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    Effect of salt substitution on community-wide blood pressure and hypertension incidence
    (Nature Research, 2020-03-01)
    Replacement of regular salt with potassium-enriched substitutes reduces blood pressure in controlled situations, mainly among people with hypertension. We report on a population-wide implementation of this strategy in a stepped-wedge cluster randomized trial (NCT01960972). The regular salt in enrolled households was retrieved and replaced, free of charge, with a combination of 75% NaCl and 25% KCl. A total of 2,376 participants were enrolled in 6 villages in Tumbes, Peru. The fully adjusted intention-to-treat analysis showed an average reduction of 1.29 mm Hg (95% confidence interval (95% CI) (−2.17, −0.41)) in systolic and 0.76 mm Hg (95% CI (−1.39, −0.13)) in diastolic blood pressure. Among participants without hypertension at baseline, in the time- and cluster-adjusted model, the use of the salt substitute was associated with a 51% (95% CI (29%, 66%)) reduced risk of developing hypertension compared with the control group. In 24-h urine samples, there was no evidence of differences in sodium levels (mean difference 0.01; 95% CI (0.25, −0.23)), but potassium levels were higher at the end of the study than at baseline (mean difference 0.63; 95% CI (0.78, 0.47)). Our results support a case for implementing a pragmatic, population-wide, salt-substitution strategy for reducing blood pressure and hypertension incidence.
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    Influenza incidence, lineages, and vaccine effectiveness estimates in Lima, Peru, 2023
    (Elsevier Ltd, 2024-04-01)
    Characterisation of influenza viruses in the southern hemisphere can guide local response and provide insights to northern hemisphere jurisdictions about their upcoming influenza season.1,2 Here, we present the information on 2023 end of influenza season in the southern hemisphere about influenza lineages, incidence of medically attended, laboratory-confirmed influenza cases, and influenza vaccine effectiveness (VE) against the antigen from surveillance clinics and a hospital in San Juan de Lurigancho and San Martin de Porres, the two most populated districts of Peru.
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    Adverse events and health literacy as barriers to childhood immunization in Peru
    (Elsevier, 2026-01-01)
    Objectives To determine whether the level of health literacy and adverse post-vaccination events (AEFI) against COVID-19 experienced by parents are barriers to childhood vaccination in Ayacucho. Methods Cross-sectional predictive level study, conducted in 2022. The analysis was performed using Poisson family generalized lineal models (GLM) and crude (cPR) and adjusted (aPR) prevalence ratios were estimated. Results The sample included 128 parents of children between 5 and 11 years of age. A total of 90.6% of the parents received the vaccine, compared to 64.2% of their children. The incidence of AEFI was higher in adults 62.9% than in children 37.1%, the most frequent being pain at the injection site and fever. Although the level of literacy about COVID-19 and vaccines was adequate, it was poor with respect to AEFI. Multivariable analysis estimated greater hesitancy to childhood vaccination in previously vaccinated parents (RPa = 0.37; 95% CI: 0.14–0.99; p -value = 0.048) and in those with low literacy about AEFI (RPa = 0.62; 95% CI = 0.50–0.76; p -value ' 0.001). Conclusions In addition, the AEFI experienced by adults and the low level of health literacy constitute significant barriers to childhood immunization, which reaffirms the need to strengthen health education and reduce vaccine hesitancy.