Santos-Antonio Gabriela, Canchihuamán Fredy, Huamán-Espino Lucio, Aparco Juan Pablo, Pillaca Jenny, Guillén-Pinto Daniel, Gozzer Ernesto
Instituto Nacional de Salud. Lima, Perú.
Universidad Peruana Cayetano Heredia. Lima, Perú.
Rev Peru Med Exp Salud Publica. 2019 Apr-Jun;36(2):222-230. doi: 10.17843/rpmesp.2019.362.4045. Epub 2019 Aug 22.
OBJECTIVES.: To determine the ratio of microcephaly in newborns in level II and III health facilities of the Ministry of Health (MINSA) of Peru for the period 2005-2013.
MATERIALS AND METHODS.: A secondary analysis of the databases of the Perinatal Information System was carried out during 2005-2013. Microcephaly was identified applying World Health Organization (WHO), Fenton, mixed (WHO-Fenton), and proportionality criteria. The ratios and indices of microcephaly were estimated per 10,000 live births (LB) by region and concordance was compared, using the WHO parameter as a reference.
RESULTS.: The ratio of microcephaly during 2005 to 2013 was 3.4%, the average rate of microcephaly was 335 per 10,000 LBs according to the WHO criterion. The mixed parameter showed a substantial concordance (Kappa of 0.635), while the proportionality parameter showed a reasonable concordance (Kappa of 0.298).
CONCLUSIONS.: The ratio of microcephaly in MINSA Level II and III health facilities was higher than that reported in other countries in the region before the appearance of Zika in the Americas. The frequency variations observed with those of other countries and among Peruvian regions could be explained by different factors, such as the technique for measuring head circumference, data capture, constitutional factors, and social determinants. We suggest standardizing measurements and their recording, harmonizing diagnostic criteria, and establishing health strategies to strengthen the epidemiological surveillance of the causes of microcephaly.
确定2005 - 2013年期间秘鲁卫生部（MINSA）二级和三级医疗机构中新生儿小头畸形的比例。
对2005 - 2013年围产期信息系统数据库进行二次分析。应用世界卫生组织（WHO）、芬顿（Fenton）、混合（WHO - Fenton）和比例标准来识别小头畸形。按地区估计每10,000例活产（LB）的小头畸形比例和指数，并以WHO参数为参考比较一致性。
2005年至2013年期间小头畸形比例为3.4%，根据WHO标准小头畸形平均发生率为每10,000例活产335例。混合参数显示出高度一致性（卡帕值为0.635），而比例参数显示出合理的一致性（卡帕值为0.298）。
在美洲出现寨卡病毒之前，MINSA二级和三级医疗机构中的小头畸形比例高于该地区其他国家报告的比例。与其他国家以及秘鲁各地区观察到的频率差异可能由不同因素解释，如头围测量技术、数据采集、体质因素和社会决定因素。我们建议规范测量及其记录，统一诊断标准，并制定卫生策略以加强对小头畸形病因的流行病学监测。
