• Wealth index and risk of childhood overweight and obesity: evidence from four prospective cohorts in Peru and Vietnam.

      Carrillo Larco, Rodrigo M.; Miranda, J Jaime; Bernabe-Ortiz, Antonio; jaime.miranda@upch.pe (Springer International Publishing, 2015-11-24)
      OBJECTIVES: To estimate the incidence and risk of childhood overweight and obesity according to socioeconomic status in Peruvian and Vietnamese school-aged children. METHODS: Longitudinal data from the Young Lives study were analyzed. Exposure was wealth index in tertiles. Outcome was overweight and obesity. Cumulative incidence per 100 children-years, relative risks (RR), and 95 % confidence intervals (95 % CI) were calculated. A hierarchical approach, including child- and family-related variables, was followed to construct multivariable models. RESULTS: The cumulative incidence of overweight and obesity was 4.8 (95 % CI 4.1-5.5) and 1.7 (95 % CI 1.3-2.2) in the younger and older Peruvian cohort, respectively; and in Vietnam 1.5 (95 % CI 1.2-1.8) and 0.3 (95 % CI 0.2-0.5), respectively. The incidence of overweight and obesity was higher at the top wealth index tertile in all samples. In the older cohorts, comparing highest versus bottom wealth index tertile, RR of overweight and obesity was four to nine times higher: 4.25 in Peru (95 % CI 2.21-8.18) and 9.11 in Vietnam (95 % CI 1.07-77.42). CONCLUSIONS: The results provide important information for childhood obesity prevention in countries moving ahead with economic, epidemiological and nutritional transitions.
      Acceso restringido temporalmente
    • Weighing the evidence for suicide prevention

      Flores Cornejo, Fiorela; Kamego Tome, Mayumi; Zapata Pachas, Mariana A.; Alvarado, German F. (Associac¸a˜ o Brasileira de Psiquiatria, 2015-10-14)
      Acceso abierto
    • Weight variation over time and its relevance among multidrug-resistant tuberculosis patients

      Chung Delgado, Kocfa; Revilla Montag, Alejandro; Guillén Bravo, Sonia; Bernabe-Ortiz, Antonio (Elsevier B.V., 2014-09-15)
      Objectives: We aimed to assess the variation in patient body weight over time according to the treatment outcome among multidrug-resistant tuberculosis (MDR-TB) cases. Methods: This was a retrospective cohort study. The data of patients commencing MDR-TB therapy were analyzed. Data were collected from different public TB treatment facilities located in peri-urban areas to the south of Lima, Peru. The outcome was patient body weight (kilograms) from treatment commencement, measured monthly. A random effects model was fitted using robust standard errors to calculate 95% confidence intervals. Results: Of a total of 1242 TB cases, 243 (19.6%) were MDR-TB. Only 201 cases were included in the analysis; 127 (63.2%) were males and the mean patient age was 33.6 (standard deviation 16.2) years. Weight changes over time among the patients who were cured differed from changes in those who died during therapy (p < 0.001). Weight curve divergence was important at the end of the third, fourth, and fifth treatment months: on average, the weight difference was 2.18 kg (p < 0.001), 3.27 kg (p = 0.007), and 3.58 kg (p = 0.03), respectively, when cured patients were compared to those who died. Conclusions: Our results show that weight variation during treatment can be a useful surrogate for the treatment outcome, specifically death during therapy. MDR-TB patients with weight loss should be followed more closely, as they are at greater risk of death.
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    • Which population level environmental factors are associated with asthma, rhinoconjunctivitis and eczema? Review of the ecological analyses of ISAAC Phase One.

      Asher, M Innes; Stewart, Alistair W; Mallol, Javier; Montefort, Stephen; Lai, Christopher K W; Aït-Khaled, Nadia; Odhiambo, Joseph; Chiarella, Pascual; The ISAAC Phase One Study Group; mi.asher@auckland.ac.nz (2010-01-21)
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    • Whole genome analysis of extensively drug resistant Mycobacterium tuberculosis strains in Peru

      Santos-Lazaro, David; Gavilan, Ronnie G.; Solari, Lely; Vigo, Aiko N.; Puyen, Zully M. (Nature Research, 2021-12-01)
      Peru has the highest burden of multidrug-resistant tuberculosis in the Americas region. Since 1999, the annual number of extensively drug-resistant tuberculosis (XDR-TB) Peruvian cases has been increasing, becoming a public health challenge. The objective of this study was to perform genomic characterization of Mycobacterium tuberculosis strains obtained from Peruvian patients with XDR-TB diagnosed from 2011 to 2015 in Peru. Whole genome sequencing (WGS) was performed on 68 XDR-TB strains from different regions of Peru. 58 (85.3%) strains came from the most populated districts of Lima and Callao. Concerning the lineages, 62 (91.2%) strains belonged to the Euro-American Lineage, while the remaining 6 (8.8%) strains belonged to the East-Asian Lineage. Most strains (90%) had high-confidence resistance mutations according to pre-established WHO-confident grading system. Discordant results between microbiological and molecular methodologies were caused by mutations outside the hotspot regions analysed by commercial molecular assays (rpoB I491F and inhA S94A). Cluster analysis using a cut-off ≤ 10 SNPs revealed that only 23 (34%) strains evidenced recent transmission links. This study highlights the relevance and utility of WGS as a high-resolution approach to predict drug resistance, analyse transmission of strains between groups, and determine evolutionary patterns of circulating XDR-TB strains in the country.
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    • Zika virus is arriving at the American continent

      Levy Blitchtein, Saul; Del Valle Mendoza, Juana Mercedes; jdelvall@upc.edu.pe (Elsevier B.V., 2016-08)
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