Engagement of Adolescents in a Health Communications Program to Prevent Noncommunicable Diseases: Multiplicadores Jóvenes, Lima, Peru, 2011

PubMed Central

Diez-Canseco, Francisco; Boeren, Yulissa; Quispe, Renato; Chiang, Mey lin

2015-01-01

Background Several risk factors for noncommunicable diseases (NCDs), including obesity, are associated with behaviors established in infancy that persist throughout adolescence and adulthood. As such, adolescents should be engaged in the design and implementation of NCD prevention strategies. Community Context In Lima, Peru’s capital, the proportion of adolescents aged 15 to 19 is 9.3% of the city’s population, and school enrollment rates are high. The prevalence of excess weight in Peruvian adolescents is 14.2%, and prevalence has not declined in recent years. Also recently, NCDs and their risk factors have gained more attention in public health and policy areas, with regulatory action focusing on healthful nutrition to address obesity and related NCDs. The Multiplicadores Jóvenes (Young Multipliers) project was conducted among adolescents aged 15 to 17 from 9 public secondary schools in peri-urban areas of Lima, Peru. Methods The project provided basic communication tools and knowledge of NCD prevention and public health research to adolescents during 16 weekly participatory sessions to enable them to design and disseminate healthful lifestyle promotion messages to their school peers. Outcome Thirty of 45 participants finished the program. Seven communications campaigns were designed and implemented in schools, reaching 1,200 students. The participants gained motivation, increased knowledge, and developed communication skills that were combined to implement healthful lifestyle promotion campaigns. Interpretation Engaging young people in public health promotion activities was feasible and advantageous for the design of tailored prevention-related content and its dissemination among peers. PMID:25742065

High prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in anal and pharyngeal sites among a community-based sample of men who have sex with men and transgender women in Lima, Peru

PubMed Central

Leon, Segundo R; Segura, Eddy R; Konda, Kelika A; Flores, Juan A; Silva-Santisteban, Alfonso; Galea, Jerome T; Coates, Thomas J; Klausner, Jeffrey D; Caceres, Carlos F

2016-01-01

Objectives This study aimed to characterise the epidemiology of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. Setting Cross-sectional study in Lima, Peru. Participants We recruited a group of 510 MSM and 208 TW for a subsequent community-based randomised controlled trial. The presence of CT and NG were evaluated using Aptima Combo2 in pharyngeal and anal swabs. We also explored correlates of these infections. Primary and secondary outcome measures: Study end points included overall prevalence of C. trachomatis and N. gonorrhoeae in anal and pharyngeal sites. Results Overall prevalence of CT was 19% (95% CI 16.1% to 22.1%) and 4.8% (95% CI 3.3% to 6.6%) in anal and pharyngeal sites, respectively, while prevalence of NG was 9.6% (95% CI 7.5% to 12.0%) and 6.5% (95% CI 4.8% to 8.5%) in anal and pharyngeal sites, respectively. Conclusions The prevalence of each infection declined significantly among participants older than 34 years (p<0.05). Efforts towards prevention and treatment of extraurogenital chlamydial and gonococcal infections in high-risk populations like MSM and TW in Lima, Peru, are warranted. Trial registration number NCT00670163; Results. PMID:26739719

High prevalence of extra-genital chlamydial or gonococcal infections among men who have sex with men and transgender women in Lima, Peru.

PubMed

Allan-Blitz, Lao-Tzu; Leon, Segundo R; Bristow, Claire C; Konda, Kelika A; Vargas, Silver K; Flores, Juan A; Brown, Brandon J; Caceres, Carlos F; Klausner, Jeffrey D

2017-02-01

Chlamydia trachomatis and Neisseria gonorrhoeae are among the most common sexually transmitted bacterial infections in the world. Data are limited, however, on the burden of extra-genital chlamydial and gonococcal infections among men who have sex with men and transgender women in Lima, Peru. Data were gathered from self-collected anal or pharyngeal swabs from participants in Lima, Peru, and analyzed via cross-sectional methods. Prevalence ratios for the association between extra-genital infection with socio-demographic and sexual behaviors were determined. Overall, 127 (32.8%) participants had anal or pharyngeal infections. On multivariate modeling, anal infection was positively associated with practicing both receptive and insertive anal sex, when compared to insertive alone (PR = 2.49; 95% CI = 1.32-4.71), and negatively associated with any antibiotic use in the prior three months (PR = 0.60; 95% CI = 0.39-0.91). Pharyngeal infection was negatively associated with age greater than 30 years compared to 18-30 years (PR = 0.54; 95% CI = 0.30-0.96), and positively associated with gender identity of transgender women (PR = 2.12; 95% CI = 1.20-3.73). This study demonstrates considerable burden of extra-genital chlamydial and gonococcal infections among men who have sex with men and transgender women in Lima, Peru.

Evaluation of Hypertension Prevention and Control Programs in Lima, Peru.

PubMed

Chung, Bonhee; Kim, Dohyeong; Nam, Eun Woo

2018-01-01

The Korea International Cooperation Agency (KOICA) established 4 health centers to provide hypertension screening and a health support program in a deprived urban area of Lima, Peru. This case report provides a mid-term evaluation of the KOICA's hypertension prevention and control programs. A follow up study was performed on 663 residents who were diagnosed with prehypertension or hypertension (Stage 1 and 2) in the 4 KOICA health centers. Patients participated in programs designed to prevent and control hypertension through education sessions over the course of 6 months. Using simple descriptive statistics and computer simulations, we evaluated the effect of hypertension prevention and control programs on the participants. The KOICA health programs appeared to significantly contribute to lowering the blood pressure (BP) of the participants. The total number of participants with normal BP increased from none to 109. Overall, the female and younger patients responded better to the KOICA programs than the male and older participants. In addition, the average systolic BP, diastolic BP, and body mass index of all participants was significantly reduced. The KOICA programs were effective at lowering blood pressure, particularly amongst the prehypertension group than the Stage 1 and 2 hypertension groups. This suggests that providing an extensive screening service for adults with prehypertension will help control hypertension in the early stages.

Consulta regional sobre investigacion en educacion y toma de decisiones en America Latina: Informe final (Lima, Peru, 11-15 de mayo de 1987) (Regional Meeting on Research in Education and Decision Making in Latin America: Final Report [Lima, Peru, May 11-15, 1987]).

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Santiago (Chile). Regional Office for Education in Latin America and the Caribbean.

This report presents the highlights of a United Nations Educational, Scientific, and Cultural Organization (UNESCO) conference that was convened to give impetus to and encourage research programs, to analyze research policy formation, and to establish research priorities in the field of educational planning and administration. The document…

Migrating to the City: Negotiating Gender and Race in Marie Arana's "Lima Nights"

ERIC Educational Resources Information Center

Heredia, Juanita

2016-01-01

This article examines Peruvian-American Marie Arana's second novel "Lima Nights" (2008) in which she represents Amazonian indigenous migrations to Lima, Peru during and after the Shining Path civil war years (1986-2006). As part of a generation of transnational US Latina authors in the post-2000 period, Arana recovers the image of the…

Gender, age, and exclusion: a challenge to community organisations in Lima, Peru.

PubMed

Clark, F C; Laurie, N

2000-07-01

This article examines the role of two successful grassroots women's organizations in empowering women in old age in Lima, Peru. These organizations include Comedores Populares (soup kitchens) and the Vaso de Leche (glass of milk) Program. The primary goal of both groups is poverty alleviation, specifically through improved nutrition. Through them, women have lobbied on issues such as provision of education and health services, and campaigned against the guerrilla insurgency of the 1980s and the early 1990s. However, evidence from three low-income settlements on the outskirts of Lima implied that no long-term support is available from these organizations to promote the welfare of elderly people. Also, the contribution that elderly members of households make to the work of the organizations is invisible and undervalued. Thus, these findings clearly suggest that even the most successful New Social Movements in Lima are also passive members of society in need of charity.

[Prevalence of overwight and obesity among children under five years in Peru 2007-2010].

PubMed

Pajuelo-Ramírez, Jaime; Miranda-Cuadros, Marianella; Campos-Sánchez, Miguel; Sánchez-Abanto, José

2011-06-01

To estimate the prevalence of overweight and obesity in children under five in Peru in the years 2007-2010 and to describe according to geographical areas, poverty levels, maternal education, breastfeeding, child age, sex and birth weight. continuous (repeated cross-sectional) multistage, random sampling survey from the universe of children under five-years and pregnant women living in Peru, divided into five geographical areas. Out of 3,669 children, 50.3% were males (Lima N=680, Remaining Coast N=763, Urban Sierra N=719, Rural Sierra N=699, Jungle N=808) having their weight and height measured according to international standards. The national prevalence of overweight and obesity was 6.9%, with Metropolitan Lima (10.1%) as the highest and in the Jungle (2.6%) as the lowest. Age, sex, geographical area and birth weight were identified as risk factors through multiple logistic regression. overweight and obesity are higher in Lima, during the first year of age and when birth weight is more than 2.5 Kg.

High prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in anal and pharyngeal sites among a community-based sample of men who have sex with men and transgender women in Lima, Peru.

PubMed

Leon, Segundo R; Segura, Eddy R; Konda, Kelika A; Flores, Juan A; Silva-Santisteban, Alfonso; Galea, Jerome T; Coates, Thomas J; Klausner, Jeffrey D; Caceres, Carlos F

2016-01-06

This study aimed to characterise the epidemiology of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. Cross-sectional study in Lima, Peru. We recruited a group of 510 MSM and 208 TW for a subsequent community-based randomised controlled trial. The presence of CT and NG were evaluated using Aptima Combo2 in pharyngeal and anal swabs. We also explored correlates of these infections. Study end points included overall prevalence of C. trachomatis and N. gonorrhoeae in anal and pharyngeal sites. Overall prevalence of CT was 19% (95% CI 16.1% to 22.1%) and 4.8% (95% CI 3.3% to 6.6%) in anal and pharyngeal sites, respectively, while prevalence of NG was 9.6% (95% CI 7.5% to 12.0%) and 6.5% (95% CI 4.8% to 8.5%) in anal and pharyngeal sites, respectively. The prevalence of each infection declined significantly among participants older than 34 years (p<0.05). Efforts towards prevention and treatment of extraurogenital chlamydial and gonococcal infections in high-risk populations like MSM and TW in Lima, Peru, are warranted. NCT00670163; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Developing a Robust Strategy for Implementing a Water Resources Master Plan in Lima, Peru

NASA Astrophysics Data System (ADS)

Kalra, N.; Groves, D.; Bonzanigo, L.; Molina-Perez, E.

2015-12-01

Lima, the capital of Peru, faces significant water stress. It is the fifth largest metropolitan area in Latin America, and the second largest desert city in the world. The city has developed a Master Plan of major investment projects to improve water reliability until 2040. Yet key questions remain. Is the Master Plan sufficient for ensuring reliability in the face of deeply uncertain future climate change and demand? How do uncertain budget and project feasibility conditions shape Lima's options? How should the investments in the plan be prioritized, and can some be delayed? Lima is not alone in facing these planning challenges. Governments invest billions of dollars annually in long-term projects. Yet deep uncertainties pose formidable challenges to making near-term decisions that make long-term sense. The World Bank has spearheaded a community of practice on methods for Decision Making Under Deep Uncertainty (DMU). This pilot project in Peru is the first in-depth application of DMU techniques to water supply planning in a developing country. It builds on prior analysis done in New York, California, and for the Colorado River, yet shows how these methods can be applied in regions which do not have as advanced data or tools available. The project combines three methods in particular -- Robust Decision Making, Decision Scaling, and Adaptive Pathways -- to help Lima implement its Master Plan in a way that is robust, no-regret, and adaptive. It was done in close partnership with SEDAPAL, the water utility company in Lima, and in coordination with other national WRM and meteorological agencies. This talk will: Present the planning challenges Lima and other cities face, including climate change Describe DMU methodologies and how they were applied in collaboration with SEDAPAL Summarize recommendations for achieving long-term water reliability in Lima Suggest how these methodologies can benefit other investment projects in developing countries.

Characteristics of Travel-Related Severe Plasmodium vivax and Plasmodium falciparum Malaria in Individuals Hospitalized at a Tertiary Referral Center in Lima, Peru.

PubMed

Llanos-Chea, Fiorella; Martínez, Dalila; Rosas, Angel; Samalvides, Frine; Vinetz, Joseph M; Llanos-Cuentas, Alejandro

2015-12-01

Severe Plasmodium falciparum malaria is uncommon in South America. Lima, Peru, while not endemic for malaria, is home to specialized centers for infectious diseases that admit and manage patients with severe malaria (SM), all of whom contracted infection during travel. This retrospective study describes severe travel-related malaria in individuals admitted to one tertiary care referral hospital in Lima, Peru; severity was classified based on criteria published by the World Health Organization in 2000. Data were abstracted from medical records of patients with SM admitted to Hospital Nacional Cayetano Heredia from 2006 to 2011. Of 33 SM cases with complete clinical data, the mean age was 39 years and the male/female ratio was 2.8. Most cases were contracted in known endemic regions within Peru: Amazonia (47%), the central jungle (18%), and the northern coast (12%); cases were also found in five (15%) travelers returning from Africa. Plasmodium vivax was most commonly identified (71%) among the severe infections, followed by P. falciparum (18%); mixed infections composed 11% of the group. Among the criteria of severity, jaundice was most common (58%), followed by severe thrombocytopenia (47%), hyperpyrexia (32%), and shock (15%). Plasmodium vivax mono-infection predominated as the etiology of SM in cases acquired in Peru. © The American Society of Tropical Medicine and Hygiene.

Outbreak of Vibrio parahaemolyticus Sequence Type 120, Peru, 2009.

PubMed

Gonzalez-Escalona, Narjol; Gavilan, Ronnie G; Toro, Magaly; Zamudio, Maria L; Martinez-Urtaza, Jaime

2016-07-01

In 2009, an outbreak of Vibrio parahaemolyticus occurred in Piura, Cajamarca, Lambayeque, and Lima, Peru. Whole-genome sequencing of clinical and environmental samples from the outbreak revealed a new V. parahaemolyticus clone. All the isolates identified belonged to a single clonal complex described exclusively in Asia before its emergence in Peru.

Outbreak of Vibrio parahaemolyticus Sequence Type 120, Peru, 2009

PubMed Central

Gonzalez-Escalona, Narjol; Gavilan, Ronnie G.; Toro, Magaly; Zamudio, Maria L.

2016-01-01

In 2009, an outbreak of Vibrio parahaemolyticus occurred in Piura, Cajamarca, Lambayeque, and Lima, Peru. Whole-genome sequencing of clinical and environmental samples from the outbreak revealed a new V. parahaemolyticus clone. All the isolates identified belonged to a single clonal complex described exclusively in Asia before its emergence in Peru. PMID:27315090

78 FR 66105 - Additional Designations, Foreign Narcotics Kingpin Designation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-04

... the Kingpin Act. Individuals 1. CALLE QUIROS, Luis Santiago, Madrid, Spain; Lima, Peru; DOB 22 Jul 1965; POB Madrid, Spain; citizen Spain; alt. citizen Peru; D.N.I. 01927713-Z (Spain); alt. D.N.I. 10831176-8 (Peru) (individual) [SDNTK] (Linked To: TEXTIMAX SPAIN S.L.; Linked To: CASTIZAL MADRILENA S.L...

Terrorism in Peru.

PubMed

Barrientos Hernandez, Dora H; Church, Adam L

2003-01-01

Two major domestic terrorist groups have plagued Peru over the past 20 years, the Sendero Luminoso or "Shining Path" (SL) and the Revolutionary Movement Túpac Amaru (MRTA). On 28 August 2003, the Peruvian Truth and Reconciliation Commission reported that an estimated 69,280 persons were killed in the internal conflict in Peru from 1980 to 2000. Most of the victims were farmers (56%), most attacks occurred in rural settings (79%), and the SL was responsible for most of the deaths (54%). Aggressive anti-terrorism efforts by police and military during this period, often at the expense of basic human rights, also contributed to this large burden of terrorism on Peru. During the 1990s, terrorist attacks in Peru had spread to its urban areas. On 17 December 1996, 22 members of MRTA took over the Japanese ambassador's residence in Lima, holding 72 hostages until the grounds were stormed by Peruvian special forces on 23 April 1997. Until recently, emergency planning and preparedness for terrorism-related events in Peru were largely underdeveloped. In the last five years, Peru has taken two key steps towards developing a mature emergency response system, with the establishment of the country's first emergency medicine residency training program and the construction of the first dedicated trauma center in Lima.

Family and peer support matter for precoital and coital behaviors among adolescents in Lima

PubMed Central

Bayer, Angela M.; Cabrera, Lilia Z.; Gilman, Robert H.; Hindin, Michelle J.; Tsui, Amy O.

2015-01-01

We analyzed the association between sub-scales developed with adolescents and the outcomes of precoital behaviors and vaginal sex in Lima, Peru. Adolescent participants in key informant sessions operationalized concepts identified during qualitative concept mapping into several sub-scales. Face and content validity testing and pilot application with respondent debriefing were used to refine the sub-scales. Three hundred 15–17 year olds were surveyed about the sub-scales, socio-demographics and sexual behaviors. Exploratory factor analysis confirmed six sub-scales, self-image, goals and decision-making, family education, parental rules/control, school support and peer support, which we regressed on the outcomes. Twice as many males as females reported more than three precoital behaviors and vaginal sex. Higher peer support reduced the likelihood of vaginal sex and precoital behaviors and higher family education reduced precoital behaviors. Results affirm the importance of including adolescents in the entire research process and of sex education with family- and peer-based strategies. PMID:25305443

[Supply and demand of clinical practice fields for training undergraduate health sciences students in Peru, 2005-2009].

PubMed

Alva, Javier; Verastegui, George; Velasquez, Edgar; Pastor, Reyna; Moscoso, Betsy

2011-06-01

To describe the supply and demand of clinical fields for undergraduate students of Peru. A descriptive study was considering as supply of clinical fields the total number of existing hospital beds in Peru. The demand was calculated using the total number of alumni registered in health science carrers following the clinical years or the internship. We calculated the number of beds per student and the coverage of clinical fields nationally and in some selected regions (Lima, Arequipa, La Libertad and Lambayeque). In 2009, Peru had 34,539 hospital beds, 78.5% of which pertained to the public sector and 48.4% are from Lima. We estimated that in 2008 44,032 alumni needed clinical fields, 70% from private universities, which grew 65% since 2005. The coverage of clinical fields, considering only interns from four carreers (medicine, nursery, obstetrics and dentistry) was only 31.5% at the national level. The number of beds per student oscillated between 0.5 in La Libertad to 0.82 in Lima with a national mean of 0.45. The supply of clinical fields for teaching undergraduates is insufficient to satisfy the demand, which continues to grow because of private universities, and hence requires urgent regulation.

Yellow Fever in an Unvaccinated Traveler to Peru.

PubMed

Winnicka, Lydia; Abdullah, Amirahwaty; Yang, Tsujung; Norville, Kim; Irizarry-Acosta, Melina

2017-01-01

We present a case of an unvaccinated traveler who traveled from New York to Peru and contracted yellow fever. He likely acquired the infection while visiting the Amazon River, with a point of exit of Lima, Peru. Our case illustrates the dramatic course that yellow fever may take, as well as the importance of pretravel vaccination.

ISOLATION AND MOLECULAR IDENTIFICATION OF POTENTIALLY PATHOGENIC Escherichia coli AND Campylobacter jejuni IN FERAL PIGEONS FROM AN URBAN AREA IN THE CITY OF LIMA, PERU

PubMed Central

CABALLERO, Moisés; RIVERA, Isabel; JARA, Luis M.; ULLOA-STANOJLOVIC, Francisco M.; SHIVA, Carlos

2015-01-01

SUMMARY Feral pigeons (Columbia livia) live in close contact with humans and other animals. They can transmit potentially pathogenic and zoonotic agents. The objective of this study was to isolate and detect strains of diarrheagenic Escherichia coli and Campylobacter jejuni of urban feral pigeons from an area of Lima, Peru. Fresh dropping samples from urban parks were collected for microbiological isolation of E. coli strains in selective agar, and Campylobacter by filtration method. Molecular identification of diarrheagenic pathotypes of E.coli and Campylobacter jejuni was performed by PCR. Twenty-two parks were sampled and 16 colonies of Campylobacter spp. were isolated. The 100% of isolates were identified as Campylobacter jejuni. Furthermore, 102 colonies of E. coliwere isolated and the 5.88% resulted as Enteropathogenic (EPEC) type and 0.98% as Shiga toxin-producing E. coli (STEC). The urban feral pigeons of Lima in Peru can act as a reservoir or carriers of zoonotic potentially pathogenic enteric agents. PMID:26603225

The 1918–1920 influenza pandemic in Peru

PubMed Central

Chowell, G.; Viboud, C.; Simonsen, L.; Miller, M.A.; Hurtado, J.; Soto, G.; Vargas, R.; Guzman, M.A.; Ulloa, M.; Munayco, C.V.

2011-01-01

Background Increasing our knowledge of past influenza pandemic patterns in different regions of the world is crucial to guide preparedness plans against future influenza pandemics. Here, we undertook extensive archival collection efforts from 3 representative cities of Peru (Lima in the central coast, Iquitos in the northeastern Amazon region, Ica in the southern coast) to characterize the age and geographic patterns of the 1918–1920 influenza pandemic in this country. Materials and Methods We analyzed historical documents describing the 1918–1920 influenza pandemic in Peru and retrieved individual mortality records from local provincial archives for quantitative analysis. We applied seasonal excess mortality models to daily and monthly respiratory mortality rates for 1917–1920 and quantified transmissibility estimates based on the daily growth rate in respiratory deaths. Results A total of 52,739 individual mortality records were inspected from local provincial archives. We found evidence for an initial mild pandemic wave during July-September 1918 in Lima, identified a synchronized severe pandemic wave of respiratory mortality in all three locations in Peru during November 1918-February 1919, and a severe pandemic wave during January 1920- March 1920 in Lima and July-October 1920 in Ica. There was no recrudescent pandemic wave in 1920 in Iquitos. Remarkably, Lima experienced the brunt of the 1918–20 excess mortality impact during the 1920 recrudescent wave, with all age groups experiencing an increase in all cause excess mortality from 1918–19 to 1920. Middle age groups experienced the highest excess mortality impact, relative to baseline levels, in the 1918–19 and 1920 pandemic waves. Cumulative excess mortality rates for the 1918–20 pandemic period were higher in Iquitos (2.9%) than Lima (1.6%). The mean reproduction number for Lima was estimated in the range 1.3–1.5. Conclusions We identified synchronized pandemic waves of intense excess respiratory mortality during November 1918-February 1919 in Lima, Iquitos, Ica, followed by asynchronous recrudescent waves in 1920. Cumulative data from quantitative studies of the 1918 influenza pandemic in Latin American settings have confirmed the high mortality impact associated with this pandemic. Further historical studies in lesser-studied regions of Latin America, Africa, and Asia are warranted for a full understanding of the global impact of the 1918 pandemic virus. PMID:21757099

Very High-Frequency (VHF) ionospheric scintillation fading measurements at Lima, Peru

NASA Technical Reports Server (NTRS)

Blank, H. A.; Golden, T. S.

1972-01-01

During the spring equinox of 1970, scintillating signals at VHF (136.4 MHz) were observed at Lima, Peru. The transmission originated from ATS 3 and was observed through a pair of antennas spaced 1200 feet apart on an east-west baseline. The empirical data were digitized, reduced, and analyzed. The results include amplitude probability density and distribution functions, time autocorrelation functions, cross correlation functions for the spaced antennas, and appropriate spectral density functions. Results show estimates of the statistics of the ground diffraction pattern to gain insight into gross ionospheric irregularity size, and irregularity velocity in the antenna planes.

Draft genome sequence of Bradyrhizobium paxllaeri LMTR 21T isolated from Lima bean (Phaseolus lunatus) in Peru.

PubMed

Ormeño-Orrillo, Ernesto; Rey, Luis; Durán, David; Canchaya, Carlos A; Rogel, Marco A; Zúñiga-Dávila, Doris; Imperial, Juan; Ruiz-Argüeso, Tomás; Martínez-Romero, Esperanza

2017-09-01

Bradyrhizobium paxllaeri is a prevalent species in root nodules of the Lima bean ( Phaseolus lunatus ) in Peru. LMTR 21 T is the type strain of the species and was isolated from a root nodule collected in an agricultural field in the Peruvian central coast. Its 8.29 Mbp genome encoded 7635 CDS, 71 tRNAs and 3 rRNAs genes. All genes required to stablish a nitrogen-fixing symbiosis with its host were present. The draft genome sequence and annotation have been deposited at GenBank under the accession number MAXB00000000.

Evidence of Rickettsial and Leptospira Infections in Andean Northern Peru

DTIC Science & Technology

2004-01-01

leptospirosis in the Amazon basin region of Peru .18,25 The differential diagnosis of leptospirosis remains a chal- lenge, and although the IgM ELISA is...EVIDENCE OF RICKETTSIAL AND LEPTOSPIRA INFECTIONS IN ANDEAN NORTHERN PERU PATRICK J. BLAIR, GEORGE B. SCHOELER, CECILIA MORON, ELIZABETH ANAYA...ZONIA RIOS, JOHN W. SUMNER, PABLO VILLASECA, AND JAMES G. OLSON U.S. Naval Medical Research Center Detachment, Lima, Peru ; National Institute of Health

An Epidemic of Oroya Fever in the Peruvian Andes

DTIC Science & Technology

1990-01-01

otras Enfermedads MAmisiero de Salud. Lima. Peru. Naval Medical Research Instaitue. Bethesda. Af: Naval Medical Research Institsaae Derachmeint. Dma. Peru...review of the manuscript. tibastonella en la enfermedad de carrion o bar- trhe outstanding field work of Enrique Morales. Jaime tonelosis humana

[Mass media influence and risk of developing eating disorders in female students from Lima, Peru].

PubMed

Lazo Montoya, Yessenia; Quenaya, Alejandra; Mayta-Tristán, Percy

2015-12-01

Eating disorders (EDs) are a public health problem, and their relationship to mass media is still controversial. To assess whether there is an association between models of body image shown in mass media and the risk of developing EDs among female adolescent students from Lima, Peru. Cross-sectional study conducted in three schools located in the district of La Victoria, Lima, Peru. The risk of developing EDs was measured using the Eating Attitudes Test-26 (EAT-26), while mass media influence was measured using the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3), which was categorized into tertiles both in the overall score and its subscales (information, pressure, general internalization, and athletic internalization). Adjusted prevalence ratios (aPR) for EDs were estimated. Four hundred and eighty-three students were included, their median age was 14 ? 3 years old. A risk of developing an ED was observed in 13.9% of them. Students who are more influenced by mass media (upper tertile of the SATAQ-3) have a higher probability of having a risk of developing an ED (aPR: 4.24; 95% confidence interval |-CI-|: 2.10-8.56), as well as those who have a greater access to information (PR: 1.89; 95% CI: 1.09-3.25), suffer more pressure (PR: 4.97; 95% CI: 2.31-10.69), show a greater general internalization (PR: 5.00; 95% CI: 2.39-10.43), and show a greater level of athletic internalization (PR: 4.35; 95% CI: 2.19-8-66). The greater the influence of mass media, the greater the probability of having a risk of developing an ED among female students from Lima, Peru.

Perceived Barriers and Facilitators to Integrating HIV Prevention and Treatment with Cross-Sex Hormone Therapy for Transgender Women in Lima, Peru.

PubMed

Reisner, Sari L; Perez-Brumer, Amaya G; McLean, Sarah A; Lama, Javier R; Silva-Santisteban, Alfonso; Huerta, Leyla; Sanchez, Jorge; Clark, Jesse L; Mimiaga, Matthew J; Mayer, Kenneth H

2017-12-01

Transgender women (TW) represent a vulnerable population at increased risk for HIV infection in Peru. A mixed-methods study with 48 TW and 19 healthcare professionals was conducted between January and February 2015 to explore barriers and facilitators to implementing a model of care that integrates HIV services with gender-affirmative medical care (i.e., hormone therapy) in Lima, Peru. Perceived acceptability of the integrated care model was high among TW and healthcare professionals alike. Barriers included stigma, lack of provider training or Peruvian guidelines regarding optimal TW care, and service delivery obstacles (e.g., legal documents, spatial placement of clinics, hours of operation). The hiring of TW staff was identified as a key facilitator for engagement in health care. Working in partnership with local TW and healthcare provider organizations is critical to overcoming existing barriers to successful implementation of an integrated HIV services and gender-affirmative medical care model for this key population in Peru.

Phylogeography of Influenza A(H3N2) Virus in Peru, 2010-2012.

PubMed

Pollett, Simon; Nelson, Martha I; Kasper, Matthew; Tinoco, Yeny; Simons, Mark; Romero, Candice; Silva, Marita; Lin, Xudong; Halpin, Rebecca A; Fedorova, Nadia; Stockwell, Timothy B; Wentworth, David; Holmes, Edward C; Bausch, Daniel G

2015-08-01

It remains unclear whether lineages of influenza A(H3N2) virus can persist in the tropics and seed temperate areas. We used viral gene sequence data sampled from Peru to test this source-sink model for a Latin American country. Viruses were obtained during 2010-2012 from influenza surveillance cohorts in Cusco, Tumbes, Puerto Maldonado, and Lima. Specimens positive for influenza A(H3N2) virus were randomly selected and underwent hemagglutinin sequencing and phylogeographic analyses. Analysis of 389 hemagglutinin sequences from Peru and 2,192 global sequences demonstrated interseasonal extinction of Peruvian lineages. Extensive mixing occurred with global clades, but some spatial structure was observed at all sites; this structure was weakest in Lima and Puerto Maldonado, indicating that these locations may experience greater viral traffic. The broad diversity and co-circulation of many simultaneous lineages of H3N2 virus in Peru suggests that this country should not be overlooked as a potential source for novel pandemic strains.

Phylogeography of Influenza A(H3N2) Virus in Peru, 2010–2012

PubMed Central

Nelson, Martha I.; Kasper, Matthew; Tinoco, Yeny; Simons, Mark; Romero, Candice; Silva, Marita; Lin, Xudong; Halpin, Rebecca A.; Fedorova, Nadia; Stockwell, Timothy B.; Wentworth, David; Holmes, Edward C.; Bausch, Daniel G.

2015-01-01

It remains unclear whether lineages of influenza A(H3N2) virus can persist in the tropics and seed temperate areas. We used viral gene sequence data sampled from Peru to test this source–sink model for a Latin American country. Viruses were obtained during 2010–2012 from influenza surveillance cohorts in Cusco, Tumbes, Puerto Maldonado, and Lima. Specimens positive for influenza A(H3N2) virus were randomly selected and underwent hemagglutinin sequencing and phylogeographic analyses. Analysis of 389 hemagglutinin sequences from Peru and 2,192 global sequences demonstrated interseasonal extinction of Peruvian lineages. Extensive mixing occurred with global clades, but some spatial structure was observed at all sites; this structure was weakest in Lima and Puerto Maldonado, indicating that these locations may experience greater viral traffic. The broad diversity and co-circulation of many simultaneous lineages of H3N2 virus in Peru suggests that this country should not be overlooked as a potential source for novel pandemic strains. PMID:26196599

Earth observations taken from shuttle orbiter Atlantis during STS-84 mission

NASA Image and Video Library

1997-05-18

STS084-727-053 (15-24 May 1997) --- This view of Lima, Peru is among a very few photographed by astronauts who have orbited Earth since the early 1960's. Francisco Pizarro founded the city of Lima in 1535. Lima is located 13 kilometers (8 miles) inland from the Peruvian coast and is surrounded by coastal desert and the Andes mountains. Suburbs of Lima extend in all directions except to the east, where the Andes prohibits growth. The three rivers, Chillion to the northeast of Lima, the Rimac which runs through the northern part of the city, and the Mala to the southeast, all drain the central Andes. The island off the coast is San Lorenzo.

Winning the Peace: The Strategic Implications of Military Civic Action

DTIC Science & Technology

1990-09-30

term health care provided by naval forces on a regular basis by means of riverine patrols in Peru and Bolivia, to military support for local...with Peru . The first of these, held at Fort Bragg, North Carolina, focused on PSYOPs; while the second, held in Lima, Peru , focused on counterinsur...gency and had a heavy PSYOP component. The net result has been that the United States and Peru have a better understanding of how the other sees the

Street-Working Children and Adolescents in Lima: Work as an Agent of Socialization.

ERIC Educational Resources Information Center

Invernizzi, Antonella

2003-01-01

Recounts an ethnographic study of children's work in Lima, Peru, examining concepts of work, family, and childhood; adult representations and norms passed on to children through work; and child's point of view regarding work and how it evolves with time. Argues children and parents' views and practices regarding work and socialization give a…

What Is Adolescence?: Adolescents Narrate Their Lives in Lima, Peru

ERIC Educational Resources Information Center

Bayer, Angela M.; Gilman, Robert H.; Tsui, Amy O.; Hindin, Michelle J.

2010-01-01

This study explores the lives of Peruvian adolescents in a low-income human settlement outside of Lima. Twenty 12-17 year olds were asked to narrate their own life stories using the life history narrative research method. Holistic content analysis was coupled with a grounded-theory approach to explore these data. Intergenerational responsibility,…

Earth Observations taken by the Expedition 10 crew

NASA Image and Video Library

2005-03-17

ISS010-E-20111 (15 March 2005) --- Lima, Peru is featured in this image photographed by an Expedition 10 crewmember on the International Space Station (ISS). Located on the broad alluvial fan of the Rimac River, Lima is the capital of Peru and the only mega city (7.7 million inhabitants in 2002) located on the western coastline of South America. The city was established by Francisco Pizarro in 1535 and became an important colonial port linking silver mines of the Altiplano of the high Andes to the east with the burgeoning Spanish empire. During the mid-20th century a significant relocation of people from rural mountain communities into the Lima metropolitan area led to its growth into a mega city. Problems now facing the metropolitan region include development of adequate water resources, control of pollution, and the potential effects of natural hazards such as earthquakes and landslides. This photograph depicts the wealthier San Isidro and Mira Flores quarters of Lima. This part of the metropolitan area is characterized by numerous vegetated parks, golf courses (such as the Lima Golf Course—approximately 1 kilometer long), and greenbelts interspersed with residential and commercial areas. The higher proportion of dark asphalt in the street grid of the residential and commercial areas lends a purple coloration to the left portion of the image (downtown Lima is to the north). Regions with fewer built materials and vegetation are light tan. Wave patterns are visible approaching beaches, popular tourist destinations, in the lower half of the image.

[Determining factors of overweight and obesity in children at school age in Peru].

PubMed

Mispireta, Monica L

2012-01-01

Obesity in children at school age is an increasing problem in Peru. It concentrates in urban areas, mainly in Lima where one out of three children is overweight. An initial study in 80 schools in Lima showed that the lack of physical activity would have a greater impact on overweight and obesity in school children than the amount of food intake. More detailed studies are required. In spite of the limited information available regarding its determining factors, it is necessary to implement culturally-sensitive measures to fight this problem as part of the current nutritional policies, and prevent the problem from spreading, making sure the sustainability of the health system is not affected.

Dolphins and Children: A Blueprint for Marine Environmental Education in Peru

ERIC Educational Resources Information Center

Van Bressem, Marie-Francoise; Alfaro-Shigueto, Joanna; Geysen, Karen; Onton, Karina; Vega, Diana; Chavez-Lisambart, Laura; Van Waerebeek, Koen

2006-01-01

To complement legislative measures protecting cetaceans and other marine animals, the Peruvian Centre for Cetacean Research in the period 1993-2000 implemented an environmental education program at the kindergartens, primary and high schools of several fishing towns and in Lima, Peru. This program included environmental classes based on selected…

Alone You Are Nobody, Together We Float: The Manuela Ramos Movement. Quality/Calidad/Qualite Number 10.

ERIC Educational Resources Information Center

Rogow, Debbie

The Manuela Ramos Movement began in the 1970s when seven women in Lima, Peru, started meeting each Tuesday to reconsider their assumptions about everyday life. By 1980, the group formed a nongovernmental organization whose strategy was to train women community leaders in Lima's barrios through workshops focusing on the following themes: identity…

Genetic Diversity and Transmission Characteristics of Beijing Family Strains of Mycobacterium tuberculosis in Peru

PubMed Central

Iwamoto, Tomotada; Grandjean, Louis; Arikawa, Kentaro; Nakanishi, Noriko; Caviedes, Luz; Coronel, Jorge; Sheen, Patricia; Wada, Takayuki; Taype, Carmen A.; Shaw, Marie-Anne; Moore, David A. J.; Gilman, Robert H.

2012-01-01

Beijing family strains of Mycobacterium tuberculosis have attracted worldwide attention because of their wide geographical distribution and global emergence. Peru, which has a historical relationship with East Asia, is considered to be a hotspot for Beijing family strains in South America. We aimed to unveil the genetic diversity and transmission characteristics of the Beijing strains in Peru. A total of 200 Beijing family strains were identified from 2140 M. tuberculosis isolates obtained in Lima, Peru, between December 2008 and January 2010. Of them, 198 strains were classified into sublineages, on the basis of 10 sets of single nucleotide polymorphisms (SNPs). They were also subjected to variable number tandem-repeat (VNTR) typing using an international standard set of 15 loci (15-MIRU-VNTR) plus 9 additional loci optimized for Beijing strains. An additional 70 Beijing family strains, isolated between 1999 and 2006 in Lima, were also analyzed in order to make a longitudinal comparison. The Beijing family was the third largest spoligotyping clade in Peru. Its population structure, by SNP typing, was characterized by a high frequency of Sequence Type 10 (ST10), which belongs to a modern subfamily of Beijing strains (178/198, 89.9%). Twelve strains belonged to the ancient subfamily (ST3 [n = 3], ST25 [n = 1], ST19 [n = 8]). Overall, the polymorphic information content for each of the 24 loci values was low. The 24 loci VNTR showed a high clustering rate (80.3%) and a high recent transmission index (RTIn−1 = 0.707). These strongly suggest the active and on-going transmission of Beijing family strains in the survey area. Notably, 1 VNTR genotype was found to account for 43.9% of the strains. Comparisons with data from East Asia suggested the genotype emerged as a uniquely endemic clone in Peru. A longitudinal comparison revealed the genotype was present in Lima by 1999. PMID:23185395

Genetic diversity and transmission characteristics of Beijing family strains of Mycobacterium tuberculosis in Peru.

PubMed

Iwamoto, Tomotada; Grandjean, Louis; Arikawa, Kentaro; Nakanishi, Noriko; Caviedes, Luz; Coronel, Jorge; Sheen, Patricia; Wada, Takayuki; Taype, Carmen A; Shaw, Marie-Anne; Moore, David A J; Gilman, Robert H

2012-01-01

Beijing family strains of Mycobacterium tuberculosis have attracted worldwide attention because of their wide geographical distribution and global emergence. Peru, which has a historical relationship with East Asia, is considered to be a hotspot for Beijing family strains in South America. We aimed to unveil the genetic diversity and transmission characteristics of the Beijing strains in Peru. A total of 200 Beijing family strains were identified from 2140 M. tuberculosis isolates obtained in Lima, Peru, between December 2008 and January 2010. Of them, 198 strains were classified into sublineages, on the basis of 10 sets of single nucleotide polymorphisms (SNPs). They were also subjected to variable number tandem-repeat (VNTR) typing using an international standard set of 15 loci (15-MIRU-VNTR) plus 9 additional loci optimized for Beijing strains. An additional 70 Beijing family strains, isolated between 1999 and 2006 in Lima, were also analyzed in order to make a longitudinal comparison. The Beijing family was the third largest spoligotyping clade in Peru. Its population structure, by SNP typing, was characterized by a high frequency of Sequence Type 10 (ST10), which belongs to a modern subfamily of Beijing strains (178/198, 89.9%). Twelve strains belonged to the ancient subfamily (ST3 [n=3], ST25 [n=1], ST19 [n=8]). Overall, the polymorphic information content for each of the 24 loci values was low. The 24 loci VNTR showed a high clustering rate (80.3%) and a high recent transmission index (RTI(n-1)=0.707). These strongly suggest the active and on-going transmission of Beijing family strains in the survey area. Notably, 1 VNTR genotype was found to account for 43.9% of the strains. Comparisons with data from East Asia suggested the genotype emerged as a uniquely endemic clone in Peru. A longitudinal comparison revealed the genotype was present in Lima by 1999.

Multidrug-resistant Mycobacterium tuberculosis in HIV-Infected Persons, Peru

PubMed Central

Campos, Pablo E.; Suarez, Pedro G.; Sanchez, Jorge; Zavala, David; Arevalo, Jorge; Ticona, Eduardo; Nolan, Charles M.; Hooton, Thomas M.

2003-01-01

During 1999 to 2000, we identified HIV-infected persons with new episodes of tuberculosis (TB) at 10 hospitals in Lima-Peru and a random sample of other Lima residents with TB. Multidrug-resistant (MDR)-TB was documented in 35 (43%) of 81 HIV-positive patients and 38 (3.9%)of 965 patients who were HIV-negative or of unknown HIV status (p < 0.001). HIV-positive patients with MDR-TB were concentrated at three hospitals that treat the greatest numbers of HIV-infected persons with TB. Of patients with TB, those with HIV infection differed from those without known HIV infection in having more frequent prior exposure to clinical services and more frequent previous TB therapy or prophylaxis. However, MDR-TB in HIV-infected patients was not associated with previous TB therapy or prophylaxis. MDR-TB is an ongoing problem in HIV-infected persons receiving care in public hospitals in Lima and Callao; they represent sentinel cases for a potentially larger epidemic of nosocomial MDR-TB. PMID:14720398

Protocol for studying cough frequency in people with pulmonary tuberculosis.

PubMed

Proaño, Alvaro; Bravard, Marjory A; Tracey, Brian H; López, José W; Comina, German; Zimic, Mirko; Coronel, Jorge; Lee, Gwenyth O'Neil; Caviedes, Luz; Cabrera, Jose Luis; Salas, Antonio; Ticona, Eduardo; Kirwan, Daniela E; Friedland, Jon S; Evans, Carlton A; Moore, David A; Gilman, Robert H

2016-04-22

Cough is a key symptom of tuberculosis (TB) as well as the main cause of transmission. However, a recent literature review found that cough frequency (number of coughs per hour) in patients with TB has only been studied once, in 1969. The main aim of this study is to describe cough frequency patterns before and after the start of TB treatment and to determine baseline factors that affect cough frequency in these patients. Secondarily, we will evaluate the correlation between cough frequency and TB microbiological resolution. This study will select participants with culture confirmed TB from 2 tertiary hospitals in Lima, Peru. We estimated that a sample size of 107 patients was sufficient to detect clinically significant changes in cough frequency. Participants will initially be evaluated through questionnaires, radiology, microscopic observation drug susceptibility broth TB-culture, auramine smear microscopy and cough recordings. This cohort will be followed for the initial 60 days of anti-TB treatment, and throughout the study several microbiological samples as well as 24 h recordings will be collected. We will describe the variability of cough episodes and determine its association with baseline laboratory parameters of pulmonary TB. In addition, we will analyse the reduction of cough frequency in predicting TB cure, adjusted for potential confounders. Ethical approval has been obtained from the ethics committees at each participating hospital in Lima, Peru, Asociación Benéfica PRISMA in Lima, Peru, the Universidad Peruana Cayetano Heredia in Lima, Peru and Johns Hopkins University in Baltimore, USA. We aim to publish and disseminate our findings in peer-reviewed journals. We also expect to create and maintain an online repository for TB cough sounds as well as the statistical analysis employed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Frequency, Patterns and Preferences of Lubricant Use During Anal Intercourse Within Male Sexual Partnerships in Lima, Peru: Implications for a Rectal Microbicide HIV Prevention Intervention

PubMed Central

Clark, J; Salvatierra, Hector Javier; Segura, Eddy Roberto; Salazar, Ximena; Konda, Kelika; Galea, Jerome; Klausner, Jeffrey D; Coates, Thomas; Caceres, Carlos Fernando

2012-01-01

Understanding current practices of lubricant use during anal intercourse can help to assess the contexts for the introduction of topical rectal microbicides as an HIV prevention tool for men who have sex with men (MSM). We used quantitative and qualitative methods to assess: current patterns of lubricant use; preferred characteristics of commercial lubricant formulations; and social and behavioral contexts of lubricant use within male sexual partnerships in Lima, Peru. Between 2007 and 2008, we conducted a quantitative behavioral survey with 547 MSM followed by qualitative individual and group interviews with 36 MSM from Lima, Peru. Approximately half of all participants in the quantitative survey (50.3%) reported using commercial lubricant during intercourse occasionally or consistently during the preceding two months, with lack of availability at the time of intercourse the most commonly reported reason for non-use. No clear preferences regarding the color, smell, taste, or viscosity of commercial lubricants were identified, and all participants who reported using a commercial lubricant used the same product (“Love-Lub”). In the qualitative analysis, participants characterized lubricant use as a sexual practice consistently controlled by the receptive partner, who typically obtained and applied lubricant independently, with or without the consent of the insertive partner. Quantitative findings supported this differential pattern of lubricant use, with men who reported sexual identities or roles consistent with receptive anal intercourse, including unprotected receptive intercourse, more likely to report lubricant use than MSM who claimed an exclusively insertive sexual role. Given the social, behavioral, and biological factors contributing to increased vulnerability for HIV and STI acquisition by the receptive partner in anal intercourse, delivery of a topical rectal microbicide as a lubricant formulation could provide an important HIV prevention resource for at-risk MSM in Lima, Peru. PMID:23082796

A cross sectional study of knowledge and attitudes towards tuberculosis amongst front-line tuberculosis personnel in high burden areas of Lima, Peru.

PubMed

Minnery, Mark; Contreras, Carmen; Pérez, Rosa; Solórzano, Ninfa; Tintaya, Karen; Jimenez, Judith; Soto, Silvia; Lecca, Leonid

2013-01-01

Tuberculosis, reported as the second most common infectious cause of death worldwide, is a key mortality contributor in developing countries and globally. The disease is endemic in Peru and while relative success was achieved during the 1990s in its control, this slowed as new complications, such as multi drug resistant TB arose. Health centre workers participating in the national DOTS program, create the front-line TB work-force in Peru meaning their knowledge and attitudes about the disease are key in its control. A Spanish language, multiple choice knowledge and attitudes survey was designed based on previous successful studies and the national Peruvian TB control guidelines. It was applied to two health networks in Lima, Peru amongst 301 health workers participating in the national TB control program from 66 different health centres. The study results were analysed to test mean knowledge scores amongst different groups, overall gaps in key areas of TB treatment and control knowledge, and attitudes towards the disease and the national TB control program. A mean knowledge score of 10.1 (+/- 1.7) out of 15 or 67.3% correct was shown. Demographics shown to have an effect on knowledge score were age and level of education. Major knowledge gaps were noted primarily in themes relating to treatment and diagnostics. Greater community involvement including better patient education about TB was seen as important in implementing the national TB control program. Participants were in disagreement about the current distribution of health resources throughout the study area. Discussion Serious knowledge gaps were identified from the survey; these reflect findings from a previous study in Lima and other studies from TB endemic areas throughout the world. Understanding these gaps and observations made by front-line TB workers in Lima may help to improve the national TB control program and other control efforts globally.

Burden of chronic kidney disease in resource-limited settings from Peru: a population-based study.

PubMed

Francis, Elizabeth R; Kuo, Chin-Chi; Bernabe-Ortiz, Antonio; Nessel, Lisa; Gilman, Robert H; Checkley, William; Miranda, J Jaime; Feldman, Harold I

2015-07-24

The silent progression of chronic kidney diseases (CKD) and its association with other chronic diseases, and high treatment costs make it a great public health concern worldwide. The population burden of CKD in Peru has yet to be fully described. We completed a cross sectional study of CKD prevalence among 404 participants (total study population median age 54.8 years, 50.2 % male) from two sites, highly-urbanized Lima and less urbanized Tumbes, who were enrolled in the population-based CRONICAS Cohort Study of cardiopulmonary health in Peru. Factors potentially associated with the presence of CKD were explored using Poisson regression, a statistical methodology used to determine prevalence ratios. In total, 68 participants (16.8 %, 95 % CI 13.5-20.9 %) met criteria for CKD: 60 (14.9%) with proteinuria, four (1%) with eGFR < 60 mL/min/1.73 m2 , and four (1%) with both. CKD prevalence was higher in Lima (20.7 %, 95 % CI 15.8-27.1) than Tumbes (12.9 %, 95 % CI 9.0-18.5). Among participants with CKD, the prevalence of diabetes and hypertension was 19.1 % and 42.7 %, respectively. After multivariable adjustment, CKD was associated with older age, female sex, greater wealth tertile (although all wealth strata were below the poverty line), residence in Lima, and presence of diabetes and hypertension. The high prevalence rates of CKD identified in Lima and Tumbes are similar to estimates from high-income settings. These findings highlight the need to identify occult CKD and implement strategies to prevent disease progression and secondary morbidity.

Civic Action Projects Report, 1 January 1965-31 December 1965. Volume 1

DTIC Science & Technology

1966-06-22

1400 kilometers of federal highway along the fringes of the Amazon jungle to the border of Brazil and Peru which will provide communications between... Peru Uruguay j ^^ Venezuela MARQUAT MEMORIAL UBRAEY U^. ARMY CIVIL AFFAIBS SCHOOL FOBX GQfiDOM, GA. f US30UTHCOM 1965 CIVIC ACTION PROJECTS...movie has been excellent. The film was also shown at the Conference of American Armies in Lima, Peru in November 1965. The military units are

Socio-Cultural Variation in Reading Comprehension Development among Fifth Graders in Peru

ERIC Educational Resources Information Center

Silva, Silvia Morales; Verhoeven, Ludo; van Leeuwe, Jan

2011-01-01

In this study, the socio-cultural variation in reading comprehension development was examined in 331 fifth graders from schools in Lima, Peru. Reading comprehension was measured using an adaptation of the PIRLS Reading Literacy test. The fifth graders' reading comprehension results, measured over the course of fifth grade, were related to the…

Sexual Abuse Experiences of Women in Peru: An Exploratory Study

ERIC Educational Resources Information Center

Deboer, Rebekah E.; Tse, Luke M.

2010-01-01

This ethnographic study relied primarily on case notes and interviews with the president of Centro Prenatal Vida Nueva, a pregnancy center in Lima, Peru, to study the sexual abuse experiences of 33 Peruvian women. Given the language limitations of the researchers, the analyses were completed in collaboration with the president of the center, a…

Prevalence of HIV, STIs, and Risk Behaviors in a Cross-Sectional Community- and Clinic-Based Sample of Men Who Have Sex with Men (MSM) in Lima, Peru

DTIC Science & Technology

2013-04-25

of Medicine at University of California at Los Angeles, Los Angeles, California, United States of America, 2Unidad de Salud Sexual y Derechos Humanos ...Sexualidad y Derechos Humanos ; and the staff of the Bacteriology and Virology Laboratories of the U.S. Naval Medical Center Research Laboratory, Lima

Maca

MedlinePlus

... product (Maca Gelatinizada La Molina, Laboratories Hersil, Lima, Peru) daily for 12 weeks can increase sexual desire in healthy men. "Tired blood" (anemia). Leukemia. Chronic fatigue syndrome (CFS). Improving energy and ...

Moderno love: sexual role-based identities and HIV/STI prevention among men who have sex with men in Lima, Peru.

PubMed

Clark, Jesse; Salvatierra, Javier; Segura, Eddy; Salazar, Ximena; Konda, Kelika; Perez-Brumer, Amaya; Hall, Eric; Klausner, Jeffrey; Caceres, Carlos; Coates, Thomas

2013-05-01

Role-based sexual identities structure male same-sex partnerships and influence HIV/STI epidemiology among MSM in Latin America. We explored shifting relationships between sexual roles, identities and practices among MSM in Lima, Peru, and implications for HIV/STI prevention. Patterns of HIV/STI epidemiology reflected differential risks for transmission within role-based partnerships with relatively low prevalences of HIV, syphilis, and HSV-2 but higher prevalences of urethral gonorrhea/chlamydia among activo MSM compared with moderno and pasivo participants. Qualitative analysis of how MSM in Peru integrate sexual identities, roles, and practices identified four key themes: pasivo role as a gay approximation of cultural femininity; activo role as a heterosexual consolidation of masculinity; moderno role as a masculine reconceptualization of gay identity; and role-based identities as social determinants of partnership, network, and community formation. The concept of role-based sexual identities provides a framework for HIV prevention for Latin American MSM that integrates sexual identities, practices, partnerships, and networks.

Moderno Love: Sexual Role-Based Identities and HIV/STI Prevention Among Men Who Have Sex with Men in Lima, Peru

PubMed Central

Salvatierra, Javier; Segura, Eddy; Salazar, Ximena; Konda, Kelika; Perez-Brumer, Amaya; Hall, Eric; Klausner, Jeffrey; Caceres, Carlos; Coates, Thomas

2012-01-01

Role-based sexual identities structure male same-sex partnerships and influence HIV/STI epidemiology among MSM in Latin America. We explored shifting relationships between sexual roles, identities and practices among MSM in Lima, Peru, and implications for HIV/STI prevention. Patterns of HIV/STI epidemiology reflected differential risks for transmission within role-based partnerships with relatively low prevalences of HIV, syphilis, and HSV-2 but higher prevalences of urethral gonorrhea/chlamydia among activo MSM compared with moderno and pasivo participants. Qualitative analysis of how MSM in Peru integrate sexual identities, roles, and practices identified four key themes: pasivo role as a gay approximation of cultural femininity; activo role as a heterosexual consolidation of masculinity; moderno role as a masculine reconceptualization of gay identity; and role-based identities as social determinants of partnership, network, and community formation. The concept of role-based sexual identities provides a framework for HIV prevention for Latin American MSM that integrates sexual identities, practices, partnerships, and networks. PMID:22614747

Child, Caregiver, and Health Care Provider Perspectives and Experiences Regarding Disclosure of HIV Status to Perinatally Infected Children in Lima, Peru.

PubMed

Baker, Amira Noori; Bayer, Angela Marie; Kolevic, Lenka; Najarro, Lizzete; Viani, Rolando Mario; Deville, Jaime Gerardo

2018-01-01

Despite recommendations for disclosure of HIV status to children living with HIV (CLHIV), fewer than half of CLHIV at the Instituto Nacional de Salud del Niño (INSN) in Lima, Peru, have had disclosure. How and when the disclosure process for CLHIV should take place in Peru has not been studied. We conducted a qualitative study at INSN to explore perceptions and experiences of 6 health care providers (HCPs), 14 disclosed and nondisclosed CLHIV (8-17 years), and their 14 caregivers regarding knowledge of illness, disclosure of HIV status, and appropriate disclosure approaches. Disclosed children wanted to be told their diagnosis earlier. Nondisclosed children expressed frustration taking medications. Caregivers and HCPs discussed motivations to disclose, including educating, honesty, improving medication adherence, and preventing secondary transmission. Culturally appropriate guidelines and training for HCPs and caregivers are needed to support disclosure of children's HIV status and ongoing support for CLHIV.

Economic Evaluation of the Initiative Control of Tuberculosis in Large Metropolitan Cities in Lima, Peru

DTIC Science & Technology

2016-03-22

crowded, education levels are low, unemployment is high, and there are high rates of crime and violence(112). Peru is located in the South America...Andean region and had an estimated 30 million inhabitants in 2011. According to the World Bank , Peru is classified as an upper middle-income country, as...poor nutritional status, unemployment , and access to basic health services are daily challenges(98). In the following sections, we are going to

Estimation of the Demand for Hospital Care After a Possible High-Magnitude Earthquake in the City of Lima, Peru.

PubMed

Bambarén, Celso; Uyen, Angela; Rodriguez, Miguel

2017-02-01

Introduction A model prepared by National Civil Defense (INDECI; Lima, Peru) estimated that an earthquake with an intensity of 8.0 Mw in front of the central coast of Peru would result in 51,019 deaths and 686,105 injured in districts of Metropolitan Lima and Callao. Using this information as a base, a study was designed to determine the characteristics of the demand for treatment in public hospitals and to estimate gaps in care in the hours immediately after such an event. A probabilistic model was designed that included the following variables: demand for hospital care; time of arrival at the hospitals; type of medical treatment; reason for hospital admission; and the need for specialized care like hemodialysis, blood transfusions, and surgical procedures. The values for these variables were obtained through a literature search of the databases of the MEDLINE medical bibliography, the Cochrane and SciELO libraries, and Google Scholar for information on earthquakes over the last 30 years of over magnitude 6.0 on the moment magnitude scale. If a high-magnitude earthquake were to occur in Lima, it was estimated that between 23,328 and 178,387 injured would go to hospitals, of which between 4,666 and 121,303 would require inpatient care, while between 18,662 and 57,084 could be treated as outpatients. It was estimated that there would be an average of 8,768 cases of crush syndrome and 54,217 cases of other health problems. Enough blood would be required for 8,761 wounded in the first 24 hours. Furthermore, it was expected that there would be a deficit of hospital beds and operating theaters due to the high demand. Sudden and violent disasters, such as earthquakes, represent significant challenges for health systems and services. This study shows the deficit of preparation and capacity to respond to a possible high-magnitude earthquake. The study also showed there are not enough resources to face mega-disasters, especially in large cities. Bambarén C , Uyen A , Rodriguez M . Estimation of the demand for hospital care after a possible high-magnitude earthquake in the City of Lima, Peru. Prehosp Disaster Med. 2017;32(1):106-111.

Empowering Women through Education and Advocacy in Breast and Cervical Cancer Prevention and Control

Cancer.gov

Through partnerships with the Peruvian Ministry of Health and the Pan American Health Organization regional office, CGH co-supported the first Women’s Cancer Summit was held in Lima, Peru. This unique training workshop brought primary-level health care providers from 26 districts together with patient advocates and survivors from Peru, Bolivia, Colombia, and Ecuador.

First Case of Systemic Coronavirus Infection in a Domestic Ferret (Mustela putorius furo) in Peru.

PubMed

Lescano, J; Quevedo, M; Gonzales-Viera, O; Luna, L; Keel, M K; Gregori, F

2015-12-01

A domestic ferret from Lima, Peru, died after ten days of non-specific clinical signs. Based on pathology, immunohistochemistry and molecular analysis, ferret systemic coronavirus (FRSCV)-associated disease was diagnosed for the first time in South America. This report highlights the potential spread of pathogens by the international pet trade. © 2015 Blackwell Verlag GmbH.

Study of the Seismic Cycle of large Earthquakes in central Peru: Lima Region

NASA Astrophysics Data System (ADS)

Norabuena, E. O.; Quiroz, W.; Dixon, T. H.

2009-12-01

Since historical times, the Peruvian subduction zone has been source of large and destructive earthquakes. The more damaging one occurred on May 30 1970 offshore Peru’s northern city of Chimbote with a death toll of 70,000 people and several hundred US million dollars in property damage. More recently, three contiguous plate interface segments in southern Peru completed their seismic cycle generating the 1996 Nazca (Mw 7.1), the 2001 Atico-Arequipa (Mw 8.4) and the 2007 Pisco (Mw 7.9) earthquakes. GPS measurements obtained between 1994-2001 by IGP-CIW an University of Miami-RSMAS on the central Andes of Peru and Bolivia were used to estimate their coseismic displacements and late stage of interseismic strain accumulation. However, we focus our interest in central Peru-Lima region, which with its about 9’000,000 inhabitants is located over a locked plate interface that has not broken with magnitude Mw 8 earthquakes since May 1940, September 1966 and October 1974. We use a network of 11 GPS monuments to estimate the interseismic velocity field, infer spatial variations of interplate coupling and its relation with the background seismicity of the region.

[Knowledge and perception about tuberculosis among public transport workers in Lima, Peru].

PubMed

Lukac, Danitza; Garaycochea, Octavio; Taype-Rondan, Alvaro; Luque Bustamante, Laura; Mujica-Vasquez, André; Zamora, Dario

2016-11-23

To describe the level of knowledge and perception of tuberculosis among public transport workers attending Road Safety Education courses in Lima, Peru. An observational, cross-sectional, analytic study was conducted between July and August 2014 in public transport workers attending the courses of Road Safety education. In Lima, such courses are mandatory for workers in the public transport area. An anonymous and voluntary survey was applied to obtain the following variables: sociodemographic characteristics, history of tuberculosis, tuberculosis knowledge and attitudes towards the disease. The factors associated to the risk perception of Tuberculosis infection were analysed using Poisson regression. From 309 attendees, 216 surveys were analysed (69.9%). Of these, 88.4% were males, 3.2% had a history of tuberculosis. The most widely known symptom was cough with phlegm (44.4%), the most popular source of information was television (39.8%), and only 9.7% had any training about tuberculosis. A 41.2% of respondents believed that working in the public transport sector was an occupation with a high risk of tuberculosis infection. No significant association between risk perception of tuberculosis and sociodemographic characteristics was found. A considerable lack of knowledge about tuberculosis symptoms and a low perception of risk for tuberculosis exists among public transport workers in Lima. Education strategies directed to this population need to be implemented.

[Prevalence of hypertension and diabetes in residents from Lima and Callao, Peru].

PubMed

Revilla, Luis; López, Tania; Sánchez, Sixto; Yasuda, Myriam; Sanjinés, Giovanna

2014-01-01

To determine the prevalence of hypertension and diabetes in residents of districts in metropolitan Lima and Callao, Peru. This was a cross-sectional study conducted during September 2006 in people aged 15 years and older, residing in metropolitan Lima and Callao. Participants were selected using a sample of “conglomerados” (neighborhoods) in three stages. Standardized procedures were used to measure weight, height, waist circumference, blood pressure and blood glucose levels. Univariate, bivariate and logistic regression analysis were performed to estimate odds ratios (OR) and their respective confidence intervals at 95%. We enrolled 1,771 subjects; the mean age was 39.5 ± 16.5 years. 62% were women. 19.5% (95% CI 17.6-21.4) were obese, 15.8% (95% CI 14.1-17.6) had hypertension and 3.9% (95% CI: 3.0-4.8) had diabetes. Obesity was associated with a greater likelihood of having hypertension (OR 2.15, 95% CI 1.57-2.94) and diabetes (OR 1.97, 95% CI 1.02-3.80). . The results of this study in a representative sample of residents in Lima and Callao showed high prevalences of hypertension and obesity and a moderate prevalence of diabetes. These results can be used as a reference for public health interventions and to monitor their impact.

Missing the Mark? A Two Time Point Cohort Study Estimating Intestinal Parasite Prevalence in Informal Settlements in Lima, Peru.

PubMed

Cooper, Michael Townsend; Searing, Rapha A; Thompson, David M; Bard, David; Carabin, Hélène; Gonzales, Carlos; Zavala, Carmen; Woodson, Kyle; Naifeh, Monique

2017-01-01

Objectives: The World Health Organization's (WHO) recommendations list Peru as potentially needing prevention of soil-transmitted helminthiasis (STH). Prevalence of STH varies regionally and remains understudied in the newest informal settlements of the capital city, Lima. The purpose of this study was to evaluate the need for Mass Drug Administration (MDA) of antiparasitic drugs in the newest informal settlements of Lima. The aim of this study was to estimate the season-specific prevalence of STH to determine if these prevalence estimates met the WHO threshold for MDA in 3 informal settlements. Methods : A 2 time point cohort study was conducted among a sample of 140 children aged 1 to 10 years living in 3 purposively sampled informal settlements of Lima, Peru. Children were asked to provide 2 stool samples that were analyzed with the spontaneous sedimentation in tube technique. The season-specific prevalence proportions of MDA-targeted STH were estimated using a hidden (latent) Markov modeling approach to adjust for repeated measurements over the 2 seasons and the imperfect validity of the screening tests. Results : The prevalence of MDA targeted STH was low at 2.2% (95% confidence interval = 0.3% to 6%) and 3.8% (95% confidence interval = 0.7% to 9.3%) among children sampled in the summer and winter months, respectively, when using the most conservative estimate of test sensitivity. These estimates were below the WHO threshold for MDA (20%). Conclusions : Empiric treatment for STH by organizations active in the newest informal settlements is not supported by the data and could contribute to unnecessary medication exposures and poor allocation of resources.

Missing the Mark? A Two Time Point Cohort Study Estimating Intestinal Parasite Prevalence in Informal Settlements in Lima, Peru

PubMed Central

Cooper, Michael Townsend; Searing, Rapha A.; Thompson, David M.; Bard, David; Carabin, Hélène; Gonzales, Carlos; Zavala, Carmen; Woodson, Kyle; Naifeh, Monique

2017-01-01

Objectives: The World Health Organization’s (WHO) recommendations list Peru as potentially needing prevention of soil-transmitted helminthiasis (STH). Prevalence of STH varies regionally and remains understudied in the newest informal settlements of the capital city, Lima. The purpose of this study was to evaluate the need for Mass Drug Administration (MDA) of antiparasitic drugs in the newest informal settlements of Lima. The aim of this study was to estimate the season-specific prevalence of STH to determine if these prevalence estimates met the WHO threshold for MDA in 3 informal settlements. Methods: A 2 time point cohort study was conducted among a sample of 140 children aged 1 to 10 years living in 3 purposively sampled informal settlements of Lima, Peru. Children were asked to provide 2 stool samples that were analyzed with the spontaneous sedimentation in tube technique. The season-specific prevalence proportions of MDA-targeted STH were estimated using a hidden (latent) Markov modeling approach to adjust for repeated measurements over the 2 seasons and the imperfect validity of the screening tests. Results: The prevalence of MDA targeted STH was low at 2.2% (95% confidence interval = 0.3% to 6%) and 3.8% (95% confidence interval = 0.7% to 9.3%) among children sampled in the summer and winter months, respectively, when using the most conservative estimate of test sensitivity. These estimates were below the WHO threshold for MDA (20%). Conclusions: Empiric treatment for STH by organizations active in the newest informal settlements is not supported by the data and could contribute to unnecessary medication exposures and poor allocation of resources. PMID:29152541

Mortality profiles in a country facing epidemiological transition: An analysis of registered data

PubMed Central

Huicho, Luis; Trelles, Miguel; Gonzales, Fernando; Mendoza, Walter; Miranda, Jaime

2009-01-01

Background Sub-national analyses of causes of death and time-trends help to define public health policy priorities. They are particularly important in countries undergoing epidemiological transition like Peru. There are no studies exploring Peruvian national and regional characteristics of such epidemiological transition. We aimed to describe Peru's national and regional mortality profiles between 1996 and 2000. Methods Registered mortality data for the study period were corrected for under-registration following standardized methods. Main causes of death by age group and by geographical region were determined. Departmental mortality profiles were constructed to evaluate mortality transition, using 1996 data as baseline. Annual cumulative slopes for the period 1996–2000 were estimated for each department and region. Results For the study period non-communicable diseases explained more than half of all causes of death, communicable diseases more than one third, and injuries 10.8% of all deaths. Lima accounted for 32% of total population and 20% of total deaths. The Andean region, with 38% of Peru's population, accounted for half of all country deaths. Departmental mortality predominance shifted from communicable diseases in 1996 towards non-communicable diseases and injuries in 2000. Maternal and perinatal conditions, and nutritional deficiencies and nutritional anaemia declined markedly in all departments and regions. Infectious diseases decreased in all regions except Lima. In all regions acute respiratory infections are a leading cause of death, but their proportion ranged from 9.3% in Lima and Callao to 15.3% in the Andean region. Tuberculosis and injuries ranked high in Lima and the Andean region. Conclusion Peruvian mortality shows a double burden of communicable and non-communicable, with increasing importance of non-communicable diseases and injuries. This challenges national and sub-national health system performance and policy making. PMID:19187553

HIV-1, sexually transmitted infections, and sexual behavior trends among men who have sex with men in Lima, Peru.

PubMed

Sanchez, Jorge; Lama, Javier R; Kusunoki, Lourdes; Manrique, Hugo; Goicochea, Pedro; Lucchetti, Aldo; Rouillon, Manuel; Pun, Monica; Suarez, Luis; Montano, Silvia; Sanchez, Jose L; Tabet, Stephen; Hughes, James P; Celum, Connie

2007-04-15

To assess and estimate trends in HIV, sexually transmitted infections (STIs), and sexual behavior among men who have sex with men (MSM) in Lima, Peru. Second-generation HIV sentinel surveillance surveys conducted in 1996, 1998, 2000, and 2002. Adult men reporting sex with at least 1 man during the previous year were eligible to participate. Sexual behavior and serum HIV-1 and syphilis antibodies were assessed. HIV seroincidence was estimated by a sensitive/less-sensitive enzyme immunoassay strategy. Rectal and pharyngeal swabs for Neisseria gonorrhoeae culture and a first-void urine sample for urethral leukocytes for presumptive diagnosis of urethritis were obtained. Herpes simplex virus 2 (HSV-2) antibodies were measured in 2002. Although HIV prevalence increased from 18.5% to 22.3% from 1996 through 2002, bacterial prevalence declined significantly for syphilis (16.0% to 12.4%), early syphilis (8.6% to 3.4%), and rectal gonorrhea (5.1% to 0.2%). High HIV seroincidence was estimated, with the lowest (4.8%) incidence in 1998. In 2002, HSV-2 seroprevalence was 51.0%. After adjustment for age, education, and self-reported sexual identity, our data suggest that a yearly increase by 6% in the prevalence of HIV occurred among MSM in Lima, with a corresponding decline in syphilis (by 9%), early syphilis (by 18%), and rectal gonorrhea (by 64%). Condom use during last sexual intercourse increased by 26% each year with the most recent male steady partner and, among non-sex workers, by 11% with the most recent casual partner. HIV continued to spread among MSM in Lima even when a decline in bacterial STIs and increase in condom use were estimated to occur. Intensification of medical and behavior prevention interventions is warranted for MSM in Peru.

Ancient DNA Analysis Suggests Negligible Impact of the Wari Empire Expansion in Peru's Central Coast during the Middle Horizon.

PubMed

Valverde, Guido; Barreto Romero, María Inés; Flores Espinoza, Isabel; Cooper, Alan; Fehren-Schmitz, Lars; Llamas, Bastien; Haak, Wolfgang

2016-01-01

The analysis of ancient human DNA from South America allows the exploration of pre-Columbian population history through time and to directly test hypotheses about cultural and demographic evolution. The Middle Horizon (650-1100 AD) represents a major transitional period in the Central Andes, which is associated with the development and expansion of ancient Andean empires such as Wari and Tiwanaku. These empires facilitated a series of interregional interactions and socio-political changes, which likely played an important role in shaping the region's demographic and cultural profiles. We analyzed individuals from three successive pre-Columbian cultures present at the Huaca Pucllana archaeological site in Lima, Peru: Lima (Early Intermediate Period, 500-700 AD), Wari (Middle Horizon, 800-1000 AD) and Ychsma (Late Intermediate Period, 1000-1450 AD). We sequenced 34 complete mitochondrial genomes to investigate the potential genetic impact of the Wari Empire in the Central Coast of Peru. The results indicate that genetic diversity shifted only slightly through time, ruling out a complete population discontinuity or replacement driven by the Wari imperialist hegemony, at least in the region around present-day Lima. However, we caution that the very subtle genetic contribution of Wari imperialism at the particular Huaca Pucllana archaeological site might not be representative for the entire Wari territory in the Peruvian Central Coast.

Adolescents Can Know Best: Using concept mapping to identify factors and pathways driving adolescent sexuality in Lima, Peru

PubMed Central

Bayer, Angela M.; Cabrera, Lilia Z.; Gilman, Robert H.; Hindin, Michelle J.; Tsui, Amy O.

2011-01-01

The primary objective of this study was to identify and describe individual- and environmental-level factors that Peruvian adolescents perceive to be related to adolescent sexuality. A series of concept mapping sessions were carried out from January-March 2006 with 63 15–17 year olds from a low-income community near Lima in order for adolescents to (1) brainstorm items that they thought were related to sexuality (2) sort, group and rate items to score their importance for sexuality-related outcomes, and (3) create pathways from the groups of items to engaging in sex. Brainstorming resulted in 61 items, which participants grouped into 11 clusters. The highest rated clusters were personal values, respect and confidence in relationships, future achievements and parent-child communication. The pathway of decision-making about having sex primarily contained items rated as only moderately important. This study identified important understudied factors, new perspectives on previously-recognized factors, and possible pathways to sexual behavior. These interesting, provocative findings underscore the importance of directly integrating adolescent voices into future sexual and reproductive health research, policies and programs that target this population. PMID:20382462

Prevalence and correlates of oral human papillomavirus infection among healthy males and females in Lima, Peru.

PubMed

Rosen, Brian J; Walter, Leora; Gilman, Robert H; Cabrerra, Lilia; Gravitt, Patti E; Marks, Morgan A

2016-03-01

The incidence of human papillomavirus (HPV) associated head and neck cancers (HNCs) have been increasing in Peru. However, the burden of oral HPV infection in Peru has not been assessed. The objective of this cross-sectional study was to estimate the prevalence and correlates of oral HPV infection in a population-based sample from males and females from Lima, Peru. Between January 2010 and June 2011, a population-based sample of 1099 individuals between the ages of 10 and 85 from a low-income neighbourhood in Lima, Peru was identified through random household sampling. Information on demographic, sexual behaviours, reproductive factors and oral hygiene were collected using interviewer-administered questionnaires. Oral rinse specimens were collected from each participant, and these specimens were genotyped using the Roche Linear Array assay. ORs were used to assess differences in the prevalence of any oral HPV and any high-risk oral HPV infection by demographic factors, sexual practices and oral hygiene among individuals 15+ years of age. The prevalence of any HPV and any high-risk HPV (HR-HPV) was 6.8% and 2.0%, respectively. The three most common types were HPV 55 (3.4%), HPV 6 (1.5%) and HPV 16 (1.1%). Male sex (aOR, 2.21; 95% CI 1.22 to 4.03) was associated with any HPV infection after adjustment. The prevalence of oral HPV in this study was similar to estimates observed in the USA. Higher prevalence of oral infections in males was consistent with a male predominance of HPV-associated HNCs and may signal a sex-specific aetiology in the natural history of infection. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Do Subjective Alcohol Screening Tools Correlate with Biomarkers Among High-Risk Transgender Women and Men Who Have Sex with Men in Lima, Peru?

PubMed

Herrera, M C; Konda, K A; Leon, S R; Brown, B; Calvo, G M; Salvatierra, H J; Caceres, C F; Klausner, J D; Deiss, R

2017-11-01

Alcohol abuse can influence sexual risk behavior; however, its measurement is not straightforward. This study compared self-reported alcohol use, via the AUDIT and CAGE, with levels of phosphatidylethanol (Peth), a phospholipid biomarker that forms with chronic, heavy drinking, among high-risk MSM and TW in Lima, Peru. Chi square, Fisher's exact, Wilcoxon ranksum tests compared the instruments. Receiver operating curves determined sensitivity and specificity of the self-reported measures. Among 69 MSM and 17 TW, PEth was positive for 86% (95% CI 77-93%) of participants, while 67% reported binge-drinking in the last 2 weeks. The AUDIT classified 25% as hazardous drinkers while CAGE identified 6% as problem drinkers. Self-reported binge drinking was more sensitive than the AUDIT for PEth positivity (71% vs. 27%, p = 0.022). Among high-risk MSM and TW in Lima, validated, self-report measures of alcohol abuse underestimated biological measures. Further research correlating bio-markers and self-reported alcohol abuse measures is needed.

Gender differences in sex-related alcohol expectancies in young adults from a peri-urban area in Lima, Peru.

PubMed

Gálvez-Buccollini, Juan A; Paz-Soldán, Valerie A; Herrera, Phabiola M; DeLea, Suzanne; Gilman, Robert H

2009-06-01

To estimate the effect of sex-related alcohol expectancies (SRAE) on hazardous drinking prevalence and examine gender differences in reporting SRAE. Trained research assistants administered part of a questionnaire to 393 men and 400 women between 18 and 30 years old from a peri-urban shantytown in Lima, Peru. The remaining questions were self-administered. Two measuring instruments-one testing for hazardous drinking and one for SRAE-were used. Multivariate data analysis was performed using logistic regression. Based on odds ratios adjusted for socio-demographic variables (age, marital status, education, and employment status) (n = 793), men with one or two SRAE and men with three or more SRAE were 2.3 (95% confidence interval (CI) = 1.4-3.8; p = 0.001) and 3.9 (95% CI = 2.1-7.3; p < 0.001) times more likely than men with no SRAE, respectively, to be hazardous drinkers. Reporting of SRAE was significantly higher in men versus women. In a shantytown in Lima, SRAE is associated with hazardous drinking among men, but not among women, and reporting of SRAE differs by gender.

Physical activity and cardiovascular risk factors among rural and urban groups and rural-to-urban migrants in Peru: a cross-sectional study.

PubMed

Masterson Creber, Ruth M; Smeeth, Liam; Gilman, Robert H; Miranda, J Jaime

2010-07-01

To compare physical activity and sedentary behavior patterns of rural-to-urban migrants in Peru versus lifetime rural and urban residents and to determine any associations between low physical activity and four cardiovascular risk factors: obesity (body mass index > 30 kg/m²), systolic and diastolic blood pressure, hypertension, and metabolic syndrome. The PERU MIGRANT (PEru's Rural to Urban MIGRANTs) cross-sectional study was designed to measure physical activity among rural, urban, and rural-to-urban migrants with the International Physical Activity Questionnaire (IPAQ). The World Health Organization (WHO) age-standardized prevalence of low physical activity was 2.2% in lifetime rural residents, 32.2% in rural-to-urban migrants, and 39.2% in lifetime urban residents. The adjusted odds ratios for low physical activity were 21.43 and 32.98 for migrant and urban groups respectively compared to the rural group. The adjusted odds ratio for being obese was 1.94 for those with low physical activity. There was no evidence of an association between low physical activity and blood pressure levels, hypertension, or metabolic syndrome. People living in a rural area had much higher levels of physical activity and lower risk of being overweight and obese compared to those living in an urban area of Lima. Study participants from the same rural area who had migrated to Lima had levels of physical inactivity and obesity similar to those who had always lived in Lima. Interventions aimed at maintaining higher levels of physical activity among rural-to-urban migrants may help reduce the epidemic of obesity in urban cities.

Home Computers and Child Outcomes: Short-Term Impacts from a Randomized Experiment in Peru. NBER Working Paper No. 18818

ERIC Educational Resources Information Center

Beuermann, Diether W.; Cristia, Julian P.; Cruz-Aguayo, Yyannu; Cueto, Santiago; Malamud, Ofer

2013-01-01

This paper presents results from a randomized control trial in which approximately 1,000 OLPC XO laptops were provided for home use to children attending primary schools in Lima, Peru. The intervention increased access and use of home computers, with some substitution away from computer use outside the home. Beneficiaries were more likely to…

‘Proyecto Orgullo’, an HIV prevention, empowerment and community mobilisation intervention for gay men and transgender women in Callao/Lima, Peru

PubMed Central

Kegeles, Susan; Salazar, Ximena; Konda, Kelika; Silva-Santiesteban, Alfonso; Cáceres, Carlos

2016-01-01

We used qualitative, quantitative and observational methods to assess the feasibility, acceptability, and potential efficacy of Proyecto Orgullo (PO), a pilot community mobilisation intervention to decrease sexual risk, promote health-seeking behaviours, and facilitate personal and community empowerment among gay men (GM) and transgender women (TW) in Peru. PO was adapted from Mpowerment and Hermanos de Luna y Sol, two US interventions. PO included six interrelated core elements: 1) Self-reflection Small Group sessions; 2) Supporting peers in HIV prevention; 3) Mobilisation Activities addressing HIV, GM/TW issues, and community empowerment; 4) A Core Group (staff + GM/TW volunteers) designing/implementing those activities; 5) A Project Space; 6) Publicity. PO included specific components for TW, but promoted that GM/TW, who historically have not worked well together, collaborate for a common goal. We found that PO was embraced by GM/TW. PO positively influenced GM/TW's HIV prevention beliefs, self-efficacy, and behaviours; provided social support and created community; facilitated individual and community empowerment; achieved that GM/TW collaborate; and established a functional Community Centre for socializing/conducting mobilisation activities. Community mobilisation strategies, lacking from HIV prevention efforts in Peru but considered key to HIV prevention, can help improve health-seeking behaviours and consolidate social norms supporting preventive behaviours among GM/TW. PMID:27373578

'Proyecto Orgullo', an HIV prevention, empowerment and community mobilisation intervention for gay men and transgender women in Callao/Lima, Peru.

PubMed

Maiorana, Andres; Kegeles, Susan; Salazar, Ximena; Konda, Kelika; Silva-Santisteban, Alfonso; Cáceres, Carlos

2016-01-01

We used qualitative, quantitative, and observational methods to assess the feasibility, acceptability, and potential efficacy of Proyecto Orgullo (PO), a pilot community mobilisation intervention to decrease sexual risk, promote health-seeking behaviours, and facilitate personal and community empowerment among gay men (GM) and transgender women (TW) in Peru. PO was adapted from Mpowerment and Hermanos de Luna y Sol, two US interventions. PO included six interrelated core elements: (1) Self-reflection Small Group sessions; (2) Supporting peers in HIV prevention; (3) Mobilisation Activities addressing HIV, GM/TW issues, and community empowerment; (4) A Core Group (staff + GM/TW volunteers) designing/implementing those activities; (5) A Project Space; (6) Publicity. PO included specific components for TW, but promoted that GM/TW, who historically have not worked well together, collaborate for a common goal. We found that PO was embraced by GM/TW. PO positively influenced GM/TW's HIV prevention beliefs, self-efficacy, and behaviours; provided social support and created community; facilitated individual and community empowerment; achieved that GM/TW collaborate; and established a functional Community Centre for socialising/conducting mobilisation activities. Community mobilisation strategies, lacking from HIV prevention efforts in Peru but considered key to HIV prevention, can help improve health-seeking behaviours and consolidate social norms supporting preventive behaviours among GM/TW.

Human papillomavirus prevalence, cervical abnormalities and risk factors among female sex workers in Lima, Peru

PubMed Central

Brown, B; Blas, M M; Cabral, A; Byraiah, G; Guerra-Giraldez, C; Sarabia-Vega, V; Carcamo, C; Gravitt, P E; Halsey, N A

2015-01-01

Summary Female sex workers (FSWs) are at high risk of human papillomavirus (HPV) infection. Questionnaires were administered to 200 FSWs aged 18–26 years in Lima, Peru, to gather risk behaviours, and cervical swab samples were collected for Pap smears and HPV DNA testing as part of a longitudinal study. Participants reported a median of 120 clients in the past month, and 99.2% reported using condoms with clients. The prevalence of any HPV in cervical samples was 66.8%; 34 (17.1%) participants had prevalent HPV 16 or 18, and 92 (46.2%) had one or more oncogenic types. Fifteen women had abnormal Pap smears, 13 of which were HPV DNA positive. Fewer years since first sex was associated with oncogenic HPV prevalence in a model adjusted for previous sexually transmitted infection (STI) status and condom use with partners (prevalence ratio = 0.77, 95% confidence interval [CI] = 0.60–0.97). Our data confirm the high rates of HPV transmission among FSWs in Peru, highlighting the need for early and effective strategies to prevent cervical cancer. PMID:22581946

The Relationship Between Risk Perception and Frequency of HIV Testing Among Men Who Have Sex with Men and Transgender Women, Lima, Peru.

PubMed

Vargas, S K; Konda, K A; Leon, S R; Brown, B; Klausner, J D; Lindan, C; Caceres, C F

2018-01-08

HIV infections in Peru are concentrated among men who have sex with men (MSM) and transgender women (TW). HIV testing rates among them remain low, delaying entrance into care. We assessed the prevalence of frequent HIV testing (at least every 6 months) and associated factors among 310 MSM and TW who attend sexual health clinics in Lima, Peru, and who reported that they were HIV seronegative or unaware of their status. Only 39% of participants tested frequently, and 22% had never tested; 29% reported that they were at low or no risk for acquiring HIV. Reporting low or no risk for acquiring HIV was associated with frequent testing (adjusted prevalence ratio [aPR] = 1.53, 95% CI 1.13-2.08); those reporting unprotected anal sex were less likely to test frequently (aPR = 0.66, 95% CI 0.50-0.87). HIV prevalence was 12% and did not vary by risk perception categories. This at-risk population tests infrequently and may not understand the risk of having unprotected sex.

Human papillomavirus prevalence, cervical abnormalities and risk factors among female sex workers in Lima, Peru.

PubMed

Brown, B; Blas, M M; Cabral, A; Byraiah, G; Guerra-Giraldez, C; Sarabia-Vega, V; Carcamo, C; Gravitt, P E; Halsey, N A

2012-04-01

Female sex workers (FSWs) are at high risk of human papillomavirus (HPV) infection. Questionnaires were administered to 200 FSWs aged 18-26 years in Lima, Peru, to gather risk behaviours, and cervical swab samples were collected for Pap smears and HPV DNA testing as part of a longitudinal study. Participants reported a median of 120 clients in the past month, and 99.2% reported using condoms with clients. The prevalence of any HPV in cervical samples was 66.8%; 34 (17.1%) participants had prevalent HPV 16 or 18, and 92 (46.2%) had one or more oncogenic types. Fifteen women had abnormal Pap smears, 13 of which were HPV DNA positive. Fewer years since first sex was associated with oncogenic HPV prevalence in a model adjusted for previous sexually transmitted infection (STI) status and condom use with partners (prevalence ratio = 0.77, 95% confidence interval [CI] = 0.60-0.97). Our data confirm the high rates of HPV transmission among FSWs in Peru, highlighting the need for early and effective strategies to prevent cervical cancer.

Cancer patterns, trends, and transitions in Peru: a regional perspective.

PubMed

Piñeros, Marion; Ramos, Willy; Antoni, Sébastien; Abriata, Graciela; Medina, Luis E; Miranda, J Jaime; Payet, Eduardo; Bray, Freddie

2017-10-01

Peru, like several other South American countries, is experiencing remarkable population growth, ageing, and urbanisation, which has given rise to profound changes in its epidemiological profile. Prostate and breast cancer are the most frequent cancers in men and women, respectively, in Lima and Arequipa, the two areas with population-based cancer registries. However, infection-associated cancers (cervix and stomach) are also common, and rank highest in the national cancer mortality profile. Although a foundation of surveillance informs cancer-control initiatives in Peru, improvements in the vital statistics system, and the quality and use of incidence data for the planning and assessment of cancer prevention and control actions, are needed. Existing population-based cancer registries in Lima and Arequipa, and linkages to the established national mandatory cancer reporting system, are crucial for the collection of high-quality data on national cancer incidence. The delivery of effective cancer prevention and control measures requires sustained investment in the collection of high-quality data capable of informing policies and driving research programmes. Copyright © 2017 Elsevier Ltd. All rights reserved.

The United States Army Medical Department Journal, April - June 2008

DTIC Science & Technology

2008-06-01

Amazon community at Iquitos, Stancil42 (Naval Medical Research Center Detachment, Peru ) received a grant to optimize strategies for preventing the breeding...Detachment, Lima, Peru ; Naval Medical Research Unit-2, Jakarta, Indonesia; and the Naval Medical Research Unit 3, Cairo, Egypt. These resources...the soil beneath tents and camps. In an effort to prevent sand flies breeding in rodent burrows, the Genesis Company (Wellington, Colorado) won an

U.S. Army Medical Department Journal, April-June 2008

DTIC Science & Technology

2008-06-01

IGR), against dengue vector mosquitoes. In the Peruvian Amazon community at Iquitos, Stancil42 (Naval Medical Research Center Detachment, Peru ...Research Unit- Kenya, Nairobi; Naval Medical Research Center Detachment, Lima, Peru ; Naval Medical Research Unit-2, Jakarta, Indonesia; and the Naval...These projects have revealed that sand flies often emerge from the soil beneath tents and camps. In an effort to prevent sand flies breeding in rodent

Potential Impact and Acceptability of Internet Partner Notification for Men Who Have Sex with Men and Transgender Women Recently Diagnosed with STD in Lima, Peru

PubMed Central

Clark, Jesse L; Segura, Eddy R; Perez-Brumer, Amaya G; Reisner, Sari L; Peinado, Jesus; Salvatierra, Hector J; Sanchez, Jorge; Lama, Javier R

2014-01-01

We assessed the potential impact of internet partner notification (PN) among MSM and transgender women in Peru recently diagnosed with STD. Use of internet PN was anticipated for 55.9% of recent partners, including 43.0% of partners not currently expected to be notified, a 20.6% increase in anticipated notification outcomes. PMID:24326581

Attitudes, perceptions and awareness concerning quaternary prevention among family doctors working in the Social Security System, Peru: a cross-sectional descriptive study.

PubMed

Cuba Fuentes, María Sofía; Zegarra Zamalloa, Carlos Orlando; Reichert, Sonja; Gill, Dawn

2016-04-27

Quaternary Prevention is defined as the action taken to identify patients at risk of overtreatment, to protect them from additional medical treatments, and to suggest interventions that are ethically acceptable. Many countries and organizations have joined in the efforts to practice quaternary prevention. These countries started a campaign called Choosing Wisely that implements recommendations in order to avoid harming patients. To determine the attitudes, perceptions and awareness towards Quaternary Prevention and the practice of “Choosing Wisely Canada Recommendations” among family doctors working in the Social Security System in Peru. A questionnaire was developed after reviewing the literature and contacting experts in the field and was sent by email to all 64 family physicians in the Social Security System (Essalud) in Lima Peru. Responses were received from 40 participants. The response rate was 64%. Approximately 95% reported that they understand the concept of quaternary prevention. Agreement with all the recommendations was 90% or higher. In most of the recommendations the applicability was more than 80%. The most important barriers perceived for the practice of Quaternary Prevention were patients’ expectations (33%). There are positive perceptions towards Quaternary Preventions and Choosing Wisely recommendations in the family doctors of social security in Lima Peru.

What Is Adolescence?: Adolescents Narrate Their Lives in Lima, Peru

PubMed Central

Bayer, Angela M.; Gilman, Robert H.; Tsui, Amy O.; Hindin, Michelle J.

2011-01-01

This study explores the lives of Peruvian adolescents in a low-income human settlement outside of Lima. Twenty 12–17 year olds were asked to narrate their own life stories using the life history narrative research method. Holistic content analysis was coupled with a grounded theory approach to explore these data. Intergenerational responsibility, family tensions, economic pressures, racism and violence emerged without prompting and dominated the narrators’ life stories, underscoring the degree to which these adolescents lack access to the supportive individuals and structures that are key to positive adolescent development. The challenges faced by these and the other 5.8 million 10 to 19 year olds in Peru requires increased attention to the role of families, peers and communities in ensuring that adolescents are able to maintain their well-being and achieve their future expectations. PMID:20207410

Use of Commercially Available Oral Rehydration Solutions in Lima, Peru

PubMed Central

Pantenburg, Birte; Ochoa, Theresa J.; Ecker, Lucie; Ruiz, Joaquim

2012-01-01

Caregivers' practices concerning oral rehydration of young children during diarrheal illness were investigated in a periurban community of low socioeconomic level in Lima, Peru. Data of 330 caregivers of children aged 6–36 months were analyzed; 72.7% of all caregivers would give commercially available oral rehydration solutions (ORSs). However, only 58.6% of those caregivers with children that had experienced diarrhea during the previous week stated that they had used commercially available ORSs, a significantly lower percentage. The main reason for not using commercially available ORSs was that caregivers did not know about them. Of all recipes caregivers provided for homemade ORS, none contained the recommended concentrations of sugar and salt. Educating caregivers about availability, benefits, and use of commercially available ORSs as well as correct preparation of homemade ORS is urgently needed. PMID:22665594

Human papillomavirus infection in female sex workers in Lima, Peru.

PubMed

Montano, Silvia M; Hsieh, Evelyn J; Calderón, Martha; Ton, Thanh G N; Quijano, Eberth; Solari, Vicky; Zunt, Joseph R

2011-02-01

To determine the prevalence and risk factors for human papillomavirus (HPV) infection in female sex workers (FSW) in Lima, Peru. Cross-sectional study of 87 FSW. Information regarding demographics, sex work practices, and genital and blood specimens was collected. Forty-four (50.6%) of 87 FSW had HPV detected in cervical swabs. The prevalence of coinfection by two or more HPV types was 39.1%. Thirty-one (35.6%) were infected by at least one high-risk HPV type, representing 70.5% of women with HPV infection. HPV infection was associated with younger age but not with any demographic or sexual characteristics. Our study confirms the high prevalence of HPV infection in FSW reported by other groups and suggests that brothel-based FSW may be at lower risk for acquiring high-risk HPV infection.

[Criminal claims about medical professional liability in the Instituto de Medicina Legal of Lima, Peru].

PubMed

Navarro-Sandoval, Cleyber; Arones-Guevara, Shermany; Carrera-Palao, Rosa; Casana-Jara, Kelly; Colque-Jaliri, Tomasa

2013-07-01

To determine the characteristics of the criminal complaints claining medical professional liability, based on the expert reports issued by the Forensic Examination Division of Lima, Peru. A cross-sectional study was carried out, which included all the expert reports issued between 2005 and 2010 at the Forensic Examination Division of Lima, Peru. A descriptive analysis of each of the variables was performed. 60.3% (495/821) of the criminal complaints for medical professional liability were valued as being in accordance with the lex artis while 16.8% (138/821) were not in accordance with the lex artis. In 13% (107/821) of the cases, conclusions could not be drawn;in 9.9% (81/821) of the cases, the conclusions in the expert report did not include an valuations of the medical act.The cases in which the injury was attributed to the process of the disease itself accounted for 80.9% (502/620), and those in which in the injury was considered a result of the health care received were 19.0% (118/620). The distribution of the cause of the injury based on accordance with the lex artis showed significant differences. In our country, the number of claims for claimed medical liability is increasing, predominantly in relation to surgical specialties, where a medical act is more likely to be considered not in accordance with the lex artis. In addition, in a significant percentage of cases, no conclusions are drawn about the medical act.

Immigration, acculturation, and risk factors for obesity and cardiovascular disease: a comparison between Latinos of Peruvian descent in Peru and in the United States.

PubMed

Lizarzaburu, Jesus L; Palinkas, Lawrence A

2002-01-01

To determine whether migration and acculturation was associated with risk factors for obesity and cardiovascular disease, whether this association is linear or curvilinear, and whether the socio-cultural context alters the association between obesity and cardiovascular disease and individual-level variables. Lima, Peru, San Diego and San Francisco, California. Ninety-two Peruvian residents of Lima and 83 Peruvian immigrant residents of California. total cholesterol, blood pressure, body mass index, waist-to-hip ratio. A significant linear association was found between migration and acculturation and alcohol consumption and total cholesterol in men and women, systolic (SBP) and diastolic (DBP) blood pressure and body mass index in men, and physical activity in women. Immigration/acculturation level was a significant independent predictor of total cholesterol. Age and body mass index were independent predictors of total cholesterol only in Peru. Sex was an independent predictor of DBP only in the United States. Body mass index was an in dependent predictor of DBP only in Peru. Household income was an independent predictor of SBP and DBP only in Peru and body mass index only in the United States, while level of education was inversely associated with body mass index only in Peru. Regular strenuous physical activity was an independent predictor of obesity measures only in the United States. The socio-cultural context alters the risk of obesity and cardiovascular disease associated with individual-level variables and accounts for gender and cross-national differences in the migration-illness association.

The societal burden of blindness secondary to retinopathy of prematurity in Lima, Peru.

PubMed

Dave, Hreem B; Gordillo, Luz; Yang, Zhou; Zhang, Monica S; Hubbard, G Baker; Olsen, Timothy W

2012-10-01

To determine the cost-effectiveness of laser treatment for retinopathy of prematurity (ROP) in Lima, Peru. A cost-of-illness study (in US dollars) to determine the direct cost of treatment, the indirect lifetime cost of blindness, and the quality-adjusted life years. The direct cost of ROP-related treatment was determined by reviewing data retrospectively from a social security sector hospital. The indirect cost was determined using national economic data of Peru published by the Central Information Agency (CIA), including the per capita gross domestic product, the sex-adjusted income distribution, and years spent in the work force. Indirect costs per child that were avoided by treatment were calculated using the known natural history of ROP vs evidence-based treatment. For ROP-related neonatal blindness in Peru, we estimate the total indirect cost saving at $197,753 per child and the direct cost of laser treatment at $2496 per child. The societal lifetime cost saving per child is estimated at $195,257. The mean annual income per educated adult in Peru is $8000 and treating 1 child is equivalent to employing 24 educated Peruvians per year. The generational cost savings for society is approximately $516 million, or the equivalent of 64,500 educated Peruvian work years. The societal burden of blindness far exceeds the costs of treatment per child. Proper screening and treatment of ROP prevents blindness and leads to substantial cost savings for society. Public health policy in Peru and other middle-income countries should consider financial impact when allocating healthcare resources. Copyright © 2012 Elsevier Inc. All rights reserved.

Military Observer Mission Ecuador-Peru (MOMEP) Doing a Lot with a Little.

DTIC Science & Technology

1997-06-01

Magazine Report on Purchase of DPRK Missiles," Lima Gestion , in FBIS Latin America, 26 March 1997. Ecuador purchased four Kfir fighter planes from...of DPRK Missiles," Lima Gestion , in FBIS, 26 March 1997. "Military: Ecuador Buying Arms From Bulgaria," La Republica, in FBIS, 22 March 1995, p. 7 7...Problem." URL: <http://www. globescope ,com//ecuador/white.htm>, accessed 30 October 1996. Fee, COL Mark, "MOMEP: Operacion Regional de Mantenimiento de

Genome sequence of Bradyrhizobium sp. LMTR 3, a diazotrophic symbiont of Lima bean (Phaseolus lunatus).

PubMed

Ormeño-Orrillo, Ernesto; Rey, Luis; Durán, David; Canchaya, Carlos A; Zúñiga-Dávila, Doris; Imperial, Juan; Martínez-Romero, Esperanza; Ruiz-Argüeso, Tomás

2017-09-01

Bradyrhizobium sp. LMTR 3 is a representative strain of one of the geno(species) of diazotrophic symbionts associated with Lima bean ( Phaseolus lunatus ) in Peru. Its 7.83 Mb genome was sequenced using the Illumina technology and found to encode a complete set of genes required for nodulation and nitrogen fixation, and additional genes putatively involved in root colonization. Its draft genome sequence and annotation have been deposited at GenBank under the accession number MAXC00000000.

Hantavirus Pulmonary Syndrome in Santa Cruz, Bolivia: Outbreak Investigation and Antibody Prevalence Study

DTIC Science & Technology

2012-10-18

transmission, is vast, including the Amazon Basin of Brazil and contiguous lowlands of Peru , Bolivia, and Paraguay [13–17]. Assuming that the episode of...U.S. Naval Medical Research Unit 6, Lima, Peru , 3 Bolivian National Center for Tropical Diseases, Santa Cruz, Bolivia, 4 Argentine National Institute...preceding the outbreak was particularly heavy in comparison to other years, suggesting a possible climatic or ecological influence on rodent populations

Report of the Defense Science Board Task Force on Department of Defense Biological Safety and Security Program

DTIC Science & Technology

2009-05-01

Three (NAMRU-3) - Lima, Peru : Naval Medical Research Center Detachment (NMRCD) *These labs are co-located. To provide some measure of the scope and...Aceh, Indonesia and the more recent earthquakes in central Java and Peru . Edgewood Chemical Biological Center (ECBC) ECBC’s science and technology... diabetes , obesity, cancer, psychiatric disorders, problems of pregnancy, AIDS, hepatitis, malaria, parasitic infections, and a host of other

Respiratory Syncytial Virus-Associated Hospitalizations in Pre-Mature Infants in Lima, Peru

PubMed Central

Ochoa, Theresa J.; Bautista, Rossana; Dávila, Carmen; Salazar, José Antonio; Bazán, Carlos; Guerra, Oscar; Llanos, Jean Pierre; López, Luis; Zea-Vera, Alonso; Ecker, Lucie

2014-01-01

We conducted a prospective cohort study in four hospitals in Lima, Peru in infants with a birth weight ≤ 1,500 g followed from birth hospital discharge up to 1 year of age to determine the incidence of respiratory syncytial virus (RSV) hospitalizations. We enrolled 222 infants from March of 2009 to March of 2010: 48 infants with a birth weight < 1,000 g and 174 infants with a birth weight of 1,000–1,500 g (birth weight = 1,197 ± 224 g; gestational age = 30.1 ± 2.6 weeks). There were 936 episodes of respiratory infections; the incidence of respiratory infections during the first 1 year of life was 5.7 episodes/child-years. The incidence of RSV respiratory infections that required emergency room management was 103.9 per 1,000 child-years, and the incidence of RSV hospitalizations was 116.2 per 1,000 child-years (244.9 in infants with a birth weight < 1,000 g and 88.9 in infants 1,000–1,500 g; P < 0.05). The incidence of RSV respiratory infections that required emergency management or hospitalization is high among pre-mature infants in Lima. PMID:25294617

INITIATIVES AND TREATMENT OF MERCURY IN ABANDONED MINES

EPA Science Inventory

This presentation discusses EPA's research activities and mitigation activities for mercury contaminated mine sites at the International meeting on mercury and artisanal gold mining in Lima, Peru. The topics discussed included the toxicological and enviornmental tasks associated ...

Fecal contamination of drinking water within peri-urban households, Lima, Peru.

PubMed

Oswald, William E; Lescano, Andrés G; Bern, Caryn; Calderon, Maritza M; Cabrera, Lilia; Gilman, Robert H

2007-10-01

We assessed fecal contamination of drinking water in households in 2 peri-urban communities of Lima, Peru. We measured Escherichia coli counts in municipal source water and, within households, water from principal storage containers, stored boiled drinking water, and water in a serving cup. Source water was microbiologically clean, but 26 (28%) of 93 samples of water stored for cooking had fecal contamination. Twenty-seven (30%) of 91 stored boiled drinking water samples grew E. coli. Boiled water was more frequently contaminated when served in a drinking cup than when stored (P < 0.01). Post-source contamination increased successively through the steps of usage from source water to the point of consumption. Boiling failed to ensure safe drinking water at the point of consumption because of easily contaminated containers and poor domestic hygiene. Hygiene education, better point-of-use treatment and storage options, and in-house water connections are urgently needed.

Diagnosis of cysticercosis in endemic regions. The Cysticercosis Working Group in Peru.

PubMed

Garcia, H H; Martinez, M; Gilman, R; Herrera, G; Tsang, V C; Pilcher, J B; Diaz, F; Verastegui, M; Gallo, C; Porras, M

1991-08-31

Taenia solium cysticercosis is a frequent cause of neurological disease in developing countries. Specific diagnosis of cysticercosis is difficult. We obtained serum and/or CSF samples from 204 consecutive patients admitted to a neurological ward in Lima, Peru, and looked for antibodies specific for T solium with the enzyme-linked immunoelectrotransfer blot (EITB) assay. 21 (12%) of 173 serum samples from these patients were EITB-positive. In contrast, only 2 (1.5%) of 135 patients attending a public endoscopy clinic and 1 (1%) of 88 patients attending a private endoscopy clinic were seropositive. 1 (1%) of 98 pregnant women living in a Lima shanty town was EITB-positive. 15 (58%) of 26 neurology patients diagnosed clinically as having cysticercosis were seronegative. Routine screening by EITB of all patients with neurological symptoms from areas of endemic cysticercosis would avoid misdiagnosis of this common and treatable disease.

[Use and perceptions of information and communication technologies in patients with hypertension, dyslipidemia or diabetes in a national hospital in Lima, Peru].

PubMed

Rivas-Nieto, Andrea C; Málaga, Germán; Ruiz-Grosso, Paulo; Huayanay-Espinoza, Carlos A; Curioso, Walter H

2015-01-01

This study aimed to determine the use and perceptions towards information and communication technologies (ICT) in 206 patients with arterial hypertension, dyslipidemia and diabetes, recruited from the outpatient clinic in a national hospital in Lima, Peru. 54.4% were older adults and 70.4% were women. The use of daily phone calls was 44.7%. Most had never used a computer (78.2%), email (84%) or the Internet (84%). Many have never sent (80.6%) or received (69.9%) a text message. 70% had at some time forgotten to take their medicine. 72.8% would like to be reminded to take their medication and 67.9% had a family member who could help them with access to ICT. Despite the low use of ICT in this population, there is willingness and expectation from the patients to participate in programs that implement them.

Association between perceived social support and induced abortion: A study in maternal health centers in Lima, Peru.

PubMed

Sánchez-Siancas, Luis E; Rodríguez-Medina, Angélica; Piscoya, Alejandro; Bernabe-Ortiz, Antonio

2018-01-01

This study aimed to assess the association between perceived social support and induced abortion among young women in Lima, Peru. In addition, prevalence and incidence of induced abortion was estimated. A cross-sectional study enrolling women aged 18-25 years from maternal health centers in Southern Lima, Peru, was conducted. Induced abortion was defined as the difference between the total number of pregnancies ended in abortion and the number of spontaneous abortions; whereas perceived social support was assessed using the DUKE-UNC scale. Prevalence and incidence of induced abortion (per 100 person-years risk) was estimated, and the association of interest was evaluated using Poisson regression models with robust variance. A total of 298 women were enrolled, mean age 21.7 (± 2.2) years. Low levels of social support were found in 43.6% (95%CI 38.0%-49.3%), and 17.4% (95%CI: 13.1%- 21.8%) women reported at least one induced abortion. The incidence of induced abortion was 2.37 (95%CI: 1.81-3.11) per 100 person-years risk. The multivariable model showed evidence of the association between low perceived social support and induced abortion (RR = 1.94; 95%CI: 1.14-3.30) after controlling for confounders. There was evidence of an association between low perceived social support and induced abortion among women aged 18 to 25 years. Incidence of induced abortion was similar or even greater than rates of countries where abortion is legal. Strategies to increase social support and reduce induced abortion rates are needed.

Molecular characterization and antifungal susceptibility of Cryptococcus neoformans strains collected from a single institution in Lima, Peru.

PubMed

Bejar, Vilma; Tello, Mercedes; García, Ruth; Guevara, José M; Gonzales, Sofia; Vergaray, German; Valencia, Esther; Abanto, Enma; Ortega-Loayza, Alex G; Hagen, Ferry; Gutierrez, Ericson L

2015-01-01

Cryptococcosis is a fungal infection with a worldwide distribution, mainly caused by Cryptococcus neoformans and Cryptococcus gattii. To molecularly characterize the mating-types, serotypes, genotypes and antifungal susceptibility profiles of a set of retrospectively isolated C. neoformans strains from Lima, Peru. A set of 32 Cryptococcus spp. strains from the Institute of Tropical Medicine of the National University of San Marcos, Lima, Peru, were included in this retrospective study. Twenty-four strains were isolated from patients, while the remaining 8 were isolated from the environment. Using conventional PCR, 27 (84.4%) of the isolates were identified as C. neoformans var. grubii mating-type alpha and serotype A. Using the AFLP fingerprinting, it was shown that 16 (50%) of the C. neoformans strains were genotype AFLP1, 13 (40.6%) were genotype AFLP1B, 2 (6.3%) were genotype AFLP2, and 1 (3.1%) was found to be a hybrid between both C. neoformans varieties (genotype AFLP3). The antifungal susceptibility profiles for amphotericin B, fluconazole and voriconazole showed that all the 32 C. neoformans are sensitive to these antifungal compounds. In this study we observed that C. neoformans var. grubii (AFLP1 and AFLP1B) and C. neoformans var. neoformans (AFLP2) were the only cryptococcal varieties involved. All strains were found to be sensitive to the antifungals tested, results that are consistent with those found in the international literature. Copyright © 2013 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

[Performance of cognitive brief test in elderly patients with dementia in advanced stage living in an urban community of Lima, Peru].

PubMed

Custodio, Nilton; Alva-Diaz, Carlos; Becerra-Becerra, Yahaira; Montesinos, Rosa; Lira, David; Herrera-Pérez, Eder; Castro-Suárez, Sheila; Cuenca-Alfaro, José; Valeriano-Lorenzo, Elizabeth

2016-01-01

Evaluate the performance of clock drawing test- Manos versión (PDR-M) and Mini Mental State Examination -Peruvian version (MMSE) to detect dementia in a sample based on urban community of Lima, Peru. This study is a secondary analysis database, observational, analytical and cross-sectional, the gold standard was the clinical and the neuropsychological evaluations together. Performance testing individually and in combination were evaluated.. Data were obtained from prevalence study conducted in 2008 in Cercado de Lima. MMSE performance for evaluation of patients with dementia of any kind showed sensitivity of 64,1%, specificity of 84,1%, PPV of 24.4%, NPV of 96.7%, PLR of 4,03 and NLR of 0,43. PDR-M showed sensitivity of 89,3%, specificity of 98,1%, PPV of 79.3%, NPV of 99.1%, PLR of 47,79 and NLR of 0,11. When both tests were applied, and at least one of them was positive, they showed sensitivity 98.1%, specificity 84.1%, PPV of 33.1%, NPV of 99.8%, PLR of 6,17 and NLR of 0,02. When performing separate analysis of Alzheimer-type dementia and non- Alzheimer dementia, the values of the parameters do not differ substantially from those obtained for dementia of any kind. The combination of MMSE and PDR-M show good discriminative ability to detect moderate and severe dementia in population living in urban community in Lima.

A Novel, Rapid Assay for Detection and Differentiation of Serotype-Specific Antibodies to Venezuelan Equine Encephalitis Complex Alphaviruses

DTIC Science & Technology

2005-01-01

Research Center Detachment, Lima, Peru Abstract. An epitope-blocking enzyme-linked immunosorbent assay was developed for the rapid differentiation of...subtype and variety of antibodies to VEEV in equines, humans, or rodent reservoir hosts can be critical for determining the potential of a naturally...of human sera from Mexico and Peru using a blocking enzyme-linked immunosorbent assay and plaque reduction neutralization tests* Serum number Country

Elite Settlements and Democracy in Latin America: The Dominican Republic and Peru

DTIC Science & Technology

1989-08-01

Social Indicators, volume 2, 3d edition, (New Haven: Yale Wuiversity Press, 1983), pg. 48. UOn a scale from one to seven, one being the greatest...Handbook of Political and Social Indicators, volume 1, 3d edition, (New Haven: Yale University Press, 1983), pg. 209. 107 (12% in 1977) was organized.53...3igarchic sentiment in Peru. Victor Andres Belaunde, Meditaciones Peruanas (Lima: Compaia de Impresiones y Publicidad, Editores, 1932), pg. 199. 192 parties

Using Adult Mosquitoes to Transfer Insecticides to Aedes Aegypti Larval Habitats

DTIC Science & Technology

2009-07-14

Playa , a municipality belonging to Ciudad de La Habana, Cuba. Rev Panam Salud Publica Pan Am J Public Health 19:379–384. 33. Harrington LC, et al...United Kingdom; bLaboratorio de Salud Publica, Iquitos, Peru; cIfakara Health Institute, Dar es Salaam, United Republic of Tanzania; dVector Group...Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom; eNaval Medical Research Center Detachment, United States Navy, Lima , Peru; and f

Prevalence of childhood overweight and obesity and associated factors in Peru.

PubMed

Preston, Emma C; Ariana, Proochista; Penny, Mary E; Frost, Melanie; Plugge, Emma

2015-12-01

To determine the prevalence of and factors associated with childhood overweight and obesity among a cohort of children 7-8 years of age in Peru. This was a cross-sectional secondary analysis of data from the Young Lives longitudinal study of childhood poverty. The sample was a cohort of 1 737 children 7-8 years of age in 2009. Prevalence of overweight and obesity was assessed using body mass index-forage Z-scores. Logistic regression was used to determine associations with a number of individual, household, and community factors. Prevalences of overweight and obesity were 19.2% and 8.6%, respectively. A prevalence of 32.0% and 23.5% overweight and obesity was found among males and females, respectively. High socioeconomic status, living in Lima, having a mother who was overweight or obese, being male, and being an only child or having only one sibling were associated with being overweight and obese at this age. This study shows a high prevalence of childhood and maternal overweight and obesity in Peru. In contrast to findings in many high-income countries, the findings in Peru indicate that children from wealthier households were more likely to be overweight or obese than those from poorer households. In addition, there is something particularly obesogenic about the Lima environment that merits further investigation, and several key issues to consider when targeting future interventions and research.

Understanding the facilitators and barriers of antiretroviral adherence in Peru: A qualitative study

PubMed Central

2010-01-01

Background Antiretroviral scale-up is increasing in resource-constrained settings. To date, few studies have explored the barriers and facilitators of adherence to ART in these settings. Facilitators and barriers of antiretroviral adherence in Peru are not completely understood. Methods At two clinics that serve a large number of HIV-positive individuals in Lima, Peru, 31 in-depth interviews were carried out in 2006 with adult HIV-positive individuals receiving ART. Purposive sampling was used to recruit the participants. Interviews were transcribed and coded using two Spanish-speaking researchers and a content analysis approach to identify themes in the data. Results Among the participants, 28/31 (90%) were male, 25/31 (81%) were self-identified as mestizo, and 19/31 (61%) had an education above high school. The most frequently discussed barriers to adherence included side effects, simply forgetting, inconvenience, dietary requirements, being away from home, and fear of disclosure/stigma. The most frequently discussed facilitators to adherence included having a fixed routine, understanding the need for compliance, seeing positive results, treatment knowledge, and faith in treatment. Conclusions Overall, these findings were similar to the facilitators and challenges experienced by individuals on ART in other resource constrained settings. Further treatment support tools and networks should be developed to decrease the challenges of ART adherence for HIV-positive individuals in Lima, Peru. PMID:20070889

High Prevalence of Mycoplasma pneumoniae and Chlamydia pneumoniae in Children with Acute Respiratory Infections from Lima, Peru

PubMed Central

del Valle-Mendoza, Juana; Orellana-Peralta, Fiorella; Marcelo-Rodríguez, Alvaro; Verne, Eduardo; Esquivel-Vizcarra, Mónica; Silva-Caso, Wilmer; Aguilar-Luis, Miguel Angel; Weilg, Pablo; Casabona-Oré, Verónica; Ugarte, Claudia; del Valle, Luis J.

2017-01-01

Background Mycoplasma pneumoniae and Chlamydia pneumoniae are atypical pathogens responsible for pneumonia and a leading cause of morbidity and mortality in low income countries. The study objective is to determine the prevalence of this pathogens in Peruvian children with acute respiratory infections. Methods A consecutive cross-sectional study was conducted in Lima, Peru from May 2009 to September 2010. A total of 675 children admitted with clinical diagnoses of acute respiratory infections were tested for Mycoplasma pneumoniae and Chlamydia pneumoniae detection by polymerase chain reaction (PCR), and clinical symptoms were registered by the attending physician. Results Mycoplasma pneumonia was detected in 25.19% (170/675) of nasopharyngeal samples and Chlamydia pneumonia in 10.52% (71/675). The most common symptoms in patients with these atypical pathogens were rhinorrhea, cough and fever. A higher prevalence of Mycoplasma pneumoniae cases were registered in summer, between December 2009 and March 2010. Conclusions Mycoplasma pneumoniae and Chlamydia pneumonia are a significant cause of morbidity in Peruvian children with acute respiratory infections (ARI). Further studies should evaluate the use of reliable techniques such as PCR in Peru in order to avoid underdiagnoses of these atypical pathogens. PMID:28129377

Presence of Porocephalus clavatus (Arthropoda: Porocephalidae) in Peruvian Boidae snakes.

PubMed

Gomez-Puerta, Luis A; Lopez-Urbina, María T; Gonzalez, Armando E

2011-09-27

The pentastome species, Porocephalus clavatus, has been found to infect the lungs of two species of snakes in the family Boidae family (Boa constrictor and Epicrates cenchria). The individual of B. constrictor was collected in the Amazonian rainforest of Departamento Loreto, Peru. The E. cenchria was recovered from the pet trade in Lima, Peru's capital city. A total of 22 P. clavatus were collected and examined from these two snakes. This is the first report of P. clavatus in Peru. The morphology of the parasites and the possible importance in public and animal health are discussed. Copyright © 2011 Elsevier B.V. All rights reserved.

Feasibility of Measuring Immune Resp, Activation in Foreskin/Mucosa in HIV-, Uncircumcised High-HIV-risk MSM, Lima Peru

ClinicalTrials.gov

2015-12-10

HIV Infections; Acquired Immunodeficiency Syndrome; Lentivirus Infections; Retroviridae Infections; RNA Virus Infections; Virus Diseases; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; Immunologic Deficiency Syndromes; Immune System Diseases; Slow Virus Diseases

Detection of Bartonella bacilliformis by Real-Time PCR in Naturally Infected Sand Flies

DTIC Science & Technology

2004-03-04

pp 231-298. 81 Maguiña, C. 1998. Bartonellosis o Enfermedad de...Carrion, nuevos aspectos de una vieja enfermedad . A.F.A. Editores Importadores. Lima, Peru Malqui, V., Speelmon, E., Verastegui, M., Maguina, C

Potential impact and acceptability of Internet partner notification for men who have sex with men and transgender women recently diagnosed as having sexually transmitted disease in Lima, Peru.

PubMed

Clark, Jesse L; Segura, Eddy R; Perez-Brumer, Amaya G; Reisner, Sari L; Peinado, Jesus; Salvatierra, Hector J; Sanchez, Jorge; Lama, Javier R

2014-01-01

We assessed the potential impact of Internet partner notification among men who have sex with men and transgender women in Peru recently diagnosed as having sexually transmitted disease. Use of Internet partner notification was anticipated for 55.9% of recent partners, including 43.0% of partners not currently expected to be notified, a 20.6% increase in anticipated notification outcomes.

Depressive Mood Among Within-Country Migrants in Periurban Shantytowns of Lima, Peru.

PubMed

Ruiz-Grosso, Paulo; Bernabe-Ortiz, Antonio; Diez-Canseco, Francisco; Gilman, Robert H; Checkley, William; Bennett, Ian M; Miranda, J Jaime

2015-12-01

In low- and middle-income countries, migration to urban settings has reshaped the sprawl and socio demographic profiles of major cities. Depressive episodes make up a large portion of the burden of disease worldwide and are related to socio-demographic disruptions. As a result of terrorism, political upheaval, followed by economic development, Peru has undergone major demographic transitions over the previous three decades including large migrations within the country. We aimed to determine the prevalence of current depressive mood and its relationship with parameters of internal migration, i.e. region of origin, age at migration, and years since migration. A community-wide census was carried out between January and June 2010 within a shantytown immigrant receiving community in Lima, Peru. One male or female adult per household completed a survey. Depressive mood was assessed with a 2-item Center for Epidemiologic Studies Depression (CESD) scale. Migration-related variables included place of birth, duration of residence in Lima, and age at migration. Prevalence ratios (PR) and 95% confidence intervals (95% CI) were calculated. A total of 8,551 out of 9,561 participants, response rate 89%, participated in the census. Of these, 8,091 records were analyzed: 71.8% were women [average age 39.4 (SD 13.9 years)] and 59.3% were immigrants. The overall prevalence of individuals with current depressive mood was 17.1% (95% CI 16.2-17.9%) and varied significantly by all socio-demographic and migration variables assessed. On unadjusted analyses, immigrants to Lima had higher prevalence of depressive mood if they originated in other costal or Andean areas, had lived in Lima for more than 20 years, or were <30 years of age when they out-migrated. When controlling for age, gender and socio-demographic variables the association was no longer significant, the only exception being a 20% lower prevalence of current depressive mood among those who out-migrated aged ≥30 years old (PR = 0.79; 95% CI 0.63-0.98). In conclusion, these results suggest that current depressive mood is very prevalent in this immigrant receiving community. Among all proxies for internal migration explored, in fully adjusted models, there was evidence of an association between age at migration (≥30 years old) and a lower probability of current depressive mood compared to non-migrants.

Defense.gov - Special Report - Travels With Mullen

Science.gov Websites

, the chairman of the Joint Chiefs of Staff said. Story» Chairman Visits Medical Researchers LIMA, Peru , March 4, 2009 – The chairman of the Joint Chiefs of Staff visited a Navy medical research unit that is

Endoscopic submucosal dissection as treatment for early gastric cancer: Experience at two centers in Lima, Peru.

PubMed

Chirinos Vega, J A; Vargas, G; Alcántara, C; Zapata, J

2018-02-09

The aim of the present study was to evaluate the feasibility of endoscopic submucosal dissection (ESD) and determine the clinical and pathologic characteristics of early gastric cancers and premalignant lesions treated with that technique at the Hospital Nacional of the Department of Health and a private clinic in Lima, Peru. A descriptive study of all pre-malignant and malignant gastric lesions treated with ESD at the Gastroenterology Service of the Hospital Arzobispo Loayza and the Clínica Angloamericana was conducted within the time frame of January 2012 and January 2017. A total of 13 lesions were resected through ESD: 8 adenocarcinomas (61.53%), 3 adenomas with high-grade dysplasia (23%), and 2 adenomas with low-grade dysplasia (15.38%). Twelve lesions (92.3%) were located in the lower third of the stomach. Slightly elevated lesions (Paris classification IIa) (4 lesions, 30.76%) and mixed slightly elevated lesions with a depressed component (IIa+IIc) (4 lesions, 30.76%) predominated. The mean size of the resected specimens was 35mm. Complete resection of all lesions was achieved in 11 cases (84.6%) and en bloc resection was carried out in 11 cases (84.6%). Resection was curative in 6 cases (75%), from the total of 8 resected adenocarcinomas. One case of perforation was the only complication reported (7.6%) and it was surgically resolved. The feasibility and efficacy of ESD for the treatment of early gastric cancer was demonstrated at two healthcare centers in Lima, Peru. The complication rate was similar to that reported in the international medical literature. Copyright © 2018 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

Association between perceived social support and induced abortion: A study in maternal health centers in Lima, Peru

PubMed Central

Rodríguez-Medina, Angélica; Piscoya, Alejandro; Bernabe-Ortiz, Antonio

2018-01-01

Objectives This study aimed to assess the association between perceived social support and induced abortion among young women in Lima, Peru. In addition, prevalence and incidence of induced abortion was estimated. Methods/Principal findings A cross-sectional study enrolling women aged 18–25 years from maternal health centers in Southern Lima, Peru, was conducted. Induced abortion was defined as the difference between the total number of pregnancies ended in abortion and the number of spontaneous abortions; whereas perceived social support was assessed using the DUKE-UNC scale. Prevalence and incidence of induced abortion (per 100 person-years risk) was estimated, and the association of interest was evaluated using Poisson regression models with robust variance. A total of 298 women were enrolled, mean age 21.7 (± 2.2) years. Low levels of social support were found in 43.6% (95%CI 38.0%–49.3%), and 17.4% (95%CI: 13.1%– 21.8%) women reported at least one induced abortion. The incidence of induced abortion was 2.37 (95%CI: 1.81–3.11) per 100 person-years risk. The multivariable model showed evidence of the association between low perceived social support and induced abortion (RR = 1.94; 95%CI: 1.14–3.30) after controlling for confounders. Conclusions There was evidence of an association between low perceived social support and induced abortion among women aged 18 to 25 years. Incidence of induced abortion was similar or even greater than rates of countries where abortion is legal. Strategies to increase social support and reduce induced abortion rates are needed. PMID:29649229

The effect of changes in visibility and price on fruit purchasing at a university cafeteria in Lima, Peru.

PubMed

Cárdenas, María Kathia; Benziger, Catherine P; Pillay, Timesh D; Miranda, J Jaime

2015-10-01

To determine the effect of increasing fruit visibility, adding information and lowering price on fruit purchasing at a university cafeteria in Lima, Peru. Quasi-experimental pilot study of a three-phase stepped intervention. In Phase 1, fruit was displayed >3 m from the point of purchase with no additional information. Phase 2 consisted in displaying the fruit near the point of purchase with added health and price information. Phase 3 added a 33% price reduction. The duration of each phase was 3 weeks and phases were separated by 2-week breaks. Primary outcomes were total pieces of fruit and number of meals sold daily. A university cafeteria in Lima, Peru. Approximately 150 people, students and non-student adults, who purchased food daily. Twelve students participated in post-intervention interviews. Fruit purchasing doubled from Phase 1 to Phase 3 (P<0·01) and remained significant after adjusting for the number of meals sold daily (P<0·05). There was no evidence of a difference in fruit sold between the other phases. Females purchased 100% of the fruit in Phase 1, 82% in Phase 2 and 67% in Phase 3 (P<0·01). Males increased their purchasing significantly between Phase 1 and 3 (P<0·01). Non-student adults purchased more fruit with each phase (P<0·05) whereas students did not. Qualitatively, the most common reason for not purchasing fruit was a marked preference to buy unhealthy snack foods. Promoting fruit consumption by product placement close to the point of purchase, adding health information and price reduction had a positive effect on fruit purchasing in a university cafeteria, especially in males and non-student adults.

Effects of Ethnic Attributes on the Quality of Family Planning Services in Lima, Peru: A Randomized Crossover Trial

PubMed Central

Planas, Maria-Elena; García, Patricia J.; Bustelo, Monserrat; Carcamo, Cesar P.; Martinez, Sebastian; Nopo, Hugo; Rodriguez, Julio; Merino, Maria-Fernanda; Morrison, Andrew

2015-01-01

Most studies reporting ethnic disparities in the quality of healthcare come from developed countries and rely on observational methods. We conducted the first experimental study to evaluate whether health providers in Peru provide differential quality of care for family planning services, based on the indigenous or mestizo (mixed ethnoracial ancestry) profile of the patient. In a crossover randomized controlled trial conducted in 2012, a sample of 351 out of the 408 public health establishments in Metropolitan Lima, Peru were randomly assigned to receive unannounced simulated patients enacting indigenous and mestizo profiles (sequence-1) or mestizo and then indigenous profiles (sequence-2), with a five week wash-out period. Both ethnic profiles used the same scripted scenario for seeking contraceptive advice but had distinctive cultural attributes such as clothing, styling of hair, make-up, accessories, posture and patterns of movement and speech. Our primary outcome measure of quality of care is the proportion of technical tasks performed by providers, as established by Peruvian family planning clinical guidelines. Providers and data analysts were kept blinded to the allocation. We found a non-significant mean difference of -0·7% (p = 0·23) between ethnic profiles in the percentage of technical tasks performed by providers. However we report large deficiencies in the compliance with quality standards of care for both profiles. Differential provider behaviour based on the patient's ethnic profiles compared in the study did not contribute to deficiencies in family planning outcomes observed. The study highlights the need to explore other determinants for poor compliance with quality standards, including demand and supply side factors, and calls for interventions to improve the quality of care for family planning services in Metropolitan Lima. PMID:25671664

Physical activity and cardiovascular risk factors among rural and urban groups and rural-to-urban migrants in Peru: a cross-sectional study

PubMed Central

Creber, Ruth M. Masterson; Smeeth, Liam; Gilman, Robert H.; Miranda, J. Jaime

2010-01-01

Objectives To compare physical activity and sedentary behavior patterns of rural-to-urban migrants in Peru versus lifetime rural and urban residents and to determine any associations between low physical activity and four cardiovascular risk factors: obesity (body mass index ≥ 30 kg/m2), systolic and diastolic blood pressure, hypertension, and metabolic syndrome. Methods The PERU MIGRANT (PEru’s Rural to Urban MIGRANTs) cross-sectional study was designed to measure physical activity among rural, urban, and rural-to-urban migrants with the International Physical Activity Questionnaire (IPAQ). Results The World Health Organization (WHO) age-standardized prevalence of low physical activity was 2.2% in lifetime rural residents, 32.2% in rural-to-urban migrants, and 39.2% in lifetime urban residents. The adjusted odds ratios for low physical activity were 21.43 and 32.98 for migrant and urban groups respectively compared to the rural group. The adjusted odds ratio for being obese was 1.94 for those with low physical activity. There was no evidence of an association between low physical activity and blood pressure levels, hypertension, or metabolic syndrome. Conclusions People living in a rural area had much higher levels of physical activity and lower risk of being overweight and obese compared to those living in an urban area of Lima. Study participants from the same rural area who had migrated to Lima had levels of physical inactivity and obesity similar to those who had always lived in Lima. Interventions aimed at maintaining higher levels of physical activity among rural-to-urban migrants may help reduce the epidemic of obesity in urban areas. PMID:20857014

Vaccine schedule compliance among very low birth weight infants in Lima, Peru.

PubMed

Ochoa, Theresa J; Zea-Vera, Alonso; Bautista, Rossana; Davila, Carmen; Salazar, José Antonio; Bazán, Carlos; López, Luis; Ecker, Lucie

2015-01-03

There is little information about vaccine schedule compliance in very-low-birth-weight infants in developing countries. The aim of the study was to describe the compliance with the vaccine schedule among this population in Lima, Peru. We conducted a prospective cohort study in four hospitals in Lima in infants with a birth-weight of less than 1500 g, followed from birth up to 12 months of age every 2 weeks. The date and age at administration of each vaccine was recorded 222 infants were enrolled. The median birth-weight was 1250 g (range 550-1499 g) and the median gestational age was 30.0 weeks (range 23-37 weeks). The mean age for the first pentavalent (DPT, Hib, HepB) and oral polio vaccine administration was 4.3 ± 1.4 months in infants with a birth-weight of < 1000 g vs. 3.1 ± 1.0 in infants with a birth-weight 1000-1500 g (p < 0.001); 4.1 ± 0.9 vs. 3.3 ± 1.1 for rotavirus (p < 0.05); and 5.1 ± 2.1 vs. 4.3 ± 1.8 for the 7-valent pneumococcal conjugated vaccine. Only 35% had received the three doses of oral polio and pentavalent vaccine by seven months, although by nine months 81% had received these vaccines. Vaccination of very-low-birth-weight infants in Peru is significantly delayed, especially in infants with a birth-weight of < 1000 g and lower gestational age. Urgent educational interventions targeting physicians and nurses should be implemented in order to improve vaccination rates and timing in these high risk populations. Copyright © 2014 Elsevier Ltd. All rights reserved.

The effect of changes in visibility and price on fruit purchasing at a university cafeteria in Lima, Peru

PubMed Central

Cárdenas, María Kathia; Benziger, Catherine P; Pillay, Timesh D; Miranda, J Jaime

2017-01-01

Objective To determine the effect of increasing fruit visibility, adding information and lowering price on fruit purchasing at a university cafeteria in Lima, Peru. Design Quasi-experimental pilot study of a three-phase stepped intervention. In Phase 1, fruit was displayed >3 m from the point of purchase with no additional information. Phase 2 consisted in displaying the fruit near the point of purchase with added health and price information. Phase 3 added a 33 % price reduction. The duration of each phase was 3 weeks and phases were separated by 2-week breaks. Primary outcomes were total pieces of fruit and number of meals sold daily. Setting A university cafeteria in Lima, Peru. Subjects Approximately 150 people, students and non-student adults, who purchased food daily. Twelve students participated in post-intervention interviews. Results Fruit purchasing doubled from Phase 1 to Phase 3 (P < 0.01) and remained significant after adjusting for the number of meals sold daily (P < 0.05). There was no evidence of a difference in fruit sold between the other phases. Females purchased 100 % of the fruit in Phase 1, 82 % in Phase 2 and 67 % in Phase 3 (P < 0.01). Males increased their purchasing significantly between Phase 1 and 3 (P < 0.01). Non-student adults purchased more fruit with each phase (P < 0.05) whereas students did not. Qualitatively, the most common reason for not purchasing fruit was a marked preference to buy unhealthy snack foods. Conclusions Promoting fruit consumption by product placement close to the point of purchase, adding health information and price reduction had a positive effect on fruit purchasing in a university cafeteria, especially in males and non-student adults. PMID:25434293

Effects of ethnic attributes on the quality of family planning services in Lima, Peru: a randomized crossover trial.

PubMed

Planas, Maria-Elena; García, Patricia J; Bustelo, Monserrat; Carcamo, Cesar P; Martinez, Sebastian; Nopo, Hugo; Rodriguez, Julio; Merino, Maria-Fernanda; Morrison, Andrew

2015-01-01

Most studies reporting ethnic disparities in the quality of healthcare come from developed countries and rely on observational methods. We conducted the first experimental study to evaluate whether health providers in Peru provide differential quality of care for family planning services, based on the indigenous or mestizo (mixed ethnoracial ancestry) profile of the patient. In a crossover randomized controlled trial conducted in 2012, a sample of 351 out of the 408 public health establishments in Metropolitan Lima, Peru were randomly assigned to receive unannounced simulated patients enacting indigenous and mestizo profiles (sequence-1) or mestizo and then indigenous profiles (sequence-2), with a five week wash-out period. Both ethnic profiles used the same scripted scenario for seeking contraceptive advice but had distinctive cultural attributes such as clothing, styling of hair, make-up, accessories, posture and patterns of movement and speech. Our primary outcome measure of quality of care is the proportion of technical tasks performed by providers, as established by Peruvian family planning clinical guidelines. Providers and data analysts were kept blinded to the allocation. We found a non-significant mean difference of -0.7% (p = 0.23) between ethnic profiles in the percentage of technical tasks performed by providers. However we report large deficiencies in the compliance with quality standards of care for both profiles. Differential provider behaviour based on the patient's ethnic profiles compared in the study did not contribute to deficiencies in family planning outcomes observed. The study highlights the need to explore other determinants for poor compliance with quality standards, including demand and supply side factors, and calls for interventions to improve the quality of care for family planning services in Metropolitan Lima.

Problem drinking is associated with increased prevalence of sexual risk behaviors among men who have sex with men (MSM) in Lima, Peru.

PubMed

Deiss, Robert G; Clark, Jesse L; Konda, Kelika A; Leon, Segundo R; Klausner, Jeffrey D; Caceres, Carlos F; Coates, Thomas J

2013-09-01

Alcohol use is an important but understudied HIV risk factor among men who have sex with men (MSM), particularly in Latin America. We studied the relationship between problem drinking and sexual risk among MSM in Lima, Peru. We recruited 718 participants from 24 neighborhoods for a study on sexually transmitted infections and community-building among MSM. Multivariate analysis was used to identify factors independently associated with problem drinking, which was defined via the CAGE Questionnaire. Of 718 participants, 58% met criteria for problem drinking. In univariate analysis, problem drinkers were significantly more likely to report failing to always use condoms, use alcohol or drugs prior to their most recent sexual encounter, report a history of sexual coercion and to engage in transactional sex. Problem drinkers also reported significantly higher numbers of recent and lifetime sexual partners. In multivariate analysis, factors independently associated with problem drinking included a history of sexual coercion [OR 1.8 95%, CI 1.2-2.6], having consumed alcohol prior to the most recent sexual encounter [OR 2.1 95%, CI 1.5-2.9], receiving compensation for sex in the last six months [OR 1.6, 95% CI 1.1-2.2] or having reported a prior HIV+ test [OR 0.5, 95% CI 0.2-0.9]. We found a high prevalence of problem drinking among MSM in Lima, Peru, which was associated with increased sexual risk in our study. Of note, individuals who were already HIV-infected were less likely to be problem drinkers. Further studies and targeted interventions to reduce problem drinking among MSM are warranted. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

[Epidemiological clinical and laboratory characterization of sporotrichosis in patients of a tertiary care hospital in Lima, Peru, from 1991 to 2014].

PubMed

Oyarce, James A; García, Coralith; Alave, Jorge; Bustamante, Beatriz

2016-06-01

Sporothricosis is endemic in numerous Latin American countries and the rest of the world. In Peru is concentrated in regions with warm and humid climate being little known in the rest of the country. To describe the epidemiological, clinical and laboratory characteristics of patients diagnosed of sporotrichosis in a tertiary-care level hospital in Lima, Peru from 1991 to 2014. This was a retrospective, case series. Ninety four patients were involved; most of them were male adults. This condition was acquired more frequently in Cajamarca, Apurímac, and Amazonas. Fixed and lymphocutaneous form were the most frequent forms of presentation in adults and were mostly distributed in upper limbs. Lesions located in head and neck were most frequent in children. Comorbidities were present in 15% of patients and were more frequent in those who presented disseminated cutaneous form. Seventy eight percent of cultures from skin lesions were positive within 7 days. The time to positivity of cultures was longer if the sample came from skin biopsies than skin scraping or skin aspiration. Most cases of sporotrichosis were acquired in areas of extreme poverty in Peru. The clinical, epidemiological and laboratory findings were similar to those reported elsewhere. The time to positivity of cultures varies based on the type of skin sample. This finding needs to be further evaluated in studies with an increased number of cases.

Neutron Scattering Facilities

Science.gov Websites

Low Energy Neutron Source (LENS), Indiana University Cyclotron Facility, USA McMaster Nuclear Reactor Research, Gaithersburg, Maryland, USA Peruvian Institute of Nuclear Energy (IPEN), Lima, Peru Spallation Nuclear Science and Technology Organisation, Lucas Heights, Australia High-flux Advanced Neutron

Maria Auxiliadora Hospital in Lima, Peru as a model for neurosurgical outreach to international charity hospitals.

PubMed

Hayden, Melanie G; Hughes, Samuel; Hahn, Edward J; Aryan, Henry E; Levy, Michael L; Jandial, Rahul

2011-01-01

A myriad of geopolitical and financial obstacles have kept modern neurosurgery from effectively reaching the citizens of the developing world. Targeted neurosurgical outreach by academic neurosurgeons to equip neurosurgical operating theaters and train local neurosurgeons is one method to efficiently and cost effectively improve sustainable care provided by international charity hospitals. The International Neurosurgical Children's Association (INCA) effectively improved the available neurosurgical care in the Maria Auxiliadora Hospital of Lima, Peru through the advancement of local specialist education and training. Neurosurgical equipment and training were provided for the local neurosurgeons by a mission team from the University of California at San Diego. At the end of 3 years, with one intensive week trip per year, the host neurosurgeons were proficiently and independently applying microsurgical techniques to previously performed operations, and performing newly learned operations such as neuroendoscopy and minimally invasive neurosurgery. Our experiences may serve as a successful template for the execution of other small scale, sustainable neurosurgery missions worldwide.

[Use of information sources by recently graduated physicians of Lima].

PubMed

Mejia, Christian R; Caceres, Onice J; Vera, Claudia A; Nizama-Vía, Ayar; Curioso, Walter H; Mayta-Tristán, Percy

2014-01-01

In order to determine the use of information sources by recently graduated physicians of Lima, Peru in 2011, a survey was conducted among graduated physicians at seven universities. They were asked about the use of search engines in the health area during their year of medical internship [last year of medical school]. Regular use was defined as the source being used once a week or daily. For 490 respondents, regularly used information sources were SciELO, accessed by 173 (36.4%); PubMed 165 (34.4%); HINARI 117 (25.5%); UpToDate 98 (22.3%); Cochrane Library 94 (20.6%); LILACS 91 (19.8%); a hospital institutional library 70 (15.0%); LIPECS 39 (8.7%); and Peru BVS 42 (9.3%). Only a minority regularly accessed information sources related to health. It is necessary to improve capacity in the efficient use of various resources of scientific information in a continuous way and that reaches students and health professionals.

Drug consumption and violence in female work Zapallal--Lima/Peru.

PubMed

Musayón, Yesenia; Caufield, Catherine

2005-01-01

The study design was descriptive, correlational, cross-sectional, and qualitative. The objective was to identify sociodemographic and labor risk factors for drug consumption and types of violence in the workplace related to drug consumption, as well as to understand the perception of female workers regarding the relationship between drug consumption and workplace violence. We surveyed 125 women workers of four slums in the area of Zapallal, Lima, Peru, interviewing 16 women who experienced workplace violence. Among the participants, 52.8% consumed alcohol and 6.4% illegal drugs. Catholic women were at risk for consuming alcohol, while participants under 20 years of age were at risk for consuming illicit drugs. In this group, 17.6% of the women experienced verbal violence, 9.6% physical violence and 1.6% were sexually harassed in the workplace. Women victims of verbal violence have a risk for consuming illicit drugs. These women perceived themselves as a vulnerable group for violence in the workplace and weak for defending themselves. They expressed fear or shame in reporting cases of violence.

Occurrence of Giardia intestinalis and Cryptosporidium sp. in wastewater samples from São Paulo State, Brazil, and Lima, Peru.

PubMed

Ulloa-Stanojlović, Francisco Miroslav; Aguiar, Bruna; Jara, Luis M; Sato, Maria Inês Zanoli; Guerrero, Juana Arzola; Hachich, Elayse; Matté, Glavur Rogério; Dropa, Milena; Matté, Maria Helena; de Araújo, Ronalda Silva

2016-11-01

The objectives of the study were to detect and genotype Cryptosporidium spp. and Giardia intestinalis in wastewater samples obtained from five cities with high transit of people in the State of São Paulo, Brazil, and at the entrance of a Wastewater Treatment Plant (WWTP) in Lima, Peru. Samples were collected and concentrated by centrifugation. The genomic DNA was extracted for molecular characterization by nested PCR for Cryptosporidium and double nested PCR for Giardia, followed by sequencing and phylogenetic analysis. G. intestinalis was found in 63.6 % of the samples, and the human assemblages A and B were identified. Cryptosporidium sp. was found in 36.4 % of the samples, and the species were corresponding to Cryptosporidium hominis, Cryptosporidium cuniculus, and Cryptosporidium muris. Results revealed the presence of human pathogenic Cryptosporidium species and G. intestinalis human pathogenic assemblages. Molecular tools highlight the importance to map the genetic diversity of these parasites, as well as to detect their epidemiological circulation pathway in the environment.

Assessing spatiotemporal patterns of multidrug-resistant and drug-sensitive tuberculosis in a South American setting

PubMed Central

Lin, H.; Shin, S.; Blaya, J. A.; Zhang, Z.; Cegielski, P.; Contreras, C.; Asencios, L.; Bonilla, C.; Bayona, J.; Paciorek, C. J.; Cohen, T.

2011-01-01

Summary We examined the spatiotemporal distribution of laboratory-confirmed multidrug-resistant tuberculosis (MDR TB) cases and that of other TB cases in Lima, Peru with the aim of identifying mechanisms responsible for the rise of MDR TB in an urban setting. All incident cases of TB in two districts of Lima, Peru during 2005–2007 were included. The spatiotemporal distributions of MDR cases and other TB cases were compared with Ripley's K statistic. Of 11 711 notified cases, 1187 received drug susceptibility testing and 376 were found to be MDR. Spatial aggregation of patients with confirmed MDR disease appeared similar to that of other patients in 2005 and 2006; however, in 2007, cases with confirmed MDR disease were found to be more tightly grouped. Subgroup analysis suggests the appearance of resistance may be driven by increased transmission. Interventions should aim to reduce the infectious duration for those with drug-resistant disease and improve infection control. PMID:21205434

Species of Macrostomum (Macrostomorpha: Macrostomidae) from the coastal region of Lima, Peru, with comments on M. rostratum Papi, 1951.

PubMed

Reyes, Jhoe; Brusa, Francisco

2017-12-05

Species of Macrostomum are present in almost all regions of the world. These flatworms occur in different kinds of environments, from freshwater to marine ecosystems. Although Peru is considered one of the megadiverse countries in South America, little is known about freshwater microturbellarians in this country. Here we report the presence of M. rostratum Papi, 1951 for the first time in Peru, in a coastal brackish water wetland, and that of M. quiritium Beklemischev, 1951 and M. tuba Graff, 1882 in an inland portion of a river near the city of Lima. All the species were studied alive. Comments on the habitat and associated fauna are given. Detailed information on the copulatory system is provided for M. rostratum; the male system has a bilobed seminal vesicle with thick walls and full of spindle-shaped sperm cells, and a stylet in the form of a solid curved inverted cone with a subterminal opening located on the concave side of the stylet. These findings led us to suggest that M. rostratum may exhibit a hypodermic mating syndrome. The three species of Macrostomum reported here are widespread and, although the diagnostic characters of the species are present, some morphological differences in the copulatory stylet suggest they are cryptic species.

Andean tectonics: Implications for Satellite Geodesy

NASA Technical Reports Server (NTRS)

Allenby, R. J.

1984-01-01

Current knowledge and theories of large scale Andean tectonics as they relate to site planning for the NASA Crustal Dynamics Program's proposed high precision geodetic measurements of relative motions between the Nazca and South American plates are summarized. The Nazca Plate and its eastern margin, the Peru-Chile Trench, is considered a prototype plate marked by rapid motion, strong seismicity and well defined boundaries. Tectonic activity across the Andes results from the Nazca Plate subducting under the South American plate in a series of discrete platelets with different widths and dip angles. This in turn, is reflected in the tectonic complexity of the Andes which are a multitutde of orogenic belts superimposed on each other since the Precambrian. Sites for Crustal Dynamics Program measurements are being located to investigate both interplate and extraplate motions. Observing operations have already been initiated at Arequipa, Peru and Easter Island, Santiago and Cerro Tololo, Chile. Sites under consideration include Iquique, Chile; Oruro and Santa Cruz, Bolivia; Cuzco, Lima, Huancayo and Bayovar, Peru; and Quito and the Galapagos Islands, Ecuador. Based on scientific considerations, Santa Cruz, Huancayo (or Lima), Quito and the Galapagos Islands should be replaced by Isla San Felix, Chile; Brazilia or Petrolina, Brazil; and Guayaquil, Ecuador. If resources permit, additional important sites would be Buenaventura and Villavicencio or Puerto La Concordia, Colombia; and Mendoza and Cordoba, Argentina.

Cost-of-illness study in a retrospective cohort of patients with dementia in Lima, Peru

PubMed Central

Custodio, Nilton; Lira, David; Herrera-Perez, Eder; del Prado, Liza Nuñez; Parodi, José; Guevara-Silva, Erik; Castro-Suarez, Sheila; Montesinos, Rosa

2015-01-01

Dementia is a major cause of dependency and disability among older persons, and imposes huge economic burdens. Only a few cost-of-illness studies for dementia have been carried out in middle and low-income countries. Objective The aim of this study was to analyze costs of dementia in demented patients of a private clinic in Lima, Peru. Methods. We performed a retrospective, cohort, 3-month study by extracting information from medical records of demented patients to assess the use of both healthcare and non-healthcare resources. The total costs of the disease were broken down into direct (medical and social care costs) and indirect costs (informal care costs). Results. In 136 outpatients, we observed that while half of non-demented patients had total care costs of less than US$ 23 over three months, demented patients had costs of US$ 1500 or over (and more than US$ 1860 for frontotemporal dementia). In our study, the monthly cost of a demented patient (US$ 570) was 2.5 times higher than the minimum wage (legal minimum monthly wage in Peru for 2011: US$ 222.22). Conclusion. Dementia constitutes a socioeconomic problem even in developing countries, since patients involve high healthcare and non-healthcare costs, with the costs being especially high for the patient's family. PMID:29213939

Cost-of-illness study in a retrospective cohort of patients with dementia in Lima, Peru.

PubMed

Custodio, Nilton; Lira, David; Herrera-Perez, Eder; Del Prado, Liza Nuñez; Parodi, José; Guevara-Silva, Erik; Castro-Suarez, Sheila; Montesinos, Rosa

2015-01-01

Dementia is a major cause of dependency and disability among older persons, and imposes huge economic burdens. Only a few cost-of-illness studies for dementia have been carried out in middle and low-income countries. The aim of this study was to analyze costs of dementia in demented patients of a private clinic in Lima, Peru. We performed a retrospective, cohort, 3-month study by extracting information from medical records of demented patients to assess the use of both healthcare and non-healthcare resources. The total costs of the disease were broken down into direct (medical and social care costs) and indirect costs (informal care costs). In 136 outpatients, we observed that while half of non-demented patients had total care costs of less than US$ 23 over three months, demented patients had costs of US$ 1500 or over (and more than US$ 1860 for frontotemporal dementia). In our study, the monthly cost of a demented patient (US$ 570) was 2.5 times higher than the minimum wage (legal minimum monthly wage in Peru for 2011: US$ 222.22). Dementia constitutes a socioeconomic problem even in developing countries, since patients involve high healthcare and non-healthcare costs, with the costs being especially high for the patient's family.

Trends in head and neck cancers in Peru between 1987 and 2008: Experience from a large public cancer hospital in Lima

PubMed Central

Walter, Leora; Vidaurre, Tatiana; Gilman, Robert H.; Poquioma, Ebert; Olaechea, Carlos; Gravitt, Patti E.; Marks, Morgan A.

2017-01-01

Background Few studies have evaluated the trends in head and neck cancer in developing countries. The purpose of this study was to estimate trends in incidence of human papillomavirus–related (HPV-R) and HPV-unrelated (HPV-U) head and neck cancer in Lima, Peru, from 1987 to 2008. Methods Registry data from a single public cancer hospital were used to estimate age and sex-specific incidence rates. Annualized percent change was estimated using Poisson regression. Results The rate of total head and neck cancers, HPV-U, and HPV-R was 11.9, 10.9, and 0.8, respectively, per 100,000 person-years. Significant increases in HPV-U head and neck cancer were observed in men aged 30 to 44 (2.5%/year) and women 15 to 29 (4.2%/year), 30 to 44 (3.4%/ year), and 60 to 74 (2.0%/year). Significant increases in HPV-R head and neck cancer were observed only among men aged 45 to 59 (9.6%/year). Conclusion Although increased exposure to tobacco, occupational carcinogens, and changing sexual behaviors could be influencing these trends, additional analyses to assess generalizability of these findings to other regions of Peru are needed. PMID:23616366

Barriers to Follow-Up for Abnormal Papanicolaou Smears among Female Sex Workers in Lima, Peru.

PubMed

Aharon, Devora; Calderon, Martha; Solari, Vicky; Alarcon, Patricia; Zunt, Joseph

2017-01-01

Cervical cancer is the most prevalent cancer among Peruvian women. Female sex workers (FSW) in Peru are at elevated risk for HPV infection, and receive annual Papanicolaou screening. The objective of this study was to identify barriers to follow-up for abnormal Pap smears among FSW in Peru. 97 FSW attending the Alberto Barton Health Center in Lima were surveyed regarding their STI screening history. 17 women with a history of an abnormal Pap smear were interviewed about their experiences regarding follow-up care. Of the 27 HPV-positive women, only 8 (30%) received follow-up treatment. Of the 19 women who did not receive follow-up, 7 (37%) had not been informed of their abnormal result. Qualitative interviews revealed that the major barrier to follow-up was lack of knowledge about HPV and potential health consequences of an abnormal Pap smear. HPV infection is highly prevalent in Peruvian FSW, yet only 30% of FSW with abnormal Pap smears receive follow-up care. The predominant barriers to follow-up were lack of standardization in recording and communicating results and insufficient FSW knowledge regarding health consequences of HPV infection. Standardization of record-keeping and distribution of educational pamphlets have been implemented to improve follow-up for HPV.

[Effect of a physiotherapy exercise program on physical performance in institutionalized elderly].

PubMed

Chávez-Pantoja, Mariana; López-Mendoza, Mariella; Mayta-Tristán, Percy

2014-01-01

To evaluate changes in physical performance in institutionalized older adults through a program of physiotherapy exercises. A quasi-experimental study was conducted on adults over 60 years-old, institutionalized in Lima, Peru. The exercise program was implemented in 45minutes sessions included warming-up, muscle strengthening exercises, balance, gait training and cooling phase, three times a week for 12 weeks. Physical performance was measured with the Short Physical Performance Battery (SPPB) one week before and after the intervention. It included 45 participants, of whom 16 did not attend any of the sessions and was used as a control group. The mean age was 77.6±7.1 years, and 62.2% were women. The mean baseline SPPB was 7.0±1.6 in the intervention group, and 6.9±1.9 in the control group (P=.90). A change of 2.6±1.8 was observed in the SPPB of the intervention group versus -1.4±2.0 in the control group (P<.001). The development of a physiotherapy exercise program for institutionalized elderly increases physical performance, which could be implemented in care centers for elderly. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

An assessment of drinking water contamination with Helicobacter pylori in Lima, Peru.

PubMed

Boehnke, Kevin F; Brewster, Rebecca K; Sánchez, Brisa N; Valdivieso, Manuel; Bussalleu, Alejandro; Guevara, Magaly; Saenz, Claudia Gonzales; Alva, Soledad Osorio; Gil, Elena; Xi, Chuanwu

2018-04-01

Helicobacter pylori is a gut bacterium that is the primary cause of gastric cancer. H. pylori infection has been consistently associated with lack of access to sanitation and clean drinking water. In this study, we conducted time-series sampling of drinking water in Lima, Peru, to examine trends of H. pylori contamination and other water characteristics. Drinking water samples were collected from a single faucet in Lima's Lince district 5 days per week from June 2015 to May 2016, and pH, temperature, free available chlorine, and conductivity were measured. Quantities of H. pylori in all water samples were measured using quantitative polymerase chain reaction. Relationships between the presence/absence and quantity of H. pylori and water characteristics in the 2015-2016 period were examined using regression methods accounting for the time-series design. Forty-nine of 241 (20.3%) of drinking water samples were contaminated with H. pylori. Statistical analyses identified no associations between sampling date and the likelihood of contamination with H. pylori. Statistically significant relationships were found between lower temperatures and a lower likelihood of the presence of H. pylori (P < .05), as well as between higher pH and higher quantities of H. pylori (P < .05). This study has provided evidence of the presence of H. pylori DNA in the drinking water of a single drinking water faucet in the Lince district of Lima. However, no seasonal trends were observed. Further studies are needed to determine the presence of H. pylori in other drinking water sources in other districts in Lima, as well as to determine the viability of H. pylori in these water sources. Such studies would potentially allow for better understanding and estimates of the risk of infection due to exposure to H. pylori in drinking water. © 2018 John Wiley & Sons Ltd.

A new species of diplectanid (Monogenoidea) from Paranthias colonus (Perciformes, Serranidae) off Peru

PubMed Central

Knoff, Marcelo; Cohen, Simone Chinicz; Cárdenas, Melissa Querido; Cárdenas-Callirgos, Jorge M.; Gomes, Delir Corrêa

2015-01-01

Pseudorhabdosynochus jeanloui n. sp. (Monogenoidea, Diplectanidae) is described from specimens collected from the gills of the Pacific creolefish, Paranthias colonus (Perciformes, Serranidae) from a fish market in Chorrillos, Lima, Peru. The new species is differentiated from other members of the genus by the structure of its sclerotized vagina, which has two spherical chambers of similar diameter. This is the first Pseudorhabdosynochus species described from the Pacific coast of America, the third species of the genus reported from South America and the first described from a member of Paranthias. PMID:25754099

A Qualitative Assessment of Alcohol Consumption and Sexual Risk Behaviors Among Men Who Have Sex With Men and Transgender Women in Peru.

PubMed

Vagenas, Panagiotis; Brown, Shan-Estelle; Clark, Jesse L; Konda, Kelika A; Lama, Javier R; Sánchez, Jorge; Duerr, Ann C; Altice, Frederick L

2017-06-07

Peruvian men who have sex with men (MSM) and transgender women (TGW) experience the double burden of a highly concentrated HIV epidemic with a high prevalence of alcohol use disorders (AUDs). Recent research has associated both with risky sexual behaviors, including unprotected sex, having multiple sexual partners, engaging in sex work, having recent sexually transmitted infections, and having HIV-infected partners. AUDs have also been associated in MSM/TGW with being unaware of HIV+ status. This study aims to further examine issues associated with alcohol consumption, HIV infection, and risk behaviors in a qualitative analysis of focus groups conducted with MSM/TGW in Peru. A total of 26 MSM/TGW participants with AUDs participated in three semi-structured focus groups in Lima, Peru. Content analysis was facilitated by software, and specific themes were elucidated. Participants described their drinking patterns, including the types of alcoholic drinks they consumed. They depicted drinking frequently and over multiple-day sessions. Problematic drinking behaviors were described, as well as the perceived characteristics of alcohol dependence. Interestingly, HIV-infected participants who were prescribed antiretroviral therapy did not believe that their drinking affected their medication adherence. These insights can aid in the design of future interventions aiming to reduce problematic drinking as well as HIV-related risk behaviors and, subsequently, HIV incidence. Peruvian MSM/TGW exhibit problematic drinking, which may be associated with risky sexual behaviors and HIV transmission. Interest in reducing alcohol consumption was high, suggesting the need for targeted behavioral and pharmacological interventions.

Predictors of functional outcome among stroke patients in Lima, Peru.

PubMed

Abanto, Carlos; Ton, Thanh G N; Tirschwell, David L; Montano, Silvia; Quispe, Yrma; Gonzales, Isidro; Valencia, Ana; Calle, Pilar; Garate, Arturo; Zunt, Joseph

2013-10-01

Because of the aging population in low- and middle-income countries, cerebrovascular disease is expected to remain a leading cause of death. Little has been published about stroke in Peru. We conducted a retrospective cohort study of hospitalized stroke patients at a referral center hospital in Lima, Peru to explore factors associated with functional outcome among stroke patients. We identified 579 patients hospitalized for ischemic stroke or intracerebral hemorrhage stroke at the National Institute of Neurologic Sciences in Lima, Peru in 2008 and 2009. A favorable outcome was defined as a modified Rankin scale score of ≤ 2 at discharge. The mean age was 63.3 years; 75.6% had ischemic stroke; the average duration of stay was 17.3 days. At hospital discharge, 231 (39.9%) had a favorable outcome. The overall mortality rate was 5.2%. In multivariate models, the likelihood of having a favorable outcome decreased linearly with increasing age (P = .02) and increasing National Institutes of Health Stroke Scale (NIHSS) score (P = .02). Favorable outcome was also associated with male gender (relative risk [RR] 1.2; 95% confidence interval [CI] 1.0-1.5) and divorced status (RR 1.3; 95% CI 1.1-1.7). Patients on Salud Integral de Salud (SIS; public assistance-type insurance; RR 0.7; 95% CI 0.5-1.0) were also less likely to have a favorable outcome. Favorable outcome after stroke was independently associated with younger age, a lower NIHSS score, male gender, being divorced, and not being on SIS insurance. These findings suggest that additional study of worse functional outcomes in patients with SIS insurance be conducted and confirm the importance of risk adjustment for age, stroke severity (according to the NIHSS scale), and other socioeconomic factors in outcomes studies. Future studies should preferentially assess outcome at 30 days and 6 months to provide more reliable comparisons and allow additional study of Peruvian end-of-life decision-making and care. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

[Clinical, functional and older socio-familiar profile of the community in a district of Lima, Peru].

PubMed

Varela-Pinedo, Luis; Chávez-Jimeno, Helver; Tello-Rodríguez, Tania; Ortiz-Saavedra, Pedro; Gálvez-Cano, Miguel; Casas-Vasquez, Paola; Aliaga-Díaz, Elizabeth; Ciudad-Fernandez, Luis

2015-10-01

To determine the clinical, functional and socio-familiar profile of seniors from a community in a district of Lima, Peru. Descriptive cross-sectional study of a sample of 501 people aged 60 and over living in the San Martin de Porres district. We used a structured questionnaire in which clinical, functional and socio-familiar variables were recorded. A physical evaluation was carried out to assess performance based measures and serum samples were taken for hematological and biochemical examination. The data were presented with descriptive statistics such as frequencies and percentages for categorical variables and means and standard deviations for the numeric variables. A total of 501 older adults were evaluated. The mean age was 71.5 years (±8.9 years). The most common chronic disease was arterial hypertension at 40.9%, followed by rheumatic diseases with 36.9%. 27.7% had some degree of partial or total dependence in activities of daily living, 16.2% had cognitive impairment, 8% lived alone, 58.5% had or were at risk of having a social problem.61% self-rated their health as normal, while 16% rated it as bad or very bad. Seniors in the community of San Martin de Porres in Lima have frequent problems of functional dependence, have or are at risk of social problems, chronic illness and a high frequency of geriatric syndromes and problems.

Understanding Perceptions of Climate Change, Priorities, and Decision-Making among Municipalities in Lima, Peru to Better Inform Adaptation and Mitigation Planning.

PubMed

Siña, Mariella; Wood, Rachel C; Saldarriaga, Enrique; Lawler, Joshua; Zunt, Joseph; Garcia, Patricia; Cárcamo, César

2016-01-01

Climate change poses multiple risks to the population of Lima, the largest city and capital of Peru, located on the Pacific coast in a desert ecosystem. These risks include increased water scarcity, increased heat, and the introduction and emergence of vector-borne and other climate sensitive diseases. To respond to these threats, it is necessary for the government, at every level, to adopt more mitigation and adaptation strategies. Here, focus groups were conducted with representatives from five Lima municipalities to determine priorities, perception of climate change, and decision-making processes for implementing projects within each municipality. These factors can affect the ability and desire of a community to implement climate change adaptation and mitigation strategies. The results show that climate change and other environmental factors are of relatively low priority, whereas public safety and water and sanitation services are of highest concern. Perhaps most importantly, climate change is not well understood among the municipalities. Participants had trouble distinguishing climate change from other environmental issues and did not fully understand its causes and effects. Greater understanding of what climate change is and why it is important is necessary for it to become a priority for the municipalities. Different aspects of increased climate change awareness seem to be connected to having experienced extreme weather events, whether related or not to climate change, and to higher socioeconomic status.

Ancient DNA Analysis Suggests Negligible Impact of the Wari Empire Expansion in Peru’s Central Coast during the Middle Horizon

PubMed Central

Barreto Romero, María Inés; Flores Espinoza, Isabel; Cooper, Alan; Fehren-Schmitz, Lars

2016-01-01

The analysis of ancient human DNA from South America allows the exploration of pre-Columbian population history through time and to directly test hypotheses about cultural and demographic evolution. The Middle Horizon (650–1100 AD) represents a major transitional period in the Central Andes, which is associated with the development and expansion of ancient Andean empires such as Wari and Tiwanaku. These empires facilitated a series of interregional interactions and socio-political changes, which likely played an important role in shaping the region’s demographic and cultural profiles. We analyzed individuals from three successive pre-Columbian cultures present at the Huaca Pucllana archaeological site in Lima, Peru: Lima (Early Intermediate Period, 500–700 AD), Wari (Middle Horizon, 800–1000 AD) and Ychsma (Late Intermediate Period, 1000–1450 AD). We sequenced 34 complete mitochondrial genomes to investigate the potential genetic impact of the Wari Empire in the Central Coast of Peru. The results indicate that genetic diversity shifted only slightly through time, ruling out a complete population discontinuity or replacement driven by the Wari imperialist hegemony, at least in the region around present-day Lima. However, we caution that the very subtle genetic contribution of Wari imperialism at the particular Huaca Pucllana archaeological site might not be representative for the entire Wari territory in the Peruvian Central Coast. PMID:27248693

Identifying Hotspots of Multidrug-Resistant Tuberculosis Transmission Using Spatial and Molecular Genetic Data

PubMed Central

Zelner, Jonathan L.; Murray, Megan B.; Becerra, Mercedes C.; Galea, Jerome; Lecca, Leonid; Calderon, Roger; Yataco, Rosa; Contreras, Carmen; Zhang, Zibiao; Manjourides, Justin; Grenfell, Bryan T.; Cohen, Ted

2016-01-01

Background. We aimed to identify and determine the etiology of “hotspots” of concentrated multidrug-resistant tuberculosis (MDR-tuberculosis) risk in Lima, Peru. Methods. From 2009 to 2012, we conducted a prospective cohort study among households of tuberculosis cases from 106 health center (HC) areas in Lima, Peru. All notified tuberculosis cases and their household contacts were followed for 1 year. Symptomatic individuals were screened by microscopy and culture; positive cultures were tested for drug susceptibility (DST) and genotyped by 24-loci mycobacterial interspersed repetitive units-variable-number tandem repeats (MIRU-VNTR). Results. 3286 individuals with culture-confirmed disease, DST, and 24-loci MIRU-VNTR were included in our analysis. Our analysis reveals: (1) heterogeneity in annual per-capita incidence of tuberculosis and MDR-tuberculosis by HC, with a rate of MDR-tuberculosis 89 times greater (95% confidence interval [CI], 54,185) in the most-affected versus the least-affected HC; (2) high risk for MDR-tuberculosis in a region spanning several HCs (odds ratio = 3.19, 95% CI, 2.33, 4.36); and (3) spatial aggregation of MDR-tuberculosis genotypes, suggesting localized transmission. Conclusions. These findings reveal that localized transmission is an important driver of the epidemic of MDR-tuberculosis in Lima. Efforts to interrupt transmission may be most effective if targeted to this area of the city. PMID:26175455

Conflict Environment Task Force (Implications of Third World Urban Involvement)

DTIC Science & Technology

1986-05-07

Pahama Panama City 17 1970)Peru Lima 40 1970) Arequipa 40 1970) Chimbote 67 1970) Venezuela Craacas 40 1969) Maracaibo 50 1969) Sarq uisimeto 41 1969... tourism ; destruction and damage to communications facilities and other public property; large numbers of casualties to civilians; and equally large numbers

78 FR 49769 - Notice Pursuant to the National Cooperative Research and Production Act of 1993-Telemanagement Forum

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-15

... the Attorney General and the Federal Trade Commission disclosing changes in its membership. The...; Innova Bilisim Cozumleri, Maslak, TURKEY; Intelli Solutions S.A., Athens, GREECE; International IT House..., GERMANY; Synopsis S.A., Lima, PERU; Trendium, Boulder, CO; University of Witwatersrand, School of...

Development of a Teaching Methodology for Undergraduate Human Development in Psychology

ERIC Educational Resources Information Center

Rodriguez, Maria A.; Espinoza, José M.

2015-01-01

The development of a teaching methodology for the undergraduate Psychology course Human Development II in a private university in Lima, Peru is described. The theoretical framework consisted of an integration of Citizen Science and Service Learning, with the application of Information and Communications Technology (ICT), specifically Wikipedia and…

[External workplace violence against doctors in hospital services in Lima Metropolitana, Peru 2014].

PubMed

Tuya-Figueroa, Ximena; Mezones-Holguin, Edward; Monge, Eduardo; Arones, Ricardo; Mier, Milagros; Saravia, Mercedes; Torres, Jose; Mayta-Tristán, Percy

2016-01-01

. To calculate the frequency and factors associated with external workplace violence (EWV) against doctors in health inpatient services in the metropolitan area of Lima (Spanish: Lima Metropolitana), Peru. . A cross-sectional analytic study, which included doctors from the Ministry of Health (MINSA), Social Security (EsSalud), and the private subsector, was carried out. The frequency of EWV was measured throughout the entire professional practice during the previous 12 months and during the last month. Variables related to the doctor, assailant, and health service were measured. Raw and adjusted prevalence ratios (PR) were calculated by means of a Poisson-family generalized linear model with non-parametric bootstrapping. . A total of 406 doctors participated; 31.5% were victims of EWV at least once during their professional practice, with 19.9% over the past 12 months and 7.6% during the last month. The chances of being threatened in the last 12 months increased if the doctor was male (adjusted PR [aPR]: 1.7; 95% confidence interval [CI] = 1.1- 2.8), had graduated from a Peruvian university outside of the metropolitan area of Lima (aPR: 1.5; 95% CI = 1.1-2.4), worked at MINSA (aPR: 7.9; 95% CI = 2.24-50.73) or EsSalud (RR: 8.68; 95% CI = 2.26-56.17), and worked in the emergency (aPR: 1.9; 95% CI = 1.2-3.6) or operating room (aPR: 1.6; 95% CI = 1.1-2.3). Age, years of professional practice, or being a medical resident were not associated with EWV. . In the hospitals studied, a large number of doctors have been victims of EWV. Working in public services increases the possibility of violence. Implementation of support, identification, and primary prevention strategies in hospitals is recommended.

Particulate matter levels in a South American megacity: the metropolitan area of Lima-Callao, Peru.

PubMed

Silva, Jose; Rojas, Jhojan; Norabuena, Magdalena; Molina, Carolina; Toro, Richard A; Leiva-Guzmán, Manuel A

2017-11-13

The temporal and spatial trends in the variability of PM 10 and PM 2.5 from 2010 to 2015 in the metropolitan area of Lima-Callao, Peru, are studied and interpreted in this work. The mean annual concentrations of PM 10 and PM 2.5 have ranges (averages) of 133-45 μg m -3 (84 μg m -3 ) and 35-16 μg m -3 (26 μg m -3 ) for the monitoring sites under study. In general, the highest annual concentrations are observed in the eastern part of the city, which is a result of the pattern of persistent local winds entering from the coast in a south-southwest direction. Seasonal fluctuations in the particulate matter (PM) concentrations are observed; these can be explained by subsidence thermal inversion. There is also a daytime pattern that corresponds to the peak traffic of a total of 9 million trips a day. The PM 2.5 value is approximately 40% of the PM 10 value. This proportion can be explained by PM 10 re-suspension due to weather conditions. The long-term trends based on the Theil-Sen estimator reveal decreasing PM 10 concentrations on the order of -4.3 and -5.3% year -1 at two stations. For the other stations, no significant trend is observed. The metropolitan area of Lima-Callao is ranked 12th and 16th in terms of PM 10 and PM 2.5 , respectively, out of 39 megacities. The annual World Health Organization thresholds and national air quality standards are exceeded. A large fraction of the Lima population is exposed to PM concentrations that exceed protection thresholds. Hence, the development of pollution control and reduction measures is paramount.

[Drug consumption and occupational violence in working women, a multicenter study: Mexico, Peru, Brazil].

PubMed

Alonso Castillo, Maria Magdalena; Musayon Oblitas, Flor Yesenia; David, Helena Maria Scherlowski Leal; Gómez Meza, Marco Vinicio

2006-01-01

The purposes of the study were: 1) Determine the proportion of working women who consume drugs; 2) identify some occupational and personal risk factors that can predict drugs consumption; 3) identify the presence of occupational violence and its relation with drugs consumption; 4) identify differences and similarities in drugs consumption and occupational violence among women from three communities in Mexico (Monterrey), Peru (Lima) and Brazil (Rio de Janeiro). A multicenter, descriptive, correlational and comparative study was carried out, with a sample of 903 women. The results show that 11% of the participants in Mexico consume alcohol, 53% in Peru and 45% in Brazil. The consumption of illicit drugs corresponded to 5% in Mexico and 6% in Peru. The presence of occupational violence was found in 16% of the Mexican participants, 24% of the Peruvians and 39% of the Brazilians.

Unexpected healers: Chinese medicine in the age of global migration (Lima and California, 1850-1930).

PubMed

Palma, Patricia

2018-03-01

The massive waves of Chinese migrants arriving in California and Lima in the second half of the nineteenth century played a crucial role in expanding Chinese medicine in both settings. From the late 1860s on, herbalists expanded their healing system beyond their ethnic community, transforming Chinese medicine into one of the healing practices most widely adopted by the local population. This article uses a comparative approach to examine the diverging trajectories of Chinese healers in Peru and the USA, as well as the social and political factors that determined how this foreign medical knowledge adapted to its new environments.

Cost-effectiveness of active case-finding of household contacts of pulmonary tuberculosis patients in a low HIV, tuberculosis-endemic urban area of Lima, Peru.

PubMed

Shah, L; Rojas, M; Mori, O; Zamudio, C; Kaufman, J S; Otero, L; Gotuzzo, E; Seas, C; Brewer, T F

2017-04-01

We compared the cost-effectiveness (CE) of an active case-finding (ACF) programme for household contacts of tuberculosis (TB) cases enrolled in first-line treatment to routine passive case-finding (PCF) within an established national TB programme in Peru. Decision analysis was used to model detection of TB in household contacts through: (1) self-report of symptomatic cases for evaluation (PCF), (2) a provider-initiated ACF programme, (3) addition of an Xpert MTB/RIF diagnostic test for a single sputum sample from household contacts, and (4) all strategies combined. CE was calculated as the incremental cost-effectiveness ratio (ICER) in terms of US dollars per disability-adjusted life years (DALYs) averted. Compared to PCF alone, ACF for household contacts resulted in an ICER of $2155 per DALY averted. The addition of the Xpert MTB/RIF diagnostic test resulted in an ICER of $3275 per DALY averted within a PCF programme and $3399 per DALY averted when an ACF programme was included. Provider-initiated ACF of household contacts in an urban setting of Lima, Peru can be highly cost-effective, even including costs to seek out contacts and perform an Xpert/MTB RIF test. ACF including Xpert MTB/RIF was not cost-effective if TB cases detected had high rates of default from treatment or poor outcomes.

Analysis of Nitrogen Dioxide and Sulphur Dioxide in Lima, Peru: Trends and Seasonal Variations

NASA Astrophysics Data System (ADS)

Pacsi, S.; Rappenglueck, B.

2007-12-01

This research was carried out to show a general analysis of the monthly and yearly variation (1996-2002) and the tendency of the nitrogen dioxide (NO2) and sulfur dioxide (SO2) for the 5 stations of the air quality network of Lima. The SO2 and NO2 concentrations were measured by the Dirección General de Salud Ambiental (DIGESA), using the active sampling method and the chemical analysis has been determined by Turbidimetry and Colorimetry for the SO2 and NO2 respectively. The monthly average variation (1996-2001) of SO2 in the Lima Center station has a small annual range (32,4 mikrograms/m3) with maximum values in autumn (April) and minimum in winter (June). The NO2 presents a higher annual range (128,2 mikrograms/m3) and its minimum values occur in the summer and the maximum in spring. The annual averages analysis (2000-2002) of the air quality monitoring network of Lima shows that the SO2 and NO2 values are maximum in the Lima Center station and exceed the Peruvian air quality standard (ECAs) in 30% and 75% respectively. The yearly variation (1996-2001) in the Lima Center station show an increasing tendency in the SO2 (significant) and NO2 (not significant) values, which indicates the critical level of the air quality in Lima, therefore the implementation of the air pollution control programs is urgent.

Coordinated satellite and incoherent scatter observations. [of the ionosphere

NASA Technical Reports Server (NTRS)

Calderon, C. H. J.

1975-01-01

Measurements taken at the Jicamarca Radar Observatory at Lima, Peru during the Cooperative Sounding Rocket Program are reported. The following types of data were acquired: (1) electron density and temperature, (2) vertical plasma drift, (3) electrojet relative echo power density, (4) electrojet Doppler shift and condition, and (5) 150 km echoing region.

Fetal Neurobehavioral Development: A Tale of Two Cities.

ERIC Educational Resources Information Center

DiPietro, Janet A.; Caulfield, Laura; Costigan, Kathleen A.; Merialdi, Mario; Nguyen, Ruby H. N.; Zavaleta, Nelly; Gurewitsch, Edith D.

2004-01-01

Longitudinal neurobehavioral development was examined in 237 fetuses of low-risk pregnancies from 2 distinct populations-Baltimore, Maryland, and Lima, Peru-at 20, 24, 28, 32, 36, and 38 weeks gestation. Data were based on digitized Doppler-based fetal heart rate (FHR) and fetal movement (FM). In both groups, FHR declined while variability,…

Puno: an attractive region in Peru to conduct genebank-related studies

USDA-ARS?s Scientific Manuscript database

The US Potato Genebank (USPG) has a wealth of genetic resources for breeding and research, and has had a major influence on the science and industry. The origin of all USPG germplasm is Latin America, and a sister genebank, the International Potato Center (CIP) is located at Lima. Thus, there has be...

Evaluation Manual for CIP Courses: Objectives and Implementation Procedures.

ERIC Educational Resources Information Center

Siri, Carmen

This manual has been designed to guide courses on potato production sponsored by the International Potato Center (CIP) in Lima (Peru). It describes the CIP Course Evaluation System that is presently used and provides guidelines on how to use feedback more effectively for improving training. CIP evaluations are largely formative. The CIP focuses on…

Anatomy of a Hostage Rescue: What Makes Hostage Rescue Operations Successful?

DTIC Science & Technology

2004-09-01

p. 5). Terrorists are usually motivated by religion or other ideology, and if they die pursuing their cause, they become martyrs and heaven waits...Lecciones de Este Siglo : El Liderazgo en el Comando; “Rescate de la Vida”. Lima, Peru: Servicio Jurídico del Ejercito. Instituto Académico de Derecho

College Students in Lima: Politics, Media and Participation

ERIC Educational Resources Information Center

Cano-Correa, Ana-María; Quiroz-Velasco, María-Teresa; Nájar-Ortega, Rosario

2017-01-01

In Peru, young college students have leading roles in social protest mobilizations even when they seldom belong to political organizations. This study aims to analyze the perception of current politics and its institutions among young college students, and to inquire into their interest on relevant events at their surroundings and into the…

A Sociolinguistic Profile of the Peruvian Deaf Community

ERIC Educational Resources Information Center

Parks, Elizabeth; Parks, Jason

2010-01-01

A sociolinguistic survey of the sign language used by the deaf communities of Peru was conducted in November and December of 2007. For eight weeks, our survey team visited six deaf communities in the cities of Lima, Arequipa, Cusco, Trujillo, Chiclayo, and Iquitos. Using sociolinguistic questionnaires and recorded text testing (RTT) tools, we…

Influence of School and Environment on Selective Memory.

ERIC Educational Resources Information Center

Wilkinson, Alex; And Others

1979-01-01

Subjects were 943 mestizo and Quechua Indian children aged five and six years who lived in jungle villages near Lanas and in slum settlements in Lima, Peru. Some six year olds attended school and others did not. The children were tested with a task that assessed memory for central and incidental features of drawings. (JMB)

Schooling, Environment and Cognitive Development: A Cross-Cultural Study.

ERIC Educational Resources Information Center

Stevenson, Harold W.; And Others

1978-01-01

Investigated the influence of schooling and environment on young children's memory and cognitive skills. Subjects were five- and six-year-old Mestizo and Quechua Indian children living in jungle villages or city slums in Peru. Samples of upper-middle-class children in Lima and poor children in Detroit were also tested. (JMB)

Changes in Tuberculin Skin Test Positivity Over 20 Years in Periurban Shantytowns in Lima, Peru

PubMed Central

Martinez, Leonardo; Arman, Alyssa; Haveman, Nathan; Lundgren, Ashley; Cabrera, Lilia; Evans, Carlton A.; Pelly, Tom F.; Saito, Mayuko; Callacondo, David; Oberhelman, Richard; Collazo, Gisela; Carnero, Andrés M.; Gilman, Robert H.

2013-01-01

A cross-sectional, community-based study was performed in 2012 with 428 residents of periurban shantytowns in Lima, Peru to study risk factors for and changes in latent tuberculosis infection in age-stratified groups compared with our data from the same region in 1990 (N = 219) and 2005 (N = 103). Tuberculin skin test positivity in these communities was highly prevalent at 52% overall, increased with age (P < 0.01) and was similar to 2005 (53%) and 1990 (48%). From 1990 to 2012, the prevalence of tuberculin positivity decreased in 5–14 and 15–24 year old groups (to 17% and 34%, respectively, both P < 0.05). However, this may be explained by cessation of Bacille Calmette-Guérin revaccination during this period, because Bacille Calmette-Guérin revaccination doubled tuberculin positivity. Over the same 22-year period, tuberculin positivity in the ≥ 25 year old group remained high (71%, P = 0.3), suggesting that prevalent latent tuberculosis infection persists in the adult population despite improving medical care and socioeconomic development in this region. PMID:23878185

Sexual Role and Transmission of HIV Type 1 among Men Who Have Sex with Men, in Peru

PubMed Central

Goodreau, Steven M.; Goicochea, L. Pedro; Sanchez, Jorge

2014-01-01

In Latin America, men who have sex with men (MSM) have traditionally practiced role segregation—that is, the adoption of a fixed role (insertive or receptive) rather than a versatile role (both practices) during anal sex. Previous modeling has shown that role segregation may yield a lower incidence of human immunodeficiency virus (HIV) type 1 infection, compared with role versatility; however, the modeling assumed no risk of acquiring HIV-1 during insertive sex, which is now recognized as unlikely. We reexamine the issue by use of a deterministic model incorporating bidirectional transmission and data from a cohort study of MSM in Lima, Peru, to demonstrate the potential effects of role segregation on the trajectory of the HIV-1 epidemic. In Lima, 67% of MSM reported segregated roles in their recent male partnerships. A population of MSM with identical contact rates but complete role versatility would have twice the prevalence of HIV-1 infection throughout the epidemic’s first 3 decades. Preferential mixing among versatile MSM does not change overall prevalence but affects which individuals become infected. PMID:15627225

Randomized Double-Blind Phase III Pivotal Field Trial of the Comparative Immunogenicity Safety and Tolerability of Two Yellow Fever 17D Vaccines (ARILVAX(Trademark) and YF-VAX(Trademark)) in Healthy Infants and Children in Peru

DTIC Science & Technology

2004-08-17

Expertos: Estrategias de Prevencion y Control de la Fiebre Amarilla y Riesgo de Urbanizacion en las Americas. May 14–15, 1998. Lima, Peru: U.S. Agency...which vaccination is indicated in en - demic areas. The origin, derivation, production, and genomic sequences of these vaccines have been previously de...by study site, mean age, sex, weight (in kg), height (in cm), body mass index (kg/m2), pulse (beats per minute), allergy history, anaphylac- tic

Urban land rights and child nutritional status in Peru, 2004.

PubMed

Vogl, Tom S

2007-07-01

Advocates of land-titling programs in developing countries posit that these programs lead to a multitude of benefits, including health improvements. This paper presents the results of a child health survey of several Lima communities after various time exposures to Peru's urban land-titling program. The results provide suggestive evidence that improved property rights increase children's weight but not their height, which is consistent with previous work on the topic. However, titles also appear to raise children's risk of being overweight or obese, implying that the observed weight gain is not necessarily an improvement in nutritional status.

Impact of violence against women on severe acute maternal morbidity in the intensive care unit, including neonatal outcomes: a case–control study protocol in a tertiary healthcare facility in Lima, Peru

PubMed Central

Ayala Quintanilla, Beatriz Paulina; Pollock, Wendy E; McDonald, Susan J; Taft, Angela J

2018-01-01

Introduction Preventing and reducing violence against women (VAW) and maternal mortality are Sustainable Development Goals. Worldwide, the maternal mortality ratio has fallen about 44% in the last 25 years, and for one maternal death there are many women affected by severe acute maternal morbidity (SAMM) requiring management in the intensive care unit (ICU). These women represent the most critically ill obstetric patients of the maternal morbidity spectrum and should be studied to complement the review of maternal mortality. VAW has been associated with all-cause maternal deaths, and since many women (30%) endure violence usually exerted by their intimate partners and this abuse can be severe during pregnancy, it is important to determine whether it impacts SAMM. Thus, this study aims to investigate the impact of VAW on SAMM in the ICU. Methods and analysis This will be a prospective case-control study undertaken in a tertiary healthcare facility in Lima-Peru, with a sample size of 109 cases (obstetric patients admitted to the ICU) and 109 controls (obstetric patients not admitted to the ICU selected by systematic random sampling). Data on social determinants, medical and obstetric characteristics, VAW, pregnancy and neonatal outcome will be collected through interviews and by extracting information from the medical records using a pretested form. Main outcome will be VAW rate and neonatal mortality rate between cases and controls. VAW will be assessed by using the WHO instrument. Binary logistic followed by stepwise multivariate regression and goodness of fit test will assess any association between VAW and SAMM. Ethics and dissemination Ethical approval has been granted by the La Trobe University, Melbourne-Australia and the tertiary healthcare facility in Lima-Peru. This research follows the WHO ethical and safety recommendations for research on VAW. Findings will be presented at conferences and published in peer-reviewed journals. PMID:29540421

Active syphilis and its association with HIV and sexual risk behaviours in a multicity sample of men who have sex with men and transgender women in Peru.

PubMed

Pizzicato, Lia N; Vagenas, Panagiotis; Gonzales, Pedro; Lama, Javier R; Pun, Monica; Sanchez, Jorge; Altice, Frederick L

2017-08-01

Background Syphilis in Peru is heavily concentrated in men who have sex with men (MSM) and transgender women (TGW). The aim of the present study was to understand the risk factors for active syphilis infection among MSM and TGW in Peru. Independent correlates suggestive of active syphilis infection were examined to better understand risk factors for syphilis in MSM and TGW, with separate analyses conducted based on location and among TGW. In 2011, 5101 MSM and TGW completed both self-report surveys and HIV and syphilis testing in five Peruvian cities. Overall, 261 (5.1%) MSM and TGW met the criteria for active syphilis, with higher prevalence in Lima than elsewhere (7.0% vs 3.0%) and in TGW than in MSM (10.7% vs 4.2%). Significant independent correlates of active syphilis infection differed greatly by location. In Lima, they included being HIV-infected (aware or unaware of status), being a TGW, being a high school graduate, engaging in receptive anal intercourse, no recent sex with a female partner and having had any symptomatic sexually transmissible infection, including syphilis, in the previous 6 months. Outside Lima, the independent correlates included being HIV-infected and unaware of status, engaging in recent sex work, no recent sex with a female partner and age 35-44 years. Among TGW, independent correlates of active syphilis included being HIV-infected (aware or unaware of status), a recent syphilis diagnosis in the previous 6 months and recent drug use. The findings of the present study support the need not only for combined HIV and syphilis screening, but also for increased screening and treatment of syphilis in MSM and TGW populations. Stratified analyses suggest different syphilis epidemics throughout the country and in TGW, yet being HIV-infected and aware were consistently associated with active syphilis, suggesting higher syphilis risk in HIV-infected MSM and TGW.

Fleas and Flea-Associated Bartonella Species in Dogs and Cats from Peru.

PubMed

Rizzo, M F; Billeter, S A; Osikowicz, L; Luna-Caipo, D V; Cáceres, A G; Kosoy, M

2015-11-01

In the present study, we investigated 238 fleas collected from cats and dogs in three regions of Peru (Ancash, Cajamarca, and Lima) for the presence of Bartonella DNA. Bartonella spp. were detected by amplification of the citrate synthase gene (16.4%) and the 16S-23S intergenic spacer region (20.6%). Bartonella rochalimae was the most common species detected followed by Bartonella clarridgeiae and Bartonella henselae. Our results demonstrate that dogs and cats in Peru are infested with fleas harboring zoonotic Bartonella spp. and these infected fleas could pose a disease risk for humans. Published by Oxford University Press on behalf of Entomological Society of America 2015. This work is written by US Government employees and is in the public domain in the US.

Complications of cochlear implant surgery: A ten-year experience in a referral hospital in Peru, 2006-2015.

PubMed

Alcas, Olenka; Salazar, Miguel A

2016-09-01

To describe the frequency and characteristics of complications of cochlear implant (CI) surgery at Edgardo Rebagliati Martins Hospital of social security in Lima-Peru between 2006 and 2015. A retrospective descriptive study of patients that underwent CI surgery between August 2006 and December 2015. Among the 107 patients with CIs, the overall proportion of complications was 18.7% (20/107): 14.9% (16/107) of minor complications, and 3.7% (4/107) of major complications. Regarding the time of onset of complications, 2.8% (3/107) were intraoperative and 14% (15/107) postoperative. CI surgery in Peru is a safe procedure with a low frequency of major complications, representing an effective therapy for patients with sensorineural hearing loss who do not respond to hearing aids.

Peril in the market-classification and dosage of species used as anti-diabetics in Lima, Peru

PubMed Central

2013-01-01

Background Peru is what Peruvian anthropologist Lupe Camino calls the “health axis” of the old Central Andean culture area stretching from Ecuador to Bolivia. In particular in the North of the country the traditional use of medicinal dates back as far as the first millennium B.C. Both healers, and the wider population, often buy their medicinal plants in local markets, but there is very little comparative information available about which plants are sold under which vernacular name at any given time, for which indication, and which dosage information and information about side effects is given by vendors. For this study we used two traditionally used species groups “Hercampuri” Gentianella spec. (Gentianaceae) and “Pasuchaca” Geranium spec. (Geraniaceae.), found in the Mercado Aviación in Lima, as small, clearly circumscribed plant group frequently used to treat symptoms of diabetes as a test case to study the taxonomy, indications, dosage, indicated side effects, and additional species used as admixtures and hypothesized that: 1. A wide variety of different species is sold under the same common name, and often several common names exist for one species. 2. There is no consistency in the dosage, or a relationship between dosage and species marketed under one name. 3. However, there is consistency in the knowledge about usage and side effects. Methods Surveys focusing on medicinal plants sold and their properties were conducted at the Mercado Aviación in Lima in December 2012. Vouchers of all specimens were deposited at the National Herbarium of Peru. Results and conclusions Our surveys in Mercado Aviación in Lima yielded four species of Gentianella, two of Geranium, and three additional species from three genera used as common additives that were sold as anti-diabetic. These results indicate that even in case of only a few plant species, used for a very clearly circumscribed application, patients run a considerable risk when purchasing their remedies in the market. The possible side effects in this case are the more serious because diabetes has to be treated long term, and as such the patients are ingesting possible toxic remedies over a long period of time. Much more control, and a much more stringent identification of the material sold in public markets, and entering the global supply chain via internet sales, would be needed. PMID:23718140

Peril in the market-classification and dosage of species used as anti-diabetics in Lima, Peru.

PubMed

Bussmann, Rainer W; Paniagua-Zambrana, Narel; Chamorro, Marinoli Rivas; Moreira, Natalia Molina; del Rosario Cuadros Negri, María Luisa; Olivera, Jose

2013-05-30

Peru is what Peruvian anthropologist Lupe Camino calls the “health axis” of the old Central Andean culture area stretching from Ecuador to Bolivia. In particular in the North of the country the traditional use of medicinal dates back as far as the first millennium B.C. Both healers, and the wider population, often buy their medicinal plants in local markets, but there is very little comparative information available about which plants are sold under which vernacular name at any given time, for which indication, and which dosage information and information about side effects is given by vendors. For this study we used two traditionally used species groups “Hercampuri” Gentianella spec. (Gentianaceae) and “Pasuchaca” Geranium spec. (Geraniaceae.), found in the Mercado Aviación in Lima, as small, clearly circumscribed plant group frequently used to treat symptoms of diabetes as a test case to study the taxonomy, indications, dosage, indicated side effects, and additional species used as admixtures and hypothesized that: 1. A wide variety of different species is sold under the same common name, and often several common names exist for one species. 2. There is no consistency in the dosage, or a relationship between dosage and species marketed under one name. 3. However, there is consistency in the knowledge about usage and side effects. Surveys focusing on medicinal plants sold and their properties were conducted at the Mercado Aviaciónin Lima in December 2012. Vouchers of all specimens were deposited at the National Herbarium of Peru. Our surveys in Mercado Aviación in Lima yielded four species of Gentianella, two of Geranium, and three additional species from three genera used as common additives that were sold as anti-diabetic. These results indicate that even in case of only a few plant species, used for a very clearly circumscribed application, patients run a considerable risk when purchasing their remedies in the market. The possible side effects in this case are the more serious because diabetes has to be treated long term, and as such the patients are ingesting possible toxic remedies over a long period of time. Much more control, and a much more stringent identification of the material sold in public markets, and entering the global supply chain via internet sales, would be needed.

Understanding Perceptions of Climate Change, Priorities, and Decision-Making among Municipalities in Lima, Peru to Better Inform Adaptation and Mitigation Planning

PubMed Central

Saldarriaga, Enrique; Lawler, Joshua; Zunt, Joseph; Garcia, Patricia; Cárcamo, César

2016-01-01

Climate change poses multiple risks to the population of Lima, the largest city and capital of Peru, located on the Pacific coast in a desert ecosystem. These risks include increased water scarcity, increased heat, and the introduction and emergence of vector-borne and other climate sensitive diseases. To respond to these threats, it is necessary for the government, at every level, to adopt more mitigation and adaptation strategies. Here, focus groups were conducted with representatives from five Lima municipalities to determine priorities, perception of climate change, and decision-making processes for implementing projects within each municipality. These factors can affect the ability and desire of a community to implement climate change adaptation and mitigation strategies. The results show that climate change and other environmental factors are of relatively low priority, whereas public safety and water and sanitation services are of highest concern. Perhaps most importantly, climate change is not well understood among the municipalities. Participants had trouble distinguishing climate change from other environmental issues and did not fully understand its causes and effects. Greater understanding of what climate change is and why it is important is necessary for it to become a priority for the municipalities. Different aspects of increased climate change awareness seem to be connected to having experienced extreme weather events, whether related or not to climate change, and to higher socioeconomic status. PMID:26808087

Effect of urbanisation on the relationship between total serum IgE and asthma.

PubMed

Checkley, William; Robinson, Colin L; Baumann, Lauren M; Romero, Karina; Combe, Juan M; Gilman, Robert H; Wise, Robert A; Hamilton, Robert G; Gonzalvez, Guillermo; Cama, Vitaliano; Hansel, Nadia N

2013-05-01

It is unclear if the relationship of total serum IgE with asthma varies with degree of urbanisation. We hypothesised that the relationship of total serum IgE to asthma is more pronounced in an urban versus a rural environment. We enrolled 1441 children aged 13-15 years in a peri-urban shanty town in Lima, Peru (n=725) and 23 villages in rural Tumbes, Peru (n=716). We asked participants about asthma and allergy symptoms, environmental exposures and sociodemographics; and performed spirometry, and exhaled nitric oxide and allergy skin testing. We obtained blood for total serum IgE in 1143 (79%) participants. Geometric means for total serum IgE were higher in Lima versus Tumbes (262 versus 192 kU·L(-1); p<0.001). The odds of asthma increased by factors of 1.6 (95% CI 1.3-2.0) versus 1.4 (95% CI 0.9-2.1) per log unit increase in total serum IgE in Lima versus Tumbes, respectively. Atopy was an effect modifier of the relationship of total serum IgE on asthma. Among atopics and non-atopics, the odds of asthma increased by a factor of 2.0 (95% CI 1.5-2.7) and 1.0 (95% CI 0.7-1.4) per log unit increase in total serum IgE, respectively. Total serum IgE was associated with atopic asthma but not with non-atopic asthma. Urbanisation did not appear to be an effect modifier of this relationship.

[Report of cases of human fascioliosis in the Specialized Children's Health Institute, Lima, Peru (1988'-2003)].

PubMed

Marcos, Luis A; Maco, Vicente; Castillo, Maria; Terashima, Angélica; Zerpa, Rito; Gotuzzo, Eduardo

2005-01-01

Human fascioliosis is one of the most important parasitic diseases in Peru, due to the high prevalence rates reported in the last few years, mainly in the Andean Trapeze. The most affected group is that of children and the clinical manifestations of the disease can be very varied. In this study we reported seven cases of human fascioliosis diagnosed in the Specialized Children's Health Institute (IESN) Lima, Peru, between 1988 and 2003. From 168 medical histories checked with the final diagnosis of parasitosis, 7 children (2 boys and 5 girls), between 2 and 14 years (average +/- DS: 8.52 +/- 1.43) were diagnosed with fascioliosis by a parasitic and/or serological examinations. Six of the seven cases came from cattle raising areas such as: Cajamarca, Ancash, Huancavelica and Junín. The most frequent clinical signs were prolonged fever (up to 42 days), hepatomegaly, moderate abdominal pain (right hypochondriac region and epigastrium), eosinophils count (between 132 and 8321/mm > or =), anemia (hematocrit up to 15%), jaundice and hypergammaglobulinemia. In some cases the diagnosis was difficult to reach with a delay between 1 and 24 weeks. It should be pointed out that one of these patients had hepatic cirrhosis diagnosed by anatomopathological investigations. Finally, we propose that in pediatric patients coming from endemic areas of animal fasciolosis who have prolonged fever, abdominal pain and hepatomegaly, should be considered suspicious and the infection of eliminated, to avoid hepatic damage caused by this parasite. We conclude that human fascioliosis must not be under-estimated as a secondary parasitic disease in patients coming from endemic areas in Peru.

Risk Factors for the Spread of HIV and Other Sexually Transmitted Infections Among HIV-infected Men Who Have Sex with Men in Lima, Peru

PubMed Central

Clark, JL; Konda, KA; Segura, ER; Salvatierra, HJ; Leon, SR; Hall, ER; Caceres, CF; Klausner, JD; Coates, TJ

2008-01-01

Objectives To assess the prevalence of sexually transmitted infections (STIs), frequency of sexual risk behaviors, and relationship between knowledge of HIV infection status and sexual risk behavior among HIV-infected men who have sex with men (MSM) attending an STI clinic in Peru. Methods We recruited a convenience sample of 559 MSM from a municipal STI clinic in Lima, Peru. Participants completed a survey and provided blood for HIV, Syphilis, and HSV-2 antibody testing, and urine for gonorrhea and chlamydia nucleic acid testing. Results Among 124 HIV-infected MSM, 72.6% were aware of their HIV-infected status. Active syphilis (RPR≥1:8) was diagnosed in 21.0% of HIV-infected participants, HSV-2 in 79.8%, urethral gonorrhea in 1.6%, and chlamydia in 1.6%. Among 41 participants reporting insertive anal intercourse with their last sex partner, 34.2% did not use a condom. Of 86 participants reporting receptive anal intercourse, 25.6% did not use a condom. At least one episode of insertive unprotected anal intercourse (UAI) with an HIV-uninfected partner during the previous six months was reported by 33.6% (35/104) of participants, and receptive UAI with an HIV-uninfected partner by 44.6% (45/101). No difference in frequency of UAI, with HIV-uninfected or HIV-infected partners, was observed between men who knew their serostatus compared with those who were previously undiagnosed (all p-values >0.05). Conclusions HIV-infected MSM in Peru engaged in high-risk behaviors for spreading HIV and STIs. Knowledge of HIV-infected status was not associated with a decreased frequency of unprotected anal intercourse. Additional efforts to reduce risk behavior after the diagnosis of HIV infection are necessary. PMID:19028945

Results from pre- and post- tests of professional development astronomy workshops for teachers in Peru

NASA Astrophysics Data System (ADS)

Deustua, Susana; Ros, Rosa

2015-08-01

Since 2009, the Network for Astronomy School Education (NASE) has held 55+ workshops in countries in Asia, Africa, Europe and Latin America, training more than 1200 teachers and potentially reaching one million or more students. Like modern professional development programs, NASE’s emphasis is on interactive, hands-on learning. However, our emphasis is on “low-tech” tools that are readily available, and, inexpensive. Teachers are led through a series of activities that cover a wide range of topics in astronomy, more or less equivalent to that covered in the typical 1st year astronomy course in US colleges.In 2014 we adopted the Astronomy Diagnostic Test as pre- and post- workshop tests to guage the change in teachers’ knowledge as a result of participation in this intervention. In this paper we discuss the first results using the Astronomy Diagnostic Test in astronomy workshops in Peru during March 2014 and February 2015. NASE workskhops were held at the facilities of the Observatorio de Radio de Sicaya of the Instituto Geofisico del Peru, in Chupaca, a farming community approximately 20 km from the Andean city, Huancayo. Sponsors of the Chupaca workshop were the IGP, NASE and the UGEL (regional school district). The second workshop was held at the University of Ica, in the coastal city of Ica, 250 km south of Lima, sponsored by the Instituto Geofisico del Peru and the University, and the 3rd workshop in Lima.We will discuss our results, which for the most part do indeed show a positive change in knowledge, but in a couple of areas the change is either null or negative.

Prevalence of HIV, STIs, and risk behaviors in a cross-sectional community- and clinic-based sample of men who have sex with men (MSM) in Lima, Peru.

PubMed

Perez-Brumer, Amaya G; Konda, Kelika A; Salvatierra, H Javier; Segura, Eddy R; Hall, Eric R; Montano, Silvia M; Coates, Thomas J; Klausner, Jeff D; Caceres, Carlos F; Clark, Jesse L

2013-01-01

Further research is necessary to understand the factors contributing to the high prevalence of HIV/STIs among men who have sex with men (MSM) in Peru. We compared HIV/STI prevalence and risk factors between two non-probability samples of MSM, one passively enrolled from an STI clinic and the other actively enrolled from community venues surrounding the clinic in Lima, Peru. A total of 560 self-identified MSM were enrolled between May-December, 2007. 438 subjects enrolled from a municipal STI clinic and 122 subjects enrolled during community outreach visits. All participants underwent screening for HIV, syphilis, HSV-2, gonorrhoea, and chlamydia and completed a survey assessing their history of HIV/STIs, prior HIV testing, and sexual behavior. HIV prevalence was significantly higher among MSM enrolled from the clinic, with previously undiagnosed HIV identified in 9.1% compared with 2.6% of community participants. 15.4 % of all MSM screened were infected with ≥ 1 curable STI, 7.4% with early syphilis (RPR ≥ 1:16) and 5.5% with urethral gonorrhoea and/or chlamydia. No significant differences between populations were reported in prevalence of STIs, number of male sex partners, history of unprotected anal intercourse, or alcohol and/or drug use prior to sex. Exchange of sex for money or goods was reported by 33.5% of MSM enrolled from the clinic and 21.2% of MSM from the community (p = 0.01). Our data demonstrate that the prevalence of HIV and STIs, including syphilis, gonorrhoea, and chlamydia are extremely high among MSM enrolled from both clinic and community venues in urban Peru. New strategies are needed to address differences in HIV/STI epidemiology between clinic- and community-enrolled samples of MSM.

Spatial and Temporal Characteristics of the 2009 A/H1N1 Influenza Pandemic in Peru

PubMed Central

Chowell, Gerardo; Viboud, Cécile; Munayco, Cesar V.; Gómez, Jorge; Simonsen, Lone; Miller, Mark A.; Tamerius, James; Fiestas, Victor; Halsey, Eric S.; Laguna-Torres, Victor A.

2011-01-01

Background Highly refined surveillance data on the 2009 A/H1N1 influenza pandemic are crucial to quantify the spatial and temporal characteristics of the pandemic. There is little information about the spatial-temporal dynamics of pandemic influenza in South America. Here we provide a quantitative description of the age-specific morbidity pandemic patterns across administrative areas of Peru. Methods We used daily cases of influenza-like-illness, tests for A/H1N1 influenza virus infections, and laboratory-confirmed A/H1N1 influenza cases reported to the epidemiological surveillance system of Peru's Ministry of Health from May 1 to December 31, 2009. We analyzed the geographic spread of the pandemic waves and their association with the winter school vacation period, demographic factors, and absolute humidity. We also estimated the reproduction number and quantified the association between the winter school vacation period and the age distribution of cases. Results The national pandemic curve revealed a bimodal winter pandemic wave, with the first peak limited to school age children in the Lima metropolitan area, and the second peak more geographically widespread. The reproduction number was estimated at 1.6–2.2 for the Lima metropolitan area and 1.3–1.5 in the rest of Peru. We found a significant association between the timing of the school vacation period and changes in the age distribution of cases, while earlier pandemic onset was correlated with large population size. By contrast there was no association between pandemic dynamics and absolute humidity. Conclusions Our results indicate substantial spatial variation in pandemic patterns across Peru, with two pandemic waves of varying timing and impact by age and region. Moreover, the Peru data suggest a hierarchical transmission pattern of pandemic influenza A/H1N1 driven by large population centers. The higher reproduction number of the first pandemic wave could be explained by high contact rates among school-age children, the age group most affected during this early wave. PMID:21712984

Giardiasis

DTIC Science & Technology

2011-06-01

5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Medical Research Detachment, Lima , Peru, 8. PERFORMING ORGANIZATION...outbreaks of giardiasis have been linked to un- filtered water from shallow wells, persistent contamination of communal drinking water sources, and...The key to the prevention of giardiasis transmission lies in preventing fecal contamination of food and water, and preventing direct transmission

Correlates of Violent Response among Peruvian Women Abused by an Intimate Partner

ERIC Educational Resources Information Center

Gelaye, Bizu; Lam, Nelly; Cripe, Swee May; Sanchez, Sixto E.; Williams, Michelle A.

2010-01-01

The authors sought to identify correlates of violent response among women exposed to intimate partner violence (IPV) in Lima, Peru. A structured questionnaire was used to collect information on exposure to IPV and women's physical violent reaction towards their abuser. Women who were sexually abused by their partners, as compared with women who…

Terrorist Group Profiles

DTIC Science & Technology

1988-11-01

Formed 1975. Estimated Membership Unknown. Headquarters Unknown. Area of Operations Worldwide. Leadership ASALA-RM: Monte Melkonian. ASALA-M: Hagop...release. Black Sea are. Stan ulSOVIEIT UNION ®ANKARA ~ Ararat TURKEY Moditerroneen Sea LES- BEIRUT ’ . Historic area claimed by Armenian terrorists...Lima, Peru. - Leadership Ernesto Montes Aliaga (AKA Raul Perez). Other Names Movimiento Revolucionario Tupac Amaru (original language). Armed members of

Immunogenicity of a Psoralen-Inactivated Dengue Virus Type 1 Vaccine Candidate in Mice

DTIC Science & Technology

2010-02-01

United States Naval Medical Research Center Detachment, Lima, Peru , 1 and United States Naval Medical Research Center, Silver Spring, Maryland2 R...and 28. The mice in group B mice received 10-ng vaccine doses on study clays 0, 14, and 28. The mice in group C received 10-ng vaccine doses on

Research Status and Recommendations from the Alaska Workshop on Gravity Waves and Turbulence in the Middle Atmosphere.

DTIC Science & Technology

1984-01-01

Sector Educacion , Apartado 3747, Lima 100, Peru /.was */% .. $~-. *0 ’~ .* ’~ $’ ~ ~P.- ~ ~ 7 K ,1N-LASSIFIErP .A%;.upiry CLASSIFICATION OF THIS PAGE 7...well known, especially in the tropics. The current data base for the mean meridional wind is completely inadequate. The latter is particularly

Writing Tasks and Immediate Auditory Memory in Peruvian Schoolchildren

ERIC Educational Resources Information Center

Ventura-León, José Luís; Caycho, Tomás

2017-01-01

The purpose of the study is to determine the relationship between a group of writing tasks and the immediate auditory memory, as well as to establish differences according to sex and level of study. Two hundred and three schoolchildren of fifth and sixth grade of elementary education from Lima (Peru) participated; they were selected by a…

"English Is Like the Dollar": Hard Currency Ideology and the Status of English in Peru.

ERIC Educational Resources Information Center

Nino-Murcia, Mercedes

2003-01-01

Presents observations from an agro-pastoral village in the Andes, at the periphery of Lima and from an upper class shopping area and discusses attitudes toward the state-driven promotion of English. Results suggest that there is a belief that English competence is needed for technological advancement, employment opportunities, national progress,…

Norovirus prevalence in ‘pathogen negative’ gastroenteritis in children from periurban areas in Lima, Peru

PubMed Central

Rivera, Fulton P.; Ochoa, Theresa J.; Ruiz, Joaquim; Medina, Anicia M.; Ecker, Lucie; Mercado, Erik; Gil, Ana I.; Huicho, Luis; Lanata, Claudio F.

2011-01-01

Summary Norovirus was detected in 17.4% of 224 diarrhoeal samples from children younger than 24 months of age in Lima, in whom all common pathogens had been excluded (pathogen negative). Norovirus was identified more frequently in children older than 12 months of age than in younger children (34% vs 8%, P<0.001). Among norovirus-positive samples, genogroup II was the predominant group (92%). Compared with rotavirus, norovirus episodes tended to be of shorter duration and less severe. The role of norovirus as a cause of diarrhoea and the ascertainment of its severity in developing countries needs further confirmation by future epidemiological studies. PMID:21962615

Interannual variability of a precipitation gradient along the semi-arid catchment areas for the metropolitan region of Lima- Peru in relation to atmospheric circulation at the mesoscale

NASA Astrophysics Data System (ADS)

Otto, Marco; Seidel, Jochen; Trachte, Katja

2013-04-01

The main moisture source for precipitation on the western slopes of the Central Andes is located east of the mountain range known as the Amazon basin. However, the Andean mountains, which reach up to 6000 m a.s.l., strongly influence climatic conditions along the Pacific coastline of South America as a climatic barrier for the low-level tropospheric flow and associated moisture transport from the Amazon basin. Additional, large scale subsidence caused by the South Pacific High inhabits convective rainfall at the Pacific coast where large metropolitan areas such as the Peruvian capital Lima are located. Two contrasts in precipitation can be found while crossing the Andean mountains from West to East. On the Pacific coast, at the location of the metropolitan area of Lima, no more than 10 mm mean annual rainfall occurs. In contrast, up to 1000 mm mean annual rainfall occur only 100 km east of Lima within the upper region (4000 m .a.s.l.) of the Western Cordillera. The transition takes place along the western slopes of the Western Cordillera and is characterised by a strong precipitation gradient. Here, catchment areas are located that provide most of the water resources needed to sustain an urban area of approximately 10 million people. This study investigates the interannual variability of the precipitation gradient between 1998 and 2012. The analysis is based on daily precipitation data of 22 rain gauge station, daily rainfall data of the Tropical Rainfall Mission (TRMM 3B42) at 0.25 degrees and reanalysis data at 36 km spatial resolution at the mesoscale. The reanalysis data was produced using the Weather Research and Forecasting Model. Station data was provided by the Peruvian weather service during the project "Sustainable Water and Wastewater Management in Urban Growth Centres Coping with Climate Change - Concepts for Lima Metropolitana (Peru) (LiWa)", which is financed by the German Federal Ministry of Education and Research (BMBF). We are interested in the following questions. How is the interannual variability of the observed precipitation gradient related to atmospheric circulation east (Amazon basin) and west (south-east Pacific) of the study region? If those relations are quantifiable, are there any forecast potentials for the characteristics of the precipitation gradient during the raining season? The results of the study provide valuable information needed to understand the generation of rainfall in the frame of a case study for the largest metropolitan area that is located at the arid Pacific coast of Peru. This information may also be useful for local managers in order to optimise water resource management and land use strategies.

[Maternal death from severe malaria due to Plasmodium vivax].

PubMed

Arróspide, Nancy; Espinoza, Máximo Manuel; Miranda-Choque, Edwin; Mayta-Tristán, Percy; Legua, Pedro; Cabezas, César

2016-06-01

Here we describe the case of a 19-year-old woman, in her 29th week of gestation, who was from Llumpe (Ancash, Peru) and had a history of traveling to Chanchamayo (Junín, Peru) and Rinconada (Ancash, Peru). The patient presented at Chacas Hospital (Chacas, Ancash, Peru) with general malaise, dehydration, respiratory distress, jaundice, the sensation of thermal rise, and abdominal pain. Analysis of blood smears revealed 60% hemoparasites. She was transferred to Ramos Guardia Hospital (Huaraz, Peru) where she presented increasing respiratory distress, choluria, hematuria, and decreased urine output, moreover she was positive for Plasmodium. From there she was transferred to Cayetano Heredia Hospital (Lima, Peru), where she was admitted to the intensive care unit (ICU) with multiple organ failure, stillbirth, and leading to death. She underwent mechanical ventilation, was administered clindamycin, and was prescribed quinine, which she did not received due a lack by availability. The evolution of the illness was torpid, and she ultimately developed multiple organ failure and died. Plasmodium vivax infection was confirmed. Accordingly, we emphasize the importance of improving our diagnostic capabilities and management techniques to enable clinicians to provide adequate and timely treatment.

Comparative analysis of antimicrobial resistance in enterotoxigenic Escherichia coli isolates from two paediatric cohort studies in Lima, Peru

PubMed Central

Medina, Anicia M.; Rivera, Fulton P.; Pons, Maria J.; Riveros, Maribel; Gomes, Cláudia; Bernal, María; Meza, Rina; Maves, Ryan C.; Huicho, Luis; Chea-Woo, Elsa; Lanata, Claudio F.; Gil, Ana I.; Ochoa, Theresa J.; Ruiz, Joaquim

2015-01-01

Background Antibiotic resistance is increasing worldwide, being of special concern in low- and middle-income countries. The aim of this study was to determine the antimicrobial susceptibility and mechanisms of resistance in 205 enterotoxigenic Escherichia coli (ETEC) isolates from two cohort studies in children <24 months in Lima, Peru. Methods ETEC were identified by an in-house multiplex real-time PCR. Susceptibility to 13 antimicrobial agents was tested by disk diffusion; mechanisms of resistance were evaluated by PCR. Results ETEC isolates were resistant to ampicillin (64%), cotrimoxazole (52%), tetracycline (37%); 39% of the isolates were multidrug-resistant. Heat-stable toxin producing (ETEC-st) (48%) and heat-labile toxin producing ETEC (ETEC-lt) (40%) had higher rates of multidrug resistance than isolates producing both toxins (ETEC-lt-st) (21%), p<0.05. Only 10% of isolates were resistant to nalidixic acid and none to ciprofloxacin or cefotaxime. Ampicillin and sulfamethoxazole resistance were most often associated with blaTEM (69%) and sul2 genes (68%), respectively. Tetracycline resistance was associated with tet(A) (49%) and tet(B) (39%) genes. Azithromycin inhibitory diameters were ≤15 mm in 36% of isolates, with 5% of those presenting the mph(A) gene. Conclusions ETEC from Peruvian children are often resistant to older, inexpensive antibiotics, while remaining susceptible to ciprofloxacin, cephalosporins and furazolidone. Fluoroquinolones and azithromycin remain the drugs of choice for ETEC infections in Peru. However, further development of resistance should be closely monitored. PMID:26175267

Anthropometric differences in preschool children of Japanese ancestry in Lima, Peru.

PubMed

Shimabuku, Roberto; Teruya, Alberto; Nakachi, Graciela

2009-08-01

Ethnic differences in the pattern and trend of growth and weight have been described in studies of migrant populations. Our objective was to compare anthropometric parameters and overweight prevalence in third and fourth generation Japanese descendant preschoolers within the Peruvian preschool population. A total of 337 measurements of height and weight from 284 children, three to five years of age, were taken over three years in one Japanese-Peruvian preschool center in Lima, Peru. The data of each parameter were classified into three ethnic groups according to their parents' surnames: Japanese descendant children (n = 104), with both parents with Japanese surnames; Japanese-Peruvian descendant (n = 93), one parent with a Japanese surname and one with a non-Japanese surname; and Peruvian descendant (n = 140), both parents with non-Japanese surnames. We used the National Center for Health Statistics (NCHS) 2000 growth charts as reference values to obtain centiles, Z scores, and body mass index (BMI). In boys, the three groups differed significantly in height, weight, BMI, Z scores, and overweight prevalence. Peruvian descendant boys were taller and heavier than Japanese-Peruvian and Japanese descendants. Moreover, Japanese-Peruvian descendant boys were taller and heavier than Japanese descendant boys. In girls, there were no significant differences in height and weight and in overweight prevalence among the three ethnic groups. Japanese descendants in Peru have height, weight and BMI values similar to those of Japanese children in Japan but lesser than Peruvian children. These findings may be related to differences in ethnic background.

Delivery of Type 2 diabetes care in low- and middle-income countries: lessons from Lima, Peru.

PubMed

Cardenas, M K; Miranda, J J; Beran, D

2016-06-01

The health system's response is crucial to addressing the increasing burden of diabetes, particularly that affecting low- and middle-income countries. This study aims to assess the facilitators and barriers that help or hinder access to care for people with diabetes in Peru. We used a survey tool to design and collect qualitative and quantitative data from primary and secondary sources of information at different levels of the health system. We performed 111 interviews in Lima, the capital city of Peru, with patients with diabetes, healthcare providers and healthcare officials. We applied the six building blocks framework proposed by the World Health Organization in our analysis. We found low political commitment, as well as several barriers that directly affect access to medicines, regular laboratory check-ups and follow-up appointments for diabetes, especially at the primary healthcare level. Three major system-level barriers were identified: (1) the availability of information at different healthcare system levels that affects several processes in the healthcare provision; (2) insufficient financial resources; and (3) insufficient human resources trained in diabetes management. Despite an initial political commitment by the Peruvian government to improve the delivery of diabetes care, there exist several key limitations that affect access to adequate diabetes care, especially at the primary healthcare level. In a context in which various low- and middle-income countries are aiming to achieve universal health coverage, this study provides lessons for the implementation of strategies related to diabetes care delivery. © 2016 Diabetes UK.

The impact of the International Atomic Energy Agency (IAEA) program on radiation and tissue banking in Peru.

PubMed

Gamero, Emma Castro; Morales Pedraza, Jorge

2009-05-01

The tissue bank "Rosa Guerzoni Chambergo" (RGCTB) located at the Child's Health Institute was inaugurated in 1996, with the financial and technical support of the IAEA program on radiation and tissue banking. Since 1998, the biological bandage of fresh and lyophilised pigskin, amnion and bone tissue is processed routinely in this bank. In all cases, the tissue is sterilised with the use of Cobalt-60 radiation, process carried out at the Laboratories of Irradiation of the Peruvian Institute of Nuclear Energy (IPEN). The tissue bank in the Child's Health Institute helped to save lives in an accident occurred in Lima, when a New Year's fireworks celebration ran out of control in January 2002. Nearly 300 people died in the tragic blaze and hundreds more were seriously burned and injured. Eight Lima hospitals and clinics suddenly were faced with saving the lives of severely burned men, women and children. Fortunately, authorities were ready to respond to the emergency. More than 1,600 dressings were sterilised and supplied to Lima surgeons. The efforts helped save the lives of patients who otherwise might not have survived the Lima fire. Between 1998 and September 2007, 35,012 tissue grafts were produced and irradiated. Radiation sterilised tissues are used by 20 national medical institutions as well as 17 private health institutions. The tissue bank established in Peru with the support of the IAEA is now producing the following tissues: pigskin dressings, fresh and freeze-dried; bone allografts, chips, wedges and powdered, and amnion dressings air-dried. It is also now leading the elaboration of national standards, assignment being entrusted by ONDT (Organización Nacional de Donación y Transplantes; National Organisation on Donation and Transplant). This among other will permit the accreditation of the tissue bank. In this task is also participating IPEN.

Intimate Partner Violence during Pregnancy: A Pilot Intervention Program in Lima, Peru

ERIC Educational Resources Information Center

Cripe, Swee May; Sanchez, Sixto E.; Sanchez, Elena; Quintanilla, Beatriz Ayala; Alarcon, Christian Hernandez; Gelaye, Bizu; Williams, Michelle A.

2010-01-01

This pilot study examined the effectiveness of standard care and an empowerment intervention for abused pregnant women. Severe psychological abuse was most prevalent (42.2%) among this sample of women. Compared with women in the standard care group at the postintervention survey, women in the empowerment group were more likely to hide money (44.6%…

Sexual Orientation, Gender Identity and Perceived Source of Infection Among Men Who Have Sex with Men (MSM) and Transgender Women (TW) Recently Diagnosed with HIV and/or STI in Lima, Peru.

PubMed

Blair, Cheríe S; Segura, Eddy R; Perez-Brumer, Amaya G; Sanchez, Jorge; Lama, Javier R; Clark, Jesse L

2016-10-01

Risk perception and health behaviors result from individual-level factors influenced by specific partnership contexts. We explored individual- and partner-level factors associated with partner-specific perceptions of HIV/STI risk among 372 HIV/STI-positive MSM and transgender women (TW) in Lima, Peru. Generalized estimating equations explored participants' perception of their three most recent partner(s) as a likely source of their HIV/STI diagnosis. Homosexual/gay (PR = 2.07; 95 % CI 1.19-3.61) or transgender (PR = 2.84; 95 % CI 1.48-5.44) partners were more likely to be considered a source of infection than heterosexual partners. Compared to heterosexual respondents, gay and TW respondents were less likely to associate their partner with HIV/STI infection, suggesting a cultural link between gay or TW identity and perceived HIV/STI risk. Our findings demonstrate a need for health promotion messages tailored to high-risk MSM partnerships addressing how perceived HIV/STI risk aligns or conflicts with actual transmission risks in sexual partnerships and networks.

Barriers to the treatment of childhood tuberculous infection and tuberculosis disease: a qualitative study.

PubMed

Chiang, S S; Roche, S; Contreras, C; Del Castillo, H; Canales, P; Jimenez, J; Tintaya, K; Becerra, M C; Lecca, L

2017-02-01

In 2012, Peru's National TB Program (NTP) reported approximately 2400 incident cases of tuberculosis (TB) disease in children aged <15 years. Peru's TB burden is concentrated in the Lima metropolitan area, particularly in poor districts such as El Agustino and La Victoria, where this study was conducted. To identify barriers to the treatment of childhood tuberculous infection and TB disease in Lima from the perspective of front-line providers and patients' families. We conducted 10 semi-structured focus groups with 53 purposefully sampled primary care providers, community health workers, and parents/guardians of pediatric TB patients. We also completed nine in-depth interviews with National TB Program administrators and pulmonologists specializing in TB. Two authors performed inductive thematic analysis and identified emerging themes. Four main treatment barriers emerged from the data: 1) dosing errors, 2) time- and labor-intensive preparation and administration of medications, 3) provider concern that isoniazid preventive therapy (IPT) generates isoniazid resistance, and 4) poor adherence to IPT. Our findings highlight the urgent need for child-friendly formulations, provider and parent/guardian education about IPT, and strategies to promote adherence to IPT, including support and supervision by health workers and/or regimens with fewer doses.

Sexual Orientation, Gender Identity and Perceived Source of Infection among Men Who Have Sex with Men (MSM) and Transgender Women (TW) Recently Diagnosed with HIV and/or STI in Lima, Peru

PubMed Central

Blair, Cheríe S; Segura, Eddy R; Perez-Brumer, Amaya G; Sanchez, Jorge; Lama, Javier R; Clark, Jesse L

2016-01-01

Risk perception and health behaviors result from individual-level factors influenced by specific partnership contexts. We explored individual- and partner-level factors associated with partner-specific perceptions of HIV/STI risk among 372 HIV/STI-positive MSM and transgender women (TW) in Lima, Peru. Generalized estimating equations (GEE) explored participants’ perception of their three most recent partner(s) as a likely source of their HIV/STI diagnosis. Homosexual/gay (PR = 2.07; 95% CI 1.19-3.61) or transgender (PR = 2.84; 95% CI 1.48-5.44) partners were more likely to be considered a source of infection than heterosexual partners. Compared to heterosexual respondents, gay and TW respondents were less likely to associate their partner with HIV/STI infection, suggesting a cultural link between gay or TW identity and perceived HIV/STI risk. Our findings demonstrate a need for health promotion messages tailored to high-risk MSM partnerships addressing how perceived HIV/STI risk aligns or conflicts with actual transmission risks in sexual partnerships and networks. PMID:26767533

Frequency of Internet addiction and development of social skills in adolescents in an urban area of Lima.

PubMed

Zegarra Zamalloa, Carlos Orlando; Cuba Fuentes, Maria Sofía

2017-01-30

To determine the frequency of Internet addiction and its relationship with the development of social skills in adolescents in the town of Condevilla, district of San Martin de Porres, Lima - Peru. The degree of social skills and level of internet use was evaluated in adolescents from 10 to 19 years of 5th to 11th grades in two secondary schools in the town of Condevilla. Classrooms were randomly selected, and the questionnaires were applied to all adolescents. Two questionnaires were applied: Scale for Internet Addiction of Lima to determine the extent of Internet use, and the Social Skills Test from the Ministry of Health of Peru, which evaluates self-esteem, assertiveness, communication and decision-making. The analyses by Chi2 test and Fisher's exact test, as well as a generalized linear model (GLM) were performed using the binomial family. Both questionnaires were applied to 179 adolescents, of whom 49.2% were male. The main age was 13 years, 78.8% of which were in secondary school. Internet addiction was found in 12.9% of respondents, of whom the majority were male (78.3%, p = 0.003) and had a higher prevalence of low social skills (21.7%, p = 0.45). In multivariate analysis, the independent factors associated with Internet addiction were gender (p = 0.016) and to have low social skills compared to high social skills (p = 0.004). In adolescents, there is a relationship between internet addiction and low social skills, among which the area of communication is statistically significant.

Socioeconomic and Nutritional Factors Account for the Association of Gastric Cancer with Amerindian Ancestry in a Latin American Admixed Population

PubMed Central

Pereira, Latife; Zamudio, Roxana; Soares-Souza, Giordano; Herrera, Phabiola; Cabrera, Lilia; Hooper, Catherine C.; Cok, Jaime; Combe, Juan M.; Vargas, Gloria; Prado, William A.; Schneider, Silvana; Kehdy, Fernanda; Rodrigues, Maira R.; Chanock, Stephen J.; Berg, Douglas E.; Gilman, Robert H.; Tarazona-Santos, Eduardo

2012-01-01

Gastric cancer is one of the most lethal types of cancer and its incidence varies worldwide, with the Andean region of South America showing high incidence rates. We evaluated the genetic structure of the population from Lima (Peru) and performed a case-control genetic association study to test the contribution of African, European, or Native American ancestry to risk for gastric cancer, controlling for the effect of non-genetic factors. A wide set of socioeconomic, dietary, and clinic information was collected for each participant in the study and ancestry was estimated based on 103 ancestry informative markers. Although the urban population from Lima is usually considered as mestizo (i.e., admixed from Africans, Europeans, and Native Americans), we observed a high fraction of Native American ancestry (78.4% for the cases and 74.6% for the controls) and a very low African ancestry (<5%). We determined that higher Native American individual ancestry is associated with gastric cancer, but socioeconomic factors associated both with gastric cancer and Native American ethnicity account for this association. Therefore, the high incidence of gastric cancer in Peru does not seem to be related to susceptibility alleles common in this population. Instead, our result suggests a predominant role for ethnic-associated socioeconomic factors and disparities in access to health services. Since Native Americans are a neglected group in genomic studies, we suggest that the population from Lima and other large cities from Western South America with high Native American ancestry background may be convenient targets for epidemiological studies focused on this ethnic group. PMID:22870209

Evaluation of health-care providers' knowledge of childhood tuberculosis in Lima, Peru.

PubMed

Chiang, Silvia S; Cruz, Andrea T; Del Castillo, Hernán; Contreras, Carmen; Becerra, Mercedes C; Lecca, Leonid

2015-02-01

As most national tuberculosis programmes (NTPs) focus on adult tuberculosis (TB), NTP providers may not appreciate differences in the pathophysiology and presentation of childhood TB. This study aimed to identify strengths and weaknesses in knowledge of childhood TB among the 326 NTP providers in Lima Ciudad and Lima Este--two of the Peruvian capital's four health districts. 310 providers--103 physicians, 106 nurses, 101 nursing technicians--accepted personal invitations to complete self-administered surveys, which included 14 childhood TB questions grouped into five sections: transmission, symptoms, diagnosis, prevention and treatment. Physicians were asked ten additional questions targeting their NTP diagnostic and management responsibilities. All three groups scored 97-99% on the transmission section and 83-85% on the treatment section; however, no group scored above 66% on any other section. Fewer than 50% of nurses and technicians recognised young children's high risk of extrapulmonary TB, extrapulmonary TB symptoms or the causes of false negative tuberculin skin tests. Twenty-three per cent of physicians correctly identified gastric aspirate culture sensitivity, and 42% the radiographical findings of pulmonary TB. Less than two-thirds of providers recognised the definition of latent TB infection (LTBI), young children's high risk of progression from LTBI to disease or indications for isoniazid preventive therapy. Providers at the frontline of Peru's TB control efforts demonstrated weaknesses in the areas of extrapulmonary disease, diagnosis and prevention. These knowledge gaps are likely to have resulted in delayed or missed diagnoses and lost opportunities for prevention. Educational interventions targeting NTP personnel may improve childhood TB care and outcomes.

[Clinical and endoscopic features of a selected population with serrated colorectal adenomas in a private clinic in Lima - Peru].

PubMed

Castillo, Ofelia; Barreda, Carlos; Recavarren, Sixto; Barriga, José A; Salazar M, Fernando; Yriberry, Simón; Barriga, Eduardo; Salazar C, Fernando

2013-01-01

To describe the clinical and endoscopic caracteristics of a population that has only serrated polyps of colon (mainly sessile serrated adenomas) in a private clinic in Lima, Perú, from 2009-2011. Retrospective study conducted at the endoscopy center of Clinic Ricardo Palma, Lima, Peru. Olympus colonoscope was used with high definition, including NBI (narrow band imaging) and electronic magnification. Patients had pathologic diagnosis of “polyps and / or colorectal serrated adenomas” and excluded those with synchronous tubular or villous adenomas. Images were evaluated by two endoscopists and then by a third gastroenterologist. We found 201 serrated polyps in 108 patients. Women were 60.2% and overweight predominated. Eighty (74.1%) had only one serrated adenoma and 23 (21.3%) with at least one synchronous hyperplastic polyp. The average size of sessile serrated adenomas was 5.12 mm (± 3.87 DS) and the flat type was 91 (58.7%). There were significant differences in the diameter of sessile serrated adenomas between the distal and proximal colon (4.47 mm ± 2.23 vs. 6.90 mm ± 6.25; p<0.000). The common features of sessile serrated adenomas were: White (31/36, 86.1%), smooth (28/36, 77.8%) and regular margins (26/36, 72.2%). There was a relationship between vascular pattern according NBI and serrated polyp histology (p=0.024). The endoscopic features of sessile serrated adenomas can evade detection to white light. NBI is a useful tool to define some features of these lesions.

Effect of urbanisation on the relationship between total serum IgE and asthma

PubMed Central

Checkley, William; Robinson, Colin L.; Baumann, Lauren M.; Romero, Karina; Combe, Juan M.; Gilman, Robert H.; Wise, Robert A.; Hamilton, Robert G.; Gonzalvez, Guillermo; Cama, Vitaliano; Hansel, Nadia N.

2017-01-01

It is unclear if the relationship of total serum IgE with asthma varies with degree of urbanisation. We hypothesised that the relationship of total serum IgE to asthma is more pronounced in an urban versus a rural environment. We enrolled 1441 children aged 13–15 years in a peri-urban shanty town in Lima, Peru (n=725) and 23 villages in rural Tumbes, Peru (n=716). We asked participants about asthma and allergy symptoms, environmental exposures and sociodemographics; and performed spirometry, and exhaled nitric oxide and allergy skin testing. We obtained blood for total serum IgE in 1143 (79%) participants. Geometric means for total serum IgE were higher in Lima versus Tumbes (262 versus 192 kU·L−1; p<0.001). The odds of asthma increased by factors of 1.6 (95% CI 1.3–2.0) versus 1.4 (95% CI 0.9–2.1) per log unit increase in total serum in Lima versus Tumbes, respectively. Atopy was an effect modifier of the relationship of total serum IgE on asthma. Among atopics and non-atopics, the odds of asthma increased by a factor of 2.0 (95% CI 1.5–2.7) and 1.0 (95% CI 0.7–1.4) per log unit increase in total serum IgE, respectively. Total serum IgE was associated with atopic asthma but not with non-atopic asthma. Urbanisation did not appear to be an effect modifier of this relationship. PMID:22835619

The transmission dynamics and diversity of human metapneumovirus in Peru.

PubMed

Pollett, Simon; Trovão, Nidia S; Tan, Yi; Eden, John-Sebastian; Halpin, Rebecca A; Bera, Jayati; Das, Suman R; Wentworth, David; Ocaña, Victor; Mendocilla, Silvia M; Álvarez, Carlos; Calisto, Maria E; Garcia, Josefina; Halsey, Eric; Ampuero, Julia S; Nelson, Martha I; Leguia, Mariana

2017-12-29

The transmission dynamics of human metapneumovirus (HMPV) in tropical countries remain unclear. Further understanding of the genetic diversity of the virus could aid in HMPV vaccine design and improve our understanding of respiratory virus transmission dynamics in low- and middle-income countries. We examined the evolution of HMPV in Peru through phylogenetic analysis of 61 full genome HMPV sequences collected in three ecologically diverse regions of Peru (Lima, Piura, and Iquitos) during 2008-2012, comprising the largest data set of HMPV whole genomes sequenced from any tropical country to date. We revealed extensive genetic diversity generated by frequent viral introductions, with little evidence of local persistence. While considerable viral traffic between non-Peruvian countries and Peru was observed, HMPV epidemics in Peruvian locales were more frequently epidemiologically linked with other sites within Peru. We showed that Iquitos experienced greater HMPV traffic than the similar sized city of Piura by both Bayesian and maximum likelihood methods. There is extensive HMPV genetic diversity even within smaller and relatively less connected cities of Peru and this virus is spatially fluid. Greater diversity of HMPV in Iquitos compared to Piura may relate to higher volumes of human movement, including air traffic to this location. © 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

[Surgical technique for the treatment of the serious acute necrotic pancreatitis in the National Hospital Edgardo Rebagliati Martins].

PubMed

Barreda Cevasco, Luis Alberto; Targarona Modena, Javier; Rodriguez Alegría, César

2002-01-01

A surgical technique for the treatment of severe acute pancreatitis with necrosis is presented as an alternative in the surgical treatment of this pathology; 60 patients underwent a surgery by the author et al. between October 1997 and January 2002, at the National Hospital Edgardo Rebagliati Martins, Lima, Peru. The mortality rate was 25%.

JPRS Report Telecommunications

DTIC Science & Technology

1988-02-18

Service, 2000 GMT 15 Jan 88] 1 GUINEA Telegraph, Telex To Link Conakry, Freetown [Conakry Domestic Service, 14 Dec 87] 1 NIGERIA NITEL Digital ...Radio-Monitoring Capability Turns Up Illegal Band Use [St Johns THE WORKERS VOICE, 5 Dec 87] 12 BAHAMAS Telephone Digital , Fibre Optic Projects Under...87] 15 PERU 5 Radio Stations Closed in Tarapoto, Moyobamba [Lima EL COMERCIO , 4 Dec 87] 16 TRINIDAD AND TOBAGO Government Studies, Weighs

Why the North Vietnamese Launched a Major Military Offensive During Tet 1968

DTIC Science & Technology

1992-06-05

journalist from Lima, Peru 4 2 Karnow, History, 451. 4 3 "Foreign Eyes," 2. 441bid. 96 stated, "It was a blow to the communists and a tangible...dweller’s daily diet averaged only 1,700 to 1,900 calories with the free market purchases, and reports spread of iron deficiency anemia . 6 1 58 Ibid

An Exploration of the Attitudinal and Perceptual Dimensions of Body Image among Male and Female Adolescents from Six Latin American Cities

ERIC Educational Resources Information Center

McArthur, Laura H.; Holbert, Donald; Pena, Manuel

2005-01-01

Using survey methodology, this exploratory study examined the attitudinal and perceptual dimensions of body image among 1,272 eighth- and ninth-grade males and females from higher and lower socioeconomic backgrounds in Buenos Aires, Argentina (n = 195), Guatemala City, Guatemala (n = 212), Havana, Cuba (n = 213), Lima, Peru (n = 218), Panama City,…

Urbanization in Peru. An International Urbanization Survey Report to the Ford Foundation.

ERIC Educational Resources Information Center

Robin, John P.; Terzo, Frederick C.

This survey paper will deal primarily with the following two issues: (1) How to cope with the growth of the metropolitan Lima area, and the current and future stresses on its social and physical environment, and (2) How to develop, if it is possible and desirable to do so, other urban growth poles in the country which will relieve the…

Impact of violence against women on severe acute maternal morbidity in the intensive care unit, including neonatal outcomes: a case-control study protocol in a tertiary healthcare facility in Lima, Peru.

PubMed

Ayala Quintanilla, Beatriz Paulina; Pollock, Wendy E; McDonald, Susan J; Taft, Angela J

2018-03-14

Preventing and reducing violence against women (VAW) and maternal mortality are Sustainable Development Goals. Worldwide, the maternal mortality ratio has fallen about 44% in the last 25 years, and for one maternal death there are many women affected by severe acute maternal morbidity (SAMM) requiring management in the intensive care unit (ICU). These women represent the most critically ill obstetric patients of the maternal morbidity spectrum and should be studied to complement the review of maternal mortality. VAW has been associated with all-cause maternal deaths, and since many women (30%) endure violence usually exerted by their intimate partners and this abuse can be severe during pregnancy, it is important to determine whether it impacts SAMM. Thus, this study aims to investigate the impact of VAW on SAMM in the ICU. This will be a prospective case-control study undertaken in a tertiary healthcare facility in Lima-Peru, with a sample size of 109 cases (obstetric patients admitted to the ICU) and 109 controls (obstetric patients not admitted to the ICU selected by systematic random sampling). Data on social determinants, medical and obstetric characteristics, VAW, pregnancy and neonatal outcome will be collected through interviews and by extracting information from the medical records using a pretested form. Main outcome will be VAW rate and neonatal mortality rate between cases and controls. VAW will be assessed by using the WHO instrument. Binary logistic followed by stepwise multivariate regression and goodness of fit test will assess any association between VAW and SAMM. Ethical approval has been granted by the La Trobe University, Melbourne-Australia and the tertiary healthcare facility in Lima-Peru. This research follows the WHO ethical and safety recommendations for research on VAW. Findings will be presented at conferences and published in peer-reviewed journals. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The risk of stable partnerships: associations between partnership characteristics and unprotected anal intercourse among men who have sex with men and transgender women recently diagnosed with HIV and/or STI in Lima, Peru.

PubMed

Cambou, Mary C; Perez-Brumer, Amaya G; Segura, Eddy R; Salvatierra, H Javier; Lama, Javier R; Sanchez, Jorge; Clark, Jesse L

2014-01-01

Partnership type is an important factor associated with unprotected anal intercourse (UAI) and subsequent risk for HIV and sexually transmitted infections (STI). We examined the association of partnership type with UAI among men who have sex with men (MSM) and male-to-female transgender women (TGW) in Lima, Peru, recently diagnosed with HIV and/or STI. We report data from a cross-sectional analysis of MSM and TGW recently diagnosed with HIV and/or STI in Lima, Peru between 2011 and 2012. We surveyed participants regarding UAI with up to their three most recent sexual partners according to partner type. Multivariable Generalized Estimate Equating (GEE) models with Poisson distribution were used to estimate prevalence ratios (PR) for UAI according to partner type. Among 339 MSM and TGW recently diagnosed with HIV and/or STI (mean age: 30.6 years, SD 9.0), 65.5% self-identified as homosexual/gay, 16.0% as bisexual, 15.2% as male-to-female transgender, and 3.3% as heterosexual. Participants provided information on 893 recent male or TGW partners with whom they had engaged in insertive or receptive anal intercourse: 28.9% stable partners, 56.4% non-stable/non-transactional partners (i.e. casual or anonymous), and 14.7% transactional partners (i.e. transactional sex client or sex worker). Unprotected anal intercourse was reported with 41.3% of all partners. In multivariable analysis, factors associated with UAI included partnership type (non-stable/non-transactional partner APR 0.73, [95% CI 0.59-0.91], transactional partner APR 0.53 [0.36-0.78], p<0.05) and the number of previous sexual encounters with the partner (>10 encounters APR 1.43 [1.06-1.92], p<0.05). UAI was more commonly reported for stable partners and in partnerships with >10 sexual encounters, suggesting UAI is more prevalent in partnerships with a greater degree of interpersonal commitment. Further research assessing partner-level factors and behavior is critical for improving HIV and/or STI prevention efforts among Peruvian MSM and TGW.

[Validation of the Glasgow-Blatchford Scoring System to predict mortality in patients with upper gastrointestinal bleeding in a hospital of Lima, Peru (June 2012-December 2013)].

PubMed

Cassana, Alessandra; Scialom, Silvia; Segura, Eddy R; Chacaltana, Alfonso

2015-07-01

Upper gastrointestinal bleeding is a major cause of hospitalization and the most prevalent emergency worldwide, with a mortality rate of up to 14%. In Peru, there have not been any studies on the use of the Glasgow-Blatchford Scoring System to predict mortality in upper gastrointestinal bleeding. The aim of this study is to perform an external validation of the Glasgow-Blatchford Scoring System and to establish the best cutoff for predicting mortality in upper gastrointestinal bleeding in a hospital of Lima, Peru. This was a longitudinal, retrospective, analytical validation study, with data from patients with a clinical and endoscopic diagnosis of upper gastrointestinal bleeding treated at the Gastrointestinal Hemorrhage Unit of the Hospital Nacional Edgardo Rebagliati Martins between June 2012 and December 2013. We calculated the area under the curve for the receiver operating characteristic of the Glasgow-Blatchford Scoring System to predict mortality with a 95% confidence interval. A total of 339 records were analyzed. 57.5% were male and the mean age (standard deviation) was 67.0 (15.7) years. The median of the Glasgow-Blatchford Scoring System obtained in the population was 12. The ROC analysis for death gave an area under the curve of 0.59 (95% CI 0.5-0.7). Stratifying by type of upper gastrointestinal bleeding resulted in an area under the curve of 0.66 (95% CI 0.53-0.78) for non-variceal type. In this population, the Glasgow-Blatchford Scoring System has no diagnostic validity for predicting mortality.

High HIV prevalence and the internet as a source of HIV-related service information at a community-based organization in Peru: a cross-sectional study of men who have sex with men.

PubMed

Passaro, R Colby; Haley, Connie A; Sanchez, Hugo; Vermund, Sten H; Kipp, Aaron M

2016-08-24

The HIV prevalence among men who have sex with men (MSM) in Peru (12.4 %) is 30 times higher than in the general adult population (0.4 %). It is critical for community-based organizations to understand how to provide HIV services to MSM while maximizing limited resources. This study describes the HIV prevalence and risk profiles of MSM seeking HIV services at a community-based organization in Lima, Peru. It then compares HIV prevalence between those who found out about the HIV services through different sources. A cross-sectional study of MSM seeking HIV services at Epicentro Salud in Lima, Peru for the first time between April 2012 and October 2013. We compared HIV prevalence among MSM who found out about Epicentro via online sources of information (N = 419), those using in-person sources (friends, partners) (N = 907), and sex workers (N = 140) using multivariable logistic regression models. HIV prevalence was 18.3 % overall: 23.2 % among MSM using online sources, 19.3 % among sex workers, and 15.9 % among MSM using in-person sources. However, when compared to the in-person group, sexual risk behaviors were not statistically higher among MSM using online sources. For the sex worker group, some behaviors were more common, while others were less. After adjusting for confounders, the odds of having HIV was higher for the online group (Odds Ratio = 1.61; 95 % Confidence Interval: 1.19-2.18), but not for the sex worker group (OR = 1.12; 95 % CI: 0.68-1.86), compared to the in-person group. Internet-based promotion appears to successfully reach MSM at high risk of HIV in Peru. Outreach via this medium can facilitate HIV diagnosis, which is the critical first step in getting infected individuals into HIV care. For community-based organizations working in resource-limited settings, this may be an effective strategy for engaging a subset of high-risk persons in HIV care.

Prevalence of smoking and other smoking related behaviors reported by the Global Youth Tobacco Survey (GYTS) in four Peruvian cities

PubMed Central

Zavaleta, Alfonso; Salas, Maria; Peruga, Armando; Hallal, Ana Luiza Curi; Warren, Charles W; Jones, Nathan R; Asma, Samira

2008-01-01

Introduction In 2004, Peru ratified the Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) and in 2006 passed Law 28705 for tobacco consumption and exposure reduction. The Global Youth Tobacco Survey (GYTS) provides data on youth tobacco use for development of tobacco control programs. Findings from the GYTS conducted in four main cities in Peru in 2000 and 2003 are reported in this paper and can be used to monitor provisions of the WHO FCTC. Methods The GYTS is a school-based survey that uses a standardized methodology for sampling, questionnaire construction, field procedures, and data management. In total, 5,332 and 7,824 students aged 13 to 15 years participated in the 2000 and 2003 surveys conducted in Huancayo, Lima, Tarapoto and Trujillo. Results In both years, Lima had the highest lifetime (54.6% and 59.6%) and current use of tobacco (18.6% and 19.2%) of the four cities. According to gender, boys smoked more than girls and less than 20% of students initiated smoking before the age of 10. Among smokers, more than 60% bought their cigarettes in a store with no restriction for their age, and approximately 12% had ever been offered "free cigarettes". Around 90% of students were in favor of banning smoking in public places. Changes between 2000 and 2003 included an increase in the percentage of smokers who wanted to have a cigarette first thing in the morning in Tarapoto (from 0% to 1.2%) and a decrease in exposure to tobacco at home in Huancayo (from 23.7% to 17.8%) and Trujillo (from 27.8% to 19.8%) Conclusion While few changes in tobacco use among youth have been observed in the GYTS in Peru, the data in this report can be used as baseline measures for future evaluation efforts. At this time, tobacco control efforts in Peru need to focus on enhancing Law 28705 to include enforcement of existing provisions and inclusion of new laws and regulations. Most of these provisions are required of all countries, such as Peru, that have ratified the WHO FCTC. PMID:19091045

Prevalence of smoking and other smoking related behaviors reported by the Global Youth Tobacco Survey (GYTS) in four Peruvian cities.

PubMed

Zavaleta, Alfonso; Salas, Maria; Peruga, Armando; Hallal, Ana Luiza Curi; Warren, Charles W; Jones, Nathan R; Asma, Samira

2008-12-15

In 2004, Peru ratified the Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) and in 2006 passed Law 28705 for tobacco consumption and exposure reduction. The Global Youth Tobacco Survey (GYTS) provides data on youth tobacco use for development of tobacco control programs. Findings from the GYTS conducted in four main cities in Peru in 2000 and 2003 are reported in this paper and can be used to monitor provisions of the WHO FCTC. The GYTS is a school-based survey that uses a standardized methodology for sampling, questionnaire construction, field procedures, and data management. In total, 5,332 and 7,824 students aged 13 to 15 years participated in the 2000 and 2003 surveys conducted in Huancayo, Lima, Tarapoto and Trujillo. In both years, Lima had the highest lifetime (54.6% and 59.6%) and current use of tobacco (18.6% and 19.2%) of the four cities. According to gender, boys smoked more than girls and less than 20% of students initiated smoking before the age of 10. Among smokers, more than 60% bought their cigarettes in a store with no restriction for their age, and approximately 12% had ever been offered "free cigarettes". Around 90% of students were in favor of banning smoking in public places. Changes between 2000 and 2003 included an increase in the percentage of smokers who wanted to have a cigarette first thing in the morning in Tarapoto (from 0% to 1.2%) and a decrease in exposure to tobacco at home in Huancayo (from 23.7% to 17.8%) and Trujillo (from 27.8% to 19.8%) While few changes in tobacco use among youth have been observed in the GYTS in Peru, the data in this report can be used as baseline measures for future evaluation efforts. At this time, tobacco control efforts in Peru need to focus on enhancing Law 28705 to include enforcement of existing provisions and inclusion of new laws and regulations. Most of these provisions are required of all countries, such as Peru, that have ratified the WHO FCTC.

The Peru Urban versus Rural Asthma (PURA) Study: methods and baseline quality control data from a cross-sectional investigation into the prevalence, severity, genetics, immunology and environmental factors affecting asthma in adolescence in Peru

PubMed Central

Robinson, Colin L; Baumann, Lauren M; Gilman, Robert H; Romero, Karina; Combe, Juan Manuel; Cabrera, Lilia; Hansel, Nadia N; Barnes, Kathleen; Gonzalvez, Guillermo; Wise, Robert A; Breysse, Patrick N

2012-01-01

Objectives According to a large-scale international survey, Peru has one of the highest prevalences of asthma worldwide; however, data from this survey were limited to participants from urban Lima. The authors sought to characterise the epidemiology of asthma in Peru in two regions with disparate degrees of urbanisation. In this manuscript, the authors summarise the study design and implementation. Design A cross-sectional study. Participants Using census data of 13–15-year-old adolescents from two communities in Peru, the authors invited a random sample of participants in Lima (n=725) and all adolescents in Tumbes (n=716) to participate in our study. Primary and secondary outcome measures The authors asked participants to complete a questionnaire on asthma symptoms, environmental exposures and socio-demographics and to undergo spirometry before and after bronchodilator, skin allergy testing and exhaled nitric oxide testing. The authors obtained blood samples for haematocrit, total IgE levels, vitamin D levels and DNA in all participants and measured indoor particulate matter concentrations for 48 h in a random subset of 70–100 households at each site. Results Of 1851 eligible participants, 1441 (78%) were enrolled and 1159 (80% of enrolled) completed all physical tests. 1283 (89%) performed spirometry according to standard guidelines, of which 86% of prebronchodilator tests and 92% of postbronchodilator tests were acceptable and reproducible. 92% of allergy skin tests had an adequate negative control. The authors collected blood from 1146 participants (79%) and saliva samples from 148 participants (9%). Overall amounts of DNA obtained from blood or saliva were 25.8 μg, with a 260/280 ratio of 1.86. Conclusions This study will contribute to the characterisation of a variety of risk factors for asthma, including urbanisation, total IgE levels, vitamin D levels and candidate genes, in a resource-poor setting. The authors present data to support high quality of survey, allergic, spirometric and genetic data collected in our study. PMID:22357570

[Neurogenetics in Peru, example of translational research].

PubMed

Mazzetti, Pilar; Inca-Martínez, Miguel; Tirado-Hurtado, Indira; Milla-Neyra, Karina; Silva-Paredes, Gustavo; Vishnevetsky, Anastasia; Cornejo-Olivas, Mario

2015-10-01

Neurogenetics is an emerging discipline in Peru that links basic research with clinical practice. The Neurogenetics Research Center located in Lima, Peru is the only unit dedicated to the specialized care of neurogenetic diseases in the country. From the beginning, neurogenetics research has been closely linked to the study of Huntington’s Disease (HD), from the PCR genotyping of the HTT gene, to the current haplogroup studies in HD. Research in other monogenic diseases led to the implementation of alternative methodologies for the genotyping of Fragile X and Myotonic Dystrophy Type 1. Both, national and international collaborative efforts have facilitated the discovery of new genetic variants in complex multigenic diseases such as Parkinson’s disease and Alzheimer’s disease. Additionally, multidisciplinary education and mentoring have allowed for the training of new neurogenetics specialists, supporting the sustained growth of the discipline in the country. The promotion of research in Peru has spurred the growth of neurogenetics research, although limitations in infrastructure, technology, and education remain a challenge for the further growth of research in this field.

Prevalence of HIV, STIs, and Risk Behaviors in a Cross-Sectional Community- and Clinic-Based Sample of Men Who Have Sex with Men (MSM) in Lima, Peru

PubMed Central

Perez-Brumer, Amaya G.; Konda, Kelika A.; Salvatierra, H. Javier; Segura, Eddy R.; Hall, Eric R.; Montano, Silvia M.; Coates, Thomas J.; Klausner, Jeff D.; Caceres, Carlos F.; Clark, Jesse L.

2013-01-01

Background Further research is necessary to understand the factors contributing to the high prevalence of HIV/STIs among men who have sex with men (MSM) in Peru. We compared HIV/STI prevalence and risk factors between two non-probability samples of MSM, one passively enrolled from an STI clinic and the other actively enrolled from community venues surrounding the clinic in Lima, Peru. Methods A total of 560 self-identified MSM were enrolled between May-December, 2007. 438 subjects enrolled from a municipal STI clinic and 122 subjects enrolled during community outreach visits. All participants underwent screening for HIV, syphilis, HSV-2, gonorrhoea, and chlamydia and completed a survey assessing their history of HIV/STIs, prior HIV testing, and sexual behavior. Results HIV prevalence was significantly higher among MSM enrolled from the clinic, with previously undiagnosed HIV identified in 9.1% compared with 2.6% of community participants. 15.4 % of all MSM screened were infected with ≥1 curable STI, 7.4% with early syphilis (RPR≥1∶16) and 5.5% with urethral gonorrhoea and/or chlamydia. No significant differences between populations were reported in prevalence of STIs, number of male sex partners, history of unprotected anal intercourse, or alcohol and/or drug use prior to sex. Exchange of sex for money or goods was reported by 33.5% of MSM enrolled from the clinic and 21.2% of MSM from the community (p = 0.01). Conclusions Our data demonstrate that the prevalence of HIV and STIs, including syphilis, gonorrhoea, and chlamydia are extremely high among MSM enrolled from both clinic and community venues in urban Peru. New strategies are needed to address differences in HIV/STI epidemiology between clinic- and community-enrolled samples of MSM. PMID:23634201

Sexual behavior and drug consumption among young adults in a shantytown in Lima, Peru

PubMed Central

Gálvez-Buccollini, Juan A; DeLea, Suzanne; Herrera, Phabiola M; Gilman, Robert H; Paz-Soldan, Valerie

2009-01-01

Background Risky sexual behaviors of young adults have received increasing attention during the last decades. However, few studies have focused on the sexual behavior of young adults in shantytowns of Latin America. Specifically, studies on the association between sexual behaviors and other risk factors for sexually transmitted infections (STI) and HIV/AIDS transmission, such as the consumption of illicit drugs or alcohol are scarce in this specific context. Methods The study participants were 393 men and 400 women between 18 and 30 years of age, from a shantytown in Lima, Peru. Data were obtained via survey: one section applied by a trained research assistant, and a self-reporting section. Logistic regression was used to estimate associations between use of any illicit drug, high-risk sexual behaviors and reported STI symptoms, adjusting for alcohol consumption level and various socio-demographic characteristics. Results Among men, age of sexual debut was lower, number of lifetime sexual partners was higher, and there were higher risk types of sexual partners, compared to women. Though consistent condom use with casual partners was low in both groups, reported condom use at last intercourse was higher among men than women. Also, a lifetime history of illicit drug consumption decreased the probability of condom use at last sexual intercourse by half. Among men, the use of illicit drugs doubled the probability of intercourse with a casual partner during the last year and tripled the probability of reported STI symptoms. Conclusion Drug consumption is associated with high-risk sexual behaviors and reported STI symptoms in a Lima shantytown after controlling for alcohol consumption level. Development of prevention programs for risky sexual behaviors, considering gender differences, is discussed. PMID:19152702

Patterns of Body Composition Relating to Chronic Respiratory Diseases Among Adults in Four Resource-Poor Settings in Peru.

PubMed

Trompeter, Grace; Grigsby, Matthew R; Miele, Catherine H; Wise, Robert A; Gilman, Robert H; Miranda, J Jaime; Bernabe-Ortiz, Antonio; Checkley, William

2018-06-01

Body composition is known to influence the development and progression of chronic respiratory diseases (CRDs). We sought to characterize the unique anthropometric phenotypes that present with asthma, chronic obstructive pulmonary disease (COPD), and chronic bronchitis across four distinct settings in Peru. We collected sociodemographic, clinical history, and spirometry data from 2959 participants from Lima, Tumbes, and rural and urban Puno. We compared the prevalence of CRDs among different study sites and described disease phenotypes. We used single and multivariable linear regression to model the influence of CRD status on various descriptors of body composition. Overall prevalence of CRDs varied across sites with the highest prevalence of asthma in Lima (14.5%) and the highest prevalence of COPD in rural Puno (9.9%). Measures of body composition also varied across sites, with highest mean body mass index (BMI) in Lima (28.4 kg/m 2 ) and the lowest mean BMI in rural Puno (25.2 kg/m 2 ). Participants with COPD had the lowest mean fat mass index (FMI) (10.5 kg/m 2 ) and waist circumference (88.3 cm), whereas participants with asthma had the highest mean FMI (14.5 kg/m 2 ), and waist circumference (94.8 cm). In multivariable analysis, participants with COPD had a lower waist circumference (adjusted mean - 2.97 cm, 95% CI 4.62 to - 1.32 cm) when compared to non-CRD participants. Our findings provide evidence that asthma and chronic bronchitis are more likely to be associated with obesity and higher fat mass, while COPD is associated with being underweight and having less lean mass.

Bus Stops and Pedestrian-Motor Vehicle Collisions in Lima, Peru: A Matched Case-Control Study

PubMed Central

Quistberg, D. Alex; Koepsell, Thomas D.; Johnston, Brian D.; Boyle, Linda Ng; Miranda, J. Jaime; Ebel, Beth E.

2015-01-01

Objective To evaluate the relationship between bus stop characteristics and pedestrian-motor vehicle collisions. Design Matched case-control study where the units of study were pedestrian crossing. Setting Random sample of 11 police commissaries in Lima, Peru. Data collection occurred from February, 2011 to September, 2011. Participants 97 intersection cases representing 1,134 collisions and 40 mid-block cases representing 469 collisions that occurred between October, 2010 and January, 2011 and their matched controls. Main Exposures Presence of a bus stop and specific bus stop characteristics. Main Outcome Occurrence of a pedestrian-motor vehicle collision. Results Intersections with bus stops were three times more likely to have a pedestrian-vehicle collision (OR 3.28, 95% CI 1.53-7.03), relative to intersections without bus stops. Both formal and informal bus stops were associated with a higher odds of a collision at intersections (OR 6.23, 95% CI 1.76-22.0 and OR 2.98, 1.37-6.49). At mid-block sites, bus stops on a bus-dedicated transit lane were also associated with collision risk (OR 2.36, 95% CI 1.02-5.42). All bus stops were located prior to the intersection, contrary to practices in most high income countries. Conclusions In urban Lima, the presence of a bus stop was associated with a three-fold increase in risk of a pedestrian collision. The highly competitive environment among bus companies may provide an economic incentive for risky practices such as dropping off passengers in the middle of traffic and jockeying for position with other buses. Bus stop placement should be considered to improve pedestrian safety. PMID:24357516

Place of origin associated with depressive symptoms in health professionals performing social health service in Ancash, Peru, 2015.

PubMed

Montesinos-Segura, Renee; Maticorena-Quevedo, Jesus; Chung-Delgado, Kocfa; Pereyra-Elías, Reneé; Taype-Rondan, Alvaro; Mayta-Tristán, Percy

2018-05-01

Health professionals performing their social health service (SHS) in rural communities could be at risk of developing depression. Moreover, those who migrate from farther places to perform their SHS could have an increased risk. The objective of this study was to evaluate the association between place of origin and the presence of depressive symptoms, in health professionals performing rural social health service (SHS) in Ancash, Peru. This was a cross-sectional study. During April 2015, a survey was applied to health professionals performing SHS in the Peruvian Ministry of Health (MINSA) facilities in Ancash. The main outcome was the presence of depressive symptoms, defined as a score ≥2 points in the Patient Health Questionnaire-2. The main exposure was the place of origin, defined as the place where the subjects completed their undergraduate professional studies (Ancash, Lima city or others). Poisson regressions with robust variance were performed to calculate crude and adjusted prevalence ratios (PR and aPR) and their 95% confidence interval (95%CI). From 573 health professionals performing their SHS in MINSA in Ancash, 347 were included in the study. The mean age was 27.2±4.5 years, 78.7% were women, and 14.7% scored positive for depressive symptoms. Those who had completed their undergraduate professional studies in Lima city had a higher prevalence of presence of depressive symptoms compared to those who did in Ancash (aPR=2.59, 95%CI=1.23-5.45). Those who completed their undergraduate professional studies in Lima had a higher prevalence of depressive symptoms than those who did in Ancash. Possible explanations include the difficulty in visiting family and friends, acculturation, and lack of Quechua language proficiency.

[Environmental impact of a public hospital in the city of Lima, Peru].

PubMed

Bambarén-Alatrista, Celso; Alatrista-Gutiérrez de Bambarén, María del Socorro

2014-01-01

The operation of hospitals produces negative effects on the environment which contributes to air pollution and climate change. The institution in this study is a category III health care facility located in the city of Lima. It generates 4.89 kg/bed/day of solid waste, and consumes 1.36 m3/bed/day of water; 25.22 kWh/bed/day of electricity, and 2.76 liters/bed/day of fuel. The level of PM10 and measured parameters of disposal to the public network are within legal limits, while mobile source noise exceeds the maximum allowable limit. The institution releases into the atmosphere 2,291 tons of CO2 equivalents per year. In conclusion, the institution studied generates a negative impact on the environment.

Allelochemical Control of Non-Indigenous Invasive Plant Species Affecting Military Testing and Training Activities

DTIC Science & Technology

2010-10-01

Evolution in invasive plants : implications for biological control. Trends in Ecology & Evolution . 19:417-422. Newingham, B.A. and R.M. Callaway...2008. Soil ecological interactions of spotted knapweed and native plant species. M.S. Thesis. Colorado State University. Fort Collins, CO...weapons and exotic plant invasions. NSF workshop on ecology and biochemical interactions , Lima. Peru. May. Keynote presentation. Callaway, R.M

Fernando de Szyszlo Military Professionalization in Chile and Peru.

DTIC Science & Technology

1982-12-01

important modern painter. That event was his discovery of the epic Quechua poem Apu Inca Atawallpaman. Szyszlo’s knowledge of Quechua poetry resulted...Atwallpaman is unknown, . . . but it is considered an authentic expression in the tradition of Quechua lyric poetry, of the suffering, humiliation...Illinois University Press, 1978. Westphalen, Emilio. "Poesia Quechua y pintura abstracta. t c ^5" Szyszlo: Indaqacion y ollage. Mirko Lauer. Lima

Complete Genome Sequence of the Symbiotic Strain Bradyrhizobium icense LMTR 13T, Isolated from Lima Bean (Phaseolus lunatus) in Peru

PubMed Central

Rogel, Marco A.; Zúñiga-Dávila, Doris; Martínez-Romero, Esperanza

2018-01-01

ABSTRACT The complete genome sequence of Bradyrhizobium icense LMTR 13T, a root nodule bacterium isolated from the legume Phaseolus lunatus, is reported here. The genome consists of a circular 8,322,773-bp chromosome which codes for a large and novel symbiotic island as well as genes putatively involved in soil and root colonization. PMID:29519840

Health workers' attitudes, perceptions and knowledge of influenza immunization in Lima, Peru: A mixed methods study.

PubMed

Bazán, Magdalena; Villacorta, Erika; Barbagelatta, Gisella; Jimenez, M Michelle; Goya, Cecilia; Bartolini, Rosario M; Penny, Mary E

2017-05-19

Vaccination against seasonal influenza in health workers is recommended but coverage is variable. This study aimed to determine coverage of influenza vaccination among health workers in Lima, Peru in 2010; explore barriers and enabling elements for vaccination; and suggest strategies to improve coverage. Qualitative interviews informed the development of a survey instrument that consisted of open and close-ended questions. Sub-analyses were done by occupational group and results were calculated as percentages for each possible response with confidence intervals of 95%. Coverage of the influenza vaccination was 77.2%. Vaccinated staff were less likely to have permanent contracts (p=0.0150) and vaccination coverage was lower in physicians (p=0.0001). Over 90% cited protection of themselves, families and patients as reasons for vaccination and 48% mentioned peer encouragement. Fear of adverse events (47%) and organizational barriers (>30%) were reasons for non-vaccination. To improve coverage, highest priority was given to strategies providing more information. Key factors in driving health worker vaccination include desire for protection and peer encouragement. Perceptual barriers based on a misunderstanding of the epidemiology of influenza and vaccination could be overcome by targeted education and information. Organizational barriers require attention to how vaccination is implemented within health facilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Factors related to the scientific production of gastroenterologists in Lima-Peru].

PubMed

Parra Pérez, V; Monge Salgado, E; Vildósola Gonzales, H

2009-01-01

The biomedical investigation in Peru is limited; among the implicated factors we have the reduced per-capita expense in investigation, the disperse efforts and the low communication between the investigations and the social productive activities. To determinate the personal, professional and academic factors related with the scientific production of the medical gastroenterologists that work in province Lima. Co-relational, observational, comparative, transversal and retrospective studies that had happened in between march 2007 and april 2008. Was elaborated a survey containing the variables of the investigation which was applied autoadministered to the gastroenterologists. Using bivaried and multivaried, were identified factors related with the scientific production of the gastroenterologist. The bivaried analysis has found, as related factors with the scientific production: Teaching, type of bibliographic research, degree of comprehension of the scientific article, facilities for the investigation at the job, subscription at the scientific magazine, to belong to the scientific society and the number of employments. The multivaried analysis found the previous factors but teaching and subscription to the scientific magazine, related with the scientific production. Those gastroenterologists that, despite being in contact with factors that impede the development of the investigation, had overcome the local negative influence and emerge, deserve consideration, because is on them were we can recognize factors that favor the investigation labor.

High Prevalence of Cardiovascular Disease in End-Stage Kidney Disease Patients Ongoing Hemodialysis in Peru: Why Should We Care About It?

PubMed

Bravo-Jaimes, Katia; Whittembury, Alvaro; Santivañez, Vilma

2015-01-01

Purpose. To determine clinical, biochemical, and pharmacological characteristics as well as cardiovascular disease prevalence and its associated factors among end-stage kidney disease patients receiving hemodialysis in the main hemodialysis center in Lima, Peru. Methods. This cross-sectional study included 103 patients. Clinical charts were reviewed and an echocardiogram was performed to determine prevalence of cardiovascular disease, defined as the presence of systolic/diastolic dysfunction, coronary heart disease, ventricular dysrhythmias, cerebrovascular disease, and/or peripheral vascular disease. Associations between cardiovascular disease and clinical, biochemical, and dialysis factors were sought using prevalence ratio. A robust Poisson regression model was used to quantify possible associations. Results. Cardiovascular disease prevalence was 81.6%, mainly due to diastolic dysfunction. It was significantly associated with age older than 50 years, metabolic syndrome, C-reactive protein levels, effective blood flow ≤ 300 mL/min, severe anemia, and absence of mild anemia. However, in the regression analysis only age older than 50 years, effective blood flow ≤ 300 mL/min, and absence of mild anemia were associated. Conclusions. Cardiovascular disease prevalence is high in patients receiving hemodialysis in the main center in Lima. Diastolic dysfunction, age, specific hemoglobin levels, and effective blood flow may play an important role.

[Epidermolysis bullosa in peru: clinical and epidemiological study of patients treated in a national reference pediatric hospital, 1993-2015].

PubMed

Torres-Iberico, Rosario; Palomo-Luck, Patricia; Torres-Ramos, Gilmer; Lipa-Chancolla, Roxana

2017-01-01

To describe the clinical and epidemiological characteristics of patients diagnosed with epidermolysis bullosa (EB) at the Instituto Nacional de Salud (INSN) in Lima, Peru; a National Reference Center for this disease. Observational, descriptive and transversal study. We reviewed the clinical histories and laboratory tests of patients diagnosed with EB treated in INSN from 1993 to 2015. 93 patients were registered. The average age was 7.9 ± 5.6 years; 53.8% (n = 50) were boys. Clinical forms corresponded to dystrophic EB with 41 (44.1%) cases, simple EB with 39 (41.9%), union EB cases with 8 (8.6%) and Kindler syndrome with 4 (4.3%) cases. The clinical form could not be identified in a case. A total of 48 cases (51.6%) came from Lima and Callao, and 45 cases (48.4%) from other provinces of the country. Extracutaneous manifestations involved gastrointestinal (44.1%), ocular (37.6%), odontogenic (87.1%), and nutritional (79.6%) involvement, as well as pseudosindactilia (16.1%). Chronic malnutrition (71.6%), acute malnutrition (17.6%) and anemia (62.4%) were found. Mortality corresponded to 6 cases (6.5%). 93 cases of EB were reported in INSN, the predominant clinical presentation was the dystrophic form.

Iron and infection: An investigation of the optimal iron hypothesis in Lima, Peru.

PubMed

Dorsey, Achsah F; Thompson, Amanda L; Kleinman, Ronald E; Duggan, Christopher P; Penny, Mary E

2018-02-19

This article explores the optimal iron hypothesis through secondary data analysis of the association between hemoglobin levels and morbidity among children living in Canto Grande, a peri-urban community located on the outskirts of Lima, Peru. Risk ratios were used to test whether lower iron status, assessed using the HemoCue B-Hemoglobin System, was associated with an increased relative risk of morbidity symptoms compared to iron replete status, controlling for infant age, sex, weight for height z-score, maternal education, and repeated measures in 515 infants aged 6-12 months. Infants with fewer current respiratory and diarrheal morbidity symptoms had a lower risk of low iron deficiency compared to participants who were iron replete (P < .10). Infants with fewer current respiratory infection symptoms had a statistically significant (P < .05) reduction in risk of moderate iron deficiency compared to infants who were iron replete. In this study, morbidity status was not predictive of iron deficient status over a six-month interval period, but nonreplete iron status was shown to be associated with current morbidity symptoms. These results support investigating iron status as an allostatic system that responds to infection adaptively, rather than expecting an optimal preinfection value. © 2018 Wiley Periodicals, Inc.

Clinical presentation of children with pulmonary tuberculosis: 25 years of experience in Lima, Peru.

PubMed

Del Castillo-Barrientos, H; Centeno-Luque, G; Untiveros-Tello, A; Simms, B; Lecca, L; Nelson, A K; Lastimoso, C; Shin, S

2014-09-01

To describe clinical presentation across age groups in 2855 children with pulmonary tuberculosis (TB) attending the Children's Hospital, Lima, Peru, to improve the diagnosis, treatment and care of childhood TB. Children aged 0-14 years admitted between 1 January 1973 and 31 December 1997 with active pulmonary TB were enrolled. Demographic information, history, physical examination data, laboratory and microbiological results, chest radiograph data, disease classification, treatment and adverse effect data, and outcome at the time of discharge were recorded by pulmonologists using detailed chart abstractions. Of the 2855 enrollees, 47% were malnourished and 56% had a household contact. Older children presented with classic TB symptoms, while weight loss and anorexia were rare in children aged <5 years. Microbiological or pathologic confirmation was obtained in 71% of children aged 10-14 years compared with 34% of children aged <2 years; however, severe extra-pulmonary TB was most common among children aged <2 years (41%). Classic TB symptoms should be considered when making a diagnosis; however, systematic symptoms among young children are also important. In high-burden settings, clinicians should have a low threshold to diagnose and treat children for TB across all ages, even in the context of a negative tuberculin skin test result and lack of micro-pathological confirmation.

Inhospital Mortality in Patients with Type 2 Diabetes Mellitus: A Prospective Cohort Study in Lima, Peru.

PubMed

Zelada, Henry; Bernabe-Ortiz, Antonio; Manrique, Helard

2016-01-01

Objective. To estimate cause of death and to identify factors associated with risk of inhospital mortality among patients with T2D. Methods. Prospective cohort study performed in a referral public hospital in Lima, Peru. The outcome was time until event, elapsed from hospital admission to discharge or death, and the exposure was the cause of hospital admission. Cox regression was used to evaluate associations of interest reporting Hazard Ratios (HR) and 95% confidence intervals. Results. 499 patients were enrolled. Main causes of death were exacerbation of chronic renal failure (38.1%), respiratory infections (35.7%), and stroke (16.7%). During hospital stay, 42 (8.4%) patients died. In multivariable models, respiratory infections (HR = 6.55, p < 0.001), stroke (HR = 7.05, p = 0.003), and acute renal failure (HR = 16.9, p = 0.001) increased the risk of death. In addition, having 2+ (HR = 7.75, p < 0.001) and 3+ (HR = 21.1, p < 0.001) conditions increased the risk of dying. Conclusion. Respiratory infections, stroke, and acute renal disease increased the risk of inhospital mortality among hospitalized patients with T2D. Infections are not the only cause of inhospital mortality. Certain causes of hospitalization require standardized and aggressive management to decrease mortality.

Inhospital Mortality in Patients with Type 2 Diabetes Mellitus: A Prospective Cohort Study in Lima, Peru

PubMed Central

Zelada, Henry; Bernabe-Ortiz, Antonio; Manrique, Helard

2016-01-01

Objective. To estimate cause of death and to identify factors associated with risk of inhospital mortality among patients with T2D. Methods. Prospective cohort study performed in a referral public hospital in Lima, Peru. The outcome was time until event, elapsed from hospital admission to discharge or death, and the exposure was the cause of hospital admission. Cox regression was used to evaluate associations of interest reporting Hazard Ratios (HR) and 95% confidence intervals. Results. 499 patients were enrolled. Main causes of death were exacerbation of chronic renal failure (38.1%), respiratory infections (35.7%), and stroke (16.7%). During hospital stay, 42 (8.4%) patients died. In multivariable models, respiratory infections (HR = 6.55, p < 0.001), stroke (HR = 7.05, p = 0.003), and acute renal failure (HR = 16.9, p = 0.001) increased the risk of death. In addition, having 2+ (HR = 7.75, p < 0.001) and 3+ (HR = 21.1, p < 0.001) conditions increased the risk of dying. Conclusion. Respiratory infections, stroke, and acute renal disease increased the risk of inhospital mortality among hospitalized patients with T2D. Infections are not the only cause of inhospital mortality. Certain causes of hospitalization require standardized and aggressive management to decrease mortality. PMID:26788522

Knowledge of tuberculosis and vaccine trial preparedness in Lima, Peru.

PubMed

Shu, E; Sobieszczyk, M E; Sal Y Rosas, V G; Segura, P; Galea, J T; Lecca, L; Sanchez, J; Lama, J R

2017-12-01

A safe, effective vaccine would improve tuberculosis (TB) control worldwide. Extensive community engagement will be essential to ensure the interest and participation of populations at highest risk. To inform the potential implementation of efficacy studies, we assessed TB knowledge, attitudes towards licensed vaccines and willingness to participate in future TB vaccine efficacy trials among 262 household contacts of 79 recently diagnosed pulmonary TB cases in Lima, Peru. Overall knowledge of TB was low. Only 41.6% of household contacts perceived themselves as being at high risk of acquiring TB. Slightly above half (54.2%) indicated willingness to participate in a TB vaccine trial. After clustered analysis adjusting for homogeneity among families, willingness to enroll was associated with belief that receiving all recommended vaccinations is important (adjusted OR [aOR] 3.28, P = 0.016), desire to know more about TB risk factors and clinical trials (aOR 2.60, P = 0.004), older age (aOR 1.02, P = 0.027) and TB knowledge (aOR 0.05, P = 0.039). Barriers to participation in TB vaccine trials exist among individuals at high risk for TB. Targeted education about TB risk factors, TB transmission and education about the clinical trial process will be critical for laying the groundwork for future vaccine trials.

The cost-effectiveness of syndromic management in pharmacies in Lima, Peru.

PubMed

Adams, Elisabeth J; Garcia, Patricia J; Garnett, Geoffrey P; Edmunds, W John; Holmes, King K

2003-05-01

Many people with sexually transmitted diseases (STDs) in Lima, Peru, seek treatment in pharmacies. The goal was to assess the cost-effectiveness of training pharmacy workers in syndromic management of STDs. Cost-effectiveness from both the program and societal perspectives was determined on the basis of study costs, societal costs (cost of medicine), and the number of cases adequately managed. The latter was calculated from estimated incidence, proportion of symptomatic patients, proportion seeking treatment in pharmacies, and proportion of cases adequately managed in both comparison and intervention districts. Univariate and multivariate sensitivity analyses were performed. Under base-case assumptions, from the societal perspective the intervention saved an estimated US$1.51 per case adequately managed; from the program perspective, it cost an estimated US$3.67 per case adequately managed. In the sensitivity analyses, the proportion of females with vaginal discharge or pelvic inflammatory disease who seek treatment in pharmacies had the greatest impact on the estimated cost-effectiveness, along with the medication costs under the societal perspective. Training pharmacists in syndromic management of STDs appears to be cost-effective when only program costs are used and cost-saving from the societal perspective. Our methods provide a template for assessing the cost-effectiveness of managing STD syndromes, on the basis of indirect estimates of effectiveness.

Worldwide Assessment of the Status of Seismic Zonation, Fourth International Forum on Seismic Zonation, Proceedings

USGS Publications Warehouse

Hays, W.W.

1994-01-01

Italy/Appendix D). 2. United States Geological Survey, 1992, The Worldwide Earthquake Risk Management (WWERM) Program, Reston, Virginia, 19 p (Paul Thenhaus or S.T. Algermissen - USA/ Appendix D). 3. Instituto Panamericano de Geografia Historia, 1992, Revista Geofisica, Lima, Peru, No. 37, July-December, 234 p (Alberto Giesecke- Peru/Appendix D). 4. Annali di Geofisica, 1992, Global Seismic Hazard Assessment Program (GSHAP) (Special Issue), International Lithosphere Program, Publication 209, Bologna, Italy, 257 p (Domenico Giardini-Italy/Appendix F). 5. International Association of Seismology and Physics of the Earth's Interior and European Seismological Commission, 1993, The Practice of Hazard Assessment, Golden, Colorado, 284 p (Write Bob Engdahl, U.S. Geological Survey, Denver Federal Center, Mail Stop 967, Denver, Colorado 80225, USA).

[Physical activity in outpatients with type 2 diabetes in a National Hospital of Peru].

PubMed

Manzaneda, Ana Josefina; Lazo-Porras, María; Málaga, Germán

2015-01-01

In order to determine the level of physical activity performed by outpatients with type 2 diabetes seen at a National Hospital in Lima, Peru, we surveyed 120 patients with the International Physical Activity Questionnaire (IPAQ). 66% were women, the mean age was 61.6 years, and 70% had poor glycemic control. 20% of the patients qualified as inactive, 68% as minimally active, and 12% had adequate physical activity. No relationship between physical activity, duration of disease, glycemic control, and body mass index was found. Age was negatively associated with physical activity. It is concluded that there are low levels of physical activity in patients with Type 2 diabetes and these are not focused on leisure activities that provide health benefits.

Effect of urbanisation on asthma, allergy and airways inflammation in a developing country setting.

PubMed

Robinson, Colin L; Baumann, Lauren M; Romero, Karina; Combe, Juan M; Gomez, Alfonso; Gilman, Robert H; Cabrera, Lilia; Gonzalvez, Guillermo; Hansel, Nadia N; Wise, Robert A; Barnes, Kathleen C; Breysse, Patrick N; Checkley, William

2011-12-01

Asthma is a growing public health problem in developing countries. However, few studies have studied the role of urbanisation in this phenomenon. It was hypothesised that children living in a peri-urban setting in Peru have higher rates of asthma and allergy than rural counterparts. 1441 adolescents aged 13-15 years were enrolled from two settings: a peri-urban shanty town in Lima (n = 725) and 23 rural villages in Tumbes (n = 716). Participants filled in questionnaires on asthma and allergy symptoms, environmental exposures and sociodemographics, and underwent spirometry, and exhaled nitric oxide (eNO) and allergy skin testing. Indoor particulate matter (PM) concentrations were measured in 170 households. Lima adolescents had higher rates of lifetime wheezing (22% vs 10%), current asthma symptoms (12% vs 3%) and physician-diagnosed asthma (13% vs 2%; all p <0.001). Current rhinitis (23% vs 12%), eczema (12% vs 0.4%), atopy (56% vs 38%), personal history of cigarette smoking (7.4% vs 1.3%) and mean indoor PM (31 vs 13 μg/m(3)) were also higher in Lima (all p < 0.001). The peri-urban environment of Lima was associated with a 2.6-fold greater odds (95% CI 1.3 to 5.3) of asthma in multivariable regression. Forced expiratory volumes were higher and FEV(1)/FVC (forced expiratory volume in 1 s/forced vital capacity) ratios were lower in Lima (all p < 0.001). Higher eNO values in Lima (p < 0.001) were attributable to higher rates of asthma and atopy. Peri-urban adolescents had more asthma, atopy and airways inflammation and were exposed to more indoor pollution. The findings provide evidence of the risks posed to lung health by peri-urban environments in developing countries.

Effect of urbanisation on asthma, allergy and airways inflammation in a developing country setting

PubMed Central

Robinson, Colin L; Baumann, Lauren M; Romero, Karina; Combe, Juan M; Gomez, Alfonso; Gilman, Robert H; Cabrera, Lilia; Gonzalvez, Guillermo; Hansel, Nadia N; Wise, Robert A; Barnes, Kathleen C; Breysse, Patrick N; Checkley, William

2017-01-01

Background Asthma is a growing public health problem in developing countries. However, few studies have studied the role of urbanisation in this phenomenon. It was hypothesised that children living in a peri-urban setting in Peru have higher rates of asthma and allergy than rural counterparts. Methods 1441 adolescents aged 13–15 years were enrolled from two settings: a peri-urban shanty town in Lima (n=725) and 23 rural villages in Tumbes (n=716). Participants filled in questionnaires on asthma and allergy symptoms, environmental exposures and sociodemographics, and underwent spirometry, and exhaled nitric oxide (eNO) and allergy skin testing. Indoor particulate matter (PM) concentrations were measured in 170 households. Results Lima adolescents had higher rates of lifetime wheezing (22% vs 10%), current asthma symptoms (12% vs 3%) and physician-diagnosed asthma (13% vs 2%; all p <0.001). Current rhinitis (23% vs 12%), eczema (12% vs 0.4%), atopy (56% vs 38%), personal history of cigarette smoking (7.4% vs 1.3%) and mean indoor PM (31 vs 13 μg/m3) were also higher in Lima (all p <0.001). The peri-urban environment of Lima was associated with a 2.6-fold greater odds (95% CI 1.3 to 5.3) of asthma in multivariable regression. Forced expiratory volumes were higher and FEV1/FVC (forced expiratory volume in 1 s/forced vital capacity) ratios were lower in Lima (all p <0.001). Higher eNO values in Lima (p <0.001) were attributable to higher rates of asthma and atopy. Conclusions Peri-urban adolescents had more asthma, atopy and airways inflammation and were exposed to more indoor pollution. The findings provide evidence of the risks posed to lung health by peri-urban environments in developing countries. PMID:21730351

[Sociodemographic and environmental factors associated with sports physical activity in the urban population of Peru].

PubMed

Seclén-Palacín, Juan A; Jacoby, Enrique R

2003-10-01

To determine the frequency of sports physical activity in the urban population of Peru and to identify the sociodemographic, economic, and environmental factors associated with that activity. This study utilized information collected by the country's National Household Survey (Encuesta Nacional de Hogares) in the second quarter of 1997. That Survey is overseen by Peru's National Institute of Statistics and Informatics (Instituto Nacional de Estadística e Informática). The Survey was based on a probabilistic, multistage sample that was stratified for all the urban areas of the country, which was divided into eight geographic regions: metropolitan Lima, northern coast, central coast, southern coast, northern mountains, central mountains, southern mountains, and jungle. In total, 14 913 homes were visited and 45 319 people at least 15 years of age were interviewed. The frequency of engaging in sports physical activity was classified as daily, every other day, weekly, or occasional. "Regular sports activity" (RSA) was defined as engaging in sports either every day or every other day. The preferences for and obstacles to sports practice were also examined. A descriptive analysis of the levels of RSA was carried out for gender, using the chi-square test. The factors associated with RSA were analyzed through conditional multiple logistic regression and analysis of residuals, multicollinearity, and interactions. The level of significance was set at P < 0.05. Practicing sports at least once a week was more common among men (44.5%) than among women (32.4%), and the same was true for RSA (12.8% versus 10.5%). The age group with the highest level of RSA was 50-55 years for men (20%), and 40-45 years for women (18%). RSA was most common in three geographic regions: jungle (15.3%), central mountains (12.8%), and central coast (12.1%). RSA was least common in two regions: southern mountains (9.7%) and metropolitan Lima (10.6%). The income bracket was not associated with RSA. However, other variables associated indirectly with the socioeconomic level - such as having more formal education, being employed, and having access to the Internet or cable television - and consumption of sports information were significantly and directly associated with RSA. The most frequent barriers to practicing sports were the lack of time, the lack of nearby sports infrastructure (playing fields or courts, etc.), and people's lack of interest. RSA on the part of the members of a household was significantly associated with RSA performed by the head of the household (male or female). RSA is limited in the urban areas of Peru. This is most true for persons who are less than 30 years old, for women, and for residents of the Lima metropolitan area. This low RSA level is a challenge for public health, and it confirms the need for promoting active lifestyles. More study is needed on the observed positive influence when the head of the household performs RSA and on the fact that RSA is more common in urban areas outside metropolitan Lima. These two findings should also be taken into consideration in designing specific interventions.

Hydrological characterization of a pre-Inca artificial recharge system to alleviate drought and flooding in the Peruvian Andes

NASA Astrophysics Data System (ADS)

Ochoa-Tocachi, B. F.; Buytaert, W.; Bardales, J. D.; Antiporta, J.; De Bièvre, B.

2017-12-01

The tropical Andes provide a broad range of ecosystem services for downstream cities, with an abundant supply of fresh water among the most important. Because of the highly seasonal precipitation regime and flashy response of the mountainous topography, rivers along the Pacific coast of Peru are prone to generate devastating flash floods during the wet season, and low to non-existing base flows during the dry season. This creates hydrological challenges, especially for Lima, Peru's capital and the second largest desert city in the world. Furthermore, the complex spatiotemporal patterns and the generalized data scarcity of tropical Andean catchments make hydrological predictions very challenging. Long before modern urbanization, pre-Incan communities already recognized the problems of such a variable hydrological regime, and as a response developed artificial recharge systems that increase water availability during the dry season. The specific kind of technique called "Mamanteo" in the central Sierra, consists of diverting flow from a natural small stream to force it to infiltrate on mountain slopes during the rainy season. This water builds in lag times of weeks to months, and resurfaces in springs to be `harvested' during critical dry months. To quantify the storage and regulation capacity of these systems, hydrological monitoring and dye tracer experiments were implemented in two subcatchments of the Chillon river, which is part of the water supply of Lima. We found a clear hydrological connectivity between the infiltration canals and open springs downslope, with travel times of dye tracer between 2 weeks and 8 months -peaking at 2 months- confirming the ability of the system to effectively make water available in the dry season. However, some challenges remain, especially with respect to an accurate quantification of harvestable water and percolated volumes to deeper soil strata, that might be a benefit for Lima in the coastal plain. Nevertheless, there is clear potential to enhance catchment hydrological regulation, and the method has already received widespread interest as part of a portfolio of "green infrastructure" to improve water security and contribute to climate change adaptation for the city of Lima.

Factors associated with consumption of fruits and vegetables among Community Kitchens customers in Lima, Peru.

PubMed

Díaz-Garcés, Flavia A; Vargas-Matos, Iván; Bernabé-Ortiz, Antonio; Diez-Canseco, Francisco; Trujillo, Antonio J; Miranda, J Jaime

2016-12-01

Community Kitchens (CKs) are one of the main food providers to low-income families in Peru and may encourage healthier diets. We aimed to determine the prevalence of fruit and vegetable consumption and associated sociodemographic and behavioral factors among CKs customers. A cross-sectional study enrolling customers of 48 CKs in two areas of Lima, Peru, was performed. The self-reported amount of fruits and vegetables consumed (< 5 vs. ≥ 5 servings/day) was the outcome. The exposures were grouped in sociodemographic variables (i.e. age, gender, education level, etc.), and self-reported intention to change eating- and exercise-related habits in the last four weeks just prior to the interview. Prevalence ratios (PR) were estimated using Poisson regression. Data from 422 subjects were analyzed, 328 females (77.9%), mean age 43.7 (± 14.5) years. Only 36 (8.5%; 95% CI 5.9%-11.2%) customers reported consuming ≥ 5 servings of fruits and vegetables daily. This pattern was 4-fold more likely among those with higher levels of education (≥ 12 vs. < 7 years), and 64% less common for migrants relative to non-migrants. In terms of intentions to change habits, those who reported having tried to reduce sugar consumption or to eat more fruits were up to 90% more likely to meet the ≥ 5 servings/day target. A substantial gap in the consumption of ≥ 5 servings of fruits and vegetables/day was found among CKs customers that does not appear to be dependent on familial income. The profiles reported in this study can inform appropriate strategies to increase healthier eating in this population.

Demographics, Behaviors, and Sexual Health Characteristics of High Risk Men Who Have Sex With Men and Transgender Women Who Use Social Media to Meet Sex Partners in Lima, Peru.

PubMed

Chow, Jeremy Y; Konda, Kelika A; Calvo, Gino M; Klausner, Jeffrey D; Cáceres, Carlos F

2017-03-01

Men who have sex with men (MSM) and transgender women (TW) in Peru bear a disproportionate burden of human immunodeficiency virus (HIV) and sexually transmitted infections (STIs). In a context of quickly expanding communication technology, increasing numbers of MSM and TW are using social media applications to seek sex partners. Understanding social media users and their sex partnering practices is needed to update HIV and STI prevention programming. In Lima, Peru, 312 MSM and 89 TW from 2 STI clinics underwent HIV and STI testing and participated in a survey of demographics, behaviors, sexual health, and social media practices. χ, t tests, and Wilcoxon Mann-Whitney tests were used to compare those with and without recent social media sex partners. Men who have sex with men with social media sex partners were younger, more educated, and more likely to identify as gay. They were significantly more likely to report greater numbers of sex partners, including anonymous sex partners; sex in higher-risk venues, orgies, and have rectal Neisseria gonorrhoeae or Chlamydia trachomatis infection. Transgender women with social media sex partners were also younger, more likely to participate in sex work, and have a lower rate of rapid plasma reagin positivity or history of syphilis. Participants reported using several social media sites including sexual hook-up applications, websites for gay men, pornographic websites, and chat sites, but the most common was Facebook. Prevention strategies targeting Peruvian MSM and TW who use social media are needed to address higher-risk sexual behavior and the high burden of STIs.

Linking HIV and antiretroviral drug resistance surveillance in Peru: a model for a third-generation HIV sentinel surveillance.

PubMed

Lama, Javier R; Sanchez, Jorge; Suarez, Luis; Caballero, Patricia; Laguna, Alberto; Sanchez, Jose L; Whittington, William L H; Celum, Connie; Grant, Robert M

2006-08-01

HIV drug resistance surveillance is limited by recruitment and selection bias and by limited information regarding HIV incidence rates, secondary resistance, and treatment prevalence. A second-generation HIV sentinel surveillance among men who have sex with men (MSM), regardless of prior history of HIV screening, serostatus, or treatment, was conducted in Peru in 2002. Recent HIV infection was estimated using sensitive/less sensitive enzyme immunoassay testing. Genotypic resistance testing was performed. HIV prevalence was 13.9% (456 HIV positive of 3280 participants). HIV incidence was estimated to be 5.1 per 100 person-years (95% confidence interval: 3.1-8.3). Among 143 MSM who were aware of their HIV infection before testing, only 20 (14.0%) were receiving antiretrovirals (ARV). Mutations conferring ARV resistance were found in 12 (3.3%) of 359 treatment-naive and 5 (31.3%) of 16 treatment-experienced participants with successful genotyping. One recently infected man from Lima demonstrated 3-class multidrug resistance. The most frequently observed mutations in treatment-naive, chronically infected persons from Lima were M184V (1.7%), D30N (1.3%), L90M (1.3%), and L10I (1.3%). The prevalence of ARV resistance among treatment-naive MSM in Peru is low, reflecting limited access to treatment before 2004, and contrasts with the history of ARV treatment in developed countries, where high levels of nucleoside reverse transcriptase inhibitor resistance occurred before introduction of highly active antiretroviral therapy. Linking ARV resistance and HIV sentinel surveillance in developing settings is feasible and should be considered in third-generation HIV sentinel surveillance programs.

Peru.

PubMed

1987-12-01

This publication provides a brief account of Peru's geographic, history, government, and political and economic conditions. With an area of 1.28 million sq. km., Peru is the third largest country in South American and is home to 20.2 million inhabitants (6 million live in the capital city of Lima). The population is 45% Indian, 37% mestizo, 15% white, and 3% black, Asian, and other. The 2 official languages are Spanish and Quechua. Its literacy rate stands at 79%, and its infant mortality rate and life expectancy measure 91/1000 and 60.8 years respectively. Peru's pre-Colombian period notes the impressive achievements of the Inca civilization, which was conquered by Spain in 1531. The country gained its independence from Spanish rule in 1821. The article also mentions Peru's turbulent contemporary history, with territorial disputes, a strong military presence, and a series of coups that have interrupted civilian constitutional governments. As recently as 1985, Peru had its first exchange of power from 1 democratically elected leader to another in 40 years, when 36 year-old Alan Garcia Perez became president. Leader of the American Popular Revolutionary Alliance (APRA), GArcia espouses leftist but not non-communist politics, and is well-known for his message of anti-imperialism and Latin American integration. Peru's has seen terrorist activity from 2 marxist organizations, the Maoist Sendero Luminoso (The Shining Path) and the MRTA-MIR (Tupac Amaru Revolutionary Movement-Movement of the Revolutionary Left. In 1986, Peru's economy had a $17 billion Gross Domestic Product (GDP), a per capital GDP of $839, and an inflation rate of 62.9. The article also provides information concerning US economic assistance to Peru, as well as an assessment of US-Peruvian relations.

The Deployed Warfighter Protection (DWFP) Research Program: Developing New Public Health Pesticides, Application Technologies, and Repellent Systems

DTIC Science & Technology

2013-01-01

military use. This article highlights DWFP program accomplishments achieved through its competitive grants process, exemplified by the rodent feed...accomplishments achieved through its competitive grants process exemplified by the rodent feed-through technique with insecticidal baits for controlling...Lima, Peru . The remaining 5% of the DWFP grants have been awarded to other Federal agencies such as the Centers for Disease Control and Prevention

Asia Pacific Economic Cooperation (APEC) and the 2008 Meetings in Lima, Peru

DTIC Science & Technology

2009-03-31

major retailers and multinational corporations who source products from manufacturers and sourcing companies around the world. In turn, these companies...on orders from U.S., European, or Japanese retailers or brand name distributors to initiate the multinational manufacturing of the consumer products...describes a “patchwork of bilateral hub-and-spoke FTAs in a noodle bowl.” According to some experts, the growth of bilateral trade agreements (BTAs

Local Area Network Strategies and Guidelines for a Peruvian Air Force Computer Center

DTIC Science & Technology

1991-03-01

service elements to support application processes such as job management, and financial data exchange. The layer also supports the virtual terminal and... virtual file concept. [Ref.3 :p. 285] Essentially, the lowest three layers are concerned with the communication protocols associated with the data...General de la Fuerza Aerea Peruana Lima, Republica del Peru 5. Escuela de Oficiales de la Fuerza Aerea Peruana 2 Biblioteca del Grupo del Instruccion Base

Dealing with Common Mistakes Using an Error Corpus for EFL Students to Increase Their Autonomy in Error Recognition and Correction in Every Day Class Tasks

ERIC Educational Resources Information Center

Terreros Lazo, Oscar

2012-01-01

In this article, you will find how autonomous students of EFL in Lima, Peru can be when they recognize and correct their errors based on the teachers' guidance about what to look for and how to do it in a process that I called "Error Hunting" during regular class activities without interfering with these activities.

Complete Genome Sequence of the Symbiotic Strain Bradyrhizobium icense LMTR 13T, Isolated from Lima Bean (Phaseolus lunatus) in Peru.

PubMed

Ormeño-Orrillo, Ernesto; Rogel, Marco A; Zúñiga-Dávila, Doris; Martínez-Romero, Esperanza

2018-03-08

The complete genome sequence of Bradyrhizobium icense LMTR 13 T , a root nodule bacterium isolated from the legume Phaseolus lunatus , is reported here. The genome consists of a circular 8,322,773-bp chromosome which codes for a large and novel symbiotic island as well as genes putatively involved in soil and root colonization. Copyright © 2018 Ormeño-Orrillo et al.

The Shining Path: The Successful Blending of Mao and Mariategui in Peru

DTIC Science & Technology

1992-06-05

the textbook models such that those familiar with the situation are unsure as to the current balance of forces and how the Peruvian government... familiar with the power of the Shining Path. The growth of the Shining Path in Lima and in the Upper Huallaga Valley is connected. By 1987 the Shining...California Press, 1972. Rojas Samanez, Alvaro, and Ouillermo Blanco Woolcott, ed. Sendero de Violencia : Testimonios Periodisticos 1980- 1989

First Peruvian binoculars

NASA Astrophysics Data System (ADS)

Baldwin, Guillermo; Gonzales, Franco; Pérez S., Carlos

2017-11-01

In Peru, as in almost all Latin America, precision optical industry is almost null. One reason is the scarcity of human and technological resources. But, a few years ago, a masters and diploma university program in optical engineering was started in our university: Pontificia Universidad Católica del Perú1 (PUCP) in Lima. Also, an optical shop on precision optics was implemented. Some students were trained at CIO in Leon, Mexico. In order to motivate optical business startups in Peru we planned to show some possibilities of optical devices fabrication trough doing prototypes. So, we started doing a small reflective telescope for moon observation2, 3, where mirror and ocular polishing and opto-mechanics had priority. Aluminum evaporation was included. Now, we do a new step developing a binocular, as we know, it never was made before in Peru. This work includes the binocular geometric optics and opto-mechanical designs, the ocular manufacturing, and the binocular characterization of an 8x35 binocular for amateur observation.

Association between food assistance program participation and overweight

PubMed Central

Chaparro, M Pia; Bernabe-Ortiz, Antonio; Harrison, Gail G

2014-01-01

OBJECTIVE The objective of this study was to investigate the association between food assistance program participation and overweight/obesity according to poverty level. METHODS A cross-sectional analysis of data from 46,217 non-pregnant and non-lactating women in Lima, Peru was conducted; these data were obtained from nationally representative surveys from the years 2003, 2004, 2006, and 2008-2010. The dependent variable was overweight/obesity, and the independent variable was food assistance program participation. Poisson regression was used to stratify the data by family socioeconomic level, area of residence (Lima versus the rest of the country; urban versus rural), and survey year (2003-2006 versus 2008-2010). The models were adjusted for age, education level, urbanization, and survey year. RESULTS Food assistance program participation was associated with an increased risk of overweight/obesity in women living in homes without poverty indicators [prevalence ratio (PR) = 1.29; 95% confidence interval (CI) 1.06;1.57]. When stratified by area of residence, similar associations were observed for women living in Lima and urban areas; no associations were found between food assistance program participation and overweight/obesity among women living outside of Lima or in rural areas, regardless of the poverty status. CONCLUSIONS Food assistance program participation was associated with overweight/obesity in non-poor women. Additional studies are required in countries facing both aspects of malnutrition. PMID:26039391

[Supply and nutritional composition of salads in the food courts of shopping centers of Metropolitan Lima, 2014].

PubMed

Bustamante-García, Marifé; Martinez-Feliu, Montserrat; Servan, Karin; Mayta-Tristán, Percy

2015-10-01

To assess supply and nutritional composition of the salads offered as an entrée main course in the food courts of the shopping centers in Lima, Peru. The menus of all food franchises present in the food courts of the eleven shopping centers of Lima were reviewed. The nutritional composition of salads offered as an entrée were calculated for calories, protein content, carbohydrates, fats, cholesterol, fiber and sodium, and the adequacy of intake for a dinner (30% of a diet of 2000 kcal). Salads as entrées accounted for 4.7% of the supply, and only 7 out of 17 franchises offered at least one salad. The average cost of the salads was higher than the other dishes ($5.3 vs $4.7; p<0.001). The average calorie content was 329 kcal and 2.7 g fiber; in relation to a dinner, we found a high percentage of adequacy for protein (172.9%), cholesterol (121.0%), and low adequacy for calories (54.8%), carbohydrates (23.1%) and fiber (36.4%). The salads that are offered in food courts in the shopping centers of Lima are scarce and more expensive, have little fiber content and are high in cholesterol. Strategies should be reviewed to improve the accessibility of quality salads offered in areas where only fast food is offered.

Association between food assistance program participation and overweight.

PubMed

Chaparro, M Pia; Bernabe-Ortiz, Antonio; Harrison, Gail G

2014-12-01

OBJECTIVE The objective of this study was to investigate the association between food assistance program participation and overweight/obesity according to poverty level. METHODS A cross-sectional analysis of data from 46,217 non-pregnant and non-lactating women in Lima, Peru was conducted; these data were obtained from nationally representative surveys from the years 2003, 2004, 2006, and 2008-2010. The dependent variable was overweight/obesity, and the independent variable was food assistance program participation. Poisson regression was used to stratify the data by family socioeconomic level, area of residence (Lima versus the rest of the country; urban versus rural), and survey year (2003-2006 versus 2008-2010). The models were adjusted for age, education level, urbanization, and survey year. RESULTS Food assistance program participation was associated with an increased risk of overweight/obesity in women living in homes without poverty indicators [prevalence ratio (PR) = 1.29; 95% confidence interval (CI) 1.06;1.57]. When stratified by area of residence, similar associations were observed for women living in Lima and urban areas; no associations were found between food assistance program participation and overweight/obesity among women living outside of Lima or in rural areas, regardless of the poverty status. CONCLUSIONS Food assistance program participation was associated with overweight/obesity in non-poor women. Additional studies are required in countries facing both aspects of malnutrition.

Spotlight: Peru.

PubMed

Yacher, L

1985-09-01

This article highlights population statistics from Peru, the 3rd largest country in Latin America. The population in 1985 has been estimated at 19.7 million. In 1982, the birth rate was 35/1000 and the mortality rate was 10/1000. Infant mortality stood at 99/1000 live births and life expectancy at birth was 59 years. 41% of Peru's population is under 15 years of age, and only 4% is 65 years of age or older. The country's total fertility rate is 5.2 births/woman. Only 0.4% of the population is foreign born. Peru is highly urbanized, and 65% of the country's total population growth in 1981 occurred in its cities. 1 in 3 Peruvians resides in the capital city of Lima. The 2 largest racial groups are mestizos and whites (53%) and Indians (46%). 21% of the population is illiterate. 40.7% of the labor force is employed in agriculture; however, only 15% of the national income is derived from agriculture. The GNP per capita was US$1040 in 1983. The country's economy is in serious trouble at present, with an annual inflation rate of 250% and a foreign debt of US$13.5 billion.

Access, use and perceptions regarding Internet, cell phones and PDAs as a means for health promotion for people living with HIV in Peru

PubMed Central

Curioso, Walter H; Kurth, Ann E

2007-01-01

Background Internet tools, cell phones, and other information and communication technologies are being used by HIV-positive people on their own initiative. Little is known about the perceptions of HIV-positive people towards these technologies in Peru. The purpose of this paper is to report on perceptions towards use of information and communication technologies as a means to support antiretroviral medication adherence and HIV transmission risk reduction. Methods We conducted a qualitative study (in-depth interviews) among adult people living with HIV in two community-based clinics in Peru. Results 31 HIV-positive individuals in Lima were interviewed (n = 28 men, 3 women). People living with HIV in Peru are using tools such as cell phones, and the Internet (via E-mail, chat, list-serves) to support their HIV care and to make social and sexual connections. In general, they have positive perceptions about using the Internet, cell phones and PDAs for HIV health promotion interventions. Conclusion Health promotion interventions using information and communication technology tools among people living with HIV in resource-constrained settings may be acceptable and feasible, and can build on existing patterns of use. PMID:17850656

Access, use and perceptions regarding Internet, cell phones and PDAs as a means for health promotion for people living with HIV in Peru.

PubMed

Curioso, Walter H; Kurth, Ann E

2007-09-12

Internet tools, cell phones, and other information and communication technologies are being used by HIV-positive people on their own initiative. Little is known about the perceptions of HIV-positive people towards these technologies in Peru. The purpose of this paper is to report on perceptions towards use of information and communication technologies as a means to support antiretroviral medication adherence and HIV transmission risk reduction. We conducted a qualitative study (in-depth interviews) among adult people living with HIV in two community-based clinics in Peru. 31 HIV-positive individuals in Lima were interviewed (n = 28 men, 3 women). People living with HIV in Peru are using tools such as cell phones, and the Internet (via E-mail, chat, list-serves) to support their HIV care and to make social and sexual connections. In general, they have positive perceptions about using the Internet, cell phones and PDAs for HIV health promotion interventions. Health promotion interventions using information and communication technology tools among people living with HIV in resource-constrained settings may be acceptable and feasible, and can build on existing patterns of use.

Surgeons' and Trauma Care Physicians' Perception of the Impact of the Globalization of Medical Education on Quality of Care in Lima, Peru.

PubMed

LaGrone, Lacey N; Isquith-Dicker, Leah N; Huaman Egoavil, Eduardo; Rodriguez Castro, Manuel J A; Allagual, Alfredo; Revoredo, Fernando; Mock, Charles N

2017-03-01

The globalization of medical education-the process by which trainees in any region gain access to international training (electronic or in-person)-is a growing trend. More data are needed to inform next steps in the responsible stewardship of this process, from the perspective of trainees and institutions at all income levels, and for use by national and international policymakers. To describe the impact of the globalization of medical education on surgical care in Peru from the perspective of Peruvian surgeons who received international training. Observational study of qualitative interviews conducted from September 2015 to January 2016 using grounded theory qualitative research methods. The study was conducted at 10 large public institutions that provide most of the trauma care in Lima, Peru, and included urban resident and faculty surgery and trauma care physicians. Access to international surgical rotations and medical information. Outcome measures defining the impact of globalization on surgical care were developed as part of simultaneous data collection and analysis during qualitative research as part of a larger project on trauma quality improvement practices in Peru. Fifty qualitative interviews of surgeons and emergency medicine physicians were conducted at 10 hospitals, including multiple from the public and social security systems. A median of 4 interviews were conducted at each hospital, and fewer than 3 interviews were conducted at only 1 hospital. From the broader theme of globalization emerged subthemes of an eroded sense of agency and a perception of inadequate training on the adaptation of international standards as negative effects of globalization on surgical care in Peru. Access to research funds, provision of incentives for acquisition of advanced clinical training, increased expectations for patient outcomes, and education in quality improvement skills are ways in which globalization positively affected surgeons and their patients in Peru. Short-term overseas training of surgeons from low- and middle-income countries may improve care in the surgeons' country of origin through the acquisition of skills and altered expectations for excellence. Prioritization of evidence-based medical education is necessary given widespread internet access and thus clinician exposure to variable quality medical information. Finally, the establishment of centers of excellence in low- and middle-income countries may address the eroded sense of agency attributable to globalization and offer a local example of world-class surgical outcomes, diminishing surgeons' most frequently cited reason for emigration: access to better surgical training.

The Risk of Stable Partnerships: Associations between Partnership Characteristics and Unprotected Anal Intercourse among Men Who Have Sex with Men and Transgender Women Recently Diagnosed with HIV and/or STI in Lima, Peru

PubMed Central

Cambou, Mary C.; Perez-Brumer, Amaya G.; Segura, Eddy R.; Salvatierra, H. Javier; Lama, Javier R.; Sanchez, Jorge; Clark, Jesse L.

2014-01-01

Background Partnership type is an important factor associated with unprotected anal intercourse (UAI) and subsequent risk for HIV and sexually transmitted infections (STI). We examined the association of partnership type with UAI among men who have sex with men (MSM) and male-to-female transgender women (TGW) in Lima, Peru, recently diagnosed with HIV and/or STI. Methods We report data from a cross-sectional analysis of MSM and TGW recently diagnosed with HIV and/or STI in Lima, Peru between 2011 and 2012. We surveyed participants regarding UAI with up to their three most recent sexual partners according to partner type. Multivariable Generalized Estimate Equating (GEE) models with Poisson distribution were used to estimate prevalence ratios (PR) for UAI according to partner type. Results Among 339 MSM and TGW recently diagnosed with HIV and/or STI (mean age: 30.6 years, SD 9.0), 65.5% self-identified as homosexual/gay, 16.0% as bisexual, 15.2% as male-to-female transgender, and 3.3% as heterosexual. Participants provided information on 893 recent male or TGW partners with whom they had engaged in insertive or receptive anal intercourse: 28.9% stable partners, 56.4% non-stable/non-transactional partners (i.e. casual or anonymous), and 14.7% transactional partners (i.e. transactional sex client or sex worker). Unprotected anal intercourse was reported with 41.3% of all partners. In multivariable analysis, factors associated with UAI included partnership type (non-stable/non-transactional partner APR 0.73, [95% CI 0.59–0.91], transactional partner APR 0.53 [0.36–0.78], p<0.05) and the number of previous sexual encounters with the partner (>10 encounters APR 1.43 [1.06–1.92], p<0.05). Conclusion UAI was more commonly reported for stable partners and in partnerships with >10 sexual encounters, suggesting UAI is more prevalent in partnerships with a greater degree of interpersonal commitment. Further research assessing partner-level factors and behavior is critical for improving HIV and/or STI prevention efforts among Peruvian MSM and TGW. PMID:25029514

[Anthropology and "crisis in medicine": The pathologist M. Kuczynski-Godard (1890-1967) and the indigenous peoples of Central Asia and Peru].

PubMed

Knipper, Michael

2009-01-01

This article examines the work of the German-Peruvian physician Max Kuczynski/Máxime Kuczynski-Godard (Berlin 1890-Lima 1967) in rural areas of Central Asia (1924-26) and Peru (1938-48). The main focus of the text is on the scientific approach behind the specific interest of this pathologist in disease and health issues among native populations. Kuczynski's theoretical considerations are analyzed in the context of the wide controversies within the German medical community around a "crisis in medicine" when he was professor at Berlin University during the interwar years. Accordingly, his determination to leave the laboratory and to shift research and healthcare practice closer to rural populations proves to be the expression of profound epistemological and ethical considerations.

The PICASSO Cohort: baseline characteristics of a cohort of men who have sex with men and male-to-female transgender women at high risk for syphilis infection in Lima, Peru.

PubMed

Kojima, Noah; Park, Hayoung; Konda, Kelika A; Joseph Davey, Dvora L; Bristow, Claire C; Brown, Brandon; Leon, Segundo R; Vargas, Silver K; Calvo, Gino M; Caceres, Carlos F; Klausner, Jeffrey D

2017-04-11

Men who have sex with men (MSM) and male-to-female transgender women (transwomen) are disproportionately at risk of syphilis infection in Peru. From 2013 to 2014, MSM and transwomen seeking human immunodeficiency virus (HIV) or sexually transmitted infection (STI) testing and/or treatment were recruited into a 2-year observational cohort study to determine predictors of recently acquired syphilis infection (defined as a rapid plasma reagin [RPR] titer ≥1:16 and a reactive treponemal antibody test) in Lima, Peru. At baseline, interviewers collected sociodemographic, behavioral, and medical characteristics from participants. All cohort participants were tested for syphilis, HIV, Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (NG) infection. Using cross-sectional analyses, bivariate and multivariate models were used to determine factors associated with recently acquired syphilis infection and calculate adjusted prevalence ratios. We recruited 401 participants, 312 MSM and 89 transwomen, with median ages of 29.0 and 32.5 years old (interquartile ranges: 23.3, 37.4 and 27.2, 39.5, respectively). The prevalence of recently acquired syphilis infection at baseline was 16.8% for MSM and 6.7% for transwomen. Among MSM and transwomen, 30.1 and 33.7% were infected with HIV, 18.6 and 24.7% were infected with CT, and 14.2 and 19.1% were infected with NG, respectively. Co-infection rates among MSM with recently acquired syphilis infection included: 44.2% with HIV, 40.4% with CT (32.7% with anal CT and 7.7% with pharyngeal CT), and 19.2% with NG (11.5% with anal NG and 7.7% with pharyngeal NG). Co-infection rates among transwomen with recently acquired syphilis infection included: 66.7% with HIV, 0% with CT, and 16.7% with anal NG. In multivariate analysis among the entire cohort, recently acquired syphilis infection was independently associated with younger age (adjusted prevalence ratio [aPR] = 0.96, 95% confidence interval [CI] = 0.93-0.99), receptive role during anal sex (aPR = 2.56, 95% CI = 1.05-6.25), prior HIV diagnosis (aPR = 1.70, 95% CI = 1.11-2.61), anal CT or NG infection (aPR = 1.69, 95% CI = 1.09-2.60), and prior syphilis diagnosis (aPR = 3.53, 95% CI = 2.20-5.68). We recruited a cohort of MSM and transwomen who had a high prevalence of recently acquired syphilis infection in Lima, Peru. Recently acquired syphilis infection was associated with socio-demographic characteristics, sexual risk, and sexually transmitted co-infections.

Towards Effective Emerging Infectious Diseases Surveillance: Evidence from Kenya, Peru, Thailand, and the U.S.-Mexico Border

DTIC Science & Technology

2012-09-01

capital  city  of  Lima.  The...the  region  the  four  freedom  of  movement:  movement  of  persons  and  workers,  goods,   capital  and   services...other  words,  if  individuals  can  barely  provide  medical   care  for  themselves,  there  is  a   good

Translations on Telecommunications Policy, Research and Development, Number 28

DTIC Science & Technology

1978-02-09

digital electronics technology — is confident that the 12-watt I’KP (Peak En- velope Tower) single side band radio will perform better and be...PRODUCED WITH FUJITSU TECHNOLOGY, EQUIPMENT Rio de Janeiro 0 GLOBO in Portuguese 21 Dec 77 p 21 [Text] Porto Alegre (0 GLOBO). EDISA [ Digital ...10042 CSO: 5500 25 PERU TELEPHONE SERVICE TO UNDERGO COSTLY EXPANSION Plan To Add Lines Approved Lima EL COMERCIO in Spanish 1? Nov 77 Front

Targeting Terrorist Leaders: The Peruvian Untouchables Experience

DTIC Science & Technology

2005-12-01

la Pacificación (Challenges to Pacification) (Lima: Paez, 1994), 212. 9 Victor Manuel Quechua , Perú. 13 Años de Oprobio (Thirteen Years of Oddity...54 Quechua , 532. 55 It was not clear if the reward would be awarded if a state agency carried out the capture. 56 Colonel PNP (r) Benedicto...Monthly Review Press, 1992. Quechua , Victor Manuel. Perú-- 13 Años de Oprobio. 2nd ed. Peru: 1994. Shamir, Boas, House, Robert J, Arthur, and

Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru.

PubMed

Zhong, Qiu-Yue; Gelaye, Bizu; Rondon, Marta B; Sánchez, Sixto E; Simon, Gregory E; Henderson, David C; Barrios, Yasmin V; Sánchez, Pedro Mascaro; Williams, Michelle A

2015-12-01

We sought to examine the concordance of two suicidal ideation items from the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS), to evaluate the prevalence of suicidal ideation among pregnant women, and to assess the co-occurrence of suicidal ideation with antepartum depressive symptoms. A cross-sectional study was conducted among 1,517 pregnant women attending prenatal care clinics in Lima, Peru. Item 9 of the PHQ-9 assesses suicidal ideation over the last 14 days while item 10 of the EPDS assesses suicidal ideation in the past 7 days. The two suicidal ideation items have a high concordance rate (84.2 %) but a moderate agreement (the Cohen's kappa = 0.42). Based on the PHQ-9 and the EPDS, 15.8 and 8.8 % of participants screened positive for suicidal ideation, respectively. Assessed by the PHQ-9, 51 % of participants with suicidal ideation had probable depression. In prenatal care clinics, screening for suicidal ideation is needed for women with and without depressive symptoms. Future studies are needed to identify additional predictors of antepartum suicidality, determine the appropriate duration of reporting period for suicidal ideation screening, and assess the percentage of individuals with positive responses to the two suicidal ideation items at high risk of planning and attempting suicide.

Characterization of Salmonella enterica isolates causing bacteremia in Lima, Peru, using multiple typing methods

PubMed Central

Betancor, Laura; García, Coralith; Astocondor, Lizeth; Hinostroza, Noemí; Bisio, Julieta; Rivera, Javier; Perezgasga, Lucía; Pérez Escanda, Victoria; Yim, Lucía; Jacobs, Jan; García-del Portillo, Francisco; Chabalgoity, José A.; Puente, José L.

2017-01-01

In this study, different molecular typing tools were applied to characterize 95 Salmonella enterica blood isolates collected between 2008 and 2013 from patients at nine public hospitals in Lima, Peru. Combined results of multiplex PCR serotyping, two- and seven-loci multilocus sequence typing (MLST) schemes, serotyping, IS200 amplification and RAPD fingerprints, showed that these infections were caused by eight different serovars: Enteritidis, Typhimurium, Typhi, Choleraesuis, Dublin, Paratyphi A, Paratyphi B and Infantis. Among these, Enteritidis, Typhimurium and Typhi were the most prevalent, representing 45, 36 and 11% of the isolates, respectively. Most isolates (74%) were not resistant to ten primarily used antimicrobial drugs; however, 37% of the strains showed intermediate susceptibility to ciprofloxacin (ISC). Antimicrobial resistance integrons were carried by one Dublin (dfra1 and aadA1) and two Infantis (aadA1) isolates. The two Infantis isolates were multidrug resistant and harbored a large megaplasmid. Amplification of spvC and spvRA regions showed that all Enteritidis (n = 42), Typhimurium (n = 34), Choleraesuis (n = 3) and Dublin (n = 1) isolates carried the Salmonella virulence plasmid (pSV). We conclude that the classic serotyping method can be substituted by the multiplex PCR and, when necessary, sequencing of only one or two loci of the MLST scheme is a valuable tool to confirm the results. The effectiveness and feasibility of different typing tools is discussed. PMID:29267322

Reliability of the MODS assay decentralisation process in three health regions in Peru

PubMed Central

Mendoza, A.; Castillo, E.; Gamarra, N.; Huamán, T.; Perea, M.; Monroi, Y.; Salazar, R.; Coronel, J.; Acurio, M.; Obregón, G.; Roper, M.; Bonilla, C.; Asencios, L.; Moore, D. A. J.

2011-01-01

OBJECTIVE To deliver rapid isoniazid (INH) and rifampicin (RMP) drug susceptibility testing (DST) close to the patient, we designed a decentralisation process for the microscopic observation drug susceptibility (MODS) assay in Peru and evaluated its reliability. METHODS After 2 weeks of training, laboratory staff processed ≥120 consecutive sputum samples each in three regional laboratories. Samples were processed in parallel with MODS testing at an expert laboratory. Blinded paired results were independently analysed by the Instituto Nacional de Salud (INS) according to predetermined criteria: concordance for culture, DST against INH and RMP and diagnosis of multidrug-resistant t uberculosis (MDR-TB) ≥ 95%, McNemar's P > 0.05, kappa index (κ) ≥ 0.75 and contamination 1–4%. Sensitivity and specificity for MDR-TB were calculated. RESULTS The accreditation process for Callao (126 samples, 79.4% smear-positive), Lima Sur (n = 130, 84%) and Arequipa (n = 126, 80%) took respectively 94, 97 and 173 days. Pre-determined criteria in all regional laboratories were above expected values. The sensitivity and specificity for detecting MDR-TB in regional laboratories were >95%, except for sensitivity in Lima Sur, which was 91.7%. Contamination was 1.0–2.3%. Mean delay to positive MODS results was 9.9–12.9 days. CONCLUSION Technology transfer of MODS was reliable, effective and fast, enabling the INS to accredit regional laboratories swiftly. PMID:21219684

[Factors associated with slow walking speed in older adults of a district in Lima, Peru].

PubMed

Rodríguez, Gabriela; Burga-Cisneros, Daniella; Cipriano, Gabriela; Ortiz, Pedro J; Tello, Tania; Casas, Paola; Aliaga, Elizabeth; Varela, Luis F

2017-01-01

To determine the factors associated with slow walking speed in older adults living in a district of Lima, Peru. Analysis of secondary data. Adults older than 60 years were included in the study, while adults with physical conditions who did not allow the evaluation of the walking speed were excluded. The dependent variable was slow walking speed (less than 1 m/s), and the independent variables were sociodemographic, clinical, and geriatric data. Raw and adjusted prevalence ratios (PR) were calculated with 95% confidence intervals (95% CI). The study sample included 416 older adults aged 60 to 99 years, and 41% of the participants met the slow walking speed criterion. The factors associated with slow walking speed in this sample were female gender (PR, 1.45; 95% CI, 1.13-1.88), age > 70 years (PR, 1.73; 95% CI, 1.30- 2.30), lower level of education (PR, 2.07, 95% CI, 1.20-3.55), social-familial problems (PR, 1.66; 95% CI, 1.08-2.54), diabetes mellitus (PR, 1.35; 95% CI, 1.01-1.80), and depression (PR, 1.41; 95% CI, 1.02-1.95). The modifiable factors associated with slow walking speed in older adults included clinical and social-familial problems, and these factors are susceptible to interventions from the early stages of life.

Design Strategy of the Sabes Study: Diagnosis and Treatment of Early HIV Infection Among Men Who Have Sex With Men and Transgender Women in Lima, Peru, 2013-2017.

PubMed

Lama, Javier R; Brezak, Audrey; Dobbins, James G; Sanchez, Hugo; Cabello, Robinson; Rios, Jessica; Bain, Carolyn; Ulrich, Angela; De la Grecca, Robert; Sanchez, Jorge; Duerr, Ann

2018-03-07

The Sabes study evaluates a treatment-as-prevention intervention in cis-gender men who have sex with men and transgender women in Lima, Peru, populations disproportionately affected by the HIV epidemic. The intervention is designed to prevent onward transmission of HIV by identifying HIV-negative, high-risk individuals, testing them monthly for the presence of HIV, and then rapidly treating those who become HIV positive. The main outcome of interest is the development of a model predicting the population-level impact of early detection of HIV infection and immediate initiation of antiretroviral therapy (ART) in this population From July 2013 to September 2015, 3,336 subjects were screened for HIV; 2,682 (80.4%) were negative and 2,084 began monthly testing. We identified 248 individuals shortly after HIV acquisition, 215 of whom were enrolled in the treatment phase of our study. All participants were followed for 48 weeks and then were referred to the Peruvian Ministry of Health to continue free HIV care and treatment. This intervention demonstrates that it is possible to recruit high-risk individuals, screen them for HIV, continue to test those who are initially HIV negative in order to identify incident cases shortly after acquisition, and then rapidly link them to care.

Direct observation of hygiene in a Peruvian shantytown: not enough handwashing and too little water

PubMed Central

Oswald, William E.; Hunter, Gabrielle C.; Lescano, Andres G.; Cabrera, Lilia; Leontsini, Elli; Pan, William K.; Soldan, Valerie Paz; Gilman, Robert H.

2014-01-01

Summary OBJECTIVE To document frequency of hygiene practices of mothers and children in a shantytown in Lima, Peru. METHODS Continuous monitoring over three 12-h sessions in households without in-house water connections to measure: (i) water and soap use of 32 mothers; (ii) frequency of interrupting faecal-hand contamination by washing; and (iii) the time until faecal-hand contamination became a possible transmission event. RESULTS During 1008 h of observation, 55% (65/119) of mothers’ and 69% (37/54) of children's faecal-hand contamination events were not followed within 15 min by handwashing or bathing. Nearly 40% (67/173) of faecal-hand contamination events became possible faecal-oral transmission events. There was no difference in the time-until-transmission between mothers and children (P = 0.43). Potential transmission of faecal material to food or mouth occurred in 64% of cases within 1 h of hand contamination. Mean water usage (6.5 l) was low compared to international disaster relief standards. CONCLUSIONS We observed low volumes of water usage, inadequate handwashing, and frequent opportunities for faecal contamination and possible transmission in this water-scarce community. PMID:19055623

[The physical activity level of people working at a regional health office in Lima, Peru].

PubMed

Sanabria-Rojas, Hernán; Tarqui-Mamani, Carolina; Portugal-Benavides, Walter; Pereyra-Zaldívar, Héctor; Mamani-Castillo, Lorenzo

2014-01-01

Determining the prevalence of physical activity for health workers from a regional health office in Lima; their nutritional status and history of non-communicable diseases is also described. The study was cross-sectional and observations were made between August and November 2012. The study population involved 172 health workers working at a regional health office in Lima (DIRESA) according to the inclusion criteria and their acceptance of the offer to participate. Workers were excluded who had some kind of physical limitation regarding physical exercise. Their physical activity level was determined by using the International Physical Activity Questionnaire (IPAQ) which measures physical activity domains: work, home, transport and leisure. SPSS-19 was used for processed the data and nutritional status was evaluated using the body mass index (BMI), according to WHO classification. 88.0 % of DIRESA workers had a low level of physical activity and 64.0 % were overweight. Among the most common non-communicable diseases, it was found that 4.7 % had diabetes, 15.6 % hypertension, 32.6 % dyslipidaemia and 15.0 % smoked. DIRESA workers had a high prevalence of physical inactivity and excess weight, so it is advisable to implement healthy policies helping to improve their health.

The provision of and need for social support among adult and pediatric patients with tuberculosis in Lima, Peru: a qualitative study

PubMed Central

2013-01-01

Background Tuberculosis (TB) remains a significant public health problem in Peru, causing an estimated 35,000 new cases each year, 6.7% of whom are co-infected with HIV. Social support mechanisms are key in influencing health-seeking behavior, adherence, and overall patient wellbeing in clinical settings. We examine the types of social support received by TB patients and parents of pediatric patients in peri-urban Lima, Peru, to understand its role in patients’ psychosocial wellbeing during treatment. Methods Semi-structured interviews were conducted between August 2004 and May 2005 among 43 individuals: 19 adults with TB, 8 adults with TB/HIV, 13 parents of pediatric TB patients, and 3 parents of pediatric TB/HIV patients. Results Patients described the need for psychosocial support to mitigate the difficulty of continually going to the clinic to take medications, tending to other family or professional responsibilities while on treatment, and confronting stigma and social isolation within their community. Family members most often contributed to meeting these psychosocial needs, and were also crucial in providing economic support to patients faced with burdensome medical expenses or who were forced to leave their jobs due to being on treatment. Most healthcare personnel were described as key providers of emotional support and encouragement for patients to successfully adhere to treatment, however there were a select few doctors whose “scare tactics” seemingly discouraged patient adherence. During the treatment process, patients described being more socially withdrawn as a result of feeling fatigued from their medications, however most participants also described forming new mutually supportive friendships among their fellow patients. Conclusions Despite the general reluctance of patients to disclose their disease status, patients received a significant amount of psychosocial support from both family members to whom they disclosed, and from positive interactions with healthcare providers. High levels of depression were reported, with many patients voicing need for improved and more frequent psychological interventions. To improve the Peru TB program, participants suggested extending educational opportunities to patients’ families and the wider community, increasing the existing amount of nutritional support, and programmatic provision of vocational activities to increase economic opportunities. PMID:23899353

Diagnosis of cysticercosis in endemic regions

PubMed Central

Garcia, H. H.; Martinez, M.; Gilman, R.; Herrera, G.; Tsang, V. C. W.; Pilcher, J. B.; Diaz, F.; Verastegui, M.; Gallo, C.; Porras, M.; Alvarado, M.; Naranjo, J.; Miranda, E.

2010-01-01

Taenia solium cysticercosis is a frequent cause of neurological disease in developing countries. Specific diagnosis of cysticercosis is difficult. We obtained serum and/or CSF samples from 204 consecutive patients admitted to a neurological ward in Lima, Peru, and looked for antibodies specific for T solium with the enzyme-linked immunoelectrotransfer blot (EITB) assay. 21 (12%) of 173 serum samples from these patients were EITB-positive. In contrast only 2 (1·5%) of 135 patients attending a public endoscopy clinic and 1 (1%) of 88 patients attending a private endoscopy clinic were seropositive. 1 (1%) of 98 pregnant women living in a Lima shanty town was EITB-positive. 15 (58%) of 26 neurology patients diagnosed clinically as having cysticercosis were seronegative. Routine screening by EITB of all patients with neurological symptoms from areas of endemic cysticercosis would avoid misdiagnosis of this common and treatable disease. PMID:1678809

"And Then Break the Cliché": Understanding and Addressing HIV Vulnerability Through Development of an HIV Prevention Telenovela with Men Who Have Sex with Men and Transwomen in Lima, Peru.

PubMed

Garcia, Jonathan; Perez-Brumer, Amaya G; Cabello, Robinson; Clark, Jesse L

2018-02-20

HIV and other sexually transmitted infections (STIs) continue to affect men who have sex with men (MSM) and transgender women (TW) in Peru at disproportionately high rates. The ineffectiveness of traditional prevention strategies may be due to the disconnect between health promotion messages and community-level understandings of sexual cultures. We conducted 15 workshops with MSM and TW to develop a community-based sexual health intervention. Intervention development consisted of focus groups and scenic improvisation to identify sexual scripts for an HIV prevention telenovela, or Spanish soap opera. Workshops were stratified by self-reported socioeconomic status, sexual orientation, and gender identity: (1) low-income MSM (n = 9); (2) middle/high-income MSM (n = 6); and (3) TW (n = 8). Employing a conceptual model based on sexual scripts and critical consciousness theories, this paper reports on three themes identified during the telenovela-development process as participants sought to "rescript" social and sexual stereotypes associated with HIV-related vulnerability: (1) management of MSM and TW social identities at the intersection of socioeconomic status, sexuality, and gender performance; (2) social constructions of gender and/or sexual role and perceived and actual HIV/STI risk(s) within sexual partnership interactions; and (3) idealized and actual sexual scripts in the negotiation of safer sex practices between MSM/TW and their partners. These findings are key to reframing existing prevention strategies that fail to effectively engage poorly defined "high-risk populations." Leveraging community-based expertise, the results provide an alternative to the static transfer of information through expert-patient interactions in didactic sessions commonly used in HIV prevention interventions among MSM and TW.

[Carbon footprint in five third-level health care centers in Peru, 2013].

PubMed

Bambarén-Alatrista, Celso; Alatrista-Gutiérrez, María Del Socorro

2016-06-01

This study was performed to calculate the carbon footprint generated by third-level health care centers located in Lima, Peru, in 2013. Reports were obtained on the consumption of energy resources and water as well as on waste generation from the five centers, which contributed to climate change with an emission of 14,462 teq of CO2. A total of 46% of these emissions were associated with fuel consumption by the powerhouse, power generators, and transport vehicles; 44% was related to energy consumption; and the remaining 10% was related to the use of water and generation of solid hospital waste. CO2, N2O, and CH4 are the greenhouse gases included in the estimated carbon footprint. Our results show that hospitals have a negative environmental impact, mainly due to fossil fuel consumption.

Within the International Collaboration CHAIN: a Summary of Events Observed with Flare Monitoring Telescope (FMT) in Peru

NASA Astrophysics Data System (ADS)

Ishitsuka, J.; Asai, A.; Morita, S.; Terrazas, R.; Cabezas, D.; Gutierrez, V.; Martinez, L.; Buleje, Y.; Loayza, R.; Nakamura, N.; Takasao, S.; Yoshinaga, Y.; Hillier, A.; Otsuji, K.; Shibata, K.; Ishitsuka, M.; Ueno, S.; Kitai, R.; Ishii, T.; Ichimoto, K.; Nagata, S.; Narukage, N.

2014-02-01

In 2008 we inaugurated the new Solar Observatory in collaboration with Faculty of Sciences of San Luis Gonzaga de Ica National University, 300 km south of Lima. In March of 2010 a Flare Monitoring Telescope of Hida Observatory of Kyoto University arrived to Ica, part of CHAIN Project (Continuous H-alpha Imaging Network). In October of the same year we hosted the First FMT Workshop in Ica, then in July of 2011 the Second FMT Workshop was opened. Since that we are focused on two events registered by FMT in Peru to publish results. FMT is a good tool to introduce young people from universities into scientific knowledge; it is good also for education in Solar Physics and outreach. Details of this successful collaboration will be explained in this presentation.

[Psychosocial aspects and accidents in land transport].

PubMed

Morales-Soto, Nelson; Alfaro-Basso, Daniel; Gálvez-Rivero, Wilfredo

2010-06-01

Road traffic accidents are a public health problem in Peru, having caused 35 596 deaths in Peru between 1998 and 2008. Lima is the most affected region, presenting 61.7% of the accidents, the annual cost reached one thousand million dollars, equivalent to a third part of the investment in health. Available studies give emphasis to the protagonists--the drivers, the pedestrians--or to equipment and roads; the laws have been modified and containment plans for accidents have been implemented, but the incidence remains the same. We raise the possibility of exploring behavioral and social factors that could be relevant in the genesis of the problem, revising those related to current disorder in transport, the behaviors of drivers and pedestrians and the permissiveness of society in general particularly of the authority. We propose research and a multidisciplinary and intersectoral intervention.

Estimation of slip scenarios of mega-thrust earthquakes and strong motion simulations for Central Andes, Peru

NASA Astrophysics Data System (ADS)

Pulido, N.; Tavera, H.; Aguilar, Z.; Chlieh, M.; Calderon, D.; Sekiguchi, T.; Nakai, S.; Yamazaki, F.

2012-12-01

We have developed a methodology for the estimation of slip scenarios for megathrust earthquakes based on a model of interseismic coupling (ISC) distribution in subduction margins obtained from geodetic data, as well as information of recurrence of historical earthquakes. This geodetic slip model (GSM) delineates the long wavelength asperities within the megathrust. For the simulation of strong ground motion it becomes necessary to introduce short wavelength heterogeneities to the source slip to be able to efficiently simulate high frequency ground motions. To achieve this purpose we elaborate "broadband" source models constructed by combining the GSM with several short wavelength slip distributions obtained from a Von Karman PSD function with random phases. Our application of the method to Central Andes in Peru, show that this region has presently the potential of generating an earthquake with moment magnitude of 8.9, with a peak slip of 17 m and a source area of approximately 500 km along strike and 165 km along dip. For the strong motion simulations we constructed 12 broadband slip models, and consider 9 possible hypocenter locations for each model. We performed strong motion simulations for the whole central Andes region (Peru), spanning an area from the Nazca ridge (16^o S) to the Mendana fracture (9^o S). For this purpose we use the hybrid strong motion simulation method of Pulido et al. (2004), improved to handle a general slip distribution. Our simulated PGA and PGV distributions indicate that a region of at least 500 km along the coast of central Andes is subjected to a MMI intensity of approximately 8, for the slip model that yielded the largest ground motions among the 12 slip models considered, averaged for all assumed hypocenter locations. This result is in agreement with the macroseismic intensity distribution estimated for the great 1746 earthquake (M~9) in central Andes (Dorbath et al. 1990). Our results indicate that the simulated PGA and PGV for all scenario slips for central Andes, and for an average soil condition, exhibit similar amplitudes and attenuation characteristics with distance as the PGA and PGV values observed during the 2010 Maule (Mw 8.8), and 2011 Tohoku-oki (Mw 9.0) earthquakes. Our results clearly indicate that the simulated ground motions for scenarios with deep rupture nucleations (~40 km) are consistently smaller than the ground motions obtained for shallower rupture nucleations. We also performed strong ground motion simulations in metropolitan Lima by using the aforementioned slip scenarios, and incorporating site amplifications obtained from several microtremors array surveys conducted at representative geotechnical zones in this city. Our simulated PGA and PGV in Lima reach values of 1000 cm/s^2 and 80 cm/s. Our results show that the largest values of PGA (at Puente Piedra district, Northern Lima) are related with short period site effects, whereas the largest values of PGV are related with large site amplifications for periods from 1s to 1.5s (at Callao, Villa el Salvador and La Molina districts). Our results also indicate that the simulated PGA and PGV in central Lima (Parque de la Reserva) are in average 2~3 times larger than the values recorded by a strong motion instrument installed at this location, during the 1974 (Mw8.0) and 1966 (Mw8.0) earthquakes off-shore Lima.

Prevalence of BRCA1 and BRCA2 mutations in unselected breast cancer patients from Peru.

PubMed

Abugattas, J; Llacuachaqui, M; Allende, Y Sullcahuaman; Velásquez, A Arias; Velarde, R; Cotrina, J; Garcés, M; León, M; Calderón, G; de la Cruz, M; Mora, P; Royer, R; Herzog, J; Weitzel, J N; Narod, S A

2015-10-01

The prevalence of BRCA1 and BRCA2 mutations among breast cancer patients in Peru has not yet been explored. We enrolled 266 women with breast cancer from a National cancer hospital in Lima, Peru, unselected for age or family history. DNA was screened with a panel of 114 recurrent Hispanic BRCA mutations (HISPANEL). Among the 266 cases, 13 deleterious mutations were identified (11 in BRCA1 and 2 in BRCA2), representing 5% of the total. The average age of breast cancer in the mutation-positive cases was 44 years. BRCA1 185delAG represented 7 of 11 mutations in BRCA1. Other mutations detected in BRCA1 included: two 2080delA, one 943ins10, and one 3878delTA. The BRCA2 3036del4 mutation was seen in two patients. Given the relatively low cost of the HISPANEL test, one should consider offering this test to all Peruvian women with breast or ovarian cancer. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Molecular characterization of the human immunodeficiency virus type 1 among children in Lima, Peru.

PubMed

Carrión, A G; Laguna-Torres, V A; Soto-Castellares, G; Castillo, M; Salazar, E; Negron, E; Kolevic, L; Montano, S M; Sánchez, J L; Bautista, C T; Oberhelman, R A; Kochel, T J

2009-08-01

In Peru, there is a lack of information on molecular analysis in pediatric human immunodeficiency virus (HIV) infection. At present, the mother-to-child transmission rate is estimated at approximately 2-4%. The objective of this study was to assess the molecular epidemiology of HIV-1 in infected children. Children with suspected or confirmed pulmonary tuberculosis were evaluated at two public hospitals between 2002 and 2007. Whole blood samples were obtained from 90 HIV-positive children, who were confirmed to be positive by enzyme-linked immunosorbent assay and Western blot. The specimens were subjected to envelope heteroduplex mobility assay (env HMA) followed by gag and pol gene region sequence analysis. Subtype B was found in 88 (98%) of 90 children and 2 (2%) children were subtype BF recombinants. This is the first report of recombinant HIV strains in HIV-infected children in Peru. Understanding the origin, diversity, and spread of HIV strains worldwide will be necessary for the development of an effective vaccine that targets pediatric populations throughout the world.

When "the program is good, but the disease is better": lessons from Peru on drug-resistant tuberculosis.

PubMed

Smith-Nonini, Sandy

2005-01-01

This is a qualitative study of the politics of public health surrounding a resurgent tuberculosis epidemic in Lima, Peru during the 1990s. The paper traces the role of debt and neoliberal economics in creating conditions for the epidemic, and the reforms that turned Peru's TB program into a model for treating drug-susceptible disease by 1996. Despite this success, public health officials were blind-sided by the appearance of drug-resistant TB in the late 1990s when their "good" program turned out to be not good enough. The study follows the conflict, and eventual collaboration, that ensued between the Ministry of Health and a local NGO affiliated with Boston-based Partners in Health, which undertook a radical program of community-based directly-observed therapy (DOTS-Plus) to treat drug-resistant patients who otherwise would have died. Lessons from this case are relevant to many international settings where "hot-spots" of drug-resistant TB currently exist and go untreated, posing a threat to the success of national TB control programs.

Compensated Sex and Sexual Risk: Sexual, Social and Economic Interactions between Homosexually- and Heterosexually-Identified Men of Low Income in Two Cities of Peru

PubMed Central

Fernández-Dávila, Percy; Salazar, Ximena; Cáceres, Carlos F.; Maiorana, Andre; Kegeles, Susan; Coates, Thomas J.; Martinez, Josefa

2009-01-01

This study describes the complex dynamics of the sexual, economic and social interactions between a group of feminized homosexual men and men who have sex with men and self-identify as heterosexual (‘mostaceros’), in lower-income peripheral urban areas of Lima and Trujillo, Peru. The study examined sexual risk between these two groups of men, and the significance of the economic exchanges involved in their sexual interactions. Using a Grounded Theory approach, 23 individual interviews and 7 focus groups were analyzed. The results reveal that cultural, economic and gender factors mold sexual and social relations among a group of men who have sex with men in Peru. Compensated sex is part of the behaviors of these men, reflecting a complicated construction of sexuality based on traditional conceptions of gender roles, sexual identity and masculinity. Several factors (e.g. difficulty in negotiating condom use, low self-esteem, low risk perception, alcohol and drug consumption), in the context of compensated sex, play a role in risk-taking for HIV infection. PMID:19890491

Ten years of international collaboration in biomedical informatics and beyond: the AMAUTA program in Peru

PubMed Central

Fuller, Sherrilynne; Garcia, Patricia J; Holmes, King K; Kimball, Ann Marie

2010-01-01

Well-trained people are urgently needed to tackle global health challenges through information and communication technologies. In this report, AMAUTA, a joint international collaborative training program between the Universidad Peruana Cayetano Heredia and the University of Washington, which has been training Peruvian health professionals in biomedical and health informatics since 1999, is described. Four short-term courses have been organized in Lima, offering training to more than 200 graduate-level students. Long-term training to masters or doctorate level has been undertaken by eight students at the University of Washington. A combination of short-term and long-term strategies was found to be effective for enhancing institutional research and training enterprise. The AMAUTA program promoted the development and institution of informatics research and training capacity in Peru, and has resulted in a group of trained people playing important roles at universities, non-government offices, and the Ministry of Health in Peru. At present, the hub is being extended into Latin American countries, promoting South-to-South collaborations. PMID:20595317

Astronomy Against Terrorism: an Educational Astronomical Observatory Project in Peru

NASA Astrophysics Data System (ADS)

Ishitsuka, M.; Montes, H.; Kuroda, T.; Morimoto, M.; Ishitsuka, J.

2003-05-01

The Cosmos Coronagraphic Observatory was completely destroyed by terrorists in 1988. In 1995, in coordination with the Minister of Education of Peru, a project to construct a new Educational Astronomical Observatory has been executed. The main purpose of the observatory is to promote an interest in basic space sciences in young students from school to university levels, through basic astronomical studies and observations. The planned observatory will be able to lodge 25 visitors; furthermore an auditorium, a library and a computer room will be constructed to improve the interest of people in astronomy. Two 15-cm refractor telescopes, equipped with a CCD camera and a photometer, will be available for observations. Also a 6-m dome will house a 60-cm class reflector telescope, which will be donated soon, thanks to a fund collected and organized by the Nishi-Harima Astronomical Observatory in Japan. In addition a new modern planetarium donated by the Government of Japan will be installed in Lima, the capital of Peru. These installations will be widely open to serve the requirements of people interested in science.

[Levels of dissatisfaction of external users of the Instituto Nacional de Salud del Niño (National Institute of Child Health) in Lima, Peru].

PubMed

Shimabuku, Roberto; Huicho, Luis; Fernández, Danitza; Nakachi, Graciela; Maldonado, Ruth; Barrientos, Armando

2012-01-01

To determine the changes in the levels of dissatisfaction of the external users of the Instituto Nacional de Salud del Niño, in Lima, Peru. Observational study based on a software to evaluate surveys completed by health care users (Software de Evaluación de Encuestas de Usuarios en Salud - SEEUS). The population consisted of every person accompanying external users to outpatient visits, inpatient visits or emergency treatment in the years 2008, 2009 and 2010. To calculate the sample size, last year's proportion of users dissatisfied with each service was used, with an estimated error of 5% at a 95% confidence level. A sample of 2051 people was obtained, which revealed a decreasing trend in the levels of dissatisfaction with outpatient visits, and an increased dissatisfaction in the medical capabilities dimension for hospitalization and emergency services. In addition, a dissatisfaction index lower than 0.20 was registered in the medical capabilities dimension for outpatient visits. In contrast, the highest dissatisfaction indexes were registered in the hygiene dimension for 2009 (0.25) and 2010 (0.25), and in the others dimension for emergency services in 2009 (0.25). The dimensions showing an increase in the dissatisfaction index were tangible aspects, hygiene and others for hospitalization and emergency services. On the other hand, the medical capabilities dimension for outpatient visits showed a decrease in the level of dissatisfaction over the evaluated period.

Workplace cluster of Bell’s palsy in Lima, Peru

PubMed Central

2014-01-01

Background We report on a workplace cluster of Bell’s palsy that occurred within a four-month period in 2011 among employees of a three-story office building in Lima, Peru and our investigation to determine the etiology and associated risk factors. Findings An outbreak investigation was conducted to identify possible common infectious or environmental exposures and included patient interviews, reviews of medical records, an epidemiologic survey, serological analysis for IgM and IgG antibodies to putative Bell’s palsy-inducing pathogens, and an environmental exposure assessment of the office building. Three cases of Bell’s palsy were reported among 65 at-risk employees, attack rate 4.6%. Although two patients had underlying risk factors, there was no clear association or common identifiable risk factor among all cases. Serologic analysis showed no evidence of recent infections, and air and water sample measures of all known chemical or neurotoxins were below maximum allowable concentrations for exposure. Conclusions An infection spread among workplace employees could not be excluded as a potential cause of this cluster; however, it was unlikely a pathogen commonly associated with individual cases of Bell’s palsy. Although a specific etiology was not identified among all cases, we believe this methodology will aid future outbreak investigations of Bell’s palsy and a better understanding of its etiology. While environmental assessments may be useful in their ability to ascertain the cause of clusters of Bell’s palsy, future investigations should prioritize focus on common infectious etiology. PMID:24885256

Association of Roadway Proximity with Indoor Air Pollution in a Peri-Urban Community in Lima, Peru

PubMed Central

Underhill, Lindsay J.; Bose, Sonali; Williams, D’Ann L.; Romero, Karina M.; Malpartida, Gary; Breysse, Patrick N.; Klasen, Elizabeth M.; Combe, Juan M.; Checkley, William; Hansel, Nadia N.

2015-01-01

The influence of traffic-related air pollution on indoor residential exposure is not well characterized in homes with high natural ventilation in low-income countries. Additionally, domestic allergen exposure is unknown in such populations. We conducted a pilot study of 25 homes in peri-urban Lima, Peru to estimate the effects of roadway proximity and season on residential concentrations. Indoor and outdoor concentrations of particulate matter (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) were measured during two seasons, and allergens were measured in bedroom dust. Allergen levels were highest for dust mite and mouse allergens, with concentrations above clinically relevant thresholds in over a quarter and half of all homes, respectively. Mean indoor and outdoor pollutant concentrations were similar (PM2.5: 20.0 vs. 16.9 μg/m3, BC: 7.6 vs. 8.1 μg/m3, NO2: 7.3 vs. 7.5 ppb), and tended to be higher in the summer compared to the winter. Road proximity was significantly correlated with overall concentrations of outdoor PM2.5 (rs = −0.42, p = 0.01) and NO2 (rs = −0.36, p = 0.03), and outdoor BC concentrations in the winter (rs = −0.51, p = 0.03). Our results suggest that outdoor-sourced pollutants significantly influence indoor air quality in peri-urban Peruvian communities, and homes closer to roadways are particularly vulnerable. PMID:26516875

[Prevalence of overweight and obesity in adolescents from an urban district of Lima, Peru 2012].

PubMed

Lozano-Rojas, Gaudi; Cabello-Morales, Emilio; Hernádez-Diaz, Herminio; Loza-Munarriz, Cesar

2014-01-01

To determine the prevalence of overweight and obesity according to the criteria of the WHO and CDC in adolescents from an urban district of Lima, Peru 2012. This cross-sectional study included 1,743 school children of 12 to 17 years of age selected from ten public and private educational institutions, using a randomized and stratified sample of "conglomerados" (neighborhoods). In the selected schools, weight and height were measured. For the diagnosis of overweight and obesity, criteria from the WHO and CDC were used. For data analysis, descriptive and inferential statistics were performed. According to the WHO criteria, the prevalence of overweight was 33.7% (95% CI 31.5-36.0) and obesity was 14.4% (95% CI 12.8-16.1). According to CDC criteria, the prevalence of overweight was 26.5% (95% CI 24.4-28.6) and obesity was 13.9% (95% CI 12.3-15.6). The prevalence of overweight and obesity was significantly higher in males aged 12 and 13 years old and private educational institutions (p<0.05). We found very good agreement between the WHO and CDC criteria for the diagnosis of overweight and obesity. A high prevalence of overweight and obesity was found, predominantly in male students between 12 and 13 years and private educational institutions. It is necessary to initiate intervention measures that can contribute to the prevention of chronic diseases in adulthood, secondary to obesity in adolescence.

Bradyrhizobium paxllaeri sp. nov. and Bradyrhizobium icense sp. nov., nitrogen-fixing rhizobial symbionts of Lima bean (Phaseolus lunatus L.) in Peru.

PubMed

Durán, David; Rey, Luis; Mayo, Juan; Zúñiga-Dávila, Doris; Imperial, Juan; Ruiz-Argüeso, Tomás; Martínez-Romero, Esperanza; Ormeño-Orrillo, Ernesto

2014-06-01

A group of strains isolated from root nodules of Phaseolus lunatus (Lima bean) in Peru were characterized by genotypic, genomic and phenotypic methods. All strains possessed identical 16S rRNA gene sequences that were 99.9% identical to that of Bradyrhizobium lablabi CCBAU 23086(T). Despite having identical 16S rRNA gene sequences, the Phaseolus lunatus strains could be divided into two clades by sequence analysis of recA, atpD, glnII, dnaK and gyrB genes. The genome sequence of a representative of each clade was obtained and compared to the genomes of closely related species of the genus Bradyrhizobium. Average nucleotide identity values below the species circumscription threshold were obtained when comparing the two clades to each other (88.6%) and with all type strains of the genus Bradyrhizobium (≤92.9%). Phenotypes distinguishing both clades from all described and closely related species of the genus Bradyrhizobium were found. On the basis of the results obtained, two novel species, Bradyrhizobium paxllaeri sp. nov. (type strain LMTR 21(T) = DSM 18454(T) = HAMBI 2911(T)) and Bradyrhizobium icense sp. nov. (type strain LMTR 13(T) = HAMBI 3584(T) = CECT 8509(T) = CNPSo 2583(T)), are proposed to accommodate the uncovered clades of Phaseolus lunatus bradyrhizobia. These species share highly related but distinct nifH and nodC symbiosis genes. © 2014 IUMS.

[Fighting cholera in shanty-town. Successful experience of a Quebec project adapted to Peru].

PubMed

Fréchette, L; Peralta, M

1994-12-01

Originally designed in Quebec, the MOI project was a collaboration between two professors of social work from Quebec and two members of the Peruvian NGO called SUR in Villa de Salvador, one of poorest slum areas on the outskirts of Lima. The approach is founded on the notion that the body is the primary instrument through which a person can interact with the world around him or her, and that the physical and mental health of an individual exists within the context of healthy conditions of life that must include at least a basic social and health infrastructure as well as healthy hygiene practices on the part of individuals, families and the local community. Preschool children (ages 4-6), study a different part of the body and its proper care each week through classroom observation games. Parents' help is requested to modify unhealthy conditions, at the same time to enrich the children's experience and to mobilize the community to improve health conditions. During the 1991 cholera epidemic, not a single case was counted in the experimental district, despite its clearly socio-economically impoverished status, and despite the fact that the Ministry of Health recorded 86,650 cases in the Lima-Callao district, accounting for about 40% of the total number of cases in the Peru. The prior work made it easier to explain how cholera is spread and what special new measures needed to be taken in addition to the hygiene habits already taught.(ABSTRACT TRUNCATED AT 250 WORDS)

A cross-sectional study of low HIV testing frequency and high-risk behaviour among men who have sex with men and transgender women in Lima, Peru.

PubMed

Lee, Sky W; Deiss, Robert G; Segura, Eddy R; Clark, Jesse L; Lake, Jordan E; Konda, Kelika A; Coates, Thomas J; Caceres, Carlos F

2015-04-21

Increased HIV testing frequency among high-risk populations such as men who have sex with men (MSM) and male-to-female transgender women (TW) can lead to earlier treatment and potentially reduce HIV transmission. We analyzed baseline survey data from 718 high-risk, young (median age 29 [interquartile range 23-35]) MSM/TW enrolled in a community-based HIV prevention trial between 2008-2009. Participants were recruited from 24 neighborhoods in and around Lima, Peru. We assessed HIV testing frequency, testing behaviour, and motivations and barriers to testing. Multivariate analysis identified correlates to prior HIV testing. Overall, 79.6% reported HIV testing within their lifetimes, however, only 6.2% reported an average of two tests per year, as per Peruvian Ministry of Health guidelines. The most commonly reported motivators for testing were to check one's health (23.3%), lack of condom use (19.7%), and availability of free testing (14.0%), while low self-perceived risk for HIV (46.9%), fear of a positive result (42.0%), and lack of access to testing services (35.7%) were the most frequently reported barriers. In multivariate analysis, factors independently associated with HIV testing included age [adjusted prevalence ratio (APR) 1.00, 95% CI (1.00-1.01)], transgender-identification vs. gay-identification [APR 1.11, 95% CI (1.03-1.20)], history of transactional sex [APR 1.16, 95% CI (1.07-1.27)], and prior sexually transmitted infection diagnosis [APR 1.15, 95% CI (1.07-1.24)]. An overwhelming majority of participants did not meet the standard-of-care for testing frequency. The reported motivations and barriers to testing highlight issues of risk perception and accessibility. Our findings suggest utilizing non-traditional outreach methods and promoting HIV testing as a routine part of healthcare in Peru to encourage testing and knowledge of HIV serostatus.

Event-level analysis of alcohol consumption and condom use in partnership contexts among men who have sex with men and transgender women in Lima, Peru.

PubMed

Delgado, Jeanne R; Segura, Eddy R; Lake, Jordan E; Sanchez, Jorge; Lama, Javier R; Clark, Jesse L

2017-01-01

We explored the association between alcohol use and condomless receptive (CRAI) and insertive (CIAI) anal intercourse within partnership contexts of men who have sex with men (MSM) and transgender women (TGW) in Lima, Peru. From 2012-2014, we surveyed men and TGW (n=1607) who reported anal intercourse with ≥1 male or TGW. Alcohol use with up to 3 sexual partners during the prior 90days was evaluated. Bivariate and multivariate analyses used generalized estimating equations to assess event-level associations between alcohol use, CRAI, CIAI, and partnership characteristics while adjusting for participant clustering from multiple partners. Of 4774 sexual partnerships reported, 48% were casual, 34% primary, 10% anonymous, and 8% commercial. Alcohol use preceding sex was significantly (p<0.05) associated with CRAI (PR=1.26) and CIAI (PR=1.37). Partnership characteristics significantly associated with alcohol use included commercial sex work (PR=2.21) and trended (p<0.10) towards alcohol use with casual (PR=1.16), transgender (PR=1.48), and moderno ("versatile"; PR=1.17) partners. CRAI and CIAI were more common among participants who reported knowing they (PR=1.52; PR=1.41, respectively) or their partner (PR=1.47; PR=1.44, respectively) was HIV-uninfected. Yet, only CIAI (PR=1.42) was more commonly reported with known HIV-infected partners. Participants who drank alcohol prior to sex were less likely to know their partner's HIV serostatus. Alcohol use prior to intercourse was associated with CRAI and CIAI, varied by partnership type, and may impair knowledge of partner HIV serostatus. Detailed knowledge of alcohol use within partner-specific contexts is essential for informing condom-based and alternative HIV prevention strategies for MSM and TGW in Peru. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Determinants of burnout in acute and critical care military nursing personnel: a cross-sectional study from Peru.

PubMed

Ayala, Elizabeth; Carnero, Andrés M

2013-01-01

Evidence on the prevalence and determinants of burnout among military acute and critical care nursing personnel from developing countries is minimal, precluding the development of effective preventive measures for this high-risk occupational group. In this context, we aimed to examine the association between the dimensions of burnout and selected socio-demographic and occupational factors in military acute/critical care nursing personnel from Lima, Peru. We conducted a cross-sectional study in 93 nurses/nurse assistants from the acute and critical care departments of a large, national reference, military hospital in Lima, Peru, using a socio-demographic/occupational questionnaire and a validated Spanish translation of the Maslach Burnout Inventory. Total scores for each of the burnout dimensions were calculated for each participant. Higher emotional exhaustion and depersonalisation scores, and lower personal achievement scores, implied a higher degree of burnout. We used linear regression to evaluate the association between each of the burnout dimensions and selected socio-demographic and occupational characteristics, after adjusting for potential confounders. The associations of the burnout dimensions were heterogeneous for the different socio-demographic and occupational factors. Higher emotional exhaustion scores were independently associated with having children (p<0.05) and inversely associated with the time working in the current department (p<0.05). Higher depersonalization scores were independently associated with being single compared with being divorced, separated or widowed (p<0.01), working in the emergency room/intensive care unit compared with the recovery room (p<0.01), and inversely associated with age (p<0.05). Finally, higher personal achievement scores were independently associated with having children (p<0.05). Among Peruvian military acute and critical care nursing personnel, potential screening and preventive interventions should focus on younger/less experienced nurses/nurse assistants, who are single, have children, or work in the most acute critical care areas (e.g. the emergency room/intensive care unit).

Feasibility of Chlamydia trachomatis screening and treatment in pregnant women in Lima, Peru: a prospective study in two large urban hospitals.

PubMed

Cabeza, Jeanne; García, Patricia J; Segura, Eddy; García, Pedro; Escudero, Francisco; La Rosa, Sayda; León, Segundo; Klausner, Jeffrey D

2015-02-01

Chlamydia trachomatis, which is asymptomatic in most women, causes significant adverse effects for pregnant women and neonates. No programmes conduct antenatal screening in Latin America. We determined chlamydia prevalence, feasibility and acceptability of chlamydia screening, and adherence to treatment in pregnant women in two urban public hospitals in Lima, Peru. We offered chlamydia screening using self-collected vaginal swabs to pregnant women ≥ 16 years of age during their first antenatal visit. Chlamydia-infected women were contacted within 14 days and asked to bring partners for counselling and directly observed therapy with oral azithromycin. Unaccompanied women received counselling, directly observed therapy, and azithromycin to take to partners. Test of cure was performed ≥ 3 weeks after treatment. We approached 640 women for the study and enrolled 600 (93.8%). Median age was 27.3 years (range 16-47), median lifetime partners 2.3 (range 1-50), and median gestational age 26.1 weeks (range 4-41). Chlamydia prevalence was 10% (95% CI 7.7% to 12.7%). Of 60 infected patients, 59 (98%) were treated with one dose of azithromycin. Fifty-two of 59 (88%) returned for test of cure, all of whom were treated successfully, with 46 (86%) achieving negative test of cure with one dose of azithromycin, and 6 (12%) after retreatment with a second dose. C. trachomatis screening and treatment in pregnancy was feasible and highly acceptable in two urban hospitals in Peru. Chlamydia prevalence was high. Clinical trials to evaluate efficacy and cost-effectiveness of chlamydia screening, and treatment of pregnant women to prevent adverse pregnancy outcomes in low-resource settings, are warranted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Population genetic analysis of Enterocytozoon bieneusi in humans.

PubMed

Li, Wei; Cama, Vitaliano; Feng, Yaoyu; Gilman, Robert H; Bern, Caryn; Zhang, Xichen; Xiao, Lihua

2012-01-01

Genotyping based on sequence analysis of the ribosomal internal transcribed spacer has revealed significant genetic diversity in Enterocytozoonbieneusi. Thus far, the population genetics of E. bieneusi and its significance in the epidemiology of microsporidiosis have not been examined. In this study, a multilocus sequence typing of E. bieneusi in AIDS patients in Lima, Peru was conducted, using 72 specimens previously genotyped as A, D, IV, EbpC, WL11, Peru7, Peru8, Peru10 and Peru11 at the internal transcribed spacer locus. Altogether, 39 multilocus genotypes were identified among the 72 specimens. The observation of strong intragenic linkage disequilibria and limited genetic recombination among markers were indicative of an overall clonal population structure of E. bieneusi. Measures of pair-wise intergenic linkage disequilibria and a standardised index of association (IAS) based on allelic profile data further supported this conclusion. Both sequence-based and allelic profile-based phylogenetic analyses showed the presence of two genetically isolated groups in the study population, one (group 1) containing isolates of the anthroponotic internal transcribed spacer genotype A, and the other (group 2) containing isolates of multiple internal transcribed spacer genotypes (mainly genotypes D and IV) with zoonotic potential. The measurement of linkage disequilibria and recombination indicated group 2 had a clonal population structure, whereas group 1 had an epidemic population structure. The formation of the two sub-populations was confirmed by STRUCTURE and Wright's fixation index (FST) analyses. The data highlight the power of MLST in understanding the epidemiology of E. bieneusi. Published by Elsevier Ltd.

Word play, ritual insult, and volleyball in Peru.

PubMed

Perez, Justin

2011-01-01

Many gay men in the popular sectors of Lima, Peru participate in vóley callejero, or street volleyball. The ethnographic data presented in this article describes verbal and corporal mechanisms through which gay identity emerges within the particular context of the street volleyball game, ultimately highlighting the contextual nature of identity. The volleyball players are not just hitting a ball back and forth, they are engaging in a meaningful activity that illuminates intersections of language, sexuality, and identity. Through the manipulation of the street into a volleyball court, the volleyball players create a space conducive to the articulation of particular verbal and embodied practices that index gay identity. The challenge to the regulations of "proper" volleyball through the practice of ritual insulting and the cultivation of gay volleyball technique are playful reconfigurations of gendered practices prominent in the sites where fieldwork was carried out.

Implementation and Evaluation of an HIV/STD Intervention in Peru

PubMed Central

Andre, Maiorana; Susan, Kegeles; Percy, Fernandez; Ximena, Salazar; Carlos, Cáceres; Clara, Sandoval; Ana María, Rosasco; Thomas, Coates

2009-01-01

This paper presents the lessons learned through a process evaluation (PE) after one year of implementation of a two-year community intervention in Lima, Peru. The intervention consisted of training and motivating community popular opinion leaders (CPOLs) for three marginal population segments to disseminate prevention messages among their peers. PE data included: observations, qualitative interviews with CPOLS, conversations and messages delivered by CPOLs, training facilitators' perceptions about implementation, and a survey of CPOLs. The PE helped to document and enhance the intervention. CPOLs were motivated to talk to their peers. CPOLs perceived that their participation had an effect on their own risk behaviors and saw their role as beneficial to their community. The PE was helpful in examining training delivery and the feasibility and acceptability of the intervention in order to assess the elements related to program success necessary to replicate the CPOL model. PMID:17689315

War and Peace in the Amazon: Strategic Implications for the United States and Latin America of the 1995 Ecuador-Peru War.

DTIC Science & Technology

1995-11-24

Agreement and Security," El Comercio (Lima), March 22, 1995, p. A2, as reported in FBIS-LA, April 3, 1995. 19. "Amnesty Law Criticized, Creation of Truth...of National Security and Strategy November 24, 1995 ******* An earlier version of this paper, to be published in the fall 1995 edition of SER en el ...had adjudicated the demarcation of the boundary between Honduras and El Salvador. Because of these considerations, the war in the Amazon headwaters

Facial porokeratosis: A series of six patients.

PubMed

Gutierrez, Ericson L; Galarza, Carlos; Ramos, Willy; Tello, Mercedes; De Paz, Patricia Chávez; Bobbio, Lucia; Barquinero, Alicia; Ronceros, Gerardo; Ortega-Loayza, Alex G

2010-08-01

Porokeratosis is a disorder of epidermal keratinization characterized by annular plaques with an atrophic centre and hyperkeratotic edges, and includes a heterogeneous group of disorders that are mostly inherited in an autosomal dominant fashion. Facial porokeratosis is rare and is not well documented. We present six cases of facial porokeratosis seen over a period of 15 years in a hospital in Lima, Peru. In most of the cases, porokeratosis was found in younger women without any significant past medical history. Oral isotretinoin showed moderate improvement in two of our patients.

The seed of abundance and misery Peruvian living standards from the early republican period to the end of the guano era (1820-1880).

PubMed

Twrdek, Linda; Manzel, Kerstin

2010-07-01

This paper examines 19th-century Peruvian heights from the early republican period to the end of the guano era (1820-1880). Analyzing male and female prisoner heights from the Lima penitentiary, we find that the physical stature of the lower classes stagnated throughout the period. In spite of the substantial profits generated by Peru's chief export product, guano, these revenues apparently did not filter down to benefit ordinary laborers. 2010 Elsevier B.V. All rights reserved.

Increasing Naval Security Cooperation between the U.S., Chile and Peru

DTIC Science & Technology

2009-03-01

del Mar: La Marina de Guerra en la historia del Perú (Lima: Marina de Guerra del Perú, 1994), 184. 108 Ibid., 188. 109 Ibid., 191-193. 42 “the...La Marina de Guerra en la historia del Perú, 205. 111 Ibid. 112 Ibid., 210. 113 Ibid., 229. 114 Ibid., 230. 115 Ibid., 246. 43 contributed to...la Puente Brunke, Los Hombres del Mar: La Marina de Guerra en la historia del Perú, 252. 117 Ibid., 264. 118 Ibid., 302. 119 Ibid., 342. 44

After the fall from grace: Negotiation of new identities among HIV-positive women in Peru

PubMed Central

Valencia-Garcia, Dellanira; Starks, Helene; Strick, Lara; Simoni, Jane M.

2008-01-01

Despite increasing rates of HIV infection among heterosexual women in Peru, married women remain virtually invisible as a group at risk of HIV or requiring treatment. This study analyzed the intersections of HIV with machismo and marianismo, the dominant discourses in Latin America that prescribe gender roles for men and women. Data sources include recent literature on machismo and marianismo and interviews conducted with 14 HIV-positive women in Lima, Peru. Findings indicate how the stigma associated with HIV constructs a discourse that restricts the identities of HIV-positive women to those of ‘fallen women’ whether or not they adhere to social codes that shape and inform their identities as faithful wives and devoted mothers. Lack of public discourse concerning HIV-positive marianas silences women as wives and disenfranchises them as mothers, leaving them little room to negotiate identities that allow them to maintain their respected social positions. Efforts must be aimed at expanding the discourse of acceptable gender roles and behaviour for both men and women within the context of machismo and marianismo so that there can be better recognition of all persons at risk of, and living with, HIV infection. PMID:18821355

[Barriers to implementing screening, brief intervention and referral to treatment for substance use in HIV/AIDS health services in Peru].

PubMed

Hoffman, Kim A; Beltrán, Jessica; Ponce, Javier; García-Fernandez, Lisset; Calderón, María; Muench, John; Benites, Carlos; Soto, Leslie; McCarty, Dennis; Fiestas, Fabián

2016-01-01

Screening and treatment for substance use among people living with HIV/AIDS (PLWHA) is highly recommended. Nevertheless, in Peru healthcare for PLWHA does not include a standardized or systematic assessment to identify substance use. The aim of this study was to assess the feasibility of implementing screening, brief intervention and referral to treatment (SBIRT) in healthcare settings attending people living with PLWHA. After providing training in SBIRT for PLWHA's healthcare personnel (including nurses and physicians) focus groups were conducted to explore knowledge, beliefs and perceived barriers to implementation and interviews were conducted to assess the barriers and facilitators of two tertiary hospitals in Lima, Peru. focus groups and interviews' thematic coding revealed three dimensions: 1) the unknown extent of substance use within PLWHA, 2) space and time limitations hinder completion of brief interventions during routine visits, and 3) insufficient access to substance use treatment appropriate for HIV patients. Multiple barriers, including lack of awareness of substance use problems, limited space and time of providers, and lack of specialized services to refer patients for treatment make it difficult to implement SBIRT in the Peruvian healthcare system.

[Access to oral health services in children under twelve years of age in Peru, 2014].

PubMed

Hernández-Vásquez, Akram; Azañedo, Diego; Díaz-Seijas, Deysi; Bendezú-Quispe, Guido; Arroyo-Hernández, Hugo; Vilcarromero, Stalin; Agudelo-Suárez, Andrés A

2016-01-01

The aim of the study was to explore the patterns of dental health services access in children under twelve years of age in Peru. Data from 25,285 children under 12 years who participated in the Demographic and Family Health Survey of 2014 were reviewed. An exploratory spatial analysis was performed to project the proportions of children with access to dental health services, according to national regions, type of health service and urban or rural place of residence. The results show that of the total sample, 26.7% had access to dental health services in the last six months, 39.6% belonged to the age group 0-4 years, 40.6% lived in the Andean region and 58.3% lived in urban areas. The regions of Huancavelica, Apurimac, Ayacucho, Lima and Pasco had the highest percentages of access nationwide. In conclusion, there is low access to dental health services in the population under 12 years of age in Peru. The spatial distribution of access to dental health services allows regions to be identified and grouped according to similar access patterns, in order to better focus public health actions.

A comparison of the performance of male and female CBD distributors in Peru.

PubMed

Foreit, J R; Garate, M R; Brazzoduro, A; Guillen, F; Herrera, M C; Suarez, F C

1992-01-01

This report presents the results of an operations research project to increase male involvement in family planning in Peru. Two community-based distribution (CBD) programs, PROFAMILIA of Lima and CENPROF of Trujillo, Peru, recruited male contraceptive distributors and compared their performance to that of female distributors recruited at the same time. Both programs found it harder to recruit men than women as distributors. Program supervisors, who were women, were less comfortable with men than with other women, even though there were no differences in distributor compliance with program norms. Male distributors were more likely to serve male clients and sell male methods (condoms), while female distributors were more likely to serve female clients and sell female methods (pills). Men sold as much or more total couple-years of protection than did women, and they recruited as many or more new acceptors. Gender was found to exert an impact on method mix independent of other distributor characteristics, such as age, education, marital status, and number of living children. The study suggests that family planning programs can influence method mix and client characteristics by recruiting men as CBD distributors.

[Practices, knowledge and attitudes about human hydatidosis in Peru].

PubMed

Moro, Pedro L; Cavero, Carlos A; Tambini, Moisés; Briceño, Yuri; Jiménez, Rosario; Cabrera, Lilia

2008-01-01

Between July 2005 and June 2006, a case-control study was carried out to identify risk factors for hydatidosis in Lima, Peru. As a result, 32 cases were matched according to age, sex and birthplace in 64 controls. The participants were interviewed using a questionnaire designed to evaluate environmental and behavior factors associated to hydatidosis. By using Multiple Conditional Logistic Regression, it was determined that the owners of >or=10 dogs in a rural area (aOR=8.7; 95% Cl=1.3-57.5) and those raising sheep (aOR=5.9; 95% Cl=1.2-28.1) were independently related to a higher risk of hydatidosis. The belief that food may transmit hydatidosis (aOR=0.1; 95% Cl=0.01-0.7) and the activity of raising goats (aOR=0.02; 95% Cl=0.001-0.6) were inversely associated to hydatidosis. Preventive measures to reduce the transmission of hydatidosis to human beings in endemic areas in Peru require: limiting the number of dogs kept in each household, regularly controlling parasites and preventing access of dogs to human food and drinking water; all of this in addition to educational campaigns to change the practices that lead to the transmission of hydatidosis.

After the fall from grace: negotiation of new identities among HIV-positive women in Peru.

PubMed

Valencia-Garcia, Dellanira; Starks, Helene; Strick, Lara; Simoni, Jane M

2008-10-01

Despite increasing rates of HIV infection among heterosexual women in Peru, married women remain virtually invisible as a group at risk of HIV or requiring treatment. This study analyzed the intersections of HIV with machismo and marianismo, the dominant discourses in Latin America that prescribe gender roles for men and women. Data sources include recent literature on machismo and marianismo and interviews conducted with 14 HIV-positive women in Lima, Peru. Findings indicate how the stigma associated with HIV constructs a discourse that restricts the identities of HIV-positive women to those of 'fallen women' whether or not they adhere to social codes that shape and inform their identities as faithful wives and devoted mothers. Lack of public discourse concerning HIV-positive marianas silences women as wives and disenfranchises them as mothers, leaving them little room to negotiate identities that allow them to maintain their respected social positions. Efforts must be aimed at expanding the discourse of acceptable gender roles and behaviour for both men and women within the context of machismo and marianismo so that there can be better recognition of all persons at risk of, and living with, HIV infection.

Pedestrian signalization and the risk of pedestrian-motor vehicle collisions in Lima, Peru

PubMed Central

Quistberg, D. Alex; Koepsell, Thomas D.; Boyle, Linda Ng; Miranda, J. Jaime; Johnston, Brian D.; Ebel, Beth E.

2014-01-01

Safe walking environments are essential for protecting pedestrians and promoting physical activity. In Peru, pedestrians comprise of over three-quarters of road fatality victims. Pedestrian signalization plays an important role managing pedestrian and vehicle traffic and may help improve pedestrian safety. We examined the relationship between pedestrian-motor vehicle collisions and the presence of visible traffic signals, pedestrian signals, and signal timing to determine whether these countermeasures improved pedestrian safety. A matched case-control design was used where the units of study were crossing locations. We randomly sampled 97 control-matched collisions (weighted N=1134) at intersections occurring from October, 2010 to January, 2011 in Lima. Each case-control pair was matched on proximity, street classification, and number of lanes. Sites were visited between February, 2011 and September, 2011. Each analysis accounted for sampling weight and matching and was adjusted for vehicle and pedestrian traffic flow, crossing width, and mean vehicle speed. Collisions were more common where a phased pedestrian signal (green or red-lit signal) was present compared to no signalization (odds ratio [OR] 8.88, 95% Confidence Interval [CI] 1.32–59.6). A longer pedestrian-specific signal duration was associated with collision risk (OR 5.31, 95% CI 1.02–9.60 per 15-second interval). Collisions occurred more commonly in the presence of any signalization visible to pedestrians or pedestrian-specific signalization, though these associations were not statistically significant. Signalization efforts were not associated with lower risk for pedestrians; rather, they were associated with an increased risk of pedestrian-vehicle collisions. PMID:24821630

Physical performance and muscle strength in older patients with and without diabetes from a public hospital in Lima, Peru.

PubMed

Palacios-Chávez, Milenka; Dejo-Seminario, Christine; Mayta-Tristán, Percy

2016-05-01

To assess the relationship between physical performance (PP) and muscle strength (MS) in elderly subjects with and without diabetes in a public hospital of Lima, Peru. A cross-sectional analysis of subjects aged 60 years or older with and without diabetes. MS was measured with a handheld dynamometer, and PP with the «timed get-up-and-go» test. Nutritional status was determined using body mass index, body fat percentage measured with a handheld fat loss monitor and protein intake based on the 24-hour recall. Age, sex, and history of hospitalization and supplementation were also recorded. The association was assessed using adjusted prevalence ratios. Overall, 139 patients with diabetes (26.6% with low PP and 13.7% with decreased MS) and 382 subjects without diabetes (36.6% with low PP and 23.0% with decreased MS) were evaluated. No association was found between T2DM and MS (aPR: 0.99; 95% CI: 0.67-1.57) or PP (aPR: 1.13; 95% CI: 0.84-1.52). Protein and supplement consumption was also unrelated (P>.05); however, history of hospitalization, age, sex, nutritional status, and body fat percentage were related (P>.05). No association was found between T2DM, MS, and PP. However, low PP was associated to female sex and overweight/obesity, and decreased MS was associated to high body fat percentage and underweight. Moreover, MS and PP were related to older age and history of hospitalization. Copyright © 2016 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Assessing the Short-Term Global Health Experience: A Cross-Sectional Study of Demographics, Socioeconomic Factors, and Disease Prevalence.

PubMed

Geen, Olivia; Pumputis, Allison; Kochi, Cristina; Costa, Andrew; Stobbe, Karl

2017-08-01

Interest in short-term global health experiences to underserviced populations has grown rapidly in the last few decades. However, there remains very little research on what participants can expect to encounter. At the same time, it has been suggested that in order for physicians and workers to provide safe and effective care, volunteers should have a basic understanding of local culture, health systems, epidemiology, and socioeconomic needs of the community before arriving. Our objective was to add to the limited literature on what short-term global health trips can expect to encounter through a cross-sectional study of patient demographics, socioeconomic markers, and the prevalence of diseases encountered on a short-term medical service trip to Lima, Peru. Descriptive analysis was conducted on clinic data collected from patients living in Pamplona Alta and Pamplona Baja, Lima, Peru, in July 2015. We found that volunteers encountered mainly female patients (70.8%), and that there were significant socioeconomic barriers to care including poverty, poor housing, environmental exposures, and lack of continuity of health care. Analysis of the disease prevalence found a high proportion of acute and chronic musculoskeletal pain in the adult populations (18.8% and 11.4%, respectively), and a high presentation of upper respiratory tract infections (25.4%) and parasites (22.0%) in the pediatric group. These findings can be used by future short-term medical service trips to address potential gaps in care including the organization of weekend clinics to allow access to working men, and the use of patient education and nonpharmacological management of acute and chronic disease.

Pedestrian signalization and the risk of pedestrian-motor vehicle collisions in Lima, Peru.

PubMed

Quistberg, D Alex; Koepsell, Thomas D; Boyle, Linda Ng; Miranda, J Jaime; Johnston, Brian D; Ebel, Beth E

2014-09-01

Safe walking environments are essential for protecting pedestrians and promoting physical activity. In Peru, pedestrians comprise over three-quarters of road fatality victims. Pedestrian signalization plays an important role managing pedestrian and vehicle traffic and may help improve pedestrian safety. We examined the relationship between pedestrian-motor vehicle collisions and the presence of visible traffic signals, pedestrian signals, and signal timing to determine whether these countermeasures improved pedestrian safety. A matched case-control design was used where the units of study were crossing locations. We randomly sampled 97 control-matched collisions (weighted N=1134) at intersections occurring from October, 2010 to January, 2011 in Lima. Each case-control pair was matched on proximity, street classification, and number of lanes. Sites were visited between February, 2011 and September, 2011. Each analysis accounted for sampling weight and matching and was adjusted for vehicle and pedestrian traffic flow, crossing width, and mean vehicle speed. Collisions were more common where a phased pedestrian signal (green or red-light signal) was present compared to no signalization (odds ratio [OR] 8.88, 95% Confidence Interval [CI] 1.32-59.6). A longer pedestrian-specific signal duration was associated with collision risk (OR 5.31, 95% CI 1.02-9.60 per 15-s interval). Collisions occurred more commonly in the presence of any signalization visible to pedestrians or pedestrian-specific signalization, though these associations were not statistically significant. Signalization efforts were not associated with lower risk for pedestrians; rather, they were associated with an increased risk of pedestrian-vehicle collisions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Association of migraine headaches with suicidal ideation among pregnant women in Lima, Peru

PubMed Central

Friedman, Lauren E.; Gelaye, Bizu; Rondon, Marta B.; Sánchez, Sixto E.; Peterlin, B. Lee; Williams, Michelle A.

2016-01-01

Background Suicide is a leading cause of maternal death globally, and suicide prevalence rates have been shown to be increased in those with migraine. No previous study has examined the association between migraine and suicidal ideation during pregnancy. Objective To examine the association between migraine and suicidal ideation among a cohort of pregnant women. Methods A cross-sectional study was conducted among 3,372 pregnant women attending prenatal care clinics in Lima, Peru. Suicidal ideation and depression were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale during early pregnancy. Migraine classification (including migraine and probable migraine) was based on International Classification of Headache Disorders (ICHD)-III beta criteria. Multivariable logistic regression analyses were performed to estimate odd ratios (OR) and 95% confidence intervals (95%CI). Results Suicidal ideation was more common among those with migraine (25.6%) as compared to those with probable migraine (22.1%, p<0.001) or non-migraineurs (12.3%, p<0.001). After adjusting for confounders, including depression, those with migraine or probable migraine had a 78% increased odds of suicidal ideation (OR=1.78; 95%CI: 1.46–2.17), as compared with non-migraineurs. Women with both migraine and depression had a 4.14-fold increased odds of suicidal ideation (OR=4.14; 95%CI: 3.17–5.42) compared to those with neither condition. Conclusion Migraine is associated with increased odds of suicidal ideation in pregnant women even when controlling for depression. These findings support the consideration of screening women with comorbid migraine and depression for suicidal behavior during pregnancy. PMID:27016264

Association of Migraine Headaches With Suicidal Ideation Among Pregnant Women in Lima, Peru.

PubMed

Friedman, Lauren E; Gelaye, Bizu; Rondon, Marta B; Sanchez, Sixto E; Peterlin, B Lee; Williams, Michelle A

2016-04-01

Suicide is a leading cause of maternal death globally, and suicide prevalence rates have been shown to be increased in those with migraine. No previous study has examined the association between migraine and suicidal ideation during pregnancy. To examine the association between migraine and suicidal ideation among a cohort of pregnant women. A cross-sectional study was conducted among 3372 pregnant women attending prenatal care clinics in Lima, Peru. Suicidal ideation and depression were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale during early pregnancy. Migraine classification (including migraine and probable migraine) was based on International Classification of Headache Disorders-III beta criteria. Multivariable logistic regression analyses were performed to estimate odds ratios (OR) and 95% confidence intervals (95% CI). Suicidal ideation was more common among those with migraine (25.6%) as compared to those with probable migraine (22.1%, P < .001) or non-migraineurs (12.3%, P < .001). After adjusting for confounders, including depression, those with migraine or probable migraine had a 78% increased odds of suicidal ideation (OR = 1.78; 95% CI: 1.46-2.17), as compared with non-migraineurs. Women with both migraine and depression had a 4.14-fold increased odds of suicidal ideation (OR = 4.14; 95% CI: 3.17-5.42) compared to those with neither condition. Migraine is associated with increased odds of suicidal ideation in pregnant women even when controlling for depression. These findings support the consideration of screening women with comorbid migraine and depression for suicidal behavior during pregnancy. © 2016 American Headache Society.

Length of urban residence and obesity among within-country rural-to-urban Andean migrants.

PubMed

Antiporta, Daniel A; Smeeth, Liam; Gilman, Robert H; Miranda, J Jaime

2016-05-01

To evaluate the association between length of residence in an urban area and obesity among Peruvian rural-to-urban migrants. Cross-sectional database analysis of the migrant group from the PERU MIGRANT Study (2007). Exposure was length of urban residence, analysed as both a continuous (10-year units) and a categorical variable. Four skinfold site measurements (biceps, triceps, subscapular and suprailiac) were used to calculate body fat percentage and obesity (body fat percentage >25% males, >33% females). We used Poisson generalized linear models to estimate adjusted prevalence ratios and 95 % confidence intervals. Multicollinearity between age and length of urban residence was assessed using conditional numbers and correlation tests. A peri-urban shantytown in the south of Lima, Peru. Rural-to-urban migrants (n 526) living in Lima. Multivariable analyses showed that for each 10-year unit increase in residence in an urban area, rural-to-urban migrants had, on average, a 12 % (95 % CI 6, 18 %) higher prevalence of obesity. This association was also present when length of urban residence was analysed in categories. Sensitivity analyses, conducted with non-migrant groups, showed no evidence of an association between 10-year age units and obesity in rural (P=0·159) or urban populations (P=0·078). High correlation and a large conditional number between age and length of urban residence were found, suggesting a strong collinearity between both variables. Longer lengths of urban residence are related to increased obesity in rural-to-urban migrant populations; therefore, interventions to prevent obesity in urban areas may benefit from targeting migrant groups.

Prevalence of and Factors Associated with Negative Microscopic Diagnosis of Cutaneous Leishmaniasis in Rural Peru.

PubMed

Lamm, Ryan; Alves, Clark; Perrotta, Grace; Murphy, Meagan; Messina, Catherine; Sanchez, Juan F; Perez, Erika; Rosales, Luis Angel; Lescano, Andres G; Smith, Edward; Valdivia, Hugo; Fuhrer, Jack; Ballard, Sarah-Blythe

2018-06-04

Cutaneous leishmaniasis is endemic to South America where diagnosis is most commonly conducted via microscopy. Patients with suspected leishmaniasis were referred for enrollment by the Ministry of Health (MoH) in Lima, Iquitos, Puerto Maldonado, and several rural areas of Peru. A 43-question survey requesting age, gender, occupation, characterization of the lesion(s), history of leishmaniasis, and insect-deterrent behaviors was administered. Polymerase chain reaction (PCR) was conducted on lesion materials at the Naval Medical Research Unit No. 6 in Lima, and the results were compared with those obtained by the MoH using microscopy. Factors associated with negative microscopy and positive PCR results were identified using χ 2 test, t -test, and multivariate logistic regression analyses. Negative microscopy with positive PCR occurred in 31% (123/403) of the 403 cases. After adjusting for confounders, binary multivariate logistic regression analyses revealed that negative microscopy with positive PCR was associated with patients who were male (adjusted OR = 1.93 [1.06-3.53], P = 0.032), had previous leishmaniasis (adjusted OR = 2.93 [1.65-5.22], P < 0.0001), had larger lesions (adjusted OR = 1.02 [1.003-1.03], P = 0.016), and/or had a longer duration between lesion appearance and PCR testing (adjusted OR = 1.12 [1.02-1.22], P = 0.017). Future research should focus on further exploration of these underlying variables, discovery of other factors that may be associated with negative microscopy diagnosis, and the development and implementation of improved testing in endemic regions.

[Prevalence of cardiovascular and metabolic risk factors in school students, university students, and women from community-based organizations in the districts of Lima, Callao, la Libertad and Arequipa, Peru 2011].

PubMed

Núñez-Robles, Eloísa; Huapaya-Pizarro, Cleopatra; Torres-Lao, Rogger; Esquivel-León, Silvia; Suarez-Moreno, Víctor; Yasuda-Espinoza, Myriam; Sanjinés-López, Giovanna

2014-01-01

To determine the prevalence of arterial hypertension, and cardiovascular and metabolic risk factors in school students, college students and women from community-based organizations (CBO) in four districts in Peru. Cross-sectional study conducted in 2011 in the districts of Lima, Callao, La Libertad and Arequipa with school students, university students and women from CBOs. A survey, anthropometric measurements, blood pressure measurements and fasting blood sampling were conducted to determine glucose and lipid levels. Thus, prevalence of overweight, hypertension, hypercholesterolemia, suspected diabetes, and other variables, were calculated. The main outcome variable was prevalence of overweight. 1,127 people were included: 283 (25.1%) school students, 431 (38.3%) university students, and 413 women (36.6%) from CBOs. Non-response rates were 3%, 0% and 8%, respectively. The average ages in the three groups were 14.3 ± 0.9; 19.6 ± 2.8; and 46.1 ± 15.3 years, respectively. Prevalence of overweight/obesity (BMI ≥ 25) was 11.3%, 20.9%, and 73.4%; hypertension was 0.7%; 1.2%, and 12.8%; high cholesterol (≥ 200 mg/dL) was 5.2%, 11.5%, and 50.1%; and suspected diabetes was 1.4%; 1.0%, and 20.3% respectively in each group of school students, university students and women from CBOs. The prevalence of cardiovascular and metabolic risk factors generally increased in older age groups. In school and university aged groups, the most frequent problems were overweight and obesity, particularly abdominal obesity.

[Prevalence and associated factors with depressive symptoms in Health Sciences students from a private university in Lima, Peru 2010].

PubMed

Pereyra-Elías, Reneé; Ocampo-Mascaró, Javier; Silva-Salazar, Vera; Vélez-Segovia, Eduardo; Costa-Bullón, A Daniel da; Toro-Polo, Luis Miguel; Vicuña-Ortega, Joanna

2010-01-01

Depressive symptoms in health sciences students are common, these might be potentially detrimental. To determine the prevalence of depressive symptoms and its associated factors in students from the Health Sciences Faculty of the Universidad Peruana de Ciencias Aplicadas in Lima (Peru), June 2010. Cross-sectional analytic study; a pre-consented survey was applied to the population 590/869 students. Zung's abbreviated scale was used to measure depressive symptoms. To evaluate de associated factors, logistic regression was used, p<0.05 was considered statistically significant. The mean age was 18.97 ± 2.45 years and 71.1% were women, 19.6% were migrants and 62.5% were medical students. The prevalence of depressive symptoms was 31.2% in the whole population and in medical students was 33.6%. Depressive symptoms were not associated in bivariate analysis with sex, career, having failed a course, living alone or being a migrant (p>0.05). In the multivariate analysis, significant statistical association was found between depressive symptoms and dissatisfaction with the own academic performance (OR=2.13 CI95%1.47-3.08), dissatisfaction with the current economic status (OR=1.93 CI95%1.24-2.99) and living with a relative external to the nuclear family (OR=1.62 CI95%1.07-2.45). A high prevalence of depressive symptoms was found, especially in medical students; being dissatisfaction with academic performance, economic status and living with a relative external to the nuclear family associated factors that could be taken into account in order to build preventive programs.

Socioeconomic and Behavioral Factors Associated with Tuberculosis Diagnostic Delay in Lima, Peru.

PubMed

Bonadonna, Lily V; Saunders, Matthew J; Guio, Heinner; Zegarra, Roberto; Evans, Carlton A

2018-06-01

Early detection and diagnosis of tuberculosis (TB) is a global priority. Prolonged symptom duration before TB diagnosis is associated with increased morbidity, mortality, and risk of transmission. We aimed to determine socioeconomic and behavioral factors associated with diagnostic delays among patients with TB. Data were collected from 105 patients with TB using a semi-structured interview guide in Lima, Peru. Factors associated with diagnostic delay were analyzed using negative binomial regression. The median delay from when symptoms commenced and the first positive diagnostic sample in public health facilities was 57 days (interquartile range: 28-126). In multivariable analysis, greater diagnostic delay was independently associated with patient older age, female gender, lower personal income before diagnosis, living with fewer people, and having more visits to professional health facilities before diagnosis (all P < 0.05). Patients who first sought care at a private health facility had more visits overall to professional health facilities before diagnosis than those who first sought care from public or insured employee health facilities and had longer diagnostic delay in analysis adjusted for age and gender. Patients with TB were significantly more likely to first self-medicate than to visit professional health facilities before diagnosis ( P = 0.003). Thus, diagnostic delay was prolonged, greatest among older, low-income women, and varied according to the type of care sought by individuals when their symptoms commenced. These findings suggest that TB case-finding initiatives should target vulnerable groups in informal and private health facilities, where many patients with TB first seek health care.

Medical compliance to evidence-based clinical guidelines on secondary prevention of coronary heart disease in a hospital from Lima, Peru: a retrospective study.

PubMed

Castañeda-Amado, Zaira; Calixto-Aguilar, Lesly; Loza Munarriz, César; Medina Palomino, Félix A

2017-06-29

Cardiovascular disease is the leading cause of mortality worldwide. When an acute myocardial infarction occurs, it is necessary to establish secondary prevention measures, which can reduce mortality by 50%. Clinical guidelines state that the optimal medical treatment is based upon four groups of drugs: antiplatelet drugs, statins, beta-blockers and angiotensin-converting-enzyme inhibitor or angiotensin II receptor antagonist. To determine physician compliance to evidence-based clinical practice guidelines on secondary prevention of coronary heart disease. Retrospective, observational study in Hospital Cayetano Heredia in Lima, Peru. The study included patients with confirmed acute coronary syndrome from February 2011 to February 2013. Medical records, laboratory results and medical therapy at discharge were collected and were compared to the American Heart Association type I, evidence level A recommendations. In addition, patient follow-up visits to the outpatient cardiology clinic at 1, 3 and 6 months after discharge were analyzed. The study population included 143 patients. Eighty-nine (89) patients were admitted with the diagnosis of unstable angina and non-ST-segment elevation (62.2%) and 54 had ST-segment elevation myocardial infarction (37.8%). Forty patients (28%) received all four recommended medications at discharge, which decreased at 1, 3 and 6 months after discharge to 12.6%, 7% and 3.5% respectively. The results showed a significant reduction in patient compliance to follow-up visits with a 48% reduction at the first visit to 10% on the last visit. Medical compliance to guidelines recommendations in secondary cardiovascular prevention is suboptimal with a compliance score under 50%.

Variation in the costs of delivering routine immunization services in Peru.

PubMed

Walker, D; Mosqueira, N R; Penny, M E; Lanata, C F; Clark, A D; Sanderson, C F B; Fox-Rushby, J A

2004-09-01

Estimates of vaccination costs usually provide only point estimates at national level with no information on cost variation. In practice, however, such information is necessary for programme managers. This paper presents information on the variations in costs of delivering routine immunization services in three diverse districts of Peru: Ayacucho (a mountainous area), San Martin (a jungle area) and Lima (a coastal area). We consider the impact of variability on predictions of cost and reflect on the likely impact on expected cost-effectiveness ratios, policy decisions and future research practice. All costs are in 2002 prices in US dollars and include the costs of providing vaccination services incurred by 19 government health facilities during the January-December 2002 financial year. Vaccine wastage rates have been estimated using stock records. The cost per fully vaccinated child ranged from 16.63-24.52 U.S. Dollars in Ayacucho, 21.79-36.69 U.S. Dollars in San Martin and 9.58-20.31 U.S. Dollars in Lima. The volume of vaccines administered and wastage rates are determinants of the variation in costs of delivering routine immunization services. This study shows there is considerable variation in the costs of providing vaccines across geographical regions and different types of facilities. Information on how costs vary can be used as a basis from which to generalize to other settings and provide more accurate estimates for decision-makers who do not have disaggregated data on local costs. Future studies should include sufficiently large sample sizes and ensure that regions are carefully selected in order to maximize the interpretation of cost variation.

An examination of current stroke rehabilitation practice in Peru: Implications for interprofessional education.

PubMed

McDonald, Cody L; Fuhs, Amy K; Kartin, Deborah

2018-05-01

This study aimed to better understand current clinical practice of rehabilitation professionals in Lima, Peru, and to explore the existence of and potential for interprofessional collaboration. A secondary purpose was to assess rehabilitation professionals' agreement with evidence-based stroke rehabilitation statements and confidence performing stroke rehabilitation tasks prior to and following an interprofessional stroke rehabilitation training. Current clinical practice for rehabilitation professionals in Peru differs from high-income counties like the United States, as physical therapists work with dysphagia and feeding, prosthetist orthotists serve a strictly technical role, and nurses have a limited role in rehabilitation. Additionally, while opportunity for future interprofessional collaboration within stroke rehabilitation exists, it appears to be discouraged by current health system policies. Pre- and post-training surveys were conducted with a convenience sample of 107 rehabilitation professionals in Peru. Survey response options included endorsement of professionals for rehabilitation tasks and a Likert scale of agreement and confidence. Training participants largely agreed with evidence-based stroke rehabilitation statements. Differences in opinion remained regarding the prevalence of dysphagia and optimal frequency of therapy post-stroke. Substantially increased agreement post-training was seen in favour of early initiation of stroke rehabilitation and ankle foot orthosis use. Participants were generally confident performing traditional profession-specific interventions and educating patients and families. Substantial increases were seen in respondents' confidence to safely and independently conduct bed to chair transfers and determine physiological stability. Identification of key differences in rehabilitation professionals' clinical practice in Peru is a first step toward strengthening the development of sustainable rehabilitation systems and interprofessional collaboration.

HIV screening among newly diagnosed TB patients: a cross sectional study in Lima, Peru.

PubMed

Ramírez, Suzanne; Mejía, Fernando; Rojas, Marlene; Seas, Carlos; Van der Stuyft, Patrick; Gotuzzo, Eduardo; Otero, Larissa

2018-03-20

Since 2006, the Peruvian National TB program (NTP) recommends voluntary counseling and testing (VCT) for all tuberculosis (TB) patients. Responding to the differential burden of both diseases in Peru, TB is managed in peripheral health facilities while HIV is managed in referral centers. This study aims to determine the coverage of HIV screening among TB patients and the characteristics of persons not screened. From March 2010 to December 2011 we enrolled new smear-positive pulmonary TB adults in 34 health facilities in a district in Lima. NTP staff offered VCT to all TB patients. Patients with an HIV positive result were referred for confirmation tests and management. We interviewed patients to collect their demographic and clinical characteristics and registered if patients opted in or out of the screening. Of the 1295 enrolled TB patients, nine had a known HIV diagnosis. Of the remaining, 76.1% (979) were screened for HIV. Among the 23.9% (307) not screened, 38.4% (118) opted out of the screening. TB patients at one of the health care facilities of the higher areas of the district (OR = 3.38, CI 95% 2.17-5.28 for the highest area and OR = 2.82, CI 95% 1.78-4.49 for the high area) as well as those reporting illegal drug consumption (OR = 1.65, CI 95% 1.15-2.37) were more likely not to be screened. Twenty-four were HIV positive (1.9% of all patients 1295, or 2.4% of those screened). Of 15 patients diagnosed with HIV during the TB episode, ten were enrolled in an HIV program. The median time between the result of the HIV screening and the first consultation at the HIV program was 82 days (IQR, 32-414). The median time between the result of the HIV screening and antiretroviral initiation was 148.5 days (IQR 32-500). An acceptable proportion of TB patients were screened for HIV in Lima. Referral systems of HIV positive patients should be strengthened for timely ART initiation.

Overweight is associated with lower serum leptin in Peruvian Indian than in Caucasian women: A dissociation contributing to low blood pressure?

PubMed

Lindgärde, F; Söderberg, S; Olsson, T; Ercilla, M B; Correa, L R; Ahrén, B

2001-03-01

We tested whether plasma levels of leptin and insulin are associated with the lower blood pressure in women of Peruvian Indian heritage compared with Caucasian women. A total of 181 women from Peru and 85 from Sweden, aged 20 to 60 years, with normal plasma glucose levels participated in the study. Measurements of anthropometry, blood pressure, and blood tests were performed after overnight fasting. Compared with women from Umeå in Sweden, women from Lima, Peru had higher body mass index (BMI) (26.2 +/- 4.9 v 24.4 +/- 3.8 kg/m(2)), waist circumference (85 +/- 11 v 79 +/- 10 cm), lower systolic blood pressure (99 +/- 15 v 114 +/- 14 mm; P <.001) and diastolic blood pressure (67 +/- 7 v 74 +/- 10 mm; P <.001). In addition, they had a reduction of the ratio of plasma leptin to BMI (0.52 +/- 0.22 v 0.61 +/- 0.36; P <.001), greater plasma insulin (80 +/- 42 v 41 +/- 21 pmol/L), but lower plasma glucose (4.2 +/- 0.5 v 5.1 +/- 0.5 mmol/L; P <.001). Furthermore, the 181 women from Lima had higher plasma triglyceride levels (1.5 +/- 0.8 v 1.3 +/- 0.7; P =.039), but lower plasma high-density lipoprotein (HDL)-cholesterol (1.0 +/- 0.2 v 1.5 +/- 0.4 mmol/L; P <.001) and total plasma cholesterol (5.0 +/- 1.1 v 5.9 +/- 1.3 mmol/L; P <.001) levels. Plasma leptin correlated with blood pressure and BMI in both populations (P <.001). In multiple regression analysis, BMI, but not log leptin, emerged as the determinant for systolic blood pressure. We concluded that women living in Lima have significant lower blood pressure levels in association with elevated plasma insulin concentrations, but lower plasma leptin values adjusted for BMI in comparison with women from northern Sweden. This may suggest that the concept of metabolic syndrome is different among women with Peruvian Indian heritage in comparison to a Caucasian population. Copyright 2001 by W.B. Saunders Company

Peru Subduction Zone Seismic Experiment (PeruSZE): Preliminary Results From a Seismic Network Between Mollendo and Lake Titicaca, Peru.

NASA Astrophysics Data System (ADS)

Guy, R.; Stubailo, I.; Skinner, S.; Phillips, K.; Foote, E.; Lukac, M.; Aguilar, V.; Tavera, H.; Audin, L.; Husker, A.; Clayton, R.; Davis, P. M.

2008-12-01

This work describes preliminary results from a 50 station broadband seismic network recently installed from the coast to the high Andes in Peru. UCLA's Center for Embedded Network Sensing (CENS) and Caltech's Tectonic Observatory are collaborating with the IRD (French L'Institut de Recherche pour le Developpement) and the Institute of Geophysics, in Lima Peru in a broadband seismic experiment that will study the transition from steep to shallow slab subduction. The currently installed line has stations located above the steep subduction zone at a spacing of about 6 km. In 2009 we plan to install a line of 50 stations north from this line along the crest of the Andes, crossing the transition from steep to shallow subduction. A further line from the end of that line back to the coast, completing a U shaped array, is in the planning phase. The network is wirelessly linked using multi-hop network software designed by computer scientists in CENS in which data is transmitted from station to station, and collected at Internet drops, from where it is transmitted over the Internet to CENS each night. The instrument installation in Peru is almost finished and we have been receiving data daily from 10 stations (out of total 50) since June 2008. The rest are recording on-site while the RF network is being completed. The software system provides dynamic link quality based routing, reliable data delivery, and a disruption tolerant shell interface for managing the system from UCLA without the need to travel to Peru. The near real-time data delivery also allows immediate detection of any problems at the sites. We are building a seismic data and GPS quality control toolset that would greatly minimize the station's downtime by alerting the users of any possible problems.

Feasibility and Acceptability of a Text Message-Based Smoking Cessation Program for Young Adults in Lima, Peru: Pilot Study

PubMed Central

Zevallos, Karine; Samolski, M Reuven; Requena, David; Velarde, Chaska; Briceño, Patricia; Piazza, Marina; Ybarra, Michele L

2017-01-01

Background In Peru’s urban communities, tobacco smoking generally starts during adolescence and smoking prevalence is highest among young adults. Each year, many attempt to quit, but access to smoking cessation programs is limited. Evidence-based text messaging smoking cessation programs are an alternative that has been successfully implemented in high-income countries, but not yet in middle- and low-income countries with limited tobacco control policies. Objective The objective was to assess the feasibility and acceptability of an short message service (SMS) text message-based cognitive behavioral smoking cessation program for young adults in Lima, Peru. Methods Recruitment included using flyers and social media ads to direct young adults interested in quitting smoking to a website where interested participants completed a Google Drive survey. Inclusion criteria were being between ages 18 and 25 years, smoking at least four cigarettes per day at least 6 days per week, willing to quit in the next 30 days, owning a mobile phone, using SMS text messaging at least once in past year, and residing in Lima. Participants joined one of three phases: (1) focus groups and in-depth interviews whose feedback was used to develop the SMS text messages, (2) validating the SMS text messages, and (3) a pilot of the SMS text message-based smoking cessation program to test its feasibility and acceptability among young adults in Lima. The outcome measures included adherence to the SMS text message-based program, acceptability of content, and smoking abstinence self-report on days 2, 7, and 30 after quitting. Results Of 639 participants who completed initial online surveys, 42 met the inclusion criteria and 35 agreed to participate (focus groups and interviews: n=12; validate SMS text messages: n=8; program pilot: n=15). Common quit practices and beliefs emerged from participants in the focus groups and interviews informed the content, tone, and delivery schedule of the messages used in the SMS text message smoking cessation program. A small randomized controlled pilot trial was performed to test the program’s feasibility and acceptability; nine smokers were assigned to the SMS text message smoking cessation program and six to a SMS text message nutrition program. Participant retention was high: 93% (14/15) remained until day 30 after quit day. In all, 56% of participants (5/9) in the SMS text message smoking cessation program reported remaining smoke-free until day 30 after quit day and 17% of participants (1/6) in the SMS text message nutrition program reported remaining smoke-free during the entire program. The 14 participants who completed the pilot reported that they received valuable health information and approved the delivery schedule of the SMS text messages. Conclusions This study provides initial evidence that a SMS text message smoking cessation program is feasible and acceptable for young adults residing in Lima. PMID:28778850

[Internet addiction: development and validation of an instrument in adolescent scholars in Lima, Peru].

PubMed

Lam-Figueroa, Nelly; Contreras-Pulache, Hans; Mori-Quispe, Elizabeth; Nizama-Valladolid, Martín; Gutiérrez, César; Hinostroza-Camposano, Williams; Reyes, Erasmo Torrejón; Hinostroza-Camposano, Richard; Coaquira-Condori, Elizabeth; Hinostroza-Camposano, Willy David

2011-01-01

To develop and validate an instrument to assess Internet Addiction (IA) phenomenon in adolescents of Metropolitan Lima. We performed an observational analytical study, including a sample of 248 high school adolescent students. In order to evaluate the IA, we constructed the questionnaire: "Scale for Internet Addiction of Lima" (SIAL), which assesses symptoms and dysfunctional characteristics. The resulting items were submitted to experts' judgment, finally obtaining a 11-item scale. The mean age was 14 years old. The psychometric analysis of the instrument showed a Cronbach' Alpha Coefficient of 0.84, with values of item-total correlation ranging from 0.45 to 0.59. The dimensional analysis yielded a two-dimensional structure that explained up to 50.7% of the total variance. The bi-dimensional data analysis revealed a significant association (p<0,001) between Dimension I (symptoms of IA) and the weekly time spent on the Internet, male sex, past history of bad behavior in school and plans for the future. Dimension II (dysfunction due to IA) had a significant association to past history of bad behavior, plans for the future (p<0,001) and missing school without valid reasons. The SIAL showed a good internal consistency, with moderate and significant inter-item correlations. The findings show that addiction has a dynamic role, which evidences a problem generated in family patterns and inadequate social networks.

[Splenic infarction at high altitude, Huaraz-Peru (3,100 masl)].

PubMed

López de Guimaraes, Douglas; Menacho López, Julio; Villanueva Palacios, Jovita; Mosquera Vásquez, Vitaliano

2009-01-01

We report three cases of splenic infarction in healthy men for the first time that amounted to high altitudes, observed in the hospital "Victor Ramos Guardia" Huaraz (3100 m). Case 1 (1995) of 55 years, born in Cuba, from Lima, caucasian suddenly presented acute abdominal pain in epigastrium, distension, nausea and vomiting, was laparotomized for acute abdomen and surgical pathology revealed thrombosis with splenic infarction splenic artery and vein. During follow-up in Lima, hemoglobin electrophoresis showed that it was heterozygous carrier of the sickle trait (Hb A: 57% Hb S: 38.5%). Case 2 (1998) of 23 years, born in Cuba, from Lima, Black said acute abdominal pain in left hypochondrium, shortness of breath and chest pain, clinical examination and radiography of the abdomen showed the spleen volume increased. Case 3 (2006) of 17 years, natural and from Lima, mestizo, who came on tour promotion, acute abdominal pain referred onset in the epigastrium and left hypochondrium, headache, increase heat, nausea and vomiting, pharyngitis was found acute and painful, and spleen increased in size by clinical and x-ray of abdomen simple stand. None had no history of hemoglobinopathy and anemia. In general, medical management was supportive and cases 2 and 3 are recommended hemoglobin electrophoresis. We conclude that we must think of splenic infarction associated with height in any healthy person who is first at high altitude (> 3000m) and having a sudden acute abdominal pain in epigastrium and / or left hypochondrium, pain and palpable spleen and radiological study compatible with image. In this case is indicated by hemoglobin electrophoresis to determine whether there is an individual heterozygous carrier of the sickle trait. splenic infarction, high altitude, sickle trait, Huaraz.

Alcohol Use Disorders Negatively Influence Antiretroviral Medication Adherence Among Men Who Have Sex with Men in Peru

PubMed Central

Ferro, Enrico G.; Weikum, Damian; Vagenas, Panagiotis; Copenhaver, Michael M.; Gonzales, Pedro; Peinado, Jesus; Lama, Javier R.; Sanchez, Jorge; Altice, Frederick L.

2014-01-01

Objective As international guidelines increase access to antiretroviral therapy (ART) globally, ART adherence becomes increasingly important to achieve HIV treatment as prevention (TasP) goals. In the concentrated HIV epidemic among men who have sex with men (MSM) and transgendered women (TGW) in Lima, Peru, the independent correlates of ART non-adherence were examined to inform treatment intervention priorities. Design Cross sectional survey of HIV-infected MSM and TGW who are engaged in clinical care in Lima, Peru. Methods From June to August 2012, 302 HIV-infected Peruvian MSM/TGW from three clinical care sites were recruited using convenience sampling to participate in a cross-sectional computer-assisted adherence survey. Several standardized screening measures associated with ART non-adherence were examined in order to determine the independent correlates of optimal (≥90%) and perfect (100%) adherence, which were assessed using logistic regression. Results Of the 302 participants recruited, 263 (87.1%) were prescribed ART. Among those prescribed ART, 229 (87.1%) reported optimal and 146 (55.5%) reported perfect adherence. The prevalence of alcohol use disorders (AUD; 43.2%), alcohol dependence (5.3%), recent drug use (6.0%) and depression (44.5%) was high and most participants had some evidence of neurocognitive impairment. Meeting criteria for having an AUD and depression were collinear (p<0.001). On multivariate analysis, having an AUD was inversely related and the only independent correlate of optimal (AOR=0.427; 95% CI=0.187–0.976) and perfect (AOR=0.552; 95% CI=0.327–0.930) ART adherence. Conclusions AUDs are highly prevalent among Peruvian HIV-infected MSM and contribute significantly to ART non-adherence. These findings support the need for screening and treating underlying AUDs. In order to meet HIV TasP goals, evidence-based strategies targeting AUDs are likely to directly improve ART adherence and indirectly improve overall individual health, HIV treatment engagement and reduce transmission to sexual partners among this vulnerable and disproportionally affected population. PMID:25277252

A Diagnostic Accuracy Study of Xpert®MTB/RIF in HIV-Positive Patients with High Clinical Suspicion of Pulmonary Tuberculosis in Lima, Peru

PubMed Central

Carriquiry, Gabriela; Otero, Larissa; González-Lagos, Elsa; Zamudio, Carlos; Sánchez, Eduardo; Nabeta, Pamela; Campos, Miguel; Echevarría, Juan; Seas, Carlos; Gotuzzo, Eduardo

2012-01-01

Background Diagnosis of pulmonary tuberculosis (TB) among human immunodeficiency virus (HIV) patients remains complex and demands easy to perform and accurate tests. Xpert®MTB/RIF (MTB/RIF) is a molecular TB diagnostic test which is rapid and convenient; the test requires minimal human resources and reports results within two hours. The majority of performance studies of MTB/RIF have been performed in high HIV burden settings, thus TB diagnostic studies among HIV patients in low HIV prevalence settings such as Peru are still needed. Methodology/Principal Findings From April 2010 to May 2011, HIV-positive patients with high clinical suspicion of TB were enrolled from two tertiary hospitals in Lima, Peru. Detection of TB by MTB/RIF was compared to a composite reference standard Löwenstein-Jensen (LJ) and liquid culture. Detection of rifampicin resistance was compared to the LJ proportion method. We included 131 patients, the median CD4 cell count was 154.5 cells/mm3 and 45 (34.4%) had TB. For TB detection among HIV patients, sensitivity of MTB/RIF was 97.8% (95% CI 88.4–99.6) (44/45); specificity was 97.7% (95% CI 91.9–99.4) (84/86); the positive predictive value was 95.7% (95% CI 85.5–98.8) (44/46); and the negative predictive value, 98.8% (95% CI 93.6–99.8) (84/85). MTB/RIF detected 13/14 smear-negative TB cases, outperforming smear microscopy [97.8% (44/45) vs. 68.9% (31/45); p = 0.0002]. For rifampicin resistance detection, sensitivity of MTB/RIF was 100% (95% CI 61.0–100.0) (6/6); specificity was 91.0% (95% CI 76.4–96.9) (30/33); the positive predictive value was 66.7% (95% CI 35.4–87.9) (6/9); and the negative predictive value was 100% (95% CI 88.7 –100.0) (30/30). Conclusions/Significance In HIV patients in our population with a high clinical suspicion of TB, MTB/RIF performed well for TB diagnosis and outperformed smear microscopy. PMID:22970271

A community-based cluster randomized survey of noncommunicable disease and risk factors in a peri-urban shantytown in Lima, Peru.

PubMed

Heitzinger, Kristen; Montano, Silvia M; Hawes, Stephen E; Alarcón, Jorge O; Zunt, Joseph R

2014-05-21

An estimated 863 million people-a third of the world's urban population-live in slums, yet there is little information on the disease burden in these settings, particularly regarding chronic preventable diseases. From March to May 2012, we conducted a cluster randomized survey to estimate the prevalence of noncommunicable diseases (NCDs) and associated risk factors in a peri-urban shantytown north of Lima, Peru. Field workers administered a questionnaire that included items from the WHO World Health Survey and the WHO STEPS survey of chronic disease risk factors. We used logistic regression to assess the associations of NCDs and related risk factors with age and gender. We accounted for sampling weights and the clustered sampling design using statistical survey methods. A total of 142 adults were surveyed and had a weighted mean age of 36 years (range 18-81). The most prevalent diseases were depression (12%) and chronic respiratory disease (8%), while lifetime prevalence of cancer, arthritis, myocardial infarction, and diabetes were all less than 5%. Fifteen percent of respondents were hypertensive and the majority (67%) was unaware of their condition. Being overweight or obese was common for both genders (53%), but abdominal obesity was more prevalent in women (54% vs. 10% in men, p < 0.001). Thirty-five percent of men binge drank and 34% reported current smoking; these behaviors were less common among women (4% binge drank, p < 0.001; 8% smoked, p = 0.002). Increasing age was associated with an increased risk of abdominal obesity (Odds Ratio (OR) = 1.04, 95% CI = 1.01, 1.07, p = 0.02), hypertension (OR = 1.06, 95% CI = 1.02, 1.10, p = 0.006), arthritis (OR = 1.07, 95% CI = 1.03, 1.11, p < 0.001) and cancer (OR = 1.13, 95% CI = 1.07, 1.20, p < 0.001) in adjusted models. The prevalences of other NCDs and related risk factors were similar when stratified by age or gender. This study underlines the important burden of noncommunicable disease in informal settlements in Peru and suggests that prevention and treatment interventions could be optimized according to age and gender.

Environmental exposure and leptospirosis, Peru.

PubMed

Johnson, Michael A S; Smith, Hannah; Joeph, Priya; Gilman, Robert H; Bautista, Christian T; Campos, Kalina J; Cespedes, Michelle; Klatsky, Peter; Vidal, Carlos; Terry, Hilja; Calderon, Martiza M; Coral, Carlos; Cabrera, Lilia; Parmar, Paminder S; Vinetz, Joseph M

2004-06-01

Human infection by leptospires has highly variable clinical manifestations, which range from subclinical infection to fulminant disease. We conducted a population-based, cross-sectional seroepidemiologic study in Peru to determine potential relationships of environmental context to human exposure to Leptospira and disease associated with seroconversion. Three areas were studied: a flooded, urban slum in the Peruvian Amazon city of Iquitos; rural, peri-Iquitos villages; and a desert shantytown near Lima. Seroprevalence in Belen was 28% (182/650); in rural areas, 17% (52/316); and in a desert shantytown, 0.7% (1/150). Leptospira-infected peridomestic rats were found in all locales. In Belen, 20 (12.4%) of 161 patients seroconverted between dry and wet seasons (an incidence rate of 288/1,000). Seroconversion was associated with history of febrile illness; severe leptospirosis was not seen. Human exposure to Leptospira in the Iquitos region is high, likely related both to the ubiquity of leptospires in the environment and human behavior conducive to transmission from infected zoonotic sources.

Dating the Late Archaic occupation of the Norte Chico region in Peru.

PubMed

Haas, Jonathan; Creamer, Winifred; Ruiz, Alvaro

2004-12-23

The Norte Chico region on the coast of Peru north of Lima consists of four adjacent river valleys--Huaura, Supe, Pativilca and Fortaleza--in which archaeologists have been aware of a number of apparently early sites for more than 40 years (refs 1- 3). To clarify the early chronology in this region, we undertook fieldwork in 2002 and 2003 to determine the dates of occupation of sites in the Fortaleza and Pativilca valleys. Here we present 95 new radiocarbon dates from a sample of 13 of more than 20 large, early sites. These sites share certain basic characteristics, including large-scale monumental architecture, extensive residential architecture and a lack of ceramics. The 95 new dates confirm the emergence and development of a major cultural complex in this region during the Late Archaic period between 3000 and 1800 calibrated calendar years bc. The results help to redefine a broader understanding of the respective roles of agricultural and fishing economies in the beginnings of civilization in South America.

Nasca Lines, Peru

NASA Image and Video Library

2001-10-22

The Nasca Lines are located in the Pampa region of Peru, the desolate plain of the Peruvian coast 400 km south of Lima. The Lines were first spotted when commercial airlines began flying across the Peruvian desert in the 1920's. Passengers reported seeing 'primitive landing strips' on the ground below. The Lines were made by removing the iron-oxide coated pebbles which cover the surface of the desert. When the gravel is removed, they contrast with the light color underneath. In this way the lines were drawn as furrows of a lighter color. On the pampa, south of the Nasca Lines, archaeologists have now uncovered the lost city of the line-builders, Cahuachi. It was built nearly two thousand years ago and was mysteriously abandoned 500 years later. This ASTER sub-image covers an area of 14 x 18 km, was acquired on December 22, 2000, and is located at 14.7 degrees south latitude and 75.1 degrees west longitude. http://photojournal.jpl.nasa.gov/catalog/PIA11097

When science and politics listen to each other: good prospects from a new school breakfast program in Peru.

PubMed

Jacoby, E R; Cueto, S; Pollitt, E

1998-04-01

This article provides an overview of a school breakfast program implemented in 1993 in the Peruvian Andes. The program, designed by the Instituto de Investigación Nutricional in Lima and supported by the government of Peru, constitutes a clear departure from previous school feeding programs, which were heavily politicized and poorly documented. From the program's inception, nutritionists, managers, and social scientists have collaborated to produce a sound nutritional design, efficient distribution mechanisms, and effective evaluation methods. During the program's first year, controlled evaluations conducted in several Andean regions documented improved dietary intake and a significant decline in the prevalence of anemia. An educational evaluation also found improved verbal skills, higher school attendance, and lower dropout rates among recipients of the school breakfast. The results have prompted the Peruvian government to continue supporting the program, thus setting a new standard for the effective management of social expenditure in the context of economic adjustment.

Partner-Level Factors Associated with Insertive and Receptive Condomless Anal Intercourse Among Transgender Women in Lima, Peru.

PubMed

Satcher, Milan F; Segura, Eddy R; Silva-Santisteban, Alfonso; Sanchez, Jorge; Lama, Javier R; Clark, Jesse L

2017-08-01

Condomless anal intercourse among transgender women (TW) in Peru has been shown to vary by the type of partner involved (e.g. primary vs. casual vs. transactional sex partner), but no previous studies have explored variations in partner-level patterns of condom use according to type of anal intercourse. We evaluated the relationship between partnership characteristics and condom use during insertive (IAI) versus receptive anal intercourse (RAI) among TW with recent, non-female partners. Condomless IAI was more common with transactional and casual sex partners and by TW who self-reported HIV-uninfected serostatus (p < 0.05), alcohol use disorders, or substance use before sex. Condomless RAI was more common with primary partners and by TW who described their HIV serostatus as unknown (p < 0.05). Examining partner-level differences between condomless IAI and RAI reveals distinct patterns of HIV/STI risk among TW, suggesting a need for HIV prevention strategies tailored to the specific contexts of partners, practices, and networks.

[Eccrine Porocarcinoma: clinical-pathological study of 19 cases in the Instituto Nacional de Enfermedades Neoplásicas, Lima - Peru].

PubMed

Casavilca, Sandro; Lama, Anny; Guerrero, Melvy; Essary, Lydia R; Mantilla, Raúl; Cano, Luis; Barrionuevo, Carlos

2013-07-01

In order to describe the clinical-pathological characteristics of the cases of Eccrine Porocarcinoma (EP) found in the Instituto Nacional de Enfermedades Neoplásicas (INEN), a cross-sectional study was carried out, including all EP cases recorded between 1998 and 2009. A revision of the clinical-pathological records indentified and a new reading of the pathology slides of the cases found were performed. 19 EP cases were found, the median age of which was 64 years (range: 37-98). EP was primarily found on male patients (57.9%) and was most commonly located on the foot (21.1%), followed by the head, thorax and thigh (15.8%, respectively). In one case, EP was located on the gluteal region, and showed an unusually invasive behavior and rectal involvement. We conclude that EP is a rather uncommon entity in Peru. Its most common location is on the foot and it affects mostly male patients for the most part.

Painful languages of the body: experiences of headache among women in two Peruvian communities.

PubMed

Darghouth, Sarah; Pedersen, Duncan; Bibeau, Gilles; Rousseau, Cecile

2006-09-01

This exploratory study focuses on the understandings of and experiences with headache in two settings in Peru: the Quechua-speaking district of Ayacucho, in southern Peru, and a poor urban district of Lima Metropolitana. More specifically, it explores the personal and collective meanings constructed around women's headache experiences. Structured and open-ended interviews were administered to patients suffering headache to elicit interpretations of headache episodes. An analysis of the collected narratives suggests that headache is often comprehended in a polysemic framework, where meanings ascribed in bodily, emotional, family, and social terms articulate individual and shared notions of suffering within larger contexts of social dislocation. Often woven into experiences of solitude, headache accounts are lived and told in dynamic temporal spaces, and narrate dissolution of family ties and tensions associated with women's roles. The results underscore the significance of patients' subjective interpretations of painful experiences and underscore the connections between bodily and emotional pain and distress experienced at family, community, and larger social levels.

Assessment of patient safety culture in private and public hospitals in Peru.

PubMed

Arrieta, Alejandro; Suárez, Gabriela; Hakim, Galed

2018-04-01

To assess the patient safety culture in Peruvian hospitals from the perspective of healthcare professionals, and to test for differences between the private and public healthcare sectors. Patient safety is defined as the avoidance and prevention of patient injuries or adverse events resulting from the processes of healthcare delivery. A non-random cross-sectional study conducted online. An online survey was administered from July to August 2016, in Peru. This study reports results from Lima and Callao, which are the capital and the port region of Peru. A total of 1679 healthcare professionals completed the survey. Participants were physicians, medical residents and nurses working in healthcare facilities from the private sector and public sector. Assessment of the degree of patient safety and 12 dimensions of patient safety culture in hospital units as perceived by healthcare professionals. Only 18% of healthcare professionals assess the degree of patient safety in their unit of work as excellent or very good. Significant differences are observed between the patient safety grades in the private sector (37%) compared to the public sub-sectors (13-15%). Moreover, in all patient safety culture dimensions, healthcare professionals from the private sector give more favorable responses for patient safety, than those from the public sub-systems. The most significant difference in support comes from patient safety administrators through communication and information about errors. Overall, the degree of patient safety in Peru is low, with significant gaps that exist between the private and the public sectors.

Active tectonics of Peru: Heterogeneous interseismic coupling along the Nazca megathrust, rigid motion of the Peruvian Sliver, and Subandean shortening accommodation

NASA Astrophysics Data System (ADS)

Villegas-Lanza, J. C.; Chlieh, M.; Cavalié, O.; Tavera, H.; Baby, P.; Chire-Chira, J.; Nocquet, J.-M.

2016-10-01

Over 100 GPS sites measured in 2008-2013 in Peru provide new insights into the present-day crustal deformation of the 2200 km long Peruvian margin. This margin is squeezed between the eastward subduction of the oceanic Nazca Plate at the South America trench axis and the westward continental subduction of the South American Plate beneath the Eastern Cordillera and Subandean orogenic wedge. Continental active faults and GPS data reveal the rigid motion of a Peruvian Forearc Sliver that extends from the oceanic trench axis to the Western-Eastern Cordilleras boundary and moves southeastward at 4-5 mm/yr relative to a stable South America reference frame. GPS data indicate that the Subandean shortening increases southward by 2 to 4 mm/yr. In a Peruvian Sliver reference frame, the residual GPS data indicate that the interseismic coupling along the Nazca megathrust is highly heterogeneous. Coupling in northern Peru is shallow and coincides with the site of previous moderate-sized and shallow tsunami-earthquakes. Deep coupling occurs in central and southern Peru, where repeated large and great megathrust earthquakes have occurred. The strong correlation between highly coupled areas and large ruptures suggests that seismic asperities are persistent features of the megathrust. Creeping segments appear at the extremities of great ruptures and where oceanic fracture zones and ridges enter the subduction zone, suggesting that these subducting structures play a major role in the seismic segmentation of the Peruvian margin. In central Peru, we estimate a recurrence time of 305 ± 40 years to reproduce the great 1746 Mw 8.8 Lima-Callao earthquake.

Resource-stratified implementation of a community-based breast cancer management programme in Peru.

PubMed

Duggan, Catherine; Dvaladze, Allison L; Tsu, Vivien; Jeronimo, Jose; Constant, Tara K Hayes; Romanoff, Anya; Scheel, John R; Patel, Shilpen; Gralow, Julie R; Anderson, Benjamin O

2017-10-01

Breast cancer incidence and mortality rates continue to rise in Peru, with related deaths projected to increase from 1208 in 2012, to 2054 in 2030. Despite improvements in national cancer control plans, various barriers to positive breast cancer outcomes remain. Multiorganisational stakeholder collaboration is needed for the development of functional, sustainable early diagnosis, treatment and supportive care programmes with the potential to achieve measurable outcomes. In 2011, PATH, the Peruvian Ministry of Health, the National Cancer Institute in Lima, and the Regional Cancer Institute in Trujillo collaborated to establish the Community-based Program for Breast Health, the aim of which was to improve breast health-care delivery in Peru. A four-step, resource-stratified implementation strategy was used to establish an effective community-based triage programme and a practical early diagnosis scheme within existing multilevel health-care infrastructure. The phased implementation model was initially developed by the Breast Cancer Initiative 2·5: a group of health and non-governmental organisations who collaborate to improve breast cancer outcomes. To date, the Community-based Program for Breast Health has successfully implemented steps 1, 2, and 3 of the Breast Cancer Initiative 2·5 model in Peru, with reports of increased awareness of breast cancer among women, improved capacity for early diagnosis among health workers, and the creation of stronger and more functional linkages between the primary levels (ie, local or community) and higher levels (ie, district, region, and national) of health care. The Community-based Program for Breast Health is a successful example of stakeholder and collaborator involvement-both internal and external to Peru-in the design and implementation of resource-appropriate interventions to increase breast health-care capacity in a middle-income Latin American country. Copyright © 2017 Elsevier Ltd. All rights reserved.

Factors associated with abandonment of therapy by children diagnosed with solid tumors in Peru.

PubMed

Vasquez, Liliana; Diaz, Rosdali; Chavez, Sharon; Tarrillo, Fanny; Maza, Ivan; Hernandez, Eddy; Oscanoa, Monica; García, Juan; Geronimo, Jenny; Rossell, Nuria

2018-06-01

Abandonment of treatment is a major cause of treatment failure and poor survival in children with cancer in low- and middle-income countries. The incidence of treatment abandonment in Peru has not been reported. The aim of this study was to examine the prevalence of and factors associated with treatment abandonment by pediatric patients with solid tumors in Peru. We retrospectively reviewed the sociodemographic and clinical data of children referred between January 2012 and December 2014 to the two main tertiary centers for childhood cancer in Peru. The definition of treatment abandonment followed the International Society of Paediatric Oncology, Paediatric Oncology in Developing Countries, Abandonment of Treatment recommendation. Data from 1135 children diagnosed with malignant solid tumors were analyzed, of which 209 (18.4%) abandoned treatment. Bivariate logistic regression analysis showed significantly higher abandonment rates in children living outside the capital city, Lima (forest; odds ratio [OR] 3.25; P < 0.001), those living in a rural setting (OR 3.44; P < 0.001), and those whose parent(s) lacked formal employment (OR 4.39; P = 0.001). According to cancer diagnosis, children with retinoblastoma were more likely to abandon treatment compared to children with other solid tumors (OR 1.79; P = 0.02). In multivariate regression analyses, rural origin (OR 2.02; P = 0.001) and lack of formal parental employment (OR 2.88; P = 0.001) were independently predictive of abandonment. Treatment abandonment prevalence of solid tumors in Peru is high and closely related to sociodemographical factors. Treatment outcomes could be substantially improved by strategies that help prevent abandonment of therapy based on these results. © 2018 Wiley Periodicals, Inc.

Postmortem findings and opportunistic infections in HIV-positive patients from a public hospital in Peru

PubMed Central

Eza, Dominique; Cerrillo, Gustavo; Moore, David A.J.; Castro, Cecilia; Ticona, Eduardo; Morales, Domingo; Cabanillas, Jose; Barrantes, Fernando; Alfaro, Alejandro; Benavides, Alejandro; Rafael, Arturo; Valladares, Gilberto; Arevalo, Fernando; Evans, Carlton A.; Gilman, Robert H.

2010-01-01

There is a paucity of HIV autopsy data from South America and none that document the postmortem findings in patients with HIV/AIDS in Peru. The purpose of this autopsy study was to determine the spectrum of opportunistic infections and the causes of mortality in HIV-positive patients at a public hospital in Lima. Clinico-epidemiological information regarding HIV infection in Peru is also reviewed. Sixteen HIV-related hospital postmortems, performed between 1999 and 2004, were included in this retrospective analysis. The primary cause of death was established in 12 patients: one died of neoplasia and 11 of infectious diseases, including 3 from pulmonary infection, 7 from disseminated infection, and 2 from central nervous system infection (one case had dual pathology). Opportunistic infections were identified in 14 cases, comprising cytomegalovirus, histoplasmosis, cryptococcosis, toxoplasmosis, Pneumocystis pneumonia, aspergillosis, tuberculosis, varicella zoster virus, and cryptosporidiosis. Fourteen patients had at least one AIDS-related disease that had been neither clinically suspected nor diagnosed premortem. Moreover, 82% of the diagnoses considered to be of important clinical significance had not been suspected antemortem. The spectrum and frequency of certain opportunistic infections differed from other South American autopsy studies, highlighting the importance of performing HIV/AIDS postmortems in resource-limited countries where locally specific disease patterns may be observed. PMID:16979302

Extended-spectrum beta-lactamase-producing Escherichia coli in common vampire bats Desmodus rotundus and livestock in Peru.

PubMed

Benavides, J A; Shiva, C; Virhuez, M; Tello, C; Appelgren, A; Vendrell, J; Solassol, J; Godreuil, S; Streicker, D G

2018-06-01

Antibiotic resistance mediated by bacterial production of extended-spectrum beta-lactamase (ESBL) is a global threat to public health. ESBL resistance is most commonly hospital-acquired; however, infections acquired outside of hospital settings have raised concerns over the role of livestock and wildlife in the zoonotic spread of ESBL-producing bacteria. Only limited data are available on the circulation of ESBL-producing bacteria in animals. Here, we report ESBL-producing Escherichia coli in wild common vampire bats Desmodus rotundus and livestock near Lima, Peru. Molecular analyses revealed that most of this resistance resulted from the expression of bla CTX-M-15 genes carried by plasmids, which are disseminating worldwide in hospital settings and have also been observed in healthy children of Peru. Multilocus sequence typing showed a diverse pool of E. coli strains carrying this resistance that were not always host species-specific, suggesting sharing of strains between species or infection from a common source. This study shows widespread ESBL resistance in wild and domestic animals, supporting animal communities as a potential source of resistance. Future work is needed to elucidate the role of bats in the dissemination of antibiotic-resistant strains of public health importance and to understand the origin of the observed resistance. © 2018 Blackwell Verlag GmbH.

Postmortem findings and opportunistic infections in HIV-positive patients from a public hospital in Peru.

PubMed

Eza, Dominique; Cerrillo, Gustavo; Moore, David A J; Castro, Cecilia; Ticona, Eduardo; Morales, Domingo; Cabanillas, Jose; Barrantes, Fernando; Alfaro, Alejandro; Benavides, Alejandro; Rafael, Arturo; Valladares, Gilberto; Arevalo, Fernando; Evans, Carlton A; Gilman, Robert H

2006-01-01

There is a paucity of HIV autopsy data from South America and none that document the postmortem findings in patients with HIV/AIDS in Peru. The purpose of this autopsy study was to determine the spectrum of opportunistic infections and the causes of mortality in HIV-positive patients at a public hospital in Lima. Clinico-epidemiological information regarding HIV infection in Peru is also reviewed. Sixteen HIV-related hospital postmortems, performed between 1999 and 2004, were included in this retrospective analysis. The primary cause of death was established in 12 patients: one died of neoplasia and 11 of infectious diseases, including 3 from pulmonary infection, 7 from disseminated infection, and 2 from central nervous system infection (one case had dual pathology). Opportunistic infections were identified in 14 cases, comprising cytomegalovirus, histoplasmosis, cryptococcosis, toxoplasmosis, Pneumocystis pneumonia, aspergillosis, tuberculosis, varicella zoster virus, and cryptosporidiosis. Fourteen patients had at least one AIDS-related disease that had been neither clinically suspected nor diagnosed premortem. Moreover, 82% of the diagnoses considered to be of important clinical significance had not been suspected antemortem. The spectrum and frequency of certain opportunistic infections differed from other South American autopsy studies, highlighting the importance of performing HIV/AIDS postmortems in resource-limited countries where locally specific disease patterns may be observed.

Understandings of reproductive tract infections in a peri-urban pueblo joven in Lima, Peru

PubMed Central

Hernández, Lisa Scipioni; Winch, Peter J; Parker, Kea; Gilman, Robert H

2006-01-01

Background Control programs for Reproductive Tract Infections (RTIs) typically focus on increasing awareness of risks associated with different forms of sexual contact, and pay little attention to how or why people may link RTIs to other features of their physical or social environments. This paper describes how women in a peri-urban pueblo joven located in the coastal desert surrounding Lima, Peru conceptualize the links between RTIs, sexual behaviour, personal hygiene, and the adverse environment in which they live. Methods We combined qualitative interviews and a participatory voting exercise to examine social and physical environmental influences on RTIs and gynaecologic symptom interpretation. Results Knowledge of RTIs in general was limited, although knowledge of AIDS was higher. Perceived causes of RTIs fell into three categories: sexual contact with infected persons, personal hygiene and exposure to the contaminated physical environment, with AIDS clearly related to sexual contact. The adverse environment is thought to be a major contributor to vaginal discharge, "inflamed ovaries" and urinary tract infection. The more remote parts of this periurban squatter settlement, characterized by blowing sand and dust and limited access to clean water, are thought to exhibit higher rates of RTIs as a direct result of the adverse environment found there. Stigma associated with RTIs often keeps women from seeking care or obtaining information about gynaecologic symptoms, and favours explanations that avoid mention of sexual practices. Conclusion The discrepancy between demonstrated disease risk factors and personal explanations influenced by local environmental conditions and RTI-related stigma poses a challenge for prevention programs. Effective interventions need to take local understandings of RTIs into account as they engage in dialogue with communities about prevention and treatment of RTIs. PMID:16670025

Public transportation and tuberculosis transmission in a high incidence setting.

PubMed

Zamudio, Carlos; Krapp, Fiorella; Choi, Howard W; Shah, Lena; Ciampi, Antonio; Gotuzzo, Eduardo; Heymann, Jody; Seas, Carlos; Brewer, Timothy F

2015-01-01

Tuberculosis (TB) transmission may occur with exposure to an infectious contact often in the setting of household environments, but extra-domiciliary transmission also may happen. We evaluated if using buses and/or minibuses as public transportation was associated with acquiring TB in a high incidence urban district in Lima, Peru. Newly diagnosed TB cases with no history of previous treatment and community controls were recruited from August to December 2008 for a case-control study. Crude and adjusted odd ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression to study the association between bus/minibus use and TB risk. One hundred forty TB cases and 80 controls were included. The overall use of buses/minibuses was 44.9%; 53.3% (72/135) among cases and 30.4% (24/79) among controls [OR: 3.50, (95% CI: 1.60-7.64)]. In the TB group, 25.7% (36/140) of subjects reported having had a recent household TB contact, and 13% (18/139) reported having had a workplace TB contact; corresponding figures for controls were 3.8% (3/80) and 4.1% (3/73), respectively[OR: 8.88 (95% CI: 2.64-29.92), and OR: 3.89 (95% CI: 1.10-13.70)]. In multivariate analyses, age, household income, household contact and using buses/minibuses to commute to work were independently associated with TB [OR for bus/minibus use: 11.8 (95% CI: 1.45-96.07)]. Bus/minibus use to commute to work is associated with TB risk in this high-incidence, urban population in Lima, Peru. Measures should be implemented to prevent TB transmission through this exposure.

Common mental disorders in public transportation drivers in Lima, Peru.

PubMed

Ruiz-Grosso, Paulo; Ramos, Mariana; Samalvides, Frine; Vega-Dienstmaier, Johann; Kruger, Hever

2014-01-01

Traffic related injuries are leading contributors to burden of disease worldwide. In developing countries a high proportion of them can be attributed to public transportation vehicles. Several mental disorders including alcohol and drug abuse, psychotic disorders, mental stress, productivity pressure, and low monetary income were found predictors of high rates of traffic related injuries in public transportation drivers. The goal of this study was to estimate the prevalence of common mental disorders in the population of public transportation drivers of buses and rickshaws in Lima, Peru. Cross sectional study. A sample of bus and rickshaw drivers was systematically selected from formal public transportation companies using a snowball approach. Participants completed self-administered questionnaires for assessing major depressive episode, anxiety symptoms, alcohol abuse, and burnout syndrome. Socio demographic information was also collected. The analyses consisted of descriptive measurement of outcomes taking into account both between and within cluster standard deviation (BCSD and WCSD). A total of 278 bus and 227 rickshaw drivers out of 25 companies agreed to participate in the study. BCSD for major depressive episode, anxiety symptoms and burnout syndrome was not found significant (p>0.05). The estimated prevalence of each variable was 13.7% (IC95%: 10.7-16.6%), 24.1% (IC95%: 19.4-28.8%) and 14.1% (IC95%: 10.8-17.4%) respectively. The estimated prevalence of alcohol abuse was 75.4% (IC95%: 69-81.7%, BCSD = 12.2%, WCSD = 41.9%, intra class correlation (ICC): 7.8%). Common mental disorders such as alcohol abuse, major depressive episode, anxiety symptoms and burnout syndrome presented higher rates in public transportation drivers than general population.

[Peruvian scientific production in medicine and collaboration networks, analysis of the Science Citation Index 2000-2009].

PubMed

Huamaní, Charles; Mayta-Tristán, Percy

2010-09-01

To describe the Peruvian scientific production in indexed journals in the Institute for Scientific Information (ISI) and the characteristics of the institutional collaborative networks. All papers published in the ISI database (Clinical Medicine collection) were included during 2000 to 2009 with at least one author with a Peruvian affiliation. The publication trend, address of corresponding author, type of article, institution, city (only for Peru), and country were evaluated. The collaborative networks were analized using the Pajek® software. 1210 papers were found, increasing from 61 in 2000 to 200 in 2009 (average of 121 articles/year). 30.4% articles included a corresponding author from a Peruvian institution. The average of authors per article was 8.3. Original articles represented 82.1% of total articles. Infectious diseases-related journals concentrated most of the articles. The main countries that collaborate with Peru are: USA (60.4%), England (12.9%), and Brazil (8.0%). Lima concentrated 94.7% of the publications and three regions (Huancavelica, Moquegua and Tacna) did not register any publication. Only two universities published more than one article/year and four institutions published more than 10 articles/year. Universidad Peruana Cayetano Heredia published 45% of the total number of articles, being the most productive institution and which concentrated the most number of collaborations with foreign institutions. The ministry of Health--including all dependencies--published 37.3% of the total number of publications. There is a higher level of collaboration with foreign institutions rather than local institutions. The Peruvian scientific production in medicine represented in the ISI database is very low but growing, and is concentrated in Lima and in a few institutions. The most productive Peruvian institutions collaborate more intensively with foreign journals rather than local institutions.

Factors associated with anti-tuberculosis medication adverse effects: a case-control study in Lima, Peru.

PubMed

Chung-Delgado, Kocfa; Revilla-Montag, Alejandro; Guillen-Bravo, Sonia; Velez-Segovia, Eduardo; Soria-Montoya, Andrea; Nuñez-Garbin, Alexandra; Silva-Caso, Wilmer; Bernabe-Ortiz, Antonio

2011-01-01

Long-term exposure to anti-tuberculosis medication increases risk of adverse drug reactions and toxicity. The objective of this investigation was to determine factors associated with anti-tuberculosis adverse drug reactions in Lima, Peru, with special emphasis on MDR-TB medication, HIV infection, diabetes, age and tobacco use. A case-control study was performed using information from Peruvian TB Programme. A case was defined as having reported an anti-TB adverse drug reaction during 2005-2010 with appropriate notification on clinical records. Controls were defined as not having reported a side effect, receiving anti-TB therapy during the same time that the case had appeared. Crude, and age- and sex-adjusted models were calculated using odds ratios (OR) and 95% confidence intervals (95%CI). A multivariable model was created to look for independent factors associated with side effect from anti-TB therapy. A total of 720 patients (144 cases and 576 controls) were analyzed. In our multivariable model, age, especially those over 40 years (OR = 3.93; 95%CI: 1.65-9.35), overweight/obesity (OR = 2.13; 95%CI: 1.17-3.89), anemia (OR = 2.10; IC95%: 1.13-3.92), MDR-TB medication (OR = 11.1; 95%CI: 6.29-19.6), and smoking (OR = 2.00; 95%CI: 1.03-3.87) were independently associated with adverse drug reactions. Old age, anemia, MDR-TB medication, overweight/obesity status, and smoking history are independent risk factors associated with anti-tuberculosis adverse drug reactions. Patients with these risk factors should be monitored during the anti-TB therapy. A comprehensive clinical history and additional medical exams, including hematocrit and HIV-ELISA, might be useful to identify these patients.

Histamine Levels in Fish from Markets in Lima, Perú†

PubMed Central

Gonzaga, Victor E.; Lescano, Andres G.; Huamán, Alfredo A.; Salmón-Mulanovich, Gabriela; Blazes, David L.

2014-01-01

Illnesses associated with seafood are an important public health concern worldwide, particularly considering the steady increase in seafood consumption. However, research about the risks associated with seafood products is scarce in developing countries. Histamine fish poisoning is the most common form of fish intoxication caused by seafood and usually presents as an allergic reaction. This condition occurs when fish are not kept appropriately refrigerated and histamine is formed in the tissues. Histamine levels of >500 ppm usually are associated with clinical illness. We assessed histamine levels in fish from markets in Lima, Peru, with a quantitative competitive enzyme-linked immunosorbent assay. Thirty-eight specimens were purchased from wholesale and retail markets: 17 bonito (Sarda sarda), 16 mackerel (Scomber japonicus peruanus), and 5 mahi-mahi (Coryphaena hippurus). Seven fish (18%) had histamine levels of 1 to 10 ppm (three mackerel and four bonito) and three (8%) had >10 ppm (three mackerel, 35 to 86 ppm). Fish from retail markets had detectable histamine levels (>1 ppm) more frequently than did fish bought at wholesale fish markets: 9 (36%) of 25 fish versus 1 (8%) of 13 fish, respectively (P = 0.063). Higher histamine levels were correlated with later time of purchase during the day (Spearman’s rho = 0.37, P = 0.024). Mackerel purchased at retail markets after 2 p.m. had a 75% prevalence of histamine levels of >10 ppm. Mackerel purchased late in the day in retail markets frequently contained high histamine levels, although the overall prevalence of elevated histamine levels was low. Despite the small sample, our findings highlight the need to reinforce seafood safety regulations and quality control in developing countries such as Peru. PMID:19517744

Patient Characteristics Associated with Tuberculosis Treatment Default: A Cohort Study in a High-Incidence Area of Lima, Peru

PubMed Central

Lackey, Brian; Seas, Carlos; Van der Stuyft, Patrick; Otero, Larissa

2015-01-01

Background Although tuberculosis (TB) is usually curable with antibiotics, poor adherence to medication can lead to increased transmission, drug resistance, and death. Prior research has shown several factors to be associated with poor adherence, but this problem remains a substantial barrier to global TB control. We studied patients in a high-incidence district of Lima, Peru to identify factors associated with premature termination of treatment (treatment default). Methods We conducted a prospective cohort study of adult smear-positive TB patients enrolled between January 2010 and December 2011 with no history of TB disease. Descriptive statistics and multivariable logistic regression analyses were performed to determine risk factors associated with treatment default. Results Of the 1233 patients studied, 127 (10%) defaulted from treatment. Patients who defaulted were more likely to have used illegal drugs (OR = 4.78, 95% CI: 3.05-7.49), have multidrug-resistant TB (OR = 3.04, 95% CI: 1.58-5.85), not have been tested for HIV (OR = 2.30, 95% CI: 1.50-3.54), drink alcohol at least weekly (OR = 2.22, 95% CI: 1.40-3.52), be underweight (OR = 2.08, 95% CI: 1.21-3.56), or not have completed secondary education (OR = 1.55, 95% CI: 1.03-2.33). Conclusions Our study identified several factors associated with defaulting from treatment, suggesting a complex set of causes that might lead to default. Addressing these factors individually would be difficult, but they might help to identify certain high-risk patients for supplemental intervention prior to treatment interruption. Treatment adherence remains a barrier to successful TB care and reducing the frequency of default is important for both the patients’ health and the health of the community. PMID:26046766

Reducing salt in bread: a quasi-experimental feasibility study in a bakery in Lima, Peru.

PubMed

Saavedra-Garcia, Lorena; Sosa-Zevallos, Vanessa; Diez-Canseco, Francisco; Miranda, J Jaime; Bernabe-Ortiz, Antonio

2016-04-01

To explore salt content in bread and to evaluate the feasibility of reducing salt contained in 'pan francés' bread. The study had two phases. Phase 1, an exploratory phase, involved the estimation of salt contained in bread as well as a triangle taste test to establish the amount of salt to be reduced in 'pan francés' bread without detection by consumers. In Phase 2, a quasi-experimental, pre-post intervention study assessed the effects of the introduction of low-salt bread on bakery sales. A municipal bakery in Miraflores, Lima, Peru. Sixty-five clients of the bakery in Phase 1 of the study; sales to usual costumers in Phase 2. On average, there was 1·25 g of salt per 100 g of bread. Sixty-five consumers were enrolled in the triangle taste test: fifty-four (83·1 %) females, mean age 58·9 (sd 13·7) years. Based on taste, bread samples prepared with salt reductions of 10 % (P=0·82) and 20 % (P=0·37) were not discernible from regular bread. The introduction of bread with 20 % of salt reduction, which contained 1 g of salt per 100 g of bread, did not change sales of 'pan francés' (P=0·70) or other types of bread (P=0·36). Results were consistent when using different statistical techniques. The introduction of bread with a 20 % reduction in salt is feasible without affecting taste or bakery sales. Results suggest that these interventions are easily implementable, with the potential to contribute to larger sodium reduction strategies impacting the population's cardiovascular health.

The Experiences of Newly Diagnosed Men Who Have Sex with Men Entering the HIV Care Cascade in Lima, Peru, 2015-2016: A Qualitative Analysis of Counselor-Participant Text Message Exchanges.

PubMed

Bayona, Erik; Menacho, Luis; Segura, Eddy R; Mburu, Gitau; Roman, Fernando; Tristan, Consuelo; Bromley, Elizabeth; Cabello, Robinson

2017-06-01

Mobile phone technology (mHealth) is a promising tool that has been used to improve HIV care in high-risk populations worldwide. Understanding patient perspectives of newly diagnosed men who have sex with men (MSM) in Lima, Peru during linkage and engagement in the HIV care continuum can help close the gaps in care following initial HIV diagnosis and ensure retention in continuous care. From June 2015 to March 2016, as part of a randomized controlled trial, 40 MSM participants were linked to care with an mHealth intervention within 3 months of HIV diagnosis at Via Libre clinic. For 12 weeks, participants agreed to receive weekly predetermined, standardized short message service (SMS), WhatsApp©, and/or Facebook© messages from an assigned HIV counselor. Text messaging was bi-directional, meaning participants could also send messages to their counselor at any time. In this qualitative study, we coded and thematically analyzed 947 SMS, 918 WhatsApp, and 2,694 Facebook bi-directional messages. Mean age of participants was 29.8 years (20-50); with 70 percent reporting some post-high school education and 73 percent self-identifying as homosexual. We identified six recurring themes that emerged from the data: (a) mental health symptoms; (b) coping behaviors; (c) interpersonal support; (d) physical symptoms; (e) HIV knowledge; and (f) care coordination. Participants sent text messages describing depressive symptoms and seeking mental health services during this initial stage of HIV care. For newly diagnosed MSM entering the HIV care continuum, a bi-directional mHealth intervention provided support to facilitate care while eliciting deeply personal mental and emotional states. Future interventions could benefit from using mHealth interventions as ancillary support for clinicians.

A case-control study to examine the association between breastfeeding during late pregnancy and risk of a small-for-gestational-age birth in Lima, Peru.

PubMed

Pareja, Rossina G; Marquis, Grace S; Penny, Mary E; Dixon, Philip M

2015-04-01

Excessive demands on maternal nutritional status may be a risk factor for poor birth outcomes. This study examined the association between breastfeeding during late pregnancy (≥ 28 weeks) and the risk of having a small-for-gestational-age (SGA) newborn, using a matched case-control design (78 SGA cases: birthweight <10th percentile for gestational age; 150 non-SGA controls: 50th percentile

Surgery and trauma care providers' perception of the impact of dual-practice employment on quality of care provided in an Andean country.

PubMed

LaGrone, L N; Isquith-Dicker, L N; Huaman Egoavil, E; Herrera-Matta, J J; Fuhs, A K; Ortega Checa, D; Revoredo, F; Rodriguez Castro, M J A; Mock, C N

2017-05-01

Dual-practice, simultaneous employment by healthcare workers in the public and private sectors is pervasive worldwide. Although an estimated 30 per cent of the global burden of disease is surgical, the implications of dual practice on surgical care are not well understood. Anonymous in-depth individual interviews on trauma quality improvement practices were conducted with healthcare providers who participate in the care of the injured at ten large hospitals in Peru's capital city, Lima. A grounded theory approach to qualitative data analysis was employed to identify salient themes. Fifty interviews were conducted. A group of themes that emerged related to the perceived negative and positive impacts of dual practice on the quality of surgical care. Participants asserted that the majority of physicians in Lima working in the public sector also worked in the private sector. Dual practice has negative impacts on physicians' time, quality of care in the public sector, and surgical education. Dual practice positively affects patient care by allowing physicians to acquire management and quality improvement skills, and providing incentives for research and academic productivity. In addition, dual practice provides opportunities for clinical innovations and raises the economic status of the physician. Surgeons in Peru report that dual practice influences patient care negatively by creating time and human resource conflicts. Participants assert that these conflicts widen the gap in quality of care between rich and poor. This practice warrants redirection through national-level regulation of physician schedules and reorganization of public investment in health via physician remuneration. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

'Just getting by': a cross-sectional study of male sex workers as a key population for HIV/STIs among men who have sex with men in Peru.

PubMed

Bayer, Angela M; Garvich, Mijail; Díaz, David A; Sánchez, Hugo; García, Patricia J; Coates, Thomas J

2014-05-01

To describe the sociodemographic and sex work characteristics, recent sexual practices, HIV risk perception and testing history, and HIV and syphilis prevalence of Cercado (downtown) and non-Cercado (close urban) male sex workers (MSWs) in Lima, Peru. Eighty-nine MSWs completed a self-administered survey and participated in HIV and syphilis testing. Cercado MSWs had significantly lower median weekly earnings than non-Cercado MSWs (US$43 vs US$72, p=0.04). Most non-Cercado MSWs (81%) reported only insertive anal intercourse with male/transgender partners, while Cercado MSWs primarily reported only insertive (52%) or insertive and receptive (45%) anal intercourse (p=0.03). Consistent condom use was low with insertive and receptive anal intercourse in both subgroups. Among MSWs with recent female partners, condom use with the last partner was lower among Cercado versus non-Cercado MSWs for vaginal sex (37% vs 65%, p=0.04) and anal sex (27% vs 80%, p=0.01). More Cercado than non-Cercado MSWs (57% vs 42%) perceived high HIV risk (p=0.05) and Cercado MSWs had a much higher prevalence than non-Cercado MSWs of HIV (23% vs 4%, p=0.04) and syphilis (22% vs 0%, p=0.02) infections. MSWs in Lima are diverse and Cercado MSWs are 'just getting by,' engaging in more risk behaviours, and more likely to have HIV/STIs. Future research should identify, describe and carry out HIV/STI testing with broader groups of MSWs and their client and non-client partners. Prevention efforts should provide HIV/STI risk reduction education for MSWs and related subgroups who are currently not targeted such as female partners.

Impact of alcohol use on sexual behavior among men who have sex with men and transgender women in Lima, Peru.

PubMed

Herrera, M C; Konda, K A; Leon, S R; Deiss, R; Brown, B; Calvo, G M; Salvatierra, H J; Caceres, C F; Klausner, J D

2016-04-01

Alcohol use disorders (AUDs) may enhance the likelihood of risky sexual behaviors and the acquisition of sexually transmitted infections (STIs). Associations between AUDs with condomless anal intercourse (CAI) and STI/HIV prevalence were assessed among men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. MSM and TW were eligible to participate based on a set of inclusion criteria which characterized them as high-risk. Participants completed a bio-behavioral survey. An AUDIT score ≥8 determined AUD presence. Recent STI diagnosis included rectal gonorrhea/chlamydia, syphilis, and/or new HIV infection within 6 months. Prevalence ratios (PR) were calculated using Poisson regression. Among 312 MSM and 89 TW, 45% (181/401) had an AUD. Among those with an AUD, 164 (91%) were hazardous/harmful drinkers, and 17 (9%) had alcohol dependence. Higher CAI was reported by participants with an AUD vs. without, (82% vs. 72% albeit not significant). Reporting anal sex in two or more risky venues was associated with screening AUD positive vs. not (24% vs. 15%, p=0.001). There was no difference in recent STI/HIV prevalence by AUD status (32% overall). In multivariable analysis, screening AUD positive was not associated with CAI or recent STI/HIV infection. In our sample AUDs were not associated with CAI or new HIV infection/recent STI. However higher prevalence of CAI, alcohol use at last sex, and anal sex in risky venues among those with AUDs suggests that interventions to reduce the harms of alcohol should be aimed toward specific contexts. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Anonymous Partnerships among MSM and Transgender Women (TW) Recently Diagnosed with HIV and other STIs in Lima, Peru: An individual and dyad-level analysis

PubMed Central

Perez-Brumer, Amaya G.; Oldenburg, Catherine E.; Segura, Eddy R.; Sanchez, Jorge; Lama, Javier R.; Clark, Jesse L.

2016-01-01

Objectives Partner notification (PN) following STI diagnosis is a key strategy for controlling HIV/STI transmission. Anonymous partnerships are an important barrier to PN and often associated with high-risk sexual behaviour. Limited research has examined the profile of MSM and TW who engage in anonymous sex. To better understand anonymous partnership practices in Lima, Peru, we assessed participant- and partnership-level characteristics associated with anonymous sex among a sample of MSM and TW recently diagnosed with HIV/STI. Methods MSM and TW diagnosed with HIV/STI within the past month completed a cross-sectional survey regarding anticipated PN practices. Participants reported sexual partnership types and characteristics of up to 3 of their most recent partners. Using a Poisson generalised estimating equation (GEE) model we assessed participant- and partnership-level characteristics associated with anonymous partnerships. Results Among 395 MSM and TW with HIV/STI, 36.0% reported at least one anonymous sexual partner in the past three months (mean of 8.6 anonymous partners per participant; SD 17.0). Of the 971 partnerships reported, 118 (12.2%) were anonymous and the majority (84.8%) were with male partners, followed by 11.0% with female partners, and 4.2% with transgender/travesti partners. Partner-level characteristics associated with increased likelihood of having an anonymous partner included female (aPR 2.28, 95% CI 1.05 to 4.95, P=0.04) or transgender/travesti (aPR 4.03, 95% CI 1.51 to 10.78, P=0.006) partner gender. Conclusions By assessing both individual- and dyadic-level factors, these results represent an important step in understanding the complexity of partnership interactions and developing alternative partner notification strategies for Latin America. PMID:26912910

Patient Characteristics Associated with Tuberculosis Treatment Default: A Cohort Study in a High-Incidence Area of Lima, Peru.

PubMed

Lackey, Brian; Seas, Carlos; Van der Stuyft, Patrick; Otero, Larissa

2015-01-01

Although tuberculosis (TB) is usually curable with antibiotics, poor adherence to medication can lead to increased transmission, drug resistance, and death. Prior research has shown several factors to be associated with poor adherence, but this problem remains a substantial barrier to global TB control. We studied patients in a high-incidence district of Lima, Peru to identify factors associated with premature termination of treatment (treatment default). We conducted a prospective cohort study of adult smear-positive TB patients enrolled between January 2010 and December 2011 with no history of TB disease. Descriptive statistics and multivariable logistic regression analyses were performed to determine risk factors associated with treatment default. Of the 1233 patients studied, 127 (10%) defaulted from treatment. Patients who defaulted were more likely to have used illegal drugs (OR = 4.78, 95% CI: 3.05-7.49), have multidrug-resistant TB (OR = 3.04, 95% CI: 1.58-5.85), not have been tested for HIV (OR = 2.30, 95% CI: 1.50-3.54), drink alcohol at least weekly (OR = 2.22, 95% CI: 1.40-3.52), be underweight (OR = 2.08, 95% CI: 1.21-3.56), or not have completed secondary education (OR = 1.55, 95% CI: 1.03-2.33). Our study identified several factors associated with defaulting from treatment, suggesting a complex set of causes that might lead to default. Addressing these factors individually would be difficult, but they might help to identify certain high-risk patients for supplemental intervention prior to treatment interruption. Treatment adherence remains a barrier to successful TB care and reducing the frequency of default is important for both the patients' health and the health of the community.

Variation in the costs of delivering routine immunization services in Peru.

PubMed Central

Walker, D.; Mosqueira, N. R.; Penny, M. E.; Lanata, C. F.; Clark, A. D.; Sanderson, C. F. B.; Fox-Rushby, J. A.

2004-01-01

OBJECTIVE: Estimates of vaccination costs usually provide only point estimates at national level with no information on cost variation. In practice, however, such information is necessary for programme managers. This paper presents information on the variations in costs of delivering routine immunization services in three diverse districts of Peru: Ayacucho (a mountainous area), San Martin (a jungle area) and Lima (a coastal area). METHODS: We consider the impact of variability on predictions of cost and reflect on the likely impact on expected cost-effectiveness ratios, policy decisions and future research practice. All costs are in 2002 prices in US dollars and include the costs of providing vaccination services incurred by 19 government health facilities during the January-December 2002 financial year. Vaccine wastage rates have been estimated using stock records. FINDINGS: The cost per fully vaccinated child ranged from 16.63-24.52 U.S. Dollars in Ayacucho, 21.79-36.69 U.S. Dollars in San Martin and 9.58-20.31 U.S. Dollars in Lima. The volume of vaccines administered and wastage rates are determinants of the variation in costs of delivering routine immunization services. CONCLUSION: This study shows there is considerable variation in the costs of providing vaccines across geographical regions and different types of facilities. Information on how costs vary can be used as a basis from which to generalize to other settings and provide more accurate estimates for decision-makers who do not have disaggregated data on local costs. Future studies should include sufficiently large sample sizes and ensure that regions are carefully selected in order to maximize the interpretation of cost variation. PMID:15628205

Peru Mercury Inventory 2006

USGS Publications Warehouse

Brooks, William E.; Sandoval, Esteban; Yepez, Miguel A.; Howard, Howell

2007-01-01

In 2004, a specific need for data on mercury use in South America was indicated by the United Nations Environmental Programme-Chemicals (UNEP-Chemicals) at a workshop on regional mercury pollution that took place in Buenos Aires, Argentina. Mercury has long been mined and used in South America for artisanal gold mining and imported for chlor-alkali production, dental amalgam, and other uses. The U.S. Geological Survey (USGS) provides information on domestic and international mercury production, trade, prices, sources, and recycling in its annual Minerals Yearbook mercury chapter. Therefore, in response to UNEP-Chemicals, the USGS, in collaboration with the Economic Section of the U.S. Embassy, Lima, has herein compiled data on Peru's exports, imports, and byproduct production of mercury. Peru was selected for this inventory because it has a 2000-year history of mercury production and use, and continues today as an important source of mercury for the global market, as a byproduct from its gold mines. Peru is a regional distributor of imported mercury and user of mercury for artisanal gold mining and chlor-alkali production. Peruvian customs data showed that 22 metric tons (t) of byproduct mercury was exported to the United States in 2006. Transshipped mercury was exported to Brazil (1 t), Colombia (1 t), and Guyana (1 t). Mercury was imported from the United States (54 t), Spain (19 t), and Kyrgyzstan (8 t) in 2006 and was used for artisanal gold mining, chlor-alkali production, dental amalgam, or transshipment to other countries in the region. Site visits and interviews provided information on the use and disposition of mercury for artisanal gold mining and other uses. Peru also imports mercury-containing batteries, electronics and computers, fluorescent lamps, and thermometers. In 2006, Peru imported approximately 1,900 t of a wide variety of fluorescent lamps; however, the mercury contained in these lamps, a minimum of approximately 76 kilograms (kg), and in other products such as batteries and computer electronics is not recycled and may ultimately be released to the environment.

HPV knowledge, burden and genital wart location among heterosexually identified versus homosexually identified men who have sex with men in Lima, Peru: cross-sectional results from a cohort study.

PubMed

Galea, Jerome T; León, Segundo R; Peinado, Jesús; Calvo, Gino; Zamora, Jonathan; Sánchez, Hugo; Brown, Brandon J

2017-10-24

The relationship between sexual practices, identity and role among Latino men who have sex with men (MSM) and HIV risk is the subject of ongoing investigation but less is known about how these aspects of sexuality relate to human papilloma-virus (HPV), an independent risk factor for HIV. This observational study investigated the relationship between HPV and sexual practices, identity and role as well as other sexually transmitted infection (STI)/HIV risk factors among HIV-negative heterosexually and homosexually identified Peruvian MSM. Community-based clinic for MSM in Lima, Peru. 756 subjects were screened based on inclusion criteria of: born anatomically male; age ≥18 years; had any anal intercourse with a man during the previous 12 months; residing in metropolitan Lima; HIV negative; willing to commit to twice-yearly clinic visits for 24 months; had not participated in an HIV or HPV vaccine study. 600/756 participants met the inclusion criteria and were enrolled, of whom 48% (284) identified as homosexual and 10% (57) as heterosexual, the basis of the analyses performed. Compared with homosexually identified MSM, heterosexually identified MSM had completed fewer years of formal education and were less likely to have: anogenital HPV or visible anal warts; given oral sex to a man; or used a condom with their most recent female sexual partner (all p<0.05). Conversely, heterosexually identified MSM were more likely to have: visible penile warts; used a condom during last anal intercourse; smoked cigarettes; had transactional sex; and used drugs during sex in the previous month (all p<0.01). There was no difference found between heterosexually and homosexually identified MSM by syphilis or high-risk HPV prevalence. HPV burden, wart type (penile vs anal) and select HIV/STI risk behaviours differed between heterosexually and homosexually identified Peruvian MSM. Understanding the implications of these differences can lead to tailored HIV/STI prevention interventions for heterosexually identified MSM. NCT01387412. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Arsenic exposure in drinking water: an unrecognized health threat in Peru.

PubMed

George, Christine Marie; Sima, Laura; Arias, M Helena Jahuira; Mihalic, Jana; Cabrera, Lilia Z; Danz, David; Checkley, William; Gilman, Robert H

2014-08-01

To assess the extent of arsenic contamination of groundwater and surface water in Peru and, to evaluate the accuracy of the Arsenic Econo-Quick(™) (EQ) kit for measuring water arsenic concentrations in the field. Water samples were collected from 151 water sources in 12 districts of Peru, and arsenic concentrations were measured in the laboratory using inductively-coupled plasma mass spectrometry. The EQ field kit was validated by comparing a subset of 139 water samples analysed by laboratory measurements and the EQ kit. In 86% (96/111) of the groundwater samples, arsenic exceeded the 10 µg/l arsenic concentration guideline given by the World Health Organization (WHO) for drinking water. In 56% (62/111) of the samples, it exceeded the Bangladeshi threshold of 50 µg/l; the mean concentration being 54.5 µg/l (range: 0.1-93.1). In the Juliaca and Caracoto districts, in 96% (27/28) of groundwater samples arsenic was above the WHO guideline; and in water samples collected from the section of the Rímac river running through Lima, all had arsenic concentrations exceeding the WHO limit. When validated against laboratory values, the EQ kit correctly identified arsenic contamination relative to the guideline in 95% (106/111) of groundwater and in 68% (19/28) of surface water samples. In several districts of Peru, drinking water shows widespread arsenic contamination, exceeding the WHO arsenic guideline. This poses a public health threat requiring further investigation and action. For groundwater samples, the EQ kit performed well relative to the WHO arsenic limit and therefore could provide a vital tool for water arsenic surveillance.

Mixed-Methods Assessment of Trauma and Acute Care Surgical Quality Improvement Programs in Peru.

PubMed

LaGrone, Lacey N; Fuhs, Amy K; Egoavil, Eduardo Huaman; Rodriguez Castro, Manuel J A; Valderrama, Roberto; Isquith-Dicker, Leah N; Herrera-Matta, Jaime; Mock, Charles N

2017-04-01

Evidence for the positive impact of quality improvement (QI) programs on morbidity, mortality, patient satisfaction, and cost is strong. Data regarding the status of QI programs in low- and middle-income countries, as well as in-depth examination of barriers and facilitators to their implementation, are limited. This cross-sectional, descriptive study employed a mixed-methods design, including distribution of an anonymous quantitative survey and individual interviews with healthcare providers who participate in the care of the injured at ten large hospitals in Lima, Peru. Key areas identified for improvement in morbidity and mortality (M&M) conferences were the standardization of case selection, incorporation of evidence from the medical literature into case presentation and discussion, case documentation, and the development of a clear plan for case follow-up. The key barriers to QI program implementation were a lack of prioritization of QI, lack of sufficient human and administrative resources, lack of political support, and lack of education on QI practices. A national program that makes QI a required part of all health providers' professional training and responsibilities would effectively address a majority of identified barriers to QI programs in Peru. Specifically, the presence of basic QI elements, such as M&M conferences, should be required at hospitals that train pre-graduate physicians. Alternatively, short of this national-level organization, efforts that capitalize on local examples through apprenticeships between institutions or integration of QI into continuing medical education would be expected to build on the facilitators for QI programs that exist in Peru.

[Spatial analysis of gestational anemia in Peru, 2015].

PubMed

Hernández-Vásquez, Akram; Azañedo, Diego; Antiporta, Daniel A; Cortés, Sandra

2017-01-01

To establish regional prevalences of anemia in pregnant women receiving care at public clinics in Peru in 2015 and identify high-prevalence district conglomerates. An ecological study was carried out on data from pregnant women with anemia registered on the Nutritional Status Information System (SIEN) who received care in 7703 public clinics in 2015. Regional and district prevalences of gestational anemia were calculated. District conglomerates with a high prevalence of gestational anemia were identified using the Moran Index. Information was gathered from 311,521 pregnant women distributed in 1638 districts in Peru. The national prevalence of anemia was 24.2% (95% confidence interval [95% CI]: 24.0-24.3%), the rural prevalence was 30.5%, and the urban prevalence was 22.0%. The regions of Huancavelica (45.5%; 95% CI: 44.2-46.7%), Puno (42.8%; 95% CI: 41.9-43.7%), Pasco (38.5%; 95% CI: 36.9-40.0%), Cusco (36.0%; 95% CI: 35.3-36.8%), and Apurímac (32.0%; 95% CI: 30.8-33.1%) had the highest prevalences of anemia. The local Moran Index identified 202 high-priority districts (hot spots) (12.3% of total; 44 urban and 158 rural) located in Ancash, Apurímac, Arequipa, Ayacucho, Cajamarca, Cusco, Huancavelica, Huánuco, Junín, La Libertad, Lima, Pasco, and Puno containing high-prevalence district conglomerates. Gestational anemia in Peru has its highest prevalence rates in rural and southern mountainous areas. The district conglomerates with high prevalence rates of gestational anemia coincide with the areas of high regional prevalence.

[Innovation in the organization of health services delivery within the Metropolitan System of Solidarity in Peru].

PubMed

Arroyo, Juan; Pastor-Goyzueta, Ada

2013-06-01

Based on the results achieved to date by the Metropolitan System of Solidarity (SISOL) in Peru, this study undertook to analyze the extent to which SISOL has contributed to innovation in the organization of health services delivery. SISOL performance indicators were analyzed and compared with those of other health services delivery models in Peru, drawing on data from a survey of 4 570 SISOL users conducted in the last quarter of 2011, National Household Surveys from 2003 through 2011, and statistical data from the Peruvian Ministry of Health and Social Security. SISOL rated high in terms of growth of the demand served in Lima, productivity of human resources in office visits, and levels of user satisfaction. These results are attributed to: (a) the presence of specialists at the first level of care; (b) an innovative public-private structure, as opposed to outsourcing; and (c) a system of incentives based on shared risk management. The findings support the need for primary health care renewal, especially in urban areas to reduce the proliferation of unnecessary levels and sublevels of care. They also point to the possibility of developing synergistic public-private partnerships in which both sectors share risks and act in collaboration within a single service system. And finally, they indicate that primary care needs to be articulated into the segmented models.

A potential contribution to human identification using peri-mortem trauma: An example from Peru.

PubMed

Baraybar, Jose P

2017-11-01

This is an exploratory study into the need for additional lines of forensic evidence in humanitarian cases using applied research. One hundred and twenty four, still unidentified terrorism inmates, were killed after surrendering to the Peruvian Army once it took control of the San Pedro-Lurigancho prison in Lima, Peru in 1986. Two questions are put forward: first, to what extent mechanism of injury (gunshot, blunt, sharp force) and bodily distribution of those injuries allow us to classify individuals into discrete sub-groups of people? The second question is to what respect can such a classification become an additional line of evidence assisting in generating hypotheses of identity regarding those individuals? The analysis of the 109 recovered bodies and their associated evidence show a sub group of four individuals differentiated from the rest based on the combination of injuries (gunshot and blunt force trauma), opposing trajectories and weapons. While the results do not constitute per se proof of identity, they suggest that such a small group of people could have been singled out from the crowd and treated differently. Such information constitutes an additional line of evidence to formulate hypotheses of identity for certain individuals that could have been ring leaders/cadres of the Shining Path, a Maoist movement that started the Internal Armed Conflict (1980-2000) in Peru. Copyright © 2017 Elsevier B.V. All rights reserved.

An explanatory factor analysis of a brief self-report scale to detect neurocognitive impairment among HIV-positive men who have sex with men and transgender women in Peru.

PubMed

Weikum, Damian; Shrestha, Roman; Ferro, Enrico G; Vagenas, Panagiotis; Copenhaver, Michael; Spudich, Serena; Alpert, Michael D; Cabello, Robinson; Lama, Javier R; Sanchez, Jorge; Altice, Frederick L

2017-10-01

Neurocognitive impairment (NCI) has been associated with poor clinical outcomes in various patient populations. This study used exploratory factor analysis (EFA) to examine the factor structure of the existing 95-item Neuropsychological Impairment Scale (NIS) to create a suitable NCI screening instrument for people living with HIV (PLH). In Lima, Peru, 313 HIV-positive men who have sex with men (MSM) and transgender women (TGW) prescribed antiretroviral therapy (ART) completed the NIS using computer-assisted self-interviews (CASI). The EFA used principal axis factoring and orthogonal varimax rotation, which resulted in 42 items with an 8-factor solution that explained 51.8% of the overall variance. The revised, 8-factor, Brief Inventory of Neurocognitive Impairment for Peru (BINI-P) showed a diverse set of factors with excellent to good reliability (i.e., F 1 α = 0.92 to F 8 α = 0.78). This EFA supports the use of the BINI-P to screen for NCI among Spanish-speaking, HIV-positive MSM and TGW. Future research should examine the effectiveness of the BINI-P in detecting NCI in clinical care settings and the impact of NCI on HIV health-related outcomes, including linkage and retention in care, ART adherence and HIV risk behaviors.

[Overweight, obesity and chronic mal nutrition in 6 to 9 year-old children in Peru, 2009-2010].

PubMed

Pajuelo-Ramírez, Jaime; Sánchez-Abanto, José; Alvarez-Dongo, Doris; Tarqui-Mamani, Carolina; Agüero-Zamora, Rosa

2013-01-01

To determine the prevalence of overweight, obesity and chronic malnutrition in 6- to 9-year-old children in Peru. A cross-cutting study based on the 2009-2010 National Household Survey. The size/age ratio was analyzed with references of the National Center for Health Statistic (NCSH) and the World Health Organization (WHO), considering less than two standard deviations for chronic malnutrition (CM); and the Must and WHO reference tables to measure the body mass index with 85 to 95 percentile values for overweight and above 95 for obesity. With Must as reference, overweight was 12.1% and obesity 9.4%, and according to WHO overweight and obesity were 10.2 and 11.3% respectively. The prevalence of CM according to NCSH and WHO is 15.4 and 17.8% respectively. The highest prevalence of CM is in the north (25.2%), center (22.9%) and south of (19%) the Highland, while obesity is more present in the south coast (28%), Metropolitan Lima (22.8%) and the central Coast (22.5%). Of all the children with CM, 6.5% has overweight and 1.2% obesity. CM is decreasing because size averages have improved, however obesity has doubled. The presence of CM and obesity in children aged 6 to 9 years old in different regions of Peru poses a challenge in the planning of food and nutrition policies.

[Results of the implementation of three national guidelines for the prevention of HIV vertical transmission in Instituto Nacional Materno Perinatal. Lima, Peru].

PubMed

Velásquez, Carlos

2011-01-01

A retrospective analysis is performed in three successive periods between the years 1996 and 2009, in order to evaluate the impact of the implementation of three national guidelines for the prevention of the vertical transmission of HIV. 275 births were included in 13 years. Significant statistical differences were found in the percentage of HIV cases in the children exposed to the virus between the three periods: 15% during the period in which only zidovudine (AZT) was administered to the pregnant woman, 6.4% during the second period (administration of AZT to the pregnant woman not fulfilling HAART initiation criteria and HAART to those fulfilling criteria for this treatment), and 4% during the third period in which HAART was applied to all pregnant women with HIV infection. 95% of pregnant women ended their pregnancy by cesarean section and the 100% of children received infant formula. Changes made in national guidelines have produced a positive impact in the decrease of HIV infected children in the Instituto Nacional Materno Perinatal in Peru.

When Sex Work Becomes Your Everything: The Complex Linkages Between Economy and Affection Among Male Sex Workers in Peru.

PubMed

Bayer, Angela M; Garvich, Mijail; Díaz, David A; Sánchez, Hugo; García, Patricia J; Coates, Thomas J

2014-09-01

In Peru, there are few studies on male sex workers (MSWs), and existing studies explore limited subgroups or offer limited information about MSWs' perspectives. This study provides in-depth perspectives from 40 MSWs who work in downtown Lima (Cercado) and in surrounding urban neighborhoods (non-Cercado) through interviews on their identities, lives, and HIV/STI (sexually transmitted infection) risks and vulnerabilities. Findings are that entry into sex work links economy and affection, particularly among Cercado MSWs. Continued sex work cements this link, making it difficult to exit sex work and establish goals. Ties between economics and affections influence MSWs' perceived HIV/STI risks, vulnerabilities, and prevention practices. Although Cercado MSWs report higher HIV/STI risks and vulnerabilities than non-Cercado peers, they report fewer prevention practices given inability to buy condoms and acceptance of client offers of higher payment, especially clients they feel affection for. MSWs need support to strengthen their self-perceptions and define and pursue their goals in order to improve their HIV/STI prevention practices, health, and well-being. © The Author(s) 2013.

When sex work becomes your everything: The complex linkages between economy and affection among male sex workers in Peru

PubMed Central

Bayer, Angela M.; Garvich, Mijail; Díaz, David A.; Sánchez, Hugo; García, Patricia J.; Coates, Thomas J.

2014-01-01

In Peru, there are few studies on male sex workers (MSWs) and existing studies explore limited sub-groups or offer limited information about MSWs’ perspectives. This study provides in-depth perspectives from 40 MSWs who work in downtown Lima (Cercado) and in surrounding urban neighborhoods (non-Cercado) through interviews on their identities, lives and HIV/STI risks and vulnerabilities. Findings are that entry into sex work links economy and affection, particularly among Cercado MSWs. Continued sex work cements this link, making it difficult to exit sex work and establish goals. Ties between economics and affections influence MSWs’ perceived HIV/STI risks, vulnerabilities and prevention practices. Although Cercado MSWs report higher HIV/STI risks and vulnerabilities than non-Cercado peers, they report fewer prevention practices given inability to buy condoms and acceptance of client offers of higher payment, especially clients they feel affection for. MSWs need support to strengthen their self-perceptions and define and pursue their goals in order to improve their HIV/STI prevention practices, health and well-being. PMID:24368712

Pharmacoeconomic study comparing carbetocin with oxytocin for the prevention of hemorrhage following cesarean delivery in Lima, Peru.

PubMed

Caceda, Sonia Indacochea; Ramos, Richard Rubio; Saborido, Carlos Martín

2018-01-01

Postpartum hemorrhage is one of the main causes of maternal death. Oxytocin has traditionally been used to prevent postpartum hemorrhage. To compare oxytocin with carbetocin, a long-acting analog of oxytocin, for prevention of uterine hemorrhage after cesarean delivery. Clinical data were retrieved from the 2012 Cochrane meta-analysis "Carbetocin for preventing postpartum hemorrhage". A decision tree was constructed. The direct costs were those of medications from the Peruvian official price list (DIGEMID). Costs associated with additional oxytocic drugs, blood transfusions, postpartum hemorrhage kits and hysterectomy were obtained from Hospital Nacional Edgardo Rebagliati Martins. The perspective of the study was that of the payer. The time horizon for calculating quality-adjusted life years (QALYs) was 1 year (2015). Patients who received carbetocin required fewer additional uterotonic agents, had fewer hemorrhages and received fewer blood transfusions. Therefore, the costs associated with these interventions were lower. The incremental cost-effectiveness ratio was S/. 49,918 per QALY gained, which is lower than the threshold we estimated for Peru. Carbetocin is more cost-effective than oxytocin for prevention of uterine hemorrhage after cesarean delivery.

Star of Lima - Overview and optical diagnostics of a barium Alfven critical velocity experiment

NASA Technical Reports Server (NTRS)

Wescott, E. M.; Stenbaek-Nielsen, H. C.; Hallinan, T.; Foeppl, H.; Valenzuela, A.

1986-01-01

The Alfven critical velocity mechanism for ionization of a neutral gas streaming across the magnetic field has been demonstrated in laboratory experiments. In March 1983, two rocket-borne experiments with Ba and Sr tested the effect in the wall-less laboratory of space from Punto Lobos, Peru, near 430 km altitude. 'Star of Lima' used a conical Ba shaped charge aimed at an instrument payload about 2 km away. Because of rocket overperformance the detonation occurred in partial sunlight, so that less than 21.6 percent of the ionizing UV was present. Particle and field measurements indicate the production of hot electrons and waves in the energy and frequency range that are respectively predicted to produce a cascade of ionization by the Alfven mechanism. However, the ionization fluxes and wave energy density did not reach cascade levels, and optical observations indicate that only 2.5 to 5 x 10 to the 20th Ba ions were produced. A substantial portion and perhaps all of the ionization could have been produced by solar UV. The failure of the Alfven process in this experiment is not well understood.

A community-based cluster randomized survey of noncommunicable disease and risk factors in a peri-urban shantytown in Lima, Peru

PubMed Central

2014-01-01

Background An estimated 863 million people–a third of the world’s urban population–live in slums, yet there is little information on the disease burden in these settings, particularly regarding chronic preventable diseases. Methods From March to May 2012, we conducted a cluster randomized survey to estimate the prevalence of noncommunicable diseases (NCDs) and associated risk factors in a peri-urban shantytown north of Lima, Peru. Field workers administered a questionnaire that included items from the WHO World Health Survey and the WHO STEPS survey of chronic disease risk factors. We used logistic regression to assess the associations of NCDs and related risk factors with age and gender. We accounted for sampling weights and the clustered sampling design using statistical survey methods. Results A total of 142 adults were surveyed and had a weighted mean age of 36 years (range 18–81). The most prevalent diseases were depression (12%) and chronic respiratory disease (8%), while lifetime prevalence of cancer, arthritis, myocardial infarction, and diabetes were all less than 5%. Fifteen percent of respondents were hypertensive and the majority (67%) was unaware of their condition. Being overweight or obese was common for both genders (53%), but abdominal obesity was more prevalent in women (54% vs. 10% in men, p < 0.001). Thirty-five percent of men binge drank and 34% reported current smoking; these behaviors were less common among women (4% binge drank, p < 0.001; 8% smoked, p = 0.002). Increasing age was associated with an increased risk of abdominal obesity (Odds Ratio (OR) = 1.04, 95% CI = 1.01, 1.07, p = 0.02), hypertension (OR = 1.06, 95% CI = 1.02, 1.10, p = 0.006), arthritis (OR = 1.07, 95% CI = 1.03, 1.11, p < 0.001) and cancer (OR = 1.13, 95% CI = 1.07, 1.20, p < 0.001) in adjusted models. The prevalences of other NCDs and related risk factors were similar when stratified by age or gender. Conclusions This study underlines the important burden of noncommunicable disease in informal settlements in Peru and suggests that prevention and treatment interventions could be optimized according to age and gender. PMID:24885980

Individual and partnership factors associated with anticipated versus actual partner notification following STI diagnosis among men who have sex with men and/or with transgender women in Lima, Peru.

PubMed

Braun, Hannan M; Segura, Eddy R; Lake, Jordan E; Gandhi, Monica; Rios, Jessica; Villaran, Manuel V; Sanchez, Jorge; Lama, Javier R; Clark, Jesse L

2017-11-30

A detailed understanding of intentions and practices related to partner notification (PN) following STI diagnosis can improve control strategies. We assessed participant-level and partner-level factors guiding notification behaviour among men who have sex with men and/or with transgender women (MSM-TW) in Lima, Peru, including discordances between anticipated and actual notification. Men newly diagnosed with gonorrhoea, chlamydia and/or syphilis between 2012 and 2014 reported recent partners' characteristics, anticipated PN practices, and actual PN outcomes following diagnosis. Generalised estimating equation Poisson regression analyses assessed factors guiding PN outcomes. Participants (n=150) predominantly identified as homosexual (70%) and moderno (versatile sexual role, 55%); 55% of partners (n=402) were casual. Among all sexual partners, 35% were notified of the STI diagnosis, though only 51% of predicted PN occurred and 26% of actual notifications were unanticipated. 47% of participants notified no partners, while 24% notified all partners. PN was more common with stable versus casual (adjusted prevalence ratio (aPR), 95% CI: 0.53, 0.39 to 0.73) or commercial (aPR, 95% CI: 0.38, 0.12 to 1.21) partners, and among participants who perceived PN as normative among their peers (aPR, 95% CI: 1.96, 1.37 to 2.82). A trend towards greater notification following condom-protected intercourse was observed (aPR, 95% CI: 1.33, 0.98 to 1.81). PN frequency did not differ by type of STI diagnosed.Anticipated notification predicted actual notification (aPR, 95% CI: 1.67, 1.19 to 2.33) only imperfectly: 81 (54%) participants' PN practices did not match their anticipated behaviour. Successful notification despite anticipated silence (40 participants, 63 partners) was associated with stable partnerships and a normative perception of PN. Non-notification despite intention (43 participants, 73 partners) frequently occurred among participants reporting exclusively oral sex with the partner or with partners identified as activo (insertive role). Anticipated notification imperfectly reflects actual PN behaviour. Future interventions to improve PN among MSM-TW in Peru need to acknowledge partnership contexts. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Biological accidents in last-year medical students from three hospitals in Lima Peru.

PubMed

Charca-Benavente, Lilyan Consuelo; Huanca-Ruelas, Grozny Howell; Moreno-Loaiza, Oscar

2016-08-11

To determine the frequency and characteristics of biological accidents in last-year medical students from three hospitals in Lima. Cross-sectional study performed at three Public Health Insurance hospitals in Lima, in December 2014. The study population comprised last-year medical interns. Biological accidents were recorded with a questionnaire of exposure to blood and body fluids based on the formats used by the Exposure Prevention Information Network system and the Centers for Disease Control and Prevention. We inquired about occurrence and number of biological accidents as well as the characteristics of the last accident. Categorical data are presented as absolute and percentage frequencies and numeric data, as median and interquartile ranges. We collected 100 respondents; 85% of them had had a biological accident during the last year, with a median of 2 and interquartile range of 3. The most frequent type of exposure was percutaneous (71.8%) and the most common device was the hollow needle (54.1%). The most frequent place of occurrence and activities at the moment of exposure were at the delivery room (44.7%), while supervising a vaginal delivery (24.7%), and during suturing (24.7%). Three accidents involved high-risk patients, but only one student received antiviral prophylaxis; 49.4% attributed the cause of the accident to fatigue, and 75.3% of accidents are not reported. Gloves are the most used protective barrier (95%). The frequency of biological accidents among last-year medical students is high. Underreporting and inappropriate use of protective barriers increase the risk of medical students for biological accidents.

[Mesenteric cyst in the Instituto Nacional de Salud del Niño, Lima, Peru: a case report].

PubMed

Cucho, Janetliz; Ormeño, Alexis; Valdivieso Falcon, Lidia; Pereyra, Sonia; Ramos Rodríguez, Karen

2013-01-01

Mesenteric cysts are rare abdominal tumors. About 60% of these cysts occurs before 5 years of age and can be located anywhere in the gastrointestinal tract, but are most often found in the small bowel mesentery. The clinical presentation depends on the location and size of the cyst and many cases are asymptomatic and are diagnosed incidentally. The most common symptoms are abdominal pain, bloating, abdominal mass, nausea, vomiting, constipation, diarrhea, weight loss, fever and peritonitis. Complications include torsion, infarction, volvulus formation, perforation, infection, anemia, intracystic hemorrhage, intestinal obstruction and obstructive uropathy. They are typically treated by simple excision, marsupialization or segmental bowel resection and have excellent long-term prognosis.

[One staged laparoscopic surgery of colon cancer with liver metastasis in the Guillermo Almenara Hospital, Lima, Peru].

PubMed

Núñez Ju, Juan José; Coronado3, Cesar Carlos; Anchante Castillo, Eduardo; Sandoval Jauregui, Javier; Arenas Gamio, José

2016-01-01

We report a patient who was diagnosed sigmoid colon cancer associated with liver metastases in segment III. The patient underwent laparoscopic surgery where the sigmoid colon resection and hepatic metastasectomy were performed in a “one staged” surgical procedure. The pathological results showed moderately differentiated tubular adenocarcinoma in sigmoid colon, tubular adenocarcinoma metastases also in liver. Oncological surgical results were obtained with free edges of neoplasia, R0 Surgery, T3N0M1. After the optimal surgical results, the patient is handled by oncology for adjuvant treatment. We report here the sequence of events and a review of the literature.

[Influence of socio-cultural context on risk perception and negotiation of protection among poor homosexual males on the Peruvian coast].

PubMed

Salazar, Ximena; Cáceres, Carlos; Maiorana, André; Rosasco, Ana M; Kegeles, Susan; Coates, Thomas

2006-10-01

This paper focuses on risk, conceived not as an individual action, but considering its social dimension, analyzing the various forms in the socio-cultural context related to internalized homophobia and hegemonic gender norms that allow barriers to be constructed in risk perception. Such barriers hinder negotiation and protection among homosexual men that have adopted a female gender identity, living in low-income barrios of Lima and Trujillo, Peru. Risk perception is analyzed on the socio-cultural plane, allowing one to explain the limited negotiating capacity of this population, even though they have extensive knowledge of HIV/AIDS and its consequences.

Ochratoxin A Contamination of Red Chili Peppers from Chile, Bolivia and Peru, Countries with a High Incidence of Gallbladder Cancer.

PubMed

Ikoma, Toshikazu; Tsuchiya, Yasuo; Asai, Takao; Okano, Kiyoshi; Ito, Naoko; Endoh, Kazuo; Yamamoto, Masaharu; Nakamura, Kazutoshi

2015-01-01

Our previous study detected aflatoxins in red chili peppers from Chile, Bolivia, and Peru, each of which have a high incidence of gallbladder cancer (GBC). Since the aflatoxin B1 concentration was not so high in these peppers, it is important to clarify the presence of other mycotoxins. Here we attempted to determine any associations between the concentrations of aflatoxins and ochratoxin A (OTA) in red chili peppers, and the corresponding GBC incidences. We collected red chili peppers from three areas in Peru: Trujillo (a high GBC incidence area), Cusco (an intermediate GBC incidence area), and Lima (a low GBC incidence rate), and from Chile and Bolivia. Aflatoxins and OTA were extracted with organic solvents. The concentrations of aflatoxins B1, B2, G1, and G2, and OTA were measured by high-performance liquid chromatography. The values obtained were compared with the incidence of GBC in each area or country. All of the red chili peppers from the three areas showed contamination with aflatoxins below the Commission of the European Communities (EC) recommended limits (5 μg/kg), but the OTA contamination of two samples was above the EC recommended limit (15 μg/kg). The mean concentrations of OTA in the peppers from Chile (mean 355 μg/kg, range <5-1,059 μg/kg) and Bolivia (mean 207 μg/kg, range 0.8-628 μg/kg), which has a high incidence of GBC, were higher than that in Peru (14 μg/kg, range <5-47 μg/kg), which has an intermediate GBC incidence. The OTA contamination in the red chili peppers from Chile, Bolivia, and Peru was stronger than that of aflatoxins. Our data suggest that OTA in red chili peppers may be associated with the development of GBC.

Arsenic exposure in drinking water: an unrecognized health threat in Peru

PubMed Central

Sima, Laura; Arias, M Helena Jahuira; Mihalic, Jana; Cabrera, Lilia Z; Danz, David; Checkley, William; Gilman, Robert H

2014-01-01

Abstract Objective To assess the extent of arsenic contamination of groundwater and surface water in Peru and, to evaluate the accuracy of the Arsenic Econo-Quick™ (EQ) kit for measuring water arsenic concentrations in the field. Methods Water samples were collected from 151 water sources in 12 districts of Peru, and arsenic concentrations were measured in the laboratory using inductively-coupled plasma mass spectrometry. The EQ field kit was validated by comparing a subset of 139 water samples analysed by laboratory measurements and the EQ kit. Findings In 86% (96/111) of the groundwater samples, arsenic exceeded the 10 µg/l arsenic concentration guideline given by the World Health Organization (WHO) for drinking water. In 56% (62/111) of the samples, it exceeded the Bangladeshi threshold of 50 µg/l; the mean concentration being 54.5 µg/l (range: 0.1–93.1). In the Juliaca and Caracoto districts, in 96% (27/28) of groundwater samples arsenic was above the WHO guideline; and in water samples collected from the section of the Rímac river running through Lima, all had arsenic concentrations exceeding the WHO limit. When validated against laboratory values, the EQ kit correctly identified arsenic contamination relative to the guideline in 95% (106/111) of groundwater and in 68% (19/28) of surface water samples. Conclusion In several districts of Peru, drinking water shows widespread arsenic contamination, exceeding the WHO arsenic guideline. This poses a public health threat requiring further investigation and action. For groundwater samples, the EQ kit performed well relative to the WHO arsenic limit and therefore could provide a vital tool for water arsenic surveillance. PMID:25177071

Attitudes and Relationship between Physicians and the Pharmaceutical Industry in a Public General Hospital in Lima, Peru

PubMed Central

De Ferrari, Aldo; Gentille, Cesar; Davalos, Long; Huayanay, Leandro; Malaga, German

2014-01-01

Background The interaction between physicians and the pharmaceutical industry influences physicians' attitudes and prescribing behavior. Although largely studied in the US, this topic has not been well studied in resource-poor settings, where a close relationship between physicians and industry still exists. Objective To describe physician interactions with and attitudes towards the pharmaceutical industry in a public general hospital in Lima, Peru. Design Descriptive, cross-sectional study through an anonymous, self-filled questionnaire distributed among faculty and trainee physicians of five different clinical departments working in a Peruvian public general hospital. A transcultural validation of an existing Spanish questionnaire was performed. Exposure to marketing activities, motivations to contact pharmaceutical representatives and attitudes towards industry were studied. Collected data was analyzed by degree of training, clinical department, gender and teaching status. Attitudes were measured on a four-point LIKERT scale. Results 155 physicians completed the survey, of which 148 were included in the study sample. 94.5% of attending physicians reported ongoing encounters with pharmaceutical representatives. The most common industry-related activities were receiving medical samples (91.2%), promotional material (87.8%) and attending meetings in restaurants (81.8%). Respondents considered medical samples and continuing medical education the most ethically acceptable benefits. We found significant differences between attendings and residents, and teaching and non-teaching attendings. An association between the amount of encounters with pharmaceutical representatives, and attitudes towards industry and acceptance of medical samples was found. Conclusions A close physician-industry relationship exists in the population under study. The contact is established mainly through pharmaceutical representatives. Medical samples are the most received and ethically accepted benefit. The attitudes of physicians on the ethical standards of acceptance of medical samples and other benefits are closely related with their exposure to the pharmaceutical industry. Future studies could explore the motivations of physicians working in resource-poor settings to maintain a close relationship with industry. PMID:24978481

Seroprevalence, cost per donation and reduction in blood supply due to positive and indeterminate results for infectious markers in a blood bank in Lima, Peru.

PubMed

Moya-Salazar, Jeel; Ubidia-Incio, Roberto; Incio-Grande, Maritza; Blejer, Jorgelina L; Gonzalez, Carlos A

Safety in Transfusion Medicine is subject to regulations and government legislation within a total quality framework. The aim of this study was to evaluate the impact of seroprevalence and indeterminate results on lost units and cost per donation. A prospective cross-sectional study was performed in the Blood Bank and Transfusion Therapy Department of the Hospital Central de la Policia Nacional del Perú in Lima, Peru. All completed donations (replacement/voluntary) without complications were included in this study. Every donation met the institutional requirements and quality criteria of Programa Nacional de Hemoterapia y Bancos de Sangre (PRONAHEBAS). Data analysis was achieved using the Statistical Package for the Social Sciences. A total of 7723 donations were evaluated during 2014 and 2015 with 493 being seropositive (overall prevalence 5.25%) and 502 having indeterminate results (overall prevalence 5.35%). Thus total loss was 995units, 437.8L of blood and 49,750 US dollars. The most common seropositive infectious markers were the core antibody of hepatitis B virus (2.82%) and syphilis (1.02%), and the most common indeterminate results were Chagas disease (1.27%) and the core antibody of hepatitis B virus (1.26%). There was no significant change in the prevalence of seropositivity (p-value=0.243) or indeterminate results (p-value=0.227) over the two-year period of the study. A statistical correlation was found between the cost per lost donation and the most prevalent markers (rho=0.848; p-value=<0.001). Seroprevalence was lower than the regional mean, but the prevalence of indeterminate results was elevated causing a great impact on blood supply and economic losses to this institution. Copyright © 2017 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.

Factors Associated with Anti-Tuberculosis Medication Adverse Effects: A Case-Control Study in Lima, Peru

PubMed Central

Chung-Delgado, Kocfa; Revilla-Montag, Alejandro; Guillen-Bravo, Sonia; Velez-Segovia, Eduardo; Soria-Montoya, Andrea; Nuñez-Garbin, Alexandra; Silva-Caso, Wilmer; Bernabe-Ortiz, Antonio

2011-01-01

Background Long-term exposure to anti-tuberculosis medication increases risk of adverse drug reactions and toxicity. The objective of this investigation was to determine factors associated with anti-tuberculosis adverse drug reactions in Lima, Peru, with special emphasis on MDR-TB medication, HIV infection, diabetes, age and tobacco use. Methodology and Results A case-control study was performed using information from Peruvian TB Programme. A case was defined as having reported an anti-TB adverse drug reaction during 2005–2010 with appropriate notification on clinical records. Controls were defined as not having reported a side effect, receiving anti-TB therapy during the same time that the case had appeared. Crude, and age- and sex-adjusted models were calculated using odds ratios (OR) and 95% confidence intervals (95%CI). A multivariable model was created to look for independent factors associated with side effect from anti-TB therapy. A total of 720 patients (144 cases and 576 controls) were analyzed. In our multivariable model, age, especially those over 40 years (OR = 3.93; 95%CI: 1.65–9.35), overweight/obesity (OR = 2.13; 95%CI: 1.17–3.89), anemia (OR = 2.10; IC95%: 1.13–3.92), MDR-TB medication (OR = 11.1; 95%CI: 6.29–19.6), and smoking (OR = 2.00; 95%CI: 1.03–3.87) were independently associated with adverse drug reactions. Conclusions Old age, anemia, MDR-TB medication, overweight/obesity status, and smoking history are independent risk factors associated with anti-tuberculosis adverse drug reactions. Patients with these risk factors should be monitored during the anti-TB therapy. A comprehensive clinical history and additional medical exams, including hematocrit and HIV-ELISA, might be useful to identify these patients. PMID:22110689

Rate of gestational weight gain, pre-pregnancy body mass index and preterm birth subtypes: a retrospective cohort study from Peru

PubMed Central

Carnero, AM; Mejía, CR; García, PJ

2014-01-01

Objective To examine the shape (functional form) of the association between the rate of gestational weight gain, pre-pregnancy body mass index (BMI), and preterm birth and its subtypes. Design Retrospective cohort study. Setting National reference obstetric centre in Lima, Peru. Population Pregnant women who delivered singleton babies during the period 2006–2009, resident in Lima, and beginning prenatal care at ≤12 weeks of gestation (n = 8964). Methods Data were collected from the centre database. The main analyses consisted of logistic regression with fractional polynomial modelling. Main outcome measures Preterm birth and its subtypes. Results Preterm birth occurred in 12.2% of women, being mostly idiopathic (85.7%). The rate of gestational weight gain was independently associated with preterm birth, and the shape of this association varied by pre-pregnancy BMI. In women who were underweight, the association was linear (per 0.1 kg/week increase) and protective (OR 0.88; 95% CI 0.82–1.00). In women of normal weight or who were overweight, the association was U-shaped: the odds of delivering preterm increased exponentially with rates <0.10 or >0.66 kg/week, and <0.04 or >0.50 kg/week, respectively. In women who were obese, the association was linear, but nonsignificant (OR 1.01; 95% CI 0.95–1.06). The association described for preterm birth closely resembled that of idiopathic preterm birth, although the latter was stronger. The rate of gestational weight gain was not associated with indicated preterm birth or preterm prelabour rupture of membranes. Conclusions In Peruvian pregnant women starting prenatal care at ≤12 weeks of gestation, the rate of gestational weight gain is independently associated with preterm birth, mainly because of its association with idiopathic preterm birth, and the shape of both associations varies by pre-pregnancy BMI. PMID:22607522

Attitudes and relationship between physicians and the pharmaceutical industry in a public general hospital in Lima, Peru.

PubMed

De Ferrari, Aldo; Gentille, Cesar; Davalos, Long; Huayanay, Leandro; Malaga, German

2014-01-01

The interaction between physicians and the pharmaceutical industry influences physicians' attitudes and prescribing behavior. Although largely studied in the US, this topic has not been well studied in resource-poor settings, where a close relationship between physicians and industry still exists. To describe physician interactions with and attitudes towards the pharmaceutical industry in a public general hospital in Lima, Peru. Descriptive, cross-sectional study through an anonymous, self-filled questionnaire distributed among faculty and trainee physicians of five different clinical departments working in a Peruvian public general hospital. A transcultural validation of an existing Spanish questionnaire was performed. Exposure to marketing activities, motivations to contact pharmaceutical representatives and attitudes towards industry were studied. Collected data was analyzed by degree of training, clinical department, gender and teaching status. Attitudes were measured on a four-point LIKERT scale. 155 physicians completed the survey, of which 148 were included in the study sample. 94.5% of attending physicians reported ongoing encounters with pharmaceutical representatives. The most common industry-related activities were receiving medical samples (91.2%), promotional material (87.8%) and attending meetings in restaurants (81.8%). Respondents considered medical samples and continuing medical education the most ethically acceptable benefits. We found significant differences between attendings and residents, and teaching and non-teaching attendings. An association between the amount of encounters with pharmaceutical representatives, and attitudes towards industry and acceptance of medical samples was found. A close physician-industry relationship exists in the population under study. The contact is established mainly through pharmaceutical representatives. Medical samples are the most received and ethically accepted benefit. The attitudes of physicians on the ethical standards of acceptance of medical samples and other benefits are closely related with their exposure to the pharmaceutical industry. Future studies could explore the motivations of physicians working in resource-poor settings to maintain a close relationship with industry.

Rate of gestational weight gain, pre-pregnancy body mass index and preterm birth subtypes: a retrospective cohort study from Peru.

PubMed

Carnero, A M; Mejía, C R; García, P J

2012-07-01

To examine the shape (functional form) of the association between the rate of gestational weight gain, pre-pregnancy body mass index (BMI), and preterm birth and its subtypes.   Retrospective cohort study.   National reference obstetric centre in Lima, Peru.   Pregnant women who delivered singleton babies during the period 2006-2009, resident in Lima, and beginning prenatal care at ≤ 12 weeks of gestation (n=8964).   Data were collected from the centre database. The main analyses consisted of logistic regression with fractional polynomial modelling.   Preterm birth and its subtypes.   Preterm birth occurred in 12.2% of women, being mostly idiopathic (85.7%). The rate of gestational weight gain was independently associated with preterm birth, and the shape of this association varied by pre-pregnancy BMI. In women who were underweight, the association was linear (per 0.1 kg/week increase) and protective (OR 0.88; 95% CI 0.82-1.00). In women of normal weight or who were overweight, the association was U-shaped: the odds of delivering preterm increased exponentially with rates <0.10 or >0.66 kg/week, and <0.04 or >0.50 kg/week, respectively. In women who were obese, the association was linear, but non-significant (OR 1.01; 95% CI 0.95-1.06). The association described for preterm birth closely resembled that of idiopathic preterm birth, although the latter was stronger. The rate of gestational weight gain was not associated with indicated preterm birth or preterm prelabour rupture of membranes.   In Peruvian pregnant women starting prenatal care at ≤ 12 weeks of gestation, the rate of gestational weight gain is independently associated with preterm birth, mainly because of its association with idiopathic preterm birth, and the shape of both associations varies by pre-pregnancy BMI. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

HIV and Sexually Transmitted Infection Incidence and Associated Risk Factors Among High-Risk MSM and Male-to-Female Transgender Women in Lima, Peru.

PubMed

Castillo, Rostislav; Konda, Kelika A; Leon, Segundo R; Silva-Santisteban, Alfonso; Salazar, Ximena; Klausner, Jeffrey D; Coates, Thomas J; Cáceres, Carlos F

2015-08-15

Men who have sex with men (MSM) and male-to-female transgender women (TW) are at increased risk of HIV and sexually transmitted infections (STIs). We evaluated factors associated with incidence of HIV, HSV-2, and chlamydia and gonorrhea (anal and pharyngeal). We used data from the Comunidades Positivas trial with MSM/TW who have sex with men in Lima, Peru. Participants were asked about sexual risk behaviors and underwent HIV/STI testing at baseline and 9- and 18-month follow-ups. We used discrete time proportional hazards regression to calculate hazard ratios for variables associated with incidence of each STI. Among 718 MSM/TW, HIV incidence was 3.6 cases per 100 person-years. HIV incidence was associated with having an incident STI adjusted hazard ratio (aHR) of 3.73. Unprotected receptive anal intercourse was associated with incident anal chlamydia (aHR 2.20). An increased number of sexual partners increased incident HSV-2 (aHR 3.15 for 6-14 partners and 3.97 for 15-46 partners compared with 0-2 partners). The risk of anal gonorrhea decreased with each sexually active year (aHR 0.94) and increased for unprotected compensated sex (aHR 2.36). The risk of pharyngeal gonorrhea also decreased with each year since sexual debut (aHR 0.95). The risk of anal chlamydia decreased with each sexually active year (aHR 0.96); the risk increased with reports of unprotected sex work (aHR 1.61) and unprotected receptive anal sex (aHR 2.63). All aHRs have P values <0.05. MSM/TW experience high incidence of HIV. Up-to-date prevalence and incidence information and identifying factors associated with infection can help develop a more effective combination prevention response.

Factors associated with previously undiagnosed human immunodeficiency virus infection in a population of men who have sex with men and male-to-female transgender women in Lima, Peru.

PubMed

Billings, Joshua D; Joseph Davey, Dvora L; Konda, Kelika A; Bristow, Claire C; Chow, Jeremy; Klausner, Jeffrey D; Cáceres, Carlos F

2016-10-01

The aim of the study was to identify factors associated with undiagnosed human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) and male-to-female transgender women in Lima, Peru.We analyzed characteristics of 378 MSM and transgender women recruited from 2 sexually transmitted infection (STI) clinics in Lima, Peru. Descriptive analyses compared: (A) HIV-uninfected, (B) previously undiagnosed HIV-infected, and (C) previously diagnosed HIV-infected participants. Multivariable logistic regression models identified: (1) correlates of previously undiagnosed HIV-infection among participants thought to be HIV-uninfected (B vs A); and (2) correlates of previously undiagnosed HIV-infection among HIV-infected participants (B vs C). Subanalysis identified correlates of frequent HIV testing among participants thought to be HIV-uninfected.Among participants, 31.0% were HIV-infected; of those, 35.0% were previously undiagnosed. Among participants thought to be HIV-uninfected (model 1), recent condomless receptive anal intercourse and last HIV test being over 1-year ago (compared to within the last 6-months) were associated with increased odds of being previously undiagnosed HIV-infected (adjusted odds ratio [aOR] = 2.43, 95% confidence interval [95%CI] = 1.10-5.36; aOR = 2.87, 95%CI = 1.10-7.53, respectively). Among HIV-infected participants (model 2), recent condomless receptive anal intercourse was again associated with previously undiagnosed HIV-infection (aOR = 2.54, 95%CI = 1.04-6.23). Achieving post-secondary education and prior syphilis infection were associated with lower odds of having previously undiagnosed HIV-infection (aOR = 0.35, 95%CI = 0.15-0.81; aOR = 0.32, 95%CI = 0.14-0.75, respectively).Reporting semiannual testing was associated with higher educational attainment, identifying as a transgender woman, or reporting a history of syphilis (aOR = 1.94, 95%CI = 1.11-3.37; aOR = 2.40, 95%CI = 1.23-4.70; aOR = 2.76, 95%CI = 1.62-4.71, respectively). Lower odds of semiannual testing were associated with recent condomless insertive anal intercourse or reporting a moderate or high self-perceived risk of acquiring HIV (aOR = 0.56, 95%CI = 0.33-0.96; aOR = 0.32, 95%CI = 0.18-0.59 and aOR = 0.43, 95%CI = 0.21-0.86, respectively).In our study, undiagnosed HIV-infection was associated with recent condomless receptive anal intercourse, infrequent HIV testing, lower education, and absence of prior syphilis diagnosis. Infrequent HIV testing was associated with lower education, not identifying as transgender, recent condomless insertive anal intercourse, absence of prior syphilis diagnosis, and higher self-perceived risk of HIV. Further efforts to decrease HIV transmission and increase HIV-serostatus awareness should be directed towards effectively promoting condom use and frequent HIV testing, integrated with STI management.

Communication technology use and mHealth acceptance among HIV-infected men who have sex with men in Peru: implications for HIV prevention and treatment.

PubMed

Krishnan, Archana; Ferro, Enrico G; Weikum, Damian; Vagenas, Panagiotis; Lama, Javier R; Sanchez, Jorge; Altice, Frederick L

2015-01-01

The HIV epidemic in Peru is concentrated among men who have sex with men (MSM). Given that MSM have been documented as early adopters of emerging technology, we examined communication technology access and utilization, and mobile health (mHealth) acceptance among Peruvian MSM and transgender women (TGW) in order to gauge opportunities for mHealth-enabled HIV interventions. A convenience sample of 359 HIV-infected MSM and TGW recruited from three sites in Lima, Peru completed standardized assessments of alcohol use disorders (AUDs), risky sexual behavior, and antiretroviral therapy (ART) adherence along with self-constructed measures of communication technology access and utilization, and mHealth acceptance. Most participants (86%) had daily access to any cell phone, including smartphones (30%). The most frequent communication activities were receiving and making calls, and receiving and sending text messages using cell phones. On a 5-point Likert scale, participants expressed interest in using mHealth for medication reminders (M = 3.21, SD = 1.32) and engaging in anonymous online interactions with health professionals to discuss HIV-related issues (M = 3.56, SD = 1.33). Importantly, no significant differences were found in communication technology use and mHealth acceptance among participants with AUDs, depression, and suboptimal ART adherence, all of which are associated with poor HIV treatment outcomes. Findings show support for implementing mHealth-based intervention strategies using cell phones to assess and reduce HIV-risk behaviors among HIV-infected MSM and TGW.

Paleomagnetism of the Puente Piedra Formation, Central Peru

NASA Astrophysics Data System (ADS)

May, Steven R.; Butler, Robert F.

1985-02-01

Paleomagnetic samples were collected from 15 sites in the early Cretaceous Puente Piedra Formation near Lima, Peru. This formation consists of interbedded volcanic flows and marine sediments and represents the oldest known rocks of the Andean coastal province in this region. The Puente Piedra Formation is interpreted as a submarine volcanic arc assemblage which along with an overlying sequence of early Cretaceous clastic and carbonate rocks represents a terrane whose paleogeographic relationship with respect to the Peruvian miogeocline in pre-Albian time is unknown. Moderate to high coercivities, blocking temperatures below 320°C, and diagnostic strong-field thermomagnetic behavior indicate that pyrrhotite is the dominant magnetic phase in the Puente Piedra Formation. This pyrrhotite carries a stable CRM acquired during an event of copper mineralization associated with the intrusion of the Santa Rosa super-unit of the Coastal Batholith at about 90 ± 5 m.y. B.P. The tectonically uncorrected formation mean direction of: D = 343.2°, I = -28.6°, α 95 = 3.4° is statistically concordant in inclination but discordant in declination with respect to the expected direction calculated from the 90-m.y. reference pole for cratonic South America. The observed declination indicates approximately 20° of counterclockwise rotation of the Puente Piedra rocks since about 90 m.y. This is consistent with other paleomagnetic data from a larger crustal block which may indicate modest counterclockwise rotation during the Cenozoic associated with crustal shortening and thickening in the region of the Peru-Chile deflection.

An open debate about the object and purpose of global health knowledge in the context of an interdisciplinary research partnership on HIV/STI prevention priorities in Peru

PubMed Central

2014-01-01

Background With the failure of the latest vaccine trial, HVTN-505, HIV prevention efforts remain critical. Social and structural factors contributing to HIV and STI transmission include stigma regarding sexual violence, HIV infection and sexual orientation. For instance, HIV prevention and overall sexual health programs in Peru have been implemented yet key populations of youth (sex workers, male and transgender youth) continue to be overrepresented in new cases of HIV and STI. This suggests that interventions must take new directions and highlights the need for additional research. Discussion While interdisciplinary, international research collaborations often are indicated as best practice in developing new knowledge in global health and an important component of the leadership in health systems, this does not mean they are free of challenges. In this debate we document our reflections on some of the challenges in developing an interdisciplinary and international research team to understand HIV and STI prevention priorities among youth in two culturally diverse cities in Peru: Lima, the capital city, and Ayacucho, in the Andean region. Summary Rather than offering solutions we aim to contribute to the debate about the object and purpose of global health research in the context of developing international research partnerships that genuinely promote a reciprocal and bidirectional flow of knowledge between the Global South and the Global North, and researchers at intersections of these locations. PMID:24886493

Development and Validation of a Food Frequency Questionnaire to Estimate Intake among Children and Adolescents in Urban Peru

PubMed Central

Rodriguez, Carly A.; Smith, Emily R.; Villamor, Eduardo; Zavaleta, Nelly; Respicio-Torres, Graciela; Contreras, Carmen; Perea, Sara; Jimenez, Judith; Tintaya, Karen; Lecca, Leonid; Murray, Megan B.; Franke, Molly F.

2017-01-01

Tools to assess intake among children in Latin America are limited. We developed and assessed the reproducibility and validity of a semi-quantitative food frequency questionnaire (FFQ) administered to children, adolescents, and their caregivers in Lima, Peru. We conducted 24-h diet recalls (DRs) and focus groups to develop a locally-tailored FFQ prototype for children aged 0–14 years. To validate the FFQ, we administered two FFQs and three DRs to children and/or their caregivers (N = 120) over six months. We examined FFQ reproducibility by quartile agreement and Pearson correlation coefficients, and validity by quartile agreement and correlation with DRs. For reproducibility, quartile agreement ranged from 60–77% with correlations highest for vitamins A and C (0.31). Age-adjusted correlations for the mean DR and the second-administered FFQ were highest in the 0–7 age group, in which the majority of caregivers completed the FFQ on behalf of the child (total fat; 0.67) and in the 8–14 age group, in which both the child and caregiver completed the FFQ together (calcium, niacin; 0.54); correlations were <0.10 for most nutrients in the 8–14 age group in which the caregiver completed the FFQ on the child’s behalf. The FFQ was reproducible and the first developed and validated to assess various nutrients in children and adolescents in Peru. PMID:29036893

HIV testing among social media-using Peruvian men who have sex with men: correlates and social context.

PubMed

Krueger, Evan A; Chiu, ChingChe J; Menacho, Luis A; Young, Sean D

2016-10-01

HIV remains concentrated among men who have sex with men (MSM) in Peru, and homophobia and AIDS-related stigmas have kept the epidemic difficult to address. Gay self-identity has been associated with increased HIV testing, though this relationship has not been examined extensively. Social media use has been rapidly increasing in Peru, yet little is known about MSM social media users in Peru. This study sought to investigate the demographic, behavioral, and stigma-related factors associated with HIV testing among social media-using Peruvian MSM. Five hundred and fifty-six MSM from Lima and surrounding areas were recruited from social networking websites to complete a survey on their sexual risk behaviors. We examined the demographic and social correlates of HIV testing behavior among this sample. Younger age and non-gay identity were significantly associated with lower likelihood of getting tested in univariate analysis. After controlling for key behaviors and AIDS-related stigma, younger age remained significantly associated with decreased testing. Participants who engaged in discussions online about HIV testing were more likely to get tested, while AIDS-related stigma presented a significant barrier to testing. Stigma severity also varied significantly by sexual identity. Youth appear to be significantly less likely than older individuals to test for HIV. Among Peruvian MSM, AIDS-related stigma remains a strong predictor of willingness to get tested. Social media-based intervention work targeting Peruvian youth should encourage discussion around HIV testing, and must also address AIDS-related stigma.

A cross-sectional study of differences in 6-min walk distance in healthy adults residing at high altitude versus sea level

PubMed Central

2014-01-01

Background We sought to determine if adult residents living at high altitude have developed sufficient adaptation to a hypoxic environment to match the functional capacity of a similar population at sea level. To test this hypothesis, we compared the 6-min walk test distance (6MWD) in 334 residents living at sea level vs. at high altitude. Methods We enrolled 168 healthy adults aged ≥35 years residing at sea level in Lima and 166 individuals residing at 3,825 m above sea level in Puno, Peru. Participants completed a 6-min walk test, answered a sociodemographics and clinical questionnaire, underwent spirometry, and a blood test. Results Average age was 54.0 vs. 53.8 years, 48% vs. 43% were male, average height was 155 vs. 158 cm, average blood oxygen saturation was 98% vs. 90%, and average resting heart rate was 67 vs. 72 beats/min in Lima vs. Puno. In multivariable regression, participants in Puno walked 47.6 m less (95% CI -81.7 to -13.6 m; p < 0.01) than those in Lima. Other variables besides age and height that were associated with 6MWD include change in heart rate (4.0 m per beats/min increase above resting heart rate; p < 0.001) and percent body fat (-1.4 m per % increase; p = 0.02). Conclusions The 6-min walk test predicted a lowered functional capacity among Andean high altitude vs. sea level natives at their altitude of residence, which could be explained by an incomplete adaptation or a protective mechanism favoring neuro- and cardioprotection over psychomotor activity. PMID:24484777

Cost Analysis of Water Transport for Climate Change Impact Assessment

NASA Astrophysics Data System (ADS)

Szaleniec, V.; Buytaert, W.

2012-04-01

It is expected that climate change will have a strong impact on water resources worldwide. Many studies exist that couple the output of global climate models with hydrological models to assess the impact of climate change on physical water availability. However, the water resources topology of many regions and especially that of cities can be very complex. Changes in physical water availability do therefore not translate easily into impacts on water resources for cities. This is especially the case for cities with a complex water supply topology, for instance because of geographical barriers, strong gradients in precipitation patterns, or competing water uses. In this study we explore the use of cost maps to enable the inclusion of water supply topologies in climate change impact studies. We use the city of Lima as a case study. Lima is the second largest desert city in the world. Although Peru as a whole has no water shortage, extreme gradients exist. Most of the economic activities including the city of Lima are located in the coastal desert. This region is geographically disconnected from the wet Amazon basin because of the Andes mountain range. Hence, water supply is precarious, provided by a complex combination of high mountain ecosystems including wetlands and glaciers, as well as groundwater aquifers depending on recharge from the mountains. We investigate the feasibility and costs of different water abstraction scenarios and the impact of climate change using cost functions for different resources. The option of building inter basins tunnels across the Andes is compared to the costs of desalinating seawater from the Pacific Ocean under different climate change scenarios and population growth scenarios. This approach yields recommendations for the most cost-effective options for the future.

Andes Altiplano, South America

NASA Image and Video Library

1991-08-11

STS043-151-159 (2-11 August 1991) --- This photograph looks westward over the high plateau of the southern Peruvian Andes west and north of Lake Titicaca (not in field of view). Lima, Peru lies under the clouds just north of the clear coastal area. Because the high Andes have been uplifted 10,000 to 13,000 feet during the past 20 million years, the rivers which cut down to the Pacific Ocean have gorges almost that deep, such as the Rio Ocona at the bottom of the photograph. The eastern slopes of the Andes are heavily forested, forming the headwaters of the Amazon system. Smoke from burning in the Amazon basin fills river valleys on the right side of the photograph. A Linhof camera was used to take this view.

Interview with Guillermo Arrévalo, a Shipibo urban shaman, by Roger Rumrrill. Interview by Roger Rumrrill.

PubMed

Arrévalo, Guillermo

2005-06-01

Roger Rumrrill, a journalist headquartered in Lima, Peru who is a noted expert on the Peruvian Amazon, interviewed Guillermo Arrévalo, a Shipibo urban shaman in Pucallpa, who utilizes ayahuasca in curing rituals. Sr. Arrévalo comments on the phenomenon known as drug tourism, where urban men and women provide tours for foreigners, for a price, to experience drug-induced mystical experiences in urban settings like Iquitos and Pucallpa, Peru, as well as in Brazil, Bolivia and Ecuador. Arrévalo distinguishes between folkloric shamanism and touristic practices which are currently in vogue and, in his opinion, are the result of people trying to resolve personal problems. Arrévalo sees a spiritual and psychological crisis in Europe and North American society. The Shipibo shaman laments the misuse of toxic plants as additives to the ayahuasca potion and the damage that these plants cause to the unsuspecting tourist who doesn't really get his money's worth from shamans without experience, people who are liars and cheats and who don't have the capacity, the preparation or the boldness to do the work.

Do Refuge Plants Favour Natural Pest Control in Maize Crops?

PubMed Central

Quispe, Reinaldo; Mazón, Marina; Rodríguez-Berrío, Alexander

2017-01-01

The use of non-crop plants to provide the resources that herbivorous crop pests’ natural enemies need is being increasingly incorporated into integrated pest management programs. We evaluated insect functional groups found on three refuges consisting of five different plant species each, planted next to a maize crop in Lima, Peru, to investigate which refuge favoured natural control of herbivores considered as pests of maize in Peru, and which refuge plant traits were more attractive to those desirable enemies. Insects occurring in all the plants, including the maize crop itself, were sampled weekly during the crop growing cycle, from February to June 2011. All individuals collected were identified and classified into three functional groups: herbivores, parasitoids, and predators. Refuges were compared based on their effectiveness in enhancing the populations of predator and parasitoid insects of the crop enemies. Refuges A and B were the most effective, showing the highest richness and abundance of both predators and parasitoids, including several insect species that are reported to attack the main insect pests of maize (Spodoptera frugiperda and Rhopalosiphum maidis), as well as other species that serve as alternative hosts of these natural enemies. PMID:28718835

Community strengthening and mental health system linking after flooding in two informal human settlements in Peru: a model for small-scale disaster response.

PubMed

Contreras, C; Aguilar, M; Eappen, B; Guzmán, C; Carrasco, P; Millones, A K; Galea, J T

2018-01-01

Mental health is an important factor in responding to natural disasters. Observations of unmet mental health needs motivated the subsequent development of a community-based mental health intervention following one such disaster affecting Peru in 2017. Two informal human settlements on the outskirts of Lima were selected for a mental health intervention that included: (1) screening for depression and domestic violence, (2) children's activities to strengthen social and emotional skills and diminish stress, (3) participatory theater activities to support conflict resolution and community resilience, and (4) community health worker (CHW) accompaniment to government health services. A total of 129 people were screened across both conditions, of whom 12/116 (10%) presented with depression and 21/58 (36%) reported domestic violence. 27 unique individuals were identified with at least one problem. Thirteen people (48%) initially accepted CHW accompaniment to government-provided services. This intervention provides a model for a small-scale response to disasters that can effectively and acceptably identify individuals in need of mental health services and link them to a health system that may otherwise remain inaccessible.

Patient Reported Delays in Seeking Treatment for Tuberculosis among Adult and Pediatric TB Patients and TB Patients Co-Infected with HIV in Lima, Peru: A Qualitative Study

PubMed Central

Paz-Soldan, Valerie A.; Alban, Rebecca E.; Dimos Jones, Christy; Powell, Amy R.; Oberhelman, Richard A.

2014-01-01

Introduction: Tuberculosis (TB) remains a significant public health challenge worldwide, and particularly in Peru with one of the highest incidence rates in Latin America. TB patient behavior has a direct influence on whether a patient will receive timely diagnosis and successful treatment of their illness. Objectives: The objective was to understand the complex factors that can impact TB patient health seeking behavior. Methods: In-depth interviews were conducted with adult and parents of pediatric patients receiving TB treatment (n = 43), within that group a sub-group was also co-infected with HIV (n = 11). Results: Almost all of the study participants recognized delays in seeking either their child’s or their own diagnosis of their TB symptoms. The principal reasons for treatment-seeking delays were lack of knowledge and confusion of TB symptoms, fear and embarrassment of receiving a TB diagnosis, and a patient tendency to self-medicate prior to seeking formal medical attention. Conclusion: Health promotion activities that target patient delays have the potential to improve individual patient outcomes and mitigate the spread of TB at a community level. PMID:25566523

Tuberculin skin test conversion among health sciences students: A retrospective cohort study

PubMed Central

Pérez-Lu, José E.; Cárcamo, Cesar P.; García, Patricia J.; Bussalleu, Alejandro; Bernabé-Ortiz, Antonio

2014-01-01

SUMMARY Previous studies have reported that health sciences students are at greater risk for tuberculosis infection, especially in developing countries. The objective of this study was to estimate the prevalence, incidence, and factors associated with latent tuberculosis infection among Health Sciences students in Peru. Students enrolled at private university (in Lima – Peru) are tested annually for tuberculosis infection by tuberculin skin test. Data on tuberculin skin test results between 2002 and 2009 was used in this retrospective cohort study, a total of 4842 students were included. Tuberculin skin test conversion was defined as the change of tuberculin skin test from negative (<10 mm) to positive (≥10 mm) after 48 –72 h of inoculation. Baseline tuberculin skin test positivity was 1.0% (95%CI: 0.6%–1.3%), whereas tuberculin skin test conversion incidence was 12.4 per 100 person-years (95%CI: 11.8–13.0). This study showed that students from clinical careers in close contact with patients had an increased risk of tuberculosis infection in the internship, especially Medicine, Dentistry, Medical Technology and Nursing. Administrative, environmental and personal protection measures should be implemented and evaluated periodically in order to reduce the risk of exposure. PMID:23116653

The value of counting BCG scars for interpretation of tuberculin skin tests in a tuberculosis hyperendemic shanty-town, Peru

PubMed Central

Saito, M.; Bautista, C. T.; Gilman, R. H.; Bowering, A.; Levy, M. Z.; Evans, C. A.

2010-01-01

SUMMARY SETTING The tuberculin skin test (TST) is widely used as a diagnostic or screening test for Mycobacterium tuberculosis infection and disease. A peri-urban shanty-town in the desert hills of south Lima, Peru, highly endemic for tuberculosis, and where bacille Calmette-Guérin (BCG) vaccine had been given in multiple doses until 1995. OBJECTIVE To analyze the effect of multiple BCG vaccines on TST in a community-based setting. DESIGN Point-prevalence survey of TST reactions of 572 people aged 6–26 years from 255 households. TST reactions were compared to the observed number of BCG scars and other potential risk factors (age, living with a TST-positive person, and contact with active tuberculosis). RESULT People with two or more scars had significantly larger reactions, even after adjusting for potential risk factors. The adjusted population attributable fraction of being TST-positive and having two or more BCG scars was 26%. CONCLUSION There is no demonstrated benefit of repeat BCG vaccination. We therefore recommend that physicians take into consideration the number of BCG scars when interpreting the TST and that programs give no more than one BCG vaccination. PMID:15260275

Tracing the genomic ancestry of Peruvians reveals a major legacy of pre-Columbian ancestors.

PubMed

Sandoval, Jose R; Salazar-Granara, Alberto; Acosta, Oscar; Castillo-Herrera, Wilder; Fujita, Ricardo; Pena, Sergio D J; Santos, Fabricio R

2013-09-01

In order to investigate the underlying genetic structure and genomic ancestry proportions of Peruvian subpopulations, we analyzed 551 human samples of 25 localities from the Andean, Amazonian, and Coastal regions of Peru with a set of 40 ancestry informative insertion-deletion polymorphisms. Using genotypes of reference populations from different continents for comparison, our analysis indicated that populations from all 25 Peruvian locations had predominantly Amerindian genetic ancestry. Among populations from the Titicaca Lake islands of Taquile, Amantani, Anapia, and Uros, and the Yanque locality from the southern Peruvian Andes, there was no significant proportion of non-autochthonous genomes, indicating that their genetic background is effectively derived from the first settlers of South America. However, the Andean populations from San Marcos, Cajamarca, Characato and Chogo, and coastal populations from Lambayeque and Lima displayed a low but significant European ancestry proportion. Furthermore, Amazonian localities of Pucallpa, Lamas, Chachapoyas, and Andean localities of Ayacucho and Huancayo displayed intermediate levels of non-autochthonous ancestry, mostly from Europe. These results are in close agreement with the documented history of post-Columbian immigrations in Peru and with several reports suggesting a larger effective size of indigenous inhabitants during the formation of the current country's population.

Identifying multidrug resistant tuberculosis transmission hotspots using routinely collected data12

PubMed Central

Manjourides, Justin; Lin, Hsien-Ho; Shin, Sonya; Jeffery, Caroline; Contreras, Carmen; Cruz, Janeth Santa; Jave, Oswaldo; Yagui, Martin; Asencios, Luis; Pagano, Marcello; Cohen, Ted

2012-01-01

SUMMARY In most countries with large drug resistant tuberculosis epidemics, only those cases that are at highest risk of having MDRTB receive a drug sensitivity test (DST) at the time of diagnosis. Because of this prioritized testing, identification of MDRTB transmission hotspots in communities where TB cases do not receive DST is challenging, as any observed aggregation of MDRTB may reflect systematic differences in how testing is distributed in communities. We introduce a new disease mapping method, which estimates this missing information through probability–weighted locations, to identify geographic areas of increased risk of MDRTB transmission. We apply this method to routinely collected data from two districts in Lima, Peru over three consecutive years. This method identifies an area in the eastern part of Lima where previously untreated cases have increased risk of MDRTB. This may indicate an area of increased transmission of drug resistant disease, a finding that may otherwise have been missed by routine analysis of programmatic data. The risk of MDR among retreatment cases is also highest in these probable transmission hotspots, though a high level of MDR among retreatment cases is present throughout the study area. Identifying potential multidrug resistant tuberculosis (MDRTB) transmission hotspots may allow for targeted investigation and deployment of resources. PMID:22401962

Formative research to develop a nutrition education intervention to improve dietary iron intake among women and adolescent girls through community kitchens in Lima, Peru.

PubMed

Creed-Kanashiro, Hilary M; Bartolini, Rosario M; Fukumoto, Mary N; Uribe, Tula G; Robert, Rebecca C; Bentley, Margaret E

2003-11-01

Formative research was conducted with 26 women and 16 adolescent girls to develop an education intervention through community kitchens (CK) in Lima, to increase their dietary iron intake and improve their iron status. A combination of qualitative research methods was used to explore perceptions about foods, nutrition, health, anemia and body image. The women recognized that there was a close association among eating well, "alimentarse bien", their health and prevention and treatment of anemia. They perceived that the nutritive value of a meal is determined primarily by its content of "nutritious" foods and by its being "balanced". Using this information the conceptual model of the education intervention was developed. The vulnerability of women to anemia was presented with the relationship between anemia and diet as the central focus. Feasible ways of achieving a nutritious diet were introduced to the community kitchens through promoting local heme iron sources and the consumption of beans with a vitamin C source. Animal source foods were amongst those considered to be nutritious and were "best buys" for iron content. CK searched for ways of assuring accessibility to these foods. The use of animal source foods in the community kitchen menus increased during the intervention.

[Prevalence of the attempts to stop pregnancy and associated factors in a marginal suburban community in Lima-Peru, 2006].

PubMed

Tarqui-Mamani, Carolina; Barreda, Alejandro; Barreda, Milagros; Sanabria-Rojas, Hernán

2010-03-01

To estimate the prevalence for the attempts to stop pregnancy among women with history of previous pregnancies, and to determine the factors associated. A cross-sectional study was performed during 2006. Samples included 1057 women with background of pregnancy, living in Pamplona Alta, selected by a systematic random sampling. We applied descriptive and inferential statistics, including a logistic regression model. The prevalence for the attempt to stop pregnancy was 13.9% (99% CI: 11.1-16.7). The factors associated identified by multivariate analysis were: Unwanted pregnancy (OR=5.7; CI: 1.9-16.7), lack of pre-natal care (OR=4.7; CI: 1.8-12.2), prostitution (OR=11.4; CI: 1.5-87.9), age below 20 years (OR=2.9; CI: 1.1-7.9), and having more than two partners (OR=3.3; CI: 1.1-10.2). The estimated prevalence for the attempt to stop pregnancy among women with history of previous pregnancies in a marginal suburban area from Lima was low when compared to the national estimated prevalence of abortion. The associated factors identified for the attempts to stop pregnancy are: unwanted pregnancy, prostitution, age below 20 years, having more than two partners and lack of pre-natal care.

Characterizing the syphilis epidemic among men who have sex with men in Lima, Peru to identify new treatment and control strategies.

PubMed

Deiss, Robert G; Leon, Segundo R; Konda, Kelika A; Brown, Brandon; Segura, Eddy R; Galea, Jerome T; Caceres, Carlos F; Klausner, Jeffrey D

2013-09-10

Syphilis is an important sexually transmitted infection (STI) with serious public health consequences. Among men who have sex with men (MSM) in Lima, the prevalence and incidence are extraordinarily high. Current syndromic approaches, however, fail to identify asymptomatic cases, and in settings where large proportions of individuals test positive again after treatment, it is frequently difficult to distinguish treatment failure from re-infection. Thus, new approaches are needed to improve treatment strategies and public health control efforts. Study participants will undergo baseline testing for syphilis infection along with a behavioral survey covering demographics, sexual behavior, drug and alcohol abuse and health-care seeking behavior. The cohort will be followed for 18 months at three-month intervals. Blood and earlobe scrapings will also be collected for T. pallidum DNA testing, to create molecular markers for subtyping. We will also perform cytokine testing on collected samples in order to create host immunologic profiles associated with recurrence, re-infection, treatment failure and success. Advances in social epidemiology, molecular typing and characterization of host immune responses will offer promise in developing new understandings of syphilis management. We will share our findings with the Peruvian Ministry of Health and other public health organizations, to identify new approaches of case detection and successful treatment.

Expedited Partner Therapy (EPT) increases the frequency of partner notification among MSM in Lima, Peru: a pilot randomized controlled trial.

PubMed

Clark, Jesse L; Segura, Eddy R; Oldenburg, Catherine E; Rios, Jessica; Montano, Silvia M; Perez-Brumer, Amaya; Villaran, Manuel; Sanchez, Jorge; Coates, Thomas J; Lama, Javier R

2017-05-04

Expedited Partner Therapy (EPT) has been shown to improve treatment outcomes among heterosexual partners of individuals with curable sexually transmitted infections (STIs). Although the use of EPT with men who have sex with men (MSM) has been debated, due to the potential for missed opportunities to diagnose unidentified cases of HIV and syphilis infection in symptomatic partners, increases in partner notification (PN) resulting from use of EPT may promote testing and treatment of otherwise unidentified partners. We assessed the impact of EPT on self-reported PN among MSM in Peru with gonorrheal (GC) and/or chlamydial (CT) infection. We enrolled 173 MSM in Lima, Peru with symptomatic or asymptomatic GC and/or CT infection between 2012 and 2014. We enrolled 44 MSM with symptomatic urethritis/proctitis and 129 MSM with asymptomatic GC/CT infection, diagnosed based on nucleic acid testing (Aptima Combo 2 Transcription-Mediated Amplification [TMA]) from urethral, pharyngeal, and rectal sites. Eligible participants were randomly assigned to receive either standard PN counseling (n = 84) or counseling plus EPT (cefixime 400 mg/azithromycin 1 g) for up to five recent partners (n = 89). Self-reported notification was assessed by computer-assisted self-administered survey among 155 participants who returned for 14-day follow-up. The median age of participants was 26 (interquartile range [IQR]: 23-31) with a median of 3 sexual partners (IQR: 2-4) in the previous 30-day period. Among all participants, 111/155 (71.6%) notified at least one partner at 14-day follow-up with a median of 1 partner notified per participant (IQR: 0-2). For participants randomized to receive EPT, 69/83 (83.1%) reported notifying at least one partner, compared with 42/72 (58.3%) of participants in the control arm (odds ratio = 3.52; 95% confidence interval [CI]: 1.68-7.39). The proportion of all recent partners notified was significantly greater in the EPT than in the control arm (53.5%, 95% CI: 45.0-62.0% versus 36.4%, 95% CI: 27.0-47.4%). Provision of EPT led to significant increases in notification among Peruvian MSM diagnosed with GC/CT infection. Additional research is needed to assess the impact of EPT on biological outcomes, including persistent or recurrent infection, antimicrobial resistance, and HIV/STI transmission, in MSM sexual networks. ClinicalTrials.gov, NCT01720654 . Registered on 10/29/2012.

Leveraging social capital: multilevel stigma, associated HIV vulnerabilities, and social resilience strategies among transgender women in Lima, Peru

PubMed Central

Perez-Brumer, Amaya G.; Reisner, Sari L.; McLean, Sarah A.; Silva-Santisteban, Alfonso; Huerta, Leyla; Mayer, Kenneth H.; Sanchez, Jorge; Clark, Jesse L.; Mimiaga, Matthew J.; Lama, Javier R.

2017-01-01

Abstract Introduction: In Peru, transgender women (TW) experience unique vulnerabilities for HIV infection due to factors that limit access to, and quality of, HIV prevention, treatment and care services. Yet, despite recent advances in understanding factors associated with HIV vulnerability among TW globally, limited scholarship has examined how Peruvian TW cope with this reality and how existing community-level resilience strategies are enacted despite pervasive social and economic exclusion facing the community. Addressing this need, our study applies the understanding of social capital as a social determinant of health and examines its relationship to HIV vulnerabilities to TW in Peru. Methods: Using qualitative methodology to provide an in-depth portrait, we assessed (1) intersections between social marginalization, social capital and HIV vulnerabilities; and (2) community-level resilience strategies employed by TW to buffer against social marginalization and to link to needed HIV-related services in Peru. Between January and February 2015, 48 TW participated (mean age = 29, range = 18–44) in this study that included focus group discussions and demographic surveys. Analyses were guided by an immersion crystallization approach and all coding was conducted using Dedoose Version 6.1.18. Results: Themes associated with HIV vulnerability included experiences of multilevel stigma and limited occupational opportunities that placed TW at risk for, and limited their engagement with, existing HIV services. Emergent resiliency-based strategies included peer-to-peer and intergenerational knowledge sharing, supportive clinical services (e.g. group-based clinic attendance) and emotional support through social cohesion (i.e. feeling part of a community). Conclusion: This study highlights the importance of TW communities as support structures that create and deploy social resiliency-based strategies aimed at deterring and mitigating the impact of social vulnerabilities to discrimination, marginalization and HIV risk for individual TW in Peru. Public health strategies seeking to provide HIV prevention, treatment and care for this population will benefit from recognizing existing social capital within TW communities and incorporating its strengths within HIV prevention interventions. At the intersection of HIV vulnerabilities and collective agency, dimensions of bridging and bonding social capital emerged as resiliency strategies used by TW to access needed healthcare services in Peru. Fostering TW solidarity and peer support are key components to ensure acceptability and sustainability of HIV prevention and promotion efforts. PMID:28362064

Leveraging social capital: multilevel stigma, associated HIV vulnerabilities, and social resilience strategies among transgender women in Lima, Peru.

PubMed

Perez-Brumer, Amaya G; Reisner, Sari L; McLean, Sarah A; Silva-Santisteban, Alfonso; Huerta, Leyla; Mayer, Kenneth H; Sanchez, Jorge; Clark, Jesse L; Mimiaga, Matthew J; Lama, Javier R

2017-02-28

In Peru, transgender women (TW) experience unique vulnerabilities for HIV infection due to factors that limit access to, and quality of, HIV prevention, treatment and care services. Yet, despite recent advances in understanding factors associated with HIV vulnerability among TW globally, limited scholarship has examined how Peruvian TW cope with this reality and how existing community-level resilience strategies are enacted despite pervasive social and economic exclusion facing the community. Addressing this need, our study applies the understanding of social capital as a social determinant of health and examines its relationship to HIV vulnerabilities to TW in Peru. Using qualitative methodology to provide an in-depth portrait, we assessed (1) intersections between social marginalization, social capital and HIV vulnerabilities; and (2) community-level resilience strategies employed by TW to buffer against social marginalization and to link to needed HIV-related services in Peru. Between January and February 2015, 48 TW participated (mean age = 29, range = 18-44) in this study that included focus group discussions and demographic surveys. Analyses were guided by an immersion crystallization approach and all coding was conducted using Dedoose Version 6.1.18. Themes associated with HIV vulnerability included experiences of multilevel stigma and limited occupational opportunities that placed TW at risk for, and limited their engagement with, existing HIV services. Emergent resiliency-based strategies included peer-to-peer and intergenerational knowledge sharing, supportive clinical services (e.g. group-based clinic attendance) and emotional support through social cohesion (i.e. feeling part of a community). This study highlights the importance of TW communities as support structures that create and deploy social resiliency-based strategies aimed at deterring and mitigating the impact of social vulnerabilities to discrimination, marginalization and HIV risk for individual TW in Peru. Public health strategies seeking to provide HIV prevention, treatment and care for this population will benefit from recognizing existing social capital within TW communities and incorporating its strengths within HIV prevention interventions. At the intersection of HIV vulnerabilities and collective agency, dimensions of bridging and bonding social capital emerged as resiliency strategies used by TW to access needed healthcare services in Peru. Fostering TW solidarity and peer support are key components to ensure acceptability and sustainability of HIV prevention and promotion efforts.

Communication Technology Use and mHealth Acceptance among HIV-infected Men who have Sex with Men in Peru: Implications for HIV Prevention and Treatment

PubMed Central

Krishnan, Archana; Ferro, Enrico G.; Weikum, Damian; Vagenas, Panagiotis; Lama, Javier R.; Sanchez, Jorge; Altice, Frederick L.

2014-01-01

The HIV epidemic in Peru is concentrated among men who have sex with men (MSM). Given that MSM have been documented as early adopters of emerging technology, we examined communication technology access and utilization, and mobile health (mHealth) acceptance among Peruvian MSM and transgender women (TGW) in order to gauge opportunities for mHealth-enabled HIV interventions. A convenience sample of 359 HIV-infected MSM and TGW recruited from three sites in Lima, Peru completed standardized assessments of alcohol use disorders (AUDs), risky sexual behavior, and antiretroviral therapy (ART) adherence along with self-constructed measures of communication technology access and utilization, and mHealth acceptance. Most (86%) participants had daily access to any cell phone, including smartphones (30%). The most frequent communication activities were receiving and making calls, and receiving and sending text messages using cell phones. On a 5-point Likert scale, participants expressed interest in using mHealth for medication reminders (M=3.21, SD=1.32) and engaging in anonymous online interactions with health professionals to discuss HIV-related issues (M=3.56, SD=1.33). Importantly, no significant differences were found in communication technology use and mHealth acceptance among participants with AUDs, depression and suboptimal ART adherence, all of which are associated with poor HIV treatment outcomes. Findings show support for implementing mHealth-based intervention strategies using cell phones to assess and reduce HIV-risk behaviors among HIV-infected MSM and TGW. PMID:25285464

Determinants of blood-lead levels in children in Callao and Lima metropolitan area.

PubMed

Espinoza, Rocío; Hernández-Avila, Mauricio; Narciso, Juan; Castañaga, Carmen; Moscoso, Shirley; Ortiz, Georgina; Carbajal, Luz; Wegner, Steve; Noonan, Gary

2003-01-01

To determine blood lead levels in urban populations of children (n = 2,510) and women (n = 874) in the early postpartum in certain districts of Lima and Callao, and to correlate those levels with particular exposures. Between July 1998 and January 1999 cross sectional study was conducted. The study population was selected using three sampling strategies in the government operated school system and from public pediatric and maternity hospitals at Lima and Callao, Peru. Study personnel were trained to collect finger stick blood samples with a protocol that minimizes external lead contamination. Lead determinations in blood and environmental samples were performed at the study site using portable anodic striping voltamenters. To determine the simultaneous effects of different predictors on blood lead levels, multivariate regression models were used to estimate adjusted mean differences. The mean blood lead level in the children studied was 9.9 micrograms/dl ranging from 1 microgram/dl to 64 micrograms/dl with 29% of the children displaying values greater than 10 micrograms/dl and 9.4% at levels greater than 20 micrograms/dl. Among the women, the mean was 3.5 micrograms/dl (SD = 2.4 micrograms/dl), and 2.4% (n = 21) displayed levels greater than 10 micrograms/dl. Important differences were observed between the sample locations, and the highest levels were documented in the port region near Callao. The mean level of blood lead in this group was 25.6 micrograms/dl (SD = 4.6 micrograms/dl), while among the rest of the sample it was 7.1 micrograms/dl (SD = 5.1 micrograms/dl). The presence of a mineral storage area signified a difference in exposure in excess of 13 micrograms/dl for children living near the port area in contrast to the other children who were not as close to such fixed sources of lead exposure. For the participants in Lima, the risk of showing levels above 10 micrograms/dl was associated with exposure to high vehicular traffic. In metropolitan Lima, we conclude that the mean blood lead levels of the populations studied were not alarming and that a positive health impact can be made by a reduction of lead in gasoline. With regard to the port area, the study demonstrates that the presence of mineral storage areas pose a detrimental risk factor for the health of the children living in this area. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.

[Resources and capacity of emergency trauma care services in Peru].

PubMed

Rosales-Mayor, Edmundo; Miranda, J Jaime; Lema, Claudia; López, Luis; Paca-Palao, Ada; Luna, Diego; Huicho, Luis

2011-09-01

The objectives of this study were to evaluate the resources and capacity of emergency trauma care services in three Peruvian cities using the WHO report Guidelines for Essential Trauma Care. This was a cross-sectional study in eight public and private healthcare facilities in Lima, Ayacucho, and Pucallpa. Semi-structured questionnaires were applied to the heads of emergency departments with managerial responsibility for resources and capabilities. Considering the profiles and volume of care in each emergency service, most respondents in all three cities classified their currently available resources as inadequate. Comparison of the health facilities showed a shortage in public services and in the provinces (Ayacucho and Pucallpa). There was a widespread perception that both human and physical resources were insufficient, especially in public healthcare facilities and in the provinces.

Association between specific plasmids and relapse in typhoid fever.

PubMed Central

Gotuzzo, E; Morris, J G; Benavente, L; Wood, P K; Levine, O; Black, R E; Levine, M M

1987-01-01

We studied isolates from 73 patients hospitalized with typhoid fever in Lima, Peru. Of these 73 patients, 11 (15%) suffered a clinical relapse, with fever and positive blood cultures, within 3 months of their original illness. Using plasmids as epidemiologic markers, we found that three patients who subsequently relapsed were initially infected with more than one strain of Salmonella typhi. There was a highly significant association between relapse and isolation of a strain containing either a 24- or a 38-kilobase plasmid at the time of the original infection; however, we were unable to show any evidence of homology between these two plasmids. Our data indicate that infection with multiple strains is not uncommon in this endemic area and suggest that relapse may be partly strain dependent. Images PMID:2821064

[Social representations of TB patients on treatment discontinuation].

PubMed

Chirinos, Narda Estela Calsin; Meirelles, Betina Hörner Schlindwein; Bousfield, Andréa Barbará Silva

2015-01-01

To understand the social representations of people with TB who discontinued treatment in a Program of Tuberculosis Control. a descriptive study of qualitative approach conducted in the city of Lima, Peru. Data were collected from October to November 2012, through semi-structured interviews with eight individuals and the method used was thematic content analysis. The categories led to the construction of the social representation that the disease and the treatment bring suffering. This representation influences non-adherence to treatment and may increase the rates of treatment discontinuation. Educational strategies linked to social interaction processes, to subjectivity and to the patient context are needed to reduce the rates of discontinuation of tuberculosis treatment, relapses and multi-drug resistance. The evaluations point to new challenges that must be faced to achieve the Millennium Development Goals.

Attitudes and Views of Medical Students toward Science and Pseudoscience.

PubMed

Peña, Adolfo; Paco, Ofelia

2004-12-01

To know opinions, attitudes and interest of medical students toward science and pseudoscience. A questionnaire was administered to 124 medical students of the San Marcos University in Lima, Peru. 173 students were surveyed. The response rate was 72%. Eighty-three percent (100/121) of respondents said that science is the best source of knowledge, 67% (82/123) said they were interested in science and technology news, 76% said they had not read any science magazine or book (other than medical texts and journals) in the last five years. Thirteen percent (16/124) of respondents said that astrology is "very scientific" and 40% (50/124) stated that it is "sort of scientific." 50% of respondents shared the opinion that some people possess psychic powers. Medical students' attitudes toward science are generally not favorable.

OAS :: 46 Regular Session of the OAS General Assembly - 2016

Science.gov Websites

, D.C., 2015 Paraguay 2014 Guatemala 2013 Bolivia 2012 El Salvador 2011 Peru 2010 Honduras 2009 Colombia 2008 Panama 2007 Dominican Republic 2006 United States 2005 Ecuador 2004 Chile 2003 Barbados 2002

Andean settlers rush for Amazonia.

PubMed

Serra-vega, J

1990-01-01

Governments of Andean countries (Peru, Bolivia, Colombia, Ecuador, and Venezuela) have encouraged migration to the Amazon Basin, which has contributed to its destruction. Population pressure, landlessness, and poverty are the inducements to migrate. Efforts to populate the Amazon forest were begun as early as 1964 in Peru without international notice. By 1980, logging was allowed in Peru, and Brazil considered colonization of the Amazon essential to national sovereignty. By 1986, outside of Lima, Peru, a development project originally funded by the World Bank, the InterAmerican Development Bank, and the US, resulted in conflicts between settlers and Indians, in loggers indiscriminately cutting, and in farmers using slash and burn techniques to clear forests. Elsewhere the Peruvian Amazon, in San Ignacio, the population was growing by 5.5%/year. The jungle road that had been started but never completed, Carretera Marginal, destroyed 5 million hectares of primary forest, and much of the 600,000 hectares of arable land gained by the road suffered from inappropriate farming practices which caused massive erosion and laterization of the soils. Food crop production declined, and production of coca for cocaine increased. Coca crops are controlled by the Shining Path guerrillas, who are trying to overthrow the Peruvian government. Devastation of Ecuador around Lago Agrio continues. In Colombia, east of Bogota, forests have disappeared and hills have eroded and silted up rivers and dams. The Andean piedmont in Bolivia has also been devastated by loggers and by slash and burn farming. Southeastern Bolivian forests have been cleared for soya bean cultivation on poor soils. Social and economic crises propel people into the remaining forests. The solution is to ease foreign debt, transfer appropriate technology at affordable prices, refuse to finance destructive development, and help to educate and train scientific researchers. Family planning services are also urgently needed. Basic facts on population, biodiversity, the greenhouse effect, deforestation, roads, iron, gold, and Indians is provided.

Geographic differences in overweight and obesity prevalence in Peruvian children, 2010-2015.

PubMed

Torres-Roman, J Smith; Urrunaga-Pastor, Diego; Avilez, Jose L; Helguero-Santin, Luis M; Malaga, German

2018-03-14

Childhood obesity is emerging as a major public health problem worldwide. To date, most studies of obesity and overweight in Peru are focused on adults, with few of them involving children, a population at a critical stage of development. The trend in overweight and obesity prevalence in Peruvian children under the age of five has not yet been determined. Thus, the objective of the present study is to evaluate the prevalence rates of overweight and obesity between 2010 and 2015 in children under the age of five, stratified by geographical areas in Peru. Data were obtained from the Nutritional Status Information System of Peru. The total number of children evaluated was 14,155,914. For the Geographic Information Systems (GIS), the program Geo Da 1.8® was used to ascertain the spatial distribution of prevalence rates and was mapped for children under five. To assess the degree of spatial dependence, exploratory spatial data analysis was performed using the Moran's I statistic and was assessed with the Local Indicators of Spatial Association (LISA) analysis to identify geographic concentrations of high and low of obesity and overweight levels. Between 2010 and 2015, the national prevalence of childhood overweight and obesity ranged from 6.2%- 6.8% and 1.5%-2.7%, respectively. The highest prevalence of childhood overweight and obesity was found in 2014 and 2013, respectively. During these years, we observed that obesity decreased, but overweight remained stable. The highest prevalence of overweight and obesity was found in the departments located on the coast. Significant positive spatial autocorrelation was found for both overweight and obesity. The departments with the highest prevalence of overweight and obesity were concentrated in Lima, Callao, Ica, Moquegua and Tacna. The lowest were found in Loreto, Cusco and San Martin. The decrease in obesity and the stabilisation of overweight are positive results for the Peruvian childhood. However, in comparison with other Latin American countries, Peru still lags in obesity prevention.

The gendered experience of stigmatization in severe and persistent mental illness in Lima, Peru.

PubMed

Robillard, Chantal

2010-12-01

Although power differentials which enable the components of stigma to unfold have been identified, literature that demonstrates the gendered disparities in stigmatization is scarce. Using a gender-based framework, this paper aims first at understanding the gendered social cues which produce the stigma in mental illness enacted by the general population. Second, it highlights the influence of gender on the everyday experiences of a severe and persistent mental illness and the related stigmatization. Results are drawn from a combination of ethnographic and qualitative methods including a field ethnography of two health centres, one psychiatric hospital, and participants' households and neighbourhoods, two group discussions with members of the general population participating in gender-specific social support groups (N = 12 women/5 men), and illness narratives of men and women with a severe and persistent mental illness (N = 22), which was conducted from May to August 2006 in a poor, urban district of Peru. It is argued that in a society like that of Peru where gender roles are segregated into specific social and economic fields, gendered expectations shape both the experience of a severe and persistent mental illness and the stigmatization of people with such a mental illness in a gender-specific way. Not only do gender inequalities create the conditions leading to a power differential which enables stigmatization to unfold, but stigma is constructed as much around gendered-defined social roles as it is enacted in distinct social spheres for men and women with a severe and persistent mental illness. The gendered experience of stigmatization must, therefore, be fully understood in order to design more effective interventions that would challenge stereotypical perceptions and discriminatory practices, and reduce their effect on the everyday life of the mentally ill in Peru. Copyright © 2010 Elsevier Ltd. All rights reserved.

Evaluation of interventions on road traffic injuries in Peru: a qualitative approach

PubMed Central

2012-01-01

Background Evaluation of interventions on road traffic injuries (RTI) going beyond the assessment of impact to include factors underlying success or failure is an important complement to standard impact evaluations. We report here how we used a qualitative approach to assess current interventions implemented to reduce RTIs in Peru. Methods We performed in-depth interviews with policymakers and technical officers involved in the implementation of RTI interventions to get their insight on design, implementation and evaluation aspects. We then conducted a workshop with key stakeholders to analyze the results of in-depth interviews, and to further discuss and identify key programmatic considerations when designing and implementing RTI interventions. We finally performed brainstorming sessions to assess potential system-wide effects of a selected intervention (Zero Tolerance), and to identify adaptation and redesign needs for this intervention. Results Key programmatic components were consistently identified that should be considered when designing and implementing RTI interventions. They include effective and sustained political commitment and planning; sufficient and sustained budget allocation; training, supervision, monitoring and evaluation of implemented policies; multisectoral participation; and strong governance and accountability. Brainstorming sessions revealed major negative effects of the selected intervention on various system building blocks. Conclusions Our approach revealed substantial caveats in current RTI interventions in Peru, and fundamental negative effects on several components of the sectors and systems involved. It also highlighted programmatic issues that should be applied to guarantee an effective implementation and evaluation of these policies. The findings from this study were discussed with key stakeholders for consideration in further designing and planning RTI control interventions in Peru. PMID:22269578

Evaluation of interventions on road traffic injuries in Peru: a qualitative approach.

PubMed

Huicho, Luis; Adam, Taghreed; Rosales, Edmundo; Paca-Palao, Ada; López, Luis; Luna, Diego; Miranda, J Jaime

2012-01-23

Evaluation of interventions on road traffic injuries (RTI) going beyond the assessment of impact to include factors underlying success or failure is an important complement to standard impact evaluations. We report here how we used a qualitative approach to assess current interventions implemented to reduce RTIs in Peru. We performed in-depth interviews with policymakers and technical officers involved in the implementation of RTI interventions to get their insight on design, implementation and evaluation aspects. We then conducted a workshop with key stakeholders to analyze the results of in-depth interviews, and to further discuss and identify key programmatic considerations when designing and implementing RTI interventions. We finally performed brainstorming sessions to assess potential system-wide effects of a selected intervention (Zero Tolerance), and to identify adaptation and redesign needs for this intervention. Key programmatic components were consistently identified that should be considered when designing and implementing RTI interventions. They include effective and sustained political commitment and planning; sufficient and sustained budget allocation; training, supervision, monitoring and evaluation of implemented policies; multisectoral participation; and strong governance and accountability. Brainstorming sessions revealed major negative effects of the selected intervention on various system building blocks. Our approach revealed substantial caveats in current RTI interventions in Peru, and fundamental negative effects on several components of the sectors and systems involved. It also highlighted programmatic issues that should be applied to guarantee an effective implementation and evaluation of these policies. The findings from this study were discussed with key stakeholders for consideration in further designing and planning RTI control interventions in Peru.

Cranio-facial clefts in pre-hispanic America.

PubMed

Marius-Nunez, A L; Wasiak, D T

2015-10-01

Among the representations of congenital malformations in Moche ceramic art, cranio-facial clefts have been portrayed in pottery found in Moche burials. These pottery vessels were used as domestic items during lifetime and funerary offerings upon death. The aim of this study was to examine archeological evidence for representations of cranio-facial cleft malformations in Moche vessels. Pottery depicting malformations of the midface in Moche collections in Lima-Peru were studied. The malformations portrayed on pottery were analyzed using the Tessier classification. Photographs were authorized by the Larco Museo.Three vessels were observed to have median cranio-facial dysraphia in association with midline cleft of the lower lip with cleft of the mandible. ML001489 portrays a median cranio-facial dysraphia with an orbital cleft and a midline cleft of the lower lip extending to the mandible. ML001514 represents a median facial dysraphia in association with an orbital facial cleft and a vertical orbital dystopia. ML001491 illustrates a median facial cleft with a soft tissue cleft. Three cases of midline, orbital and lateral facial clefts have been portrayed in Moche full-figure portrait vessels. They represent the earliest registries of congenital cranio-facial malformations in ancient Peru. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Feasibility and yield of screening for non-communicable diseases among treated tuberculosis patients in Peru.

PubMed

Byrne, A L; Marais, B J; Mitnick, C D; Garden, F L; Lecca, L; Contreras, C; Yauri, Y; Garcia, F; Marks, G B

2018-01-01

The increasing prevalence of non-communicable diseases (NCDs) poses a major challenge to low- and middle-income countries. Patients' engagement with health services for anti-tuberculosis treatment provides an opportunity for screening for NCDs and for linkage to care. We explored the feasibility and yield of screening for NCDs in patients treated for tuberculosis (TB) in Lima, Peru, as part of a study focused on chronic respiratory sequelae. A representative sample of community controls was recruited from the same geographical area. Screening entailed taking a medical history and performing ambulatory blood pressure measurement and urinalysis. A total of 177 participants with previous TB (33 with multidrug-resistant TB) and 161 community controls were evaluated. There was an almost four-fold increased prevalence of self-reported diabetes mellitus (DM) in the TB group (adjusted prevalence ratio 3.66, 95%CI 1.68-8.01). Among those without self-reported DM, 3.3% had glycosuria, with a number needed to screen (NNS) of 31. The NNS to find one (new) case of hypertension or proteinuria in the TB group was respectively 24 and 5. Patient-centred care that includes pragmatic NCD screening is feasible in TB patients, and the treatment period provides a good opportunity to link patients to ongoing care.

Taeniasis and cysticercosis in housemaids working in affluent neighborhoods in Lima, Peru.

PubMed

Huisa, Branko N; Menacho, Luis A; Rodriguez, Silvia; Bustos, Javier A; Gilman, Robert H; Tsang, Victor C W; Gonzalez, Armando E; García, Hector H

2005-09-01

Taenia solium taeniasis/cysticercosis is endemic in most developing countries, where it is an important cause of epileptic seizures and other neurologic symptoms. In industrialized countries, cysticercosis results from travel or immigration of tapeworm carriers from endemic areas. In both endemic and nonendemic countries, housemaids commonly immigrate from cysticercosis-endemic areas and can transmit the infection if they carry the adult tapeworm. Between July 2001 and July 2002, 1,178 housemaids (961 of them work in the top five most affluent districts of Lima, a metropolis of 8 million inhabitants considered nonendemic for cysticercosis) were evaluated for serum antibodies to Taenia solium and stool microscopy for taeniasis and cysticercosis. The serosurvey revealed a prevalence of cysticercosis-specific antibodies of 14.6% (95% CI: 12.6-16.6%), and stool microscopy detected 12 T. solium tapeworm carriers, for a prevalence of taeniasis of 1.2% (95% CI: 0.6-1.8%). A nonrandom sample of 26 seropositive housemaids was examined by brain CT and 50% of them had brain lesions compatible with neurocysticercosis, mainly calcifications. From the families who used a tapeworm-carrier housemaid, cysticercosis antibodies were detected in 6 (23%) of 26 persons who agreed to participate. One seropositive member of the employer families was symptomatic for seizures and had brain calcifications. The prevalence of tapeworm infections in this housemaid group is similar to levels in endemic areas, constituting a source of neurocysticercosis infection.

Characterizing the syphilis epidemic among men who have sex with men in Lima, Peru to identify new treatment and control strategies

PubMed Central

2013-01-01

Background Syphilis is an important sexually transmitted infection (STI) with serious public health consequences. Among men who have sex with men (MSM) in Lima, the prevalence and incidence are extraordinarily high. Current syndromic approaches, however, fail to identify asymptomatic cases, and in settings where large proportions of individuals test positive again after treatment, it is frequently difficult to distinguish treatment failure from re-infection. Thus, new approaches are needed to improve treatment strategies and public health control efforts. Methods/Design Study participants will undergo baseline testing for syphilis infection along with a behavioral survey covering demographics, sexual behavior, drug and alcohol abuse and health-care seeking behavior. The cohort will be followed for 18 months at three-month intervals. Blood and earlobe scrapings will also be collected for T. pallidum DNA testing, to create molecular markers for subtyping. We will also perform cytokine testing on collected samples in order to create host immunologic profiles associated with recurrence, re-infection, treatment failure and success. Discussion Advances in social epidemiology, molecular typing and characterization of host immune responses will offer promise in developing new understandings of syphilis management. We will share our findings with the Peruvian Ministry of Health and other public health organizations, to identify new approaches of case detection and successful treatment. PMID:24016185

[Mother’s strategies in the feeding process of children aged 6 to 24 months in two rural communities of Lima, Peru].

PubMed

Dolores-Maldonado, Gandy; Delgado-Pérez, Doris; Creed-Kanashiro, Hilary

2015-01-01

To know the strategies of mothers during the feeding process in children aged 6 to 24 months in two communities of Lima. Qualitative study in which 18 primiparous or multiparous mothers of children aged 6-24 months participated. We used intentional sampling by age and parity of the mother, and conducted 36 direct observations and 12 in-depth interviews. Inductive data analysis was conducted, categories were grouped by subject and technique, reaching a consensus of the themes among the authors. Verbal communication was markedly greater in multiparous mothers. Three major themes were found. Verbal mother-child communication, multiparous mothers were those who used affectionate words during the meal. Involvement and strategies in the feeding process was seen as characterized by encouraging the child to finish the meal with games and singing that multiparous mothers performed sometimes with help from other family members. However these results were not obtained by primiparous mothers, they usually became withdrawn upon the rejection of food. The context during eating favors whether a child will finish the meal. The strategies used during meal time were varied and biased, predominantly by multiparous mothers, acting in a more active and responsive way. However primiparous mothers may act in an authoritarian manner when the child gets dirty, plays and/or refuses food.

Influences on eating: a qualitative study of adolescents in a periurban area in Lima, Peru.

PubMed

Banna, Jinan C; Buchthal, Opal Vanessa; Delormier, Treena; Creed-Kanashiro, Hilary M; Penny, Mary E

2016-01-15

Peruvian adolescents are at high nutritional risk, facing issues such as overweight and obesity, anemia, and pregnancy during a period of development. Research seeking to understand contextual factors that influence eating habits to inform the development of public health interventions is lacking in this population. This study aimed to understand socio-cultural influences on eating among adolescents in periurban Lima, Peru using qualitative methods. Semi-structured interviews and pile sort activities were conducted with 14 adolescents 15-17 years. The interview was designed to elicit information on influences on eating habits at four levels: individual (intrapersonal), social environmental (interpersonal), physical environmental (community settings), and macrosystem (societal). The pile sort activity required adolescents to place cards with food images into groups and then to describe the characteristics of the foods placed in each group. Content analysis was used to identify predominant themes of influencing factors in interviews. Multidimensional scaling and hierarchical clustering analysis was completed with pile sort data. Individual influences on behavior included lack of financial resources to purchase food and concerns about body image. Nutrition-related knowledge also played a role; participants noted the importance of foods such as beans for anemia prevention. At the social environmental level, parents promoted healthy eating by providing advice on food selection and home-cooked meals. The physical environment also influenced intake, with foods available in schools being predominantly low-nutrient energy-dense. Macrosystem influences were evident, as adolescents used the Internet for nutrition information, which they viewed as credible. To address nutrition-related issues such as obesity and iron-deficiency anemia in Peruvian adolescents, further research is warranted to elucidate the roles of certain factors shaping behavior, particularly that of family, cited numerous times as having a positive influence. Addressing nutrition-related issues such as obesity and iron-deficiency anemia in this population requires consideration of the effect of social and environmental factors in the context of adolescent lifestyles on behavior. Nutrition education messages for adolescents should consider the cultural perceptions and importance of particular foods, taking into account the diverse factors that influence eating behaviors.

Anonymous partnerships among MSM and transgender women (TW) recently diagnosed with HIV and other STIs in Lima, Peru: an individual-level and dyad-level analysis.

PubMed

Perez-Brumer, Amaya G; Oldenburg, Catherine E; Segura, Eddy R; Sanchez, Jorge; Lama, Javier R; Clark, Jesse L

2016-02-24

Partner notification (PN) following sexually transmitted disease (STI) diagnosis is a key strategy for controlling HIV/STI transmission. Anonymous partnerships are an important barrier to PN and often associated with high-risk sexual behaviour. Limited research has examined the profile of men who have sex with men (MSM) and transgender women (TW) who engage in anonymous sex. To better understand anonymous partnership practices in Lima, Peru, we assessed participant-level and partnership-level characteristics associated with anonymous sex among a sample of MSM and TW recently diagnosed with HIV/STI. MSM and TW diagnosed with HIV/STI within the past month completed a cross-sectional survey regarding anticipated PN practices. Participants reported sexual partnership types and characteristics of up to three of their most recent partners. Using a Poisson generalised estimating equation model, we assessed participant-level and partnership-level characteristics associated with anonymous partnerships. Among 395 MSM and TW with HIV/STI, 36.0% reported at least one anonymous sexual partner in the past 3 months (mean of 8.6 anonymous partners per participant; SD 17.0). Of the 971 partnerships reported, 118 (12.2%) were anonymous and the majority (84.8%) were with male partners, followed by 11.0% with female partners and 4.2% with transgender/travesti partners. Partner-level characteristics associated with increased likelihood of having an anonymous partner included female (adjusted prevalence ratio (aPR) 2.28, 95% CI 1.05 to 4.95, p=0.04) or transgender/travesti (aPR 4.03, 95% CI 1.51 to 10.78, p=0.006) partner gender. By assessing both individual-level and dyadic-level factors, these results represent an important step in understanding the complexity of partnership interactions and developing alternative PN strategies for Latin America. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Characterization of past landslides and slope susceptibility analysis for Lima and Callao provinces, Peru

NASA Astrophysics Data System (ADS)

Tatard, Lucile; Villacorta, Sandra; Metzger, Pascale

2013-04-01

85% of people exposed to earthquakes, hurricanes, floods and drought live in developing countries (IPU, 2010). This population is also exposed to the landslide risk as this phenomenon is mainly triggered by earthquakes and rainfall. There is an urgent need to propose methods to evaluate and mitigate the landslide risk for developing countries, where few studies were undergone and data, and information on data, are scarce. In this study, we characterize a landslide inventory set up for the megalopolis of Lima, Peru, by the local geological bureau (INGEMMET). This inventory was set up using satellite images and includes landslides of all ages. It is composed of two landslide types: rockfalls and debris flows (huaycos) that we investigate together and separately. First, we describe qualitatively the landslide occurrences in terms of geology, slope steepness, altitude, etc. We notably find that debris flows occur at altitudes larger than the ones of the rockfalls, probably due to the climatic conditions. Then we find that the rockfalls and debris flows area distributions follow a power law when investigated separately whereas it does not follow a power law when investigated together. This highlights a logical difference of mechanics between the two landslide types. Then, using the dimension of correlation D (Grassberger and Procaccia, 1983) we show that the event spatial occurrences are not uniformly distributed but clustered. It supports the existence of controlling parameters on the spatial occurrence of landslides and the research to identify them. Last, we investigate the relationships between different landslide parameters (geology, altitude, slope steepness, ...) using the linear correlation coefficient r, and we find that all these parameters are independent to each other. This allows us to investigate each parameter separately in terms of landslide susceptibility and to define values for which the landslide susceptibility is low, medium or high for each parameter. The characterization of the landslide database is a necessary step to assess the good quality of the data. It then allows us to pursue our investigation and set up a robust landslide susceptibility analysis using our good-quality inventory.

Convenio "Andres Bello:" Informe Final [de la] Segunda Reunion de Ministros de Educacion de la Region Andina ("Andres Bello" Agreement: Final Report of the Second Meeting of the Andean Region Ministers of Education).

ERIC Educational Resources Information Center

Ministros de Educacion de la Region Andina, Lima (Peru).

This final report of the second meeting of the Andean Region Ministers of Education subscribing to the Andres Bello Agreement on education and culture contains a resume of the individual sessions and the proposals approved during that meeting. The proposals cover various educational problems and issues and begin with the Declaration of Lima which…

The Peruvian diaspora: portrait of a migratory process.

PubMed

Durand, Jorge

2010-01-01

Since the 1980s and especially the 1990s, Peru has become a nation of emigrants. Emigration has become massive over the past two decades, and the Peruvian populations of the United States, Japan, and Spain have tripled in less than a decade. A survey of households in five localities, three urban and two rural, in and around Lima helps to reveal the special character of this emigration. It tends to involve older and better-educated individuals than are typical of international migration and to target a wider variety of destinations. Moreover, it is a multiclass phenomenon. The economic, political, and social crisis brought about by a change in the economic model, two decades of terrorism, and a succession of failed democratic administrations has affected the society as a whole, and international migration seems to operate as an escape valve.

Diagnosis of sputum-scarce HIV-associated pulmonary tuberculosis in Lima, Peru

PubMed Central

Vargas, Daniel; García, Luis; Gilman, Robert H; Evans, Carlton; Ticona, Eduardo; Ñavincopa, Marcos; Luo, Robert F; Caviedes, Luz; Hong, Clemens; Escombe, Rod; Moore, David A J

2010-01-01

Sputum induction, bronchoalveolar lavage, or gastric aspiration are often needed to produce adequate diagnostic respiratory samples from people with HIV in whom tuberculosis is suspected. Since these procedures are rarely appropriate in less-developed countries, we compared the performances of a simple string test and the gold-standard sputum induction. 160 HIV-positive adults under investigation for tuberculosis, and 52 asymptomatic HIV-positive control patients underwent the string test followed by sputum induction. The string test detected tuberculosis in 14 patients in whom this disease was suspected; sputum induction detected only eight of them (McNemar's test, p=0·03). These preliminary data suggest that the string test is safe and effective for retrieval of useful clinical specimens for diagnosis of pulmonary tuberculosis, and is at least as sensitive as sputum induction. PMID:15639297

[Rectal mucosal prolapse syndrome: study of cases. Hospital Daniel A Carrion, Lima, Peru, 2010-2013].

PubMed

Arévalo Suarez, Fernando; Cárdenas Vela, Irene; Rodríguez Rodríguez, Kriss; Pérez Narrea, María Teresa; Rodríguez Vargas, Omar; Montes Teves, Pedro; Monge Salgado, Eduardo

2014-04-01

to describe the clinical, endoscopic, and histological characteristics of rectal mucosal prolapse syndrome, formerly known as Solitary rectal ulcer, in patients from a general hospital. All patient diagnosed as rectal mucosal prolapse syndrome during 2010-2013 was selected; the medical history war reviewed and the histological slides were reevaluated by two pathologists. 17 cases of rectal mucosal prolapse syndrome were selected, the majority were males under 50 years, the most common clinical findings were rectal bleeding (82%) and constipation (65%), the endocopic findings were heterogeneous,: erythema (41%), ulcers (35%) and elevated lesions (29%). All cases presented fibromuscularhyperplasia in lamina propia and crypt distortion in the microscopic evaluation. In our study of rectal mucosal prolapse syndrome. The most common clinical findings were rectal bleeding and constipation. Erythematous mucosa was the most common endoscopic finding.

Are health interventions implemented where they are most needed? District uptake of the integrated management of childhood illness strategy in Brazil, Peru and the United Republic of Tanzania.

PubMed Central

Victora, C. G.; Huicho, L.; Amaral, J. J.; Armstrong-Schellenberg, J.; Manzi, F.; Mason, E.; Scherpbier, R.

2006-01-01

OBJECTIVE: To describe geographical patterns of implementation of the Integrated Management of Childhood Illness (IMCI) strategy in three countries and to assess whether the strategy was implemented in areas with the most pressing child health needs. METHODS: We conducted interviews with key informants at the national and district levels in Brazil, Peru and the United Republic of Tanzania, and an ecological study of factors associated with health worker training in IMCI. Explanatory factors included district population, distance from the capital, human development index, other socioeconomic indicators and baseline mortality rates in children younger than five years. FINDINGS: In line with recommendations by WHO, early implementation districts were characterized by proximity to the capital and suitable training sites, presence of motivated health managers and a functioning health system. In the expansion phase, IMCI tended to be adopted by other districts with similar characteristics. In Brazil, uptake by poor and small municipalities and those further away from the state capital was significantly lower. In Peru, there was no association with distance from Lima, and a non-significant trend for IMCI adoption by small and poor departments. In the United Republic of Tanzania, the only statistically significant finding was a lower uptake by remote districts. Implementation was not associated with baseline mortality levels in any country studied. CONCLUSION: Whereas clear and reasonable guidelines are provided for selection of early use districts, no criteria for promoting IMCI expansion had been issued, and areas of greatest need were not prioritized. Equity analyses based on the geographical deployment of new programmes and strategies can contribute to assessing whether they are reaching those who need them most. PMID:17128359

Provider Attitudes Toward Oral Preexposure Prophylaxis for HIV Prevention Among High-Risk Men Who Have Sex with Men in Lima, Peru

PubMed Central

Tang, Eric C.; Sobieszczyk, Magdalena E.; Shu, Eileen; Gonzales, Pedro; Sanchez, Jorge

2014-01-01

Abstract Oral preexposure prophylaxis (PrEP) was the first biomedical intervention to demonstrate efficacy in preventing HIV infection among men who have sex with men (MSM). Healthcare providers' attitudes toward PrEP will be critical in translating this finding into effective public health rollout programs. In a convenience sample of 186 healthcare providers in Peru, we assessed knowledge, barriers, and attitudes to prescribe and monitor HIV PrEP for high-risk MSM and transgender women, the populations with the highest HIV incidence in this setting. A total of 57.5% reported awareness of PrEP, and awareness was independently associated with caring for more than 50 MSM (OR: 3.67, p<0.002). Lack of local guidelines, concern about increased high-risk behavior, antiretroviral drug resistance, and limited availability of antiretrovirals for HIV-infected individuals were the most common barriers to prescribing PrEP. Of all physicians 44.6% indicated that they would be likely to prescribe oral PrEP now; likelihood to prescribe was higher if PrEP were supported by local guidelines (70.3%, p<0.001), if more trials supported its effectiveness (68.5%, p<0.001), and if intermittent use were shown to be effective (62.2%, p=0.019). Physicians were more likely to prescribe PrEP now if they care for more than 50 MSM (OR: 6.62, p=0.010). Infectious disease specialists were less likely to prescribe PrEP (OR: 0.10, p=0.003) than nonspecialists. Successful large-scale implementation of PrEP in Peru will require focused educational campaigns to increase awareness and address concerns among healthcare providers. PMID:24319983

Medication possession ratio predicts antiretroviral regimens persistence in Peru.

PubMed

Salinas, Jorge L; Alave, Jorge L; Westfall, Andrew O; Paz, Jorge; Moran, Fiorella; Carbajal-Gonzalez, Danny; Callacondo, David; Avalos, Odalie; Rodriguez, Martin; Gotuzzo, Eduardo; Echevarria, Juan; Willig, James H

2013-01-01

In developing nations, the use of operational parameters (OPs) in the prediction of clinical care represents a missed opportunity to enhance the care process. We modeled the impact of multiple measurements of antiretroviral treatment (ART) adherence on antiretroviral treatment outcomes in Peru. Retrospective cohort study including ART naïve, non-pregnant, adults initiating therapy at Hospital Nacional Cayetano Heredia, Lima-Peru (2006-2010). Three OPs were defined: 1) Medication possession ratio (MPR): days with antiretrovirals dispensed/days on first-line therapy; 2) Laboratory monitory constancy (LMC): proportion of 6 months intervals with ≥1 viral load or CD4 reported; 3) Clinic visit constancy (CVC): proportion of 6 months intervals with ≥1 clinic visit. Three multi-variable Cox proportional hazard (PH) models (one per OP) were fit for (1) time of first-line ART persistence and (2) time to second-line virologic failure. All models were adjusted for socio-demographic, clinical and laboratory variables. 856 patients were included in first-line persistence analyses, median age was 35.6 years [29.4-42.9] and most were male (624; 73%). In multivariable PH models, MPR (per 10% increase HR=0.66; 95%CI=0.61-0.71) and LMC (per 10% increase 0.83; 0.71-0.96) were associated with prolonged time on first-line therapies. Among 79 individuals included in time to second-line virologic failure analyses, MPR was the only OP independently associated with prolonged time to second-line virologic failure (per 10% increase 0.88; 0.77-0.99). The capture and utilization of program level parameters such as MPR can provide valuable insight into patient-level treatment outcomes.

Obesity and Hypertension among School-going Adolescents in Peru.

PubMed

Nam, Eun Woo; Sharma, Bimala; Kim, Ha Yun; Paja, Doris Jackeline Vasquez; Yoon, Young Min; Lee, Sun Ha; Kim, Eun Hwan; Oh, Chung Hyeon; Kim, Yun Seop; Song, Chang Hoon; Kim, Jong Koo

2015-09-01

Adolescent obesity and hypertension are global public health issues. The burden of adolescent obesity and hypertension in Peru is unclear. The aim of this study was to determine the prevalence of obesity and hypertension and their relationship among school-attending adolescents and to assess the need for health-promoting school programs in the study area. A cross-sectional school-based survey was conducted in a randomly selected sample of 952 secondary school adolescents from 11 schools in Lima or Callao, Peru, in 2014. Weight, height, and blood pressure (BP) were measured and categorized. Obesity was defined as ≥ 95(th) percentile in body mass index (BMI) for age and sex. Hypertension was defined as average systolic blood pressure and/or diastolic blood pressure ≥95(th) percentile in BP for sex, age, and height. Chi-square test and univariate logistic regressions were used at a 5% significance level to determine the relationship between BMI and BP category. The mean age of subjects was 14.6 years; 46.4% were boys and 53.6% were girls. The prevalence of overweight and obesity was 20.2% and 9.5% overall, 17.4% and 11.1% for boys, and 22.5% and 8.0% for girls, respectively. The prevalence of hypertension was 26.7% overall, 34.8% for boys, and 19.6% for girls. In both sexes, BMI was strongly associated with BP (p < 0.01). The prevalence of obesity and hypertension observed in the study area is relatively high. Overweight and obesity are strongly associated with BP status among adolescents. Health-promoting school programs may reduce the burdens of obesity and hypertension among school-going adolescents.

Acceptability of oral versus rectal HIV preexposure prophylaxis among men who have sex with men and transgender women in Peru.

PubMed

Peinado, Jesus; Lama, Javier R; Galea, Jerome T; Segura, Patricia; Casapia, Martin; Ortiz, Abner; Montano, Silvia M; Kochel, Tadeusz; Sánchez, Jorge

2013-01-01

Oral preexposure prophylaxis (PrEP) with antiretrovirals (ARVs) is at the forefront of biomedical HIV prevention research, and ARVs are also being tested for rectal administration to target people practicing unprotected receptive anal intercourse (URAI) and at risk of HIV infection. This study assessed the acceptability of daily oral PrEP and rectal PrEP during URAI among men who have sex with men (MSM) and transgender women (TGW) in Peru. During the 2008 HIV sentinel surveillance survey conducted in 3 Peruvian cities (Lima, Iquitos, and Pucallpa), MSM and TGW reported being "versatile," "most of the time receptive," and "exclusively receptive" during anal sex behavior where surveyed on their acceptability of oral and rectal PrEP. Among 532 individuals, high acceptance of either oral (96.2%) or rectal (91.7%) PrEP products was reported. If both products were efficacious/available, 28.6% would prefer a pill, 57.3% a rectal lubricant, and 14.1% either. A trend toward higher acceptance was observed as receptive anal sex behavior exclusivity rose (P = .013). Being receptive most of the time (adjusted odds ratio [aOR]: 9.1, P = .01) and exclusively receptive (aOR: 7.5, P = .01), compared to being versatile, were independently associated with oral PrEP acceptability. A similar association was found with the acceptability of rectal formulations (aOR: 2.3, P = .07; and aOR: 2.5, P = .02; respectively). Oral and rectal PrEP were highly acceptable among Peruvian MSM and TGW, particularly among those at the highest HIV infection risk. These data can guide the implementation of PrEP programs in Peru and similar settings and populations.

Sex differences in health care-seeking behavior for acute coronary syndrome in a low income country, Peru.

PubMed

Pastorius Benziger, Catherine; Bernabe-Ortiz, Antonio; Miranda, J Jaime; Bukhman, Gene

2011-06-01

: Recognizing reasons for prehospital delay after symptoms of acute coronary syndrome (ACS) is established in developed countries yet evidence from Latin America is limited. We aimed to assess ACS symptom recognition, health care-seeking behavior, and confidence in local health care facilities to take care of ACS by gender in a sample of Peruvians. : A community-based interview survey in a peri-urban area in Lima, Peru. The 24-item study instrument included vignettes and questions assessing identification of urgent and emergent ACS symptoms, anticipated help-seeking behaviors, and confidence in local health care facilities. : In the study population (90 people; 45.6% men; mean age, 43.5 years), women were 4 times less likely to correctly attribute symptoms of chest pain to the heart (OR = 0.23; 95% CI: 0.063-0.87; P = 0.03). Women were much more likely to respond that a man would "Seek help" (OR = 4.54; 95% CI: 1.21-16.90; P = 0.024) and that "Yes," a woman would be less likely to seek help for chest pain symptoms (OR = 3.26; 95% CI: 1.13-9.41 P = 0.029) after adjusting for age, education level, age at migration, and history of chest pain. Women were less likely than men to think that their local Health Care Post would help them if they had a heart attack (2.1% vs. 14.6%; P = 0.04), and only 18.7% of women believed that their local emergency room would help them. : Our findings suggest women are less likely to seek help for chest pain and women and men in a peri-urban area in Peru are not confident in their local health care facility to treat urgent or emergent ACS symptoms.

Provider attitudes toward oral preexposure prophylaxis for HIV prevention among high-risk men who have sex with men in Lima, Peru.

PubMed

Tang, Eric C; Sobieszczyk, Magdalena E; Shu, Eileen; Gonzales, Pedro; Sanchez, Jorge; Lama, Javier R

2014-05-01

Oral preexposure prophylaxis (PrEP) was the first biomedical intervention to demonstrate efficacy in preventing HIV infection among men who have sex with men (MSM). Healthcare providers' attitudes toward PrEP will be critical in translating this finding into effective public health rollout programs. In a convenience sample of 186 healthcare providers in Peru, we assessed knowledge, barriers, and attitudes to prescribe and monitor HIV PrEP for high-risk MSM and transgender women, the populations with the highest HIV incidence in this setting. A total of 57.5% reported awareness of PrEP, and awareness was independently associated with caring for more than 50 MSM (OR: 3.67, p<0.002). Lack of local guidelines, concern about increased high-risk behavior, antiretroviral drug resistance, and limited availability of antiretrovirals for HIV-infected individuals were the most common barriers to prescribing PrEP. Of all physicians 44.6% indicated that they would be likely to prescribe oral PrEP now; likelihood to prescribe was higher if PrEP were supported by local guidelines (70.3%, p<0.001), if more trials supported its effectiveness (68.5%, p<0.001), and if intermittent use were shown to be effective (62.2%, p=0.019). Physicians were more likely to prescribe PrEP now if they care for more than 50 MSM (OR: 6.62, p=0.010). Infectious disease specialists were less likely to prescribe PrEP (OR: 0.10, p=0.003) than nonspecialists. Successful large-scale implementation of PrEP in Peru will require focused educational campaigns to increase awareness and address concerns among healthcare providers.

Present coupling along the Peruvian subduction asperity that devastated Lima while breaking during the 1746 earthquake

NASA Astrophysics Data System (ADS)

Cavalié, O.; Chlieh, M.; Villegas Lanza, J. C.

2016-12-01

Subduction zone are particularly prone to generating large earthquakes due to its wide lateral extension. In order to understand where, and possibly when, large earthquakes will occur, interseismic deformation observation is a key information because it allows to map asperities that accumulate stress on the plate interface. South American subduction is one of the longest worldwide, running all along the west coast of the continent. Combined with the relatively fast convergence rate between the Nazca plate and the South American continent, Chile and Peru experience regularly M>7.5 earthquakes. In this study, we focused on the Peruvian subduction margin and more precisely on the Central segment containing Lima where the seismic risk is the highest in the country due the large population that lives in the Peruvian capital. On the Central segment (10°S and 15°S), we used over 50 GPS interseismic measurements from campaign and continuous sites, as well as InSAR data to map coupling along the subduction interface. GPS data come from the Peruvian GPS network and InSAR data are from the Envisat satellite. We selected two tracks covering the central segment (including Lima) and with enough SAR image acquisitions between 2003 and 2010 to get a robust deformation estimation. GPS and InSAR data show a consistent tectonic signal with a maximum of surface displacement by the coast: the maximum horizontal velocities from GPS is about 20 mm and InSAR finds 12-13 mm in the LOS component. In addition, InSAR reveals lateral variations along the coast: the maximum motion is measured around Lima (11°S) and fades on either side. By inverting the geodetic data, we were able to map the coupling along the segment. It results in a main asperity where interseismic stress is loading. However, compared the previous published models based on GPS only, the coupling in the central segment seems more heterogeneous. Finally, we compared the deficit of seismic moment accumulating in the interseismic period with the long-term seismicity. Based on the instrumental and historical seismicity, and the present seismic coupling, a M>8.8 earthquake is expected before the end of the century. However, the actual magnitude relies on how much aseismic slip, that has not been measured during the geodesy period (i.e since 2003) occurred.

Present coupling along the Peruvian subduction asperity that devastated Lima while breaking during the 1746 earthquake

NASA Astrophysics Data System (ADS)

Cavalié, O.; Chlieh, M.; Villegas Lanza, J. C.

2017-12-01

Subduction zone are particularly prone to generating large earthquakes due to its wide lateral extension. In order to understand where, and possibly when, large earthquakes will occur, interseismic deformation observation is a key information because it allows to map asperities that accumulate stress on the plate interface. South American subduction is one of the longest worldwide, running all along the west coast of the continent. Combined with the relatively fast convergence rate between the Nazca plate and the South American continent, Chile and Peru experience regularly M>7.5 earthquakes. In this study, we focused on the Peruvian subduction margin and more precisely on the Central segment containing Lima where the seismic risk is the highest in the country due the large population that lives in the Peruvian capital. On the Central segment (10°S and 15°S), we used over 50 GPS interseismic measurements from campaign and continuous sites, as well as InSAR data to map coupling along the subduction interface. GPS data come from the Peruvian GPS network and InSAR data are from the Envisat satellite. We selected two tracks covering the central segment (including Lima) and with enough SAR image acquisitions between 2003 and 2010 to get a robust deformation estimation. GPS and InSAR data show a consistent tectonic signal with a maximum of surface displacement by the coast: the maximum horizontal velocities from GPS is about 20 mm and InSAR finds 12-13 mm in the LOS component. In addition, InSAR reveals lateral variations along the coast: the maximum motion is measured around Lima (11°S) and fades on either side. By inverting the geodetic data, we were able to map the coupling along the segment. It results in a main asperity where interseismic stress is loading. However, compared the previous published models based on GPS only, the coupling in the central segment seems more heterogeneous. Finally, we compared the deficit of seismic moment accumulating in the interseismic period with the long-term seismicity. Based on the instrumental and historical seismicity, and the present seismic coupling, a M>8.8 earthquake is expected before the end of the century. However, the actual magnitude relies on how much aseismic slip, that has not been measured during the geodesy period (i.e since 2003) occurred.

Aqueducts and geoglyphs : the response of Ancient Nasca to water shortages in the desert of Atacama (Peru)

NASA Astrophysics Data System (ADS)

Masini, Nicola; Lasaponara, Rosa

2016-04-01

The desert of Atacama is a plateau in South America, covering a 1,000-kilometre strip of land on the Pacific coast, west of the Andes mountains, between Chile and Peru. Due to the confluence of a cold ocean current (the Humboldt Current) along with other climatic factors, connected to the particular topography and geomorphology of the region, Atacama desert is one of the most arid areas of the world. In particular, in Nasca region (Southern Peru) the lack of water was (and still is) due to the following causes: (i) the scarce pluvial precipitations and the (ii) high infiltration capacity, and the consequent yearly significant reduction of the surface water (Schreiber & Lancho Rojas 2009). Over the millennia long periods of drought occurred and frequently the lack of water was persistent for several decades. Despite the arid and extreme nature of the environment, this region was populated by important civilizations, such as Paracas and Nasca, which flourished in the Early Intermediate period (200 BCE-500 AD) (Silvermann & Proulx 2002). In particular the Nasca civilization is well-known for its refined and colourful pottery, characterized by a rich icononographic repertory, and, above all, by the huge and mysterious geoglyphs drawn on the arid plateaus of the Rio Grande de Nasca Basin. In order to practice agriculture, the Nasca developed adequate strategies to cope with hostile environmental factors and water scarcity, building a very efficient aqueduct system. They were aided by the fact that underground water was likely enough close to the surface and accessible by constructing wells and underground aqueducts, known with quechua name of puquios (Schreiber & Lancho Rojas 2009; Lasaponara & Masini 2012a; 2012b) The effectiveness of the techniques of hydraulic engineering depended on the climate and the weather events that sometimes underwent drastic changes, as results of the cyclical phenomenon of El Niño Southern Oscillation (commonly called ENSO). Hence the origin of Nasca religious belief based on the worship of the mountain gods, in charge of the rain, and, therefore, related to the worship of water and fertility, including rituals which took place inside and outside Cahuachi pyramids (Orefici 2012; Masini et al. 2008; 2009) and over the famous geoglyphs (Orefici 2009; Reinhard 1988) Therefore, the response of Nasca to make liveable the desert was twofold, aimed at addressing the problem in its causes (climate), by religion, ritual and ceremonial activities, and in its effects, through the construction of aqueducts. The paper deals with the results from 3-year scientific and interdisciplinary investigations conducted by ITACA Mission (Masini et al. 2012) in Peru of CNR-IBAM and IMAA, in the Rio Nasca drainage basin. The main purpose of the investigations was the study of lost and functioning aqueducts using active and passive satellite data along with spatial analysis and geophysics (Cigna et al. 2013: Tapete et al. 2013). In particular, multitemporal analyses of satellite data were carried out in order to identify the different moisture content from upper to lower valley and the seasonal changes from one to another year. Geoelectrical prospecting along with geological investigations enabled us to characterize the table water and to study the hydrogeology of the investigated area. Finally, GIS and spatial analyses provided new information on the relationship between the puquios , settlement patterns and geoglyphs. References Cigna F., Tapete D., Lasaponara R., Masini N. 2013. Amplitude change detection with ENVISAT ASAR to image the cultural landscape of the Nasca region, Peru Archaeological Prospection, 20, 117-131, doi: 10.1002/arp.1451 Lasaponara R., Masini N. 2012a. Following the Ancient Nasca Puquios from Space, In: Lasaponara R., Masini N. (Eds) 2012, Satellite Remote Sensing: a new tool for Archaeology, Springer, Verlag Berlin Heidelberg, ISBN 978-90-481-8800-0, pp. 269-290, doi: 10.1007/978-90-481-8801-7_12 Lasaponara R., Masini N. 2012b. Investigating satellite Landsat TM and ASTER multitemporal data set to discover ancient canals and aqueduct systems, in Lecture Notes in Computer Science, Vol. 7335, Issue 3, 2012, Pages 497-511, 12th International Conference on Computational Science and Its Applications, ICCSA 2012, doi: 10.1007/978-3-642-31137-6_38 Masini N., Rizzo E., Lasaponara R., and Orefici G. 2008, Integrated remote sensing techniques for the detection of buried archaeological adobe structures: preliminary results in Cahuachi (Peru), Advances in Geosciences, 19, 75-82 Masini N., Lasaponara N., Orefici G. 2009, Addressing the challenge of detecting archaeological adobe structures in Southern Peru using QuickBird imagery, Journal of Cultural Heritage, 10S, pp. e3-e9 [doi:10.1016/j.culher.2009.10.005] Masini N., Lasaponara R., Rizzo E., Orefici G. 2012. Integrated Remote Sensing Approach in Cahuachi (Peru): Studies and Results of the ITACA Mission (2007-2010), In: Lasaponara R., Masini N. (Eds) 2012, Satellite Remote Sensing: a new tool for Archaeology, Springer, Verlag Berlin Heidelberg, ISBN 978-90-481-8800-0, doi: 10.1007/978-90-481-8801-7_14; pp. 307-344 Orefici G (2009) Los geoglifos: espacios abiertos y ceremonias colectivas. In Nasca. El desierto de los Dioses de Cahuachi. Graph Ediciones, Lima, pp. 94-113 Orefici G. (2012), Cahuachi. Capital Teocratica Nasca. Lima: Universidad de San Martin de Porres Reinhard J. (1988) The Nazca Lines, Water and Mountains: An Ethno-archaeological Study. In recent studies in Pre-Columbian Archaeology, N. Saunders and O. de Montmollin (eds.), Oxford: British Archaeological Reports, pp. 363-414 Schreiber H, Lancho Rojas J (2009) El control del agua y los puquios de Nasca. In: Nasca. El desierto del los Dioses de Cahuachi, Graph, Lima : 132-151 Silverman H, Proulx D A (2002) The Nasca. Balckwell Publishing Ltd, Malden, USA Tapete D., Cigna F., Masini N., Lasaponara R. 2013. Prospection and monitoring of the archaeological heritage of Nasca, Peru, with ENVISAT ASAR, Archaeological Prospection, 20, 133-147, doi: 10.1002/arp.1449

The HOPE social media intervention for global HIV prevention in Peru: a cluster randomised controlled trial.

PubMed

Young, Sean D; Cumberland, William G; Nianogo, Roch; Menacho, Luis A; Galea, Jerome T; Coates, Thomas

2015-01-01

Social media technologies offer new approaches to HIV prevention and promotion of testing. We examined the efficacy of the Harnessing Online Peer Education (HOPE) social media intervention to increase HIV testing among men who have sex with men (MSM) in Peru. In this cluster randomised controlled trial, Peruvian MSM from Greater Lima (including Callao) who had sex with a man in the past 12 months, were 18 years of age or older, were HIV negative or serostatus unknown, and had a Facebook account or were willing to create one (N=556) were randomly assigned (1:1) by concealed allocation to join intervention or control groups on Facebook for 12 weeks. For the intervention, Peruvian MSM were trained and assigned to be HIV prevention mentors (peer-leaders) to participants in Facebook groups. The interventions period lasted 12 weeks. Participants in control groups received an enhanced standard of care, including standard offline HIV prevention available in Peru and participation in Facebook groups (without peer leaders) that provided study updates and HIV testing information. After accepting a request to join the groups, continued participation was voluntary. Participants also completed questionnaires on HIV risk behaviours and social media use at baseline and 12 week follow-up. The primary outcome was the number of participants who received a free HIV test at a local community clinic. The facebook groups were analysed as clusters to account for intracluster correlations. This trial is registered with ClinicalTrials.gov, number NCT01701206. Of 49 peer-leaders recruited, 34 completed training and were assigned at random to the intervention Facebook groups. Between March 19, 2012, and June 11, 2012, and Sept 26, 2012, and Dec 19, 2012, 556 participants were randomly assigned to intervention groups (N=278) or control groups (N=278); we analyse data for 252 and 246. 43 participants (17%) in the intervention group and 16 (7%) in the control groups got tested for HIV (adjusted odds ratio 2·61, 95% CI 1·55–4·38). No adverse events were reported. Development of peer-mentored social media communities seemed to be an efficacious method to increase HIV testing among high-risk populations in Peru. Results suggest that the HOPE social media intervention could improve HIV testing rates among MSM in Peru. National Institute of Mental Health.

[Contextualization of sexual initiation and individual barriers to the use of contraceptives by adolescents of Lima, Huamanga, and Iquitos].

PubMed

Carmona, Gloria; Beltran, Jessica; Calderón, María; Piazza, Marina; Chávez, Susana

2017-01-01

To contextualize sexual initiation and barriers to the use of contraceptives by adolescents as well as the acquisition of adequate knowledge regarding contraception and sexually transmitted diseases. This quantitative and qualitative study evaluated adolescents living in three cities with high pregnancy rates in Peru: Iquitos, Huamanga, and Lima. Subjects were invited to participate in the study via Facebook. Questionnaires were then used to select adolescents who met the inclusion criteria, and interviews were conducted to obtain detailed data regarding the study topic. A total of 33 women and 23 men aged 18 to 19 years participated in the study. The age of onset of sexual activity ranged from 14 to 16 years; the main reasons for sexual initiation were sexual desire among men and pressure from the partner among women; in most cases, the sexual partner was an occasional companion for men and a boyfriend for women. The barriers related to the use of contraceptives were the financial stability of the partner, responsibility of the female partner when using contraceptives, limited capacity to negotiate choices, fear of abandonment by the male partner for demanding the use of contraceptives, and the reduction of sexual sensitivity with the use of condoms. The barriers identified in this study limit the use of contraceptives and indicate the need to develop specific strategies to strengthen the interpersonal skills of adolescents and provide accurate information about the risks of unprotected sex.

The syphilis care cascade: tracking the course of care after screening positive among men and transgender women who have sex with men in Lima, Peru

PubMed Central

Tang, Eric C; Segura, Eddy R; Clark, Jesse L; Sanchez, Jorge; Lama, Javier R

2015-01-01

Objectives Syphilis is endemic among men who have sex with men (MSM) and transgender women in Latin America. The objective of this study was to assess if those who screen positive for syphilis are receiving appropriate care and treatment. Methods We use data from the 2011 Peruvian National HIV Sentinel Surveillance to describe the syphilis care cascade among high-risk MSM and transgender women. Medical records from participants who had a positive syphilis screening test at two of the enrolment sites in Lima were reviewed to determine their subsequent course of care. Results We identified a cohort of 314 syphilis seropositive participants (median age: 30, 33.7% self-identified as transgender). Only 284/314 (90.4%) participants saw a physician for evaluation within 28 days of their positive test. Of these, 72/284 (25.4%) were asked to return for confirmatory results before deciding whether or not to start treatment; however, 45/72 (62.5%) of these participants did not follow up within 28 days. Of the people prescribed three weekly doses of penicillin, 34/63 (54%) received all three doses on time. Conclusions Many MSM and transgender women with a positive syphilis screening test are lost at various steps along the syphilis care cascade and may have persistent infection. Interventions in this population are needed to increase testing, link seropositive patients into care and ensure that they receive appropriate and timely treatment. PMID:26384725

TBT is still a matter of concern in Peru.

PubMed

Castro, Ítalo Braga; Iannacone, José; Santos, Sabino; Fillmann, Gilberto

2018-08-01

Tributyltin (TBT) environmental concentrations as well as imposex levels have been declining in several coastal areas worldwide. However, recent studies have shown that TBT contamination is still an important issue along some Latin American coastal areas. Thus, the incidence of imposex and butyltin compounds (BTs) in sediments and gastropod tissues was spatially and temporally (2009 and 2012) appraised in Lima (Peru) along potential TBT sources (harbors and marinas). Despite the general pattern of reduction close to Callao harbor, a clear increment in the levels of imposex (RPLI = 0.0 to 8.4 and 0.0 to 28.4/VDSI = 0.0 to 3.3 and 0.0 to 3.5) and TBT in tissues (25 to 112 and 62 to 146 ng Sn g -1 ) of Thaisella chocolata were seen from 2009 to 2012 in two sampling sites, respectively, located nearby a newly established marina. Thus, despite the international restrictions on the use of TBT-based antifouling paints are apparently reducing the inputs at international harbors, the present study clearly shows that marinas are still acting as important sources of TBT to the study area due possibly to the lack of legal restrictions on production, trading and/or use of TBT. The present findings reinforce what has been seen along many other Latin American coastal areas. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Environmental pollution, climate variability and climate change: a review of health impacts on the Peruvian population].

PubMed

Gonzales, Gustavo F; Zevallos, Alisson; Gonzales-Castañeda, Cynthia; Nuñez, Denisse; Gastañaga, Carmen; Cabezas, César; Naeher, Luke; Levy, Karen; Steenland, Kyle

2014-01-01

This article is a review of the pollution of water, air and the effect of climate change on the health of the Peruvian population. A major air pollutant is particulate matter less than 2.5 μ (PM 2.5). In Lima, 2,300 premature deaths annually are attributable to this pollutant. Another problem is household air pollution by using stoves burning biomass fuels, where excessive indoor exposure to PM 2.5 inside the household is responsible for approximately 3,000 annual premature deaths among adults, with another unknown number of deaths among children due to respiratory infections. Water pollution is caused by sewage discharges into rivers, minerals (arsenic) from various sources, and failure of water treatment plants. In Peru, climate change may impact the frequency and severity of El Niño Southern Oscillation (ENSO), which has been associated with an increase in cases of diseases such as cholera, malaria and dengue. Climate change increases the temperature and can extend the areas affected by vector-borne diseases, have impact on the availability of water and contamination of the air. In conclusion, Peru is going through a transition of environmental risk factors, where traditional and modern risks coexist and infectious and chronic problems remain, some of which are associated with problems of pollution of water and air.

The Association between Mycobacterium Tuberculosis Genotype and Drug Resistance in Peru

PubMed Central

Grandjean, Louis; Iwamoto, Tomotada; Lithgow, Anna; Gilman, Robert H; Arikawa, Kentaro; Nakanishi, Noriko; Martin, Laura; Castillo, Edith; Alarcon, Valentina; Coronel, Jorge; Solano, Walter; Aminian, Minoo; Guezala, Claudia; Rastogi, Nalin; Couvin, David; Sheen, Patricia; Zimic, Mirko; Moore, David AJ

2015-01-01

Background The comparison of Mycobacterium tuberculosis bacterial genotypes with phenotypic, demographic, geospatial and clinical data improves our understanding of how strain lineage influences the development of drug-resistance and the spread of tuberculosis. Methods To investigate the association of Mycobacterium tuberculosis bacterial genotype with drug-resistance. Drug susceptibility testing together with genotyping using both 15-loci MIRU-typing and spoligotyping, was performed on 2,139 culture positive isolates, each from a different patient in Lima, Peru. Demographic, geospatial and socio-economic data were collected using questionnaires, global positioning equipment and the latest national census. Results The Latin American Mediterranean (LAM) clade (OR 2.4, p<0.001) was significantly associated with drug-resistance and alone accounted for more than half of all drug resistance in the region. Previously treated patients, prisoners and genetically clustered cases were also significantly associated with drug-resistance (OR's 2.5, 2.4 and 1.8, p<0.001, p<0.05, p<0.001 respectively). Conclusions Tuberculosis disease caused by the LAM clade was more likely to be drug resistant independent of important clinical, genetic and socio-economic confounding factors. Explanations for this include; the preferential co-evolution of LAM strains in a Latin American population, a LAM strain bacterial genetic background that favors drug-resistance or the "founder effect" from pre-existing LAM strains disproportionately exposed to drugs. PMID:25984723

Metabolic control in patients with type 2 diabetes mellitus in a public hospital in Peru: a cross-sectional study in a low-middle income country.

PubMed

Huayanay-Espinoza, Irma Elizabeth; Guerra-Castañon, Felix; Lazo-Porras, María; Castaneda-Guarderas, Ana; Thomas, Nimmy Josephine; Garcia-Guarniz, Ana-Lucia; Valdivia-Bustamante, Augusto A; Málaga, Germán

2016-01-01

The objective of this study was to assess patients' achievement of ADA (American Diabetes Association) guideline recommendations for glycosylated hemoglobin, lipid profile, and blood pressure in a type 2 diabetes mellitus (T2DM) outpatient clinic in a low-middle income country (LMIC) setting. This is a descriptive cross-sectional study with 123 ambulatory T2DM patients who are being treated at a public hospital in Lima, Peru. Data was gathered via standardized interviews, clinical surveys, and anthropomorphic measurements for each patient. Blood samples were drawn in fasting state for measures of glucose, glycosylated hemoglobin (HbA1c), and lipid profile. Laboratory parameters and blood pressure were evaluated according to ADA recommendations. Of the 123 patients, 81 were women and the mean age was 61.8 years. Glycemic control was abnormal in 82 (68.33%) participants, and 45 (37.50%) were unable to control their blood pressure. Lipid profile was abnormal in 73 (60.83%) participants. Only nine (7.50%) participants fulfilled ADA recommendations for glycemic, blood pressure, and lipid control. Amongst individuals with type 2 diabetes, there was poor attainment of the ADA recommendations (HbA1c, blood pressure and LDL-cholesterol) for ambulatory T2DM patients. Interventions are urgently needed in order to prevent long-term diabetic complications.

Metabolic control in patients with type 2 diabetes mellitus in a public hospital in Peru: a cross-sectional study in a low-middle income country

PubMed Central

Guerra-Castañon, Felix; Lazo-Porras, María; Castaneda-Guarderas, Ana; Thomas, Nimmy Josephine; Garcia-Guarniz, Ana-Lucia; Valdivia-Bustamante, Augusto A.; Málaga, Germán

2016-01-01

Objective The objective of this study was to assess patients’ achievement of ADA (American Diabetes Association) guideline recommendations for glycosylated hemoglobin, lipid profile, and blood pressure in a type 2 diabetes mellitus (T2DM) outpatient clinic in a low-middle income country (LMIC) setting. Methods This is a descriptive cross-sectional study with 123 ambulatory T2DM patients who are being treated at a public hospital in Lima, Peru. Data was gathered via standardized interviews, clinical surveys, and anthropomorphic measurements for each patient. Blood samples were drawn in fasting state for measures of glucose, glycosylated hemoglobin (HbA1c), and lipid profile. Laboratory parameters and blood pressure were evaluated according to ADA recommendations. Results Of the 123 patients, 81 were women and the mean age was 61.8 years. Glycemic control was abnormal in 82 (68.33%) participants, and 45 (37.50%) were unable to control their blood pressure. Lipid profile was abnormal in 73 (60.83%) participants. Only nine (7.50%) participants fulfilled ADA recommendations for glycemic, blood pressure, and lipid control. Conclusions Amongst individuals with type 2 diabetes, there was poor attainment of the ADA recommendations (HbA1c, blood pressure and LDL-cholesterol) for ambulatory T2DM patients. Interventions are urgently needed in order to prevent long-term diabetic complications. PMID:27761351

Sálvese Quien Pueda: Structural Adjustment and Emigration from Lima

PubMed Central

MASSEY, DOUGLAS S.; CAPOFERRO, CHIARA

2010-01-01

Beginning in 1987, Peru imposed a regime of structural adjustment to transform its economy along neoliberal lines. This analysis suggests that a shift resulted in the odds of international migration and the motivations for leaving among inhabitants of Peru’s largest labor market. Before 1987, under the regime of import substitution industrialization, jobs at wages capable of sustaining a basic standard of living were widely available; those few who left the country self-selected for higher human capital and moved abroad to improve their earnings. Under neoliberalism, however, both employment and wages fell to levels that made it difficult for families to sustain themselves. In response, households—with the assistance of friends and relatives with foreign experience—diversified their labor portfolios away from the local job market structural adjustment zones. The number of migrants then rose, the diversity of foreign destinations increased, and migration became less selective with respect to human capital. PMID:20824152

[Medical residency program: perceptions of medical residents in hospitals of Lima and Callao].

PubMed

Miní, Elsy; Medina, Julio; Peralta, Verónica; Rojas, Luis; Butron, Joece; Gutiérrez, Ericson L

2015-01-01

In order to rate the medical residency training program from the perceptions of residents, a structured survey, based on international literature, was applied to 228 participants. 48.2% of residents rated their training as “good,” 36.4% as “fair” and 15.4% as “poor”. Most of the residents had low supervision while on call, were overworked and did not have rest after being on call. Having a good annual curriculum (OR: 8.5; 95% CI: 4.1 to 7.4) and university promotion of research (OR 2.4, 95% CI: 1.1 to 5.2) were independent factors associated with higher ratings of training. In conclusion, the rating of residents about their training is mostly good, but this percentage does not exceed 50%. Training authorities could use these results to propose improvements in training programs for medical residents in Peru.

Exhaled Nitric Oxide is Not a Biomarker for Pulmonary Tuberculosis.

PubMed

López, José W; Loader, Maria-Cristina I; Smith, Daniel; Pastorius, Daniel; Bravard, Marjory; Caviedes, Luz; Romero, Karina M; Clark, Taryn; Checkley, William; Ticona, Eduardo; Friedland, Jon S; Gilman, Robert H

2018-06-01

To reduce transmission of tuberculosis (TB) in resource-limited countries where TB remains a major cause of mortality, novel diagnostic tools are urgently needed. We evaluated the fractional concentration of exhaled nitric oxide (FeNO) as an easily measured, noninvasive potential biomarker for diagnosis and monitoring of treatment response in participants with pulmonary TB including multidrug resistant-TB in Lima, Peru. In a longitudinal study however, we found no differences in baseline median FeNO levels between 38 TB participants and 93 age-matched controls (13 parts per billion [ppb] [interquartile range (IQR) = 8-26] versus 15 ppb [IQR = 12-24]), and there was no change over 60 days of treatment (15 ppb [IQR = 10-19] at day 60). Taking this and previous evidence together, we conclude FeNO is not of value in either the diagnosis of pulmonary TB or as a marker of treatment response.

Long-term albendazole effectiveness for hepatic cystic echinococcosis.

PubMed

Salinas, Jorge Luis; Vildozola Gonzales, Herman; Astuvilca, Juan; Arce-Villavicencio, Yanet; Carbajal-Gonzalez, Danny; Talledo, Lety; Willig, James H

2011-12-01

Little is known about the long-term effectiveness of albendazole in the medical therapy of non-complicated hepatic cystic echinococcosis (HCE) in resource-constrained settings. We performed a retrospective review of patients starting albendazole for HCE in Lima, Peru from January 1997 to December 2007. Patients successfully recontacted underwent chart abstraction and clinical and ultrasonographic reevaluation. Descriptive statistics were used to delineate patient characteristics and treatment effectiveness at the conclusion of albendazole and after reevaluation. Patients (N = 27) were primarily female, mean age was 51. Initial treatment success at albendazole conclusion was 26% (N = 7) per patient and 37.5% (N = 24) per cyst. After 3.8 ± 2.5 years, albendazole success was 34% (N = 9) per patient and 40% (N = 24) per cyst. We found a gap in the effectiveness of albendazole HCE therapy compared with the efficacy reported in clinical trials. This underscores the need for further investigation into alternate therapeutic strategies for this neglected disease.

Preparing for rectal microbicides: sociocultural factors affecting product uptake among potential South American users.

PubMed

Galea, Jerome T; Kinsler, Janni J; Imrie, John; Nureña, César R; Ruiz, Lucía; Galarza, Luis Fernando; Sánchez, Jorge; Cunningham, William E

2014-06-01

We examined views on rectal microbicides (RMs), a potential HIV prevention option, among men who have sex with men and transgender women in 3 South American cities. During September 2009 to September 2010, we conducted 10 focus groups and 36 in-depth interviews (n = 140) in Lima and Iquitos, Peru, and Guayaquil, Ecuador, to examine 5 RM domains: knowledge, thoughts and opinions about RM as an HIV prevention tool, use, condoms, and social concerns. We coded emergent themes in recorded and transcribed data sets and extracted representative quotes. We collected sociodemographic information with a self-administered questionnaire. RM issues identified included limited knowledge; concerns regarding plausibility, side effects, and efficacy; impact on condom use; target users (insertive vs receptive partners); and access concerns. Understanding the sociocultural issues affecting RMs is critical to their uptake and should be addressed prior to product launch.

[Mechanical versus manual suture in the jejunal esophageal anastomosis after total gastrectomy in gastric cancer].

PubMed

Celis, J; Ruiz, E; Berrospi, F; Payet, E

2001-01-01

To compare the leakage rate of esophagojejunal anastomosis performed with stapler or hand sutures. We studied a series of 367 patients who underwent total gastrectomy for gastric cancer at the Instituto de Enfermedades Neoplásicas (Lima-Peru) from 1986 to 1999. In 197 patients esophagojejunal anastomosis was performed with stapler and in 170 with manual sutures. There were no differences between both groups with regard to age, TNM stage, operating time and hospital stay. There were 8 anastomotic leakage (4.1%) in the stapler group and 4 (2.4%) in the hand sutures group (p> 0.05). Of these 12 cases, 2 patients (16%) died of causes directly related to the leak of the esophagojejunal anastomosis. There were no statistical differences in the rate of leakage of the esophagojejunal anastomosis performed with stapler or hand sutures, thus both techniques should be accepted as standard procedures.

Preparing for Rectal Microbicides: Sociocultural Factors Affecting Product Uptake Among Potential South American Users

PubMed Central

Kinsler, Janni J.; Imrie, John; Nureña, César R.; Ruiz, Lucía; Galarza, Luis Fernando; Sánchez, Jorge; Cunningham, William E.

2014-01-01

Objectives. We examined views on rectal microbicides (RMs), a potential HIV prevention option, among men who have sex with men and transgender women in 3 South American cities. Methods. During September 2009 to September 2010, we conducted 10 focus groups and 36 in-depth interviews (n = 140) in Lima and Iquitos, Peru, and Guayaquil, Ecuador, to examine 5 RM domains: knowledge, thoughts and opinions about RM as an HIV prevention tool, use, condoms, and social concerns. We coded emergent themes in recorded and transcribed data sets and extracted representative quotes. We collected sociodemographic information with a self-administered questionnaire. Results. RM issues identified included limited knowledge; concerns regarding plausibility, side effects, and efficacy; impact on condom use; target users (insertive vs receptive partners); and access concerns. Conclusions. Understanding the sociocultural issues affecting RMs is critical to their uptake and should be addressed prior to product launch. PMID:24825222

[Primary testicular lymphoma: experience at the Instituto Especializado de Enfermedades Neoplásicas, Lima-Peru].

PubMed

Díaz Pérez, Gilmer A; Pow-Sang Godoy, Mariela; Morante Deza, Carlos; Meza Montoya, Luis; Destefano Urrutia, Víctor

2009-02-01

Testicular lymphoma is a rare illness with peculiar characteristics but with a poor prognosis. We evaluated 32 patients retrospectively studying their epidemiologic characteristics, hematologic values, histologic type, metastasis sites, the treatment given and the survival. We compared our results with international reports and we think that prospective studies are needed for better conclusions. The average of age was 45-years-old, with more than the half of patients with clinical stage IV at the moment of the diagnosis, the histiocitic pathology was the most frequent, and the time of survival was 39,543 +/- 14,451 months and the time in which the 50% of the patients die is 15 +/- 7,025 months. This is a rare disease, with a very poor prognosis, with a time of survival of 39,543 +/- 14,451 months and the time in which the 50% of the patients die is 15 +/- 7,025 months.

Disinfection of contaminated water by using solar irradiation.

PubMed

Caslake, Laurie F; Connolly, Daniel J; Menon, Vilas; Duncanson, Catriona M; Rojas, Ricardo; Tavakoli, Javad

2004-02-01

Contaminated water causes an estimated 6 to 60 billion cases of gastrointestinal illness annually. The majority of these cases occur in rural areas of developing nations where the water supply remains polluted and adequate sanitation is unavailable. A portable, low-cost, and low-maintenance solar unit to disinfect unpotable water has been designed and tested. The solar disinfection unit was tested with both river water and partially processed water from two wastewater treatment plants. In less than 30 min in midday sunlight, the unit eradicated more than 4 log10 U (99.99%) of bacteria contained in highly contaminated water samples. The solar disinfection unit has been field tested by Centro Panamericano de Ingenieria Sanitaria y Ciencias del Ambiente in Lima, Peru. At moderate light intensity, the solar disinfection unit was capable of reducing the bacterial load in a controlled contaminated water sample by 4 log10 U and disinfected approximately 1 liter of water in 30 min.

[Association between the risk of major depression and low physical activity in peruvian workers studying in universities].

PubMed

Murillo-Pérez, Luis; Rojas-Adrianzén, Carolay; Ramos-Torres, Gabriela; Cárdenas-Vicente, Bryan; Hernández-Fernández, Wendy; Larco-Castilla, Piero; Haro-García, Luis; Mezones-Holguín, Edward

2014-01-01

In order to assess if an association exists between the risk of major depression (RMD) and physical activity (PA), controlling for demographic and academic variables in workers enrolled in undergraduate studies at a private university in Lima, Peru, we carried out a cross-sectional study of 1,111 people. We used the Major Depression Inventory (MDI) and the International Physical Activity Questionnaire (IPAQ) to measure RMD and PA, respectively. RMD prevalence was 4.2%. In the multiple regression model adjusted for age, gender, unemployment and hours of sleep, low levels of PA were associated with increased odds of RDM (OR: 2.15, 95% CI: 1.16 to 4.00). We conclude that there is an association between RMD and PA in the study population, independent of demographic and academics factors. Strategies to improve screening and development of longitudinal studies to assess causality are suggested.

Role versatility among men who have sex with men in urban Peru.

PubMed

Goodreau, Steven M; Peinado, Jesus; Goicochea, Pedro; Vergara, Jorge; Ojeda, Nora; Casapia, Martin; Ortiz, Abner; Zamalloa, Victoria; Galvan, Rosa; Sanchez, Jorge R

2007-08-01

Role versatility refers to the practice in which individual men who have sex with men (MSM) play both insertive and receptive sexual roles over time. Versatility has been thought to be relatively uncommon among Latin American MSM but possibly rising. Versatility has also been shown to be a potentially large population-level risk factor for HIV infection. In this study we examine the correlates of versatile behavior and identity among 2,655 MSM in six Peruvian cities. Versatile behavior with recent male partners was found in 9% of men and versatile ("moderno") identity was reported by 16%. Significant predictors included high education, white-collar occupation, sex work, and residence in Lima. Age was not significant in any analysis. Since sex work is negatively correlated with other predictors, versatile men appear to comprise two distinct sub-populations. Insertive-only men appear to play a strong role in bridging the HIV epidemic between MSM and women.

Sex education for local tourism/hospitality employees: addressing a local health need.

PubMed

Bauer, Irmgard L

2009-11-01

Health concerns arising from sexual relationships between tourists and locals usually focus on the travelling public. The local sex partners' health, and their impact on their communities' health, seem far less acknowledged. This paper describes a local health education session which implemented recommendations based on a study in Cuzco/Peru on tourists' and locals' views, knowledge, attitudes and experiences relating to sexual relationships between them. On location, fifteen discotheque employees received a health education session at the establishment's owner's request. Concluding from the positive experience, it is argued that researchers should, where possible, respond to requests to deliver ad hoc health education sessions while on location to address an identified local health need.

Risk factors for early lactation problems among Peruvian primiparous mothers.

PubMed

Matias, Susana L; Nommsen-Rivers, Laurie A; Creed-Kanashiro, Hilary; Dewey, Kathryn G

2010-04-01

The aim of this study was to determine the incidence and risk factors for early lactation problems [suboptimal infant breastfeeding behaviour (SIBB), delayed onset of lactogenesis (OL) and excessive neonatal weight loss] among mother-infant pairs in Lima, Peru. All primiparous mothers who gave birth to a healthy, single, term infant at a government hospital in a peri-urban area of Lima during the 8-month recruitment period were invited to participate in the study. Data were collected at the hospital (day 0) and during a home visit (day 3). Infant breastfeeding behaviour was evaluated using the Infant Breastfeeding Assessment Tool; SIBB was defined as < or = 10 score. OL was determined by maternal report of breast fullness changes; delayed OL was defined as perceived after 72 h. Excessive neonatal weight loss was defined as > or = 10% of birthweight by day 3. One hundred seventy-one mother-infant pairs participated in the study. SIBB prevalence was 52% on day 0 and 21% on day 3; it was associated with male infant gender (day 0), < 8 breastfeeds during the first 24 h (days 0 and 3), and gestational age < 39 weeks (day 3). Delayed OL incidence was 17% and was associated with infant Apgar score < 8. Excessive neonatal weight loss occurred in 10% of neonates and was associated with maternal overweight and Caesarean-section delivery. Early lactation problems may be influenced by modifiable factors such as delivery mode and breastfeeding frequency. Infant status at birth and maternal characteristics could indicate when breastfeeding dyads need extra support.

[Obesity, overweight and anemia in children from a rural area of Lima, Peru].

PubMed

Rodríguez-Zúñiga, Milton J

2015-01-01

We evaluated the association between anemia, overweight and obesity in a children population of a rural area in Lima.Demographic, anthropometric and hemoglobin information (from the Information System of Nutritional Status of Children, ISNSC, 2014, of schoolchildren 1-15 attending public schools under the Micro Red Pachacamac jurisdiction) were employed in a cross sectional design. Descriptive statistical and association analysis between anemia and nutritional status were carried out. Logistic regression was used to find significant variables associated to anemia.The prevalence of anemia was 10.8% (CI95% 9.5-12.0), overweight was 17.3% (CI95% 15.8-18.9) and 16.2% of children were obese (CI95% 14.7 - 17.7). No significant association between the diagnosis of anemia, overweight or obesity (chi2 = 1.68, p = 0.432) was found. However, there was an inverse significant association between the diagnosis of anemia and Body Mass Index (BMI) (z =-3.77, p = 0.000); and a higher level of hemoglobin among those over 12 y/o (ANOVA, F = 108.19, p = 0.006). In univariate analysis, only age (OR 1.14, IC95% 1.08-1.20) and IMC (OR 1.08, IC95% 1.04-1.13) were associated to anemia. There is no relationship between nutritional diagnosis of obesity, overweight and anemia in this population. However, children with older age and greater BMI were less likely to present anemia. Public policies in the last five years have focused on reducing this double nutritional problem in children.

[Experiences in the training of health human resources for the integral care of the victims of violence in a suburban area of Lima, Peru].

PubMed

Garmendia, Fausto; Perales, Alberto; Miranda, Eva; Mendoza, Pedro; Calderón, Walter; Miano, Jorge

2010-01-01

In the year 2003, in the Faculty of Medicine of the Universidad Nacional Mayor de San Marcos, the Permanent Program of Training for the Integral Attention of the Victims of Violence was created, has been training human resources for the comprehensive health care to victims of violence. In this sense, we was considered necessary to develop a methodology for health professionals, identifying their training needs and the conditions under how they work. It is in this context, that the year 2004, a base line study was delineated in the Microrred de Salud Huaycán, in the east of Lima city; that included diverse stages with a multisectorial approach with the aim to identify the training needs of the health professionals, as well as the evaluation of the logistic and administrative support for the development of training activities to diverse levels. In this paper, the procedures and principal results are exposed, in a succinct way. There was demonstrated that the population of Huaycán were affected by the sequels of the political violence; nevertheless, the health services have severe limited resources to give appropriate health care to victims of violence. The health professionals require an intensive training on this issue. An adequate logistic and administrative conditions allowed to carry out an appropriate training program. We suggest that this methodology will facilitate to construct products and instruments for a suitable and specific training for the integral health care to the victims of the violence.

Surgery and Trauma Care Providers’ Perception of the Impact of Dual-Practice Employment on Quality of Care Provided in an Andean Country

PubMed Central

LaGrone, Lacey N.; Isquith-Dicker, Leah N.; Egoavil, Eduardo Huaman; Herrera-Matta, Juan Jaime; Fuhs, Amy K.; Checa, David Ortega; Revoredo, Fernando; Rodriguez Castro, Manuel J.A.; Mock, Charles N.

2017-01-01

Background Dual practice, simultaneous employment by healthcare workers in the public and private sector, is pervasive worldwide. Although an estimated 30% of the global burden of disease is surgical, the implications of dual practice on surgical care are not well studied. Methods We conducted anonymous in-depth individual interviews on trauma quality improvement practices with healthcare providers who participate in the care of the injured at ten large hospitals in Peru’s capital city, Lima. A grounded theory approach to qualitative data analysis was employed to identify salient themes. Results Fifty interviews were conducted. A group of themes that emerged related to the perceived negative and positive impacts of dual practice on the quality of surgical care. Participants asserted that the majority of physicians in Lima working in the public sector also worked in the private sector. Dual practice has negative impacts on physicians’ time, the quality of care in the public sector, and surgical education. Dual practice positively affects patient care by allowing physicians to acquire management and quality improvement skills and providing incentives for research and academic productivity. In addition, dual practice provides opportunities for clinical innovations and raises the economic status of the physician. Conclusions Surgeons in Peru report that dual practice negatively impacts patient care by creating time and human resource conflicts. Participants assert that these conflicts widen the gap in quality of care between rich and poor. This practice warrants redirection through national-level regulation of physician schedules and reorganization of public investment in health via physician remuneration. PMID:28251600

[Risk factors of small for the gestational age neonates in a hospital of Lima, Peru].

PubMed

Tejeda-Mariaca, J Eduardo; Pizango-Mallqui, Orion; Alburquerque-Duglio, Miguel; Mayta-Tristán, Percy

2015-01-01

Identify risk factors for at-term small for gestational age newborns. Retrospective cohort study using data from the Maternal Perinatal Information System of the Maria Auxiliadora Hospital of Lima, from the period 2000-2010. Maternal age, parity, education level, marital status, pregestational body mass index, number of prenatal care visits, presence of conditions such as preeclampsia, eclampsia, urinary tract infection and gestational diabetes as risk factors in small for gestational age newborns were evaluated. The weight for gestational age was calculated based on Peruvian percentiles. Crude relative risk (RR) and adjusted (ARR) were calculated with confidence intervals of 95% using log-binomial generalized linear models. 64,670 pregnant women were included. The incidence for small for gestational age was 7.2%. Preeclampsia (ARR 2.0, 95% CI: 1.86 to 2.15), eclampsia (ARR 3.22, 95% CI: 2.38 to 4.35), low maternal weight (ARR 1.38; 95% CI: 1.23 to 1.54), nulliparity (ARR 1.32, 95% CI: 1.23 to 1.42), age ≥35 years (ARR 1.16, 95% CI: 1.04 -1.29), having prenatal care visits from 0 to 2 (ARR 1.43, 95% CI: 1.32 to 1.55) and 3 to 5 (ARR 1.22, 95% CI: 1.14 to 1.32) were risk factors for small for gestational age. It is necessary to identify pregnant women with risk factors such as those found to decrease the condition of small for gestational age. Actions should emphasize modifiable factors, such as the frequency of prenatal care visits.

Diffusion of innovation: enhancing the dissemination of the Ponseti method in Latin America through virtual forums.

PubMed

Jayawardena, Asitha; Boardman, Allison; Cook, Thomas; Oprescu, Florin; Morcuende, Jose A

2011-01-01

This ethnographic study evaluated the use of low-bandwidth web-conferencing to enhance diffusion of a specific best practice, the Ponseti method to treat clubfoot, in three economically diverse countries in Latin America. A "Ponseti Virtual Forum" (PVF) was organized in Guatemala, Peru and Chile to examine the influences of economic level and telecommunication infrastructure on the effectiveness of tins approach. Across the three countries, a total of 14 different sites participated in the PVFs. Thirty-three Ponseti-trained practitioners were interviewed before and after each PVF, which included interactions with a Spanish-speaking Ponseti method expert. Semi-structured interviews, observations, and IP address data were triangulated and analyzed. The results demonstrated that 100% of the practitioners rated the sessions as very useful and that they would use this approach again. The largest obstacles to using PVFs were financial (7 out of 9 practitioners) in Guatemala; a lack of equipment and network access (6 out of 11) in Peru; and the organization and implementation of the conferences themselves (7 out of 9) in Chile. This study illustrates the usefulness of Ponseti Virtual Forums in Latin America. Health officials in Peru are currently developing a large-scale information session for traumatologists about the Ponseti method, while practitioners in Guatemala and Chile are organizing monthly scholarly meetings for physicians in remote areas. This initial feedback suggests that low-bandwidth web-conferencing can be an important vehicle for the dissemination of best practices, such as the Ponseti method, in developing countries.

DIFFUSION OF INNOVATION: ENHANCING THE DISSEMINATION OF THE PONSETI METHOD IN LATIN AMERICA THROUGH VIRTUAL FORUMS

PubMed Central

Jayawardena, Asitha; Boardman, Allison; Cook, Thomas; Oprescu, Florin; Morcuende, Jose A

2011-01-01

This ethnographic study evaluated the use of low-bandwidth web-conferencing to enhance diffusion of a specific best practice, the Ponseti method to treat clubfoot, in three economically diverse countries in Latin America. A “Ponseti Virtual Forum” (PVF) was organized in Guatemala, Peru and Chile to examine the influences of economic level and telecommunication infrastructure on the effectiveness of tins approach. Across the three countries, a total of 14 different sites participated in the PVFs. Thirty-three Ponseti-trained practitioners were interviewed before and after each PVF, which included interactions with a Spanish-speaking Ponseti method expert. Semi-structured interviews, observations, and IP address data were triangulated and analyzed. The results demonstrated that 100% of the practitioners rated the sessions as very useful and that they would use this approach again. The largest obstacles to using PVFs were financial (7 out of 9 practitioners) in Guatemala; a lack of equipment and network access (6 out of 11) in Peru; and the organization and implementation of the conferences themselves (7 out of 9) in Chile. This study illustrates the usefulness of Ponseti Virtual Forums in Latin America. Health officials in Peru are currently developing a large-scale information session for traumatologists about the Ponseti method, while practitioners in Guatemala and Chile are organizing monthly scholarly meetings for physicians in remote areas. This initial feedback suggests that low-bandwidth web-conferencing can be an important vehicle for the dissemination of best practices, such as the Ponseti method, in developing countries. PMID:22096417

Rapid Syphilis Tests as Catalysts for Health Systems Strengthening: A Case Study from Peru

PubMed Central

García, Patricia J.; Cárcamo, César P.; Chiappe, Marina; Valderrama, Maria; La Rosa, Sayda; Holmes, King K.; Mabey, David C. W.; Peeling, Rosanna W.

2013-01-01

Objectives Untreated maternal syphilis leads to adverse pregnancy outcomes. The use of point of care tests (POCT) offers an opportunity to improve screening coverage for syphilis and other aspects of health systems. Our objective is to present the experience of the introduction of POCT for syphilis in Peru and describe how new technology can catalyze health system strengthening. Methods The study was implemented from September 2009–November 2010 to assess the feasibility of the use of a POCT for syphilis for screening pregnant women in Lima, Peru. Outcomes measured included access to syphilis screening, treatment coverage, partner treatment, effect on patient flow and service efficiency, acceptability among providers and patients, and sustainability. Results Before the introduction of POCT, a pregnant woman needed 6 visits to the health center in 27 days before she received her syphilis result. We trained 604 health providers and implemented the POCT for syphilis as the “two for one strategy”, offering with one finger stick both syphilis and HIV testing. Implementation of the POCT resulted in testing and treatment on the first visit. Screening and treatment coverages for syphilis improved significantly compared with the previous year. Implementation of POCT has been scaled up nationally since the study ended, and coverages for screening, treatment and partner treatment have remained over 92%. Conclusions Implementation of POCT for syphilis proved feasible and acceptable, and led to improvement in several aspects of health services. For the process to be effective we highlight the importance of: (1) engaging the authorities; (2) dissipating tensions between providers and identifying champions; (3) training according to the needs; (4) providing monitoring, supervision, support and recognition; (5) sharing results and discussing actions together; (6) consulting and obtaining feedback from users; and (7) integrating with other services such as with rapid HIV testing. PMID:23840552

Association between follicular gastritis and Helicobacter pylori in children seen at a public hospital in Peru.

PubMed

Mejia, C R; Vera, C A; Huiza-Espinoza, L

2016-01-01

For the last 15 years, infection from Helicobacter pylori (H. pylori) has been recognized in gastritis pathogenesis, and is known to trigger an important inflammatory response in these patients. To determine the association between follicular gastritis and H. pylori infection in children seen at a public hospital in Peru. An analytic, cross-sectional study was conducted on all the children treated at the Hospital Nacional Docente Madre "Niño San Bartolomé" in Lima, Peru, within the time frame of 2011-2012. All the personal data from the patients' medical histories and endoscopic procedures were collected. The crude prevalence ratios (PR) were obtained and adjusted (aPR) with their 95% confidence intervals (95%CI), using generalized linear models with the binomial family and log link function. A total of 123 children met the study criteria. Forty-eight (39%) of the study sample were girls and the mean age of the children was 12 years. H. pylori was present in 44% of the sample and 9% presented with more than 100 bacteria per field (classified as +++). Thirty-five percent of the children had esophagitis due to concomitant reflux. The presence of H. pylori was associated with follicular gastritis (P<0.01; aPR: 2.3; 95% CI:1.49-3.49), adjusted by the children's age. Based on the data analyzed, it was concluded that the children with follicular gastritis had a greater likelihood of having H. pylori than those that did not present with gastritis. These results can be extrapolated to other similar populations and should be evaluated in each setting so that this does not become a public health problem within the next few years. Copyright © 2016 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

Factors behind the success story of under-five stunting in Peru: a district ecological multilevel analysis.

PubMed

Huicho, Luis; Huayanay-Espinoza, Carlos A; Herrera-Perez, Eder; Segura, Eddy R; Niño de Guzman, Jessica; Rivera-Ch, María; Barros, Aluisio J D

2017-01-19

Stunting prevalence in children less than 5 years has remained stagnated in Peru from 1992 to 2007, with a rapid reduction thereafter. We aimed to assess the role of different predictors on stunting reduction over time and across departments, from 2000 to 2012. We used various secondary data sources to describe time trends of stunting and of possible predictors that included distal to proximal determinants. We determined a ranking of departments by annual change of stunting and of different predictors. To account for variation over time and across departments, we used an ecological hierarchical approach based on a multilevel mixed-effects regression model, considering stunting as the outcome. Our unit of analysis was one department-year. Stunting followed a decreasing trend in all departments, with differing slopes. The reduction pace was higher from 2007-2008 onwards. The departments with the highest annual stunting reduction were Cusco (-2.31%), Amazonas (-1.57%), Puno (-1.54%), Huanuco (-1.52%), and Ancash (-1.44). Those with the lowest reduction were Ica (-0.67%), Ucayali (-0.64%), Tumbes (-0.45%), Lima (-0.37%), and Tacna (-0.31%). Amazon and Andean departments, with the highest baseline poverty rates and concentrating the highest rural populations, showed the highest stunting reduction. In the multilevel analysis, when accounting for confounding, social determinants seemed to be the most important factors influencing annual stunting reduction, with significant variation between departments. Stunting reduction may be explained by the adoption of anti-poverty policies and sustained implementation of equitable crosscutting interventions, with focus on poorest areas. Inclusion of quality indicators for reproductive, maternal, neonatal and child health interventions may enable further analyses to show the influence of these factors. After a long stagnation period, Peru reduced dramatically its national and departmental stunting prevalence, thanks to a combination of social determinants and crosscutting factors. This experience offers useful lessons to other countries trying to improve their children's nutrition.

[Antibiotic resistance of streptococcus pneumoniae among healthy nasopharyngeal carriers in seven regions of Peru].

PubMed

Torres, Nancy; Velásquez, Ricardo; Mercado, Erik H; Egoavil, Martha; Horna, Gertrudis; Mejía, Lida; Castillo, María E; Chaparro, Eduardo; Hernández, Roger; Silva, Wilda; Campos, Francisco E; Sáenz, Andrés; Hidalgo, Félix; Letona, Carolina; Valencia, Angel G; Cerpa, Rosario; López-de-Romaña, Bernardo; Torres, Berenice; Castillo, Fiorella; Calle, Andrea; Rabanal, Synthia; Pando, Jackeline; Lacroix, Elizabeth; Reyes, Isabel; Guerra, Humberto; Ochoa, Theresa J

2013-01-01

To determine the pattern of antibiotic susceptibility of isolated Streptococcus pneumoniae strains of healthy nasopharyngeal carriers younger than 2 years in seven regions of Peru. Between 2007 and 2009, nasopharyngeal swab samples were collected among 2123 healthy children aged 2-24 months in growth and development medical practices (CRED) and vaccination offices of hospitals and health centers in Lima, Piura, Cusco, Abancay, Arequipa, Huancayo, and Iquitos. The resistance to ten antibiotics through disk diffusion sensitivity testing of isolated pneumococcus strains was determined. 572 strains were isolated. High rates of resistance to co-trimoxazole (58%), penicillin (52.2% non-sensitive); tetracycline (29,1%); azithromycin (28,9%), and erythromycin (26,3%). Resistance to chloramphenicol was low (8.8%). Multiresistance was found at 29.5%. Resistance to azithromycin and penicillin was different in all seven regions (p<0,05), the highest percentage of non-sensitive strains being found in Arequipa (63,6%), whereas the lowest percentage was found in Cusco (23.4%). High levels of resistance found to penicillin, co-trimoxasole and macrolides in isolated pneumococcus strains of healthy carriers in all studied regions, and their association to a previous use of antibiotics, represent a significant public health problem in our country. This emphasizes the need to implement nationwide strategies to reduce the irrational use of antibiotics, especially among children. It is necessary to complement data of resistance to penicillin with the determination of minimal inhibitory concentration to make proper therapeutic recommendations.

“Manejar la Situacion”: Partner Notification, Partner Management, and Conceptual Frameworks for HIV/STI Control Among MSM in Peru

PubMed Central

Clark, Jesse L.; Perez-Brumer, Amaya; Salazar, Ximena

2015-01-01

Previous analyses of Partner Notification (PN) have addressed individual, interpersonal, social, and structural issues influencing PN outcomes but have paid less attention to the conceptual framework of PN itself. We conducted 18 individual interviews and 8 group discussions, in a two-stage qualitative research process, to explore the meanings and contexts of PN for sexually transmitted infections (STI) among men who have sex with men (MSM) and men who have sex with men and women (MSMW) in Lima, Peru. Participants described PN as the open disclosure of private, potentially stigmatizing information that could strengthen or disrupt a partnership, structured by the tension between concealment and revelation. In addition to informing partners of an STI diagnosis, the act of PN was believed to reveal other potentially stigmatizing information related to sexual identity and practices such as homosexuality, promiscuity, and HIV co-infection. In this context, the potential development of visible, biological STI symptoms represented a risk for disruption of the boundary between secrecy and disclosure that could result in involuntary disclosure of STI status. To address the conflict between concealment and disclosure, participants cited efforts to “manejar la situacion” [manage the situation] by controlling the biological risks of STI exposure without openly disclosing STI status. We use this concept of “managing the situation” as a practical and theoretical framework for comprehensive Partner Management for HIV/STI control systems among MSM in Latin America. PMID:25821149

Association between Facebook dependence and poor sleep quality: a study in a sample of undergraduate students in Peru.

PubMed

Wolniczak, Isabella; Cáceres-DelAguila, José Alonso; Palma-Ardiles, Gabriela; Arroyo, Karen J; Solís-Visscher, Rodrigo; Paredes-Yauri, Stephania; Mego-Aquije, Karina; Bernabe-Ortiz, Antonio

2013-01-01

Internet can accelerate information exchange. Social networks are the most accessed especially Facebook. This kind of networks might create dependency with several negative consequences in people's life. The aim of this study was to assess potential association between Facebook dependence and poor sleep quality. A cross sectional study was performed enrolling undergraduate students of the Universidad Peruana de Ciencias Aplicadas, Lima, Peru. The Internet Addiction Questionnaire, adapted to the Facebook case, and the Pittsburgh Sleep Quality Index, were used. A global score of 6 or greater was defined as the cutoff to determine poor sleep quality. Generalized linear model were used to determine prevalence ratios (PR) and 95% confidence intervals (95%CI). A total of 418 students were analyzed; of them, 322 (77.0%) were women, with a mean age of 20.1 (SD: 2.5) years. Facebook dependence was found in 8.6% (95% CI: 5.9%-11.3%), whereas poor sleep quality was present in 55.0% (95% CI: 50.2%-59.8%). A significant association between Facebook dependence and poor sleep quality mainly explained by daytime dysfunction was found (PR = 1.31; IC95%: 1.04-1.67) after adjusting for age, sex and years in the faculty. There is a relationship between Facebook dependence and poor quality of sleep. More than half of students reported poor sleep quality. Strategies to moderate the use of this social network and to improve sleep quality in this population are needed.

Characterization of the intra-annual variability in the Oxygen Minimum Zone (OMZ) off Peru

NASA Astrophysics Data System (ADS)

Paulmier, A.; Campos, F.; Dewitte, B.; Garcon, V.; Illig, S.; Carrasco, E.; Depretz de Gesincourt, O.; Grelet, J.; Ledesma, J. A.; Maes, C.; Montes, I.; Oschlies, A.; Quispe, J.; Scouarnec, L.

2016-02-01

The Oxygen Minimum Zones (OMZs) are oceanic deoxygenated layers between 50 and 1000 meters depth, which impact climate and ecosystems at both local and global scales. In particular, associated with the most productive upwelling system (10% of the world fisheries), the OMZ off Peru has the shallowest and most intense core with the lowest O2 concentration. Little is known on O2 variability at hourly to intra-seasonal timescales in this region. Thanks to the first long term subsurface mooring deployed off Lima (12°02'S, 77°40'W) at 30 nm from the coast, this study investigates the OMZ variability. The mooring consists in an instrumented line including sensors of pressure, temperature, salinity and oxygen located at 5 depths (30, 50, 75, 145 and 160 meters below the surface) with an acquisition frequency of 15 minutes during 14 months from January 5th , 2013 until February 21th, 2014. These data collected in the framework of the trans-disciplinary AMOP project (Activity of investigation dedicated to Oxygen Minimum Zone of the eastern Pacific) allow documenting the dynamics of both the oxycline and core and of their physical forcing (e.g. waves, wind). Three main regimes of variability are reported: sub-daily (< 1 day), sub-monthly (1-30 days) and sub-seasonal (30-90 days), which corresponds to distinct physical mechanisms. Preliminary results from a high-resolution coupled model platform are presented, which serve as material for the interpretation of the data.

[Spatial analysis of childhood obesity and overweight in Peru, 2014].

PubMed

Hernández-Vásquez, Akram; Bendezú-Quispe, Guido; Díaz-Seijas, Deysi; Santero, Marilina; Minckas, Nicole; Azañedo, Diego; Antiporta, Daniel A

2016-01-01

To estimate regional prevalence and identify the spatial patterns of the degree of overweight and obesity by districts in under five years children in Peru during 2014. Analysis of the information reported by the Information System Nutritional Status (SIEN) of the number of cases of overweight and obesity in children under five years recorded during 2014. Regional prevalence for overweight and obesity, and their respective confidence intervals to 95% were calculated. Moran index was used to determine patterns of grouping districts with high prevalence of overweight and/or obesity. Data from 1834 districts and 2,318,980 children under five years were analyzed. 158,738 cases (6.84%; CI 95%: 6.81 to 6.87) were overweight, while 56,125 (2.42%; CI 95%: 2.40 to 2.44) obesity. The highest prevalence of overweight were identified in the regions of Tacna (13.9%), Moquegua (11.8%), Callao (10.4%), Lima (10.2%) and Ica (9.3%), and in the same regions for obesity with 5.3%; 4.3%; 4.0%; 4.0% and 3.8% respectively. The spatial analysis found grouping districts of high prevalence in 10% of all districts for both overweight and obesity, identifying 199 districts for overweight (126 urban and 73 rural), and 184 for obesity (136 urban and 48 rural). The highest prevalence of overweight and obesity were identified in the Peruvian coast regions. Moreover, these regions are predominantly exhibited a spatial clustering of districts with high prevalence of overweight and obesity.

"Manejar la Situacion": Partner Notification, Partner Management, and Conceptual Frameworks for HIV/STI Control Among MSM in Peru.

PubMed

Clark, Jesse L; Perez-Brumer, Amaya; Salazar, Ximena

2015-12-01

Previous analyses of partner notification (PN) have addressed individual, interpersonal, social, and structural issues influencing PN outcomes but have paid less attention to the conceptual framework of PN itself. We conducted 18 individual interviews and 8 group discussions, in a two-stage qualitative research process, to explore the meanings and contexts of PN for sexually transmitted infections (STI) among men who have sex with men (MSM) and men who have sex with men and women (MSMW) in Lima, Peru. Participants described PN as the open disclosure of private, potentially stigmatizing information that could strengthen or disrupt a partnership, structured by the tension between concealment and revelation. In addition to informing partners of an STI diagnosis, the act of PN was believed to reveal other potentially stigmatizing information related to sexual identity and practices such as homosexuality, promiscuity, and HIV co-infection. In this context, the potential development of visible, biological STI symptoms represented a risk for disruption of the boundary between secrecy and disclosure that could result in involuntary disclosure of STI status. To address the conflict between concealment and disclosure, participants cited efforts to "manejar la situacion" (manage the situation) by controlling the biological risks of STI exposure without openly disclosing STI status. We use this concept of "managing the situation" as a practical and theoretical framework for comprehensive Partner Management for HIV/STI control systems among MSM in Latin America.

Plagiarism, Cheating and Research Integrity: Case Studies from a Masters Program in Peru.

PubMed

Carnero, Andres M; Mayta-Tristan, Percy; Konda, Kelika A; Mezones-Holguin, Edward; Bernabe-Ortiz, Antonio; Alvarado, German F; Canelo-Aybar, Carlos; Maguiña, Jorge L; Segura, Eddy R; Quispe, Antonio M; Smith, Edward S; Bayer, Angela M; Lescano, Andres G

2017-08-01

Plagiarism is a serious, yet widespread type of research misconduct, and is often neglected in developing countries. Despite its far-reaching implications, plagiarism is poorly acknowledged and discussed in the academic setting, and insufficient evidence exists in Latin America and developing countries to inform the development of preventive strategies. In this context, we present a longitudinal case study of seven instances of plagiarism and cheating arising in four consecutive classes (2011-2014) of an Epidemiology Masters program in Lima, Peru, and describes the implementation and outcomes of a multifaceted, "zero-tolerance" policy aimed at introducing research integrity. Two cases involved cheating in graded assignments, and five cases correspond to plagiarism in the thesis protocol. Cases revealed poor awareness of high tolerance to plagiarism, poor academic performance, and widespread writing deficiencies, compensated with patchwriting and copy-pasting. Depending on the events' severity, penalties included course failure (6/7) and separation from the program (3/7). Students at fault did not engage in further plagiarism. Between 2011 and 2013, the Masters program sequentially introduced a preventive policy consisting of: (i) intensified research integrity and scientific writing education, (ii) a stepwise, cumulative writing process; (iii) honor codes; (iv) active search for plagiarism in all academic products; and (v) a "zero-tolerance" policy in response to documented cases. No cases were detected in 2014. In conclusion, plagiarism seems to be widespread in resource-limited settings and a greater response with educational and zero-tolerance components is needed to prevent it.