Examinando por Autor "Hernández-Vásquez, Akram"

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Gender Differences in the Factors Associated with Alcohol Binge Drinking: A Population-Based Analysis in a Latin American Country
(MDPI, 2022-04-19) Hernández-Vásquez, Akram; Chacón-Torrico, Horacio; Vargas-Fernández, Rodrigo; Nicolás Grendas, Leandro; Bendezu-Quispe, Guido
“Alcohol consumption is a public health problem in Peru, fostered by traditional practices, where promoting social interaction in celebrations, facilitating field work as a source of energy and warmth, and achieving objectives in certain labor negotiations, play an important role. However, research on the risk factors of binge drinking according to gender is limited. The study aim was to determine the factors associated with binge drinking in the Peruvian adult population by gender. An analytical study of secondary data from the 2018 Peruvian Demographic and Family Health Survey was conducted. The dependent variable was binge drinking in the last 30 days. Adjusted prevalence ratios (aPR) were estimated for the association between sociodemographic and healthrelated variables with binge drinking. A total of 32,020 adults were included. Binge drinking was found in 22.4%. Men (32.6%; 95% confidence interval [CI]: 31.4–33.8) presented a higher consumption pattern compared to women (12.8%; 95% CI: 12.0–13.6). For both genders, differences were found in binge drinking according to sociodemographic characteristics (age and wealth quintile was associated in both genders while the educational level was associated only for men, and ethnic self-identification and marital status for women) and health- characteristics related (health insurance, smoking in the last 30 days, overweight and obesity were associated in both genders). Several factors are associated with binge drinking according to gender in the Peruvian population, including age and education level among men, as well as marital status and ethnic self-identification among women.“
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Gender Differences in the Factors Associated withAlcohol Binge Drinking: A Population-Based Analysis ina Latin American Country
(MDPI, 2022-04-19) Hernández-Vásquez, Akram; Chacón-Torrico, Horacio; Vargas-Fernández, Rodrigo; Nicolás Grendas, Leandro; Bendezu-Quispe, Guido
Alcohol consumption is a public health problem in Peru, fostered by traditional practices,where promoting social interaction in celebrations, facilitating field work as a source of energy andwarmth, and achieving objectives in certain labor negotiations, play an important role. However,research on the risk factors of binge drinking according to gender is limited. The study aim was todetermine the factors associated with binge drinking in the Peruvian adult population by gender.An analytical study of secondary data from the 2018 Peruvian Demographic and Family HealthSurvey was conducted. The dependent variable was binge drinking in the last 30 days. Adjustedprevalence ratios (aPR) were estimated for the association between sociodemographic and health-related variables with binge drinking. A total of 32,020 adults were included. Binge drinking wasfound in 22.4%. Men (32.6%; 95% confidence interval [CI]: 31.4–33.8) presented a higher consumptionpattern compared to women (12.8%; 95% CI: 12.0–13.6). For both genders, differences were found inbinge drinking according to sociodemographic characteristics (age and wealth quintile was associatedin both genders while the educational level was associated only for men, and ethnic self-identificationand marital status for women) and health- characteristics related (health insurance, smoking in thelast 30 days, overweight and obesity were associated in both genders). Several factors are associatedwith binge drinking according to gender in the Peruvian population, including age and educationlevel among men, as well as marital status and ethnic self-identification among women.
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Geographic and socioeconomic inequalities in cesarean birth rates in Peru: A comparison between 2009 and 2018
(John Wiley and Sons Inc, 2021-07-08) Hernández-Vásquez, Akram; Chacón-Torrico, Horacio; Bendezu-Quispe, Guido
Background There is a global concern about the high rates of cesarean birth (CB). This study aimed to investigate the geographic and socioeconomic inequalities in CB rates in the Peruvian population. Methods We conducted a population-based study using the Peruvian Demographic and Family Health Surveys (ENDES, the Spanish acronym for Encuesta Demográfica y de Salud Familiar) between 2009 and 2018. ENDES reported data from births registered in the five years preceding survey execution. For the years 2009 (n = 10 289) and 2018 (n = 23 077), we calculated the weighted rates of CB among variables such as natural geographic domain (Coast, Andean, or Amazon), area of residence (rural or urban), wealth index quintile (quintile 1 is poorest, and quintile 5 is richest), and educational level. To assess inequalities, we calculated the concentration index (CIs), the slope index of inequality (SII), and the relative index of inequality (RII). Results The CB rates by year were 21.4% (95% confidence interval [CI]: 20.0-22.9) in 2009 and 34.5% (95% CI: 33.4-35.5) in 2018. Women living in urban and coastal regions and with a higher education level had the highest CB rates. All the CIs were positive, reflecting a prowealthy inequality in CB rates, and both SII and RII were positive, indicating a gap between the use of cesarean in women in the higher wealth quintile compared with those in the lower quintile. Conclusions Cesarean birth rates have increased by 60% during the last decade in Peru. The richest wealth quintiles had the highest CB rates during the study years, which were well above global recommendations.
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Indigenous communities of Peru: Level of accessibility to health facilities
(Elsevier B.V., 2022-02-25) Hernández-Vásquez, Akram; Bendezu-Quispe, Guido; Turpo Cayo, Efrain Y.
“Objectives: This study aimed to geospatially model the level of geographic accessibility to health facilities among Amazonian Indigenous communities in a region of Peru. Methods: Spatial modeling of the physical accessibility of the Indigenous communities to the nearest health facility was performed through cost-distance analysis. The study area was Loreto, the region with the largest territorial area and number of Indigenous communities in Peru. The time required to reach a health facility was determined by cumulatively adding the time needed to cross the grids on the lowest cost route from the Indigenous communities’ locations to the nearest health facility, by considering Amazonian geographical conditions and the main types of transport used. Results: The median time to reach a health facility was 0.96 h (interquartile range: 0.45e2.41). Of the total communities (n ¼ 1043), only 479 (45.93%) communities were within 1 h from the nearest health facility, and 161 (15.44%) were more than 8 h away. The Indigenous communities more than 8 h away from a health estab- lishment were located in the border areas of the depart- ment of Loreto. Conclusion: One in two Indigenous communities is more than 1 h from the nearest health facility.“
Acceso abierto
Indigenous communities of Peru: Level of accessibility to health facilities
(Elsevier B.V., 2022-02-25) Hernández-Vásquez, Akram; Bendezu-Quispe, Guido; Turpo Cayo, Efrain Y.
“Objectives: This study aimed to geospatially model the level of geographic accessibility to health facilities among Amazonian Indigenous communities in a region of Peru. Methods: Spatial modeling of the physical accessibility of the Indigenous communities to the nearest health facility was performed through cost-distance analysis. The study area was Loreto, the region with the largest territorial area and number of Indigenous communities in Peru. The time required to reach a health facility was determined by cumulatively adding the time needed to cross the grids on the lowest cost route from the Indigenous communities’ locations to the nearest health facility, by considering Amazonian geographical conditions and the main types of transport used. Results: The median time to reach a health facility was 0.96 h (interquartile range: 0.45e2.41). Of the total communities (n ¼ 1043), only 479 (45.93%) communities were within 1 h from the nearest health facility, and 161 (15.44%) were more than 8 h away. The Indigenous communities more than 8 h away from a health estab- lishment were located in the border areas of the depart- ment of Loreto. Conclusion: One in two Indigenous communities is more than 1 h from the nearest health facility.“
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Measuring the Protective Effect of Health Insurance Coverage on Out-of-Pocket Expenditures During the COVID-19 Pandemic in the Peruvian Population
(Kerman University of Medical Sciences, 2021-11-07) Hernández-Vásquez, Akram; Rojas-Roque, Carlos; Barrenechea-Pulache, Antonio; Guido Bendezú-Quispe
Abstract Background: Health insurance coverage is expected to protect individuals from out-of-pocket (OOP) expenditures, potentially preventing them from falling into poverty. However, to date, the effect of health insurance on OOP spending during the coronavirus disease 2019 (COVID-19) pandemic has not been fully explored. This study aimed to estimate differences in the proportion and the amount of OOP expenditures among Peruvians during the pre- and post-mandatory lockdown response to COVID-19 in 2020 according to the health insurance coverage status. Methods: This study utilized repeated cross-sectional data from the National Household Survey on Living and Poverty Conditions (ENAHO) from the first quarter of 2017 until the fourth quarter of 2020. The outcomes were (i) the proportion of individuals who incurred OOP expenditures and (ii) the monetary value of OOP expenditures. An interrupted time series analysis (ITS) and a quasi-experimental difference-in-difference (DID) analysis were performed to examine the outcomes among the control (individuals without health insurance) and treatment groups (individuals with health insurance) after the COVID-19 pandemic. Results: ITS analysis showed that the proportion of individuals reporting OOP expenditures after implementation of mandatory lockdown due to COVID-19 in Peru decreased in both groups, but no difference in the slope trend was found (P=.916). The average quarterly amount of OOP spending increased in both groups, but no difference in the slope trend was found (P=.073). Lastly, the DID analysis showed that the mandatory lockdown was associated with a higher amount of OOP, but there was no evidence to indicate that the higher amount was different between the control and treatment groups. Conclusion: The mandatory lockdown in response to the COVID-19 was associated with a higher amount of OOP expenditures and a lower likelihood of incurring OOP expenditures. However, our findings suggest that health insurance coverage does not lower OOP expenditures or reduce the likelihood of incurring OOP expenditures.
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Prevalence and Factors Associated with Gaming Disorder in Latin America and the Caribbean: A Systematic Review
(MDPI, 2022-08-15) Hernández-Vásquez, Akram; Vargas-Fernández , Rodrigo; Visconti-Lopez, Fabriccio J.; Comandé, Daniel; Bendezu-Quispe, Guido
“We aimed to determine the prevalence and factors associated with gaming disorder (GD) in the population of Latin America and the Caribbean (LAC). A systematic review was performed (PROSPERO protocol registration: CRD42021230565). We included studies that identified participants with GD and/or factors associated with this condition, reported the prevalence of GD, or contained data that assisted in its estimation, were published after 2013 (the year of inclusion of GD in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders) and were carried out in a population residing in an LAC country. Evaluation of the quality of the studies was carried out using the Joanna Briggs Institute Critical appraisal checklist tool. A qualitative synthesis of the data was performed. Of the total of 1567 records identified, 25 passed the full-text review phase, and 6 met the selection criteria. These studies were published between 2018 and 2021 and had a cross-sectional design (three in Brazil, one in Ecuador, Mexico, and the other was multi-country, including a LAC country [Peru]). The prevalence of GD ranged from 1.1% to 38.2%. The three studies in Brazil had the highest figures of GD prevalence (20.4–38.2%). Four studies evaluated factors associated with GD. Characteristics regarding the game (type), pattern of use (hours played), as well as gender (higher in men), tobacco and alcohol consumption, poor interpersonal relationships, and the presence of mental disorders were found to be associated with GD in LAC. Evidence on the prevalence and factors associated with GD in LAC is limited. Studies on GD in LAC evaluate different population subgroups, describing a wide prevalence of this condition (present in up to 38 out of 100 evaluated). Characteristics such as the type and hours of use of the games, sociodemographic data, lifestyles, interpersonal relationships, and the presence of mental disorders increase the probability of presenting GD. “
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Prevalence and Factors Associated with Gaming Disorder in Latin America and the Caribbean: A Systematic Review
(MDPI, 2022-08-15) Hernández-Vásquez, Akram; Vargas-Fernández, Rodrigo; Visconti-Lopez, Fabriccio J.; Comandé, Daniel; Bendezu-Quispe, Guido
“We aimed to determine the prevalence and factors associated with gaming disorder (GD) in the population of Latin America and the Caribbean (LAC). A systematic review was performed (PROSPERO protocol registration: CRD42021230565). We included studies that identified participants with GD and/or factors associated with this condition, reported the prevalence of GD, or contained data that assisted in its estimation, were published after 2013 (the year of inclusion of GD in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders) and were carried out in a population residing in an LAC country. Evaluation of the quality of the studies was carried out using the Joanna Briggs Institute Critical appraisal checklist tool. A qualitative synthesis of the data was performed. Of the total of 1567 records identified, 25 passed the full-text review phase, and 6 met the selection criteria. These studies were published between 2018 and 2021 and had a cross-sectional design (three in Brazil, one in Ecuador, Mexico, and the other was multi-country, including a LAC country [Peru]). The prevalence of GD ranged from 1.1% to 38.2%. The three studies in Brazil had the highest figures of GD prevalence (20.4–38.2%). Four studies evaluated factors associated with GD. Characteristics regarding the game (type), pattern of use (hours played), as well as gender (higher in men), tobacco and alcohol consumption, poor interpersonal relationships, and the presence of mental disorders were found to be associated with GD in LAC. Evidence on the prevalence and factors associated with GD in LAC is limited. Studies on GD in LAC evaluate different population subgroups, describing a wide prevalence of this condition (present in up to 38 out of 100 evaluated). Characteristics such as the type and hours of use of the games, sociodemographic data, lifestyles, interpersonal relationships, and the presence of mental disorders increase the probability of presenting GD.“
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Socioeconomic Inequalities in the Prevalence of Diabetes in Argentina: A Repeated Cross-Sectional Study in Urban Women and Men
(MDPI, 2022-07-22) Rojas-Roque , Carlos; Hernández-Vásquez, Akram; Azañedo, Diego; Bendezu-Quispe, Guido
“This study measured the socioeconomic inequalities in the prevalence of diabetes between 2005 and 2018 in an urban Argentinian population. Data were obtained from the repeated crosssectional surveys “National Survey of Risk Factors” (ENFR is its acronym in Spanish). From 2005 to 2018, four rounds of ENFR were administered to men and women over 18 years of age. Concentration curves (CC) and the Erreygers concentration index (ECI) were used to describe the socioeconomic inequalities in diabetes’ prevalence. A decomposition analysis was performed to determine the contribution of each variable to inequality in diabetes’ prevalence. Data from 41,219 (2005), 34,583 (2009), 32,232 (2013), and 29,094 (2018) individuals were analyzed. Women reported a greater prevalence of diabetes compared with men for all the years included. According to the CC and ECI, we found no evidence of inequality in men throughout all study years. For women, throughout all years, the CCs were above the line of equity, and the ECIs during all the years were negative and different from zero (p < 0.01). For women, we found no evidence of a reduction in inequalities between 2005 and 2018 (p = 0.475). The socioeconomic inequality for women was largely driven by public insurance, primary and secondary education, and employment. Diabetes’ prevalence was not associated with socioeconomic status in men, while the prevalence of diabetes in women was more concentrated among poorer women. During the 13 years, there was no evidence of a reduction of inequality in women, noting that interventions must prioritize and should focus on the main contribution of inequalities, such as education and employment.“
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Trends in Mortality from Ischemic Heart Disease in Peru, 2005 to 2017
(MDPI, 2022-06-09) Vázquez-Troche, Jesús Austin; García-Fernández, Vanessa; Hernández-Vásquez, Akram; Vargas-Fernández, Rodrigo; Bendezu-Quispe, Guido
The highest proportion of deaths among patients with cardiovascular diseases is due to ischemic heart disease (IHD), which is the second most common cause of death in Peru. This study aims to measure and identify changes in the temporal trend in mortality from ischemic heart disease in the Peruvian population. An ecological study was carried out with data from individual death records from the Ministry of Health between 2005 and 2017. A death was considered attributable to IHD if it was registered with the codes I20 to I25 of the ICD-10. Crude and adjusted mortality rates for IHD were calculated for the general population by age and according to sex. A joinpoint regression analysis was performed to assess trends in IHD mortality. There were 61,524 deaths due to IHD (55.69% men) from 2005 to 2017. According to the ICD-10, acute myocardial infarction (I21) accounted for the highest proportion of deaths (88.16%), followed by chronic IHD (I25), with 6.53%. In general, a decrease in adjusted IHD mortality rates was found in the general population over time (45.34 in 2005; 22.18 in 2017). By sex, men possessed a 1.5-fold higher rate than women. The highest mortality rates from IHD were found in the natural coastal region (68.55%) and in urban areas (86.43%). A joinpoint regression analysis showed a reduction in the mortality trend over time due to IHD for both the general population and the population when grouped by sex. In conclusion, there was a continuous decrease in mortality rates due to IHD in the Peruvian population between 2005 and 2017. Strategies focused on mitigating the impact of this disease are required and should emphasize the subgroups most likely to die from this cause.
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Trends in Mortality from Ischemic Heart Disease in Peru, 2005 to 2017
(MDPI, 2022-06-09) Vázquez-Troche, Jesús Austin; García-Fernández, Vanessa; Hernández-Vásquez, Akram; Vargas-Fernández, Rodrigo; Bendezu-Quispe, Guido
The highest proportion of deaths among patients with cardiovascular diseases is due to ischemic heart disease (IHD), which is the second most common cause of death in Peru. This study aims to measure and identify changes in the temporal trend in mortality from ischemic heart disease in the Peruvian population. An ecological study was carried out with data from individual death records from the Ministry of Health between 2005 and 2017. A death was considered attributable to IHD if it was registered with the codes I20 to I25 of the ICD-10. Crude and adjusted mortality rates for IHD were calculated for the general population by age and according to sex. A joinpoint regression analysis was performed to assess trends in IHD mortality. There were 61,524 deaths due to IHD (55.69% men) from 2005 to 2017. According to the ICD-10, acute myocardial infarction (I21) accounted for the highest proportion of deaths (88.16%), followed by chronic IHD (I25), with 6.53%. In general, a decrease in adjusted IHD mortality rates was found in the general population over time (45.34 in 2005; 22.18 in 2017). By sex, men possessed a 1.5-fold higher rate than women. The highest mortality rates from IHD were found in the natural coastal region (68.55%) and in urban areas (86.43%). A joinpoint regression analysis showed a reduction in the mortality trend over time due to IHD for both the general population and the population when grouped by sex. In conclusion, there was a continuous decrease in mortality rates due to IHD in the Peruvian population between 2005 and 2017. Strategies focused on mitigating the impact of this disease are required and should emphasize the subgroups most likely to die from this cause.
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Women’s Autonomy and Intimate Partner Violence in Peru: Analysis of a National Health Survey
(University of Salamanca, 2022-11-03) Barón-Lozada, Francisco A.; Basualdo-Meléndez, Gianfranco W.; Vargas-Fernández, Rodrigo; Hernández-Vásquez, Akram; Bendezu-Quispe, Guido
To assess the association between women’s autonomy and intimate partner violence (IPV) against women of childbearing age. Secondary analysis of the 2019 Demographic and Family Health Survey (ENDES-acronym in Spanish) was carried out. The study population was women aged 15–49 years who are currently married or living with a partner. A Poisson family generalized linear regression model was estimated to calculate adjusted prevalence ratios (aPR) for the association between women’s autonomy and IPV with their respective 95% confidence intervals (CI). Data from 18,621 women were analyzed. The highest proportion of women had low autonomy (low: 42%; moderate: 39.2%; high: 18.8%). A prevalence of IPV of 40.1% was found (psychological/verbal: 38.8%; physical: 8.8%; sexual: 2.3%). The adjusted model found that women with a low level of autonomy (aPR: 1.15, 95%CI: 1.01–1.31) had a higher prevalence of IPV compared to women with high autonomy. This association was also found for the specific case of psychological/verbal violence (aPR: 1.15, 95%CI: 1.01–1.31). No association was found between women’s level of autonomy and physical or sexual violence by a partner. Four out of 10 women of childbearing age have experienced IPV in the last 12 months. In general, women with lower levels of autonomy are more likely to present IPV compared to women with high autonomy.
Acceso abierto
Women’s Autonomy and Intimate Partner Violence in Peru: Analysis of a National Health Survey
(University of Salamanca, 2022-11-03) Barón-Lozada, Francisco A.; Basualdo-Meléndez, Gianfranco W.; Vargas-Fernández, Rodrigo; Hernández-Vásquez, Akram; Bendezu-Quispe, Guido
To assess the association between women’s autonomy and intimate partner violence (IPV) against women of childbearing age. Secondary analysis of the 2019 Demographic and Family Health Survey (ENDES-acronym in Spanish) was carried out. The study population was women aged 15–49 years who are currently married or living with a partner. A Poisson family generalized linear regression model was estimated to calculate adjusted prevalence ratios (aPR) for the association between women’s autonomy and IPV with their respective 95% confidence intervals (CI). Data from 18,621 women were analyzed. The highest proportion of women had low autonomy (low: 42%; moderate: 39.2%; high: 18.8%). A prevalence of IPV of 40.1% was found (psychological/verbal: 38.8%; physical: 8.8%; sexual: 2.3%). The adjusted model found that women with a low level of autonomy (aPR: 1.15, 95%CI: 1.01–1.31) had a higher prevalence of IPV compared to women with high autonomy. This association was also found for the specific case of psychological/verbal violence (aPR: 1.15, 95%CI: 1.01–1.31). No association was found between women’s level of autonomy and physical or sexual violence by a partner. Four out of 10 women of childbearing age have experienced IPV in the last 12 months. In general, women with lower levels of autonomy are more likely to present IPV compared to women with high autonomy.