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  • First report of Myroides phaeus bacteraemia identified by Polymerase chain reaction and genetic sequencing

    Pérez-Lazo, G.; Morales-Moreno, A.; Soto-Febres, F.; Jove-Químper, H.; Morales-Castillo, L.; Palomares-Reyes, C.; Del Valle-Mendoza, J.; Aguilar-Luis, M.; Silva-Caso, W. (lsevier Ltd, 2020-01-01)
    We report the first case of Myroides phaeus isolated from blood, causing bacteremia in an immunocompromised patient using the automated MicroScan Walk Away 96 system, followed by bacterial identification by amplification-sequencing of the 16S rDNA. The sequences obtained were compared with the reference sequence of the BLAST ® platform - National Library of Medicine, USA, and the isolation was identified as Myroides phaeus strain with 99.67 % identity in Blast report. In the literature we did not find previous reported cases of infections by this bacterium, however its pathogenic role is still controversial; therefore, this isolation alerts us to carry out an exhaustive surveillance of other possible acquisition routes.
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  • Gut microbiota in hospitalized children with acute infective gastroenteritis caused by virus or bacteria in a regional Peruvian hospital

    Taco-Masias, Andre Alonso; Fernandez-Aristi, Augusto R.; Cornejo-Tapia, Angela; Aguilar-Luis, Miguel Angel; Del Valle, Luis J.; Silva-Caso, Wilmer; Zavaleta-Gavidia, Victor; Weilg, Pablo; Cornejo-Pacherres, Hernán; Bazán-Mayra, Jorge; Puyen, Zully M.; del Valle-Mendoza, Juana (PeerJ Inc., 2020-11-03)
    Background. Acute infective gastroenteritis (AIG) is a leading cause of mortality in children worldwide. In Peru, more than 40% of cases of AIG occurring in children under 5 years old. The disruption of the gut microbiota can increase risk for several health complications especially in patients with gastric infections caused by viruses or bacteria. Objective. The main objective of this study was to describe the prevalence of 13 representative bacteria from the gut microbiota (GM) in stools samples from children under 5 years of age with acute infective gastroenteritis. Results. The most commonly isolated bacteria from the GM were Firmicutes (63.2% 74/117) Bacteriodetes (62.4%; 73/117), Lactobacillus (59.8%; 70/117), Prevotella (57.2%; 67/117), Proteobacterium (53.8%; 63/117), regardless of the etiological agent responsible for the AIG. Interestingly, despite the high prevalence of Firmicutes, Bacteroidetes, Lactobacillus and Prevotella across all samples, a visible reduction of these agents was observed especially among patients with a single bacterial infection or even bacteria–bacteria coinfections when compared to viral etiologies. Patients with exclusive or mixed breastfeeding registered the highest amount of gut microbiota bacteria, in contrast to infants who received formula or were not breastfed.
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  • Coronal microleakage according to the temporary restorative materials used in endodontic treatment

    Prado, Luisa Stephanie Nohelya Junes; Garcia, Stefany Caballero; Salazar, Carolina Barragán; Soto, Néstor Gonzales (Editorial Ciencias Medicas, 2020-04-01)
    Introduction: Coronal microleakage caused by temporary restorative materials is viewed as one of the reasons for endodontic failure. Efforts have been made in recent years to create a temporary restorative material capable of preventing that problem. Objective: Compare in vitro coronal microleakage of an "experimental cement" and four temporary restorative materials used in endodontics. Methods: Class I cavities were made in 90 premolar teeth divided into 10 groups (n= 9) and evaluated at two time periods (1 and 2 weeks). The "experimental cement" was prepared and then coronal sealing of the teeth was performed with the experimental Cement, F (VOCO), Eugenato (MOYCO), Ketac™ Molar Easymix 3M (ESPE) and Coltosol® F. The pieces were submerged in India ink (Pelikan)for 1 and 2 weeks. Microleakage was evaluated on the interface dentin wall / temporary restoration using a stereo microscope (Leica Microsystems LAS EZ version 2.0.0). Measurement was made in millimeters using the software LAS EZ version 2.0.0. Results: Statistically significant differences were found (p< 0.05) when comparing coronal microleakage in the five temporary restorative materials according to exposure time in ink (1 and 2 weeks). Conclusions: The experimental cement had less microleakage than Coltosol® F and Ketac™ Molar EasyMix 3M (ESPE). However, none of the four materials was capable of completely preventing microleakage.
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  • Comment about the article: «Understanding of different front-of-package labels by the Spanish population: Results of a comparative study»

    Grados-Jares, Manuel D.; Munoz-Denegri, Viviana M.; Medina-Pizzali, Maria L. (Elsevier Doyma, 2020-08-01)
    Carta al editor.
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  • Prevalence of venous thromboembolism in admissions and readmissions with and without syncope: A nationwide cohort study

    Kadri, Amer N.; Zawit, Misam; Al-Adham, Raed; Hader, Ismail; Nusairat, Leen; Almahmoud, Mohamed F.; Senussi, Mourad; Altibi, Ahmed; Barakat, Amr; Hernandez, Adrian V.; Masri, Ahmad (Oxford University Press, 2021-01-01)
    Aims: The Pulmonary Embolism in Syncope Italian Trial reported 17.3% prevalence of pulmonary embolism (PE) in patients admitted with syncope. We investigated the prevalence of venous thromboembolism [VTE, including PE and deep vein thrombosis (DVT)] in syncope vs. non-syncope admissions and readmissions, and if syncope is an independent predictor of VTE. Methods and results: We conducted an observational study of index admissions of the 2013-14 Nationwide Readmission Database.
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  • Comments on: "Family life stories in teenage mothers: Qualitative study conducted at the Engativá ESE Hospital in Bogotá, Colombia"

    Rodríguez-Soto, Karen; Reyes-Aranibar, Sara; Uribe-Chincha, Tula; Torres-Slimming, Paola (NLM (Medline), 2020-06-01)
    Carta al editor.
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  • Perception about chagas disease and the risk of oral transmission in Andoas, Loreto, Peru

    Cabrera, Rufino; Valderrama, Yadira; Meza, Juan Ramón (Instituto Nacional de Salud, 2020-01-01)
    Carta al editor.
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  • Let’s Talk About Sex: The Impact of Partnership Contexts on Communication About HIV Serostatus and Condom Use Among Men Who Have Sex with Men (MSM) and Transgender Women (TW) in Lima, Peru

    Ayer, Amrita; Perez-Brumer, Amaya; Segura, Eddy R.; Chavez-Gomez, Susan; Fernandez, Rosario; Arroyo, Cecilia; Barrantes, Alex; Lake, Jordan E.; Cabello, Robinson; Clark, Jesse L. (Springer, 2021-01-01)
    Sexual communication with partners informs risk assessment and sexual practices. We evaluated participant, partner, and network factors associated with communication about condom use and HIV serostatus and explored their relationships with condomless anal intercourse (CAI) among 446 men who have sex with men (MSM) and 122 transgender women (TW) in Lima, Peru. Generalized estimating equations assessed contextual influences on communication and practices with recent sexual partners. More frequent HIV communication was reported by MSM who: identified as heterosexual, compared to bisexual or gay; characterized partnerships as stable, compared to casual, anonymous, or commercial; or discussed HIV/STIs with close social contacts (p < 0.05). TW in concurrent partnerships discussed condom use more frequently than those in monogamous relationships (p < 0.05). Condom use discussions and alcohol use among MSM were associated with CAI (p < 0.05). Findings highlight complexity in sexual decision-making and call for further study of conversation content and practices to inform HIV prevention messaging.
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  • Electrohydraulic lithotripsy for the treatment of stone impacted in a lumen-apposing metal stent in a patient with endoscopic cholecystoduodenostomy

    Guzmán-Calderón, Edson; Martínez-Moreno, Belén; Casellas, Juan A.; Aparicio, José Ramó (2021-01-01)
    Resumen no disponible.
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  • Factors Associated with Health Anxiety in Medical Students at a Private University in Lima, Peru

    Robles-Mariños, Rodrigo; Angeles, Andrea I.; Alvarado, Germán F. (Elsevier Doyma, 2021-01-01)
    Introduction: There are few studies that examine the factors associated with the different levels of health anxiety in medical students. The objective was to determine the factors associated with the levels of health anxiety in medical students in 2018. Methods: An analytical cross-sectional study was carried out with 657 medical students from a private Peruvian university. Participants answered a questionnaire from which information was collected regarding levels of health anxiety (SHAI). For the analysis, linear regression was used to calculate crude and adjusted betas, and their 95% confidence intervals. Results: The mean health anxiety score was 14 ± 6.7. An association between health anxiety and the year of study is reported, with the second year showing the highest scores. In addition, an association between health anxiety and smoking is highlighted, as there are higher levels in occasional smokers, as well as a weak inverse correlation with age. No association was found with sex, place of birth, or having a first-degree relative that is a doctor or health worker. Conclusions: The present study showed that age, year of studies and smoking are associated with health anxiety levels. More studies are required, especially of a longitudinal nature.
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  • PrEP Awareness, Use, Intention to Use, and Information Source Among Geosocial Networking Application Users in Mexico in 2018–2019

    Blair, Kevin J.; Segura, Eddy R.; Garner, Alex; Lai, Jianchao; Ritterbusch, Amy; Leon-Giraldo, Sebastian; Guilamo-Ramos, Vincent; Lake, Jordan E.; Clark, Jesse; Holloway, Ian W. (Springer, 2021-01-01)
    Pre-exposure prophylaxis (PrEP) has limited availability across Latin America, though access is increasing. We explored PrEP uptake in Mexico via an online survey completed by Spanish-speaking, Hornet geosocial networking application (GSN app) users without HIV (n = 2020). Most (81.3%) had heard of PrEP, 3.5% were current users, and 34.2% intended to take PrEP within six months. Current PrEP use was associated with PrEP eligibility (aOR 26.07 [95%CI 13.05–52.09], p < 0.001), recent STI testing (aOR 3.79 [95%CI 1.10–13.11], p = 0.035), and recent chemsex (aOR 3.02 [95%CI 1.02–8.93], p = 0.046). Recent STI testing was associated with hearing about PrEP from a doctor (aOR 3.26 [95%CI 1.98–5.36], p < 0.001), and those who lived in large cities were less likely to have learned about PrEP via Hornet (aOR 0.52 [95%CI 0.32–0.85], p = 0.009). Interventions to increase PrEP uptake in Mexico should build upon existing health networks and utilize GSN apps for PrEP information dissemination, particularly in less populated areas.
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  • Novel 2019 coronavirus infection in children

    Llaque Quiroz, Patricia Beatriz (Instituto Nacional de Salud, 2020-01-01)
    COVID-19 is rarely reported in children and they are mildly affected in most cases. The most common clinical presentation of COVID-19 is cough, fever and sore throat; severe cases show tachypnea. The course of the disease is from one to two weeks. Laboratory findings are nonspecific; lymphopenia, elevation of C-reactive protein and procalcitonin have been described. Early chest X-ray is usually normal, and the most common tomographic findings are consolidations with halo, ground-glass opacities and tiny nodules which mainly affects subpleural areas. Management of the disease is supportive; in severe cases, it should be focused on respiratory support. It is recommended to limit the handling of respiratory secretions and to follow the same preventive measures provided to adults.
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  • Association between household socioeconomic level and consumption of fast food and soft drinks: A cross-sectional assessment of the Young Lives cohort in Peru

    Najar, Carol Argelia; Vila-Quispe, Jessi Nataly; Astete-Robilliard, Laura; Bernabe-Ortiz, Antonio (Asociacion Espanola de Dietistas-Nutricionistas, 2020-01-01)
    Introduction: The consumption of fast food and soft drinks is a risk factor for developing overweight and obesity. This study aimed at assessing if there is association between household socioeconomic level and the consumption of fast food and soft drinks among children. Material and Methods: A cross-sectional assessment of the data from the third round (2009-2010) of the youngest cohort of the Young Lives study in Peru was conducted. Sampling was conducted in three stages: In the first one, the country was divided into equal geographical regions, excluding the 5% of the richest district; in the second stage, 20 sentinel sites were chosen and an area within each sentinel site was selected. Finally, in the third stage, eligible children were selected. Outcomes were the self-reported consumption of fast food and soft drinks (never, sometimes, and always), whereas the exposure was household socioeconomic status (in quintiles). Crude and adjusted models were created between variables of interest using Poisson regression models, with robust variance, to report prevalence ratios (PR) and 95% confidence intervals (95% CI). Results: Data of 1901 children, of which 942 (49.6%) were girls, with a mean age of 7.5 (SD: 0.5) was analyzed. A total of 24.1% (95%CI: 22.2%-26.1%) reported always consuming fast food, whilst this number was 22.4% (20.5%-24.3%) for soft drinks. Compared to the lowest socioeconomic quintile, those who were in higher socioeconomic status had more probability of consuming fast food and soft drinks (Chi-squared for trends <0.001). The highest socioeconomic quintile had a greater probability to always consume fast food (PR=1.42; 95%CI: 1.08-1.88) and soft drinks (PR=1.71; 95%CI: 1.24-2.37). Conclusions: This study shows that there is a significant association between the household socioeconomic level and the consumption of soft drinks and fast food.
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  • Screening and Assessment of Antimicrobial Susceptibility of Periodontopathic Bacteria in Peruvian Patients with Periodontitis: A Pilot Study

    Aguilar-Luis, Miguel Angel; Casas Apayco, Leslie; Tinco Valdez, Carmen; De Lama-Odría, María del Carmen; Weilg, Claudia; Mazulis, Fernando; Silva-Caso, Wilmer Gianfranco; Del Valle-Mendoza, Juana Mercedes (Hindawi Limited, 2021-01-01)
    Background. Severe periodontal disease is highly prevalent worldwide, affecting 20% of the population between the ages of 35 and 44 years. The etiological epidemiology in Peru is scarce, even though some studies describe a prevalence of 48.5% of periodontal disease in the general population. Periodontitis is one of the most prevalent oral diseases associated with site-specific changes in the oral microbiota and it has been associated with a socioeconomic state. This study aimed to determine the etiology and resistance profile of bacteria identified in a group of Peruvian patients with periodontal disease. Methods. Six subgingival plaque samples were collected from eight patients with severe periodontitis. Bacterial identification was carried out by an initial culture, PCR amplification, and subsequently DNA sequencing. We evaluated the antibiotic susceptibility by the disk diffusion method. Results. Variable diversity in oral microbiota was identified in each one of the eight patients. The bacterial genus most frequently found was Streptococcus spp. (15/48, 31.3%) followed by Rothia spp. (11/48, 22.9%), Actinomyces spp. (9/48, 18.8%), and Eikenella spp. (4/48, 8.3%). The most common species found was Rothia dentocariosa (8/48, 16.7%). The antimicrobial susceptibility assay varied according to the species tested; however, among all the isolates evaluated, Actinomyces naeslundii was resistant to penicillin and tetracycline; Eikenella corrodens was resistant to dicloxacillin; and Rothia dentocariosa was resistant to amoxicillin + clavulanic acid and metronidazole but also susceptible to trimethoprim-sulfamethoxazole. Conclusions. The most prevalent periodontal bacterium found in this study was Rothia dentocariosa. Specific antimicrobial therapy is required to improve the treatment outcomes of patients with periodontal disease and avoid antibiotic resistance.
  • Surgical Treatment and Reconstruction of Nasal Defects According to the Aesthetic Subunits Principles

    Núñez-Castañeda, José Miguel; Chang-Grozo, Silvana Lucia (Springer, 2021-01-01)
    The aim of this study was to determine the prevalence of nasal skin cancer, its location by facial aesthetic subunits and the type of reconstructive procedures performed for each nasal subunit after excision for nasal skin tumors. Observational cross-sectional study of all consecutive patients with the diagnosis of skin tumor located in the nasal unit, treated from 2018 to 2019 by the department of head and neck surgery of a general hospital. 60 patients were treated with nasal skin tumors excisions. A total of 52 patients (86,6%) had basal cell skin cancer, 7 (11,6%) had squamous cell skin cancer and 1 (1,6%) had melanoma. Fifty-nine patients (98.33%) presented a primary tumor and just 1 case (1,66%) recived a previous surgical treatment. Regardless of the type of tumor, the tip subunit was the most often involved with 29 (48,33%) cases in total. Despite of the nasal aesthetic subunit affected, the most frequent type of procedure used for reconstruction was the rotation or advancement flap, based on aesthetic nasal subunits, which was performed in 39 cases (65%). Nasal reconstruction after skin cancer can be very complex, especially since all patients have high expectations about the results. In order to achieve good results, there is a necessity for careful analysis of the defect, correct planning and excellent technical execution of the procedures Frequently, staged procedures will be needed to achieve an optimal result.
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  • Vasoactive agents for the management of acute variceal bleeding: A systematic review and meta-analysis

    Huaringa-Marcelo, Jorge; Huaman, Mariella R.; Brañez-Condorena, Ana; Villacorta-Landeo, Pamela; Pinto-Ruiz, Diego F.; Urday-Ipanaqué, Diana; García-Gomero, David; Montes-Teves, Pedro; Miranda, Adelina Lozano (Romanian Society of Gastroenterology, 2021-01-01)
    Background & Aims: Vasoactive agents with endoscopic therapy are used to treat acute variceal bleeding (AVB). There are two main groups of vasoactive agents: terlipressin and vasopressin (T-V), and octreotide and somatostatin (O-S). However, the benefit/harm balance is unclear. Our aim was to assess the efficacy and safety of T-V versus O-S for the management of AVB. Methods: We performed a systematic search for randomized controlled trials (RCTs) in PubMed, Scopus, and CENTRAL. Our main outcomes were mortality and adverse events. Secondary outcomes were bleeding control, rebleeding, blood transfusion, hospital stay. We evaluated the certainty of evidence using GRADE methodology. Results: We included 21 RCTs. The risk of mortality (RR: 1.01; 95%CI: 0.83-1.22), bleeding control (RR: 0.96; 95%CI: 0.91-1.02; I2=53%), early rebleeding (RR: 0.91; 95%CI: 0.66-1.24: I2=0%), late rebleeding (RR: 0.94; 95 CI: 0.56-1.60; I2=0%), blood transfusion (MD: 0.04; 95%CI:-0.31-0.39; I2=68%) and hospital stay (MD:-1.06; 95%CI:-2.80-0.69; I2=0%) were similar between T-V and O-S groups. Only 15 studies reported adverse events, which were significantly higher in the T-V compared to the O-S group (RR 2.39; 95%CI: 1.58-3.63; I2=57%). The certainty of evidence was moderate for the main outcomes, and low or very low for others. Conclusions: In cirrhotic patients with AVB, those treated with T-V had similar mortality risk compared to O-S. However, the use of T-V showed an increased risk of adverse events compared to O-S.
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  • Hepatocellular carcinoma in a woman with 34 weeks gestation and chronic hepatitis b

    Sato-Espinoza, Karina; Ferrer, Javier Díaz; Ventura, Yessica Mitzy Jaramillo (Sociedad Argentina de Gastroenterologia, 2021-01-01)
    A 24-year-old pregnant woman arrived at the emergency service at 34 weeks of gestational age with intermittent right upper abdominal pain. An abdominal ultrasound was performed showing signs of hepatopathy with multiple neo-formative nodules with mild ascites and fetal biometry confirmed at 34 weeks gestation. During her hospitalization, an emergency caesarean was induced with favorable result in the survival of the mother and the baby.
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  • Olga and olgim stage distribution according to age and helicobacter pylori status in a public hospital in Lima, Peru

    Ronquillo, Andrea Carlin; León, Alex Ventura; Ríos, Jorge L.Espinoza; Paredes, Eduar A.Bravo; Hinojosa, Paúl Gómez; Solis, Shirley Alva; Valdivia, José L.Pinto; Silva-Caso, Wilmer (Sociedad Argentina de Gastroenterologia, 2021-01-01)
    Introduction. The operative link for gastritis assessment (OLGA) and the operative link on gastric intestinal meta-plasia assessment (OLGIM) staging systems have been sug-gested to provide risk of assessment for gastric cancer. Objec-tive. To evaluate the distribution of OLGA and OLGIM staging by age and Helicobacter pylori status. Material and methods. We studied 197 subjects undergoing elective upper gastrointestinal endoscopy. The presence of the H. pylori and histological changes were evaluated using the updated Sydney system. Stages III and IV of OLGA/OLGIM were considered high risk stages. Results. The H. pylori rate was 56.85% (112/197). High-risk OLGA/OLGIM cases were rare: 7/112 (6.5%) cases of OLGA in the H. pylori positive group and 6/85 (7%) in the H. pylori negative group; 5 (4.4%) cases of OLGIM in the H. pylori positive and 6 (7%) in the H. pylori negative. The proportion of advanced stages of OLGA and OLGIM increased with age (p < 0.001). High-risk OLGA was not found before age 40 regardless of the presence of H. pylori, but increased to 16.2%, 10.3%, 17.3% and 40.8% in subjects in the fourth, fifth, sixth and seventh decade of life respectively. The OLGIM high risk showed a similar trend: 0% before 40 years and up to 22.6% in people of 70 years. Conclusions. High-risk OLGA/OLGIM cases are infrequent before age 40 and increase significantly with age. No relation was found with the presence of the H. pylori. According to these protocols, only a fifth of the patients would strictly require endoscopic control.
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  • Cross-sectional study of the clinical characteristics and outcomes of children hospitalized with COVID-19 in Lima, Peru

    Domínguez Rojas, Jesús; Estupiñan Vigil, Matilde; Garcés-Ghilardi, Raquel; Alvarado-Gamarra, Giancarlo; Del Águila, Olguita; Lope Tenorio, Adanida Flor; Ayón Dejo, Carmen Cecilia; Chonlon Murillo, Kenny; Boluarte Baca, Sebastián; Stapleton Herbozo, Angie; Seminario Aliaga, Ricardo; Reyes Florian, Giuliana; Dávila Riega, Diana; Fernández Suárez, Sarah; Coronado Muñoz, Álvaro (NLM (Medline), 2021-01-20)
    Introduction: Coronavirus 2019 (SARS-CoV-2) infection in children occurred in Peru as of March 2020, leading to pediatric patients' hospitalization in areas adapted for this purpose at the Edgardo Rebagliati Martins National Hospital. In the beginning, the demand for hospitalization was low, but it increased gradually. Consistent with international reports, the majority of patients presented mild or moderate symptoms. Nonetheless, there were also severe cases, even fatal ones. Objectives: To describe the characteristics and clinical outcome of pediatric patients with COVID-19 hospitalized in a referral hospital in Lima, Peru, between March and August 2020. Methods: A descriptive and inferential cross-sectional study was carried out. The population includes all hospitalized patients in the Department of Pediatrics, with clinical and surgical diagnoses associated with COVID-19. Results: We included 100 patients, with an average age of 83.4 ± 54 months, with a predominance of male patients (55%). Hospitalized patients were grouped into five categories: respiratory failure (17%), multisystemic inflammatory syndrome (MIS-C) (31%), neurological presentation (19%), acute abdomen (20%), and patients with oncological problems (13%). Most of the patients (74%) had comorbidities. Regarding the presenting symptoms, intestinal pain predominated in the appendicitis group (90%, p < 0.001), fever was present in most patients with respiratory failure (64.7%); multisystemic inflammatory syndrome (90.3%), neurological manifestations (15.8%), acute abdomen (50%) and oncological conditions (61.5%) were also present in these patients. Kawasaki symptoms were found in 38.7% of the patients with multisystemic inflammatory syndrome. Mortality was 4%. Respiratory problems (29.4%) and multisystemic inflammatory syndrome (22.6%) required admission to intensive care, more frequently than the other presentations (p = 0.008). Conclusions: We conclude that the vulnerability in the pediatric population is the one that has preexisting conditions. We divided our patients according to presentation, diagnosis, and complications, which were predominantly respiratory. We also had oncological patients with COVID-19.
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  • Clinical characteristics and molecular detection of in hospitalized children with a clinical diagnosis of whooping cough in Peru.

    Del Valle-Mendoza, Juana; del Valle-Vargas, Cristina; Aquino-Ortega, Ronald; Del Valle, Luis J; Cieza-Mora, Erico; Silva-Caso, Wilmer; Bazán-Mayra, Jorge; Zavaleta-Gavidia, Victor; Aguilar-Luis, Miguel Angel; Cornejo-Pacherres, Hernán; Martins-Luna, Johanna; Cornejo-Tapia, Angela (Tehran University of Medical Sciences, 2021-01)
    Pertussis is an infectious disease caused by the Gram-negative bacterium Bordetella pertussis. In Peru, actual public health programs indicate that vaccination against B. pertussis must be mandatory and generalized, besides all detected cases must be reported. The objective of this study was to determine the prevalence of B. pertussis among children under five years of age with a presumptive diagnosis of whopping cough in Cajamarca, a region located in northern Peru.
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