ORCID Profile
0000-0002-2090-1856
Current Organisations
Universidad Peruana Cayetano Heredia
,
Imperial College London
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Publisher: Instituto Nacional de Salud (Peru)
Date: 24-09-2020
DOI: 10.17843/RPMESP.2020.373.5980
Abstract: Las personas con diabetes mellitus tipo 2 infectadas por SARS-CoV-2 tienen mayores riesgos de desarrollar COVID-19 con complicaciones y de morir como consecuencia de ella. La diabetes es una condición crónica en la que se requiere continuidad de cuidados que implican un contacto con los establecimientos de salud, pues deben tener acceso regular a medicamentos, exámenes y citas con personal de salud. Esta continuidad de cuidados se ha visto afectada en el Perú a raíz de la declaratoria del estado de emergencia nacional, producto de la pandemia por la COVID-19 pues muchos establecimientos de salud han suspendido las consultas externas. Este artículo describe algunas estrategias que han desarrollado los diferentes proveedores de salud peruanos en el marco de la pandemia para proveer continuidad del cuidado a las personas con diabetes y finalmente brinda recomendaciones para que reciban los cuidados que necesitan a través del fortalecimiento del primer nivel de atención, como el punto de contacto más cercano con las personas con diabetes.
Publisher: MDPI AG
Date: 22-02-2018
DOI: 10.3390/NU10020245
Publisher: JMIR Publications Inc.
Date: 15-03-2018
Abstract: he uptake of an intervention aimed at improving health-related lifestyles may be influenced by the participant’s stage of readiness to change behaviors. e conducted secondary analysis of the Grupo de Investigación en Salud Móvil en América Latina (GISMAL) trial according to levels of uptake of intervention (dose-response) to explore outcomes by country, in order to verify the consistency of the trial’s pooled results, and by each participant’s stage of readiness to change a given lifestyle at baseline. The rationale for this secondary analysis is motivated by the original design of the GISMAL study that was independently powered for the primary outcome—blood pressure—for each country. e conducted a secondary analysis of a mobile health (mHealth) multicountry trial conducted in Argentina, Guatemala, and Peru. The intervention consisted of monthly motivational phone calls by a trained nutritionist and weekly tailored text messages (short message service), over a 12-month period, aimed to enact change on 4 health-related behaviors: salt added to foods when cooking, consumption of high-fat and high-sugar foods, consumption of fruits or vegetables, and practice of physical activity. Results were stratified by country and by participants’ stage of readiness to change (precontemplation or contemplation preparation or action or maintenance) at baseline. Exposure (intervention uptake) was the level of intervention ( %, 50%-74%, and ≥75%) received by the participant in terms of phone calls. Linear regressions were performed to model the outcomes of interest, presented as standardized mean values of the following: blood pressure, body weight, body mass index, waist circumference, physical activity, and the 4 health-related behaviors. or each outcome of interest, considering the intervention uptake, the magnitude and direction of the intervention effect differed by country and by participants’ stage of readiness to change at baseline. Among those in the high intervention uptake category, reductions in systolic blood pressure were only achieved in Peru, whereas fruit and vegetable consumption also showed reductions among those who were at the maintenance stage at baseline in Argentina and Guatemala. esigning interventions oriented toward improving health-related lifestyle behaviors may benefit from recognizing baseline readiness to change and issues in implementation uptake. linicalTrials.gov NCT01295216 t2/show/NCT01295216 (Archived by WebCite at 2tMF0B7B).
Publisher: Ubiquity Press, Ltd.
Date: 03-2015
Publisher: Springer Science and Business Media LLC
Date: 11-02-2016
DOI: 10.1038/JHH.2015.124
Publisher: Elsevier BV
Date: 03-2023
Publisher: BMJ
Date: 23-01-2017
Publisher: Public Library of Science (PLoS)
Date: 13-11-2014
Publisher: BMJ
Date: 05-2020
DOI: 10.1136/BMJOPEN-2019-035983
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. 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. 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.
Publisher: BMJ
Date: 06-08-2015
Publisher: Wiley
Date: 19-06-2021
DOI: 10.1002/OBY.23188
Abstract: This study assessed the relationship between urbanization and the double burden of malnutrition (DBM) in Peru. A cross‐sectional analysis of the Demographic and Health Survey (2009 to 2016) was conducted. A DBM “case” comprised a child with undernutrition and a mother with overweight/obesity. For urbanization, three indicators were used: an eight‐category variable based on district‐level population density (inhabitants/km 2 ), a dichotomous urban/rural variable, and place of residence (countryside, towns, small cities, or capital/large cities). The prevalence of DBM was lower in urban than in rural areas (prevalence ratio [PR] 0.70 95% CI: 0.65‐0.75), and compared with the countryside, DBM was less prevalent in towns (PR 0.75 95% CI: 0.69‐0.82), small cities (PR 0.73 95% CI: 0.67‐0.79), and capital/large cities (PR 0.53 95% CI: 0.46‐0.61). Using population density, the adjusted prevalence of DBM was 9.7% (95% CI: 9.4%‐10.1%) in low‐density settings (1 to 500 inhabitants/km 2 ), 5.9% (95% CI: 4.9%‐6.8%) in mid‐urbanized settings (1,001 to 2,500 inhabitants/km 2 ), 5.8% (95% CI: 4.5%‐7.1%) in more densely populated settings (7,501 to 10,000 inhabitants/km 2 ), and 5.5% (95% CI: 4.1%‐7.0%) in high‐density settings ( ,000 inhabitants/km 2 ). The prevalence of DBM is higher in the least‐urbanized settings such as rural and peri‐urban areas, particularly those under 2,500 inhabitants/km 2 .
Publisher: Springer Science and Business Media LLC
Date: 31-07-2015
DOI: 10.1038/IJO.2015.140
Publisher: Springer Science and Business Media LLC
Date: 24-11-2015
DOI: 10.1007/S00038-015-0767-7
Abstract: To estimate the incidence and risk of childhood overweight and obesity according to socioeconomic status in Peruvian and Vietnamese school-aged children. 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. 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 s les. 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). The results provide important information for childhood obesity prevention in countries moving ahead with economic, epidemiological and nutritional transitions.
Publisher: PeerJ
Date: 21-04-2021
DOI: 10.7717/PEERJ.11307
Abstract: Understanding the relationship between BMI and blood pressure requires assessing whether this association is similar or differs across population groups. This study aimed to assess the association between body mass index (BMI) and blood pressure levels, and how these associations vary between socioeconomic groups and geographical settings. Data from the National Demographic Health Survey of Peru from 2014 to 2019 was analyzed considering the complex survey design. The outcomes were levels of systolic (SBP) and diastolic blood pressure (DBP), and the exposure was BMI. Exposure and outcomes were fitted as continuous variables in a non-linear quadratic regression model. We explored effect modification by six socioeconomic and geographical variables (sex, age, education level, socioeconomic position, study area, and altitude), fitting an interaction term between each of these variables and BMI. Data from 159, 940 subjects, mean age 44.4 (SD: 17.1), 54.6% females, was analyzed. A third (34.0%) of in iduals had ≥12 years of education, 24.7% were from rural areas, and 23.7% lived in areas located over 2,500 m above sea level. In the overall s le mean BMI was 27.1 (SD: 4.6) kg/m 2 , and mean SBP and DBP were 122.5 (SD: 17.2) and 72.3 (SD: 9.8) mmHg, respectively. In the multivariable models, greater BMI levels were associated with higher SBP ( p -value 0.001) and DBP ( p -value 0.001). There was strong evidence that sex, age, education level, and altitude were effect modifiers of the association between BMI and both SBP and DBP. In addition to these socio-demographic variables, socioeconomic position and study area were also effect modifiers of the association between BMI and DBP, but not SBP. The association between BMI and levels of blood pressure is not uniform on a range of socio-demographic and geographical population groups. This characterization can inform the understanding of the epidemiology and rise of blood pressure in a ersity of low-resource settings.
Publisher: Ubiquity Press, Ltd.
Date: 03-2016
Publisher: Elsevier BV
Date: 2017
Publisher: Ubiquity Press, Ltd.
Date: 03-2016
DOI: 10.1016/J.GHEART.2015.12.003
Abstract: Cost-effective primary prevention of cardiovascular disease (CVD) in low- and middle-income countries requires accurate risk assessment. Laboratory-based risk tools currently used in high-income countries are relatively expensive and impractical in many settings due to lack of facilities. This study sought to assess the correlation between a non-laboratory-based risk tool and 4 commonly used, laboratory-based risk scores in 7 countries representing nearly one-half of the world's population. We calculated 10-year CVD risk scores for 47,466 persons with cross-sectional data collected from 16 different cohorts in 9 countries. The performance of the non-laboratory-based risk score was compared with 4 laboratory-based risk scores: Pooled Cohort Risk Equations (ASCVD [Atherosclerotic Cardiovascular Disease]), Framingham, and SCORE (Systematic Coronary Risk Evaluation) for high- and low-risk countries. Rankings of each score were compared using Spearman rank correlations. Based on these correlations, we measured concordance between in idual absolute CVD risk as measured by the Harvard NHANES (National Health and Nutrition Examination Survey) risk score, and the 4 laboratory-based risk scores, using both the conventional Framingham risk thresholds of >20% and the recent ASCVD guideline threshold of >7.5%. The aggregate Spearman rank correlations between the non-laboratory-based risk score and the laboratory-based scores ranged from 0.915 to 0.979 for women and from 0.923 to 0.970 for men. When applying the conventional Framingham risk threshold of >20% over 10 years, 92.7% to 96.0% of women and 88.3% to 92.8% of men were equivalently characterized as "high" or "low" risk. Applying the recent ASCVD guidelines risk threshold of >7.5% resulted in risk characterization agreement for women ranging from 88.1% to 94.4% and from 89.0% to 93.7% for men. The correlation between non-laboratory-based and laboratory-based risk scores is very high for both men and women. Potentially large numbers of high-risk in iduals could be detected with relatively simple tools.
Publisher: Ubiquity Press, Ltd.
Date: 03-2016
Publisher: JMIR Publications Inc.
Date: 11-2018
DOI: 10.2196/10226
Publisher: Elsevier BV
Date: 10-2022
DOI: 10.1016/J.CLNESP.2022.07.019
Abstract: Although diet has been extensively studied in relation to in idual chronic conditions, studies linking diet with multiple chronic conditions (multimorbidity) remained scarce. We aimed to undertake a comprehensive analysis evaluating associations of overall dietary patterns and specific food groups with long-term risk of multimorbidity. The study included 348,290 participants from UK Biobank who completed eligible food frequency questionnaires (FFQ) and were not diagnosed with any of the 38 chronic or mental health conditions of interest at baseline (2006-2010). Dietary patterns were identified using exploratory factor analysis. Cox regression models were used to estimate corresponding hazard ratios (HRs) and 95% confidence intervals (CIs). The median follow-up was 8.01 years, and 50,837 (14.60%) participants developed multimorbidity. Among the three identified dietary patterns, the Western Pattern was associated with an increased risk of multimorbidity (HR Dietary patterns and specific food groups are associated with the risk of multimorbidity. These findings suggest the importance of considering dietary interventions in the prevention and management of multimorbidity.
Publisher: Human Kinetics
Date: 06-2016
Abstract: Physical inactivity and sedentary behaviors have been linked with impaired health outcomes. Establishing the physical inactivity profiles of a given population is needed to establish program targets and to contribute to international monitoring efforts. We report the prevalence of, and explore sociodemographical and built environment factors associated with physical inactivity in 4 resource-limited settings in Peru: rural Puno, urban Puno, P as de San Juan de Miraflores (urban), and Tumbes (semiurban). Cross-sectional analysis of the CRONICAS Cohort Study’s baseline assessment. Outcomes of interest were physical inactivity of leisure time ( MET-min/week) and transport-related physical activity (not reporting walking or cycling trips) domains of the IPAQ, as well as watching TV, as a proxy of sedentarism (≥2 hours per day). Exposures included demographic factors and perceptions about neighborhood’s safety. Associations were explored using Poisson regression models with robust standard errors. Prevalence ratios (PR) and 95% confidence intervals (95% CI) are presented. Data from 3593 in iduals were included: 48.5% males, mean age 55.1 (SD: 12.7) years. Physical inactivity was present at rates of 93.7% (95% CI 93.0%–94.5%) and 9.3% (95% CI 8.3%–10.2%) within the leisure time and transport domains, respectively. In addition, 41.7% (95% CI 40.1%–43.3%) of participants reported watching TV for more than 2 hours per day. Rates varied according to study settings ( P .001). In multivariable analysis, being from rural settings was associated with 3% higher prevalence of leisure time physical inactivity relative to highly urban Lima. The pattern was different for transport-related physical inactivity: both Puno sites had around 75% to 50% lower prevalence of physical inactivity. Too much traffic was associated with higher levels of transport-related physical inactivity (PR = 1.24 95% CI 1.01–1.54). Our study showed high levels of inactivity and marked contrasting patterns by rural/urban sites. These findings highlight the need to generate synergies to expand nationwide physical activity surveillance systems.
Publisher: Ubiquity Press, Ltd.
Date: 03-2016
Publisher: Oxford University Press (OUP)
Date: 13-05-2023
DOI: 10.1093/IJE/DYAD057
Abstract: The burden of chronic conditions associated with sugary beverages is increasing but little is known about the role of different types of sugary beverages in the co-occurrence of multiple chronic conditions (‘multimorbidity’). To inform future sugar-reduction guidelines, we aimed to examine the associations of sugar-sweetened beverages (SSB), artificially sweetened beverages (ASB) and natural juices (NJ) with multimorbidity. This prospective cohort study included 184 093 UK Biobank participants aged 40–69 years at baseline who completed at least one occasion of 24-h dietary recall between 2009 and 2012. Daily consumptions of SSB, ASB and NJ were assessed using 24-h dietary recall. Participants were followed from the first 24-h assessment until the onset of two or more new chronic conditions, or the end of follow-up (31 March 2017), whichever occurred first. Logistic regression models, Cox proportional hazard models and quasi-Poisson mixed effects models were used to estimate the association of beverages intakes with chronic conditions and multimorbidity. A total of 19 057 participants had multimorbidity at baseline and 19 968 participants developed at least two chronic conditions during follow-up. We observed dose–response relationships of SSB and ASB consumptions with the prevalence and incidence of multimorbidity. For ex le, the adjusted hazard ratios (HRs) and 95% CIs of the incidence of developing at least two chronic conditions ranged from 1.08 (1.01–1.14) for SSB intake of 1.1–2 units/day to 1.23 (1.14–1.32) for & units/day compared with 0 units/day. Also, the adjusted HRs (95% CIs) of ASB consumption ranged from 1.08 (1.03–1.13) for 0.1–1 unit/day to 1.28 (1.17–1.40) for & units/day compared with non-consumers. Conversely, moderate consumption of NJ was associated with a smaller risk of the prevalence and incidence of multimorbidity. Moreover, higher intakes of SSB and ASB were positively associated whereas moderate intake of NJ was inversely associated with increased number of new-onset chronic conditions during follow-up. Higher SSB and ASB intakes were positively associated whereas moderate NJ intake was inversely associated with the higher risk of multimorbidity and increased number of chronic conditions. Current and intended policy options to decrease the burden of chronic conditions and multimorbidity need a formulation of SSB and ASB reduction strategies.
Publisher: F1000 Research Ltd
Date: 02-09-2021
DOI: 10.12688/WELLCOMEOPENRES.16947.2
Abstract: Background : Financial incentives may improve the initiation and engagement of behaviour change that reduce the negative outcomes associated with non-communicable diseases. There is still a paucity in guidelines or recommendations that help define key aspects of incentive-oriented interventions, including the type of incentive (e.g. cash rewards, vouchers), the frequency and magnitude of the incentive, and its mode of delivery. We aimed to systematically review the literature on financial incentives that promote healthy lifestyle behaviours or improve health profiles, and focused on the methodological approach to define the incentive intervention and its delivery. The protocol was registered at PROSPERO on 26 July 2018 ( CRD42018102556 ). Methods : We sought studies in which a financial incentive was delivered to improve a health-related lifestyle behaviour (e.g., physical activity) or a health profile (e.g., HbA1c in people with diabetes). The search (which took place on March 3 rd 2018) was conducted using OVID (MEDLINE and Embase), CINAHL and Scopus. Results : The search yielded 7,575 results and 37 were included for synthesis. Of the total, 83.8% (31/37) of the studies were conducted in the US, and 40.5% (15/37) were randomised controlled trials. Only one study reported the background and rationale followed to develop the incentive and conducted a focus group to understand what sort of incentives would be acceptable for their study population. There was a degree of consistency across the studies in terms of the direction, form, certainty, and recipient of the financial incentives used, but the magnitude and immediacy of the incentives were heterogeneous. Conclusions : The available literature on financial incentives to improve health-related lifestyles rarely reports on the rationale or background that defines the incentive approach, the magnitude of the incentive and other relevant details of the intervention, and the reporting of this information is essential to foster its use as potential effective interventions.
Publisher: F1000 Research Ltd
Date: 25-06-2021
DOI: 10.12688/WELLCOMEOPENRES.16947.1
Abstract: Background : Financial incentives may improve the initiation and engagement of behaviour change that reduce the negative outcomes associated with non-communicable diseases. There is still a paucity in guidelines or recommendations that help define key aspects of incentive-oriented interventions, including the type of incentive (e.g. cash rewards, vouchers), the frequency and magnitude of the incentive, and its mode of delivery. We aimed to systematically review the literature on financial incentives that promote healthy lifestyle behaviours or improve health profiles, and focused on the methodological approach to define the incentive intervention and its delivery. The protocol was registered at PROSPERO on 26 July 2018 ( CRD42018102556 ). Methods : We sought studies in which a financial incentive was delivered to improve a health-related lifestyle behaviour (e.g., physical activity) or a health profile (e.g., HbA1c in people with diabetes). The search (which took place on March 3 rd 2018) was conducted using OVID (MEDLINE and Embase), CINAHL and Scopus. Results : The search yielded 7,575 results and 37 were included for synthesis. Of the total, 83.8% (31/37) of the studies were conducted in the US, and 40.5% (15/37) were randomised controlled trials. Only one study reported the background and rationale followed to develop the incentive and conducted a focus group to understand what sort of incentives would be acceptable for their study population. There was a degree of consistency across the studies in terms of the direction, form, certainty, and recipient of the financial incentives used, but the magnitude and immediacy of the incentives were heterogeneous. Conclusions : The available literature on financial incentives to improve health-related lifestyles rarely reports on the rationale or background that defines the incentive approach, the magnitude of the incentive and other relevant details of the intervention, and the reporting of this information is essential to foster its use as potential effective interventions.
Publisher: BMJ
Date: 18-05-2015
Publisher: PeerJ
Date: 10-04-2014
DOI: 10.7717/PEERJ.345
Publisher: PeerJ
Date: 23-06-2015
DOI: 10.7717/PEERJ.1046
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Rodrigo M. Carrillo-Larco.