotype 19A in hospitalized children with invasive pneumococcal disease after the introduction of conjugated vaccines in Lima, Peru.
https://hdl.handle.net/20.500.12866/14726
Streptococcus pneumoniae serotype 19A in hospitalized children with invasive pneumococcal disease after the introduction of conjugated vaccines in Lima, Peru.
Ochoa Woodell, Theresa Jean; Del Águila, Olguita; Reyes, Isabel; Chaparro Dammert, Luis Eduardo; Castillo Díaz, María Esther; Campos, Francisco; Saenz, Andrés; Hernandez, Roger; Luna Muschi, Alessandra Joanna; Castillo Tokumori, Franco; Montero Quiñe, Andrea Estefania; Gonzales Jaimes, Brayan Enrique; Mercado Zarate, Erik Hernan
BACKGROUND: The Pneumococcal conjugate vaccine (PCV) has decreased cases of invasive pneumococcal disease (IPD) worldwide. However, the impact of PCVs introduction may be affected by the serotype distribution in a specific context. METHODS: Cross-sectional multicenter passive surveillance study of IPD cases in pediatric patients hospitalized in Lima, Peru between 2016 and 2019 (after PCV13 introduction) to determine the serotype distribution and antimicrobial resistance of Streptococcus pneumoniae. Serotyping was performed by a sequential multiplex PCR and confirmed by whole genome sequencing. RESULTS: Eighty-five S. pneumoniae isolates were recovered (4.07/100,000 among children <60 months of age). Serotype 19A was the most common (49.4%). Children infected with serotype 19A in comparison with children infected with other serotypes were younger, had a lower rate of meningitis and higher rates of pneumonia, complicated pneumonia and antimicrobial resistance; 28.6% of patients with serotype 19A have received at least one dose of PCV13 vs. 62.8% of patients with other serotypes. Using MIC-breakpoints, 81.2% (56/69) of non-meningitis strains and 31.2% (5/16) of meningitis strains were susceptible to penicillin; 18.8% (3/16) of meningitis strains had intermediate resistance to ceftriaxone. Resistance to azithromycin was 78.8% (67/85). Serotype 19A frequency increased over time in the same study population, from 4.2% (4/96) in 2006-2008, to 8.6% (5/58) in 2009-2011, to 49.4% (42/85) in the current study (2016-2019) (p < 0.001). CONCLUSIONS: After PCV13 introduction in Peru, serotype 19A remains the most prevalent; however, the vaccination coverage is still not optimal. Therefore, additonal surveillance studies are needed to determine the remaining IPD burden.
2023-01-01T00:00:00ZSpecimen sharing for epidemic preparedness: Building a virtual biorepository system from local governance to global partnerships.
https://hdl.handle.net/20.500.12866/14723
Specimen sharing for epidemic preparedness: Building a virtual biorepository system from local governance to global partnerships.
Giri, Judith; Pezzi, Laura; Cachay Figueroa, Rodrigo Antonio; Gèlvez Ramirez, Rosa Margarita; Tami, Adriana; Bethencourt, Sarah; Lozano, Anyela; Gotuzzo Herencia, José Eduardo; Poje, Julia; Jaenisch, Thomas; Chu, May
We present a framework for a federated, virtual biorepository system (VBS) with locally collected and managed specimens, as a 'global public good' model based on principles of equitable access and benefit sharing. The VBS is intended to facilitate timely access to biological specimens and associated data for outbreak-prone infectious diseases to accelerate the development and evaluation of diagnostics, assess vaccine efficacy, and to support surveillance and research needs. The VBS is aimed to be aligned with the WHO BioHub and other specimen sharing efforts as a force multiplier to meet the needs of strengthening global tools for countering epidemics. The purpose of our initial research is to lay the basis of the collaboration, management and principles of equitable sharing focused on low- and middle-income country partners. Here we report on surveys and interviews undertaken with biorepository-interested parties to better understand needs and barriers for specimen access and share examples from the ZIKAlliance partnership on the governance and operations of locally organized biorepositories.
2023-01-01T00:00:00ZSodium content in commonly consumed away-from-home food in three areas of Metropolitan Lima, Peru.
https://hdl.handle.net/20.500.12866/14722
Sodium content in commonly consumed away-from-home food in three areas of Metropolitan Lima, Peru.
Meza Hernandez, Mayra Milagros; Duran Galdo, Rafael Federico; Torres Schiaffino, Daniella; Saavedra Garcia, Lorena Maria
The aim of this study was to characterize the sodium content in commonly consumed away-from-home food in three areas of Metropolitan Lima. We conducted a cross-sectional study, in which twenty frequently consumed foods were identified according to the place of sale. Sodium content was determined through atomic absorption spectroscopy in preparations collected in 2019. The median sodium content in street food products was 492.36 mg/100g (IQR: 83.93 - 918.78), 471.37 mg/100 g in artisanal food (IQR: 76.04 - 765.39) and 471.06 mg/100 g in fast food (IQR: 115.31 - 695.18). Sixty-five percent of the foods were classified as having high sodium content according to Peruvian regulations, while 30% of the preparations had high sodium content, according to UK parameters. Most food sold and consumed away from home have high sodium content. It is essential to engage all stakeholders involved in food preparation for away-from-home consumption in order to raise awareness and involve them in the promotion of policies aimed at reducing sodium intake.
2023-01-01T00:00:00ZThe burden of antimicrobial resistance in the Americas in 2019: a cross-country systematic analysis
https://hdl.handle.net/20.500.12866/14729
The burden of antimicrobial resistance in the Americas in 2019: a cross-country systematic analysis
Aguilar, GR; Swetschinski, LR; Weaver, ND; Ikuta, KS; Mestrovic, T; Gray, AP; Chung, E; Wool, EE; Han, C; Hayoon, AG; Araki, DT; Abdollahi, A; Abu-Zaid, A; Adnan, M; Agarwal, R; Dehkordi, JA; Aravkin, AY; Areda, D; Azzam, AY; Berezin, EN; Bhagavathula, AS; Bhutta, ZA; Bhuyan, SS; Browne, AJ; Castañeda-Orjuela, CA; Chandrasekar, EK; Ching, PR; Dai, XC; Darmstadt, GL; De la Hoz, FP; Diao, N; Diaz, D; dos Santos, WM; Eyre, D; García Apac, Coralith Marlinda; Haines-Woodhouse, G; Hassen, MB; Henry, NJ; Hopkins, S; Hossain, MM; Iregbu, KC; Iwu, CCD; Jacobs, JA; Janko, MM; Jones, R; Karaye, IM; Khalil, IA; Khan, IA; Khan, T; Khubchandani, J; Khusuwan, S; Kisa, A; Koyaweda, GW; Krapp Lopez, Fiorella del Carmen; Kumaran, EAP; Kyu, HH; Lim, SS; Liu, XF; Luby, S; Maharaj, SB; Maronga, C; Martorell, M; May, J; McManigal, B; Mokdad, AH; Moore, CE; Mostafavi, E; Murillo-Zamora, E; Mussi-Pinhata, MM; Nanavati, R; Nassereldine, H; Natto, ZS; Qamar, FN; Nunez-Samudio, V; Ochoa Woodell, Theresa Jean; Ojo-Akosile, TR; Olagunju, AT; Olivas-Martinez, A; Ortiz-Brizuela, E; Ounchanum, P; Paredes Sosa, José Luis; Patthipati, VS; Pawar, S; Pereira, M; Pollard, A; Ponce-De-Leon, A; Prates, EJS; Qattea, I; Reyes, LF; Roilides, E; Rosenthal, VD; Rudd, KE; Sangchan, W; Seekaew, S; Seylani, A; Shababi, N; Sham, S; Sifuentes-Osornio, J; Singh, H; Stergachis, A; Tasak, N; Tat, NY; Thaiprakong, A; Valdez, PR; Yada, DY; Yunusa, I; Zastrozhin, MS; Hay, SI; Dolecek, C; Sartorius, B; Murray, CJL; Naghavi, M; Antimicrobial Resistance Colla
Background Antimicrobial resistance (AMR) is an urgent global health challenge and a critical threat to modern health care. Quantifying its burden in the WHO Region of the Americas has been elusive-despite the region's long history of resistance surveillance. This study provides comprehensive estimates of AMR burden in the Americas to assess this growing health threat.Methods Weestimated deaths and disability-adjusted life-years (DALYs) attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen-drug combinations for countries in the WHO Region of the Americas in 2019. We obtained data from mortality registries, surveillance systems, hospital systems, systematic literature reviews, and other sources, and applied predictive statistical modelling to produce estimates of AMR burden for all countries in the Americas. Five broad components were the backbone of our approach: the number of deaths where infection had a role, the proportion of infectious deaths attributable to a given infectious syndrome, the proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of pathogens resistant to an antibiotic class, and the excess risk of mortality (or duration of an infection) associated with this resistance. We then used these components to estimate the disease burden by applying two counterfactual scenarios: deaths attributable to AMR (compared to an alternative scenario where resistant infections are replaced with susceptible ones), and deaths associated with AMR (compared to an alternative scenario where resistant infections would not occur at all). We generated 95% uncertainty intervals (UIs) for final estimates as the 25th and 975th ordered values across 1000 posterior draws, and models were cross-validated for out-of-sample predictive validity. Findings We estimated 569,000 deaths (95% UI 406,000-771,000) associated with bacterial AMR and 141,000 deaths (99,900-196,000) attributable to bacterial AMR among the 35 countries in the WHO Region of the Americas in 2019. Lower respiratory and thorax infections, as a syndrome, were responsible for the largest fatal burden of AMR in the region, with 189,000 deaths (149,000-241,000) associated with resistance, followed by bloodstream infections (169,000 deaths [94,200-278,000]) and peritoneal/intra-abdominal infections (118,000 deaths [78,600-168,000]). The six leading pathogens (by order of number of deaths associated with resistance) were Staphylococcus aureus , Escherichia coli , Klebsiella pneumoniae , Streptococcus pneumoniae , Pseudomonas aeruginosa , and Acinetobacter baumannii. Together, these pathogens were responsible for 452,000 deaths (326,000-608,000) associated with AMR. Methicillin-resistant S. aureus predominated as the leading pathogen-drug combination in 34 countries for deaths attributable to AMR, while aminopenicillin-resistant E. coli was the leading pathogen-drug combination in 15 countries for deaths associated with AMR. Interpretation Given the burden across different countries, infectious syndromes, and pathogen-drug combinations, AMR represents a substantial health threat in the Americas. Countries with low access to antibiotics and basic health-care services often face the largest age-standardised mortality rates associated with and attributable to AMR in the region, implicating specific policy interventions. Evidence from this study can guide mitigation efforts that are tailored to the needs of each country in the region while informing decisions regarding funding and resource allocation. Multisectoral and joint cooperative efforts among countries will be a key to success in tackling AMR in the Americas.
2023-01-01T00:00:00ZPrevalence, awareness, treatment and control of high blood pressure in a cohort in Northern Andean Peru.
https://hdl.handle.net/20.500.12866/14719
Prevalence, awareness, treatment and control of high blood pressure in a cohort in Northern Andean Peru.
Sanchez-Samaniego, Giuliana; Hartinger Peña, Stella Maria; Mäusezahl, Daniel; Hattendorf, Jan; Fink, Günther; Probst-Hensch, Nicole
BACKGROUND: Gaps exist along the high blood pressure (HBP) diagnosis-treatment-control pathway in high, low and middle-income countries. OBJECTIVE: To determine the prevalence of HBP and to describe the levels of awareness, control and treatment of HBP in the rural Peruvian Andes. METHODS: This cross-sectional study is embedded into a multigenerational cohort. We analysed data of all adult participants aged ≥ 30 years (n = 2752) who answered a baseline health and lifestyle questionnaire and underwent a physical examination, which included three blood pressure readings. HBP was defined as measured systolic or diastolic blood pressure (BP) ≥140 and/or 90 mm Hg and/or self-reported physician-diagnosed hypertension and/or self-reported antihypertensive intake. The determinants of the prevalence of HBP, unawareness of HBP and uncontrolled HBP were assessed using mixed-effect logistic regressions. RESULTS: HBP was present in 18.9% of the participants. Of those with measured HBP, 72.2% were unaware of their HBP. Among those with a diagnosed or medically treated hypertension, 58.4% had uncontrolled HBP. The prevalence of HBP was higher in women (OR: 1.12, CI: 1.02-1.24), increased with age (OR: 1.01, CI: 1.01-1.01) and the presence of family history of hypertension (OR: 1.15, CI: 1.08-1.24), and decreased with healthier lifestyle score (OR: 0.93, CI: 0.91-0.95). Unawareness of HBP was lower among women (OR: 0.56, CI: 0.38-0.83), higher among participants living over 3000 m Above Sea Level (OR: 1.15, CI: 1.03-1.27) and decreased with age (OR: 0.99, CI: 0.98-0.99). CONCLUSIONS: Unawareness of HBP was high, few HTN patients received treatment and BP remained high in the presence of antihypertensive treatment.
2023-01-01T00:00:00ZStellate Ganglion Block in Subarachnoid Hemorrhage: A Promising Protective Measure against Vasospasm?
https://hdl.handle.net/20.500.12866/14724
Stellate Ganglion Block in Subarachnoid Hemorrhage: A Promising Protective Measure against Vasospasm?
de Barros Oliveira, Leonardo; Batista, Sávio; Prestes, Milena Zadra; Bocanegra Becerra, Jhon Ernesto; Rabelo, Nicollas Nunes; Bertani, Raphael; Welling, Leonardo Christiaan; Figueiredo, Eberval Gadelha
BACKGROUND: Stellate ganglion block (SGB) may have protective effects in patients at risk of vasospasm following subarachnoid hemorrhage (SAH) due to reduced sympathetic activity. However, the safety and clinical outcomes of SGB in this scenario are not definitively known. The objective was to evaluate the safety, clinical outcomes, and cerebral blood flow velocity in patients submitted to SGB or cervical sympathectomy with SAH. METHODS: Following PRISMA guidelines, a systematic review and meta-analysis of studies investigating SGB or cervical sympathectomy use in SAH were conducted. PubMed, Cochrane Library, and Embase were evaluated. Patients with mRS from 0 to 2, GOS from 4 to 5, or symptom resolution were considered favorable clinical outcomes. Related mortality was defined as death by vasospasm or delayed cerebral ischemia. RESULTS: The analysis included eight studies comprising 182 patients. Only two studies employed SGB prophylactically. The results revealed favorable outcomes in 52% of patients (95% CI: 37% - 65%). The overall incidence of complications was 2% (95% CI: 0% - 26%). The mortality rate was 13% (95% CI: 7% - 21%), with a vasospasm-related mortality rate of 11% (95% CI: 2% - 20%). A decrease of cerebral blood flow velocity was reported in four studies. CONCLUSION: The notable reduction in CBFV following SGB, alongside positive outcomes and a low occurrence of mortality and complications, highlights its significance as a therapeutic intervention for vasospasm following SAH. While the number of studies evaluating SGB as a preventive measure is limited, the promising results emphasize the importance of future research.
2023-01-01T00:00:00ZThe 2023 report of the Lancet Countdown on health and climate change: the imperative for a health-centred response in a world facing irreversible harms
https://hdl.handle.net/20.500.12866/14728
The 2023 report of the Lancet Countdown on health and climate change: the imperative for a health-centred response in a world facing irreversible harms
Romanello, M.; Napoli, C.D.; Green, C.; Kennard, H.; Lampard, P.; Scamman, D.; Walawender, M.; Ali, Z.; Ameli, N.; Ayeb-Karlsson, S.; Beggs, P.J.; Belesova, K.; Berrang Ford, L.; Bowen, K.; Cai, W.; Callaghan, M.; Campbell-Lendrum, D.; Chambers, J.; Cross, T.J.; van Daalen, K.R.; Dalin, C.; Dasandi, N.; Dasgupta, S.; Davies, M.; Dominguez-Salas, P.; Dubrow, R.; Ebi, K.L.; Eckelman, M.; Ekins, P.; Freyberg, C.; Gasparyan, O.; Gordon-Strachan, G.; Graham, H.; Gunther, S.H.; Hamilton, I.; Hang, Y.; Hänninen, R.; Hartinger Peña, Stella Maria; He, K.; Heidecke, J.; Hess, J.J.; Hsu, S.-C.; Jamart, L.; Jankin, S.; Jay, O.; Kelman, I.; Kiesewetter, G.; Kinney, P.; Kniveton, D.; Kouznetsov, R.; Larosa, F.; Lee, J.K.W.; Lemke, B.; Liu, Y.; Liu, Z.; Lott, M.; Lotto Batista, M.; Lowe, R.; Odhiambo Sewe, M.; Martinez-Urtaza, J.; Maslin, M.; McAllister, L.; McMichael, C.; Mi, Z.; Milner, J.; Minor, K.; Minx, J.C.; Mohajeri, N.; Momen, N.C.; Moradi-Lakeh, M.; Morrissey, K.; Munzert, S.; Murray, K.A.; Neville, T.; Nilsson, M.; Obradovich, N.; O'Hare, M.B.; Oliveira, C.; Oreszczyn, T.; Otto, M.; Owfi, F.; Pearman, O.; Pega, F.; Pershing, A.; Rabbaniha, M.; Rickman, J.; Robinson, E.J.Z.; Rocklöv, J.; Salas, R.N.; Semenza, J.C.; Sherman, J.D.; Shumake-Guillemot, J.; Silbert, G.; Sofiev, M.; Springmann, M.; Stowell, J.D.; Tabatabaei, M.; Taylor, J.; Thompson, R.; Tonne, C.; Treskova, M.; Trinanes, J.A.; Wagner, F.; Warnecke, L.; Whitcombe, H.; Winning, M.; Wyns, A.; Yglesias-González, Marisol; Zhang, S.; Zhang, Y.; Zhu, Q.; Gong, P.; Montgomery, H.; Costello, A.
The Lancet Countdown is an international research collaboration that independently monitors the evolving impacts of climate change on health, and the emerging health opportunities of climate action. In its eighth iteration, this 2023 report draws on the expertise of 114 scientists and health practitioners from 52 research institutions and UN agencies worldwide to provide its most comprehensive assessment yet.
2023-01-01T00:00:00ZSituational Descriptive Analysis of COVID-19 in Pregnant Women and Perinatal Outcomes at the Lircay Hospital, Huancavelica-Peru, from May 2020 to April 2021
https://hdl.handle.net/20.500.12866/14721
Situational Descriptive Analysis of COVID-19 in Pregnant Women and Perinatal Outcomes at the Lircay Hospital, Huancavelica-Peru, from May 2020 to April 2021
Cardenas-Pineda, L.; Solano-Tacza, J.; Capani-Jurado, G.; Saenz, L.J.A.; Ordoñez-Ccora, G.; Cieza Terrones, Michael Javier; Mantari, A.A.
This situational descriptive study of COVID-19 in pregnant women aims to identify the perinatal outcomes of pregnant women who suffered from COVID-19 treated at the Lircay hospital from May 2020 to April 2021. Methodology: observational, retrospective, cross-sectional research developed on 124 pregnant women diagnosed with COVID-19. Results: Of 124 pregnant women with COVID-19, 65% are between 20 and 34 years old, 82% are of rural origin, and 95% are housewives. 100% presented mild COVID-19. The births were preterm in 6%, term in 91%, and post-term in 3%. The births were vaginal in 85% and cesarean section in 15%. Hypertensive disorders of pregnancy were the most frequent pathology (19%). The most frequent complications observed in the fetus were hypoxia 19%, oligohydramnios (6%), and IUGR (6%); the amniotic fluid at birth was fluid green (10%) and meconium (5%). The Apgar at minute was 7 to 10 minutes in 93%, 4 to 6 in 6%, and 1% had less than 4, and at 5 minutes, 99% had an Apgar of 7 to 10. Newborn tested positive for COVID-19. Conclusion: The perinatal pregnant women with mild COVID-19 presented fetal hypoxia, fluid green amniotic fluid and meconium, a situation that suggests a compromise of fetal oxygenation and a newborn was positive for the test.
2023-01-01T00:00:00ZStrengthening evidence to inform health systems: opportunities for the WHO and partners to accelerate progress on non-communicable diseases.
https://hdl.handle.net/20.500.12866/14725
Strengthening evidence to inform health systems: opportunities for the WHO and partners to accelerate progress on non-communicable diseases.
Hyder, Adnan A.; Rylance, Sarah; Al Saegh, Abeer; Feigin, Valery L.; Kataria, Ishu; Laatikainen, Tiina; Lee, Liming; Mahendradhata, Yodi; Marten, Robert; Mikkelsen, Bente; Miranda, J. Jaime; Nugent, Rachel; Owolabi, Mayowa; Sullivan, Richard; Virani, Salim S.; Reddy, K. Srinath
Non-communicable diseases (NCDs) have a remarkably high burden globally, accounting for 74% of all deaths. Every year 17 million people die from an NCD before the age of 70, and 86% of these premature deaths occur in low-income and middle-income countries (LMICs). The World Health Assembly endorsed the Global Action Plan for the Prevention and Control of NCDs 2013–2020 (NCD-GAP), now extended to 2030, to provide member states, international partners and the WHO with the tools, knowledge and policy options to reduce the impact of NCDs. The NCD-GAP includes a specific objective relating to research for NCD prevention and control, however the midpoint evaluation for the NCD-GAP, published in 2020, found that ‘overwhelmingly, research has been the weakest NCD-GAP objective in terms of implementation. Progress towards the NCD-GAP and United Nations Sustainable Development Goal (SDG) targets has been slow and hugely disrupted by the COVID-19 pandemic, with only a handful of countries on-track to reach SDG target 3.4—a one-third reduction in premature mortality from NCDs through prevention and treatment by 2030...
2023-01-01T00:00:00ZSensitivity and specificity of the ICDAS II system and bitewing radiographs for detecting occlusal caries using the Spectra™ caries detection system as the reference test in children
https://hdl.handle.net/20.500.12866/14720
Sensitivity and specificity of the ICDAS II system and bitewing radiographs for detecting occlusal caries using the Spectra™ caries detection system as the reference test in children
Caceda, Jorge H.; Jiang, Shuying; Calderón Ubaqui, Victor; Villavicencio Caparo, Ebigen
Background: Most studies assessing the sensitivity and specificity of caries detection methods have been performed in vitro using the histological method as the gold standard showing inconsistent values. The aim of this study was to compare the sensitivity and specificity in detecting occlusal caries using the International Caries Detection and Assessment System (ICDAS II) with the radiographic method (RM), while using the Spectra™ Caries Detection System (SCDS) as the reference test. Methods: One hundred sixty children, ages 7–12 years, participated in the study. Five zones in the occlusal surfaces of 859 primary and 632 first permanent molars were examined visually using ICDAS-II, the RM using bitewing radiographs and SCDS. The descriptive statistics of sensitivity and specificity were calculated and compared. Results: For all molars combined and for primary molars only, the sensitivity of ICDAS II was higher for detecting total caries (p < 0.001), caries in enamel (p < 0.001), and caries in dentin (p = 0.016), but it was not different for detecting caries in the dentin of permanent first molars (p = 0.214), and primary second molars (p = 0.761). The specificity of RM was higher for detecting total caries, caries in enamel for all molars combined and for permanent first molars (p < 0.001). For caries in dentin, the specificity of ICDAS II was higher for all molars combined and for primary molars only (p < 0.001). For total caries in primary molars only, and caries in dentin of permanent first molars only, the specificity was not different (p = 0.156 and p = 0.181 respectively). Conclusions: The sensitivity and specificity of ICDAS II and RM changes depending on whether the carious lesion compromises the enamel or dentin, and if the caries detection is performed in the primary molars or permanent first molars.
2023-01-01T00:00:00ZPolitical and socioeconomic factors that shaped health taxes implementation in Peru
https://hdl.handle.net/20.500.12866/14718
Political and socioeconomic factors that shaped health taxes implementation in Peru
Zuleta, Mario; Pérez León Quinoso, Silvana Patricia; Mialon, Melissa; Delgado-Zegarra, Jaime
Background In 2016 and 2018, the Peruvian Ministry of Economy and Finance (MoEF) significantly reformulated taxes on tobacco products, alcohol and sugar-sweetened beverages (SSBs). During these processes, different actors advanced arguments supporting or opposing the taxes. This study examines Peru's political and socioeconomic factors, the role of other actors and framing strategies, shaping health taxes introduction. Methods We conducted qualitative analysis by collecting information from three sources, such as: (1) media material (n=343 documents), (2) government documents (n=34) and (3) semistructured interviews (n=11). That data allowed us to identify and characterise the actors involved in implementing health taxes in Peru. We combined the data from these sources, synthesised our findings and conducted a stakeholder analysis. Results Key actors supporting taxes were the MoEF and civil society organisations, while trade associations and the alcohol, SSBs and tobacco industries opposed them using economic, trade-related arguments and criticised the policy process. The supporting group used arguments related to the economy and health to legitimate its narrative. The framing strategies employed by these stakeholders shaped and determined the outcome of the policy process. Conclusion Peruvian stakeholders against health taxes demonstrated a strong capacity to convey their messages to the media and high-level policy-makers. Despite these efforts, attempts to interfere with health taxes were unsuccessful in 2016 and 2018 and failed to overcome state institutions, particularly the MoEF. Strong institutions and individual decision-makers in Peru also contributed to the successful implementation of health taxes in Peru in 2016 and 2018.
2023-01-01T00:00:00ZSystematic Review on Methods for Detection and Diagnosis of Diabetic Retinopathy from the Year 2013 to 2023
https://hdl.handle.net/20.500.12866/14727
Systematic Review on Methods for Detection and Diagnosis of Diabetic Retinopathy from the Year 2013 to 2023
Ramos-Cosi, S.; Coquis-Flames, J.; Cieza Terrones, Michael Javier; Llulluy-Nuñez, D.; Alva- Mantari, A.
Diabetes is an illness that causes a multiple number of complications, Diabetic Retinopathy being one of them. The high level of glucose in the bloodstream eventually causes damage to the blood vessels and narrowing, including the small blood vessels in the eyes. If left unattended, this causes changes in the retina, and it can affect vision and lead to blindness. The present study was conducted to review the most predominant methods of detection and diagnosis of Diabetic Retinopathy from the years 2013 to 2023. The selection of the documents was done using the Scopus database, and the data gathered was then processed using RStudio and Google Collaborate. After processing the 9610 documents that were gathered, it was shown that with the technological advancements in recent years, new ideas and ways of detecting and diagnosing diabetic retinopathy have been developed. These include ways to get images of the fundus of the eye and process them more efficiently through methods like the use of artificial intelligence or neural networks and deep learning, the construction of hardware using microcontrollers and the use of smartphone cameras to capture the image in order to lower the costs. The use of artificial intelligence for image processing is most dominant in current trends, but the work on the development of new hardware built for image capture is not as numerous in comparison.
2023-01-01T00:00:00ZGlobal variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c
https://hdl.handle.net/20.500.12866/14709
Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c
Zhou, B.; Sheffer, K.E.; Bennett, J.E.; Gregg, E.W.; Danaei, G.; Singleton, R.K.; Shaw, J.E.; Mishra, A.; Lhoste, V.P.F.; Carrillo-Larco, R.M.; Kengne, A.P.; Phelps, N.H.; Heap, R.A.; Rayner, A.W.; Stevens, G.A.; Paciorek, C.J.; Riley, L.M.; Cowan, M.J.; Savin, S.; Vander Hoorn, S.; Lu, Y.; Pavkov, M.E.; Imperatore, G.; Aguilar-Salinas, C.A.; Ahmad, N.A.; Anjana, R.M.; Davletov, K.; Farzadfar, F.; González-Villalpando, C.; Khang, Y.-H.; Kim, H.C.; Laatikainen, T.; Laxmaiah, A.; Mbanya, J.C.N.; Narayan, K.M.V.; Ramachandran, A.; Wade, A.N.; Zdrojewski, T.; Abbasi-Kangevari, M.; Rahim, H.F.A.; Abu-Rmeileh, N.M.; Adambekov, S.; Adams, R.J.; Aekplakorn, W.; Agdeppa, I.A.; Aghazadeh-Attari, J.; Agyemang, C.; Ahmadi, A.; Ahmadi, N.; Ahmadi, N.; Ahmed, S.H.; Ajlouni, K.; Al-Hinai, H.; Al-Lahou, B.; Al-Lawati, J.A.; Asfoor, D.A.; Al Qaoud, N.M.; Alarouj, M.; AlBuhairan, F.; AlDhukair, S.; Aldwairji, M.A.; Ali, M.M.; Alinezhad, F.; Alkandari, A.; Alomirah, H.F.; Aly, E.; Amarapurkar, D.N.; Andersen, L.B.; Anderssen, S.A.; Andrade, D.S.; Ansari-Moghaddam, A.; Aounallah-Skhiri, H.; Aris, T.; Arlappa, N.; Aryal, K.K.; Assah, F.K.; Assembekov, B.; Auvinen, J.; Avdičová, M.; Azad, K.; Azimi-Nezhad, M.; Azizi, F.; Bacopoulou, F.; Balakrishna, N.; Bamoshmoosh, M.; Banach, M.; Bandosz, P.; Banegas, J.R.; Barbagallo, C.M.; Barceló, A.; Baretić, M.; Barrera, L.; Basit, A.; Batieha, A.M.; Batista, A.P.; Baur, L.A.; Belavendra, A.; Ben Romdhane, H.; Benet, M.; Berkinbayev, S.; Bernabé Ortiz, Antonio; Berrios Carrasola, X.; Bettiol, H.; Beybey, A.F.; Bhargava, S.K.; Bika Lele, E.C.; Bikbov, M.M.; Bista, B.; Bjerregaard, P.; Bjertness, E.; Bjertness, M.B.; Björkelund, C.; Bloch, K.V.; Blokstra, A.; Bo, S.; Bobak, M.; Boggia, J.G.; Bonaccio, M.; Bonilla-Vargas, A.; Borghs, H.; Bovet, P.; Brajkovich, I.; Brenner, H.; Brewster, L.M.; Brian, G.R.; Briceño, Y.; Brito, M.; Bugge, A.; Buntinx, F.; Cabrera de León, A.; Caixeta, R.B.; Can, G.; Cândido, A.P.C.; Capanzana, M.V.; Čapková, N.; Capuano, E.; Capuano, R.; Capuano, V.; Cardoso, V.C.; Carlsson, A.C.; Casanueva, F.F.; Censi, L.; Cervantes‐Loaiza, M.; Chamnan, P.; Chamukuttan, S.; Chan, Q.; Charchar, F.J.; Chaturvedi, N.; Chen, H.; Cheraghian, B.; Chirlaque, M.-D.; Chudek, J.; Cifkova, R.; Cirillo, M.; Claessens, F.; Cohen, E.; Concin, H.; Cooper, C.; Costanzo, S.; Cowell, C.; Crujeiras, A.B.; Cruz, J.J.; Cureau, F.V.; Cuschieri, S.; D’Arrigo, G.; d’Orsi, E.; Dallongeville, J.; Damasceno, A.; Dastgiri, S.; De Curtis, A.; de Gaetano, G.; De Henauw, S.; Deepa, M.; DeGennaro, V., Jr; Demarest, S.; Dennison, E.; Deschamps, V.; Dhimal, M.; Dika, Z.; Djalalinia, S.; Donfrancesco, C.; Dong, G.; Dorobantu, M.; Dörr, M.; Dragano, N.; Drygas, W.; Du, Y.; Duante, C.A.; Duboz, P.; Dushpanova, A.; Dziankowska-Zaborszczyk, E.; Ebrahimi, N.; Eddie, R.; Eftekhar, E.; Efthymiou, V.; Egbagbe, E.E.; Eghtesad, S.; El-Khateeb, M.; El Ati, J.; Eldemire-Shearer, D.; Elosua, R.; Enang, O.; Erasmus, R.T.; Erbel, R.; Erem, C.; Ergor, G.; Eriksen, L.; Eriksson, J.G.; Esmaeili, A.; Evans, R.G.; Fakhradiyev, I.; Fall, C.H.; Faramarzi, E.; Farjam, M.; Farzi, Y.; Fattahi, M.R.; Fawwad, A.; Felix-Redondo, F.J.; Ferguson, T.S.; Fernández-Bergés, D.; Ferrari, M.; Ferreccio, C.; Ferreira, H.S.; Ferrer, E.; Feskens, E.J.M.; Flood, D.; Forsner, M.; Fosse, S.; Fottrell, E.F.; Fouad, H.M.; Francis, D.K.; Frontera, G.; Furusawa, T.; Gaciong, Z.; Garnett, S.P.; Gasull, M.; Gazzinelli, A.; Gehring, U.; Ghaderi, E.; Ghamari, S.-H.; Ghanbari, A.; Ghasemi, E.; Gheorghe-Fronea, O.-F.; Ghimire, A.; Gialluisi, A.; Giampaoli, S.; Gianfagna, F.; Gill, T.K.; Gironella, G.; Giwercman, A.; Goltzman, D.; Gomula, A.; Gonçalves, H.; Gonçalves, M.; Gonzalez-Chica, D.A.; Gonzalez-Gross, M.; González-Rivas, J.P.; González-Villalpando, M.-E.; Gonzalez, A.R.; Gottrand, F.; Grafnetter, D.; Grodzicki, T.; Grøntved, A.; Guerrero, R.; Gujral, U.P.; Gupta, R.; Gutierrez, L.; Gwee, X.; Haghshenas, R.; Hakimi, H.; Hambleton, I.R.; Hamzeh, B.; Hanekom, W.A.; Hange, D.; Hantunen, S.; Hao, J.; Hari Kumar, R.; Harooni, J.; Hashemi-Shahri, S.M.; Hata, J.; Heidemann, C.; Henrique, R.S.; Herrala, S.; Herzig, K.-H.; Heshmat, R.; Ho, S.Y.; Holdsworth, M.; Homayounfar, R.; Hopman, W.M.; Horimoto, A.R.V.R.; Hormiga, C.; Horta, B.L.; Houti, L.; Howitt, C.; Htay, T.T.; Htet, A.S.; Htike, M.M.T.; Huerta, J.M.; Huhtaniemi, I.T.; Huisman, M.; Husseini, A.; Huybrechts, I.; Iacoviello, L.; Iakupova, E.M.; Iannone, A.G.; Ibrahim Wong, N.; Ijoma, C.; Irazola, V.E.; Ishida, T.; Isiguzo, G.C.; Islam, S.M.S.; Islek, D.; Ittermann, T.; Iwasaki, M.; Jääskeläinen, T.; Jacobs, J.M.; Jaddou, H.Y.; Jadoul, M.; Jallow, B.; James, K.; Jamil, K.M.; Janus, E.; Jarvelin, M.-R.; Jasienska, G.; Jelaković, A.; Jelaković, B.; Jennings, G.; Jha, A.K.; Jimenez, R.O.; Jöckel, K.-H.; Jokelainen, J.J.; Jonas, J.B.; Joshi, P.; Josipović, J.; Joukar, F.; Jóźwiak, J.; Kafatos, A.; Kajantie, E.O.; Kalmatayeva, Z.; Karki, K.B.; Katibeh, M.; Kauhanen, J.; Kazakbaeva, G.M.; Kaze, F.F.; Ke, C.; Keinänen-Kiukaanniemi, S.; Kelishadi, R.; Keramati, M.; Kersting, M.; Khader, Y.S.; Khaledifar, A.; Khalili, D.; Kheiri, B.; Kheradmand, M.; Khosravi, A.; Kiechl-Kohlendorfer, U.; Kiechl, S.J.; Kiechl, S.; Kingston, A.; Klakk, H.; Klanova, J.; Knoflach, M.; Kolsteren, P.; König, J.; Korpelainen, R.; Korrovits, P.; Kos, J.; Koskinen, S.; Kowlessur, S.; Koziel, S.; Kriemler, S.; Kristensen, P.L.; Kromhout, D.; Kubinova, R.; Kujala, U.M.; Kulimbet, M.; Kurjata, P.; Kyobutungi, C.; La, Q.N.; Labadarios, D.; Lachat, C.; Laid, Y.; Lall, L.; Lankila, T.; Lanska, V.; Lappas, G.; Larijani, B.; Latt, T.S.; Laurenzi, M.; Lehmann, N.; Lehtimäki, T.; Lemogoum, D.; Leung, G.M.; Li, Y.; Lima-Costa, M.F.; Lin, H.-H.; Lind, L.; Lissner, L.; Liu, X.; Lopez-Garcia, E.; Lopez, T.; Lozano, J.E.; Luksiene, D.; Lundqvist, A.; Lunet, N.; Lustigová, M.; Machado-Coelho, G.L.L.; Machado-Rodrigues, A.M.; Macia, E.; Macieira, L.M.; Madar, A.A.; Maestre, G.E.; Maggi, S.; Magliano, D.J.; Magriplis, E.; Mahasampath, G.; Maire, B.; Makdisse, M.; Malekpour, M.-R.; Malekzadeh, F.; Malekzadeh, R.; Mallikharjuna Rao, K.; Malyutina, S.; Maniego, L.V.; Manios, Y.; Mannix, M.I.; Mansour-Ghanaei, F.; Manzato, E.; Margozzini, P.; Mariño, J.; Marques, L.P.; Martorell, R.; Mascarenhas, L.P.; Masinaei, M.; Mathiesen, E.B.; Matsha, T.E.; Mc Donald Posso, A.J.; McFarlane, S.R.; McGarvey, S.T.; Mediene Benchekor, S.; Mehlig, K.; Mehrparvar, A.H.; Melgarejo, J.D.; Méndez, F.; Menezes, A.M.B.; Mereke, A.; Meshram, I.I.; Meto, D.T.; Minderico, C.S.; Mini, G.K.; Miquel, J.F.; Miranda, J. 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Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29–39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance.
2023-01-01T00:00:00Z