RESUMEN Introducción. La escasez de investigación en la formación en Administración y Gestión en Salud (AyGS), junto con la necesidad de fortalecer los programas de residencia, fundamentó este estudio. Objetivo. Describir la oferta de vacantes y los planes curriculares del residentado en AyGS en Perú. Métodos. Estudio observacional, descriptivo y retrospectivo. Se revisó el número de plazas ofertadas y adjudicadas entre 2013 y 2022 en la web del Consejo Nacional de Residentado Médico (CONAREME). Además, se analizaron los planes curriculares actualizados al 2022, identificando los logros mínimos por año académico y comparándolos con los estándares aprobados por CONAREME. Resultados. Entre 2013 y 2022, se identificaron nueve universidades que ofrecieron el programa de residentado en AyGS, seis de ellas ubicadas en Lima. La adjudicación de plazas libres mostró una tendencia mayor, alcanzando el 100% en cuatro de los diez años analizados, mientras que el porcentaje máximo de adjudicación para plazas cautivas fue de 78%. En cuanto a los planes curriculares, seis de los ocho disponibles en 2022 incluían información sobre logros mínimos, y describieron los cursos que deben llevar los residentes. Conclusión. No se observaron cambios en el número total de vacantes ofertadas para el programa en AyGS. Tres universidades en Lima concentran más del 50% de la oferta del programa. Los planes curriculares muestran similitudes entre las universidades que lo ofrecen.

ABSTRACT Introduction. The lack of research in Health Administration and Management (AyGS) training, along with the need to improve residency programs, motivated this study. Objective. We described the availability of offered positions and curriculum plans for AyGS residency programs in Peru. Methods. Descriptive observational study. We reviewed the number of positions offered and awarded between 2013 and 2022 on the National Medical Residency Council (CONAREME) website. Additionally, we analyzed curriculum plans updated to 2022, identifying minimum achievements per academic year and comparing them with CONAREME standards. Results. Between 2013 and 2022, nine universities offered the AyGS residency program, with six located in Lima. The allocation of open vacancies showed a higher trend, reaching 100% in four of the ten years analyzed, while the highest allocation percentage for captive positions was 78%. Regarding the curriculum plans, six of the eight available in 2022 provided information on minimum achievements and described the courses that residents must take. Conclusion. There were no changes in the total number of positions offered for the AyGS program. Three universities in Lima concentrate more than 50% of the program offerings. The curriculum plans show similarities across the universities offering the program.

Abstract Objectives: to assess the association between mothers age and the presence of acute respiratory infections (ARIs) and acute diarrhea (AD) in Peruvian children under five years old. Methods: secondary analysis of the database of the “Demographic and Family Health Survey” of 2015 and 2019. We analyzed data from children under five and their reproductive-age mothers who live in the same household. Poisson regression models were used to generate adjusted prevalence ratios (aPR) with 95% confidence intervals (95%CI) to assess the association between mothers’ age group and the presence of ARIs and AD in their children. Results: 84,671 mother/child data were analyzed. In the adjusted regression model, being a young mother (aPR= 1.18; 95%CI= 1.11-1.25; p<0.001) or an teenage (aPR= 1.11; 95%CI= 1.01-1.22; p=0.045) were associated with a higher prevalence of ARIs in their children. In addition, being a young mother a teenage (aPR= 1.18; 95%CI= 1.11-1.25; p<0.001) or a teenage (aPR= 1.22; 95%CI= 1.10-1.35; p<0.001) were also associated with a higher prevalence of AD cases in their children. Conclusions: mothers’ age was found to be associated with the prevalence of ARIs and AD in Peruvian children under five, with teenagers and young mothers having the greatest probability of ARIs and AD.

Resumen Objetivos: evaluar la asociación entre la edad materna y la presencia de infecciones respiratorias agudas (IRAs) y enfermedades diarreicas agudas (EDAs) en niños peruanos menores de cinco años. Métodos: análisis secundario de la base de datos de la “Encuesta Demográfica y de Salud Familiar” de 2015 y 2019. Se analizaron datos de niños menores de cinco años y sus madres en edad reproductiva que viven en el mismo hogar. Se utilizaron modelos de regresión de Poisson para calcular razones de prevalencia ajustadas (RPa) con sus intervalos de confianza del 95% (IC95%) para evaluar la asociación entre el grupo de edad de las madres y la presencia de IRAs y EDAs en sus hijos. Resultados: se analizaron 84,671 datos madre/hijo. En el modelo de regresión ajustado, ser madre joven (RPa= 1,18; IC95%= 1,11-1,25; p<0,001) o adolescente (RPa= 1,11; IC95%= 1,01-1,22; p=0,045) se asoció con una mayor prevalencia de IRAs en sus hijos. Además, ser madre joven (RPa= 1,18; IC95%= 1,11-1,25; p<0,001) o adolescente RPa= 1,22; IC95%= 1,10-1,35; p<0,001 también se asoció con una mayor prevalencia de EDAs en sus hijos. Conclusiones: la edad de las madres se asoció con la prevalencia de IRAs y EDAs en niños peruanos menores de cinco años, siendo las madres adolescentes y jóvenes las que presentaron mayor probabilidad de IRAs y EDAs.

RESUMEN Objetivos. Determinar la asociación entre el grado de severidad de la infección por COVID-19 durante el embarazo y la rotura prematura de membranas pretérmino (RPMP) en un hospital nivel III de Perú. Materiales y Métodos. Estudio transversal, analítico y observacional en mujeres mayores de 18 años con diagnóstico de infección por COVID-19 en el embarazo durante el 2020-2022. Se recogieron variables clínicas y obstétricas. Para el análisis descriptivo se realizaron las pruebas de Chi Cuadrado y exacta de Fisher, y para el análisis multivariado, se calculó la razón de prevalencia mediante regresión de Poisson en modelos crudos y ajustados. Todas las pruebas estadísticas se realizaron considerando un valor de p<0,05 como significativo y con un nivel de confianza de 95%. Resultados. Se analizaron los datos de 163 gestantes con COVID-19, de las cuales el 9,2% tuvieron RPMP, todas fueron casos sintomáticos. Los casos leves de COVID-19 tuvieron 1,10 veces la probabilidad de presentar RPMP (RPa=1,10; IC95%: 1,02−1,18) y los casos moderados/severos tuvieron 1,64 veces esta probabilidad (RPa=1,64; IC95%: 1,43−1,87), en comparación con los casos asintomáticos. Conclusiones. Se identificó que un mayor grado de severidad de la infección por COVID-19 durante el embarazo se asoció a una mayor probabilidad de tener RPMP.

ABSTRACT Objectives. To determine the association between the degree of severity of COVID-19 infection during pregnancy and preterm premature rupture of membranes (PPROM) in a level III hospital in Peru. Materials and Methods. Cross-sectional, analytical and observational study in women older than 18 years diagnosed with COVID-19 infection during pregnancy, between the years 2020 and 2022. Clinical and obstetric variables were collected. The chi-square and Fisher’s exact tests were used for the descriptive analysis. For the multivariate analysis, we calculated the prevalence ratio by using Poisson regression in crude and adjusted models. All statistical tests were performed considering a value of p<0.05 as significant and with a confidence level of 95%. Results. We analyzed data from 163 pregnant women with COVID-19, of which 9.2% had PPROM; all were symptomatic cases. Mild COVID-19 cases were 1.10 times more likely to have PPROM (RPa=1.10; 95%CI: 1.02-1.18) and moderate/severe cases were 1.64 times more likely (RPa=1.64; 95%CI: 1.43-1.87), compared to asymptomatic cases. Conclusions. We identified that a higher degree of severity of COVID-19 infection during pregnancy was associated with a higher probability of having PPROM.

RESUMEN Objetivos. Determinar la asociación entre el grado de severidad de la infección por COVID-19 durante el embarazo y la rotura prematura de membranas pretérmino (RPMP) en un hospital nivel III de Perú. Materiales y Métodos. Estudio transversal, analítico y observacional en mujeres mayores de 18 años con diagnóstico de infección por COVID-19 en el embarazo durante el 2020-2022. Se recogieron variables clínicas y obstétricas. Para el análisis descriptivo se realizaron las pruebas de Chi Cuadrado y exacta de Fisher, y para el análisis multivariado, se calculó la razón de prevalencia mediante regresión de Poisson en modelos crudos y ajustados. Todas las pruebas estadísticas se realizaron considerando un valor de p<0,05 como significativo y con un nivel de confianza de 95%. Resultados. Se analizaron los datos de 163 gestantes con COVID-19, de las cuales el 9,2% tuvieron RPMP, todas fueron casos sintomáticos. Los casos leves de COVID-19 tuvieron 1,10 veces la probabilidad de presentar RPMP (RPa=1,10; IC95%: 1,02−1,18) y los casos moderados/severos tuvieron 1,64 veces esta probabilidad (RPa=1,64; IC95%: 1,43−1,87), en comparación con los casos asintomáticos. Conclusiones. Se identificó que un mayor grado de severidad de la infección por COVID-19 durante el embarazo se asoció a una mayor probabilidad de tener RPMP.

ABSTRACT Objectives. To determine the association between the degree of severity of COVID-19 infection during pregnancy and preterm premature rupture of membranes (PPROM) in a level III hospital in Peru. Materials and Methods. Cross-sectional, analytical and observational study in women older than 18 years diagnosed with COVID-19 infection during pregnancy, between the years 2020 and 2022. Clinical and obstetric variables were collected. The chi-square and Fisher’s exact tests were used for the descriptive analysis. For the multivariate analysis, we calculated the prevalence ratio by using Poisson regression in crude and adjusted models. All statistical tests were performed considering a value of p<0.05 as significant and with a confidence level of 95%. Results. We analyzed data from 163 pregnant women with COVID-19, of which 9.2% had PPROM; all were symptomatic cases. Mild COVID-19 cases were 1.10 times more likely to have PPROM (RPa=1.10; 95%CI: 1.02-1.18) and moderate/severe cases were 1.64 times more likely (RPa=1.64; 95%CI: 1.43-1.87), compared to asymptomatic cases. Conclusions. We identified that a higher degree of severity of COVID-19 infection during pregnancy was associated with a higher probability of having PPROM.

Resumen Introducción. Los cursos en línea, masivos y abiertos, brindan la oportunidad de formar profesionales e investigadores en Latinoamérica sobre salud global. Objetivos. Determinar la oferta global de los cursos en línea, masivos y abiertos, sobre salud global y conocer las características de su contenido. Materiales y métodos. Se examinaron las plataformas especializadas en cursos en línea, masivos y abiertos, para recopilar aquellos sobre salud global. La búsqueda no tuvo restricción de tiempo y se realizó por última vez en noviembre de 2021. La estrategia de búsqueda solo incluyó el descriptor “global health”. Posteriormente, se obtuvieron las características del curso, su contenido y el dominio abordado de salud global. Estos datos fueron analizados descriptivamente, y se reportaron frecuencias absolutas y relativas. Resultados. La estrategia de búsqueda identificó 4.724 cursos en línea, masivos y abiertos. De ellos, solo 92 estaban relacionados con salud global. La mayoría de estos cursos (n=44; 47,8 %) se ofrecieron mediante la plataforma Coursera. Más de la mitad de los cursos (n=50; 54,4 %) fueron realizados por instituciones de Estados Unidos y en idioma inglés (n=90; 97,8 %). La mayor parte de los cursos se centró en la “globalización de la salud y la asistencia sanitaria” (n=24; 26,1 %), seguido de los dominios “fortalecimiento de capacidades” (n=16; 17,4 %), “carga global de enfermedad” y “determinantes sociales y ambientales de la salud” (n=15; 16,3 %). Conclusiones. Se encontró una importante oferta de cursos en línea, masivos y abiertos, sobre salud global. Estos cursos abordaron las competencias de la salud global que se requieren para los profesionales sanitarios.

Abstract Introduction. Massive open online courses provide the opportunity to train health professionals and researchers from Latin America in global health. Objective. To determine the global offer of massive open online courses in global health and the characteristics of their content. Material and methods. We examined massive open online course platforms to compile the global health offerings. The search had no time restriction and was last conducted in November, 2021. The search strategy only included the descriptor “global health”. We obtained the characteristics of the courses, their content, and the global health domain covered. These data were analyzed using descriptive statistics, reporting absolute and relative frequencies. Results. Our search strategy identified 4,724 massive open online courses. Of these, only 92 were related to global health. Most of these courses (n=44; 47.8%) were offered through Coursera. More than half (n=50; 54.4%) of the MOOCs were conducted by U.S.A. institutions and in English language (n=90; 97.8%). Most courses focused on “globalization of health and healthcare” (n=24; 26.1%), followed by the domains “capacity building” (n=16; 17.4%), “global burden of disease” and “social and environmental determinants of health” (n=15; 16.3%). Conclusions. We found a high offer of massive open online courses on global health. These courses covered the global health competencies required for health professionals.

RESUMEN Introducción: En Perú, las empresas mineras debían registrar e implementar el plan para la vigilancia, prevención y control de la COVID-19 en el trabajo (requerido por el Ministerio de Salud), previo al reinicio de actividades suspendidas debido a la pandemia. Objetivo: Describir el estado situacional de los planes para la vigilancia, prevención y control de la COVID-19 en el trabajo del sector minero (1ra y 2da fase de reactivación económica, 2020). Métodos: Se realizó un estudio transversal de la base de datos del sistema SISCOVID-Empresas. Se reportaron frecuencias y proporciones de las características de los planes (región de procedencia, número de trabajadores, número de profesionales de salud, existencia de comité o supervisor de seguridad y salud en el trabajo, estado de registro y reporte de presupuesto) según el número de trabajadores de la empresa. Resultados: Se revisaron 2 236 registros de planes. El 6,2 % indica no contar con supervisor o comité de seguridad y salud en el trabajo y el 71,5 % no cuenta con profesional de la salud. El 81,2 % de las empresas con más de 500 trabajadores contaban con profesionales de medicina y enfermería. El 89,2 % de las empresas con 1 a 20 trabajadores no contaban con profesionales de la salud. Conclusiones: Tres de cada 4 empresas del sector minero incumplen lo requerido en el plan para la vigilancia, prevención y control de la COVID-19 en el trabajo.

ABSTRACT Introduction: In Peru, mining companies had to register and implement the Plan for the surveillance, prevention, and control of COVID-19 at work (requested by the Ministry of Health), prior to restarting activities suspended due to the pandemic. Objective: To describe the situational status of the plans for the surveillance, prevention, and control of COVID-19 at work in the mining sector (1st and 2nd phases of economic reactivation, 2020). Methods: A cross-sectional study was carried out of the database from the SISCOVID- Empresas system. Frequencies and proportions of the characteristics of the plans were reported (region of origin, number of workers, number of health professionals, existence of an occupational health and safety committee or supervisor, status of registration and budget report) according to the number of company workers. Results: In total 2,236 plan records were reviewed. Of the total, 6.2% of the registered plans indicate that they do not have an occupational health and safety supervisor or committee, and 71.5% do not have a health professional. Furthermore, 81.2% of the companies with more than 500 workers had medicine and nursing professionals, and 89.2% of companies with 1 to 20 workers did not have health professionals. Conclusions: Three out of 4 companies in the mining sector fail to comply with the requirements of the plan for the surveillance, prevention, and control of COVID-19 at work.

RESUMO Objetivo: Determinar a associação entre o diabetes mellitus tipo 2 e catarata em adultos peruanos com mais de 50 anos de idade. Métodos: Estudo analítico observacional transversal correspondente à análise secundária da base de dados do Encuesta Demográfica y de Salud Familiar de 2019. O diabetes mellitus tipo 2 foi considerado variável independente e a catarata, variável dependente. Foi realizada uma análise descritiva utilizando frequências absolutas e proporções ponderadas, bem como uma análise multivariada, usando modelos lineares generalizados da família Poisson com função de ligação logarítmica para estimar razões de prevalência sobre a associação entre o diabetes e a catarata. Resultados: Foram analisados dados de 8.775 adultos peruanos com mais de 50 anos de idade, dos quais 1.322 autorrelataram diagnóstico de catarata. Do total de inquiridos, 9,2% relataram ter sido diagnosticados com diabetes mellitus e 16,7%, com cataratas. O modelo bruto (p<0,001), o modelo ajustado 1 (p=0,007) e o modelo ajustado 2 (p=0,029) encontraram associação entre ter diabetes mellitus e ter catarata. Conclusão: Dois em cada dez adultos com 50 anos de idade ou mais no Peru tinham catarata. Houve associação entre ter diabetes e a presença de catarata na população peruana. Objetivo 5 Métodos 2019 dependente ponderadas multivariada Resultados 8775 8 775 8.77 1322 322 1.32 inquiridos 92 9 9,2 167 16 7 16,7% cataratas p<0,001, p0001 p p<0,001 , 0 001 (p<0,001) p=0,007 p0007 007 (p=0,007 p=0,029 p0029 029 (p=0,029 Conclusão peruana 201 877 77 8.7 132 32 1.3 9, 16,7 p000 p<0,00 00 (p<0,001 p=0,00 (p=0,00 p=0,02 p002 02 (p=0,02 20 87 8. 13 3 1. 16, p00 p<0,0 (p<0,00 p=0,0 (p=0,0 p0 p<0, (p<0,0 p=0, (p=0, p<0 (p<0, p=0 (p=0 p< (p<0 p= (p= (p< (p

ABSTRACT Objective: To determine the association between type 2 diabetes mellitus and cataracts in Peruvian adults over 50 years of age. Methods: Cross-sectional analytical observational study corresponding to the secondary analysis of the 2019 Encuesta Demográfica y de Salud Familiar database. Type 2 diabetes mellitus was considered an independent variable and cataract as a dependent variable. A descriptive analysis was performed using absolute frequencies and weighted proportions, as well as a multivariate analysis using generalized linear models of the Poisson family with logarithmic link function to estimate prevalence ratios on the association between diabetes and cataracts. Results: Data from a total of 8,775 Peruvian adults over 50 years of age were analyzed, of whom 1,322 self-reported a diagnosis of cataract. Of the total respondents, 9.2% reported having been diagnosed with diabetes mellitus and 16.7% with cataracts. The crude model (p<0.001) and the adjusted models 1 (p=0.007) and 2 (p=0.029) found an association between having diabetes mellitus and having cataracts. Conclusion: Two out of ten adults aged 50 years old and older in Peru had cataracts. There was an association between having diabetes and the presence of cataracts in the Peruvian population. Objective 5 Methods Crosssectional Cross sectional 201 database proportions Results 8775 8 775 8,77 analyzed 1322 322 1,32 selfreported self respondents 92 9 9.2 167 16 7 16.7 p<0.001 p0001 p 0 001 (p<0.001 p=0.007 p0007 007 (p=0.007 p=0.029 p0029 029 (p=0.029 Conclusion population 20 877 77 8,7 132 32 1,3 9. 16. p<0.00 p000 00 (p<0.00 p=0.00 (p=0.00 p=0.02 p002 02 (p=0.02 87 8, 13 3 1, p<0.0 p00 (p<0.0 p=0.0 (p=0.0 p<0. p0 (p<0. p=0. (p=0. p<0 (p<0 p=0 (p=0 p< (p< p= (p= (p

Abstract Objective To determine the association between fetal macrosomia (FM) and postpartum hemorrhage (PPH) in Latin American and Caribbean (LAC) women. Data Sources Studies evaluating the association between FM and PPH (≥ 500 ml) and severe PPH (≥ 1,000 ml) until November 4, 2021, indexed in CINHAL, Scopus, Embase, Cochrane Library, MEDLINE, LILACS, and SciELO. Selection of Studies Inclusion criteria were cohort and case-control studies that provided the number of PPH and FM cases. Exclusion criteria were studies lacking information about the number of cases, with a population of women who were not from LAC; published in a language other than English, Spanish, or Portuguese, and with a different design. Data Collection Data extraction was performed independently by two authors, and discrepancies were resolved with a third author. Data regarding FM and PPH cases were retrieved. Data Synthesis Of the 1,044 articles evaluated, 5 studies were included, from 6 different countries: Argentina and Uruguay (multi-country), West Indies, Antigua and Barbuda, French Guyana, and Suriname. The pooled odds ratio (OR) for FM and PPH in the meta-analysis (five studies) was 2.10 (95% confidence interval [CI]: 1.79–2.47; I2: 0%), with estimates within this 95% CI in the sensitivity analysis. The combined OR for severe PPH (3 studies) was 1.61 (95% CI: 0.40–6.48; I2: 91.89%), showing high heterogeneity. Conclusion There was a positive association between FM and PPH in the LAC, increasing the risk of the presence of this event 2-fold. The high heterogeneity of the studies that measured severe PPH does not allow drawing conclusions about the estimates obtained.

Resumo Objetivo Determinar a associação entre macrossomia fetal (FM) e hemorragia pós-parto (HPP) em mulheres da América Latina e Caribe (ALC). Fontes de dados Estudos avaliando a associação entre FM e HPP (≥ 500 ml) e HPP grave (≥ 1.000 ml) até 4 de novembro de 2021, indexados no CINHAL, Scopus, Embase, Biblioteca Cochrane, MEDLINE, LILACS e SciELO. Seleção de estudos Os critérios de inclusão foram estudos de corte e caso-controle que forneceram o número de casos de HPP e FM. Os critérios de exclusão foram estudos sem informação sobre o número de casos, com uma população de mulheres que não eram da ALC; publicado em um idioma diferente do inglês, espanhol ou português e com um design diferente. Coleta de dados A extração de dados foi realizada independentemente por dois autores, as discrepâncias foram resolvidas com um terceiro autor. Os dados relativos aos casos de FM e HPP foram recuperados. Síntese dos dados Dos 1.044 artigos avaliados, foram incluídos 5 estudos, de 6 países diferentes: Argentina e Uruguai (multipaíses), Índias Ocidentais, Antígua e Barbuda, Guiana Francesa e Suriname. O odds ratio agrupado (OR) para FM e HPP na meta-análise (cinco estudos) foi de 2,10 (intervalo de confiança de 95% [IC]: 1,79–2,47; I2: 0%), com estimativas dentro deste IC de 95% no análise sensitiva. O OR combinado para HPP grave (3 estudos) foi de 1,61 (95% CI: 0.40–6.48; I2: 91.89%), mostrando alta heterogeneidade. Conclusão Houve associação positiva entre FM e HPP na ALC, aumentando em 2 vezes o risco da presença desse evento. A alta heterogeneidade dos estudos que mediram a HPP grave não permite tirar conclusões sobre as estimativas obtidas.

We aimed to estimate the prevalence and factors associated with parents’ non-intention to vaccinate their children and adolescents against COVID-19 in Colombia and Peru. We performed a secondary analysis using a database generated by the University of Maryland and Facebook (Facebook, Inc). We included adult (18 and over) Facebook users residing in LAC who responded to the survey between May 20, and November 5, 2021. We included sociodemographic characteristics, comorbidities, mental health, economic and food insecurity, compliance with mitigation strategies against COVID-19, and practices related to vaccination against this disease. We estimated crude (cPR) and adjusted (aPR) prevalence ratios with their respective 95%CI. We analyzed a sample of 44,678 adults from Colombia and 24,302 from Peru. The prevalence of parents' non-intention to vaccinate their children and adolescents against COVID-19 was 7.41% (n=3,274) for Colombia and 6.64% (n=1,464) for Peru. In Colombia, age above 35 years old, compliance with physical distancing, use of masks, having economic insecurity, anxiety symptoms, having a chronic condition or more comorbidities, and being vaccinated were associated with a lower prevalence of non-intention to vaccinate children and adolescents against COVID-19. In Peru, gender, compliance with physical distancing, use of masks, having economic insecurity, anxiety symptoms, having a chronic condition or more comorbidities, having had COVID-19, and being vaccinated were associated with a higher probability of vaccinating children against COVID-19. Living in a town, a village, or a rural area was associated with a higher prevalence of non-intention to vaccinate children and adolescents against COVID-19. About 9 out of 10 parents in Colombia and Peru intend to vaccinate their children and adolescents against COVID-19. This intention is associated with some factors which are similar between the two countries, as well as other factors and variations among the different regions of each country.

RESUMEN Objetivo: Evaluar los factores asociados a un resultado de citología cervical positiva en la prueba de Papanicolau en una muestra de mujeres peruanas en Lima, Perú - 2013. Material y métodos: Se realizó un estudio transversal analítico que incluyó a mujeres con edades entre 21 a 64 años y empleó la prueba de Papanicolaou para evaluar la citología cervical. Se incluyó factores sociodemográficos y antecedentes de la mujer obtenidos de la historia clínica de las pacientes. Se realizaron modelos lineales generalizados de familia Poisson con varianzas robustas para evaluar los factores asociados a la citología positiva. La medida de asociación reportada fue la razón de prevalencia (RP) con sus respectivos intervalos de confianza al 95% (IC95%). Resultados: Se incluyeron a 11110 mujeres en el análisis con una edad media de 41,5±10,9 años y la prevalencia de un resultado positivo en la prueba de Papanicolau fue de 2,8%. En el modelo ajustado, se halló que tener entre 21 a 30 años (RPa=1,97;IC95%:1,30-3,00), 31 a 40 años (RPa=2,56;IC95%:1,76-3,72) y 41 a 50 años (RPa=2,16;IC95%:1,47-3,17), ser soltera (RPa=1,41;IC95%:1,10-1,83), viuda o divorciada (RPa=1,90;IC95%:1,27-2,87), haber tenido inicio de vida sexual antes de los 16 años (RPa=1,30;IC95%:1,01-1,68) o entre los 16 a 19 años (RPa=1,69;IC95%:1,22-2,36) se asoció a una mayor probabilidad de presentar un resultado de citología cervical positivo. Conclusiones: El cáncer de cuello uterino representa un problema de salud pública en Perú, por lo que identificar sus factores asociados es útil para mejorar las estrategias de tamizaje, priorizando grupos de mayor riesgo.

ABSTRACT Objective: To evaluate the factors associated with a positive cervical cytology result in the Pap smear test in a sample of Peruvian women from Lima, Peru - 2013. Methods: We conducted an analytical cross-sectional study including women from 21 to 64 years and we used the Pap smear test to evaluate cervical cytology. We included sociodemographic and medical history variables obtained from medical records of the patients. We elaborated generalized linear models from Poisson family with robust variances to evaluate the factors associated with positive cytology. The association measure reported was the prevalence ratio (PR) with their respective 95% confidence intervals (95%CI). Results: We analyzed 11110 women with a mean age of 41.5 ± 10.9 years and a prevalence of a positive Pap smear test of 2.8%. In the adjusted model, we found that women between 21 and 30 years old (aPR=1.97; 95%CI:1.30-3.00), 31 to 40 years (aPR=2.56; 95%CI:1.76 -3.72) and 41 to 50 years (aPR=2.16; 95%CI:1.47-3.17), single (aPR=1.41; 95%CI:1.10-1.83), widowed or divorced (aPR=1.90; 95%CI:1.27-2.87), with a sexual life onset before 16 years (aPR=1.30; 95%CI:1.01- 1.68) or between 16 and 19 years (aPR=1.69; 95%CI:1.22-2.36) had a greater prevalence of a positive cervical cytology result. Conclusions: Cervical cancer is a public health problem in Peru, then, identifying the factors associated will allow us to improve screening strategies and prioritize groups at higher risk.

RESUMEN Las mujeres están subrepresentadas en la producción científica. Diversos estudios demuestran que las mujeres tienen menor participación en la autoría de artículos científicos. El objetivo del presente estudio fue determinar si el sexo se asocia con el impacto académico en investigadores de países latinoamericanos. Para esto se comparó el índice h y el número de citas. Se realizó un estudio bibliométrico con datos de la página Webometrics Ranking of World Universities que publica periódicamente “ránquines” de investigadores según sus perfiles en Google Académico. Se revisaron los 150 primeros puestos de 12 países de Latinoamérica y se evaluaron las diferencias en el impacto académico según el sexo. De un total de 1 750 investigadores, solo el 17,3 % (303) fueron mujeres. De los 12 países analizados, la mayoría (ocho) no presentó diferencias significativas en el impacto académico según el sexo y solo cuatro presentaron estas diferencias, aunque con un tamaño del efecto pequeño (r < 0,3). Menos de la quinta parte de los investigadores considerados en la muestra fueron mujeres; sin embargo, en la mayoría de los países el impacto académico de las mujeres resultó ser similar y en algunos casos superior al de sus homólogos masculinos.

ABSTRACT Women are underrepresented in scientific production. Several studies show that women have less participation in the authorship of scientific articles. The objective of the present study was to determine if sex is associated with academic impact in researchers of Latin American countries. A comparison between the h-index and the number of citations was carried out. A bibliometric study was conducted with data from the Webometrics Ranking of World Universities page that periodically publishes rankings of researchers according to their profiles in Google Scholar. The first 150 positions from 12 Latin American countries were reviewed and the differences in academic impact according to sex were evaluated. Of a total 1 750 researchers, only 17.3% (303) were women. Of the 12 countries analyzed, the majority (8) did not present significant differences in academic impact by sex and only four presented these differences, although with a small effect size (r < 0.3). Less than one-fifth of the researchers considered in the sample were women; however, in most countries the academic impact of women was similar and in some cases greater than that of their male counterparts.

RESUMEN Objetivos: Estimar la prevalencia y los factores asociados a la intención de vacunación (IDV) contra la COVID-19 en el Perú. Materiales y métodos: Estudio transversal analítico utilizando una encuesta realizada por la Universidad de Maryland, EUA, en Facebook. La variable dependiente fue la IDV. Se calcularon razones de prevalencia (RP) crudas y ajustadas, con sus intervalos de confianza al 95% (IC95%), mediante modelos lineales generalizados de la familia Poisson para evaluar la asociación de variables sociodemográficas, el cumplimiento de estrategias comunitarias de mitigación, los síntomas de la COVID-19, la salud mental y la aceptación de la vacunación ante la recomendación (AVR) por diversos actores y autoridades sanitarias. Resultados: Se analizaron los datos de 17 162 adultos. La prevalencia general de la IDV fue del 74,9%. Se asociaron a una menor prevalencia de la IDV ser de sexo femenino (RP=0,95; IC95%:0,94-0,97), vivir en un pueblo (RP=0,95; IC95%:0,91-0,99) o en una aldea u otra área rural (RP=0,90; IC95%:0,86-0,93) y la AVR de políticos (RP=0,89; IC95%: 0,87-0,92). Contrariamente, tener síntomas de COVID-19 (RP=1,06; IC95%:1,03-1,09), inseguridad económica (RP=1,04; IC95%: 1,01-1,06), miedo a enfermar o que un familiar enferme de COVID-19 (RP=1,49; IC95%: 1,36-1,64) y la AVR de familiares y amigos (RP=1,10; IC95%: 1,08-1,12), trabajadores de la salud (RP=1,29; IC95%: 1,26-1,32), la Organización Mundial de la Salud (RP=1,34; IC95%: 1,29-1,40) y funcionarios del gobierno (RP=1,18; IC95%: 1,15-1,22) se asociaron con mayor prevalencia de IDV. Conclusiones: Tres cuartas partes de los encuestados manifiestan IDV. Existen factores potencialmente modificables que podrían mejorar la aceptación de la vacuna.

ABSTRACT Objectives: To estimate the prevalence and factors associated with the intention to be vaccinated (ITV) against COVID-19 in Peru. Materials and methods: Analytical cross-sectional study using the survey conducted by the University of Maryland, USA, on Facebook. The dependent variable is the ITV. Crude and adjusted prevalence ratios (PR) were calculated, with their 95% confidence intervals (95% CI) using generalized linear models of the Poisson family, in order to evaluate the association of sociodemographic variables, compliance with community mitigation strategies, symptoms of COVID-19, mental health and acceptance of vaccination before the recommendation (AVR) by various actors and health authorities, with the ITV. Results: Data from 17,162 adults were analyzed. The overall prevalence of the ITV was 74.9%. A lower prevalence of the ITV was associated with the female sex (PR=0.95; 95% CI: 0.94-0.97), living in a town (PR=0.95; 95% CI: 0.91-0.99) or village or other rural area (PR=0.90; 95% CI: 0.86-0.93) and the AVR of politicians (PR=0.89; 95% CI: 0.87-0.92). Conversely, having COVID-19 symptoms (PR=1.06; 95% CI: 1.03-1.09), economic insecurity (PR=1.04; 95% CI: 1.01-1.06), fears of becoming seriously ill or that a family member becomes seriously ill from COVID-19 (PR=1.49; 95% CI: 1.36-1.64) and the AVR of family and friends (PR=1.10; 95% CI: 1.08-1.12), healthcare workers (PR=1.29; 95% CI: 1.26-1.32), World Health Organization (PR=1.34; 95% CI: 1.29-1.40) and government officials (PR=1.18; 95% CI: 1.15-1.22) was associated with a higher prevalence of the ITV. Conclusions: Three-quarters of the respondents had the ITV. There are potentially modifiable factors that could improve vaccine acceptance.

RESUMEN Objetivos: Estimar la prevalencia y los factores asociados a la intención de vacunación (IDV) contra la COVID-19 en el Perú. Materiales y métodos: Estudio transversal analítico utilizando una encuesta realizada por la Universidad de Maryland, EUA, en Facebook. La variable dependiente fue la IDV. Se calcularon razones de prevalencia (RP) crudas y ajustadas, con sus intervalos de confianza al 95% (IC95%), mediante modelos lineales generalizados de la familia Poisson para evaluar la asociación de variables sociodemográficas, el cumplimiento de estrategias comunitarias de mitigación, los síntomas de la COVID-19, la salud mental y la aceptación de la vacunación ante la recomendación (AVR) por diversos actores y autoridades sanitarias. Resultados: Se analizaron los datos de 17 162 adultos. La prevalencia general de la IDV fue del 74,9%. Se asociaron a una menor prevalencia de la IDV ser de sexo femenino (RP=0,95; IC95%:0,94-0,97), vivir en un pueblo (RP=0,95; IC95%:0,91-0,99) o en una aldea u otra área rural (RP=0,90; IC95%:0,86-0,93) y la AVR de políticos (RP=0,89; IC95%: 0,87-0,92). Contrariamente, tener síntomas de COVID-19 (RP=1,06; IC95%:1,03-1,09), inseguridad económica (RP=1,04; IC95%: 1,01-1,06), miedo a enfermar o que un familiar enferme de COVID-19 (RP=1,49; IC95%: 1,36-1,64) y la AVR de familiares y amigos (RP=1,10; IC95%: 1,08-1,12), trabajadores de la salud (RP=1,29; IC95%: 1,26-1,32), la Organización Mundial de la Salud (RP=1,34; IC95%: 1,29-1,40) y funcionarios del gobierno (RP=1,18; IC95%: 1,15-1,22) se asociaron con mayor prevalencia de IDV. Conclusiones: Tres cuartas partes de los encuestados manifiestan IDV. Existen factores potencialmente modificables que podrían mejorar la aceptación de la vacuna.

ABSTRACT Objectives: To estimate the prevalence and factors associated with the intention to be vaccinated (ITV) against COVID-19 in Peru. Materials and methods: Analytical cross-sectional study using the survey conducted by the University of Maryland, USA, on Facebook. The dependent variable is the ITV. Crude and adjusted prevalence ratios (PR) were calculated, with their 95% confidence intervals (95% CI) using generalized linear models of the Poisson family, in order to evaluate the association of sociodemographic variables, compliance with community mitigation strategies, symptoms of COVID-19, mental health and acceptance of vaccination before the recommendation (AVR) by various actors and health authorities, with the ITV. Results: Data from 17,162 adults were analyzed. The overall prevalence of the ITV was 74.9%. A lower prevalence of the ITV was associated with the female sex (PR=0.95; 95% CI: 0.94-0.97), living in a town (PR=0.95; 95% CI: 0.91-0.99) or village or other rural area (PR=0.90; 95% CI: 0.86-0.93) and the AVR of politicians (PR=0.89; 95% CI: 0.87-0.92). Conversely, having COVID-19 symptoms (PR=1.06; 95% CI: 1.03-1.09), economic insecurity (PR=1.04; 95% CI: 1.01-1.06), fears of becoming seriously ill or that a family member becomes seriously ill from COVID-19 (PR=1.49; 95% CI: 1.36-1.64) and the AVR of family and friends (PR=1.10; 95% CI: 1.08-1.12), healthcare workers (PR=1.29; 95% CI: 1.26-1.32), World Health Organization (PR=1.34; 95% CI: 1.29-1.40) and government officials (PR=1.18; 95% CI: 1.15-1.22) was associated with a higher prevalence of the ITV. Conclusions: Three-quarters of the respondents had the ITV. There are potentially modifiable factors that could improve vaccine acceptance.

Resumo Objetivo Determinar a adequação do cumprimento dos cuidados pré-natais (CPN) por mulheres grávidas no Peru e identificar os fatores associados. Métodos Foi realizado um estudo analítico transversal dos dados da Pesquisa Demográfica e de Saúde da Família Peruana de 2019 (Encuesta Demográfica y de Salud Familiar, ENDES, em espanhol). A variável dependente foi conformidade adequada coma CPN (fornecida por profissionais de saúde qualificados; primeira visita CPN durante o primeiro trimestre de gravidez; seis ou mais visitas CPN durante a gravidez; visitas CPN com conteúdo apropriado) por mulheres de 15 a 49 anos em seu último parto nos cinco anos anteriores à pesquisa. Os índices de prevalência bruta e ajustada e seus intervalos de confiança de 95% foram calculados usando um modelo de regressão log-binomial. Resultados Foi analisado um total de 18.386 mulheres, das quais 35,0% cumpriram adequadamente o CPN. A menor proporção de conformidade foi encontrada com o conteúdo de ANC (42,6%). Fatores sociodemográficos e aqueles relacionados à gravidez, como estar na faixa etária de 20 a 34 anos e 35 a 49 anos, ter educação secundária ou superior, pertencer a um quintil de riqueza da população que não a mais pobre, ser da região da selva, não ser de etnia nativa, ter um segundo ou terceiro gravidez, e tendo uma gravidez desejada, aumentou a probabilidade de apresentar conformidade adequada com CPN. Conclusão Apenas 3 em cada 10 mulheres no Peru mostraram conformidade adequada com o CPN. O cumprimento do conteúdo do CPN deve ser melhorado, e estratégias devem ser desenvolvidas para aumentar a proporção de cumprimento adequado com o CPN.

Abstract Objective To determine the adequacy of compliance with antenatal care (ANC) by pregnant women in Peru and to identify the associated factors. Methods An analytical cross-sectional study of data from the 2019 Peruvian Demographic and Family Health Survey (Encuesta Demográfica y de Salud Familiar, ENDES, in Spanish) was conducted. The dependent variable was adequate compliance with ANC (provided by skilled health care professionals; first ANC visit during the first trimester of pregnancy; six or more ANC visits during pregnancy; ANC visits with appropriate content) by women aged 15 to 49 years in their last delivery within the five years prior to the survey. Crude and adjusted prevalence ratios and their 95% confidence intervals were calculated using a log-binomial regression model. Results A total of 18,386 women were analyzed, 35.0% of whom adequately complied with ANC. The lowest proportion of compliance was found with the content of ANC (42.6%). Sociodemographic factors and those related to pregnancy, such as being in the age groups of 20 to 34 years and 35 to 49 years, havingsecondaryor higher education, belonging to a wealth quintile of the population other than the poorest, being from the Amazon region, not being of native ethnicity, having a second or third pregnancy, and having a desired pregnancy, increased the probability of presenting adequate compliance with ANC. Conclusion Only 3 out of 10women in Peru showed adequate compliancewith ANC. Compliance with the content of ANC must be improved, and strategies must be developed to increase the proportion of adequate compliance with ANC.

Objective: To determine the prevalence and factors associated with the intention to vaccinate (ITV) against COVID-19 in Peru. Material and methods: Analytical cross-sectional study using the survey conducted by the University of Maryland, USA, on Facebook. The dependent variables were ITV. Crude and adjusted prevalence ratios (PR) were calculated, with their 95% confidence intervals (95% CI) using generalized linear models of the Poisson family, to evaluate the association of sociodemographic variables, compliance with community mitigation strategies, symptoms of COVID-19, mental health and acceptance of vaccination before the recommendation (AVR) by various actors and health authorities, with the ITV. Results: Data from 17,162 adults were analyzed. The overall prevalence of ITV was 74.9%. A lower prevalence of IDV was associated with the female sex, living in a town or rural area and the AVR of politicians, PR=0.95 (95%CI:0.94-0.96), PR=0.95 (95%CI:0.91-0.99), PR=0.90 (95%CI:0.86-0.93) and PR=0.89 (95%CI:0.87-0.91); respectively. Conversely, having COVID-19 symptoms, economic insecurity, fear of a family member getting sick from COVID-19, depressive symptoms, and the AVR of family and friends, healthcare workers, world health organization and government officials partnered with higher prevalence of ITV, PR=1.05 (95%CI:1.03-1.08), PR=1.03 (95%CI:1.01-1.06), PR=1.48 (95%CI:1.35-1.63), PR = 1.03 (95%CI:1.01-1.06), PR=1.10 (95%CI: 1.08-1.12), PR = 1.29 (95%CI: 1.26-1.32), PR=1.34 (95%CI: 1.29-1.40) and PR=1.18 (95%CI: 1.15-1.21); respectively. Conclusion: Three-quarters of the respondents manifest ITV. There are potentially modifiable factors that could improve vaccine acceptance.

Objetivo: Determinar la prevalencia y factores asociados a la intención de vacunación (IDV) contra la COVID-19 en el Perú. Material y métodos: Estudio transversal analítico utilizando la encuesta realizada por Universidad de Maryland, EUA, en Facebook. Las variables dependientes fueron la IDV. Se calcularon razones de prevalencia (RP) crudas y ajustadas, con sus intervalos de confianza al 95% (IC95%), mediante modelos lineales generalizados de la familia Poisson, para evaluar la asociación de variables sociodemográficas, cumplimiento de estrategias comunitarias de mitigación, síntomas de COVID-19, salud mental y aceptación de la vacunación ante la recomendación (AVR) por diversos actores y autoridades sanitarias, con la IDV. Resultados: Se analizaron los datos de 17.162 adultos. La prevalencia general de IDV fue de 74,9%. Se asoció a menor prevalencia de IDV el sexo femenino, vivir en un pueblo o zona rural y la AVR de políticos, RP=0,95 (IC95%:0,94-0,96), RP=0,95 (IC95%:0,91-0,99), RP=0,90 (IC95%:0,86-0,93) y RP=0,89 (IC95%:0,87-0,91); respectivamente. Contrariamente, tener síntomas de COVID-19, inseguridad económica, miedo a que un familiar enferme de COVID-19, síntomas depresivos y la AVR de familiares y amigos, trabajadores de la salud, organización mundial de la salud y funcionarios del gobierno se asociaron con mayor prevalencia de IDV, RP=1,05 (IC95%:1,03-1,08), RP=1,03 (IC95%:1,01-1,06), RP=1,48 (IC95%:1,35-1,63), RP=1,03 (IC95%:1,01-1,06), RP=1,10 (IC95%:1,08-1,12), RP=1,29 (IC95%:1,26-1,32), RP=1,34 (IC95%:1,29-1,40) y RP=1,18 (IC95%:1,15-1,21); respectivamente. Conclusión: Tres cuartas partes de los encuestados manifiestan IDV. Existen factores potencialmente modificables que podrían mejorar la aceptación de la vacuna.

Objetivo: Determinar a prevalência e os fatores associados à intenção de vacinar (IDV) contra COVID-19 no Peru.Material e métodos: Estudo transversal analítico a partir de survey realizado pela University of Maryland, EUA, no Facebook. As variáveis ​​dependentes foram IDV. Foram calculadas razões de prevalência (RP) brutas e ajustadas, com seus intervalos de confiança de 95% (IC 95%), utilizando modelos lineares generalizados da família Poisson, para avaliar a associação de variáveis ​​sociodemográficas, adesão a estratégias de mitigação da comunidade, sintomas de COVID- 19, saúde mental e aceitação da vacinação antes da recomendação (AVR) por diversos atores e autoridades sanitárias, junto ao IDV.Resultados: Dados de 17.162 adultos foram analisados. A prevalência geral de IDV foi de 74,9%. A menor prevalência de IDV foi associada ao sexo feminino, residente em cidade ou zona rural e ao AVR de políticos, RP = 0,95 (IC95%: 0,94-0,96), RP = 0,95 (IC95%: 0,91-0,99) , RP = 0,90 (IC 95%: 0,86-0,93) e RP = 0,89 (IC 95%: 0,87-0,91); respectivamente. Por outro lado, ter sintomas de COVID-19, insegurança econômica, medo de um membro da família ficar doente por causa de COVID-19, sintomas depressivos e AVR de familiares e amigos, profissionais de saúde, organização mundial de saúde e funcionários do governo em parceria com maior prevalência de IDV, PR = 1,05 (IC 95%: 1,03-1,08), PR = 1,03 (IC 95%: 1,01-1,06), PR = 1,48 (IC 95%: 1,35-1,63), PR = 1,03 (IC 95%: 1,01-1,06 ), RP = 1,10 (IC 95%: 1,08-1,12), RP = 1,29 (IC 95%: 1,26-1,32), RP = 1,34 (IC 95%: 1,29-1,40) e RP = 1,18 (IC 95%: 1,15 -1,21); respectivamente.Conclusão: Três quartos dos entrevistados manifestam IDV. Existem fatores potencialmente modificáveis ​​que podem melhorar a aceitação da vacina.