GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Multimorbidity in Latin America and the Caribbean: a systematic review and meta-analysis
    BMJ ; 2021
    In:  BMJ Open Vol. 11, No. 7 ( 2021-07), p. e050409-
    Details
    In: BMJ Open, BMJ, Vol. 11, No. 7 ( 2021-07), p. e050409-
    Abstract: To estimate the pooled prevalence of multimorbidity (≥2 non-communicable diseases in the same individual) among adults of the general population of Latin American and the Caribbean (LAC). Design Systematic review and meta-analysis. Data sources MEDLINE, Embase, Global Health, Scopus and LILACS up to 1 July 2020. Eligibility criteria for selecting studies The outcome was the prevalence of multimorbidity. Reports were selected whether they enrolled adult individuals (age ≥18 years) from the general population. Data extraction and synthesis Reviewers extracted relevant data and assessed risk of bias independently. A random-effects meta-analysis was conducted to report pooled prevalence estimates of multimorbidity; pooled estimates by pre-specified subgroups (eg, national studies) were also pursued. Results From 5830 results, we selected 28 reports, mostly from Brazil and 16 were based on a nationally representative sample. From the 28 selected reports, 26 were further included in the meta-analysis revealing a pooled multimorbidity prevalence of 43% (95% CI: 35% to 51%; I 2 : 99.9%). When only reports with a nationally representative sample were combined, the pooled prevalence was 37% (95% CI: 27% to 47%; I 2 : 99.9%). When the ascertainment of multimorbidity was based on self-reports alone, the pooled prevalence was 40% (95% CI: 31% to 48%; I 2 : 99.9%); this raised to 52% (95% CI: 33% to 70%; I 2 : 99.9%) for reports including self-reported and objective diagnosis. Conclusions Our results complement and advance those from global efforts by incorporating much more reports from LAC. We revealed a larger presence of multimorbidity in LAC than previously reported. PROSPERO registration number CRD42020196177.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2021-050409
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2599832-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    Migration, urbanisation and mortality: 5-year longitudinal analysis of the PERU MIGRANT study
    BMJ ; 2015
    In:  Journal of Epidemiology and Community Health Vol. 69, No. 7 ( 2015-07), p. 715-718
    Details
    In: Journal of Epidemiology and Community Health, BMJ, Vol. 69, No. 7 ( 2015-07), p. 715-718
    Type of Medium: Online Resource
    ISSN: 0143-005X , 1470-2738
    URL: Article
    DOI: 10.1136/jech-2015-205657
    Language: English
    Publisher: BMJ
    Publication Date: 2015
    detail.hit.zdb_id: 2015405-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    Machine learning health-related applications in low-income and middle-income countries: a scoping review protocol
    BMJ ; 2020
    In:  BMJ Open Vol. 10, No. 5 ( 2020-05), p. e035983-
    Details
    In: BMJ Open, BMJ, Vol. 10, No. 5 ( 2020-05), p. e035983-
    Abstract: Machine learning (ML) has been used in bio-medical research, and recently in clinical and public health research. However, much of the available evidence comes from high-income countries, where different health profiles challenge the application of this research to low/middle-income countries (LMICs). It is largely unknown what ML applications are available for LMICs that can support and advance clinical medicine and public health. We aim to address this gap by conducting a scoping review of health-related ML applications in LMICs. Methods and analysis This scoping review will follow the methodology proposed by Levac et al . The search strategy is informed by recent systematic reviews of ML health-related applications. We will search Embase, Medline and Global Health (through Ovid), Cochrane and Google Scholar; we will present the date of our searches in the final review. Titles and abstracts will be screened by two reviewers independently; selected reports will be studied by two reviewers independently. Reports will be included if they are primary research where data have been analysed, ML techniques have been used on data from LMICs and they aimed to improve health-related outcomes. We will synthesise the information following evidence mapping recommendations. Ethics and dissemination The review will provide a comprehensive list of health-related ML applications in LMICs. The results will be disseminated through scientific publications. We also plan to launch a website where ML models can be hosted so that researchers, policymakers and the general public can readily access them.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2019-035983
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2599832-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    Street images classification according to COVID-19 risk in Lima, Peru: a convolutional neural networks feasibility analysis
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 9 ( 2022-09), p. e063411-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 9 ( 2022-09), p. e063411-
    Abstract: During the COVID-19 pandemic, convolutional neural networks (CNNs) have been used in clinical medicine (eg, X-rays classification). Whether CNNs could inform the epidemiology of COVID-19 classifying street images according to COVID-19 risk is unknown, yet it could pinpoint high-risk places and relevant features of the built environment. In a feasibility study, we trained CNNs to classify the area surrounding bus stops (Lima, Peru) into moderate or extreme COVID-19 risk. Design CNN analysis based on images from bus stops and the surrounding area. We used transfer learning and updated the output layer of five CNNs: NASNetLarge, InceptionResNetV2, Xception, ResNet152V2 and ResNet101V2. We chose the best performing CNN, which was further tuned. We used GradCam to understand the classification process. Setting Bus stops from Lima, Peru. We used five images per bus stop. Primary and secondary outcome measures Bus stop images were classified according to COVID-19 risk into two labels: moderate or extreme. Results NASNetLarge outperformed the other CNNs except in the recall metric for the moderate label and in the precision metric for the extreme label; the ResNet152V2 performed better in these two metrics (85% vs 76% and 63% vs 60%, respectively). The NASNetLarge was further tuned. The best recall (75%) and F1 score (65%) for the extreme label were reached with data augmentation techniques. Areas close to buildings or with people were often classified as extreme risk. Conclusions This feasibility study showed that CNNs have the potential to classify street images according to levels of COVID-19 risk. In addition to applications in clinical medicine, CNNs and street images could advance the epidemiology of COVID-19 at the population level.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2022-063411
    DOI: 10.1136/bmjopen-2022-063411.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    Systematic review of diagnostic and prognostic models of chronic kidney disease in low-income and middle-income countries
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 3 ( 2022-03), p. e058921-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 3 ( 2022-03), p. e058921-
    Abstract: To summarise available chronic kidney disease (CKD) diagnostic and prognostic models in low-income and middle-income countries (LMICs). Method Systematic review (Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines). We searched Medline, EMBASE, Global Health (these three through OVID), Scopus and Web of Science from inception to 9 April 2021, 17 April 2021 and 18 April 2021, respectively. We first screened titles and abstracts, and then studied in detail the selected reports; both phases were conducted by two reviewers independently. We followed the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies recommendations and used the Prediction model Risk Of Bias ASsessment Tool for risk of bias assessment. Results The search retrieved 14 845 results, 11 reports were studied in detail and 9 (n=61 134) were included in the qualitative analysis. The proportion of women in the study population varied between 24.5% and 76.6%, and the mean age ranged between 41.8 and 57.7 years. Prevalence of undiagnosed CKD ranged between 1.1% and 29.7%. Age, diabetes mellitus and sex were the most common predictors in the diagnostic and prognostic models. Outcome definition varied greatly, mostly consisting of urinary albumin-to-creatinine ratio and estimated glomerular filtration rate. The highest performance metric was the negative predictive value. All studies exhibited high risk of bias, and some had methodological limitations. Conclusion There is no strong evidence to support the use of a CKD diagnostic or prognostic model throughout LMIC. The development, validation and implementation of risk scores must be a research and public health priority in LMIC to enhance CKD screening to improve timely diagnosis.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2021-058921
    DOI: 10.1136/bmjopen-2021-058921.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    Trends in the prevalence and treatment of depressive symptoms in Peru: a population-based study
    BMJ ; 2020
    In:  BMJ Open Vol. 10, No. 7 ( 2020-07), p. e036777-
    Details
    In: BMJ Open, BMJ, Vol. 10, No. 7 ( 2020-07), p. e036777-
    Abstract: This study aimed to estimate the trends in the prevalence and treatment of depressive symptoms using nationally representative surveys in Peru from 2014 to 2018. Design A secondary analysis was conducted using five nationally representative surveys carried out consecutively in the years between 2014 and 2018. Setting The study was conducted in Peru. Participants Individuals, men and women, aged ≥15 years who participated in the selected surveys. Sampling was probabilistic using a two-stage approach. Main outcome measures Two versions of the Patient Health Questionnaire (PHQ-9) that focused on the presence of depressive symptoms were administered (one in the last 2 weeks and other in the last year). Scores ≥15 were used as the cut-off point in both versions of the PHQ-9 to define the presence of depressive symptoms. Also, the treatment rate was based on the proportion of individuals who had experienced depressive symptoms in the last year and who had self-reported having received specific treatment for these symptoms. The age-standardised prevalence was estimated. Results A total of 161 061 participants were included. There was no evidence of a change in age-standardised prevalence rates of depressive symptoms at the 2 weeks prior to the point of data collection (2.6% in 2014 to 2.3% in 2018), or in the last year (6.3% in 2014 to 6.2% in 2018). Furthermore, no change was found in the proportion of depressive cases treated in the last year (14.6% in 2014 to 14.4% in 2018). Rural areas and individuals with low-level of wealth had lower proportion of depressive cases treated. Conclusions No changes in trends of rates of depressive symptoms or in the proportion of depressive cases treated were observed. This suggests the need to reduce the treatment gap considering social determinants associated with inequality in access to adequate therapy.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2020-036777
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2599832-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 7
    Online Resource
    Online Resource
    Trajectories of body mass index and waist circumference in four Peruvian settings at different level of urbanisation: the CRONICAS Cohort Study
    BMJ ; 2018
    In:  Journal of Epidemiology and Community Health Vol. 72, No. 5 ( 2018-05), p. 397-403
    Details
    In: Journal of Epidemiology and Community Health, BMJ, Vol. 72, No. 5 ( 2018-05), p. 397-403
    Abstract: Studies have reported the incidence/risk of becoming obese, but few have described the trajectories of body mass index (BMI) and waist circumference (WC) over time, especially in low/middle-income countries. We assessed the trajectories of BMI and WC according to sex in four sites in Peru. Methods Data from the population-based CRONICAS Cohort Study were analysed. We fitted a population-averaged model by using generalised estimating equations. The outcomes of interest, with three data points over time, were BMI and WC. The exposure variable was the factorial interaction between time and study site. Results At baseline mean age was 55.7 years (SD: 12.7) and 51.6% were women. Mean follow-up time was 2.5 years (SD: 0.4). Over time and across sites, BMI and WC increased linearly. The less urbanised sites showed a faster increase than more urbanised sites, and this was also observed after sex stratification. Overall, the fastest increase was found for WC compared with BMI. Compared with Lima, the fastest increase in WC was in rural Puno (coefficient=0.73, P 〈 0.001), followed by urban Puno (coefficient=0.59, P=0.001) and Tumbes (coefficient=0.22, P=0.088). Conclusions There was a linear increase in BMI and WC across study sites, with the greatest increase in less urbanised areas. The ongoing urbanisation process, common to Peru and other low/middle-income countries, is accompanied by different trajectories of increasing obesity-related markers.
    Type of Medium: Online Resource
    ISSN: 0143-005X , 1470-2738
    URL: Article
    URL: Article
    DOI: 10.1136/jech-2017-209795
    DOI: 10.1136/jech-2017-209795.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2018
    detail.hit.zdb_id: 2015405-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 8
    Online Resource
    Online Resource
    Contribution of modifiable risk factors for hypertension and type-2 diabetes in Peruvian resource-limited settings
    BMJ ; 2016
    In:  Journal of Epidemiology and Community Health Vol. 70, No. 1 ( 2016-01), p. 49-55
    Details
    In: Journal of Epidemiology and Community Health, BMJ, Vol. 70, No. 1 ( 2016-01), p. 49-55
    Type of Medium: Online Resource
    ISSN: 0143-005X , 1470-2738
    URL: Article
    DOI: 10.1136/jech-2015-205988
    Language: English
    Publisher: BMJ
    Publication Date: 2016
    detail.hit.zdb_id: 2015405-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 9
    Online Resource
    Online Resource
    Longitudinal association between food frequency and changes in body mass index: a prospective cohort study
    BMJ ; 2020
    In:  BMJ Open Vol. 10, No. 9 ( 2020-09), p. e037057-
    Details
    In: BMJ Open, BMJ, Vol. 10, No. 9 ( 2020-09), p. e037057-
    Abstract: Analysing data of the Young Lives Study in Peru, we aimed at assessing the association between daily food frequency and body mass index (BMI) changes between 2006 and 2016. Design Secondary analysis of a prospective ongoing cohort study. Setting 20 sentinel sites in Peru. Participants Children enrolled in the younger cohort of the Young Lives Study. We used information from the second (2006–2007), third (2009–2010), fourth (2013–2014) and fifth (2016–2017) rounds of the younger cohort in Peru. Primary and secondary outcomes BMI as well as BMI-for-age z-score, both as numerical variables. Results Data from 1948 children, mean age 4.3 (SD: 0.3) years and 966 (49.6%) women were included at baseline. In multivariable model, lower food consumption frequency was associated with increased BMI and BMI-for-age z-scores: children reporting 〈 4 times of food consumption per day had a greater increase in BMI (β=0.39; 95% CI 0.17 to 0.62) and BMI-for-age z-score (β=0.07; 95% CI 0.01 to 0.13) compared with those reporting 5 per day. Results were consistent for those reporting exactly eating 4 times per day (β for BMI=0.16; 95% CI 0.02 to 0.30 and β for BMI-for-age z-score=0.05; 95% CI 0.01 to 0.09). Conclusions Children who eat 〈 5 times per day, gain more BMI compared with those who eat ≥5 times. Parents should receive information to secure adequate nutrition for their children, both in terms of quality and quantity.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2020-037057
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2599832-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 10
    Online Resource
    Online Resource
    Agreement between the laboratory-based and non-laboratory-based WHO cardiovascular risk charts: a cross-sectional analysis of a national health survey in Peru
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 11 ( 2022-11), p. e063289-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 11 ( 2022-11), p. e063289-
    Abstract: To determine the agreement between the cardiovascular disease (CVD) risk predictions computed with the WHO non-laboratory-based model and laboratory-based model in a nationally representative sample of Peruvian adults. Design Cross-sectional analysis of a national health survey. Methods Absolute CVD risk was computed with the 2019 WHO laboratory-based and non-laboratory-based models. The risk predictions from both models were compared with Bland-Altman plots, Lin’s concordance coefficient correlation (LCCC), and kappa statistics, stratified by sex, age, body mass index categories, smoking and diabetes status. Results 663 people aged 30–59 years were included in the analysis. Overall, there were no substantial differences between the mean CVD risk computed with the laboratory-based model 2.0% (95% CI 1.8% to 2.2%) and the non-laboratory-based model 2.0% (95% CI 1.8% to 2.1%). In the Bland-Altman plots, the limits of agreement were the widest among people with diabetes (−0.21; 4.37) compared with people without diabetes (−1.17; 0.95). The lowest agreement as per the LCCC was also seen in people with diabetes (0.74 (95% CI 0.63 to 0.82)), the same was observed with the kappa statistic (kappa=0.36). In general, agreement between the scores was appropriate in terms of clinical significance. Conclusions The absolute cardiovascular predicted risk was similar between the laboratory-based and non-laboratory-based 2019 WHO cardiovascular risk models. Pending validation from longitudinal studies, the non-laboratory-based model (instead of the laboratory-based) could be used when assessing CVD risk in Peruvian population.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2022-063289
    DOI: 10.1136/bmjopen-2022-063289.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...