77 FR 64031 - United States-Peru Trade Promotion Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-18

... CFR Parts 10, 24, 162, 163, and 178 [USCBP-2011-0043; CBP Dec. 12-18] RIN 1515-AD79 United States-Peru... tariff treatment and other customs-related provisions of the United States-Peru Trade Promotion Agreement... other customs-related provisions of the United States-Peru Trade Promotion Agreement (PTPA). Please...

Functional Domains of the Quechua Language in Peru: Issues of Status Planning.

ERIC Educational Resources Information Center

Coronel-Molina, Serafin M.

1999-01-01

Examines the status of Quechua in Peru and how it has affected language maintenance efforts; discusses the functional domains served by Quechua, relating them to Peruvian language policies; notes the lack of grassroots efforts by indigenous people in Peru; and suggests possible measures to improve its status, noting predictions of the future of…

Do Social Factors Predict Appropriate Treatment of Child Diarrheal Disease in Peru?

PubMed

Volpicelli, Kathryn; Buttenheim, Alison M

2016-11-01

Objectives Diarrheal disease is a significant cause of morbidity among children in Peru. Oral rehydration therapy (ORT) is a cost-effective evidence-based approach to treat diarrhea in young children, yet many Peruvian children in poorer households do not receive this life-saving treatment. This study investigates the social determinants of care-seeking behavior and utilization of appropriate home treatment for diarrheal episodes. Methods We used the nationally-representative 2008 Peru Demographic and Health Survey to: (1) describe the burden of non-bloody diarrheal disease among children <5 years old; and (2) identify socioeconomic correlates of care-seeking behavior and utilization/appropriateness of treatment among mothers of children with recent non-bloody diarrheal episodes (N = 1365). For the former, we reported descriptive statistics; for the latter, we utilized logistic regression to generate odds ratios. Results 2-week period prevalence of diarrheal disease was almost twice as high among poor (17 %) compared with wealthier (10 %) children, higher among children aged 12-23 months old (22 %), and higher among children from households that do not have an improved source of drinking water (16 %) compared with those that have an improved source (12 %). Interestingly, rural residence was a significant predictor of seeking care for diarrhea. Furthermore, although widely available, few mothers (15 %) used appropriate treatment for a recent diarrheal episode. Water source, mother's education, and wealth were significant predictors of appropriate home treatment. Conclusions Mothers in rural areas-typically with less access to care-were more likely to seek care for diarrheal disease in their children, even when adjusting for other variables. However, this increase in care seeking behavior did not extend to appropriate home treatment. Innovative behavior change strategies to reduce barriers to access and appropriate home treatment for diarrheal disease are

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.

Therapeutic community drug treatment success in Peru: a follow-up outcome study

PubMed Central

Johnson, Knowlton; Pan, Zhenfeng; Young, Linda; Vanderhoff, Jude; Shamblen, Steve; Browne, Thom; Linfield, Ken; Suresh, Geetha

2008-01-01

Background The purpose of this study was to assess the impact of drug abuse treatment in Peru that used the therapeutic community (TC) model. Program directors and several staff members from all study treatment facilities received two to eight weeks of in-country training on how to implement the TC treatment model prior to the follow-up study. Methods This outcome study involved 33 TC treatment facilities and 509 former clients in Lima and other cities in five providences across Peru. A retrospective pre-test (RPT) follow-up design was employed in which 30-day use of illegal drugs and alcohol to intoxication was measured at baseline retrospectively, at the same time of the six-month follow-up. In-person interview data were collected from directors of 73 percent of the eligible TC organizations in January and February 2003 and from former 58 percent of the eligible TC former clients between October 2003 and October 2004. Drug testing was conducted on a small sample of former clients to increase the accuracy of the self-reported drug use data. Results Medium to large positive treatment effects were found when comparing 30-day illegal drug and alcohol use to intoxication before and six months after receiving treatment. As a supplemental analysis, we assumed the 42 percent of the former clients who were not interviewed at the six month assessment had returned to drugs. These results showed medium treatment effects as well. Hierarchical Generalized Linear Modeling (HGLM) results showed higher implementation fidelity, less stigma after leaving treatment, and older clients, singly or in combination are key predictors of treatment success. Conclusion This study found that former clients of drug and alcohol treatment in facilities using the TC model reported substantial positive change in use of illegal drugs and alcohol to intoxication at a six-month follow-up. The unique contribution of this study is that the results also suggest attention should be placed on the

[Peru, climate change and non-communicable diseases: ¿where are we and where are we headed?].

PubMed

Avilez, José L; Bazalar, Janina; Azañedo, Diego; Miranda, J Jaime

2016-03-01

The world is facing a crisis of noncommunicable diseases alongside a state of climate volatility. Of the total health burden attributable to climate change, 99% will be assumed by developing countries. In light of climate change, Peru's best opportunity is to create mitigation and adaptation policies focused on developing health co-benefits, which will improve the state of noncommunicable diseases and the climate system. This article presents Peru's compromises in terms of mitigation of greenhouse gas emissions; identifies public health opportunities for Peru under the Paris Agreement signed in the 21st Conference of the Parties (COP21); and makes recommendations for evidence and policy generation for the National Academy of Medicine and the Peruvian government.

Epidemiology of Plasmodium vivax Malaria in Peru

PubMed Central

Rosas-Aguirre, Angel; Gamboa, Dionicia; Manrique, Paulo; Conn, Jan E.; Moreno, Marta; Lescano, Andres G.; Sanchez, Juan F.; Rodriguez, Hugo; Silva, Hermann; Llanos-Cuentas, Alejandro; Vinetz, Joseph M.

2016-01-01

Malaria in Peru, dominated by Plasmodium vivax, remains a public health problem. The 1990s saw newly epidemic malaria emerge, primarily in the Loreto Department in the Amazon region, including areas near to Iquitos, the capital city, but sporadic malaria transmission also occurred in the 1990s–2000s in both north-coastal Peru and the gold mining regions of southeastern Peru. Although a Global Fund-supported intervention (PAMAFRO, 2005–2010) was temporally associated with a decrease of malaria transmission, from 2012 to the present, both P. vivax and Plasmodium falciparum malaria cases have rapidly increased. The Peruvian Ministry of Health continues to provide artemesinin-based combination therapy for microscopy-confirmed cases of P. falciparum and chloroquine–primaquine for P. vivax. Malaria transmission continues in remote areas nonetheless, where the mobility of humans and parasites facilitates continued reintroduction outside of ongoing surveillance activities, which is critical to address for future malaria control and elimination efforts. Ongoing P. vivax research gaps in Peru include the following: identification of asymptomatic parasitemics, quantification of the contribution of patent and subpatent parasitemics to mosquito transmission, diagnosis of nonparasitemic hypnozoite carriers, and implementation of surveillance for potential emergence of chloroquine- and 8-aminoquinoline-resistant P. vivax. Clinical trials of tafenoquine in Peru have been promising, and glucose-6-phosphate dehydrogenase deficiency in the region has not been observed to be a limitation to its use. Larger-scale challenges for P. vivax (and malaria in general) in Peru include logistical difficulties in accessing remote riverine populations, consequences of government policy and poverty trends, and obtaining international funding for malaria control and elimination. PMID:27799639

Epidemiology of Plasmodium vivax Malaria in Peru.

PubMed

Rosas-Aguirre, Angel; Gamboa, Dionicia; Manrique, Paulo; Conn, Jan E; Moreno, Marta; Lescano, Andres G; Sanchez, Juan F; Rodriguez, Hugo; Silva, Hermann; Llanos-Cuentas, Alejandro; Vinetz, Joseph M

2016-12-28

Malaria in Peru, dominated by Plasmodium vivax, remains a public health problem. The 1990s saw newly epidemic malaria emerge, primarily in the Loreto Department in the Amazon region, including areas near to Iquitos, the capital city, but sporadic malaria transmission also occurred in the 1990s-2000s in both north-coastal Peru and the gold mining regions of southeastern Peru. Although a Global Fund-supported intervention (PAMAFRO, 2005-2010) was temporally associated with a decrease of malaria transmission, from 2012 to the present, both P. vivax and Plasmodium falciparum malaria cases have rapidly increased. The Peruvian Ministry of Health continues to provide artemesinin-based combination therapy for microscopy-confirmed cases of P. falciparum and chloroquine-primaquine for P. vivax Malaria transmission continues in remote areas nonetheless, where the mobility of humans and parasites facilitates continued reintroduction outside of ongoing surveillance activities, which is critical to address for future malaria control and elimination efforts. Ongoing P. vivax research gaps in Peru include the following: identification of asymptomatic parasitemics, quantification of the contribution of patent and subpatent parasitemics to mosquito transmission, diagnosis of nonparasitemic hypnozoite carriers, and implementation of surveillance for potential emergence of chloroquine- and 8-aminoquinoline-resistant P. vivax Clinical trials of tafenoquine in Peru have been promising, and glucose-6-phosphate dehydrogenase deficiency in the region has not been observed to be a limitation to its use. Larger-scale challenges for P. vivax (and malaria in general) in Peru include logistical difficulties in accessing remote riverine populations, consequences of government policy and poverty trends, and obtaining international funding for malaria control and elimination. © The American Society of Tropical Medicine and Hygiene.

Interculturality for Afro-Peruvians: Towards a Racially Inclusive Education in Peru

ERIC Educational Resources Information Center

Valdiviezo, Laura Alicia

2006-01-01

Intercultural education policy and programs in Peru emerged as a response to the right of education for marginalised indigenous populations. Under the influence of international dialogue regarding education for all, Peruvian policy has recently proposed interculturality as a guiding principle of education for all Peruvians. In this context,…

Joint Peru/United States report on Peru/United States cooperative energy assessment. Volume 4 of 4 Volumes Annexes 8-11

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1979-08-01

A comprehensive assessment of the biofuel potential of Peru is presented. Topics discussed cover current biofuel utilization practices; evaluation of Peruvian biomass productivity; identification of Peruvian agricultural and forestry resources; assessment of resource development and management concerns; identification of market considerations; description of biofuel technological options; and regional identification of biofuel technology applications. The discussion of current biofuel utilization centers on a qualitative description of the main conversion approaches now being practiced in Peru. Biomass productivity is evaluated in the context of the terrain, soil, and climatic conditions found in Peru. A quantitative description of the energy potential that couldmore » be realized from agricultural and forestry resources of Peru follows. A regional picture is given for the production of agricultural residues and forest resources that could potentially supply energy. The assessment of resource development and management concerns focuses on harvesting, reforestation, training, and the environmental consequences of utilization of forest resources. Market factors assessed include: importation, internal market development, external market development, energy policy and pricing, and transportation. Ten biofuel technology options for Peru were identified: small- to medium-scale gasification, a wood waste inventory, stationary and mobile charcoal production systems, wood distillation, forest resource development and management, electrical cogeneration, anaerobic digestion technology, development of ethanol production capabilities, and agricultural strategies for fuel production.Based upon these biofuel options, nine applications were identified for the Costa Region, eight for the Sierra Region, and ten for the Selva Region.« less

A randomized controlled study of socioeconomic support to enhance tuberculosis prevention and treatment, Peru.

PubMed

Wingfield, Tom; Tovar, Marco A; Huff, Doug; Boccia, Delia; Montoya, Rosario; Ramos, Eric; Datta, Sumona; Saunders, Matthew J; Lewis, James J; Gilman, Robert H; Evans, Carlton A

2017-04-01

To evaluate the impact of socioeconomic support on tuberculosis preventive therapy initiation in household contacts of tuberculosis patients and on treatment success in patients. A non-blinded, household-randomized, controlled study was performed between February 2014 and June 2015 in 32 shanty towns in Peru. It included patients being treated for tuberculosis and their household contacts. Households were randomly assigned to either the standard of care provided by Peru's national tuberculosis programme (control arm) or the same standard of care plus socioeconomic support (intervention arm). Socioeconomic support comprised conditional cash transfers up to 230 United States dollars per household, community meetings and household visits. Rates of tuberculosis preventive therapy initiation and treatment success (i.e. cure or treatment completion) were compared in intervention and control arms. Overall, 282 of 312 (90%) households agreed to participate: 135 in the intervention arm and 147 in the control arm. There were 410 contacts younger than 20 years: 43% in the intervention arm initiated tuberculosis preventive therapy versus 25% in the control arm (adjusted odds ratio, aOR: 2.2; 95% confidence interval, CI: 1.1-4.1). An intention-to-treat analysis showed that treatment was successful in 64% (87/135) of patients in the intervention arm versus 53% (78/147) in the control arm (unadjusted OR: 1.6; 95% CI: 1.0-2.6). These improvements were equitable, being independent of household poverty. A tuberculosis-specific, socioeconomic support intervention increased uptake of tuberculosis preventive therapy and tuberculosis treatment success and is being evaluated in the Community Randomized Evaluation of a Socioeconomic Intervention to Prevent TB (CRESIPT) project.

Perceptions and Acceptability of Short Message Services Technology to Improve Treatment Adherence amongst Tuberculosis Patients in Peru: A Focus Group Study

PubMed Central

Albino, Sandra; Tabb, Karen M.; Requena, David; Egoavil, Miguel; Pineros-Leano, Maria F.; Zunt, Joseph R.; García, Patricia J.

2014-01-01

Background Tuberculosis (TB) is global health concern and a leading infectious cause of mortality. Reversing TB incidence and disease-related mortality is a major global health priority. Infectious disease mortality is directly linked to failure to adhere to treatments. Using technology to send reminders by short message services have been shown to improve treatment adherence. However, few studies have examined tuberculosis patient perceptions and attitudes towards using SMS technology to increase treatment adherence. In this study, we sought to investigate perceptions related to feasibility and acceptability of using text messaging to improve treatment adherence among adults who were receiving treatment for TB in Callao, Peru. Methods We conducted focus group qualitative interviews with current TB positive and non-contagious participants to understand the attitudes, perceptions, and feasibility of using short message service (SMS) reminders to improve TB treatment adherence. Subjects receiving care through the National TB Program were recruited through public health centers in Ventanilla, Callao, Peru. In four focus groups, we interviewed 16 patients. All interviews were recorded and transcribed verbatim. Thematic network analysis and codebook techniques were used to analyze data. Results Three major themes emerged from the data: limits on health literacy and information posed challenges to successful TB treatment adherence, treatment motivation at times facilitated adherence to TB treatment, and acceptability of SMS including positive perceptions of SMS to improve TB treatment adherence. The majority of patients shared considerations about how to effectively and confidentially administer an SMS intervention with TB positive participants. Conclusion The overall perceptions of the use of SMS were positive and indicated that SMS technology may be an efficient way to transmit motivational texts on treatment, health education information, and simple reminders to

Perceptions and acceptability of short message services technology to improve treatment adherence amongst tuberculosis patients in Peru: a Focus Group Study.

PubMed

Albino, Sandra; Tabb, Karen M; Requena, David; Egoavil, Miguel; Pineros-Leano, Maria F; Zunt, Joseph R; García, Patricia J

2014-01-01

Tuberculosis (TB) is global health concern and a leading infectious cause of mortality. Reversing TB incidence and disease-related mortality is a major global health priority. Infectious disease mortality is directly linked to failure to adhere to treatments. Using technology to send reminders by short message services have been shown to improve treatment adherence. However, few studies have examined tuberculosis patient perceptions and attitudes towards using SMS technology to increase treatment adherence. In this study, we sought to investigate perceptions related to feasibility and acceptability of using text messaging to improve treatment adherence among adults who were receiving treatment for TB in Callao, Peru. We conducted focus group qualitative interviews with current TB positive and non-contagious participants to understand the attitudes, perceptions, and feasibility of using short message service (SMS) reminders to improve TB treatment adherence. Subjects receiving care through the National TB Program were recruited through public health centers in Ventanilla, Callao, Peru. In four focus groups, we interviewed 16 patients. All interviews were recorded and transcribed verbatim. Thematic network analysis and codebook techniques were used to analyze data. Three major themes emerged from the data: limits on health literacy and information posed challenges to successful TB treatment adherence, treatment motivation at times facilitated adherence to TB treatment, and acceptability of SMS including positive perceptions of SMS to improve TB treatment adherence. The majority of patients shared considerations about how to effectively and confidentially administer an SMS intervention with TB positive participants. The overall perceptions of the use of SMS were positive and indicated that SMS technology may be an efficient way to transmit motivational texts on treatment, health education information, and simple reminders to increase treatment adherence for low

Language Planning Orientations and Bilingual Education in Peru.

ERIC Educational Resources Information Center

Hornberger, Nancy H.

1988-01-01

Considers the status and corpus planning aspects of three of Peru's Quechua policies in light of the language planning orientations of language-as-problem, language-as-right, and language-as-resource. Current Quechua/Spanish bilingual education recognizes the rights of Quechua speakers and the role of the language as a national resource.…

75 FR 1 - Importation of Hass Avocados From Peru

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-04

...We are amending the fruits and vegetables regulations to allow the importation of Hass avocados from Peru into the continental United States. As a condition of entry, Hass avocados from Peru will have to be produced in accordance with a systems approach that includes requirements for importation in commercial consignments; registration and monitoring of places of production and packinghouses; grove sanitation; pest-free areas or trapping for the South American fruit fly; pest-free areas or treatment for the Mediterranean fruit fly; surveys for the avocado seed moth; and inspection for quarantine pests by the national plant protection organization of Peru. Hass avocados from Peru will also be required to be accompanied by a phytosanitary certificate with an additional declaration stating that the avocados were grown, packed, and inspected and found to be free of pests in accordance with these requirements. This action will allow the importation of Hass avocados from Peru into the United States while continuing to provide protection against the introduction of quarantine pests.

Peru Country Analysis Brief

EIA Publications

2015-01-01

The economy of Peru has grown rapidly since the year 2000. Peru's GDP per capita has nearly tripled since then. In tandem with the economic growth, energy demand has also grown considerably. Peru, which is rich in hydrocarbons, has oil, natural gas, and coal reserves. Despite its increased energy consumption, Peru exports both oil and natural gas.

[Interventions to control overweight and obesity in children and adolescents in Peru].

PubMed

Aquino-Vivanco, Óscar; Aramburu, Adolfo; Munares-García, Óscar; Gómez-Guizado, Guillermo; García-Torres, Elizabeth; Donaires-Toscano, Fernando; Fiestas, Fabián

2013-04-01

Overweight and obesity in children and adolescents represent a serious public health problem in Peru, with high costs for society that require the implementation of a set of public policies directed toward its control. Thus, interventions have been proposed as the regulation of advertising of unhealthy foods, self-regulation, the implementation of kiosks healthy and nutritional labeling. From the analysis of the problem of overweight and obesity in children and adolescents in Peru, this article is a narrative review of such interventions.

Effect of universal MODS access on pulmonary tuberculosis treatment outcomes in new patients in Peru

PubMed Central

Alarcón, E.; Alarcón, V.; Bissell, K.; Castillo, E.; Sabogal, I.; Mora, J.; Moore, D.; Harries, A. D.

2012-01-01

Setting: Primary health care centres in Callao, Peru. Objectives: To evaluate the effect of universal access to the microscopic-observation drug susceptibility (MODS) assay on treatment outcomes in new and primary multidrug-resistant tuberculosis (MDR-TB) patients and on the process of drug susceptibility testing (DST). Design: Retrospective review of tuberculosis (TB) registers and clinical records before (2007) and after (2009) the introduction of MODS in 2008. Results: There were 281 patients in each cohort. Favourable treatment outcomes for 2007 (81%) and 2009 (77%) cohorts were similar. There was an increase in loss to follow-up (from 6% to 10%, P = 0.04) and a reduction in failure rates (from 4% to 0.4%, P = 0.01) in the 2009 compared with the 2007 cohort. In new MDR-TB cases (n = 22), a favourable treatment outcome was improved (from 46% to 82%, P = 0.183) in the 2009 cohort. DST coverage improved (from 24% to 74%, P < 0.001), and a significant reduction in time to diagnosis of drug-susceptible (from 118 to 33 days, P < 0.001) and MDR-TB (from 158 to 52 days, P = 0.003) was observed in the 2009 cohort. Conclusion: Universal access to MODS increased DST coverage, reduced the time required to obtain DST results and was associated with reduced failure rates. MODS can make an important contribution to TB management and control in Peru. PMID:24579063

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.

Diabetes Mellitus in Peru.

PubMed

Villena, Jaime E

2015-01-01

Peru is an upper medium-income developing country with an increasing prevalence of chronic diseases, including diabetes. To review and describe the epidemiology, drivers, and diabetes care plan in Peru. The medical literature was reviewed based on systematic searching of PubMed, Scielo, and various gray literature from the International Diabetes Federation, World Health Organization, and local Peruvian agencies. In Peru, diabetes affects 7% of the population. Type 2 diabetes accounts for 96.8% of outpatients visits with this condition. Type 1 diabetes has an incidence of 0.4/100,000 per year, and gestational diabetes affects 16% of pregnancies. The prevalence of glucose intolerance is 8.11% and that of impaired fasting glucose 22.4%. The prevalence of overweight, obesity, and metabolic syndrome in adults is 34.7%, 17.5%, and 25%, respectively. Metabolic syndrome prevalence is greater in women and the elderly and at urban and low-altitude locations. Diabetes is the eighth cause of death, the sixth cause of blindness, and the leading cause of end-stage kidney disease and nontraumatic lower limb amputation. In Peru, diabetes accounts for 31.5% of acute myocardial infarctions and 25% of strokes. Infections, diabetic emergencies, and cardiovascular disorders are the main causes for admissions, with a mortality rate < 10%, mainly as a result of infections, chronic kidney disease, and stroke. Sixty-two percent of the population has health insurance coverage, with inequities in the distribution of health care personnel across the country. Less than 30% of treated patients have a hemoglobin A1c < 7%. Diabetes is a major health care issue in Peru that exposes difficult challenges and shortcomings. The national strategy for tackling diabetes includes promotion of healthy lifestyles; training primary care physicians and providing them with evidence-based clinical practice guidelines, safe and effective medications, and tools for monitoring treatment; and, finally, construction

Implications of raising cigarette excise taxes in Peru.

PubMed

Gonzalez-Rozada, Martin; Ramos-Carbajales, Alejandro

2016-10-01

To assess how raising cigarette excise taxes in Peru might impact cigarette consumption, and to determine if higher taxes would be regressive. Total demand price elasticity was estimated by income groups using two datasets: quarterly time-series data from 1993 - 2012 and data from a cross-sectional survey of income and expenses conducted in 2008 - 2009 . A functional form of the cigarette demand in Peru was specified using the quarterly data set, and the demand price elasticity was estimated for the short and long run. Using the second data set and Deaton methodology, the implementation of elasticity estimation and by groups' elasticity was done in a two-step procedure. Demand price elasticity was -0.7, implying that a 10% price increase via a new tax would reduce consumption by 7%. Demand price elasticity estimations by income group suggested that poorer families are not more price sensitive than richer ones, which implies that increasing cigarette taxes could be regressive. Increasing cigarette taxes is the most efficient policy for inducing a reduction in smoking. However, in the case of Peru, an increase in cigarette taxes could be regressive.

Joint Peru/United States report on Peru/United States cooperative energy assessment. Volume 2. Annex 1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1979-08-01

An examination of the energy sources of Peru was undertaken by the USA in collaboration with Peru. First, an introduction establishes the purpose and summarizes results, after which the status of energy supply is presented. The ensuing sections contain the contributions of the participating technical specialists, namely: Peru's hydrocarbon potential, estimated reserves, and projected production rates; coal deposits in Peru; geothermal energy; uranium; miscellaneous energy sources; energy-related minerals; water resources in Peru; and geologic hazards in Peru. A separate abstract was prepared for each of the sections. (MCW)

[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.

Teaching the History of Colonial Peru.

ERIC Educational Resources Information Center

Campbell, Leon G.

1981-01-01

Presents a bibliographic review essay on the topic of colonial Peru organized according to the following topics: Pre-Columbian Peru, 5500 B.C.- 1532; the conquest of Peru, 1532-1572; Peru under the Hapsburgs, 1516-1700; Bourbon Peru, 1700-1808; and the coming of independence, 1808-1821. The essay is based on a bibliography composed largely of…

Missed Opportunities for Health Education on Pap Smears in Peru

PubMed Central

Bayer, Angela M.; Nussbaum, Lauren; Cabrera, Lilia; Paz-Soldan, Valerie A.

2013-01-01

Despite cervical cancer being one of the leading causes of cancer-related deaths among women in Peru, cervical Pap smear coverage is low. This article uses findings from 185 direct clinician observations in four cities of Peru (representing the capital and each of the three main geographic regions of the country) to assess missed opportunities for health education on Pap smears and other preventive women’s health behaviors during women’s visits to a health care provider. Various types of health establishments, provider settings, and provider types were observed. Opportunities for patient education on the importance of prevention were rarely exploited. In fact, health education provided was minimal. Policy and programmatic implications are discussed. PMID:21464205

21 CFR 524.2620 - Liquid crystalline trypsin, Peru balsam, castor oil.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Conditions of use. The drug is used as an aid in the treatment of external wounds and assists healing by... delivered to the wound site contains 0.12 milligram of crystalline trypsin, 87.0 milligrams of Peru balsam... gram delivered to the wound site contains 0.1 milligram of crystalline trypsin, 72.5 milligrams of Peru...

21 CFR 524.2620 - Liquid crystalline trypsin, Peru balsam, castor oil.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Conditions of use. The drug is used as an aid in the treatment of external wounds and assists healing by... delivered to the wound site contains 0.12 milligram of crystalline trypsin, 87.0 milligrams of Peru balsam... gram delivered to the wound site contains 0.1 milligram of crystalline trypsin, 72.5 milligrams of Peru...

21 CFR 524.2620 - Liquid crystalline trypsin, Peru balsam, castor oil.

Code of Federal Regulations, 2011 CFR

2011-04-01

... delivered to the wound site contains 0.12 milligram of crystalline trypsin, 87.0 milligrams of Peru balsam... gram delivered to the wound site contains 0.1 milligram of crystalline trypsin, 72.5 milligrams of Peru...) Conditions of use. The drug is used as an aid in the treatment of external wounds and assists healing by...

21 CFR 524.2620 - Liquid crystalline trypsin, Peru balsam, castor oil.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Conditions of use. The drug is used as an aid in the treatment of external wounds and assists healing by... delivered to the wound site contains 0.12 milligram of crystalline trypsin, 87.0 milligrams of Peru balsam... gram delivered to the wound site contains 0.1 milligram of crystalline trypsin, 72.5 milligrams of Peru...

Cost-Effectiveness Analysis of Breast Cancer Control Interventions in Peru

PubMed Central

Zelle, Sten G.; Vidaurre, Tatiana; Abugattas, Julio E.; Manrique, Javier E.; Sarria, Gustavo; Jeronimo, José; Seinfeld, Janice N.; Lauer, Jeremy A.; Sepulveda, Cecilia R.; Venegas, Diego; Baltussen, Rob

2013-01-01

Objectives In Peru, a country with constrained health resources, breast cancer control is characterized by late stage treatment and poor survival. To support breast cancer control in Peru, this study aims to determine the cost-effectiveness of different breast cancer control interventions relevant for the Peruvian context. Methods We performed a cost-effectiveness analysis (CEA) according to WHO-CHOICE guidelines, from a healthcare perspective. Different screening, early detection, palliative, and treatment interventions were evaluated using mathematical modeling. Effectiveness estimates were based on observational studies, modeling, and on information from Instituto Nacional de Enfermedades Neoplásicas (INEN). Resource utilizations and unit costs were based on estimates from INEN and observational studies. Cost-effectiveness estimates are in 2012 United States dollars (US$) per disability adjusted life year (DALY) averted. Results The current breast cancer program in Peru ($8,426 per DALY averted) could be improved through implementing triennial or biennial screening strategies. These strategies seem the most cost-effective in Peru, particularly when mobile mammography is applied (from $4,125 per DALY averted), or when both CBE screening and mammography screening are combined (from $4,239 per DALY averted). Triennially, these interventions costs between $63 million and $72 million per year. Late stage treatment, trastuzumab therapy and annual screening strategies are the least cost-effective. Conclusions Our analysis suggests that breast cancer control in Peru should be oriented towards early detection through combining fixed and mobile mammography screening (age 45-69) triennially. However, a phased introduction of triennial CBE screening (age 40-69) with upfront FNA in non-urban settings, and both CBE (age 40-49) and fixed mammography screening (age 50-69) in urban settings, seems a more feasible option and is also cost-effective. The implementation of this

Cost-effectiveness analysis of breast cancer control interventions in Peru.

PubMed

Zelle, Sten G; Vidaurre, Tatiana; Abugattas, Julio E; Manrique, Javier E; Sarria, Gustavo; Jeronimo, José; Seinfeld, Janice N; Lauer, Jeremy A; Sepulveda, Cecilia R; Venegas, Diego; Baltussen, Rob

2013-01-01

In Peru, a country with constrained health resources, breast cancer control is characterized by late stage treatment and poor survival. To support breast cancer control in Peru, this study aims to determine the cost-effectiveness of different breast cancer control interventions relevant for the Peruvian context. We performed a cost-effectiveness analysis (CEA) according to WHO-CHOICE guidelines, from a healthcare perspective. Different screening, early detection, palliative, and treatment interventions were evaluated using mathematical modeling. Effectiveness estimates were based on observational studies, modeling, and on information from Instituto Nacional de Enfermedades Neoplásicas (INEN). Resource utilizations and unit costs were based on estimates from INEN and observational studies. Cost-effectiveness estimates are in 2012 United States dollars (US$) per disability adjusted life year (DALY) averted. The current breast cancer program in Peru ($8,426 per DALY averted) could be improved through implementing triennial or biennial screening strategies. These strategies seem the most cost-effective in Peru, particularly when mobile mammography is applied (from $4,125 per DALY averted), or when both CBE screening and mammography screening are combined (from $4,239 per DALY averted). Triennially, these interventions costs between $63 million and $72 million per year. Late stage treatment, trastuzumab therapy and annual screening strategies are the least cost-effective. Our analysis suggests that breast cancer control in Peru should be oriented towards early detection through combining fixed and mobile mammography screening (age 45-69) triennially. However, a phased introduction of triennial CBE screening (age 40-69) with upfront FNA in non-urban settings, and both CBE (age 40-49) and fixed mammography screening (age 50-69) in urban settings, seems a more feasible option and is also cost-effective. The implementation of this intervention is only meaningful if

The Allure of Quick Victory. Lessons from Peru’s Fight Against Sendero Luminoso

DTIC Science & Technology

2010-10-01

example of successful government consolidation following an internal conflict. 1. “Si no hacemos algo tendremos unas FARC,” El Comercio (19 April 2009...and Shining Path in Peru,” Shining Path of Peru, 3-4. 18. “Suman 15 los Soldados Asesinados,” El Comercio , 22 April 2009. 19. “Por lo menos 50...terroristas atacaron sede policial del poblado de San Jose de Secce,” El Comercio , 2 August 2009. 20. “Helicóptero Caído Cumplía Misión de Rescate de Heridos

Can oral challenge with balsam of Peru predict possible benefit from a low-balsam diet?

PubMed

Veien, N K; Hattel, T; Laurberg, G

1996-06-01

Previous studies have shown that some patients sensitive to balsams and/or fragrances obtain long-term benefits by following a low-balsam diet, whereas others do not. This study was performed to determine whether a low-balsam diet was a helpful long-term treatment for selected patients sensitive to balsam of Peru and/or a perfume mixture and to determine whether oral challenge with balsam of Peru could predict which balsam-sensitive patients might benefit from a reduction in balsam intake. Questionnaires were sent to 46 patients with positive patch test results to balsam of Peru and/or a perfume mixture and chronic dermatitis of a morphology consistent with endogenous dermatitis who had experienced improvement after 1 to 2 months on a diet intended to reduce the intake of balsams. The questionnaires were mailed 1 to 3 years after the initiation of the diet treatment to inquire about a possible long-term benefit of the diet. Twenty-eight of the 46 patients stated in the questionnaire that they had long-term benefits from the diet treatment. These included 16 of 22 patients who had reacted to a placebo-controlled oral challenge with 1 g balsam of Peru, 3 of 10 who had no reaction or a placebo reaction to the oral challenge, and 9 of 14 who had not been challenged orally. The efficacy of the diet treatment was not correlated to whether the patient had patch test reactivity to either balsam of Peru, the perfume mixture, or both substances. Food items most commonly mentioned by patients as causing aggravation of their symptoms on at least three different occasions were wine, candy, chocolate, cinnamon, curry, citrus fruit, and flavorings. In its present form, the oral challenge procedure with balsam of Peru offers only limited assistance in selecting patients who are likely to benefit from diet treatment.

Treatment Failure after Multiple Courses of Triclabendazole among Patients with Fascioliasis in Cusco, Peru: A Case Series

PubMed Central

Cabada, Miguel M.; Lopez, Martha; Cruz, Maria; Delgado, Jennifer R.; Hill, Virginia; White, A. Clinton

2016-01-01

Triclabendazole is reported to be highly effective in treatment of human fascioliasis. We present 7 of 19 selected cases of human fascioliasis referred to our center in the Cusco region of Peru that failed to respond to triclabendazole. These were mostly symptomatic adults of both sexes that continued passing Fasciola eggs in the stool despite multiple treatments with 2 doses of triclabendazole at 10 mg/kg per dose. We documented the presence of eggs by rapid sedimentation and Kato Katz tests after each treatment course. We found that repeated triclabendazole courses were not effective against fascioliasis in this group of people. These findings suggest that resistance to triclabendazole may be an emerging problem in the Andes. PMID:26808543

Treatment Failure after Multiple Courses of Triclabendazole among Patients with Fascioliasis in Cusco, Peru: A Case Series.

PubMed

Cabada, Miguel M; Lopez, Martha; Cruz, Maria; Delgado, Jennifer R; Hill, Virginia; White, A Clinton

2016-01-01

Triclabendazole is reported to be highly effective in treatment of human fascioliasis. We present 7 of 19 selected cases of human fascioliasis referred to our center in the Cusco region of Peru that failed to respond to triclabendazole. These were mostly symptomatic adults of both sexes that continued passing Fasciola eggs in the stool despite multiple treatments with 2 doses of triclabendazole at 10 mg/kg per dose. We documented the presence of eggs by rapid sedimentation and Kato Katz tests after each treatment course. We found that repeated triclabendazole courses were not effective against fascioliasis in this group of people. These findings suggest that resistance to triclabendazole may be an emerging problem in the Andes.

Determinants of unequal HIV care access among people living with HIV in Peru

PubMed Central

2013-01-01

Background Equity in access to health care among people living with HIV (PLHA) has not been extensively studied in Peru despite the fact there is significant social diversity within this group. We aimed to assess the extent to which health care provision to PLHA, including ARVT, was equitable and, if appropriate, identify factors associated with lower access. Methods We conducted a survey among adult PLHA in four cities in Peru, recruited through respondent-driven sampling (RDS), to collect information on socio-demographic characteristics, social network size, household welfare, economic activity, use of HIV-related services including ARV treatment, and health-related out-of-pocket expenses. Results Between September 2008 and January 2009, 863 individuals from PLHA organizations in four cities of Peru were enrolled. Median age was 35 (IQR = 29–41), and mostly male (62%). Overall, 25% reported to be gay, 11% bisexual and 3% transgender. Most PLHA (96%) reported access to some kind of HIV-related health service, and 84% were receiving those services at a public facility. Approximately 85% of those reporting access to care were receiving antiretroviral treatment (ARV), and 17% of those not in treatment already had indication to start treatment. Among those currently on ARV, 36% percent reported out-of-pocket expenses within the last month. Transgender identity and age younger than 35 years old, were associated with lower access to health care. Conclusions Our findings contribute to a better social and demographic characterization of the situation of PLHAs, their access to HIV care and their source of care, and provide an assessment of equity in access. In the long term, it is expected that HIV care access, as well as its social determinants, will impact on the morbidity and mortality rates among those affected by the HIV/AIDS epidemic. HIV care providers and program managers should further characterize the barriers to healthcare access and develop strategies to

[Social programs and reducing obesity in Peru: reflections from the research].

PubMed

Diez-Canseco, Francisco; Saavedra-Garcia, Lorena

2017-01-01

In recent decades, overweight or obesity have increased dramatically in middle- and low-income countries; a situation which consolidates chronic non-communicable diseases (NCD) as one of the leading causes of mortality and disability worldwide. Currently, half the people in Peru over the age of 15 years are overweight, and one fifth suffer from obesity. The situation is worsening and increasingly affects people in poverty, who frequently benefit from food supplement programs designed to combat food insecurity and malnutrition. There is an urgent worldwide need to find policies and programs that help fight the problem of obesity at the population level, a task that is still pending. In this article, we review the current epidemic of overweight and obesity in Peru and the world and its most significant consequences and causes, with an emphasis on access to and availability of foods. We describe the largest food supplement programs and synthesize the research on interventions in order to reflect on how their findings might help social programs work as a platform to reduce obesity and prevent NCD in Peru.

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.

[Cost-Fffectiveness of Two Antiviral Therapies for Chronic Hepatitis B in Peru: Entecavir and Tenofovir].

PubMed

Bolaños-Díaz, Rafael; Tejada, Romina A; Sanabria, César; Escobedo-Palza, Seimer

2017-01-01

To compare in terms of cost-effectiveness to entecavir (ETV) and tenofovir (TDF) in the treatment of hepatitis B virus (HBV) in public hospitals in Peru. We structured a Markov model. We define effectiveness adjusted life years for quality (QALY). We include the direct costs of treatment in soles from the perspective of the Ministry of Health of Peru. We estimate the relationship between cost and effectiveness ratios (ICER). We performed sensitivity analyzes considering a range of willingness to pay (WTP) from one to three times the Gross Domestic Product (GDP) per capita, and a tornado analysis regarding Monetary Net Profit (BMN) or ICER. Treatment with TDF is more effective and less expensive than ETV. The ETV had a cost per QALY of PEN 4482, and PEN 1526 TDF. The PTO maintains a progressively larger with increasing WTP BMN. The discount rate was the only variable with a significant effect on model uncertainty. Treatment with TDF is more cost-effective than ETV in public hospitals in Peru.

Current approaches to gastric cancer in Peru and Mexico.

PubMed

Santos, Erlan

2017-01-01

In Peru, the incidence of gastric cancer is reported to be around 15.8 per 100,000 inhabitants and it is the second most common oncological disease in men and the third one in women. Additionally, a high mortality index was reported, especially among poor people. To address this issue, in 2008, Peru initiated several insurance treatment plans of oncological diseases with promising results. In Mexico, there is a high predominance of gastric cancer in male gender compared to female gender, even reaching a 2/1 ratio, and the detection rate of early gastric cancer is low (10% to 20%) which results in a mainly palliative treatment with an overall survival rate in 5 years about 10% to 15% only. In Peru, the average age at diagnosis is around 62.96±14.75 years old and the most frequent symptoms includes abdominal pain, indigestion, loss of appetite, weight loss and gastrointestinal bleeding, while in Mexico, some studies reported an average age at diagnosis around 60.3±4.1 years old (range, 23-78 years old) and the most frequent symptoms were postprandial fullness (74.4%), abdominal pain (37.2%), weight loss (18.6%), and melena (4.6%). The anemia rate was 65.1% with a mean Hb level of 6.14 g/dL. In Peru, the most common gastric cancer type is the intestinal-type adenocarcinoma (around 34%), followed by the diffuse-type adenocarcinoma (18.7%), whilst among Mexicans, the diffuse-type was reported in 55.2% of cases, the intestinal-type was reported in 28.2% and the undifferentiated-type corresponded to 6%. In both, Peru and Mexico, 90% of the associated factors includes tabaquismo, diets rich in salt, smoked foods, and a sedentary lifestyle. Family inheritance and advanced age and pharmacological-resistant Helicobacter pylori infection are also important. Poverty has been heavily associated with a higher incidence of gastric cancer. The management of gastric cancer patients in Peru is carried out by general surgeons or general surgical oncologists. In recent years, efforts

Peru, People and Plants.

ERIC Educational Resources Information Center

Thompson, Dennis

Designed for horticulture, horticulture therapy, and botany students at Edmonds Community College (Washington), this 6-hour module explores the pre-Columbian use of plant materials in Peru and its relationships to cultural practices in modern Peru. The first sections provide basic information about the module, such as its objectives, the concepts…

The economic effects of supporting tuberculosis-affected households in Peru

PubMed Central

Tovar, Marco A.; Huff, Doug; Boccia, Delia; Montoya, Rosario; Ramos, Eric; Lewis, James J.; Gilman, Robert H.; Evans, Carlton A.

2016-01-01

The End TB Strategy mandates that no tuberculosis (TB)-affected households face catastrophic costs due to TB. However, evidence is limited to evaluate socioeconomic support to achieve this change in policy and practice. The objective of the present study was to investigate the economic effects of a TB-specific socioeconomic intervention. The setting was 32 shantytown communities in Peru. The participants were from households of consecutive TB patients throughout TB treatment administered by the national TB programme. The intervention consisted of social support through household visits and community meetings, and economic support through cash transfers conditional upon TB screening in household contacts, adhering to TB treatment/chemoprophylaxis and engaging with social support. Data were collected to assess TB-affected household costs. Patient interviews were conducted at treatment initiation and then monthly for 6 months. From February 2014 to June 2015, 312 households were recruited, of which 135 were randomised to receive the intervention. Cash transfer total value averaged US$173 (3.5% of TB-affected households' average annual income) and mitigated 20% of households' TB-related costs. Households randomised to receive the intervention were less likely to incur catastrophic costs (30% (95% CI 22–38%) versus 42% (95% CI 34–51%)). The mitigation impact was higher among poorer households. The TB-specific socioeconomic intervention reduced catastrophic costs and was accessible to poorer households. Socioeconomic support and mitigating catastrophic costs are integral to the End TB strategy, and our findings inform implementation of these new policies. PMID:27660507

The economic effects of supporting tuberculosis-affected households in Peru.

PubMed

Wingfield, Tom; Tovar, Marco A; Huff, Doug; Boccia, Delia; Montoya, Rosario; Ramos, Eric; Lewis, James J; Gilman, Robert H; Evans, Carlton A

2016-11-01

The End TB Strategy mandates that no tuberculosis (TB)-affected households face catastrophic costs due to TB. However, evidence is limited to evaluate socioeconomic support to achieve this change in policy and practice. The objective of the present study was to investigate the economic effects of a TB-specific socioeconomic intervention.The setting was 32 shantytown communities in Peru. The participants were from households of consecutive TB patients throughout TB treatment administered by the national TB programme. The intervention consisted of social support through household visits and community meetings, and economic support through cash transfers conditional upon TB screening in household contacts, adhering to TB treatment/chemoprophylaxis and engaging with social support. Data were collected to assess TB-affected household costs. Patient interviews were conducted at treatment initiation and then monthly for 6 months.From February 2014 to June 2015, 312 households were recruited, of which 135 were randomised to receive the intervention. Cash transfer total value averaged US$173 (3.5% of TB-affected households' average annual income) and mitigated 20% of households' TB-related costs. Households randomised to receive the intervention were less likely to incur catastrophic costs (30% (95% CI 22-38%) versus 42% (95% CI 34-51%)). The mitigation impact was higher among poorer households.The TB-specific socioeconomic intervention reduced catastrophic costs and was accessible to poorer households. Socioeconomic support and mitigating catastrophic costs are integral to the End TB strategy, and our findings inform implementation of these new policies. Copyright ©ERS 2016.

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.

Area Assessment: Peru.

DTIC Science & Technology

1985-09-24

covers over half the country, including the vast Amazon River Basin and the Madre de Dio River Basin. The sierra, which makes up over one-fourth of Peru...departments. d. FOURTH (HQ CUSCO): Puno, Cusco, Apurimac, Junin, Pasco, Huanuco, San Martin, Auacucho, and Madre de Dios departments. e. FIFTH (HQ...panies. In Peru the gold boom began in 1978 in the southeastern jungle region ( Madre de Dios ) when the Peruvian Government issued Decree-Law No. 22178

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.

Operation Safe Border: The Ecuador-Peru Crisis

DTIC Science & Technology

1996-01-01

52 JFQ / Spring 1996 In January 1995, the hemisphere was shocked by an outbreak of fighting between Ecuador and Peru over a long-festering border...Weidner, USA, is commander of the U.S. Military Group-Honduras and served as commander of the U.S. Contingent, Military Observer Mission, Ecuador ...Peru. Operation Safe Border: The Ecuador -Peru Crisis By G L E N N R. W E I D N E R Santiago River (fore- ground) and Yaupi River on Ecuador -Peru

Current approaches to gastric cancer in Peru and Mexico

PubMed Central

2017-01-01

In Peru, the incidence of gastric cancer is reported to be around 15.8 per 100,000 inhabitants and it is the second most common oncological disease in men and the third one in women. Additionally, a high mortality index was reported, especially among poor people. To address this issue, in 2008, Peru initiated several insurance treatment plans of oncological diseases with promising results. In Mexico, there is a high predominance of gastric cancer in male gender compared to female gender, even reaching a 2/1 ratio, and the detection rate of early gastric cancer is low (10% to 20%) which results in a mainly palliative treatment with an overall survival rate in 5 years about 10% to 15% only. In Peru, the average age at diagnosis is around 62.96±14.75 years old and the most frequent symptoms includes abdominal pain, indigestion, loss of appetite, weight loss and gastrointestinal bleeding, while in Mexico, some studies reported an average age at diagnosis around 60.3±4.1 years old (range, 23–78 years old) and the most frequent symptoms were postprandial fullness (74.4%), abdominal pain (37.2%), weight loss (18.6%), and melena (4.6%). The anemia rate was 65.1% with a mean Hb level of 6.14 g/dL. In Peru, the most common gastric cancer type is the intestinal-type adenocarcinoma (around 34%), followed by the diffuse-type adenocarcinoma (18.7%), whilst among Mexicans, the diffuse-type was reported in 55.2% of cases, the intestinal-type was reported in 28.2% and the undifferentiated-type corresponded to 6%. In both, Peru and Mexico, 90% of the associated factors includes tabaquismo, diets rich in salt, smoked foods, and a sedentary lifestyle. Family inheritance and advanced age and pharmacological-resistant Helicobacter pylori infection are also important. Poverty has been heavily associated with a higher incidence of gastric cancer. The management of gastric cancer patients in Peru is carried out by general surgeons or general surgical oncologists. In recent years

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

Pottery from Peru. A Handbook. Second Edition.

ERIC Educational Resources Information Center

Rammage, Alix

One of three handbooks dealing with pottery traditions from around the world, this packet draws together information about historical, ethnographic, and pottery traditions of Peru. The first of 13 brief subsections focuses on Peru's land and people. A presentation of a potter's history of Peru is followed by a discussion of the Chavin Cult (800…

[Health promoting messages posted in Facebook by the health ministries of Brazil and Peru during an AIDS awareness campaign].

PubMed

Cadaxa, Aedê Gomes; Sousa, Maria Fátima de; Mendonça, Ana Valéria Machado

2015-12-01

To identify health promoting contents (information that can be transformed into decision-making resources to improve quality of life and the health of individuals or groups) in Facebook postings by the ministries of health in Brazil and Peru. This case study compared the messages published in Facebook by the ministries of health from Brazil and Peru during World AIDS Day. Content analysis was employed to identify health promoting contents in the messages posted between November 2013 and February 2014. A total of 105 messages were published on the topic of interest (37 from Peru and 68 from Brazil). In both cases, most messages focused on individuals, addressing the change or adoption of personal behaviors relating to the prevention and detection of HIV - 34 messages (50.0%) for Brazil and 17 (45.9%) for Peru. Twenty-one (30.9%) messages with a structural emphasis were published by Brazil and 14 (37.8%) by Peru, addressing the context of health care system organization, including HIV/ AIDS health policies, available services, access to HIV testing and initiatives to promote testing. Hybrid messages, including both emphases, were less frequent: 13 (19.1%) for Brazil and six (16.2%) for Peru. Health promoting contents were identified in hybrid messages, which provided resources to expand the understanding of individuals about the susceptibility to AIDS.

New species and host plants of Anastrepha (Diptera: Tephritidae) primarily from Peru and Bolivia.

PubMed

Norrbom, Allen L; Rodriguez, Erick J; Steck, Gary J; Sutton, Bruce A; Nolazco, Norma

2015-11-16

Twenty-eight new species of Anastrepha are described and illustrated: A. acca (Bolivia, Peru), A. adami (Peru), A. amplidentata (Bolivia, Peru), A. annonae (Peru), A. breviapex (Peru), A. caballeroi (Peru), A. camba (Bolivia, Peru), A. cicra (Bolivia, Peru), A. disjuncta (Peru), A. durantae (Peru), A. echaratiensis (Peru), A. eminens (Peru), A. ericki (Peru), A. gonzalezi (Bolivia, Peru), A. guevarai (Peru), A. gusi (Peru), A. kimi (Colombia, Peru), A. korytkowskii (Bolivia, Peru), A. latilanceola (Bolivia, Peru), A. melanoptera (Peru), A. mollyae (Bolivia, Peru), A. perezi (Peru), A. psidivora (Peru), A. robynae (Peru), A. rondoniensis (Brazil, Peru), A. tunariensis (Bolivia, Peru), A. villosa (Bolivia), and A. zacharyi (Peru). The following host plant records are reported: A. amplidentata from Spondias mombin L. (Anacardiaceae); A. caballeroi from Quararibea malacocalyx A. Robyns & S. Nilsson (Malvaceae); A. annonae from Annona mucosa Jacq. and Annona sp. (Annonaceae); A. durantae from Duranta peruviana Moldenke (Verbenaceae); and A. psidivora from Psidium guajava L. (Myrtaceae).

Improving sputum microscopy services for the diagnosis of tuberculosis in Peru and Bolivia.

PubMed

Siddiqi, K; Newell, J N; Van der Stuyft, P; Gotuzzo, E; Torrico, F; Van Deun, A; Walley, J

2007-06-01

Sixteen primary care health centres in Peru and Bolivia. To assess the utilisation of microscopy services in Peru and Bolivia and determine if clinical audit, a quality improvement tool, improves the utilisation of these services. We estimated the percentage of patients with suspected tuberculosis (TB) in whom sputum microscopy was effectively utilised in Peru and Bolivia over two 6-month periods before and after a clinical audit intervention that included standards setting, measuring clinical performance and feedback. Before the intervention, only 31% (95%CI 27-35) of TB suspects were assessed with sputum microscopy in Peru. In Bolivia, 30% (95%CI 25-35) underwent at least two sputum microscopy examinations. After clinical audit, the availability of sputum microscopy results improved by respectively 7% (95%CI 1-12, P < 0.05) and 23% (95%CI 15-30, P < 0.05) over 2 years in Peru and Bolivia. Despite World Health Organization recommendations that all TB suspects should undergo sputum microscopy before treatment, results are available for further assessment for only one third. This is a potentially serious obstacle to TB case detection. Clinical audit can bring some improvement. We recommend regular monitoring of effective utilisation of microscopy services and investigations to ascertain organisational and structural issues in their uptake and use.

Changing Girls' Education in Peru.

ERIC Educational Resources Information Center

Heyman, Cory; Brush, Lorie; Provasnik, Stephen; Fanning, Marina; Lent, Drew; De Wilde, Johan

Access to quality education is a problem for all rural children in Peru, but especially for rural girls, who complete primary school at far lower rates than other Peruvian children. In 1998, USAID launched the Girls' Education Activity (GEA) in Peru, also known as New Horizons for Girls' Education, which aims to increase girls' completion of…

7 CFR 319.56-41 - Citrus from Peru.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 5 2010-01-01 2010-01-01 false Citrus from Peru. 319.56-41 Section 319.56-41... from Peru. Grapefruit (Citrus paradisi), limes (C. aurantiifolia), mandarins or tangerines (C... States from Peru under the following conditions: (a) The fruit must be accompanied by a permit issued in...

7 CFR 319.56-41 - Citrus from Peru.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 5 2011-01-01 2011-01-01 false Citrus from Peru. 319.56-41 Section 319.56-41... from Peru. Grapefruit (Citrus paradisi), limes (C. aurantiifolia), mandarins or tangerines (C... States from Peru under the following conditions: (a) The fruit must be accompanied by a permit issued in...

New species and host plants of Anastrepha (Diptera: Tephritidae) primarily from Peru and Bolivia

USDA-ARS?s Scientific Manuscript database

Twenty-eight new species of Anastrepha are described and illustrated: A. acca (Bolivia, Peru), A. adami (Peru), A. amplidentata (Bolivia, Peru), A. annonae (Peru), A. breviapex (Peru), A. caballeroi (Peru), A. camba (Bolivia, Peru), A. cicra (Bolivia, Peru), A. disjuncta (Peru), A. durantae (Peru), ...

Successful malaria elimination in the Ecuador-Peru border region: epidemiology and lessons learned.

PubMed

Krisher, Lyndsay K; Krisher, Jesse; Ambuludi, Mariano; Arichabala, Ana; Beltrán-Ayala, Efrain; Navarrete, Patricia; Ordoñez, Tania; Polhemus, Mark E; Quintana, Fernando; Rochford, Rosemary; Silva, Mercy; Bazo, Juan; Stewart-Ibarra, Anna M

2016-11-28

In recent years, malaria (Plasmodium vivax and Plasmodium falciparum) has been successfully controlled in the Ecuador-Peru coastal border region. The aim of this study was to document this control effort and to identify the best practices and lessons learned that are applicable to malaria control and to other vector-borne diseases. A proximal outcome evaluation was conducted of the robust elimination programme in El Oro Province, Ecuador, and the Tumbes Region, Peru. Data collection efforts included a series of workshops with local public health experts who played central roles in the elimination effort, review of epidemiological records from Ministries of Health, and a review of national policy documents. Key programmatic and external factors are identified that determined the success of this eradication effort. From the mid 1980s until the early 2000s, the region experienced a surge in malaria transmission, which experts attributed to a combination of ineffective anti-malarial treatment, social-ecological factors (e.g., El Niño, increasing rice farming, construction of a reservoir), and political factors (e.g., reduction in resources and changes in management). In response to the malaria crisis, local public health practitioners from El Oro and Tumbes joined together in the mid-1990s to forge an unofficial binational collaboration for malaria control. Over the next 20 years, they effectively eradicated malaria in the region, by strengthening surveillance and treatment strategies, sharing of resources, operational research to inform policy, and novel interventions. The binational collaboration at the operational level was the fundamental component of the successful malaria elimination programme. This unique relationship created a trusting, open environment that allowed for flexibility, rapid response, innovation and resilience in times of crisis, and ultimately a sustainable control programme. Strong community involvement, an extensive microscopy network and

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.

Modeling the Impact of Smoking Cessation Treatment Policies on Quit Rates

PubMed Central

Levy, David T.; Graham, Amanda L.; Mabry, Patricia L.; Abrams, David B.; Orleans, C. Tracy

2010-01-01

Background: Smoking cessation treatment policies could yield substantial increases in adult quit rates in the U.S. Purpose: The goals of this paper are to model the effects of individual cessation treatment policies on population quit rates, and to illustrate the potential benefits of combining policies to leverage their synergistic effects. Methods: A mathematical model is updated to examine the impact of five cessation treatment policies on quit attempts, treatment use, and treatment effectiveness. Policies include: (1) Expand cessation treatment coverage and provider reimbursement; (2) Mandate adequate funding for the use and promotion of evidence-based state-sponsored telephone quitlines; (3) Support healthcare systems changes to prompt, guide, and incentivize tobacco treatment; (4) Support and promote evidence-based treatment via the Internet; and (5) Improve individually tailored, stepped care approaches and the long-term effectiveness of evidence-based treatments. Results: The annual baseline population quit rate is 4.3% of all current smokers. Implementing any policy in isolation is projected to make the quit rate increase to between 4.5% and 6%. By implementing all five policies in combination, the quit rate is projected to increase to 10.9%, or 2.5 times the baseline rate. Conclusions: If fully implemented in a coordinated fashion, cessation treatment policies could reduce smoking prevalence from its current rate of 20.5% to 17.2% within 1 year. By modeling the policy impacts on the components of the population quit rate (quit attempts, treatment use, treatment effectiveness), key indicators are identified to analyze in improving the effect of cessation treatment policies. PMID:20176309

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

Genotypes and subgenotypes of hepatitis B virus circulating in an endemic area in Peru.

PubMed

Ramírez-Soto, Max Carlos; Bracho, Maria Alma; González-Candelas, Fernando; Huichi-Atamari, Milagros

2018-01-01

Although hepatitis B virus (HBV) infection is still endemic in Abancay, Peru, two decades after vaccination against hepatitis B started in the area, little is known about the diversity and circulation of genotypes and subgenotypes of the virus. To identify the genotypes and subtypes of HBV circulating in Abancay, complete genome sequences of 11 treatment-naive HBV-infected patients were obtained, and phylogenetic analysis was conducted with these and additional sequences from GenBank. Genotyping revealed the presence of genotype F in all the samples from Abancay. Subgenotype F1b was dominant and only one isolate belonged to subgenotype F4, which represents the first description of this subgenotype in Peru. Phylogenetic analysis revealed that most subgenotype F1b isolates from Peru clustered in a subgroup along with two sequences from Argentina, whereas two clusters with two HBV/F1b sequences each were indicative of recent epidemiological linkage, but only one could be verified by independent data. These results suggest that the HBV subgenotype F1b seems to be the predominant subgenotype in Abancay, Peru.

Cystic echinococcosis in immigrant from Peru: first case treated with percutaneous treatment in Japan.

PubMed

Sakaguchi, Hiroshi; Tanaka, Toshihiro; Marugami, Nagaaki; Kichikawa, Kimihiko; Horiuchi, Hazuki; Morioka, Chie; Toyohara, Masahisa; Moriya, Kei; Nishiofuku, Mariko; Mitoro, Akira; Fukui, Hiroshi; Hirai, Toshiko; Yamashita, Namiko; Ouji, Yukiteru; Ishizaka, Shigeaki; Yoshikawa, Masahide

2007-09-01

We report a case of cystic echinococcosis (CE) caused by Echinococcusgranulosus, for which a modified percutaneous evacuation (PEVAC) treatment was applied. The patient had immigrated from Peru to Japan and had 2 hydatid cystic masses, 1 located in segment (S)5 of the liver and the other in S3 (5.3 and 3.5 cm in diameter, respectively), both of which were visualized as pseudotumors by ultrasound (US) examinations. Albendazole treatment showed no effects and surgical treatment was refused. After punctuation of the S5 cyst under US guidance and S3 with CT guidance, 10- and 12-French gauge catheters, respectively, with multiple side holes were inserted. About 60 ml of the cyst contents was drawn out from the S5 lesion and 2 ml from the S3 lesion. Using repetitive manual injections and aspiration of small amounts of hypertonic saline, the remaining cyst content was removed as much as possible, after which 20 and 10 ml of 98% ethanol was injected into the S5 and S3 lesions, respectively. A short-term evaluation during the 4 month-period following the procedure using US revealed nearly complete evacuation of the S5 lesion, whereas that at S3 remained as a pseudo-solid mass. We consider that percutaneous treatment is a safe therapeutic modality for hydatid cysts. This is the first case report of CE treated percutaneously in Japan.

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

Prevalence of Marijuana Use among University Students in Bolivia, Colombia, Ecuador, and Peru.

PubMed

Hynes, Marya; Demarco, Maria; Araneda, Juan Carlos; Cumsille, Francisco

2015-05-15

Young adults 18 to 25 years old show the highest prevalence of marijuana use in Latin America. This study analyzes the changes in prevalence of marijuana use among university students in the Andean Community (Bolivia, Colombia, Ecuador, and Peru) from two studies carried out in 2009 and in 2012. Data were collected through representative two-stage samples of universities and students in the Andean Community. An online survey was administered using a standardized questionnaire. Prevalence was calculated for lifetime, past year, and past month. Marijuana was the most widely used illicit substance consumed among university students, in 2009 and in 2012. Past month prevalence among university students in 2009 in Colombia was 5.27%, in Peru 1.00%, in Ecuador 1.68%, and in Bolivia 0.76%. Past month prevalence in 2012 in Colombia was 7.14%, in Ecuador 3.67%, in Peru 1.62%, and in Bolivia 1.45% in 2012. Among university students in the Andean Community, past month prevalence increased among both males and females between 2009 and 2012 in most countries. Marijuana continues to be the most commonly used illicit drug in Latin American countries. Increases in prevalence among young adults could have important implications for national drug policy.

A CLAS act? Community-based organizations, health service decentralization and primary care development in Peru. Local Committees for Health Administration.

PubMed

Iwami, Michiyo; Petchey, Roland

2002-12-01

In 1994 Peru embarked on a programme of health service reform, which combined primary care development and community participation through Local Committees for Health Administration (CLAS). They are responsible for carrying out local health needs assessments and identifying unmet health needs through regular household surveys. These enable them to determine local health provision and tailor services to local requirements. CLAS build on grassroots self-help circles that developed during the economic and political crises of the 1980s, and in which women have been prominent. However, they function under a 3 year contract with the Ministry of Health and within a framework of centrally determined guidelines and regulations. These reforms were implemented in the context of neo-liberal economic policies, which stressed financial deregulation and fiscal and monetary restraint, and were aimed at reducing foreign indebtedness and inflation. We evaluate the achievements of the CLAS and analyse the relationship between health and economic policy in Peru, with the aid of two contrasting models of the role of the state - 'agency' and 'stewardship'. We argue that Peru's experience holds valuable lessons for other countries seeking to foster community involvement. These include the need for community capacity building and partnership between community organizations and state (and other civil) agencies.

Evaluating the impact and costs of deploying an electronic medical record system to support TB treatment in Peru

PubMed Central

Fraser, Hamish SF; Blaya, Joaquin; Choi, Sharon S; Bonilla, Cesar; Jazayeri, Darius

2006-01-01

The PIH-EMR is a Web based electronic medical record that has been in operation for over four years in Peru supporting the treatment of drug resistant TB. We describe here the types of evaluations that have been performed on the EMR to assess its impact on patient care, reporting, logistics and observational research. Formal studies have been performed on components for drug order entry, drug requirements prediction tools and the use of PDAs to collect bacteriology data. In addition less formal data on the use of the EMR for reporting and research are reviewed. Experience and insights from porting the PIH-EMR to the Philippines, and modifying it to support HIV treatment in Haiti and Rwanda are discussed. We propose that additional data of this sort is valuable in assessing medical information systems especially in resource poor areas. PMID:17238344

Evaluating the impact and costs of deploying an electronic medical record system to support TB treatment in Peru.

PubMed

Fraser, Hamish S F; Blaya, Joaquin; Choi, Sharon S; Bonilla, Cesar; Jazayeri, Darius

2006-01-01

The PIH-EMR is a Web based electronic medical record that has been in operation for over four years in Peru supporting the treatment of drug resistant TB. We describe here the types of evaluations that have been performed on the EMR to assess its impact on patient care, reporting, logistics and observational research. Formal studies have been performed on components for drug order entry, drug requirements prediction tools and the use of PDAs to collect bacteriology data. In addition less formal data on the use of the EMR for reporting and research are reviewed. Experience and insights from porting the PIH-EMR to the Philippines, and modifying it to support HIV treatment in Haiti and Rwanda are discussed. We propose that additional data of this sort is valuable in assessing medical information systems especially in resource poor areas.

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

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.

Boosting Population Quits Through Evidence-Based Cessation Treatment and Policy

PubMed Central

Abrams, David B.; Graham, Amanda L.; Levy, David T.; Mabry, Patricia L.; Orleans, C. Tracy

2015-01-01

Only large increases in adult cessation will rapidly reduce population smoking prevalence. Evidence-based smoking-cessation treatments and treatment policies exist but are underutilized. More needs to be done to coordinate the widespread, efficient dissemination and implementation of effective treatments and policies. This paper is the first in a series of three to demonstrate the impact of an integrated, comprehensive systems approach to cessation treatment and policy. This paper provides an analytic framework and selected literature review that guide the two subsequent computer simulation modeling papers to show how critical leverage points may have an impact on reductions in smoking prevalence. Evidence is reviewed from the U.S. Public Health Service 2008 clinical practice guideline and other sources regarding the impact of five cessation treatment policies on quit attempts, use of evidence-based treatment, and quit rates. Cessation treatment policies would: (1) expand cessation treatment coverage and provider reimbursement; (2) mandate adequate funding for the use and promotion of evidence-based state-sponsored telephone quitlines; (3) support healthcare systems changes to prompt, guide, and incentivize tobacco treatment; (4) support and promote evidence-based treatment via the Internet; and (5) improve individually tailored, stepped-care approaches and the long-term effectiveness of evidence-based treatments. This series of papers provides an analytic framework to inform heuristic simulation models in order to take a new look at ways to markedly increase population smoking cessation by implementing a defined set of treatments and treatment-related policies with the potential to improve motivation to quit, evidence-based treatment use, and long-term effectiveness. PMID:20176308

Elimination of Taenia solium Transmission in Northern Peru.

PubMed

Garcia, Hector H; Gonzalez, Armando E; Tsang, Victor C W; O'Neal, Seth E; Llanos-Zavalaga, Fernando; Gonzalvez, Guillermo; Romero, Jaime; Rodriguez, Silvia; Moyano, Luz M; Ayvar, Viterbo; Diaz, Andre; Hightower, Allen; Craig, Philip S; Lightowlers, Marshall W; Gauci, Charles G; Leontsini, Elli; Gilman, Robert H

2016-06-16

Taeniasis and cysticercosis are major causes of seizures and epilepsy. Infection by the causative parasite Taenia solium requires transmission between humans and pigs. The disease is considered to be eradicable, but data on attempts at regional elimination are lacking. We conducted a three-phase control program in Tumbes, Peru, to determine whether regional elimination would be feasible. We systematically tested and compared elimination strategies to show the feasibility of interrupting the transmission of T. solium infection in a region of highly endemic disease in Peru. In phase 1, we assessed the effectiveness and feasibility of six intervention strategies that involved screening of humans and pigs, antiparasitic treatment, prevention education, and pig replacement in 42 villages. In phase 2, we compared mass treatment with mass screening (each either with or without vaccination of pigs) in 17 villages. In phase 3, we implemented the final strategy of mass treatment of humans along with the mass treatment and vaccination of pigs in the entire rural region of Tumbes (107 villages comprising 81,170 people and 55,638 pigs). The effect of the intervention was measured after phases 2 and 3 with the use of detailed necropsy to detect pigs with live, nondegenerated cysts capable of causing new infection. The necropsy sampling was weighted in that we preferentially included more samples from seropositive pigs than from seronegative pigs. Only two of the strategies implemented in phase 1 resulted in limited control over the transmission of T. solium infection, which highlighted the need to intensify the subsequent strategies. After the strategies in phase 2 were implemented, no cyst that was capable of further transmission of T. solium infection was found among 658 sampled pigs. One year later, without further intervention, 7 of 310 sampled pigs had live, nondegenerated cysts, but no infected pig was found in 11 of 17 villages, including all the villages in which mass

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.

A randomized controlled study of socioeconomic support to enhance tuberculosis prevention and treatment, Peru

PubMed Central

Tovar, Marco A; Huff, Doug; Boccia, Delia; Montoya, Rosario; Ramos, Eric; Datta, Sumona; Saunders, Matthew J; Lewis, James J; Gilman, Robert H; Evans, Carlton A

2017-01-01

Abstract Objective To evaluate the impact of socioeconomic support on tuberculosis preventive therapy initiation in household contacts of tuberculosis patients and on treatment success in patients. Methods A non-blinded, household-randomized, controlled study was performed between February 2014 and June 2015 in 32 shanty towns in Peru. It included patients being treated for tuberculosis and their household contacts. Households were randomly assigned to either the standard of care provided by Peru’s national tuberculosis programme (control arm) or the same standard of care plus socioeconomic support (intervention arm). Socioeconomic support comprised conditional cash transfers up to 230 United States dollars per household, community meetings and household visits. Rates of tuberculosis preventive therapy initiation and treatment success (i.e. cure or treatment completion) were compared in intervention and control arms. Findings Overall, 282 of 312 (90%) households agreed to participate: 135 in the intervention arm and 147 in the control arm. There were 410 contacts younger than 20 years: 43% in the intervention arm initiated tuberculosis preventive therapy versus 25% in the control arm (adjusted odds ratio, aOR: 2.2; 95% confidence interval, CI: 1.1–4.1). An intention-to-treat analysis showed that treatment was successful in 64% (87/135) of patients in the intervention arm versus 53% (78/147) in the control arm (unadjusted OR: 1.6; 95% CI: 1.0–2.6). These improvements were equitable, being independent of household poverty. Conclusion A tuberculosis-specific, socioeconomic support intervention increased uptake of tuberculosis preventive therapy and tuberculosis treatment success and is being evaluated in the Community Randomized Evaluation of a Socioeconomic Intervention to Prevent TB (CRESIPT) project. PMID:28479622

Climate change mitigation opportunities based on carbon footprint estimates of dietary patterns in Peru.

PubMed

Vázquez-Rowe, Ian; Larrea-Gallegos, Gustavo; Villanueva-Rey, Pedro; Gilardino, Alessandro

2017-01-01

status. When compared to GHG emissions computed in the literature for developed nations, where the average caloric intake is substantially higher, diet-related emissions in Peru were in the low range. Our results could be used as a baseline for policy support to align nutritional and health policies in Peru with the need to reduce the environmental impacts linked to food production.

Climate change mitigation opportunities based on carbon footprint estimates of dietary patterns in Peru

PubMed Central

Larrea-Gallegos, Gustavo; Villanueva-Rey, Pedro; Gilardino, Alessandro

2017-01-01

status. When compared to GHG emissions computed in the literature for developed nations, where the average caloric intake is substantially higher, diet-related emissions in Peru were in the low range. Our results could be used as a baseline for policy support to align nutritional and health policies in Peru with the need to reduce the environmental impacts linked to food production. PMID:29145461

Invoking conscientious objection in reproductive health care: evolving issues in Peru, Mexico and Chile.

PubMed

Casas, Lidia

2009-11-01

As Latin American countries seek to guarantee sexual and reproductive health and rights, opponents of women's rights and reproductive choice have become more strident in their opposition, and are increasingly claiming conscientious objection to providing these services. Conscientious objection must be seen in the context of the rights and interests at stake, including women's health needs and right to self-determination. An analysis of law and policy on conscientious objection in Peru, Mexico and Chile shows that it is being used to erode women's rights, especially where it is construed to have no limits, as in Peru. Conscientious objection must be distinguished from politically-motivated attempts to undermine the law; otherwise, the still fragile re-democratisation processes underway in Latin America may be placed at risk. True conscientious objection requires that a balance be struck between the rights of the objector and the health rights of patients, in this case women. Health care providers are entitled to their beliefs and to have those beliefs accommodated, but it is neither viable nor ethically acceptable for conscientious objectors to exercise this right without regard for the right to health care of others, or for policy and services to be rendered ineffectual because of individual objectors.

Comparing Treatment Policies with Assistance from the Structural Nested Mean Model

PubMed Central

Lu, Xi; Lynch, Kevin G.; Oslin, David W.; Murphy, Susan

2015-01-01

Summary Treatment policies, also known as dynamic treatment regimes, are sequences of decision rules that link the observed patient history with treatment recommendations. Multiple, plausible, treatment policies are frequently constructed by researchers using expert opinion, theories and reviews of the literature. Often these different policies represent competing approaches to managing an illness. Here we develop an “assisted estimator” that can be used to compare the mean outcome of competing treatment policies. The term “assisted” refers to the fact estimators from the Structural Nested Mean Model, a parametric model for the causal effect of treatment at each time point, are used in the process of estimating the mean outcome. This work is motivated by our work on comparing the mean outcome of two competing treatment policies using data from the ExTENd study in alcohol dependence. PMID:26363892

Clinical characteristics, drug resistance, and treatment outcomes among tuberculosis patients with diabetes in Peru.

PubMed

Magee, M J; Bloss, E; Shin, S S; Contreras, C; Huaman, H Arbanil; Ticona, J Calderon; Bayona, J; Bonilla, C; Yagui, M; Jave, O; Cegielski, J P

2013-06-01

Diabetes is a risk factor for active tuberculosis (TB). Data are limited regarding the association between diabetes and TB drug resistance and treatment outcomes. We examined characteristics of TB patients with and without diabetes in a Peruvian cohort at high risk for drug-resistant TB. Among TB patients with diabetes (TB-DM), we studied the association between diabetes clinical/management characteristics and TB drug resistance and treatment outcomes. During 2005-2008, adults with suspected TB with respiratory symptoms in Lima, Peru, who received rapid drug susceptibility testing (DST), were prospectively enrolled and followed during treatment. Bivariate and Kaplan-Meier analyses were used to examine the relationships of diabetes characteristics with drug-resistant TB and TB outcomes. Of 1671 adult TB patients enrolled, 186 (11.1%) had diabetes. TB-DM patients were significantly more likely than TB patients without diabetes to be older, have had no previous TB treatment, and to have a body mass index (BMI) >18.5 kg/m(2) (p<0.05). In patients without and with previous TB treatment, the prevalence of multidrug-resistant TB was 23% and 26%, respectively, among patients without diabetes, and 12% and 28%, respectively, among TB-DM patients. Among 149 TB-DM patients with DST results, 104 (69.8%) had drug-susceptible TB and 45 (30.2%) had drug-resistant TB, of whom 29 had multidrug-resistant TB. There was no association between diabetes characteristics and drug-resistant TB. Of 136 TB-DM patients with outcome information, 107 (78.7%) had a favorable TB outcome; active diabetes management was associated with a favorable outcome. Diabetes was common in a cohort of TB patients at high risk for drug-resistant TB. Despite prevalent multidrug-resistant TB among TB-DM patients, the majority had a favorable TB treatment outcome. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Prevalence and risk factors for encephalomyocarditis virus infection in Peru.

PubMed

Czechowicz, Josephine; Huaman, Jose Luis; Forshey, Brett M; Morrison, Amy C; Castillo, Roger; Huaman, Alfredo; Caceda, Roxana; Eza, Dominique; Rocha, Claudio; Blair, Patrick J; Olson, James G; Kochel, Tadeusz J

2011-04-01

Although encephalomyocarditis virus (EMCV) infection has been commonly documented among domestic animals, less is known about EMCV transmission among humans. Recently, we described the isolation of EMCV from two febrile patients in Peru. To further investigate EMCV transmission in Peru, we screened febrile patients reporting to health clinics in Peru for serological evidence of recent EMCV infection. We also conducted a serological survey for EMCV-neutralizing antibodies in the city of Iquitos, located in the Amazon basin department of Loreto, Peru. Additionally, we screened serum from rodents collected from 10 departments in Peru for evidence of EMCV exposure. EMCV infection was found to be only rarely associated with acute febrile disease in Peru, accounting for <1% of febrile episodes analyzed. Despite the low acute disease burden associated with the virus, human exposure was quite common, as prevalence of EMCV-neutralizing antibodies ranged between 6.0% in the coastal city of Tumbes and >17% in cities in the tropical rainforest of northeastern Peru (Iquitos and Yurimaguas). On the basis of the serological survey conducted in Iquitos, risk factors for past infection include increased age, socioeconomic indicators such as residence construction materials and neighborhood, and swine ownership. Evidence from the rodent survey indicates that EMCV exposure is common among Murinae subfamily rodents in Peru (9.4% EMCV IgG positive), but less common among Sigmodontinae rodents (1.0% positive). Further studies are necessary to more precisely delineate the mode of EMCV transmission to humans, other potential disease manifestations, and the economic impact of EMCV transmission among swine in Peru.

Military Rule and the Problem of Legitimacy: Peru, 1968-1975 and Argentina, 1976-1983

DTIC Science & Technology

1992-05-01

national development. To develop, Peru needed to forge a modem industrial society as well as an efficient agrarian sector. The military’s first step was...while reserving certain ’key industrial sectors to the state." 11 The military government also developed innovative structural reforms designed to do...away with the old elitist and corrupt way of implementing socioeconomic policies. One of these reforms, the Industrial Community, was to result in

Peru action simmering despite privatization delays

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1995-08-07

After months of delays, the sale of Petroleos del Peru SA (Petroperu) was postponed earlier this year until after the elections, which saw Peru`s incumbent President Alberto Fujimori reelected. In June, Fujimori appointed Amado Yataco Minister of Energy and Mines. Yataco, also serving as president of the privatization commission Copri, said a decision on the sale of Petroperu would be made quickly, perhaps by July 28, ahead of this report`s presstime. The uncertain status of Petroperu has not, however, slowed activity in Peru`s petroleum sector. The paper first discusses privatization plans and Petroperu`s budget, then describes exploration and development activitiesmore » in the supergiant Camisea gas/condensate fields in the central southern jungle. Activities in several smaller fields are briefly described.« less

Occupational Safety and Health in Peru.

PubMed

Cruz, Ismael; Huerta-Mercado, Raul

2015-01-01

Peru is a country located on the Pacific coast of South America with a population of more than 30 million inhabitants. In the past 10 years, Peru has had a steady economic growth. Peru is predominantly an extractive industry country, but the manufacturing and construction sectors are booming. It is in this context that regulations have been implemented to protect the safety and health of workers. One of the most important regulations is the Law on Safety and Health at Work, which has been recently promulgated. Regulations are complemented by training and education in occupational safety and health. The measures are yet to be fully implemented thus a positive effect in reducing accidents and occupational diseases at work has not yet been seen. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia.

PubMed

Terris-Prestholt, Fern; Vickerman, Peter; Torres-Rueda, Sergio; Santesso, Nancy; Sweeney, Sedona; Mallma, Patricia; Shelley, Katharine D; Garcia, Patricia J; Bronzan, Rachel; Gill, Michelle M; Broutet, Nathalie; Wi, Teodora; Watts, Charlotte; Mabey, David; Peeling, Rosanna W; Newman, Lori

2015-06-01

Rapid plasma reagin (RPR) is frequently used to test women for maternal syphilis. Rapid syphilis immunochromatographic strip tests detecting only Treponema pallidum antibodies (single RSTs) or both treponemal and non-treponemal antibodies (dual RSTs) are now available. This study assessed the cost-effectiveness of algorithms using these tests to screen pregnant women. Observed costs of maternal syphilis screening and treatment using clinic-based RPR and single RSTs in 20 clinics across Peru, Tanzania, and Zambia were used to model the cost-effectiveness of algorithms using combinations of RPR, single, and dual RSTs, and no and mass treatment. Sensitivity analyses determined drivers of key results. Although this analysis found screening using RPR to be relatively cheap, most (>70%) true cases went untreated. Algorithms using single RSTs were the most cost-effective in all observed settings, followed by dual RSTs, which became the most cost-effective if dual RST costs were halved. Single test algorithms dominated most sequential testing algorithms, although sequential algorithms reduced overtreatment. Mass treatment was relatively cheap and effective in the absence of screening supplies, though treated many uninfected women. This analysis highlights the advantages of introducing RSTs in three diverse settings. The results should be applicable to other similar settings. Copyright © 2015 International Federation of Gynecology and Obstetrics. All rights reserved.

The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia

PubMed Central

Terris-Prestholt, Fern; Vickerman, Peter; Torres-Rueda, Sergio; Santesso, Nancy; Sweeney, Sedona; Mallma, Patricia; Shelley, Katharine D.; Garcia, Patricia J.; Bronzan, Rachel; Gill, Michelle M.; Broutet, Nathalie; Wi, Teodora; Watts, Charlotte; Mabey, David; Peeling, Rosanna W.; Newman, Lori

2015-01-01

Objective Rapid plasma reagin (RPR) is frequently used to test women for maternal syphilis. Rapid syphilis immunochromatographic strip tests detecting only Treponema pallidum antibodies (single RSTs) or both treponemal and non-treponemal antibodies (dual RSTs) are now available. This study assessed the cost-effectiveness of algorithms using these tests to screen pregnant women. Methods Observed costs of maternal syphilis screening and treatment using clinic-based RPR and single RSTs in 20 clinics across Peru, Tanzania, and Zambia were used to model the cost-effectiveness of algorithms using combinations of RPR, single, and dual RSTs, and no and mass treatment. Sensitivity analyses determined drivers of key results. Results Although this analysis found screening using RPR to be relatively cheap, most (> 70%) true cases went untreated. Algorithms using single RSTs were the most cost-effective in all observed settings, followed by dual RSTs, which became the most cost-effective if dual RST costs were halved. Single test algorithms dominated most sequential testing algorithms, although sequential algorithms reduced overtreatment. Mass treatment was relatively cheap and effective in the absence of screening supplies, though treated many uninfected women. Conclusion This analysis highlights the advantages of introducing RSTs in three diverse settings. The results should be applicable to other similar settings. PMID:25963907

Baseline evaluation of nutritional status and government feeding programs in Chiclayo, Peru.

PubMed

Gross, Rainer; Lechtig, Aarón; López de Romaña, Daniel

2006-01-01

Because of the rapid growth of the urban population in Peru, food and nutrition insecurity will occur increasingly in this population. For appropriate policy setting and programming, the food and nutrition situation of the urban poor requires better understanding. To gain information about the nature, magnitude, severity, and causes of the nutritional problems of the population in low-income areas of the city of Chiclayo, Peru. A cross-sectional nutrition survey was conducted in 1,604 households, covering children under 5 years of age and their parents. The prevalence rates of stunting, wasting, overweight. and anemia in children were 15.4%, 1.3%, 4.6%, and 65.7%, respectively; one third of adults were overweight, and one tenth were obese; 2.1% of the mothers were underweight; and 34.3% of mothers and 12.2% of fathers had anemia. Governmental feeding programs did not address these problems adequately. Interventions must have adequate targeting; address appropriate responses at the household, community, and national levels; and reduce stunting, obesity, and iron-deficiency anemia.

Bilingual Education Policy and Practice in the Andes: Ideological Paradox and Intercultural Possibility.

ERIC Educational Resources Information Center

Hornberger, Nancy H.

2000-01-01

Discusses bilingual education policy and reform in the context of indigenous languages of Peru, Ecuador, and Bolivia, exploring the ideological paradox inherent in transforming a standardizing education into a diversifying one and in constructing a multilingual, multicultural national identity. Data come from policy documents and practitioner…

Pediatric cryptosporidiosis: An evaluation of health care and societal costs in Peru, Bangladesh and Kenya.

PubMed

Rafferty, Ellen R; Schurer, Janna M; Arndt, Michael B; Choy, Robert K M; de Hostos, Eugenio L; Shoultz, David; Farag, Marwa

2017-01-01

Cryptosporidium is a leading cause of pediatric diarrhea in resource-limited settings; yet, few studies report the health care costs or societal impacts of this protozoan parasite. Our study examined direct and indirect costs associated with symptomatic cryptosporidiosis in infants younger than 12 months in Kenya, Peru and Bangladesh. Inputs to the economic burden model, such as disease incidence, population size, health care seeking behaviour, hospital costs, travel costs, were extracted from peer-reviewed literature, government documents, and internationally validated statistical tools for each country. Indirect losses (i.e. caregiver income loss, mortality, and growth faltering) were also estimated. Our findings suggest that direct treatment costs per symptomatic cryptosporidiosis episode were highest in Kenya ($59.01), followed by Peru ($23.32), and Bangladesh ($7.62). The total annual economic impacts for the 0-11 month cohorts were highest in Peru ($41.5M; range $0.88-$599.3M), followed by Kenya ($37.4M; range $1.6-$804.5M) and Bangladesh ($9.6M, range $0.28-$91.5M). For all scenarios, indirect societal costs far outweighed direct treatment costs. These results highlight the critical need for innovative improvements to current prevention, diagnostic and treatment strategies available in resource poor settings, as well as the need for solutions that span multiple disciplines including food and water safety, sanitation and livestock production.

Pediatric cryptosporidiosis: An evaluation of health care and societal costs in Peru, Bangladesh and Kenya

PubMed Central

Arndt, Michael B.; Choy, Robert K. M.; de Hostos, Eugenio L.; Shoultz, David; Farag, Marwa

2017-01-01

Cryptosporidium is a leading cause of pediatric diarrhea in resource-limited settings; yet, few studies report the health care costs or societal impacts of this protozoan parasite. Our study examined direct and indirect costs associated with symptomatic cryptosporidiosis in infants younger than 12 months in Kenya, Peru and Bangladesh. Inputs to the economic burden model, such as disease incidence, population size, health care seeking behaviour, hospital costs, travel costs, were extracted from peer-reviewed literature, government documents, and internationally validated statistical tools for each country. Indirect losses (i.e. caregiver income loss, mortality, and growth faltering) were also estimated. Our findings suggest that direct treatment costs per symptomatic cryptosporidiosis episode were highest in Kenya ($59.01), followed by Peru ($23.32), and Bangladesh ($7.62). The total annual economic impacts for the 0–11 month cohorts were highest in Peru ($41.5M; range $0.88-$599.3M), followed by Kenya ($37.4M; range $1.6-$804.5M) and Bangladesh ($9.6M, range $0.28-$91.5M). For all scenarios, indirect societal costs far outweighed direct treatment costs. These results highlight the critical need for innovative improvements to current prevention, diagnostic and treatment strategies available in resource poor settings, as well as the need for solutions that span multiple disciplines including food and water safety, sanitation and livestock production. PMID:28832624

New Trends on Intellectual Assessment in Peru

ERIC Educational Resources Information Center

Blumen, Sheyla

2016-01-01

The history of intellectual assessment with children and youth in Peru is presented from the foundation of scientific psychology in Peru until now. Current practices are affected by the multicultural ethnolinguistic diversity of the country, the quality of the different training programs, as well as by Peruvian regulations for becoming an academic…

19 CFR 10.909 - Certification for goods exported to Peru.

Code of Federal Regulations, 2014 CFR

2014-04-01

...; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Peru... from the United States to Peru must provide a copy of the certification (or such other medium or format... Peru and who has reason to believe that the certification contains or is based on incorrect information...

19 CFR 10.909 - Certification for goods exported to Peru.

Code of Federal Regulations, 2012 CFR

2012-04-01

...; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Peru... from the United States to Peru must provide a copy of the certification (or such other medium or format... Peru and who has reason to believe that the certification contains or is based on incorrect information...

19 CFR 10.909 - Certification for goods exported to Peru.

Code of Federal Regulations, 2013 CFR

2013-04-01

...; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. United States-Peru... from the United States to Peru must provide a copy of the certification (or such other medium or format... Peru and who has reason to believe that the certification contains or is based on incorrect information...

Commentary on "National Education Policies for Aboriginal Peoples."

ERIC Educational Resources Information Center

Power, Donald F.

1989-01-01

Reviews educational policies for indigenous peoples in the United States, Canada, Australia, Scandinavia, New Zealand, Mexico, Brazil, Bolivia, Peru, Ecuador, and South Africa. Suggests that the continued survival of indigenous people requires cultural equality, achieved through self-determined, culturally relevant education; plus cooperation with…

Countdown to 2015 country case studies: systematic tools to address the "black box" of health systems and policy assessment.

PubMed

Singh, Neha S; Huicho, Luis; Afnan-Holmes, Hoviyeh; John, Theopista; Moran, Allisyn C; Colbourn, Tim; Grundy, Chris; Matthews, Zoe; Maliqi, Blerta; Mathai, Matthews; Daelmans, Bernadette; Requejo, Jennifer; Lawn, Joy E

2016-09-12

Evaluating health systems and policy (HSP) change and implementation is critical in understanding reproductive, maternal, newborn and child health (RMNCH) progress within and across countries. Whilst data for health outcomes, coverage and equity have advanced in the last decade, comparable analyses of HSP changes are lacking. We present a set of novel tools developed by Countdown to 2015 (Countdown) to systematically analyse and describe HSP change for RMNCH indicators, enabling multi-country comparisons. International experts worked with eight country teams to develop HSP tools via mixed methods. These tools assess RMNCH change over time (e.g. 1990-2015) and include: (i) Policy and Programme Timeline Tool (depicting change according to level of policy); (ii) Health Policy Tracer Indicators Dashboard (showing 11 selected RMNCH policies over time); (iii) Health Systems Tracer Indicators Dashboard (showing four selected systems indicators over time); and (iv) Programme implementation assessment. To illustrate these tools, we present results from Tanzania and Peru, two of eight Countdown case studies. The Policy and Programme Timeline tool shows that Tanzania's RMNCH environment is complex, with increased funding and programmes for child survival, particularly primary-care implementation. Maternal health was prioritised since mid-1990s, yet with variable programme implementation, mainly targeting facilities. Newborn health only received attention since 2005, yet is rapidly scaling-up interventions at facility- and community-levels. Reproductive health lost momentum, with re-investment since 2010. Contrastingly, Peru moved from standalone to integrated RMNCH programme implementation, combined with multi-sectoral, anti-poverty strategies. The HSP Tracer Indicators Dashboards show that Peru has adopted nine of 11 policy tracer indicators and Tanzania has adopted seven. Peru costed national RMNCH plans pre-2000, whereas Tanzania developed a national RMNCH plan in 2006 but

New Trends in Talent Development in Peru

ERIC Educational Resources Information Center

Blumen, Sheyla

2013-01-01

A comprehensive portrait of the current status of gifted and talented concepts, identification of the gifted, and associated provisions within Peru is presented. The major purposes of this article are (a) to analyze the primary conception of giftedness in Peru; (b) to describe the beliefs that people have about gifted individuals; (c) to present…

[Establishment of a trauma surgical department at the Diospi Suyana missionary hospital in Curahuasi, Peru].

PubMed

Boeker, T

2017-10-01

The confusingly structured and in many areas corrupt health system in Peru even today provides only a fragmentary and insufficient medical treatment especially for the indigenous population (mainly Quechua Indians). Since October 2007 the Diospi Suyana missionary hospital in Curahuasi (State of Apurímac) has provided an affordable medical treatment at a high level mainly for these indigenous people of Peru; however, so far the hospital could only insufficiently meet the traumatological needs of the region. The establishment of a surgical trauma department aims to meet those needs but is also encumbered by special problems and challenges. Some patients, for example only present at the hospital after the fractures have already incorrectly healed, sometimes many weeks or even months after the trauma either due to a long journey through the country to different hospitals where treatment was not possible or they could not pay for the treatment and sometimes because of inadequate prior treatment, for example by traditional healers. Cultural and infrastructural particularities of the country must be included in the process of choosing the right method of treatment.

Polyclonal Pulmonary Tuberculosis Infections and Risk for Multidrug Resistance, Lima, Peru

PubMed Central

Shi, Cynthia X.; Chindelevitch, Leonid; Calderon, Roger; Zhang, Zibiao; Galea, Jerome T.; Contreras, Carmen; Yataco, Rosa; Lecca, Leonid; Becerra, Mercedes C.; Murray, Megan B.; Cohen, Ted

2017-01-01

Because within-host Mycobacterium tuberculosis diversity complicates diagnosis and treatment of tuberculosis (TB), we measured diversity prevalence and associated factors among 3,098 pulmonary TB patients in Lima, Peru. The 161 patients with polyclonal infection were more likely than the 115 with clonal or the 2,822 with simple infections to have multidrug-resistant TB. PMID:29048297

Craniofacial plasticity in ancient Peru.

PubMed

Stone, Jessica H; Chew, Kristen; Ross, Ann H; Verano, John W

2015-01-01

Numerous studies have utilized craniometric data to explore the roles of genetic diversity and environment in human cranial shape variation. Peru is a particularly interesting region to examine cranial variation due to the wide variety of high and low altitude ecological zones, which in combination with rugged terrain have created isolated populations with vastly different physiological adaptations. This study examines seven samples from throughout Peru in an effort to understand the contributions of environmental adaptation and genetic relatedness to craniofacial variation at a regional scale. Morphological variation was investigated using a canonical discriminant analysis and Mahalanobis D(2) analysis. Results indicate that all groups are significantly different from one another with the closest relationship between Yauyos and Jahuay, two sites that are located geographically close in central Peru but in very different ecozones. The relationship between latitude/longitude and face shape was also examined with a spatial autocorrelation analysis (Moran's I) using ArcMap and show that there is significant spatial patterning for facial measures and geographic location suggesting that there is an association between biological variation and geographic location.

The history of 20th century malaria control in Peru

PubMed Central

2013-01-01

Malaria has been part of Peruvian life since at least the 1500s. While Peru gave the world quinine, one of the first treatments for malaria, its history is pockmarked with endemic malaria and occasional epidemics. In this review, major increases in Peruvian malaria incidence over the past hundred years are described, as well as the human factors that have facilitated these events, and concerted private and governmental efforts to control malaria. Political support for malaria control has varied and unexpected events like vector and parasite resistance have adversely impacted morbidity and mortality. Though the ready availability of novel insecticides like DDT and efficacious medications reduced malaria to very low levels for a decade after the post eradication era, malaria reemerged as an important modern day challenge to Peruvian public health. Its reemergence sparked collaboration between domestic and international partners towards the elimination of malaria in Peru. PMID:24001096

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.

Policy Development for Environmental Licensing and Biodiversity Offsets in Latin America

PubMed Central

Villarroya, Ana; Barros, Ana Cristina; Kiesecker, Joseph

2014-01-01

Attempts to meet biodiversity goals through application of the mitigation hierarchy have gained wide traction globally with increased development of public policy, lending standards, and corporate practices. With interest in biodiversity offsets increasing in Latin America, we seek to strengthen the basis for policy development through a review of major environmental licensing policy frameworks in Argentina, Brazil, Chile, Colombia, Mexico, Peru and Venezuela. Here we focused our review on an examination of national level policies to evaluate to which degree current provisions promote positive environmental outcomes. All the surveyed countries have national-level Environmental Impact Assessment laws or regulations that cover the habitats present in their territories. Although most countries enable the use of offsets only Brazil, Colombia, Mexico and Peru explicitly require their implementation. Our review has shown that while advancing quite detailed offset policies, most countries do not seem to have strong requirements regarding impact avoidance. Despite this deficiency most countries have a strong foundation from which to develop policy for biodiversity offsets, but several issues require further guidance, including how best to: (1) ensure conformance with the mitigation hierarchy; (2) identify the most environmentally preferable offsets within a landscape context; (3) determine appropriate mitigation replacement ratios; and (4) ensure appropriate time and effort is given to monitor offset performance. PMID:25191758

Policy development for environmental licensing and biodiversity offsets in Latin America.

PubMed

Villarroya, Ana; Barros, Ana Cristina; Kiesecker, Joseph

2014-01-01

Attempts to meet biodiversity goals through application of the mitigation hierarchy have gained wide traction globally with increased development of public policy, lending standards, and corporate practices. With interest in biodiversity offsets increasing in Latin America, we seek to strengthen the basis for policy development through a review of major environmental licensing policy frameworks in Argentina, Brazil, Chile, Colombia, Mexico, Peru and Venezuela. Here we focused our review on an examination of national level policies to evaluate to which degree current provisions promote positive environmental outcomes. All the surveyed countries have national-level Environmental Impact Assessment laws or regulations that cover the habitats present in their territories. Although most countries enable the use of offsets only Brazil, Colombia, Mexico and Peru explicitly require their implementation. Our review has shown that while advancing quite detailed offset policies, most countries do not seem to have strong requirements regarding impact avoidance. Despite this deficiency most countries have a strong foundation from which to develop policy for biodiversity offsets, but several issues require further guidance, including how best to: (1) ensure conformance with the mitigation hierarchy; (2) identify the most environmentally preferable offsets within a landscape context; (3) determine appropriate mitigation replacement ratios; and (4) ensure appropriate time and effort is given to monitor offset performance.

Illicit Cigarette Trade in Five South American Countries: A Gap Analysis for Argentina, Brazil, Chile, Colombia and Peru.

PubMed

Paraje, Guillermo

2018-05-15

Due to its nature, it is very hard to measure tobacco illicit trade in any product. In the case of Latin American countries, there is scant information on the magnitude and characteristics of this trade in the case of cigarettes. The goal of this article is to provide estimates on the evolution of the illicit cigarette trade in five South American countries: Argentina, Brazil, Chile, Colombia and Peru. Gap analysis estimates for cigarette tax evasion/avoidance (a comparison on the evolution of the difference between registered cigarette sales and measured population consumption) is developed for Argentina, Brazil, Chile, Colombia and Peru. Nationally representative surveys, conducted regularly, are used to measure population consumption. Confidence intervals constructed by bootstrapping sample estimates are generated in order to statistically evaluate the evolution of the gap. Cigarette illicit trade has increased as a percentage of total sales in Brazil in recent years. In the case of Argentina, after a relative decrease between 2005 and 2009 it seems to have stabilized. There is no statistical evidence to argue that there has been an increase of cigarette illicit trade in Chile, Colombia and Peru, despite substantial price increases in Chile and tax increase in both Colombia and Peru. Using simple statistical methods, it is possible to assess the trend in tobacco illicit trend over time to better inform policy-makers. Getting reliable and regular population consumption surveys can also help to track tobacco illicit trade. Claims by tobacco industry of a positive association between price/tax changes and illicit trade are unsubstantiated. Evolution of cigarette illicit trade in five Latin American countries show different trajectories, not in line with tobacco industry estimates, which highlight the importance of producing solid, independent estimates. There are inexpensive methodologies that can provide estimates of the evolution of the relative importance of

Mineral resources of Peru's ancient societies

USGS Publications Warehouse

Brooks, W.E.

2003-01-01

Northern Peru has an exceptionally rich archaeological heritage that includes metalwork, ceramics and textiles. The success of at least a half-dozen pre-Columbian societies dating back 3,000 years and subsequent Spanish colonization in the 1400s has rested on the effective use of northern Peru's abundant resources. In the summer of 2000, my son Matt and I learned about that connection firsthand by volunteering at the Santa Rita B archaeological site in the Chao Valley near Trujillo in northern Peru. Riding donkey-back through the Andes and talking with local people, we got our hands dirty in the rich archaeology and geology of the area. We were able to correlate mineral occurrences to their various roles in society - opening a window into the region's fascinating past. From construction to metallurgy, pre-Columbian societies flourished and advanced because of their understanding and use of the available mineral resources.

Impact of HIV on mortality among patients treated for tuberculosis in Lima, Peru: a prospective cohort study.

PubMed

Velásquez, Gustavo E; Cegielski, J Peter; Murray, Megan B; Yagui, Martin J A; Asencios, Luis L; Bayona, Jaime N; Bonilla, César A; Jave, Hector O; Yale, Gloria; Suárez, Carmen Z; Sanchez, Eduardo; Rojas, Christian; Atwood, Sidney S; Contreras, Carmen C; Santa Cruz, Janeth; Shin, Sonya S

2016-02-01

Human immunodeficiency virus (HIV)-associated tuberculosis deaths have decreased worldwide over the past decade. We sought to evaluate the effect of HIV status on tuberculosis mortality among patients undergoing treatment for tuberculosis in Lima, Peru, a low HIV prevalence setting. We conducted a prospective cohort study of patients treated for tuberculosis between 2005 and 2008 in two adjacent health regions in Lima, Peru (Lima Ciudad and Lima Este). We constructed a multivariate Cox proportional hazards model to evaluate the effect of HIV status on mortality during tuberculosis treatment. Of 1701 participants treated for tuberculosis, 136 (8.0%) died during tuberculosis treatment. HIV-positive patients constituted 11.0% of the cohort and contributed to 34.6% of all deaths. HIV-positive patients were significantly more likely to die (25.1 vs. 5.9%, P < 0.001) and less likely to be cured (28.3 vs. 39.4%, P = 0.003). On multivariate analysis, positive HIV status (hazard ratio [HR] = 6.06; 95% confidence interval [CI], 3.96-9.27), unemployment (HR = 2.24; 95% CI, 1.55-3.25), and sputum acid-fast bacilli smear positivity (HR = 1.91; 95% CI, 1.10-3.31) were significantly associated with a higher hazard of death. We demonstrate that positive HIV status was a strong predictor of mortality among patients treated for tuberculosis in the early years after Peru started providing free antiretroviral therapy. As HIV diagnosis and antiretroviral therapy provision are more widely implemented for tuberculosis patients in Peru, future operational research should document the changing profile of HIV-associated tuberculosis mortality.

Bilingual Intercultural Education in Indigenous Schools: An Ethnography of Teacher Interpretations of Government Policy

ERIC Educational Resources Information Center

Valdiviezo, Laura

2009-01-01

This paper explores how teachers' beliefs and practices create spaces for the contestation and innovation of bilingual intercultural education (BIE) policy, a policy of indigenous culture and language revitalization in Peru. Based on ethnographic research, there are two central arguments developed throughout this paper. First, the author argues…

U.S. Military Nation-Building Peru - A Question of National Interests

DTIC Science & Technology

1989-06-02

time, the Country Team left the possibility of hosting the exercise open after the elections. 11lbid. Also, En rque Gegos Yenero, "Success in Peru ... en Peru ." Diario de las Americas 36/150 (30 Dec 1988). "Nos dejan solos frente a Sendero." Diario La Republica (19 March 1989). "On Peru’s Future...U.S. MILITARY NATION-BUILDING IN PERU A QUESTION OF NATIONAL INTERESTS A thesis presented to the Faculty of the U.S. Army Command and General Staff

Trepanation Procedures/Outcomes: Comparison of Prehistoric Peru with Other Ancient, Medieval, and American Civil War Cranial Surgery.

PubMed

Kushner, David S; Verano, John W; Titelbaum, Anne R

2018-06-01

More prehistoric trepanned crania have been found in Peru than any other location worldwide. We examine trepanation practices and outcomes in Peru over nearly 2000 years from 400 BC to provide a perspective on the procedure with comparison with procedures/outcomes of other ancient, medieval, and American Civil War cranial surgery. Data on trepanation demographics, techniques, and survival rates were collected through the scientific analysis of more than 800 trepanned crania discovered in Peru, through field studies and the courtesy of museums and private collections in the United States and Peru, over nearly 3 decades. Data on procedures and outcomes of cranial surgery ancient, medieval, and during 19th-century through the American Civil war were obtained via a literature review. Successful trepanations from prehistoric times through the American Civil War likely involved shallow surgeries that did not pierce the dura mater. Although there are regional and temporal variations in ancient Peru, overall long-term survival rates for the study series were about 40% in the earliest period (400-200 BC), with improvement to a high of 91% in samples from AD 1000-1400, to an average of 75%-83% during the Inca Period (AD 1400s-1500). In comparison, the average cranial surgery mortality rate during the American Civil war was 46%-56%, and short- and long-term survival rates are unknown. The contrast in outcomes highlights the astonishing success of ancient cranial surgery in Peru in the treatment of living patients. Copyright © 2018 Elsevier Inc. All rights reserved.

Modeling an economic evaluation of a salt fluoridation program in Peru.

PubMed

Mariño, Rodrigo J; Fajardo, Jorge; Arana, Ana; Garcia, Carlos; Pachas, Flor

2011-01-01

This article models the cost-effectiveness, from a societal viewpoint, of a dental caries prevention program using salt fluoridation for children 12 years of age, compared with non-intervention (or status quo) in Arequipa, Peru. Standard cost-effectiveness analysis methods were used. The costs associated with implementing and operating the salt-fluoridation program were identified and measured using 2009 prices. Health outcomes were measured as dental caries averted over a 6-year period. Clinical effectiveness data was taken from published data. Costs were measured as direct treatment costs, programs costs and costs of productivity losses as a result of dental treatments. The incremental cost-effectiveness ratio was calculated. A hypothetical population of 25,000 12-year-olds living in Arequipa, Peru was used in this analysis. Two-way sensitivity analyses were conducted over a range of values for key parameters. Our primary analysis estimated that if a dental caries prevention program using salt-fluoridation was available for 25,000 6-year-old children for 6 years, the net saving from a societal perspective would total S/. 11.95 [1 US$ = S/. (2009) 3.01] per diseased tooth averted when compared with the status quo group. That is, after 6 years, an investment of S/.0.32 per annum per child would result in a net saving of S/.11.95 per decayed/missing/filled teeth prevented. While the analysis has inherent limitations as a result of its reliance on a range of assumptions, the findings indicate that for the situations prevailing in Peru, there are significant health and economic benefits to be gained from the use of salt fluoridation.

An Ancient Inca Tax and Metallurgy in Peru

ERIC Educational Resources Information Center

Journal of Chemical Education, 2007

2007-01-01

The discovery of ancient Inca tax rulers and other metallurgical objects in Peru show that the ancient civilizations of the country smelted metals. The analysis shows that the smelters in Peru switched from the production of copper to silver after a tax was imposed on them by the Inca rulers.

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

Crafting regulations in emerging geothermal countries: The Peru example

DOE Office of Scientific and Technical Information (OSTI.GOV)

Armstrong, A.J.

1996-12-31

Conventional wisdom holds that no prudent investor or lender will ante up a penny of investment money in a geothermal project unless and until there is a geothermal resources law in place. Since every law depends on a regulatory regime to make the law work in actual practice, implemented regulations are equally important conditions precedent for geothermal development. In recognition of the importance of assisting geothermal regulatory development in the emerging geothermal countries of Latin America, during the 1995 to 1996 timeframe, the Geothermal Energy Association has acted in an advisory capacity to the Ministry of Energy and Mines ofmore » Peru, in the drafting of geothermal regulations for Peru. These regulations are designed to promote developmental investment in the geothermal resources of Peru, while simultaneously establishing reasonable standards for the protection of the people and the environment of the country. While these regulations are specific to Peru, they may well serve as a model for other countries of Latin America. Thus, the lessons learned in crafting the Peru regulatory regime may have applicability in other countries in which the geothermal industry is now working or may work in the future.« less

19 CFR 10.934 - Goods re-entered after repair or alteration in Peru.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 1 2013-04-01 2013-04-01 false Goods re-entered after repair or alteration in... States-Peru Trade Promotion Agreement Goods Returned After Repair Or Alteration § 10.934 Goods re-entered...” means restoration, addition, renovation, re-dyeing, cleaning, re-sterilizing, or other treatment that...

19 CFR 10.934 - Goods re-entered after repair or alteration in Peru.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 1 2012-04-01 2012-04-01 false Goods re-entered after repair or alteration in... States-Peru Trade Promotion Agreement Goods Returned After Repair Or Alteration § 10.934 Goods re-entered...” means restoration, addition, renovation, re-dyeing, cleaning, re-sterilizing, or other treatment that...

19 CFR 10.934 - Goods re-entered after repair or alteration in Peru.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 1 2014-04-01 2014-04-01 false Goods re-entered after repair or alteration in... States-Peru Trade Promotion Agreement Goods Returned After Repair Or Alteration § 10.934 Goods re-entered...” means restoration, addition, renovation, re-dyeing, cleaning, re-sterilizing, or other treatment that...

Main Trends in Education. PERU [And] The Problem of Information at the National and International Level as a Consequence of the Improvement of Educational Systems.

ERIC Educational Resources Information Center

Ministerio de Educacion, Lima (Peru).

These two documents describe developments and methods of information dissemination which have contributed to strengthening educational reform in Peru since 1972. Educational developments discussed include: (1) decentralization of school administration with increased community participation; (2) a policy calling for the implementation of…

U.S. and Peru Formalize Alliance in Cancer Research

Cancer.gov

The National Cancer Institute (NCI) Center for Global Health (CGH) had the pleasure of welcoming a delegation of health officials from the Government of Peru for the signing of a memorandum of understanding (MOU) between the U.S. and Peru.

Sporotrichosis: The Story of an Endemic Region in Peru over 28 Years (1985 to 2012)

PubMed Central

Ramírez Soto, Max Carlos

2015-01-01

Background Abancay province is a long-standing geographical focus of sporotrichosis in the south central highlands of Peru. Therefore, we examined the features of 36 newly identified cases of sporotrichosis from two hospital centers in Abancay province. We also performed a literature review of studies conducted in this endemic geographical focus over a period of 28 years (1998 to 2012), and analyzed the demographic, clinical and epidemiological features of sporotrichosis in the cases reported in these studies. Methodology We examined the features of 36 new cases of sporotrichosis identified from two hospital centers in Abancay. Furthermore, we searched for relevant studies of cases of sporotrichosis in the endemic region using healthcare databases and literature sources. We analyzed a detailed subset of data on cases collected in Abancay, neighboring provinces, and other regions of Peru. Results A total of nine studies were identified, with 1467 cases included in the final analysis. We also analyzed 36 new cases found in the two hospital centers. Therefore, the combined total of cases analyzed was 1503. Of this total, 58% were male, and approximately 62% were aged ≤14 years. As expected, most cases were from Abancay province (88%), although 12% were from neighboring provinces and other regions of Peru. The lymphocutaneous form (939 cases) was the commonest. The face was the most commonly affected region (647 cases). A total of 1224 patients (81.4%) received treatment: 95.8% received potassium iodide, 2.6% ketoconazole and 1.6% itraconazole. The overall success rates were 60.7% with potassium iodide, 32.2% with ketoconazole and 85% with itraconazole. Conclusions The epidemic of sporotrichosis has been occurring for three decades in the province of Abancay in Peru. This mycosis affects primarily the pediatric population, with predominantly the lymphocutaneous form in the facial region. Although treatment with potassium iodide is safe and effective, response and

Sporotrichosis: The Story of an Endemic Region in Peru over 28 Years (1985 to 2012).

PubMed

Ramírez Soto, Max Carlos

2015-01-01

Abancay province is a long-standing geographical focus of sporotrichosis in the south central highlands of Peru. Therefore, we examined the features of 36 newly identified cases of sporotrichosis from two hospital centers in Abancay province. We also performed a literature review of studies conducted in this endemic geographical focus over a period of 28 years (1998 to 2012), and analyzed the demographic, clinical and epidemiological features of sporotrichosis in the cases reported in these studies. We examined the features of 36 new cases of sporotrichosis identified from two hospital centers in Abancay. Furthermore, we searched for relevant studies of cases of sporotrichosis in the endemic region using healthcare databases and literature sources. We analyzed a detailed subset of data on cases collected in Abancay, neighboring provinces, and other regions of Peru. A total of nine studies were identified, with 1467 cases included in the final analysis. We also analyzed 36 new cases found in the two hospital centers. Therefore, the combined total of cases analyzed was 1503. Of this total, 58% were male, and approximately 62% were aged ≤14 years. As expected, most cases were from Abancay province (88%), although 12% were from neighboring provinces and other regions of Peru. The lymphocutaneous form (939 cases) was the commonest. The face was the most commonly affected region (647 cases). A total of 1224 patients (81.4%) received treatment: 95.8% received potassium iodide, 2.6% ketoconazole and 1.6% itraconazole. The overall success rates were 60.7% with potassium iodide, 32.2% with ketoconazole and 85% with itraconazole. The epidemic of sporotrichosis has been occurring for three decades in the province of Abancay in Peru. This mycosis affects primarily the pediatric population, with predominantly the lymphocutaneous form in the facial region. Although treatment with potassium iodide is safe and effective, response and adherence to treatment are influenced by its

Who is getting Pap smears in urban Peru?

PubMed Central

Paz Soldan, Valerie A; Lee, Frank H; Carcamo, Cesar; Holmes, King K; Garnett, Geoff P; Garcia, Patricia

2008-01-01

Background Cervical cancer, although usually preventable by Pap smear screening, remains the leading cause of cancer-related deaths among women in Peru. The percentages and characteristics of women in Peru who have or have not had a Pap smear have not been defined. Methods In an urban community randomized trial of sexually transmitted infection (STI)/HIV prevention in Peru, 6712 randomly selected women between the ages of 18 and 29 from 20 cities were interviewed regarding having had cervical Pap smears. Results Among women sampled, only 30.9% had had a Pap smear. By multivariate analysis, the main predictors of having a Pap smear were having had sex, having had children, completion of secondary education and increasing age. Regional variations were also found: women from the highlands and rainforest were less likely to have had Pap smears than women from the coast. Conclusion A norm of seeking and receiving Pap smears has not been established among sexually active young Peruvian women. To improve Pap smear coverage in Peru, promotion efforts should target underserved women and regions with less coverage. PMID:18653515

Peru's Gentle Revolutionary.

ERIC Educational Resources Information Center

Sweeney, Thomas W.; Toledo, Alejandro

2003-01-01

Alejandro Toledo, the first Native person to be elected president of Peru, talks about his Quechua roots; his proposed constitutional amendment to ensure equal rights for indigenous peoples; financial support for Native cultural preservation efforts; and his number one priority--to fight poverty through education, focusing on basic education,…

Informatics for Peru in the new millennium.

PubMed

Karras, B T; Kimball, A M; Gonzales, V; Pautler, N A; Alarcón, J; Garcia, P J; Fuller, S

2001-01-01

As efforts continue to narrow the digital divide between the North and South, a new biomedical and health informatics training effort has been launched in Peru. This report describes the first year of work on this collaborative effort between the University of Washington (Seattle) Universidad Peruana Cayetano Heredia and Universidad Nacional de San Marcos (Peru) To describe activities in the first year of a new International Research and Training Program in Biomedical and Health Informatics. Descriptive analysis of key activities including an assessment of electronic environment through observation and survey, an in country short course with quantitative evaluation, and first round of recruitment of Peruvian scholars for long-term training in Seattle. A two-week short course on informatics was held in the country. Participants' success in learning was demonstrated through pretest/posttest. A systematic assessment of electronic environment in Peru was carried out and two scholars for long-term training were enrolled at the University of Washington, Seattle. Initial activity in the collaborative training effort has been high. Of particular importance in this environment is orchestration of efforts among interested parties with similar goals in Peru, and integration of informatics skills into ongoing large-scale research projects in country.

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.

Cost-effectiveness of rotavirus vaccination in peru.

PubMed

Clark, Andrew D; Walker, Damian G; Mosqueira, N Rocio; Penny, Mary E; Lanata, Claudio F; Fox-Rushby, Julia; Sanderson, Colin F B

2009-11-01

There are plans to introduce the oral rotavirus vaccine Rotarix (GlaxoSmithKline), 1 of 2 recently developed vaccines against rotavirus, in Peru. We modeled the cost-effectiveness of adding a rotavirus vaccine to the Peruvian immunization program under 3 scenarios for the timing of vaccination: (1) strictly according to schedule, at 2 and 4 months of age (on time); (2) distributed around the target ages in the same way as the actual timings in the program (flexible); and (3) flexible but assuming vaccination is not initiated for infants >12 weeks of age (restricted). We assumed an introductory price of US $7.50 per dose, and varied the annual rate of price decrease in sensitivity analyses. The discounted cost per disability-adjusted life-year averted for restricted, flexible, and on-time schedules was $621, $615, and $581, respectively. For each of the 3 scenarios, the percentage reduction in deaths due to rotavirus infection was 53%, 66%, and 69%, respectively. The cost per disability-adjusted life-year averted for alternative "what-if" scenarios ranged from $229 (assuming a 1-dose schedule, administered on time) to $1491 (assuming a 2-dose schedule, with half the baseline vaccine efficacy rates and a restricted timing policy). On the basis of current World Health Organization guidelines, rotavirus vaccination represents a highly cost-effective intervention in Peru. Withholding the vaccine from children who present for their first dose after 12 weeks of age would reduce the number of deaths averted by approximately 20%. A single dose may be more cost-effective than 2 doses, but more evidence on the protection conferred by a single dose is required.

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.

Inhalants in Peru.

PubMed

Lerner, R; Ferrando, D

1995-01-01

In Peru, the prevalence and consequences of inhalant abuse appear to be low in the general population and high among marginalized children. Inhalant use ranks third in lifetime prevalence after alcohol and tobacco. Most of the use appears to be infrequent. Among marginalized children, that is, children working in the streets but living at home or children living in the street, the problem of inhalant abuse is a serious problem. Among children working in the streets but living at home, the lifetime prevalence rate for inhalant abuse is high, ranging from 15 to 45 percent depending on the study being cited. For children living in the streets, the use of inhalant is even more severe. As mentioned earlier in this chapter, most of these street children use inhalants on a daily basis. The lack of research on the problem of inhalant abuse is a serious impediment to development of intervention programs and strategies to address this problem in Peru. Epidemiologic and ethnographic research on the nature and extent of inhalant abuse are obvious prerequisites to targeted treatment and preventive intervention programs. The urgent need for current and valid data is underscored by the unique vulnerability of the youthful population at risk and the undisputed harm that results from chronic abuse of inhalants. Nonetheless, it is important to mention several programs that work with street children. Some, such as the Information and Education Center for the Prevention of Drug Abuse, Generation, and Centro Integracion de Menores en Abandono have shelters where street children are offered transition to a less marginal lifestyle. Teams of street educators provide the children with practical solutions and gain their confidence, as well as offer them alternative socialization experiences to help them survive the streets and avoid the often repressive and counterproductive environments typical of many institutions. Most of the children who go through these programs tend to abandon

Assessing the Potential for Interstate Conflict Between Chile and Peru: A Political Economy Approach

DTIC Science & Technology

2009-03-01

Militares Peru-Chile no Se Han Afectado por Diferendo,” El Comercio , April 6, 2008. 329 Chile/Peru: Tensions Flare on Maritime Border Change.” 330 “FF...Relaciones Militares Peru-Chile no Se Han Afectado por Diferendo.” El Comercio , April 6, 2008. “Relations Falter for Peru, Chile.” Chicago Tribune...América Latina y el Mediterráneo (Centro de Estudios e Investigaciones Militares: Santiago, 2000), 82. 129 “A. P. Bureau Chief in Peru is Ordered out of

Determining a cost effective intervention response to HIV/AIDS in Peru.

PubMed

Aldridge, Robert W; Iglesias, David; Cáceres, Carlos F; Miranda, J Jaime

2009-09-18

The HIV epidemic in Peru is still regarded as concentrated -- sentinel surveillance data shows greatest rates of infection in men who have sex with men, while much lower rates are found in female sex workers and still lower in the general population. Without an appropriate set of preventive interventions, continuing infections could present a challenge to the sustainability of the present programme of universal access to treatment. Determining how specific prevention and care strategies would impact on the health of Peruvians should be key in reshaping the national response. HIV/AIDS prevalence levels for risk groups with sufficient sentinel survey data were estimated. Unit costs were calculated for a series of interventions against HIV/AIDS which were subsequently inputted into a model to assess their ability to reduce infection transmission rates. Interventions included: mass media, voluntary counselling and testing; peer counselling for female sex workers; peer counselling for men who have sex with men; peer education of youth in-school; condom provision; STI treatment; prevention of mother to child transmission; and highly active antiretroviral therapy. Impact was assessed by the ability to reduce rates of transmission and quantified in terms of cost per DALY averted. Results of the analysis show that in Peru, the highest levels of HIV prevalence are found in men who have sex with men. Cost effectiveness varied greatly between interventions ranging from peer education of female commercial sex workers at $US 55 up to $US 5,928 (per DALY averted) for prevention of mother to child transmission. The results of this work add evidence-based clarity as to which interventions warrant greatest consideration when planning an intervention response to HIV in Peru. Cost effectiveness analysis provides a necessary element of transparency when facing choices about priority setting, particularly when the country plans to amplify its response through new interventions partly

Disruptions in adaptation of sudden-onset and slow-onset risks: insights from a local case in the Andes of Peru for global policies

NASA Astrophysics Data System (ADS)

Huggel, Christian; Carey, Mark; Frey, Holger; Jurt, Christine; Mechler, Reinhard; Motschmann, Alina; Vicuña, Luis

2017-04-01

Climatic changes involve emergence and changes of both sudden-onset and slow-onset risks. In the field of disaster risk reduction a solid range of strategies and measures has been developed to address sudden-onset risks such as floods, mass movements or storms. Comparably less experience is available for management of slow-onset risks. While, for instance, drought prone regions do have important knowledge how to cope with such conditions in other regions where climatic changes have induced new challenges and risks there is limited experience about how to adapt to slow-onset processes and risks. Examples are impacts of sea level rise in coastal regions or glacier shrinkage in mountain regions. The lack of understanding of how to address impacts from slow-onset processes has recently also been highlighted by the Executive Committee of the Warsaw International Mechanism on Loss and Damage (WIM) acting under the United Nations Framework Convention on Climate Change (UNFCCC). In climate change science, practice and policy it is often assumed that risk management and climate change adaptation would see a seamless continuum when addressing both sudden-onset and slow-onset risks. Here we draw on recent experiences from the Andes of Peru showing that management of, and adaptation to combined sudden-onset and slow-onset impacts of climate change may involve serious social disruption. Carhuaz, a city in the Cordillera Blanca of Peru with a number of local communities pertaining to it, is affected by multiple effects of climate change and glacier shrinkage. After a flood event from glacier lake 513 a flood early warning system has been developed and installed. Multiple use and demand of glacier melt water makes water resource management a challenge and conflicts arise especially during the dry season when water is scarce. The drought at the end of 2016 over much of the tropical Andes has resulted in a situation where local communities started to vigorously and violently turn

Syndromic Management and STI Control in Urban Peru

PubMed Central

Clark, Jesse L.; Lescano, Andres G.; Konda, Kelika A.; Leon, Segundo R.; Jones, Franca R.; Klausner, Jeffrey D.; Coates, Thomas J.; Caceres, Carlos F.

2009-01-01

Background Syndromic management is an inexpensive and effective method for the treatment of symptomatic sexually transmitted infections (STIs), but its effectiveness as a method of STI control in at-risk populations is questionable. We sought to determine the potential utility of syndromic management as a public health strategy to control STI transmission in high-risk populations in urban Peru. Methodology We surveyed 3,285 at-risk men and women from three Peruvian cities from 2003–05. Participants were asked about the presence of genital ulcers, discharge, or dysuria in the preceding six months. Participants reporting symptoms were asked about subsequent health-seeking and partner notification behavior. Urine and vaginal swab samples were tested for Neisseria gonorrhoeae and Chlamydia trachomatis by nucleic acid testing. Serum was tested for syphilis and Herpes Simplex Virus-Type 2 antibodies. Findings Recent urogenital discharge or dysuria was reported by 42.1% of participants with gonorrhea or chlamydia versus 28.3% of participants without infection. Genital ulceration was reported by 6.2% of participants with, and 7.4% of participants without, recent syphilis. Many participants reporting symptoms continued sexual activity while symptomatic, and approximately half of all symptomatic participants sought treatment. The positive and negative predictive values of urogenital discharge or genital ulcer disease in detecting STIs that are common in the study population were 14.4% and 81.5% for chlamydia in women and 8.3% and 89.5% for syphilis among gay-identified men. Conclusions In our study, STIs among high-risk men and women in urban Peru were frequently asymptomatic and symptomatic participants often remained sexually active without seeking treatment. Additional research is needed to assess the costs and benefits of targeted, laboratory-based STI screening as part of a comprehensive STI control program in developing countries. PMID:19779620

Economic impact of cystic echinococcosis in peru.

PubMed

Moro, Pedro L; Budke, Christine M; Schantz, Peter M; Vasquez, Julio; Santivañez, Saul J; Villavicencio, Jaime

2011-05-01

Cystic echinococcosis (CE) constitutes an important public health problem in Peru. However, no studies have attempted to estimate the monetary and non-monetary impact of CE in Peruvian society. We used official and published sources of epidemiological and economic information to estimate direct and indirect costs associated with livestock production losses and human disease in addition to surgical CE-associated disability adjusted life years (DALYs) lost. The total estimated cost of human CE in Peru was U.S.$2,420,348 (95% CI:1,118,384-4,812,722) per year. Total estimated livestock-associated costs due to CE ranged from U.S.$196,681 (95% CI:141,641-251,629) if only direct losses (i.e., cattle and sheep liver destruction) were taken into consideration to U.S.$3,846,754 (95% CI:2,676,181-4,911,383) if additional production losses (liver condemnation, decreased carcass weight, wool losses, decreased milk production) were accounted for. An estimated 1,139 (95% CI: 861-1,489) DALYs were also lost due to surgical cases of CE. This preliminary and conservative assessment of the socio-economic impact of CE on Peru, which is based largely on official sources of information, very likely underestimates the true extent of the problem. Nevertheless, these estimates illustrate the negative economic impact of CE in Peru.

Economic Impact of Cystic Echinococcosis in Peru

PubMed Central

Moro, Pedro L.; Budke, Christine M.; Schantz, Peter M.; Vasquez, Julio; Santivañez, Saul J.; Villavicencio, Jaime

2011-01-01

Background Cystic echinococcosis (CE) constitutes an important public health problem in Peru. However, no studies have attempted to estimate the monetary and non-monetary impact of CE in Peruvian society. Methods We used official and published sources of epidemiological and economic information to estimate direct and indirect costs associated with livestock production losses and human disease in addition to surgical CE-associated disability adjusted life years (DALYs) lost. Findings The total estimated cost of human CE in Peru was U.S.$2,420,348 (95% CI:1,118,384–4,812,722) per year. Total estimated livestock-associated costs due to CE ranged from U.S.$196,681 (95% CI:141,641–251,629) if only direct losses (i.e., cattle and sheep liver destruction) were taken into consideration to U.S.$3,846,754 (95% CI:2,676,181–4,911,383) if additional production losses (liver condemnation, decreased carcass weight, wool losses, decreased milk production) were accounted for. An estimated 1,139 (95% CI: 861–1,489) DALYs were also lost due to surgical cases of CE. Conclusions This preliminary and conservative assessment of the socio-economic impact of CE on Peru, which is based largely on official sources of information, very likely underestimates the true extent of the problem. Nevertheless, these estimates illustrate the negative economic impact of CE in Peru. PMID:21629731

My Classroom: Peru

ERIC Educational Resources Information Center

Paglia, Deanna

2015-01-01

Angela Huanca Barrantes, a highly respected teacher of English as a foreign language (EFL) in the city of Ilo, has a strong impact on the lives of students at the Admirante Miguel Grau secondary school and at Centro Cultural Peruano Norteamericano, which is one of four binational centers in southern Peru. Due to Ms. Huanca's lack of understanding…

The effect on cardiovascular risk factors of migration from rural to urban areas in Peru: PERU MIGRANT Study

PubMed Central

Miranda, J Jaime; Gilman, Robert H; García, Héctor H; Smeeth, Liam

2009-01-01

Background Mass-migration observed in Peru from the 1970s occurred because of the need to escape from politically motivated violence and work related reasons. The majority of the migrant population, mostly Andean peasants from the mountainous areas, tends to settle in clusters in certain parts of the capital and their rural environment could not be more different than the urban one. Because the key driver for migration was not the usual economic and work-related reasons, the selection effects whereby migrants differ from non-migrants are likely to be less prominent in Peru. Thus the Peruvian context offers a unique opportunity to test the effects of migration. Methods/Design The PERU MIGRANT (PEru's Rural to Urban MIGRANTs) study was designed to investigate the magnitude of differences between rural-to-urban migrant and non-migrant groups in specific CVD risk factors. For this, three groups were selected: Rural, people who have always have lived in a rural environment; Rural-urban, people who migrated from rural to urban areas; and, Urban, people who have always lived in a urban environment. Discussion Overall response rate at enrolment was 73.2% and overall response rate at completion of the study was 61.6%. A rejection form was obtained in 282/323 people who refused to take part in the study (87.3%). Refusals did not differ by sex in rural and migrant groups, but 70% of refusals in the urban group were males. In terms of age, most refusals were observed in the oldest age-group (>60 years old) in all study groups. The final total sample size achieved was 98.9% of the target sample size (989/1000). Of these, 52.8% (522/989) were females. Final size of the rural, migrant and urban study groups were 201, 589 and 199 urban people, respectively. Migrant's average age at first migration and years lived in an urban environment were 14.4 years (IQR 10–17) and 32 years (IQR 25–39), respectively. This paper describes the PERU MIGRANT study design together with a

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.

International Briefing 27: Training and Development in Peru

ERIC Educational Resources Information Center

Talleri, Andres Velarde; Llinas-Audet, Xavier; Escardibul, Josep-Oriol

2013-01-01

Peru is in the central, western part of South America. It is the third largest country in South America and number 20 in the world. It is the country with the fourth highest population in South America. In 2010, the gross domestic product (GDP) of Peru was 154 billion USD, and its rate of growth was 8.8% (higher than the average for the region for…

Joint Peru/United States report on Peru/United States cooperative energy assessment. Volume 1. Executive summary, main report and appendices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1979-08-01

In 1978, the US and Peru conducted a comprehensive assessment of Peru's energy resources, needs, and uses and developed several alternative energy strategies that utilize the available resources to meet their energy requirements. This Volume I reports the findings of the assessment and contains the executive summary, the main report, and five appendices of information that support the integrated energy supply and demand analysis. The following chapters are included: The Energy Situation in Peru (economic context and background, energy resources and production, energy consumption patterns); Reference Supply and Demand Projection (approach, procedures, and assumptions; economic projections; energy demand and supplymore » projections; supply/demand integration; uncertainties); and The Development of Strategies and Options (the analysis of options; strategies; increased use of renewables, hydropower, coal; increased energy efficiency; and financial analysis of strategies).« less

Endemic Venezuelan Equine Encephalitis in Northern Peru

PubMed Central

Aguilar, Patricia V.; Greene, Ivorlyne P.; Coffey, Lark L.; Medina, Gladys; Moncayo, Abelardo C.; Anishchenko, Michael; Ludwig, George V.; Turell, Michael J.; O’Guinn, Monica L.; Lee, John; Tesh, Robert B.; Watts, Douglas M.; Russell, Kevin L.; Hice, Christine; Yanoviak, Stephen; Morrison, Amy C.; Klein, Terry A.; Dohm, David J.; Guzman, Hilda; Travassos da Rosa, Amelia P.A.; Guevara, Carolina; Kochel, Tadeusz; Olson, James; Cabezas, Cesar

2004-01-01

Since Venezuelan equine encephalitis virus (VEEV) was isolated in Peru in 1942, >70 isolates have been obtained from mosquitoes, humans, and sylvatic mammals primarily in the Amazon region. To investigate genetic relationships among the Peru VEEV isolates and between the Peru isolates and other VEEV strains, a fragment of the PE2 gene was amplified and analyzed by single-stranded conformation polymorphism. Representatives of seven genotypes underwent sequencing and phylogenetic analysis. The results identified four VEE complex lineages that cocirculate in the Amazon region: subtypes ID (Panama and Colombia/Venezuela genotypes), IIIC, and a new, proposed subtype IIID, which was isolated from a febrile human, mosquitoes, and spiny rats. Both ID lineages and the IIID subtype are associated with febrile human illness. Most of the subtype ID isolates belonged to the Panama genotype, but the Colombia/Venezuela genotype, which is phylogenetically related to epizootic strains, also continues to circulate in the Amazon basin. PMID:15200823

Endemic Venezuelan equine encephalitis in northern Peru.

PubMed

Aguilar, Patricia V; Greene, Ivorlyne P; Coffey, Lark L; Medina, Gladys; Moncayo, Abelardo C; Anishchenko, Michael; Ludwig, George V; Turell, Michael J; O'Guinn, Monica L; Lee, John; Tesh, Robert B; Watts, Douglas M; Russell, Kevin L; Hice, Christine; Yanoviak, Stephen; Morrison, Amy C; Klein, Terry A; Dohm, David J; Guzman, Hilda; Travassos da Rosa, Amelia P A; Guevara, Carolina; Kochel, Tadeusz; Olson, James; Cabezas, Cesar; Weaver, Scott C

2004-05-01

Since Venezuelan equine encephalitis virus (VEEV) was isolated in Peru in 1942, >70 isolates have been obtained from mosquitoes, humans, and sylvatic mammals primarily in the Amazon region. To investigate genetic relationships among the Peru VEEV isolates and between the Peru isolates and other VEEV strains, a fragment of the PE2 gene was amplified and analyzed by single-stranded conformation polymorphism. Representatives of seven genotypes underwent sequencing and phylogenetic analysis. The results identified four VEE complex lineages that cocirculate in the Amazon region: subtypes ID (Panama and Colombia/Venezuela genotypes), IIIC, and a new, proposed subtype IIID, which was isolated from a febrile human, mosquitoes, and spiny rats. Both ID lineages and the IIID subtype are associated with febrile human illness. Most of the subtype ID isolates belonged to the Panama genotype, but the Colombia/Venezuela genotype, which is phylogenetically related to epizootic strains, also continues to circulate in the Amazon basin.

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.

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

Risk factors associated with drug use before imprisonment in Peru.

PubMed

Hernández-Vásquez, A; Núñez, S; Santero, M; Grendas, L; Huarez, B; Vilcarromero, S; Casas-Bendezú, M; Braun, S; Cortés, S; Rosselli, D

2018-01-01

To assess the prevalence of drug abuse before prison admission and to identify associated sociodemographic and family history risk factors, according to gender, in prisons of Peru. A secondary analysis was carried out with data from the First National Prisoner Census 2016, using a questionnaire of 173 items that was applied to the whole prison population of Peru. The types of drugs used before admission were analyzed according to characteristics of the penitentiary population, and generalized linear models were used to calculate prevalence ratios with 95% confidence intervals to identify possible factors associated with drug use. Out of a population of 76,180 prisoners, 71,184 (93.4%) answered the survey (men 67,071, 94.2%). The overall prevalence of drug consumption before admission was 24.4% (25.3 % in men and 9.1% in women), the highest prevalence in the 18-29 age group (36.3% in men and 14.9% in women). The most commonly used drugs were marijuana (58.2%), coca paste/cocaine or crack (40.3%) and inhalants (1%). The factors most strongly associated with consumption were having a family member who consumed drugs (59.8%), history of previous imprisonment (59.1%), unemployment (48.4%), relationships at school with classmates who had problems with the law (46.9%), background of a family member who attended a penitentiary (38.4%), and history of running away from home before age 15 (35.9%). In Peru, drug use is higher in the prison population than in the general population, and there are differences according to sex in the prevalence of drug use and associated factors prior to admission to a prison. The study demonstrated that childhood events, such as child abuse, having a family member imprisoned, having a family member who used drugs, or who previously abused alcohol, are factors associated with drug use in the penitentiary population. Some of these risk factors are modifiable, so it is important to consider these in the design of social and health policies focused

Plants used by native Amazonian groups from the Nanay River (Peru) for the treatment of malaria.

PubMed

Ruiz, Lastenia; Ruiz, Liliana; Maco, Martha; Cobos, Marianela; Gutierrez-Choquevilca, Andréa-Luz; Roumy, Vincent

2011-01-27

In order to evaluate the antimalarial potential of traditional remedies used in Peru, Indigenous and Mestizo populations from the river Nanay in Loreto were interviewed about traditional medication for the treatment of malaria. The survey took place on six villages and led to the collection of 59 plants. 35 hydro-alcoholic extractions were performed on the 21 most cited plants. The extracts were then tested for antiplasmodial activity in vitro on Plasmodium falciparum chloroquine resistant strain (FCR-3), and ferriprotoporphyrin inhibition test was also performed in order to assume pharmacological properties. Extracts from 9 plants on twenty-one tested (Abuta rufescens, Ayapana lanceolata, Capsiandra angustifolia, Citrus limon, Citrus paradise, Minquartia guianensis, Potalia resinífera, Scoparia dulcis, and Physalis angulata) displayed an interesting antiplasmodial activity (IC(50)<10 μg/ml) and 16 remedies were active on the ferriprotoporphyrin inhibition test. The results give scientific validation to the traditional medical knowledge of the Amerindian and Mestizo populations from Loreto and exhibit a source of potentially active plants. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Andes hantavirus variant in rodents, southern Amazon Basin, Peru.

PubMed

Razuri, Hugo; Tokarz, Rafal; Ghersi, Bruno M; Salmon-Mulanovich, Gabriela; Guezala, M Claudia; Albujar, Christian; Mendoza, A Patricia; Tinoco, Yeny O; Cruz, Christopher; Silva, Maria; Vasquez, Alicia; Pacheco, Víctor; Ströher, Ute; Guerrero, Lisa Wiggleton; Cannon, Deborah; Nichol, Stuart T; Hirschberg, David L; Lipkin, W Ian; Bausch, Daniel G; Montgomery, Joel M

2014-02-01

We investigated hantaviruses in rodents in the southern Amazon Basin of Peru and identified an Andes virus variant from Neacomys spinosus mice. This finding extends the known range of this virus in South America and the range of recognized hantaviruses in Peru. Further studies of the epizoology of hantaviruses in this region are warranted.

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.

Progressive universalism? The impact of targeted coverage on health care access and expenditures in Peru.

PubMed

Neelsen, Sven; O'Donnell, Owen

2017-12-01

Like other countries seeking a progressive path to universalism, Peru has attempted to reduce inequalities in access to health care by granting the poor entitlement to tax-financed basic care without charge. We identify the impact of this policy by comparing the target population's change in health care utilization with that of poor adults already covered through employment-based insurance. There are positive effects on receipt of ambulatory care and medication that are largest among the elderly and the poorest. The probability of getting formal health care when sick is increased by almost two fifths, but the likelihood of being unable to afford treatment is reduced by more than a quarter. Consistent with the shallow coverage offered, there is no impact on use of inpatient care. Neither is there any effect on average out-of-pocket health care expenditure, but medical spending is reduced by up to 25% in the top quarter of the distribution. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Outbreak of Paratyphoid Fever Among Naval Personnel in Peru (Brote de Fiebre Paratifoidea Entre Personal de la Marina Del Peru.)

DTIC Science & Technology

1992-01-01

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Andes Hantavirus Variant in Rodents, Southern Amazon Basin, Peru

PubMed Central

Tokarz, Rafal; Ghersi, Bruno M.; Salmon-Mulanovich, Gabriela; Guezala, M. Claudia; Albujar, Christian; Mendoza, A. Patricia; Tinoco, Yeny O.; Cruz, Christopher; Silva, Maria; Vasquez, Alicia; Pacheco, Víctor; Ströher, Ute; Guerrero, Lisa Wiggleton; Cannon, Deborah; Nichol, Stuart T.; Hirschberg, David L.; Lipkin, W. Ian; Bausch, Daniel G.; Montgomery, Joel M.

2014-01-01

We investigated hantaviruses in rodents in the southern Amazon Basin of Peru and identified an Andes virus variant from Neacomys spinosus mice. This finding extends the known range of this virus in South America and the range of recognized hantaviruses in Peru. Further studies of the epizoology of hantaviruses in this region are warranted. PMID:24447689

Treatment for Addiction: Advancing the Common Good. Recommendations from a Join Together Policy Panel on Treatment and Recovery.

ERIC Educational Resources Information Center

Join Together, Boston, MA.

Join Together convened a panel of experts to review U.S. policies for addiction treatment and recovery. Although the panel reached an agreement on six recommendations for policy changes that can make help more accessible and expand treatment to more people. These recommendations are: (1) treatment for alcoholism and other drug addiction must be…

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.

Beetles (Coleoptera) of Peru: a survey of the families

Treesearch

Rachel A. Arango; Caroline S. Chaboo

2016-01-01

A checklist of the ptinid beetles (including Anobiidae) of Peru is presented with 5 subfamilies, 22 genera, and 33 identified species. One species, Calymmaderus funki Pic, is reported as a new country record. Six genera are reported as new records for Peru (i.e. Byrrhodes, Caenocara,...

Nutritional transition in children under five years and women of reproductive age: a 15-years trend analysis in Peru.

PubMed

Loret de Mola, Christian; Quispe, Renato; Valle, Giancarlo A; Poterico, Julio A

2014-01-01

Rapid urbanization, increase in food availability, and changes in diet and lifestyle patterns have been changing nutritional profiles in developing nations. We aimed to describe nutritional changes in children under 5 years and women of reproductive age in Peru, during a 15-year period of rapid economic development and social policy enhancement. Trend analyses of anthropometric measures in children of preschool age and women between 15-49 years, using the Peruvian National Demographic and Family Health Surveys (DHS) from 1996 to 2011. WHO growth curves were used to define stunting, underweight, wasting and overweight in children <5 y. We employed the WHO BMI-age standardized curves for teenagers between 15-19 y. In women >19 years, body mass index (BMI) was analyzed both categorically and as a continuous variable. To statistically analyze the trends, we used regression models: Linear and Poisson for continuous and binary outcomes, respectively. We analyzed data from 123 642 women and 64 135 children, from 1996 to 2011. Decreases over time were evidenced for underweight (p<0.001), wasting (p<0.001), and stunting (p<0.001) in children under 5 y. This effect was particularly noted in urban settings. Overweight levels in children reduced (p<0.001), however this reduction stopped, in urban settings, since 2005 (∼12%). Anemia decreased in children and women (p<0.001); with higher reduction in urban (↓43%) than in rural children (↓24%). BMI in women aged 15-19 years increased (p<0.001) across time, with noticeable BMI-curve shift in women older than 30 years. Moreover, obesity doubled during this period in women more than 19 y. Nutrition transition in Peru shows different patterns for urban and rural populations. Public policies should emphasize targeting both malnutrition conditions--undernutrition/stunting, overweight/obesity and anemia--considering age and place of residence in rapid developing societies like Peru.

Economic burden of neurocysticercosis: results from Peru.

PubMed

Rajkotia, Yogesh; Lescano, Andres G; Gilman, Robert H; Cornejo, Christian; Garcia, Hector H

2007-08-01

Neurocysticercosis (NCC) is a major cause of neurological morbidity in the developing world. This study aimed to assess the treatment costs and productivity losses associated with NCC in Peru. NCC patients were identified through retrospective chart analysis. Patients meeting inclusion criteria were interviewed in order to obtain data on symptom history, treatment costs, productivity losses and health service utilisation patterns. These data were modelled to determine average treatment costs and productivity losses over 2 years. Our findings show that treatment costs and productivity losses consume 54% of an annual minimum wage salary during the first year of treatment and 16% during the second year. Diagnosis (36%) and drug therapy (27%) represent the most expensive healthcare-related costs. These costs are prohibitive for some-8% of our study sample had no diagnostic tests during their first 6 months of disease, and two-thirds of those who delayed treatment reportedly did so due to their inability to pay. Two-thirds of wage-earners lost their jobs owing to NCC and only 61% were able to re-engage in wage-earning activities. This study highlights the need to expand financial coverage to ensure the poor have access to health services and do not become further impoverished.

Job Preferences of Nurses and Midwives for Taking Up a Rural Job in Peru: A Discrete Choice Experiment

PubMed Central

Huicho, Luis; Miranda, J. Jaime; Diez-Canseco, Francisco; Lema, Claudia; Lescano, Andrés G.; Lagarde, Mylene; Blaauw, Duane

2012-01-01

Background Robust evidence on interventions to improve the shortage of health workers in rural areas is needed. We assessed stated factors that would attract short-term contract nurses and midwives to work in a rural area of Peru. Methods and Findings A discrete choice experiment (DCE) was conducted to evaluate the job preferences of nurses and midwives currently working on a short-term contract in the public sector in Ayacucho, Peru. Job attributes, and their levels, were based on literature review, qualitative interviews and focus groups of local health personnel and policy makers. A labelled design with two choices, rural community or Ayacucho city, was used. Job attributes were tailored to these settings. Multiple conditional logistic regressions were used to assess the determinants of job preferences. Then we used the best-fitting estimated model to predict the impact of potential policy incentives on the probability of choosing a rural job or a job in Ayacucho city. We studied 205 nurses and midwives. The odds of choosing an urban post was 14.74 times than that of choosing a rural one. Salary increase, health center-type of facility and scholarship for specialization were preferred attributes for choosing a rural job. Increased number of years before securing a permanent contract acted as a disincentive for both rural and urban jobs. Policy simulations showed that the most effective attraction package to uptake a rural job included a 75% increase in salary plus scholarship for a specialization, which would increase the proportion of health workers taking a rural job from 36.4% up to 60%. Conclusions Urban jobs were more strongly preferred than rural ones. However, combined financial and non-financial incentives could almost double rural job uptake by nurses and midwifes. These packages may provide meaningful attraction strategies to rural areas and should be considered by policy makers for implementation. PMID:23284636

Perfume dermatitis in children sensitized to balsam of Peru in topical agents.

PubMed

Fisher, A A

1990-01-01

Hjorth in his classic monogram "Eczematous Allergy to Balsams" emphasized that sensitization to balsam of Peru is most important since secondary allergens such as "fragrances" are ubiquitous. The application of a topical medication containing balsam of Peru to the skin of an infant, particularly in the occluded diaper area, seems a great way to sensitize the infant not only to balsam of Peru but also to our fragrant environment.

Decomposing Educational Inequalities in Child Mortality: A Temporal Trend Analysis of Access to Water and Sanitation in Peru

PubMed Central

Bohra, Tasneem; Benmarhnia, Tarik; McKinnon, Britt; Kaufman, Jay S.

2017-01-01

Previous studies of inequality in health and mortality have largely focused on income-based inequality. Maternal education plays an important role in determining access to water and sanitation, and inequalities in child mortality arising due to differential access, especially in low- and middle-income countries such as Peru. This article aims to explain education-related inequalities in child mortality in Peru using a regression-based decomposition of the concentration index of child mortality. The analysis combines a concentration index created along a cumulative distribution of the Demographic and Health Surveys sample ranked according to maternal education, and decomposition measures the contribution of water and sanitation to educational inequalities in child mortality. We observed a large education-related inequality in child mortality and access to water and sanitation. There is a need for programs and policies in child health to focus on ensuring equity and to consider the educational stratification of the population to target the most disadvantaged segments of the population. PMID:27821698

[Evaluation of physical fitness levels in children and adolescents: establishing percentile charts for the central region of Peru].

PubMed

Bustamante, Alcibíades; Beunen, Gastón; Maia, José

2012-06-01

Construct percentile charts and physical fitness (PF) reference values stratified by age and sex of children and adolescents from Peru's central region. The sample was comprised of 7,843 subjects (4,155 females and 3,688 males) between the ages of 6 to 17 years old. Physical fitness was assessed using six tests developed by EUROFIT, FITNESSGRAM and AAPHERD. Percentile charts were developed separately for males and females using the LMS method calculated with LMSchartmaker software. Results. Males showed higher PF values with the exception of flexibility; a clear increase in PF with increasing age was verified. Inter-individual variability in both sexes is substantial. Charts and specific reference values by age and sex may be used for the assessment and interpretation of children's and adolescents' PF levels in Peru's central region. These findings may be of help to educators, public health professionals, parents, and policy-makers when assessing schools' physical education programs.

Indian Education in Colonial Peru

ERIC Educational Resources Information Center

Martin, Luis

1973-01-01

The Spaniards who dedicated themselves to the education of the American Indians in colonial Peru were firm believers in intellectual capabilities of the Indians and in the need to approach them through their own Quechua language. (FF)

[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.

Peru 2007 tsunami runup observations and modeling

NASA Astrophysics Data System (ADS)

Fritz, H. M.; Kalligeris, N.; Borrero, J. C.

2008-05-01

On 15 August 2007 an earthquake with moment magnitude (Mw) of 8.0 centered off the coast of central Peru, generated a tsunami with locally focused runup heights of up to 10 m. A reconnaissance team was deployed in the immediate aftermath and investigated the tsunami effects at 51 sites. The largest runup heights were measured in a sparsely populated desert area south of the Paracas Peninsula resulting in only 3 tsunami fatalities. Numerical modeling of the earthquake source and tsunami suggest that a region of high slip near the coastline was primarily responsible for the extreme runup heights. The town of Pisco was spared by the presence of the Paracas Peninsula, which blocked tsunami waves from propagating northward from the high slip region. The coast of Peru has experienced numerous deadly and destructive tsunamis throughout history, which highlights the importance of ongoing tsunami awareness and education efforts in the region. The Peru tsunami is compared against recent mega-disasters such as the 2004 Indian Ocean tsunami and Hurricane Katrina.

Sociocultural Comparison of Bilingual Education Policies and Programmes in Three Andean Countries and the United States.

ERIC Educational Resources Information Center

Minaya-Rowe, Liliana

1986-01-01

Presents a model of the sociocultural circumstances surrounding the development of language policies and planning and of bilingual education programs in the United States and three Andean countries: Peru, Bolivia, and Ecuador. (Author/CB)

76 FR 21786 - Meetings of The United States-Peru Environmental Affairs Council, Environmental Cooperation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-18

... DEPARTMENT OF STATE [Public Notice: 7417] Meetings of The United States-Peru Environmental Affairs... of meetings of the United States-Peru Environmental Affairs Council, Environmental Cooperation... notice that the United States and Peru intend to hold the third meeting of the Sub-Committee on Forest...

77 FR 28419 - Meetings of the United States-Peru Environmental Affairs Council, Environmental Cooperation...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-14

... DEPARTMENT OF STATE [Public Notice: 7873] Meetings of the United States-Peru Environmental Affairs... of meetings of the United States-Peru Environmental Affairs Council, Environmental Cooperation... the United States and Peru intend to hold the fifth meeting of the Sub-Committee on Forest Sector...

Ecologic studies of Venezuelan encephalitis virus in Peru during 1970-1971.

PubMed

Scherer, W F; Madalengoitia, J; Flores, W; Acosta, M

1975-04-01

Venezuelan encephalitis (VE) virus has intermittently produced epidemics and equine epizootics on the dry Pacific coastal plain of Peru since at least the 1930's. However, evidence that the virus exists in the Amazon region of Peru to the east of the Andes mountains was not obtained until antibodies were found in human sera collected in 1965, and 10 strains of the virus were isolated in a forest near the city of Iquitos, Peru during February and March 1971. Eight strains came from mosquitoes and two from dead sentinel hamsters. Three hamsters exposed in forests near Iquitos developed VE virus antibodies suggesting that hamster-benign strains also exist there. Antibody tests of equine sera revealed no evidence that VE virus was actively cycling during the late 1950's or 1960's in southern coastal Peru, where equine epizootics had occurred in the 1930's and 1940's. In northern coastal Peru bordering Ecuador, antibodies were present in equine sera, presumably residual from the 1969 outbreak caused by subtype I virus, since neutralizing antibody titers were higher to subtype I virus than to subtypes III or IV. No VE virus was detected in this northern region during the dry season of 1970 by use of sentinel hamsters. The possibility is considered that VE epidemics and equine epizootics on the Pacific coast of Peru are caused by movements of virus in infected vertebrates traversing Andean passes or in infected vertebrates or mosquitoes carried in airplanes from the Amazon region.

An astronomical observatory for Peru

NASA Astrophysics Data System (ADS)

del Mar, Juan Quintanilla; Sicardy, Bruno; Giraldo, Víctor Ayma; Callo, Víctor Raúl Aguilar

2011-06-01

Peru and France are to conclude an agreement to provide Peru with an astronomical observatory equipped with a 60-cm diameter telescope. The principal aims of this project are to establish and develop research and teaching in astronomy. Since 2004, a team of researchers from Paris Observatory has been working with the University of Cusco (UNSAAC) on the educational, technical and financial aspects of implementing this venture. During an international astronomy conference in Cusco in July 2009, the foundation stone of the future Peruvian Observatory was laid at the top of Pachatusan Mountain. UNSAAC, represented by its Rector, together with the town of Oropesa and the Cusco regional authority, undertook to make the sum of 300,000€ available to the project. An agreement between Paris Observatory and UNSAAC now enables Peruvian students to study astronomy through online teaching.

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

Accessibility and Affordability of Tertiary Education in Brazil, Colombia, Mexico and Peru within a Global Context. Policy Research Working Paper 4517

ERIC Educational Resources Information Center

Murakami, Yuki; Blom, Andreas

2008-01-01

This paper examines the financing of tertiary education in Brazil, Colombia, Mexico and Peru, comparing the affordability and accessibility of tertiary education with that in high-income countries. To measure affordability, the authors estimate education costs, living costs, grants, and loans. Further, they compute the participation rate,…

Determining a cost effective intervention response to HIV/AIDS in Peru

PubMed Central

Aldridge, Robert W; Iglesias, David; Cáceres, Carlos F; Miranda, J Jaime

2009-01-01

Background The HIV epidemic in Peru is still regarded as concentrated - sentinel surveillance data shows greatest rates of infection in men who have sex with men, while much lower rates are found in female sex workers and still lower in the general population. Without an appropriate set of preventive interventions, continuing infections could present a challenge to the sustainability of the present programme of universal access to treatment. Determining how specific prevention and care strategies would impact on the health of Peruvians should be key in reshaping the national response. Methods HIV/AIDS prevalence levels for risk groups with sufficient sentinel survey data were estimated. Unit costs were calculated for a series of interventions against HIV/AIDS which were subsequently inputted into a model to assess their ability to reduce infection transmission rates. Interventions included: mass media, voluntary counselling and testing; peer counselling for female sex workers; peer counselling for men who have sex with men; peer education of youth in-school; condom provision; STI treatment; prevention of mother to child transmission; and highly active antiretroviral therapy. Impact was assessed by the ability to reduce rates of transmission and quantified in terms of cost per DALY averted. Results Results of the analysis show that in Peru, the highest levels of HIV prevalence are found in men who have sex with men. Cost effectiveness varied greatly between interventions ranging from peer education of female commercial sex workers at $US 55 up to $US 5,928 (per DALY averted) for prevention of mother to child transmission. Conclusion The results of this work add evidence-based clarity as to which interventions warrant greatest consideration when planning an intervention response to HIV in Peru. Cost effectiveness analysis provides a necessary element of transparency when facing choices about priority setting, particularly when the country plans to amplify its

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.

Can legality verification enhace local rights to forest resources? Piloting the policy learning protocol in the Peruvian forest context

Treesearch

B. Cashore; I. Visseren-Hamakers; P. Caro Torres; W. de Jong; A. Denvir; D. Humphreys; Kathleen McGinley; G. Auld; S. Lupberger; C. McDermott; S. Sax; D. Yin

2016-01-01

This report, “Can Legality Verification Enhance Local Rights to Forest Resources? Piloting the policy learning protocol in the Peruvian forest context,” reports on the testing of the application of the 11-step Policy Learning Protocol in Peru in 2015-16. The Protocol (Cashore et al. 2014) enables actors to draw from international policy initiatives in order to improve...

Developing and sustaining adolescent-friendly health services: A multiple case study from Ecuador and Peru.

PubMed

Goicolea, Isabel; Coe, Anna-Britt; San Sebastián, Miguel; Hurtig, Anna-Karin

2017-08-01

Adolescent-Friendly Health Services (AFHSs) are those that are accessible, acceptable, equitable, appropriate and effective for different youth sub-populations. This study investigated the process through which four clinics in two countries - Peru and Ecuador - introduced, developed and sustained AFHSs. A multiple case study design was chosen, and data from each clinic were collected through document review, observations and informant interviews. National level data were also collected. Data were analysed following thematic analysis. The findings showed that the process of introducing, developing and sustaining AFHSs was long term, and required a creative team effort and collaboration between donors, public institutions and health providers. The motivation and external support was crucial to initiating and sustaining the implementation of AFHSs. Health facilities' transformation into AFHSs was linked to the broader organisation of country health systems, and the evolution of national adolescent health policies. In Peru, the centralised approach to AFHSs introduction facilitated the dissemination of a comprehensive national model to health facilities, but dependency on national directives made it more difficult to systemise them when ideological and organisational changes occurred. In Ecuador, a less centralised approach to introducing AFHSs made for easier integration of the AFHSs model.

Missed Opportunities for Health Education on Pap Smears in Peru

ERIC Educational Resources Information Center

Bayer, Angela M.; Nussbaum, Lauren; Cabrera, Lilia; Paz-Soldan, Valerie A.

2011-01-01

Despite cervical cancer being one of the leading causes of cancer-related deaths among women in Peru, cervical Pap smear coverage is low. This article uses findings from 185 direct clinician observations in four cities of Peru (representing the capital and each of the three main geographic regions of the country) to assess missed opportunities for…

Additions to the checklist of the ants (Hymenoptera: Formicidae) of Peru.

PubMed

Guénard, Benoit; Economo, Evan P

2015-11-10

A recent species checklist of the ants of Peru recorded 592 nominal species and 79 genera on the basis of a literature review. Here we complement the previously published checklist with the addition of 83 nominal species and six genera, including three genera recorded only from morphospecies. This increases the list of ants reported from Peru to at least 679 species and subspecies and 85 genera. We also modify the list of species known as endemic from Peru, discuss the historical importance of the Peruvian ant fauna in myrmecology, and highlight potential research for future studies.

Carrion's disease (Bartonellosis bacilliformis) confirmed by histopathology in the High Forest of Peru.

PubMed

Maco, Vicente; Maguiña, Ciro; Tirado, Antonio; Maco, Vicente; Vidal, José E

2004-01-01

Bartonellosis or Carrion's disease is endemic in some regions of Peru, classically found in the inter-Andean valleys located between 500 and 3200 meters above sea level. We report the case of a 43 year-old male patient, farmer, who was born in the Pichanaki district (Chanchamayo, Junin), located in the High Forest of Peru. He presented with disseminated, raised, erythematous cutaneous lesions, some of which bled. The distribution of these lesions included the nasal mucosa and penile region. Additionally subcutaneous nodules were distributed over the trunk and extremities. Hematologic exams showed a moderate anemia. Serologic studies for HIV and Treponema pallidum were negative. The histopathologic results of two biopsies were compatible with Peruvian wart. Oral treatment with ciprofloxacin (500 mg BID) was begun. Over 10 days, the patient showed clinical improvement. This is the first report of a confirmed case of bartonellosis in the eruptive phase originating from the Peruvian High Forest, showing the geographical expansion of the Carrion's disease.

Social control and coercion in addiction treatment: towards evidence-based policy and practice.

PubMed

Wild, T Cameron

2006-01-01

Social pressures are often an integral part of the process of seeking addiction treatment. However, scientists have not developed conclusive evidence on the processes, benefits and limitations of using legal, formal and informal social control tactics to inform policy makers, service providers and the public. This paper characterizes barriers to a robust interdisciplinary analysis of social control and coercion in addiction treatment and provides directions for future research. Conceptual analysis and review of key studies and trends in the area are used to describe eight implicit assumptions underlying policy, practice and scholarship on this topic. Many policies, programmes and researchers are guided by a simplistic behaviourist and health-service perspective on social controls that (a) overemphasizes the use of criminal justice systems to compel individuals into treatment and (b) fails to take into account provider, patient and public views. Policies and programmes that expand addiction treatment options deserve support. However, drawing a firm distinction between social controls (objective use of social pressure) and coercion (client perceptions and decision-making processes) supports a parallel position that rejects treatment policies, programmes, and associated practices that create client perceptions of coercion.

Cost-effectiveness analysis of 10- and 13-valent pneumococcal conjugate vaccines in Peru.

PubMed

Mezones-Holguin, Edward; Canelo-Aybar, Carlos; Clark, Andrew David; Janusz, Cara Bess; Jaúregui, Bárbara; Escobedo-Palza, Seimer; Hernandez, Adrian V; Vega-Porras, Denhiking; González, Marco; Fiestas, Fabián; Toledo, Washington; Michel, Fabiana; Suárez, Víctor J

2015-05-07

To evaluate the cost-effectiveness of introducing the 10-valent pneumococcal conjugate vaccine (PCV10) versus the 13-valent PCV (PCV13) to the National Immunization Schedule in Peru for prevention of pneumococcal disease (PD) in children <5 years of age. The integrated TRIVAC vaccine cost-effectiveness model from the Pan American Health Organization's ProVac Initiative (version 2.0) was applied from the perspective of the Government of Peru. Twenty successive cohorts of children from birth to 5 years were evaluated. Clinical outcomes were pneumococcal pneumonia (PP), pneumococcal meningitis (PM), pneumococcal sepsis (PS) and acute otitis media from any causes (AOM). Measures included prevention of cases, neurological sequelae (NS), auditory sequelae (AS), deaths and disability adjusted life years (DALYs). A sensitivity analyses was also performed. For the 20 cohorts, net costs with PCV10 and PCV13 were US$ 363.26 million and US$ 408.26 million, respectively. PCV10 prevented 570,273 AOM; 79,937 PP; 2217 PM; 3049 PS; 282 NS; 173 AS; and 7512 deaths. PCV13 prevented 419,815 AOM; 112,331 PN; 3116 PM; 4285 PS; 404 NS; 248 AS; and 10,386 deaths. Avoided DALYs were 226,370 with PCV10 and 313,119 with PCV13. Saved treatment costs were US$ 37.39 million with PCV10 and US$ 47.22 million with PCV13. Costs per DALY averted were US$ 1605 for PCV10, and US$ 1304 for PCV13. Sensitivity analyses showed similar results. PCV13 has an extended dominance over PCV10. Both pneumococcal vaccines are cost effective in the Peruvian context. Although the net cost of vaccination with PCV10 is lower, PCV13 prevented more deaths, pneumococcal complications and sequelae. Costs per each prevented DALY were lower with PCV13. Thus, PCV13 would be the preferred policy; PCV10 would also be reasonable (and cost-saving relative to the status quo) if for some reason 13-valent were not feasible. Copyright © 2015. Published by Elsevier Ltd.

77 FR 33624 - Extension of Import Restrictions Imposed on Archaeological and Ethnological Materials From Peru

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-07

... and Ethnological Materials From Peru AGENCY: U.S. Customs and Border Protection, Department of... archaeological and ethnological material from Peru. The restrictions, which were originally imposed by Treasury... with the Republic of Peru on June 9, 1997, concerning the imposition of import restrictions on pre...

78 FR 32529 - Meeting of the United States-Peru Environmental Affairs Council and Environmental Cooperation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-30

... DEPARTMENT OF STATE [Public Notice 8339] Meeting of the United States-Peru Environmental Affairs Council and Environmental Cooperation Commission ACTION: Notice of meetings of the United States-Peru... the United States and Peru intend to hold the fourth meeting of the Environmental Affairs Council (the...

[First report of alkaptonuria in Peru].

PubMed

Guillén-Mendoza, Daniel; Quiroga de Michelena, María

2014-01-01

Alkaptonuria is an inborn error of metabolism caused by deficiency of homogentisate 1,2-dioxygenase (HGD) which produces an excess of homogentisic acid (HGA). A case is presented of a 57 year old woman whose urine has turned black since birth. For 9 years she presented a greenish pigmentation in her nail beds that did not improve with antifungal treatments, and in the last 9 months she showed worsening large joint osteoarthritis. This situation forced her to use a wheelchair due to the intense pain caused by osteoarthritis in her hips and lumbar spine. From the description of symptoms, her urinary HGA was measured which confirmed the diagnosis of alkaptonuria. Analgesics and a diet without tyrosine-containing products were suggested. The patient was also referred for hip replacement surgery. This is the first reported case of alkaptonuria in Peru.

75 FR 3179 - Defense Federal Acquisition Regulation Supplement; Trade Agreements-Costa Rica and Peru (DFARS...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-20

...-AG31 Defense Federal Acquisition Regulation Supplement; Trade Agreements--Costa Rica and Peru (DFARS... respect to Costa Rica, and the United States-Peru Trade Promotion Agreement. The trade agreements waive... States Free Trade Agreement with respect to Costa Rica and the United States-Peru Trade Promotion...

[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.

Stated Preferences of Doctors for Choosing a Job in Rural Areas of Peru: A Discrete Choice Experiment

PubMed Central

Miranda, J. Jaime; Diez-Canseco, Francisco; Lema, Claudia; Lescano, Andrés G.; Lagarde, Mylene; Blaauw, Duane; Huicho, Luis

2012-01-01

Background Doctors’ scarcity in rural areas remains a serious problem in Latin America and Peru. Few studies have explored job preferences of doctors working in underserved areas. We aimed to investigate doctors’ stated preferences for rural jobs. Methods and Findings A labelled discrete choice experiment (DCE) was performed in Ayacucho, an underserved department of Peru. Preferences were assessed for three locations: rural community, Ayacucho city (Ayacucho’s capital) and other provincial capital city. Policy simulations were run to assess the effect of job attributes on uptake of a rural post. Multiple conditional logistic regressions were used to assess the relative importance of job attributes and of individual characteristics. A total of 102 doctors participated. They were five times more likely to choose a job post in Ayacucho city over a rural community (OR 4.97, 95%CI 1.2; 20.54). Salary increases and bonus points for specialization acted as incentives to choose a rural area, while increase in the number of years needed to get a permanent post acted as a disincentive. Being male and working in a hospital reduced considerably chances of choosing a rural job, while not living with a partner increased them. Policy simulations showed that a package of 75% salary increase, getting a permanent contract after two years in rural settings, and getting bonus points for further specialisation increased rural job uptake from 21% to 77%. A package of 50% salary increase plus bonus points for further specialisation would also increase the rural uptake from 21% to 52%. Conclusions Doctors are five times more likely to favour a job in urban areas over rural settings. This strong preference needs to be overcome by future policies aimed at improving the scarcity of rural doctors. Some incentives, alone or combined, seem feasible and sustainable, whilst others may pose a high fiscal burden. PMID:23272065

Peru. America = Las Americas [Series].

ERIC Educational Resources Information Center

Toro, Leonor; Doran, Sandra

Intended for elementary teachers to use with migrant students, this bilingual English/Spanish social studies resource booklet provides an encyclopedia-style overview of Peru's history, geography, economy, and culture. Topics included are the people, geographic regions, festivals and celebrations, the economy, natural resources, Lake Titicaca,…

Eugenics, medicine and psychiatry in Peru.

PubMed

Stucchi-Portocarrero, Santiago

2018-03-01

Eugenics was defined by Galton as 'the science which deals with all influences that improve the inborn qualities of a race'. In Peru, eugenics was related to social medicine and mental hygiene, in accordance with the neo-Lamarckian orientation, that predominated in Latin America. Peruvian eugenists assumed the mission of fighting hereditary and infectious diseases, malnutrition, alcoholism, drug addiction, prostitution, criminality and everything that threatened the future of the 'Peruvian race'. There were some enthusiastic advocates of 'hard' eugenic measures, such as forced sterilization and eugenic abortion, but these were never officially implemented in Peru (except for the compulsory sterilization campaign during the 1995-2000 period). Eugenics dominated scientific discourse during the first half of the twentieth century, but eugenic discourse did not disappear completely until the 1970s.

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

Association of the Endobiont Double-Stranded RNA Virus LRV1 With Treatment Failure for Human Leishmaniasis Caused by Leishmania braziliensis in Peru and Bolivia

PubMed Central

Adaui, Vanessa; Lye, Lon-Fye; Akopyants, Natalia S.; Zimic, Mirko; Llanos-Cuentas, Alejandro; Garcia, Lineth; Maes, Ilse; De Doncker, Simonne; Dobson, Deborah E.; Arevalo, Jorge; Dujardin, Jean-Claude; Beverley, Stephen M.

2016-01-01

Cutaneous and mucosal leishmaniasis, caused in South America by Leishmania braziliensis, is difficult to cure by chemotherapy (primarily pentavalent antimonials [SbV]). Treatment failure does not correlate well with resistance in vitro, and the factors responsible for treatment failure in patients are not well understood. Many isolates of L. braziliensis (>25%) contain a double-stranded RNA virus named Leishmaniavirus 1 (LRV1), which has also been reported in Leishmania guyanensis, for which an association with increased pathology, metastasis, and parasite replication was found in murine models. Here we probed the relationship of LRV1 to drug treatment success and disease in 97 L. braziliensis–infected patients from Peru and Bolivia. In vitro cultures were established, parasites were typed as L. braziliensis, and the presence of LRV1 was determined by reverse transcription–polymerase chain reaction, followed by sequence analysis. LRV1 was associated significantly with an increased risk of treatment failure (odds ratio, 3.99; P = .04). There was no significant association with intrinsic SbV resistance among parasites, suggesting that treatment failure arises from LRV1-mediated effects on host metabolism and/or parasite survival. The association of LRV1 with clinical drug treatment failure could serve to guide more-effective treatment of tegumentary disease caused by L. braziliensis. PMID:26123565

The Changing Role of International Cooperation in Developing Countries (as They Develop): A Case Study of Skills Development Policies in Peru

ERIC Educational Resources Information Center

Jaramillo, Miguel

2012-01-01

A focus on the changes in the relationship between international cooperation and local actors in the skills development field in Peru as the country strengthened its financial position in the last two decades allows us to examine the role of the economic factor in these changes. The paper argues that indeed there is an association between the two.…

76 FR 44609 - United States-Peru Trade Promotion Agreement Notice of Determination Regarding Review of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-26

... DEPARTMENT OF LABOR Office of the Secretary United States-Peru Trade Promotion Agreement Notice of... (the Labor Chapter) of the United States-Peru Trade Promotion Agreement (PTPA). The submission was... alleges the Government of Peru has violated Article 17.2 of the Labor Chapter of the PTPA by failing to...

School attributes, household characteristics, and demand for schooling: A case study of rural Peru

NASA Astrophysics Data System (ADS)

Ilon, Lynn; Moock, Peter

1991-12-01

Educational expansion, long a goal of many LDCs, has become a difficult policy to pursue. Growing populations, shrinking national incomes and higher marginal costs of schooling as schooling reaches more rural dwellers have caused policy makers to take a hard look at factors which influence educational demand and expansion. This paper examines the case of Peru where rural areas have yet to attain the nearly universal enrollment of urban areas. The study examines 2500 rural households to explore reasons why children do not attend school, drop out of school, and begin school at later ages. The study finds that the monetary costs of schools (fees and other costs) have a substantial influence on parental decisions regarding school attendance and continuation. Sensitivity analysis reveals that mother's education has a bearing on their children's educational participation, particularly in low-income households. Sensitivity analysis also reveals that school attendance of low income and female children are most strongly affected by simulated changes in school fees.

Epidemiology of Transfusion-Transmitted Infections Among Multi-Transfused Patients in Seven Hospitals in Peru

DTIC Science & Technology

2005-01-01

locate jcv Epidemiology of transfusion-transmitted infections among multi-transfused patients in seven hospitals in Peru 1 VA. Laguna-Torres a...and risk factors associated with TTIs among a sample of multi-transfused adult patients in Peru Study design: A cross- sectional multi-center study...was conducted across seven major hospitals in Peru fi’om February 2003 to September 2004 Self-reported behavior lntbrmatlon (medical procedures

Decomposing Educational Inequalities in Child Mortality: A Temporal Trend Analysis of Access to Water and Sanitation in Peru.

PubMed

Bohra, Tasneem; Benmarhnia, Tarik; McKinnon, Britt; Kaufman, Jay S

2017-01-11

Previous studies of inequality in health and mortality have largely focused on income-based inequality. Maternal education plays an important role in determining access to water and sanitation, and inequalities in child mortality arising due to differential access, especially in low- and middle-income countries such as Peru. This article aims to explain education-related inequalities in child mortality in Peru using a regression-based decomposition of the concentration index of child mortality. The analysis combines a concentration index created along a cumulative distribution of the Demographic and Health Surveys sample ranked according to maternal education, and decomposition measures the contribution of water and sanitation to educational inequalities in child mortality. We observed a large education-related inequality in child mortality and access to water and sanitation. There is a need for programs and policies in child health to focus on ensuring equity and to consider the educational stratification of the population to target the most disadvantaged segments of the population. © The American Society of Tropical Medicine and Hygiene.

DoD Global Emerging Infections System Annual Report, Fiscal Year 1999

DTIC Science & Technology

1999-01-01

findings provided the impetus to the government of Peru to change national drug policy regarding treatment of malaria in the Peruvian Amazon . As soon as...feasible, a 13 14 Malaria Emerges in the Amazon Basin of Peru (Department of Loreto) 1992-1997 During the last 10-15 years, malaria has emerged as a major...public health problem in the Amazon basin of South America. In Peru the total number of malaria cases reported annually from the Peruvian Amazon

Cost-effectiveness of norovirus vaccination in children in Peru.

PubMed

Mirelman, Andrew J; Ballard, Sarah Blythe; Saito, Mayuko; Kosek, Margaret N; Gilman, Robert H

2015-06-17

With candidate norovirus (NV) vaccines in a rapid phase of development, assessment of the potential economic value of vaccine implementation will be necessary to aid health officials in vaccine implementation decisions. To date, no evaluations have been performed to evaluate the benefit of adopting NV vaccines for use in the childhood immunization programs of low- and middle-income countries. We used a Markov decision model to evaluate the cost-effectiveness of adding a two-dose NV vaccine to Peru's routine childhood immunization schedule using two recent estimates of NV incidence, one for a peri-urban region and one for a jungle region of the country. Using the peri-urban NV incidence estimate, the annual cost of vaccination would be $13.0 million, offset by $2.6 million in treatment savings. Overall, this would result in 473 total DALYs averted; 526,245 diarrhea cases averted;153,735 outpatient visits averted; and 414 hospitalizations averted between birth and the fifth year of life. The incremental cost-effectiveness ratio would be $21,415 per DALY averted; $19.86 per diarrhea case; $68.23 per outpatient visit; and $26,298 per hospitalization. Using the higher jungle NV incidence rates provided a lower cost per DALY of $10,135. The incremental cost per DALY with per-urban NV incidence is greater than three times the 2012 GDP per capita of Peru but the estimate drops below this threshold using the incidence from the jungle setting. In addition to the impact of incidence, sensitivity analysis showed that vaccine price and efficacy play a strong role in determining the level of cost-effectiveness. The introduction of a NV vaccine would prevent many healthcare outcomes in the Peru and potentially be cost-effective in scenarios with high NV incidence. The vaccine cost-effectiveness model could also be applied to the evaluation of NV vaccine cost-effectiveness in other countries. In resource-poor settings, where NV incidence rates are expected to be higher. Published

Contribution to the Uropodina mites of Peru (Acari: Mesostigmata).

PubMed

Kontschán, Jenő; Friedrich, Stefan

2017-02-27

Soil dwelling Uropodina mites were collected from a primary lowland rainforest in Amazonian Peru. The species found belong to three different families. A new diagnosis and the type genus of Tetrasejaspidae fam. nov. are given, and the family is recorded from Peru for the first time on the basis of Tetrasejaspis sellnicki Hirschmann, 1973. Two rotundabaloghid mites were collected (Rotundabaloghia (Circobaloghia) magna Hirschmann, 1992 and Rotundabaloghia (Circobaloghia) iquitosensis Hirschmann, 1992), both already reported from Peru. A new species (Origmatrachys peruensis sp. nov.) from the family Trachyuropodidae was collected in large numbers from soil, and is described on the basis of females, males, nymphs and larvae. This is the first description of the protonymphs and larvae of Origmatrachys. The new species differs from the previously described ones in the basis of sculptural pattern of dorsal, ventral, sternal shields and the length of the setae in the central part of the dorsal shield. A new key to the known adults and deutonymphs of Origmatrachys is given.

Rickettsia asembonensis Characterization by Multilocus Sequence Typing of Complete Genes, Peru.

PubMed

Loyola, Steev; Flores-Mendoza, Carmen; Torre, Armando; Kocher, Claudine; Melendrez, Melanie; Luce-Fedrow, Alison; Maina, Alice N; Richards, Allen L; Leguia, Mariana

2018-05-01

While studying rickettsial infections in Peru, we detected Rickettsia asembonensis in fleas from domestic animals. We characterized 5 complete genomic regions (17kDa, gltA, ompA, ompB, and sca4) and conducted multilocus sequence typing and phylogenetic analyses. The molecular isolate from Peru is distinct from the original R. asembonensis strain from Kenya.

Nutritional Transition in Children under Five Years and Women of Reproductive Age: A 15-Years Trend Analysis in Peru

PubMed Central

Loret de Mola, Christian; Quispe, Renato; Valle, Giancarlo A.; Poterico, Julio A.

2014-01-01

Background Rapid urbanization, increase in food availability, and changes in diet and lifestyle patterns have been changing nutritional profiles in developing nations. We aimed to describe nutritional changes in children under 5 years and women of reproductive age in Peru, during a 15-year period of rapid economic development and social policy enhancement. Materials and Methods Trend analyses of anthropometric measures in children of preschool age and women between 15–49 years, using the Peruvian National Demographic and Family Health Surveys (DHS) from 1996 to 2011. WHO growth curves were used to define stunting, underweight, wasting and overweight in children <5y. We employed the WHO BMI-age standardized curves for teenagers between 15–19y. In women >19 years, body mass index (BMI) was analyzed both categorically and as a continuous variable. To statistically analyze the trends, we used regression models: Linear and Poisson for continuous and binary outcomes, respectively. Results We analyzed data from 123 642 women and 64 135 children, from 1996 to 2011. Decreases over time were evidenced for underweight (p<0.001), wasting (p<0.001), and stunting (p<0.001) in children under 5y. This effect was particularly noted in urban settings. Overweight levels in children reduced (p<0.001), however this reduction stopped, in urban settings, since 2005 (∼12%). Anemia decreased in children and women (p<0.001); with higher reduction in urban (↓43%) than in rural children (↓24%). BMI in women aged 15–19 years increased (p<0.001) across time, with noticeable BMI-curve shift in women older than 30 years. Moreover, obesity doubled during this period in women more than 19y. Conclusion Nutrition transition in Peru shows different patterns for urban and rural populations. Public policies should emphasize targeting both malnutrition conditions—undernutrition/stunting, overweight/obesity and anemia—considering age and place of residence in rapid developing societies

Pastoralism in the drylands of Latin America: Argentina, Chile, Mexico and Peru.

PubMed

Grünwaldt, J M; Castellaro, G; Flores, E R; Morales-Nieto, C R; Valdez-Cepeda, R D; Guevera, J C; Grünwaldt, E G

2016-11-01

This article discusses various aspects of pastoralism in the Latin American countries with the largest dryland areas. The topics covered include: social, economic and institutional issues; grasslands and their carrying capacity; production systems and productivity rates; competition for forage resources between domestic livestock and wildlife; and the health status of livestock and wildlife. Most grasslands exhibit some degree of degradation. The percentage of offspring reaching weaning age is low: 47-66% of calves and 40-80% of lambs. Some pastoralists adopt patterns of transhumance. In the main, pastoralists experience a high poverty rate and have poor access to social services. For many pastoralists, wildlife is a source of food and by-products. Argentina, Chile, Mexico and Peru have animal health control agencies, are members of the World Organisation for Animal Health (OIE) and have signed the United Nations Convention to Combat Desertification. Pastoral systems subsist mainly on income unrelated to pastoral farming. The OIE recognises all four countries as free from infection with peste des petits ruminants virus, and from rinderpest and African horse sickness. It is difficult to predict the future of pastoralism in Latin America because the situation differs from country to country. For instance, pastoralism is more important in Peru than in Argentina, where it is a more marginal activity. In the future, lack of promotion and protection policies could lead to a decline in pastoralism or to an adverse environmental impact on drylands.

Feasibility and cost-effectiveness of standardised second-line drug treatment for chronic tuberculosis patients: a national cohort study in Peru.

PubMed

Suárez, Pedro G; Floyd, Katherine; Portocarrero, Jaime; Alarcón, Edith; Rapiti, Elisabetta; Ramos, Gilbert; Bonilla, Cesar; Sabogal, Ivan; Aranda, Isabel; Dye, Christopher; Raviglione, Mario; Espinal, Marcos A

2002-06-08

There are no data on the feasibility and cost-effectiveness of using second-line drugs to treat patients with chronic tuberculosis, many of whom are infected with multidrug resistant (MDR) strains of Mycobacterium tuberculosis, in low or middle-income countries. A national programme to treat chronic tuberculosis patients with a directly observed standardised 18-month daily regimen, consisting of kanamycin (3 months only), ciprofloxacin, ethionamide, pyrazinamide, and ethambutol, was established in Peru in 1997. Compliance and treatment outcomes were analysed for the cohort started on treatment between October, 1997, and March, 1999. Total and average costs were assessed. Cost-effectiveness was estimated as the cost per DALY gained. 466 patients were enrolled; 344 were tested for drug susceptibility and 298 (87%) had MDR tuberculosis. 225 patients (48%) were cured, 57 (12%) died, 131 (28%) did not respond to treatment, and 53 (11%) defaulted. Of the 413 (89%) patients who complied with treatment, 225 (55%) were cured. Among MDR patients, resistance to five or more drugs was significantly associated with an unfavourable outcome (death, non-response to treatment, or default; odds ratio 3.37, 95% CI 1.32-8.60; p=0.01). The programme cost US $0.6 million per year, 8% of the National Tuberculosis Programme budget, and US $2381 per patient for those who completed treatment. The mean cost per DALY gained was $211 ($165 at drug prices projected for 2002). Treating chronic tuberculosis patients with high levels of MDR with second-line drugs can be feasible and cost-effective in middle-income countries, provided a strong tuberculosis control programme is in place.

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.

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

Smoothing the way to opportunity in Peru.

PubMed

Valdivia, B

1999-11-01

Since 1990, poor women in Peru have suffered from the impact of structural adjustment policies, which have lead to low wages, poor working conditions, and a general deterioration in the status of women workers. To address these problems, the Asociacion Aurora Vivar began its Alternative Technical Training Program for Women in July 1992, with the aim of increasing the entrepreneurial skills of women. The project aimed to support women who have problems at work, those who are unemployed and those with low income. Moreover, the project sought to increase women's participation in nontraditional areas of work. Training focused on increasing women's technical skills, including the repair of home appliances, and on personal development, such as leadership skills, confidence building, and business management. The project attracted a diverse group of women who took part in the training for a variety of reasons. The women's new capacities and skills create a positive image for them within the household. Aurora Vivar acknowledges the importance of vocational education to increase women's opportunities to earn a living. The association is proposing reforms in the educational system to introduce courses on business management, credit, and other technical skills as part of the formal education system.

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

Traditional medicinal plant use in Northern Peru: tracking two thousand years of healing culture

PubMed Central

Bussmann, Rainer W; Sharon, Douglas

2006-01-01

This paper examines the traditional use of medicinal plants in Northern Peru, with special focus on the Departments of Piura, Lambayeque, La Libertad, Cajamarca, and San Martin. Northern Peru represents the center of the old Central Andean "Health Axis," stretching from Ecuador to Bolivia. The roots of traditional healing practices in this region go at least as far back as the Moche period (AC 100–800). Although about 50% of the plants in use reported in the colonial period have disappeared from the popular pharmacopoeia, the plant knowledge of the population is much more extensive than in other parts of the Andean region. 510 plant species used for medicinal purposes were collected, identified and their vernacular names, traditional uses and applications recorded. The families best represented were Asteraceae with 69 species, Fabaceae (35), Lamiaceae (25), and Solanaceae (21). Euphorbiaceae had twelve species, and Apiaceae and Poaceae 11 species. The highest number of species was used for the treatment of "magical/ritual" ailments (207 species), followed by respiratory disorders (95), problems of the urinary tract (85), infections of female organs (66), liver ailments (61), inflammations (59), stomach problems (51) and rheumatism (45). Most of the plants used (83%) were native to Peru. Fresh plants, often collected wild, were used in two thirds of all cases, and the most common applications included the ingestion of herb decoctions or the application of plant material as poultices. PMID:17090303

ENSO impact on hydrology in Peru

NASA Astrophysics Data System (ADS)

Lavado-Casimiro, W. S.; Felipe, O.; Silvestre, E.; Bourrel, L.

2013-04-01

The El Niño and La Niña impacts on the hydrology of Peru were assessed based on discharge data (1968-2006) of 20 river catchments distributed over three drainage regions in Peru: 14 in the Pacific Coast (PC), 3 in the Lake Titicaca (TL) region, and 3 in the Amazonas (AM). To classify the El Niño and La Niña events, we used the Southern Oscillation Index (SOI) based on hydrological years (September to August). Using the SOI values, the events were re-classified as strong El Niño (SEN), moderate El Niño (MEN), normal years (N), moderate La Niña (MLN) and strong La Niña (SLN). On average during the SEN years, sharp increases occurred in the discharges in the north central area of the PC and decreases in the remaining discharge stations that were analyzed, while in the years of MEN events, these changes show different responses than those of the SEN. During the years classified as La Niña, positive changes are mostly observed in the majority of the stations in the rivers located in the center of Peru's Pacific Coast. Another important result of this work is that the Ilave River (south of the Titicaca watershed) shows higher positive (negative) impacts during La Niña (El Niño) years, a fact that is not clearly seen in the rivers of the northern part of the Titicaca watershed (Ramis and Huancane rivers).

Diagnostics barriers and innovations in rural areas: insights from junior medical doctors on the frontlines of rural care in Peru.

PubMed

Anticona Huaynate, Cynthia Fiorella; Pajuelo Travezaño, Monica Jehnny; Correa, Malena; Mayta Malpartida, Holger; Oberhelman, Richard; Murphy, Laura L; Paz-Soldan, Valerie A

2015-10-05

Worldwide, rural communities face barriers when accessing health services. In response, numerous initiatives have focused on fostering technological innovations, new management approaches and health policies. Research suggests that the most successful innovations are those involving stakeholders at all levels. However, there is little evidence exploring the opinions of local health providers that could contribute with further innovation development and research. The aims of this study were to explore the perspectives of medical doctors (MDs) working in rural areas of Peru, regarding the barriers impacting the diagnostic process, and ideas for diagnostic innovations that could assist them. Data gathered through three focus group discussions (FGG) and 18 individual semi-structured interviews (SSI) with MDs who had completed their medical service in rural areas of Peru in the last two years were analyzed using thematic analysis. Three types of barriers emerged. The first barrier was the limited access to point of care (POC) diagnostic tools. Tests were needed for: i) the differential diagnosis of malaria vs. pneumonia, ii) dengue vs. leptospirosis, iii) tuberculosis, iv) vaginal infections and cervical cancer, v) neurocysticercosis, and vi) heavy metal toxicity. Ultrasound was needed for the diagnosis of obstetric and intra-abdominal conditions. There were also health system-related barriers such as limited funding for diagnostic services, shortage of specialists, limited laboratory services and access to telecommunications, and lack of institutional support. Finally, the third type of barriers included patient related-barriers to follow through with diagnostic referrals. Ideas for innovations proposed included POC equipment and tests, and telemedicine. MDs at primary health facilities in rural Peru face diagnostic challenges that are difficult to overcome due to a limited access to diagnostic tools. Referrals to specialized facilities are constrained by deficiencies

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

Emerging and reemerging arboviruses: A new threat in Eastern Peru.

PubMed

Alva-Urcia, Carlos; Aguilar-Luis, Miguel Angel; Palomares-Reyes, Carlos; Silva-Caso, Wilmer; Suarez-Ognio, Luis; Weilg, Pablo; Manrique, Carlos; Vasquez-Achaya, Fernando; Del Valle, Luis J; Del Valle-Mendoza, Juana

2017-01-01

Arboviral diseases are one of the most common causes of acute febrile illness (AFI) and a significant health problem in South America. In Peru, laboratory etiologic identification of these infections occurs in less than 50% of cases, leading to underdiagnoses of important emerging arboviruses. To assess the prevalence of the Dengue (DENV), Oropouche (OROV), Chikungunya (CHIKV), Mayaro (MAYV) and Zika (ZIKV) viruses in patients with acute febrile illness from Puerto Maldonado (Peru). Serum samples were obtained from patients with AFI during January 2016 to March 2016. A total of 139 specimens were analyzed for the presence of DENV, OROV, CHIKV, MAYV, and ZIKV using polymerase chain reaction (PCR). CHIKV in 9.4% and OROV in 8.6% were the most prevalent arboviruses, followed by DENV and ZIKV, with a prevalence of 6.5% and 5%, respectively. Among all patients, the most common symptoms accompanying fever were headaches 79.9%, muscle pain 65.5% and joint pain 63.3%. During this short 3-month period, 4 arboviruses were detected by PCR, CHIKV and OROV being the most common arboviruses in Puerto Maldonado (Peru). Thus, it is crucial to include OROV detection in the national health surveillance. Furthermore, the etiologic clinical diagnosis of arboviral infections is not possible due to the low specificity of symptoms; therefore an increase of cases confirmed by molecular diagnostic methods will enhance arboviral surveillance in Peru.

Itaya virus, a Novel Orthobunyavirus Associated with Human Febrile Illness, Peru.

PubMed

Hontz, Robert D; Guevara, Carolina; Halsey, Eric S; Silvas, Jesus; Santiago, Felix W; Widen, Steven G; Wood, Thomas G; Casanova, Wilma; Vasilakis, Nikos; Watts, Douglas M; Kochel, Tadeusz J; Ebihara, Hideki; Aguilar, Patricia V

2015-05-01

Our genetic analyses of uncharacterized bunyaviruses isolated in Peru identified a possible reassortant virus containing small and large gene segment sequences closely related to the Caraparu virus and a medium gene segment sequence potentially derived from an unidentified group C orthobunyavirus. Neutralization tests confirmed serologic distinction among the newly identified virus and the prototype and Caraparu strains. This virus, named Itaya, was isolated in 1999 and 2006 from febrile patients in the cities of Iquitos and Yurimaguas in Peru. The geographic distance between the 2 cases suggests that the Itaya virus could be widely distributed throughout the Amazon basin in northeastern Peru. Identification of a new Orthobunyavirus species that causes febrile disease in humans reinforces the need to expand viral disease surveillance in tropical regions of South America.

Itaya virus, a Novel Orthobunyavirus Associated with Human Febrile Illness, Peru

PubMed Central

Hontz, Robert D.; Guevara, Carolina; Halsey, Eric S.; Silvas, Jesus; Santiago, Felix W.; Widen, Steven G.; Wood, Thomas G.; Casanova, Wilma; Vasilakis, Nikos; Watts, Douglas M.; Kochel, Tadeusz J.; Ebihara, Hideki

2015-01-01

Our genetic analyses of uncharacterized bunyaviruses isolated in Peru identified a possible reassortant virus containing small and large gene segment sequences closely related to the Caraparu virus and a medium gene segment sequence potentially derived from an unidentified group C orthobunyavirus. Neutralization tests confirmed serologic distinction among the newly identified virus and the prototype and Caraparu strains. This virus, named Itaya, was isolated in 1999 and 2006 from febrile patients in the cities of Iquitos and Yurimaguas in Peru. The geographic distance between the 2 cases suggests that the Itaya virus could be widely distributed throughout the Amazon basin in northeastern Peru. Identification of a new Orthobunyavirus species that causes febrile disease in humans reinforces the need to expand viral disease surveillance in tropical regions of South America. PMID:25898901

Sermons, Carrots or Sticks? Explaining Successful Policy Implementation in a Low Performance Institution

ERIC Educational Resources Information Center

Salazar-Morales, Diego Alonso

2018-01-01

This article explains how after 43 years of unsatisfactory outcomes, the Ministry of Education of Peru (MoE) suddenly ranked at the top of governmental performance tables. To do so, this study relies on implementation and major discussions of policy instrument theories to provide a comprehensive explanation of the reasons underlying the MoE's…

[Nursing performance in the policy transfer of directly observed treatment of tuberculosis].

PubMed

Souza, Káren Mendes Jorge de; Sá, Lenilde Duarte de; Silva, Laís Mara Caetano da; Palha, Pedro Fredemir

2014-10-01

Analyzing the policy transfer of directly observed treatment of tuberculosis from the perspective of nursing. This is a descriptive study with qualitative approach, which had 10 nurses of the Family Health Strategy in São Paulo as subjects. The interviews were carried out between May and June 2013, and were adopted the technique of thematic content analysis and the referential of policy transfer. On the signification of this treatment, are related the senses of disciplinary monitoring, the bond and approximation to the context of patients' lives. Operationally, nurses, community health agents and nursing technicians stand out as agents of implementation of this policy, developing multiple actions of user embracement. The nurse is evidenced as an educator in health, leader in the family health team, and capable of creating emotional bond with users. It was found that the innovations proposed in the treatment are incipient in the daily work of nurses.

HIV self-testing in Peru: questionable availability, high acceptability but potential low linkage to care among men who have sex with men and transgender women.

PubMed

Bustamante, Maria Jose; Konda, Kelika A; Joseph Davey, Dvora; León, Segundo R; Calvo, Gino M; Salvatierra, Javier; Brown, Brandon; Caceres, Carlos F; Klausner, Jeffrey D

2017-02-01

HIV status awareness is key to prevention, linkage-to-care and treatment. Our study evaluated the accessibility and potential willingness of HIV self-testing among men who have sex with men (MSM) and transgender women in Peru. We surveyed four pharmacy chains in Peru to ascertain the commercial availability of the oral HIV self-test. The pharmacies surveyed confirmed that HIV self-test kits were available; however, those available were not intended for individual use, but for clinician use. We interviewed 147 MSM and 45 transgender women; nearly all (82%) reported willingness to perform the oral HIV self-test. However, only 55% of participants would definitely seek a confirmatory test in a clinic after an HIV-positive test result. Further, price may be a barrier, as HIV self-test kits were available for 18 USD, and MSM and transgender women were only willing to pay an average of 5 USD. HIV self-testing may facilitate increased access to HIV testing among some MSM/transgender women in Peru. However, price may prevent use, and poor uptake of confirmatory testing may limit linkage to HIV treatment and care.

[Third preparatory committee for the International Conference on Population and Development. Peru presentation].

PubMed

Lopez, C

1994-01-01

This address by the Peruvian delegation to the Third Preparatory Committee Meeting for the International Conference on Population and Development focuses on four points in the proposed Plan of Action that might require further development. First, the link between drug trafficking and environmental degradation should be recognized. Cultivation of narcotic plants contributes to deforestation of the tropical forest and contamination of rivers, and along with terrorism has caused considerable population movement in Peru. The second point is that widespread poverty, limited investment in human capital, insufficient institutional capacity, and the external debt burden of the developing countries are clearly interrelated with sociodemographic processes and decisively affect the capacity of the nation to implement population policies and programs as a function of current and future international commitments. The third point is that, in the area of information, education, and communication, attention should be given to the entire life cycle and the entirety of themes related to population. Finally, coordinated programs between public and private institutions and nongovernmental organizations at the national level, and between the U.N. Population Fund, the Population Commission, and the Commission on Sustainable Development at the international level, should be organized to assure effective follow-up on Plan of Action proposals and agreements. Peru has participated in a wide variety of international conferences and activities related to population, and was a major participant in the subregional preparatory conference of the Andean nations.

An Ectopic Case of Tunga spp. Infection in Peru

PubMed Central

Maco, Vicente; Maco, Vicente P.; Gotuzzo, Eduardo

2010-01-01

Tungiasis is a neglected ectoparasitism of impoverished areas in South America and sub-Saharan Africa. The sand flea Tunga spp. preferably infests the soles and the periungueal and interdigital regions of the feet. Ectopic tungiasis is rare, even in highly endemic areas. We describe a case of an indigenous patient in Peru who presented with a nodular lesion in the extensor aspect of the knee and whose biopsy was compatible with Tunga spp. This is the first documented case of knee tungiasis in an endemic country. The historical, clinical, histological, and current epidemiological aspects of tungiasis in Peru are discussed here. PMID:20519602

A new species of Eumops (Chiroptera: Molossidae) from southwestern Peru.

PubMed

Medina, César E; Gregorin, Renato; Zeballos, Horacio; Zamora, Hugo T; Moras, Ligiane M

2014-10-22

The genus Eumops is the most diverse genera of molossid bats in the Neotropics. In Peru this genus is widely distributed and represented by nine species: E. auripendulus, E. delticus, E. hansae, E. maurus, E. nanus, E. patagonicus, E. perotis, E. trumbulli, and E. wilsoni. After several years of mammalian diversity surveys in the coastal desert and western slopes of southwestern Peru, a specimen of Eumops was collected whose unique set of traits allows us to assert that deserves to be described as a new species. Based on molecular and morphological evidence, the new species is related to medium-large sized species (i.e. E. glaucinus, E. auripendulus, and E. perotis). Cytochrome b genetic divergence between the new species and the other species of the genus was high (> 12%) and it is consistent with morphological divergence presented for this new species. This new species, endemic to Peru, increases the diversity of Eumops to 16 species.

Shadows of the colonial past--diverging plant use in Northern Peru and Southern Ecuador.

PubMed

Bussmann, Rainer W; Sharon, Douglas

2009-02-02

This paper examines the traditional use of medicinal plants in Northern Peru and Southern Ecuador, with special focus on the Departments of Piura, Lambayeque, La Libertad, Cajamarca, and San Martin, and in Loja province, with special focus on the development since the early colonial period. Northern Peru represents the locus of the old Central Andean "Health Axis." The roots of traditional healing practices in this region go as far back as the Cupisnique culture early in the first millennium BC. Northern Peru and Southern Ecuador share the same cultural context and flora but show striking differences in plant use and traditional knowledge. Two hundred fifteen plant species used for medicinal purposes in Ecuador and 510 plant species used for medicinal purposes in Peru were collected, identified,. and their vernacular names, traditional uses, and applications recorded. This number of species indicates that the healers, market vendors, and members of the public interviewed in Peru still have a very high knowledge of plants in their surroundings, which can be seen as a reflection of the knowledge of the population in general. In Ecuador much of the original plant knowledge has already been lost. In Peru, 433 (85%) were Dicotyledons, 46 (9%) Monocotyledons, 21 (4%) Pteridophytes, and 5 (1%) Gymnosperms. Three species of Giartina (Algae) and one species of the Lichen genus Siphula were used. The families best represented were Asteraceae with 69 species, Fabaceae (35), Lamiaceae (25), and Solanaceae (21). Euphorbiaceae had 12 species, and Poaceae and Apiaceae each accounted for 11 species. In Ecuador the families best represented were Asteraceae (32 species), Euphorbiaceae, Lamiaceae, and Solanaceae (11 species each), and Apiaceae, Fabaceae, Lycopodiaceae (9 species each). One hundred eighty-two (85%) of the species used were Dicotyledons, 20 Monocotyledons (9.3%), 12 ferns (5.5%), and one unidentified lichen was used. Most of the plants used (83%) were native to Peru

Molecular Epidemiology and Genetic Variation of Pathogenic Vibrio parahaemolyticus in Peru

PubMed Central

Gavilan, Ronnie G.; Zamudio, Maria L.; Martinez-Urtaza, Jaime

2013-01-01

Vibrio parahaemolyticus is a foodborne pathogen that has become a public health concern at the global scale. The epidemiological significance of V. parahaemolyticus infections in Latin America received little attention until the winter of 1997 when cases related to the pandemic clone were detected in the region, changing the epidemic dynamics of this pathogen in Peru. With the aim to assess the impact of the arrival of the pandemic clone on local populations of pathogenic V. parahaemolyticus in Peru, we investigated the population genetics and genomic variation in a complete collection of non-pandemic strains recovered from clinical sources in Peru during the pre- and post-emergence periods of the pandemic clone. A total of 56 clinical strains isolated in Peru during the period 1994 to 2007, 13 strains from Chile and 20 strains from Asia were characterized by Multilocus Sequence Typing (MLST) and checked for the presence of Variable Genomic Regions (VGRs). The emergence of O3:K6 cases in Peru implied a drastic disruption of the seasonal dynamics of infections and a shift in the serotype dominance of pathogenic V. parahaemolyticus. After the arrival of the pandemic clone, a great diversity of serovars not previously reported was detected in the country, which supports the introduction of additional populations cohabitating with the pandemic group. Moreover, the presence of genomic regions characteristic of the pandemic clone in other non-pandemic strains may represent early evidence of genetic transfer from the introduced population to the local communities. Finally, the results of this study stress the importance of population admixture, horizontal genetic transfer and homologous recombination as major events shaping the structure and diversity of pathogenic V. parahaemolyticus. PMID:23696906

Adenovirus Respiratory Tract Infections in Peru

PubMed Central

Ampuero, Julia S.; Ocaña, Víctor; Gómez, Jorge; Gamero, María E.; Garcia, Josefina; Halsey, Eric S.; Laguna-Torres, V. Alberto

2012-01-01

Background Currently, there is a paucity of data regarding human adenovirus (HAdv) circulation in Andean regions of South America. To address this shortcoming, we report the clinical, phylogenetic, and epidemiologic characteristics of HAdv respiratory tract infection from a large sentinel surveillance study conducted among adults and children in Peru. Methods/Principal Findings Oropharyngeal swabs were collected from participants visiting any of 38 participating health centers, and viral pathogens were identified by immunofluorescence assay in cell culture. In addition, molecular characterization was performed on 226 randomly selected HAdv samples. Between 2000 and 2010, a total of 26,375 participants with influenza-like illness (ILI) or severe acute respiratory infection (SARI) were enrolled in the study. HAdv infection was identified in 2.5% of cases and represented 6.2% of all viral pathogens. Co-infection with a heterologous virus was found in 15.5% of HAdv cases. HAdv infection was largely confined to children under the age of 15, representing 88.6% of HAdv cases identified. No clinical characteristics were found to significantly distinguish HAdv infection from other respiratory viruses. Geographically, HAdv infections were more common in sites from the arid coastal regions than in the jungle or highland regions. Co-circulation of subgroups B and C was observed each year between 2006 and 2010, but no clear seasonal patterns of transmission were detected. Conclusions/Significance HAdv accounted for a significant fraction of those presenting with ILI and SARI in Peru and tended to affect the younger population disproportionately. Longitudinal studies will help better characterize the clinical course of patients with HAdv in Peru, as well as determine the role of co-infections in the evolution of illness. PMID:23056519

Diagnostic overview of the illegal trade in primates and law enforcement in Peru.

PubMed

Shanee, Noga; Mendoza, A Patricia; Shanee, Sam

2017-11-01

Peru has one of the richest primate faunas of any country. The illegal trade in wild primates is one of the largest threats to this fauna in Peru. We characterize the illegal trade in primates through empirical and ethnographic data. We collected data from traffic routes and centers throughout Peru and evaluate current efforts to combat this traffic. Based on our findings from 2,070 instances of wildlife crime involving 6,872 primates, we estimate the domestic trade in primates for pets and bushmeat in Peru in the hundreds of thousands per year, with the larger bodied Atelidae facing the highest direct consequences. We found that government authorities lack sufficient staff, capacity, resources, infrastructure, and protocols to efficiently combat illegal trade in primates. Also, the complicated legal framework and lack of cooperation and antagonism with the public further limit these efforts. Wildlife authorities in Peru are able to confiscate only a fraction of primates traded and mostly intervene in cases of private pet owners rather than traffickers. We estimate that the current rate of illegal trade in primates is comparable to levels of trade prior to the 1973 ban on primates' exportation. The combination of direct observations on primate trade and ethnographic data allows a comprehensive look at primate trade in Peru. We call upon decision makers and international funders to channel their efforts toward "on the ground" actions such as increasing the ability of the authorities to act, giving them "in action" training in law enforcement and establishing strict control measures against corruption. Am. J. Primatol. 79:e22516, 2017. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

[Policy dilemmas in providing antiretroviral treatment in Brazil].

PubMed

do Lago, Regina Ferro; Costa, Nilson do Rosário

2010-11-01

This paper addresses institutional constraints that have affected Brazilian politics regarding provision of anti-retroviral treatment (ART) to HIV/Aids patients. We analyzed the normative conflict resulting from international agreements on intellectual property rights, especially patent protection, and the constitutional rights of Brazilian patients to universal and free access to ART. These constraints have not substantially changed the Brazilian public policy yet, but they may impact the future sustainability of this policy. As the main barrier to the production of patented drugs is not technological but institutional, Brazilian government faces a dilemma. It may either abide by existing monopolistic restrictions or it may incite competitiveness of domestic industries and developing countries in the pharmaceutical market.

Astrology in seventeenth-century Peru.

PubMed

Brosseder, Claudia

2010-06-01

This article discusses three aspects of the history of astrology in seventeenth-century Peru that are of larger interest for the history of science in Latin America: Creole concerns about indigenous idolatry, the impact of the Inquisition on natural philosophy, and communication between scholars within the Spanish colonies and the transatlantic world. Drawing mainly on the scholars Antonio de la Calancha, Juan de Figueroa, and Ruiz de Lozano, along with several Jesuits, the article analyzes how natural and medical astrology took shape in Peru and how they fostered astronomical investigations of the southern skies. While natural and medical astrology, showing New and Old World influences, oscillated between orthodoxy and heterodoxy, and between scholasticism and new science, judicial astrology remained undeveloped. Toward the end of the seventeenth century the discourse about astrology took an unexpected turn, reflecting a newly invigorated moral and Christian reading of the heavens that was in part a response to a deep-rooted dissatisfaction with the failure of the extirpation of idolatry campaigns. Inscribing divine and cardinal virtues, the Virgin Mary, Christian saints, and Greco-Roman allegories into the heavens was considered a way to finally solve the problem of idolatry and to convey Creole greatness.

Language Policy: Status Planning for the Quechua Language in Peru.

ERIC Educational Resources Information Center

Coronel-Molina, Serafin

1997-01-01

The status of Quechua in Peruvian society is discussed, noting specific social and political factors contributing to the dying out of the Quechua language, functional domains the language serves, and possible measures to improve its status. The relationship of those functional domains to Peruvian language policies is also explored. An introductory…

Association of the Endobiont Double-Stranded RNA Virus LRV1 With Treatment Failure for Human Leishmaniasis Caused by Leishmania braziliensis in Peru and Bolivia.

PubMed

Adaui, Vanessa; Lye, Lon-Fye; Akopyants, Natalia S; Zimic, Mirko; Llanos-Cuentas, Alejandro; Garcia, Lineth; Maes, Ilse; De Doncker, Simonne; Dobson, Deborah E; Arevalo, Jorge; Dujardin, Jean-Claude; Beverley, Stephen M

2016-01-01

Cutaneous and mucosal leishmaniasis, caused in South America by Leishmania braziliensis, is difficult to cure by chemotherapy (primarily pentavalent antimonials [Sb(V)]). Treatment failure does not correlate well with resistance in vitro, and the factors responsible for treatment failure in patients are not well understood. Many isolates of L. braziliensis (>25%) contain a double-stranded RNA virus named Leishmaniavirus 1 (LRV1), which has also been reported in Leishmania guyanensis, for which an association with increased pathology, metastasis, and parasite replication was found in murine models. Here we probed the relationship of LRV1 to drug treatment success and disease in 97 L. braziliensis-infected patients from Peru and Bolivia. In vitro cultures were established, parasites were typed as L. braziliensis, and the presence of LRV1 was determined by reverse transcription-polymerase chain reaction, followed by sequence analysis. LRV1 was associated significantly with an increased risk of treatment failure (odds ratio, 3.99; P = .04). There was no significant association with intrinsic Sb(V) resistance among parasites, suggesting that treatment failure arises from LRV1-mediated effects on host metabolism and/or parasite survival. The association of LRV1 with clinical drug treatment failure could serve to guide more-effective treatment of tegumentary disease caused by L. braziliensis. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Molecular epidemiology of American/Asian genotype DENV-2 in Peru.

PubMed

Cruz, Cristhopher D; Forshey, Brett M; Juarez, Diana S; Guevara, Carolina; Leguia, Mariana; Kochel, Tadeusz J; Halsey, Eric S

2013-08-01

During the past decade, countries in South America have reported dengue hemorrhagic fever (DHF) associated with American/Asian genotype of dengue virus serotype 2 (DENV-2). DENV-2 strains have been associated with large outbreaks of dengue fever and DHF in numerous regions of Peru since the mid-1990s, but studies to address the origins, distribution, and genetic diversity of DENV-2 strains have been limited. To address this knowledge gap, we sequenced the envelope gene region of DENV-2 isolates from Peru, Ecuador, Paraguay, and Bolivia. Sequences were aligned and compared to a global sample of DENV-2 viruses. Phylogenetic analysis confirmed the circulation of two DENV-2 genotypes in Peru: American (prior to 2001) and American/Asian (2000 to present). American/Asian genotype variants can be classified into two lineages, and these were introduced into Peru from the north (Ecuador, Colombia, and/or Venezuela) and the east (Brazil and Bolivia). American/Asian lineage II replaced lineage I after 2009. We estimate the time to the most recent common ancestor for American/Asian DENV-2 genotype in the Americas was in 1980, and 1984 and 1989 for lineages I and II, respectively. In light of evidence for increased virulence of lineage II of American/Asian DENV-2, our results support the need for continuous monitoring for the emergence of new DENV genotypes that may be associated with severe disease. Copyright © 2013. Published by Elsevier B.V.

Emerging and reemerging arboviruses: A new threat in Eastern Peru

PubMed Central

Palomares-Reyes, Carlos; Silva-Caso, Wilmer; Suarez-Ognio, Luis; Weilg, Pablo; Manrique, Carlos; Vasquez-Achaya, Fernando; del Valle, Luis J.

2017-01-01

Background Arboviral diseases are one of the most common causes of acute febrile illness (AFI) and a significant health problem in South America. In Peru, laboratory etiologic identification of these infections occurs in less than 50% of cases, leading to underdiagnoses of important emerging arboviruses. Aim To assess the prevalence of the Dengue (DENV), Oropouche (OROV), Chikungunya (CHIKV), Mayaro (MAYV) and Zika (ZIKV) viruses in patients with acute febrile illness from Puerto Maldonado (Peru). Methodology Serum samples were obtained from patients with AFI during January 2016 to March 2016. A total of 139 specimens were analyzed for the presence of DENV, OROV, CHIKV, MAYV, and ZIKV using polymerase chain reaction (PCR). Results CHIKV in 9.4% and OROV in 8.6% were the most prevalent arboviruses, followed by DENV and ZIKV, with a prevalence of 6.5% and 5%, respectively. Among all patients, the most common symptoms accompanying fever were headaches 79.9%, muscle pain 65.5% and joint pain 63.3%. Conclusions During this short 3-month period, 4 arboviruses were detected by PCR, CHIKV and OROV being the most common arboviruses in Puerto Maldonado (Peru). Thus, it is crucial to include OROV detection in the national health surveillance. Furthermore, the etiologic clinical diagnosis of arboviral infections is not possible due to the low specificity of symptoms; therefore an increase of cases confirmed by molecular diagnostic methods will enhance arboviral surveillance in Peru. PMID:29136650

The "rule of halves" does not apply in Peru: awareness, treatment, and control of hypertension and diabetes in rural, urban, and rural-to-urban migrants.

PubMed

Lerner, Alana G; Bernabe-Ortiz, Antonio; Gilman, Robert H; Smeeth, Liam; Miranda, J Jaime

2013-06-01

To determine the awareness, treatment, and control of hypertension and diabetes by migration status. Cross-sectional study, secondary analyses of the PERU MIGRANT study. Rural, rural-to-urban migrants, and urban participants. Awareness, treatment, and control of hypertension and diabetes mellitus were calculated using weights to account for participant's group size. Of 205 of the 987 (weighted prevalence 24.1%, 95% confidence interval: 21.1%-27.1%) participants identified as hypertensive, 48.3% were aware of their diagnosis, 40% of them were receiving treatment, and 30.4% of those receiving treatment were controlled. Diabetes was present in 33 of the 987 (weighted prevalence 4.6%, 95% confidence interval: 3.1%-6%), and diabetes awareness, treatment, and control were 71.1%, 40.6%, and 7.7%, respectively. Suboptimal control rates, defined as those not meeting blood pressure or glycaemia targets among those with the condition, were 95.1% for hypertension and 97% for diabetes. Higher awareness, treatment, and control rates, for both hypertension and diabetes, were observed in rural-to-urban migrants and urban participants compared with rural participants. However, treatment rates were much lower among migrants compared with the urban group. These results identify major unmet needs in awareness, treatment, and control of hypertension and diabetes. Particular challenges are lack of awareness of both hypertension and diabetes in rural areas, and poor levels of treatment and control among people who have migrated from rural into urban areas.

Cluster of Imported Vivax Malaria in Travelers Returning From Peru.

PubMed

Weitzel, Thomas; Labarca, Jaime; Cortes, Claudia P; Rosas, Reinaldo; Balcells, M Elvira; Perret, Cecilia

2015-01-01

We report a cluster of imported vivax malaria in three of five Chilean travelers returning from Peru in March 2015. The cluster highlights the high risk of malaria in the Loreto region in northern Peru, which includes popular destinations for international nature and adventure tourism. According to local surveillance data, Plasmodium vivax is predominating, but Plasmodium falciparum is also present, and the incidence of both species has increased during recent years. Travelers visiting this region should be counseled about the prevention of malaria and the options for chemoprophylaxis. © 2015 International Society of Travel Medicine.

Women's Work, Education, and Family Welfare in Peru. World Bank Discussion Papers 116.

ERIC Educational Resources Information Center

Herz, Barbara K., Ed.; Khandker, Shahidur R., Ed.

This report examines ways of improving women's productivity and education and the consequences for development in Peru. The research finds that women account for about 39 percent of family income in Peru. They carry the main responsibility for child care and heavily influence family decisions on children's education and family size. Improving…

The IXth Neotropical Ornithological Congress in Peru (Cusco, 8-14 November 2011)

Treesearch

G. P. Servat; J. M. Wunderle Jr.

2012-01-01

The IXth Neotropical Ornithological Congress in Peru (Cusco, 8 – 14 November 2011). -The IXth Neotropical Congress of Ornithology (IX NOC), co-sponsored by the Neotropical Ornithological Society (NOS) and the Union of Peruvian Ornithologists (UNOP), took place in Cusco, Peru, from the 8 – 14 November 2011. The IX NOC was dedicated to the memory of Maria Koepcke for her...

Who’s on top? SST proxy comparison from the Peru Margin Upwelling System

NASA Astrophysics Data System (ADS)

Chazen, C.; Herbert, T.; Altabet, M. A.

2009-12-01

The Peru Margin upwelling region is situated at the interface between the poleward Peru Undercurrent and the equatorward Peru Coastal current. Strong coastal winds force cold, nutrient-rich thermocline waters to the surface. Sea surface temperatures in this region fluctuate sub-annually with changes in the position of the Intertropical convergence zone (ITCZ) and sub-decadally with modifications in the strength of Walker Circulation. In contrast, the temperature of the Peru Margin thermocline is stable, isolated from surface winds and slow to respond to major perturbations in surface temperature. Using high resolution sampling (6-7 year) across an annually laminated sediment core from the heart of the Peru Margin upwelling system (15°S) we explore how Uk’37 temperatures compare with TEX86 temperatures across a 200-year interval in the Mid-late Holocene. Mean late Holocene Uk’37 temperatures, extracted from a high sedimentation rate core from the Peru Margin are similar to modern mean annual sea surface temperatures at 15°S. Multi-decadal-scale (50-100 year) Uk’37 temperature fluctuations oscillate about the mean by 1.5°C. These rapid temperature changes are coherent with fluctuations in surface productivity (C37total and Biogenic Silica) in addition to sub-surface denitrification (δ15N). In contrast, TEX86 temperatures derived from identical samples exhibit colder temperatures than modern mean annual conditions and virtually no temperature fluctuation. We posit that TEX86 values are recording temperatures below the photic zone near the mix-layer-thermocline boundary and may, on longer timescales provide invaluable information about thermocline temperature. With this interpretation in mind, we present a TEX86-based long-term thermocline reconstruction over the Holocene.

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.

Records of Coendouichillus (Rodentia, Erethizontidae) from the Lower Urubamba Region of Peru.

PubMed

Gregory, Tremaine; Lunde, Darrin; Zamora-Meza, Hugo Tomás; Carrasco-Rueda, Farah

2015-01-01

Coendouichillus was first described in 2001 by Voss and da Silva, with a range from Amazonian Ecuador to Iquitos, Peru. Here, we describe an adult female Coendouichillus specimen collected in a Tomahawk trap in the forest canopy of the Lower Urubamba Region of Peru in October 2013. We also describe pathologies and behaviors observed through 379 camera trapping photo events (2,196 photos) gathered in natural canopy bridges over the course of a year (7,198 trap nights), including information on activity period over the course of the day and over the course of the lunar cycle. We conservatively estimate that 17 individuals were photographed, including one juvenile. Being 900 km away from Iquitos, Peru (the site of the closest record), discovery of this species in the Lower Urubamba constitutes a significant range extension.

Assessment of treatment patterns and patient outcomes before vs after implementation of a severity-based Clostridium difficile infection treatment policy.

PubMed

Jardin, C G M; Palmer, H R; Shah, D N; Le, F; Beyda, N D; Jiang, Z; Garey, K W

2013-09-01

National guidelines recommend oral vancomycin for severe Clostridium difficile infection (CDI) based on results from recent clinical trials demonstrating improved clinical outcomes. However, real-world data to support these clinical trials are scant. To compare treatment patterns and patient outcomes of those treated for CDI before and after implementation of a severity-based CDI treatment policy at a tertiary teaching hospital. This study evaluated adult patients with a positive C. difficile toxin before and after implementation of a policy where patients with severe CDI given metronidazole were switched to oral vancomycin unless contra-indicated. Patients were stratified according to disease severity using a modified published severity score. Treatment patterns based on CDI severity and rates of refractory CDI were assessed. In total, 256 patients with CDI (mean age 66 years, standard deviation 17, 52% female) were evaluated (before implementation: N = 144; after implementation: N = 112). Use of oral vancomycin for severe CDI increased significantly from 14% (N = 8) to 91% (N = 48) following implementation of the policy (P < 0.0001). Refractory disease in patients with severe CDI decreased significantly from 37% to 15% following implementation of the policy (P = 0.035). No significant differences were noted among patients with mild to moderate CDI. A severity-based CDI treatment policy at a tertiary teaching hospital increased the use of oral vancomycin and was associated with decreased rates of refractory CDI. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Khipu accounting in ancient Peru.

PubMed

Urton, Gary; Brezine, Carrie J

2005-08-12

Khipu are knotted-string devices that were used for bureaucratic recording and communication in the Inka Empire. We recently undertook a computer analysis of 21 khipu from the Inka administrative center of Puruchuco, on the central coast of Peru. Results indicate that this khipu archive exemplifies the way in which census and tribute data were synthesized, manipulated, and transferred between different accounting levels in the Inka administrative system.

Shadows of the colonial past – diverging plant use in Northern Peru and Southern Ecuador

PubMed Central

Bussmann, Rainer W; Sharon, Douglas

2009-01-01

This paper examines the traditional use of medicinal plants in Northern Peru and Southern Ecuador, with special focus on the Departments of Piura, Lambayeque, La Libertad, Cajamarca, and San Martin, and in Loja province, with special focus on the development since the early colonial period. Northern Peru represents the locus of the old Central Andean "Health Axis." The roots of traditional healing practices in this region go as far back as the Cupisnique culture early in the first millennium BC. Northern Peru and Southern Ecuador share the same cultural context and flora but show striking differences in plant use and traditional knowledge. Two hundred fifteen plant species used for medicinal purposes in Ecuador and 510 plant species used for medicinal purposes in Peru were collected, identified,. and their vernacular names, traditional uses, and applications recorded. This number of species indicates that the healers, market vendors, and members of the public interviewed in Peru still have a very high knowledge of plants in their surroundings, which can be seen as a reflection of the knowledge of the population in general. In Ecuador much of the original plant knowledge has already been lost. In Peru, 433 (85%) were Dicotyledons, 46 (9%) Monocotyledons, 21 (4%) Pteridophytes, and 5 (1%) Gymnosperms. Three species of Giartina (Algae) and one species of the Lichen genus Siphula were used. The families best represented were Asteraceae with 69 species, Fabaceae (35), Lamiaceae (25), and Solanaceae (21). Euphorbiaceae had 12 species, and Poaceae and Apiaceae each accounted for 11 species. In Ecuador the families best represented were Asteraceae (32 species), Euphorbiaceae, Lamiaceae, and Solanaceae (11 species each), and Apiaceae, Fabaceae, Lycopodiaceae (9 species each). One hundred eighty-two (85%) of the species used were Dicotyledons, 20 Monocotyledons (9.3%), 12 ferns (5.5%), and one unidentified lichen was used. Most of the plants used (83%) were native to Peru

Counterfeit medicines in Peru: a retrospective review (1997–2014)

PubMed Central

Medina, Edwin; Bel, Elvira; Suñé, Josep María

2016-01-01

Objective To consolidate and assess information on counterfeit medicines subject to pharmaceutical alerts issued by the Peruvian Medicines Regulatory Authority over 18 years (1997–2014) of health monitoring and enforcement. Design A retrospective review of drug alerts. Setting A search of the website of the General Directorate of Medicines, Supplies and Drugs (DIGEMID) of the Ministry of Health of Peru for drug alerts issued between 1997 and 2014. Eligibility criteria Drug alerts related to counterfeit medicines. Results A total of 669 DIGEMID alerts were issued during the study period, 354 (52.91%) of which cover 1738 cases of counterfeit medicines (many alerts deal with several cases at a time). 1010 cases (58.11%) involved pharmaceutical establishments and 349 (20.08%) involved non-pharmaceutical commercial outlets. In 126 cases (7.25%), counterfeit medicines were seized in an unauthorised trade (without any marketing authorisation); in 253 cases (14.56%) the type of establishment or business associated with the seized product was not identified. Conclusions Counterfeit medicines are a serious public health problem in Peru. A review of the data cannot determine whether counterfeit medicines in Peru increased during the study period, or if monitoring by different government health agencies highlighted the magnitude of the problem by providing more evidence. The problem is clearly structural, since the majority of cases (58.11% of the total) were detected in legitimate supply chains. Most counterfeit medicines involve staple pharmaceutical products and common dosage forms. Considerable work remains to be done to control the serious problem of counterfeit medicines in Peru. PMID:27044580

Counterfeit medicines in Peru: a retrospective review (1997-2014).

PubMed

Medina, Edwin; Bel, Elvira; Suñé, Josep María

2016-04-04

To consolidate and assess information on counterfeit medicines subject to pharmaceutical alerts issued by the Peruvian Medicines Regulatory Authority over 18 years (1997-2014) of health monitoring and enforcement. A retrospective review of drug alerts. A search of the website of the General Directorate of Medicines, Supplies and Drugs (DIGEMID) of the Ministry of Health of Peru for drug alerts issued between 1997 and 2014. Drug alerts related to counterfeit medicines. A total of 669 DIGEMID alerts were issued during the study period, 354 (52.91%) of which cover 1738 cases of counterfeit medicines (many alerts deal with several cases at a time). 1010 cases (58.11%) involved pharmaceutical establishments and 349 (20.08%) involved non-pharmaceutical commercial outlets. In 126 cases (7.25%), counterfeit medicines were seized in an unauthorised trade (without any marketing authorisation); in 253 cases (14.56%) the type of establishment or business associated with the seized product was not identified. Counterfeit medicines are a serious public health problem in Peru. A review of the data cannot determine whether counterfeit medicines in Peru increased during the study period, or if monitoring by different government health agencies highlighted the magnitude of the problem by providing more evidence. The problem is clearly structural, since the majority of cases (58.11% of the total) were detected in legitimate supply chains. Most counterfeit medicines involve staple pharmaceutical products and common dosage forms. Considerable work remains to be done to control the serious problem of counterfeit medicines in Peru. 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/

Epidemiology of Spotted Fever Group and Typhus Group Rickettsial Infection in the Amazon Basin of Peru

DTIC Science & Technology

2010-01-01

MediCine and Hyg1cne Epidemiology of Spotted Fever Group and Typhus Group Rickettsial Infection in the Amazon Basin of Peru Brett M. Forshey, Allison...approximately 4% of acute febrile episodes detected in Iquitos, a city located in the Amazon region of northeast- ern Peru , could be attributed to SFGR...2010 to 00-00-2010 4. TITLE AND SUBTITLE Epidemiology Of Spotted Fever Group And Typhus Group Rickettsial Infection In The Amazon Basin Of Peru 5a

Medicaid Prior Authorization Policies for Medication Treatment of Attention-Deficit/Hyperactivity Disorder in Young Children, United States, 2015.

PubMed

Hulkower, Rachel L; Kelley, Meghan; Cloud, Lindsay K; Visser, Susanna N

In 2011, the American Academy of Pediatrics updated its guidelines for the diagnosis and treatment of children with attention-deficit/hyperactivity disorder (ADHD) to recommend that clinicians refer parents of preschoolers (aged 4-5) for training in behavior therapy and subsequently treat with medication if behavior therapy fails to sufficiently improve functioning. Data available from just before the release of the guidelines suggest that fewer than half of preschoolers with ADHD received behavior therapy and about half received medication. About half of those who received medication also received behavior therapy. Prior authorization policies for ADHD medication may guide physicians toward recommended behavior therapy. Characterizing existing prior authorization policies is an important step toward evaluating the impact of these policies on treatment patterns. We inventoried existing prior authorization policies and characterized policy components to inform future evaluation efforts. A 50-state legal assessment characterized ADHD prior authorization policies in state Medicaid programs. We designed a database to capture data on policy characteristics and authorization criteria, including data on age restrictions and fail-first behavior therapy requirements. In 2015, 27 states had Medicaid policies that prevented approval of pediatric ADHD medication payment without additional provider involvement. Seven states required that prescribers indicate whether nonmedication treatments were considered before Medicaid payment for ADHD medication could be approved. Medicaid policies on ADHD medication treatment are diverse; some policies are tied to the diagnosis and treatment guidelines of the American Academy of Pediatrics. Evaluations are needed to determine if certain policy interventions guide families toward the use of behavior therapy as the first-line ADHD treatment for young children.

Efficient design and inference for multistage randomized trials of individualized treatment policies.

PubMed

Dawson, Ree; Lavori, Philip W

2012-01-01

Clinical demand for individualized "adaptive" treatment policies in diverse fields has spawned development of clinical trial methodology for their experimental evaluation via multistage designs, building upon methods intended for the analysis of naturalistically observed strategies. Because often there is no need to parametrically smooth multistage trial data (in contrast to observational data for adaptive strategies), it is possible to establish direct connections among different methodological approaches. We show by algebraic proof that the maximum likelihood (ML) and optimal semiparametric (SP) estimators of the population mean of the outcome of a treatment policy and its standard error are equal under certain experimental conditions. This result is used to develop a unified and efficient approach to design and inference for multistage trials of policies that adapt treatment according to discrete responses. We derive a sample size formula expressed in terms of a parametric version of the optimal SP population variance. Nonparametric (sample-based) ML estimation performed well in simulation studies, in terms of achieved power, for scenarios most likely to occur in real studies, even though sample sizes were based on the parametric formula. ML outperformed the SP estimator; differences in achieved power predominately reflected differences in their estimates of the population mean (rather than estimated standard errors). Neither methodology could mitigate the potential for overestimated sample sizes when strong nonlinearity was purposely simulated for certain discrete outcomes; however, such departures from linearity may not be an issue for many clinical contexts that make evaluation of competitive treatment policies meaningful.

Numbers and Codes in Ancient Peru: The Quipu.

ERIC Educational Resources Information Center

Zepp, Raymond A.

1992-01-01

Describes the Quipu, a mathematical device invented by the Incas of Peru that used the base-10 number system to store information. Suggests ways of incorporating material on the quipu into the arithmetic class. (MDH)

Database and Map of Quaternary Faults and Folds in Peru and its Offshore Region

USGS Publications Warehouse

Machare, Jose; Fenton, Clark H.; Machette, Michael N.; Lavenu, Alain; Costa, Carlos; Dart, Richard L.

2003-01-01

This publication consists of a main map of Quaternary faults and fiolds of Peru, a table of Quaternary fault data, a region inset map showing relative plate motion, and a second inset map of an enlarged area of interest in southern Peru. These maps and data compilation show evidence for activity of Quaternary faults and folds in Peru and its offshore regions of the Pacific Ocean. The maps show the locations, ages, and activity rates of major earthquake-related features such as faults and fault-related folds. These data are accompanied by text databases that describe these features and document current information on their activity in the Quaternary.

The ‘rule of halves’ does not apply in Peru: Awareness, treatment, and control of hypertension and diabetes in rural, urban and rural-to-urban migrants

PubMed Central

Lerner, Alana G.; Bernabe-Ortiz, Antonio; Gilman, Robert H.; Smeeth, Liam; Miranda, J. Jaime

2015-01-01

Objective To determine the awareness, treatment, and control of hypertension and diabetes by migration status. Design Cross-sectional study, secondary analyses of the PERU MIGRANT study. Patients Rural, rural-to-urban migrants, and urban participants. Main outcome measures Awareness, treatment and control of hypertension and diabetes mellitus were calculated using weights to account for participant’s group size. Results Of the 205/987 (weighted prevalence 24.1%, 95%CI: 21.1%–27.1%) participants identified as hypertensive 48.3% were aware of their diagnosis, 40% of them were receiving treatment, and 30.4% of those receiving treatment were controlled. Diabetes was present in 33/987 (weighted prevalence 4.6%, 95%CI: 3.1%–6%) and diabetes awareness, treatment and control were 71.1%, 40.6%, and 7.7%, respectively. Sub-optimal control rates, defined as those not meeting blood pressure or glycaemia targets among those with the condition, were 95.1% for hypertension and 97% for diabetes. Higher awareness, treatment and control rates, for both hypertension and diabetes, were observed in rural-to-urban migrants and urban participants compared to rural participants. However, treatment rates were much lower among migrants compared to the urban group. Conclusions These results identify major unmet needs in awareness, treatment, and control of hypertension and diabetes. Particular challenges are lack of awareness of both hypertension and diabetes in rural areas, and poor levels of treatment and control among people who have migrated from rural into urban areas. PMID:23680809

Out of the ordinary: nursing in Peru.

PubMed

Dols, Mary Ann

2008-01-01

A high school friendship inspired a love of other cultures and a desire to pursue missionary nursing in South America. As a parish nurse in a remote village in Peru, the author trained village health workers in the basics of hygiene, first aid, and disease prevention.

[Prevalence and associated factors of macrosomia in Peru, 2013].

PubMed

Cunha, Antonio José Ledo Alves da; Toro, Manuel Sobrino; Gutiérrez, César; Alarcón-Villaverde, Jorge

2017-01-01

To determine the prevalence of macrosomia and factors associated with it in Peru and to describe the occurrence of complications peri- and postpartum. Birth weights of children under the age of 5 years were analyzed using data from the 2013 Demographic and Family Health Survey (ENDES) carried out by the Instituto Nacional de Estadística e Informática. Children with a birth weight higher than 4000 g were considered macrosomic. A logistic regression analysis was used to establish the independent association of sociodemographic factors with macrosomia. The sample comprised 6121 children. The prevalence of macrosomia was 5.3% (95% interval confidence: 4.8-5.9%). Being male, a higher birth order, maternal obesity, and greater maternal height were independently linked with macrosomia. Caesarean births were more common in macrosomic children than unaffected ones (43.9% vs 26.9%). Complications during birth and postpartum were common but not statistically linked with macrosomia. The prevalence of macrosomia in Peru is relatively low compared to other low-to-middle income countries. The factors associated with macrosomia were mainly unmodifiable, with the exception of maternal obesity. Macrosomic children were more frequently born by caesarean. Weight reduction and the prevention of obesity in women of childbearing age in Peru could potentially reduce macrosomia and caesarean rates.

Disease Vector Ecology Profile: Peru

DTIC Science & Technology

1998-12-01

mi) border), on the south by Chile (160 km (99 mi) border), and in the west by the Pacific Ocean (2,414 km (1,497 mi) coast). Peru consists of three...1993), Brazil (1993), Paraguay (1996) and Chile (1997). Two isolates of hantavirus were reported in late 1996 from the rice rat, Oligoryzomys...Simuliidae. Fauna de Agua Dulce de la Republica Argentina. 38. (Insecta, Diptera, Simuliidae), Fascicle 2, 304 pp. +78 pp. of unnumbered figures

Barium Cloud Test in Peru.

DTIC Science & Technology

1981-11-01

site. The irregularity would be measured by the AFWAL and AFGL equipped aircraft, the Jacamarca radar site, and receivers set at several Peruvian ground...The launch was made from Punta Lobos, Peru, a station of the Peruvian Space Commission (CONIDA). 1I AFWAL-TR-81-1178 SECTION II DESCRIPTION OF TEST...forming a football -shaped irregularity ion cloud (Figure 2). The clouds were then expected to drift eastwardly with the neutral ionospheric winds, crossing

Women as Child Abusers: Indicators, Treatment, and Policy Directions.

ERIC Educational Resources Information Center

Kemp, Donna R.; And Others

Child abuse is a major problem in the United States. Policy concerning child abuse involves a criminal justice approach, a treatment approach, and a prevention approach. Prevention programs have focused on identifying and serving high-risk groups and on preventive education. A study was conducted to examine issues related to child abuse. Four…

[An assessment of fiscal space for public health in Peru].

PubMed

Matus-López, Mauricio; Toledo, Lorena Prieto; Pedraza, Camilo Cid

2016-08-01

Objective To assess the fiscal space for public health in Peru so as to attain the goal of raising health spending to 6% of gross domestic product, as agreed upon by member countries of the Pan American Health Organization in 2014. Methods The main sources of fiscal space were identified by means of a thorough literature review. Technical feasibility was determined from statistics and national and international surveys and by reviewing various documents and official reports. Political feasibility was ascertained by studying policy guidelines. Results The sources showing the greatest technical and political feasibility are economic growth, a broadening of the personal income tax base, and an increase in tobacco-specific taxes. Decreasing informality in the job market and increasing contributory coverage are considered to be less politically feasible, but there is ample technical space for these measures. Conclusions There is enough fiscal space to allow for an increase in public health spending. Nevertheless, the 6% target will be reached only if the timeline is extended, tax revenues are increased, and informality in the job market is reduced.

Two new species of Euconnus (Rhomboconnus) in Peru and Bolivia (Coleoptera, Staphylinidae, Scydmaeninae).

PubMed

JaŁoszyŃski, PaweŁ

2018-01-25

To date, the subgenus Rhomboconnus Franz of Euconnus Thomson was represented by ten species known to occur in Venezuela, Panama and Ecuador. For the first time Rhomboconnus is reported to occur in Peru and Bolivia, and two new species are described: Euconnus wari sp. n. (Peru) and E. inkachakanus sp. n. (Bolivia). The latter species is the largest representative of Rhomboconnus, with body length exceeding 3 mm.

Survey of Infection Control Policies within Dental/Educational Patient Treatment Centers.

ERIC Educational Resources Information Center

Dickey, Keith Winfield

1986-01-01

The article describes a survey of 36 dental education programs to identify educators' reactive policies and procedures in their patient treatment centers to minimize dental contamination and cross-contamination. (Author/CT)

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.

[Urban employment and internal migration in Peru].

PubMed

Cotlear, D

1984-06-01

The relationship between internal migration and employment problems in Peru is examined. The author argues that regional differences in income distribution are the primary causes of migration, particularly to urban areas. A model of the migration process is developed and tested using data from official sources, surveys, and the published literature.

Institutional stakeholder perceptions of barriers to addiction treatment under Mexico's drug policy reform.

PubMed

Werb, Dan; Strathdee, Steffanie A; Meza, Emilo; Rangel Gomez, Maria Gudelia; Palinkas, Lawrence; Medina-Mora, Maria Elena; Beletsky, Leo

2017-05-01

Mexico has experienced disproportionate drug-related harms given its role as a production and transit zone for illegal drugs destined primarily for the USA. In response, in 2009, the Mexican federal government passed legislation mandating pre-arrest diversion of drug-dependent individuals towards addiction treatment. However, this federal law was not specific about how the scale-up of the addiction treatment sector was to be operationalised. We therefore conducted in-depth qualitative interviews with key 'interactors' in fields affected by the federal legislation, including participants from the law enforcement, public health, addiction treatment, and governmental administration sectors. Among 19 participants from the municipal, state and federal levels were interviewed and multiple barriers to policy reform were identified. First, there is a lack of institutional expertise to implement the reform. Second, the operationalisation of the reform was not accompanied by a coordinated action plan. Third, the law is an unfunded mandate. Institutional barriers are likely hampering the implementation of Mexico's policy reform. Addressing the concerns expressed by interactors through the scale-up of services, the provision of increased training and education programmes for stakeholders and a coordinated action plan to operationalise the policy reform are likely needed to improve the policy reform process.

Legal consequences for torture in children cases: the Gomez Paquiyauri Brothers vs Peru case.

PubMed

Tinta, Monica Feria

2009-01-01

The Gomez Paquiyauri Brothers case, before the Inter-American Court of Human Rights, was the first international case concerning the protection of children in the context of armed conflict where an international court stated the law concerning the duties of States towards children even in the context of war, and provided for reparations. As such it represents a landmark decision. The case arose from the illegal detention, torture and extrajudicial execution of two minors, Emilio and Rafael Gomez Paquiyauri, at the hands of Peruvian Police in 1991, under the Fujimori Administration at a time when the internal war in Peru was at its peak. Unlike most cases coming to the jurisdiction of the Inter-American Court, the case had been subject to domestic criminal investigations that had led to the convictions of two low ranking policemen. Yet a more subtle pattern of impunity lied at the root of the case. Torture had been denied by the State, and the prosecutions of low ranking policemen had intended to cover up the responsibility of those who ordered a policy of torture and executions (including the existence of secret codes for the torture and elimination of suspects of "terrorism") during the years of the internal armed conflict in Peru. The joint work of legal and medical expertise in the litigation of the case permitted the establishment of the facts and the law, obtaining an award of 740,500 dollars for the victims and a number of measures of reparation including guarantees of non-repetition and satisfaction, such as the naming of a school after the victims.

[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.

Epidemiology of road traffic incidents in Peru 1973-2008: incidence, mortality, and fatality.

PubMed

Miranda, J Jaime; López-Rivera, Luis A; Quistberg, D Alex; Rosales-Mayor, Edmundo; Gianella, Camila; Paca-Palao, Ada; Luna, Diego; Huicho, Luis; Paca, Ada

2014-01-01

The epidemiological profile and trends of road traffic injuries (RTIs) in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973-2008, as well as their relationship to population trends such as economic growth. Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs) of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43-5.31) on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15-0.43), while among adults the fatality rate increased by 1.25 (95% CI 1.09-1.43). Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP) per capita. The significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs.

Records of Coendou ichillus (Rodentia, Erethizontidae) from the Lower Urubamba Region of Peru

PubMed Central

Gregory, Tremaine; Lunde, Darrin; Zamora-Meza, Hugo Tomás; Carrasco-Rueda, Farah

2015-01-01

Abstract Coendou ichillus was first described in 2001 by Voss and da Silva, with a range from Amazonian Ecuador to Iquitos, Peru. Here, we describe an adult female Coendou ichillus specimen collected in a Tomahawk trap in the forest canopy of the Lower Urubamba Region of Peru in October 2013. We also describe pathologies and behaviors observed through 379 camera trapping photo events (2,196 photos) gathered in natural canopy bridges over the course of a year (7,198 trap nights), including information on activity period over the course of the day and over the course of the lunar cycle. We conservatively estimate that 17 individuals were photographed, including one juvenile. Being 900 km away from Iquitos, Peru (the site of the closest record), discovery of this species in the Lower Urubamba constitutes a significant range extension. PMID:26175605

New subtypes and genetic recombination in HIV type 1-infecting patients with highly active antiretroviral therapy in Peru (2008-2010).

PubMed

Yabar, Carlos Augusto; Acuña, Maribel; Gazzo, Cecilia; Salinas, Gabriela; Cárdenas, Fanny; Valverde, Ada; Romero, Soledad

2012-12-01

HIV-1 subtype B is the most frequent strain in Peru. However, there is no available data about the genetic diversity of HIV-infected patients receiving highly active antiretroviral therapy (HAART) here. A group of 267 patients in the Peruvian National Treatment Program with virologic failure were tested for genotypic evidence of HIV drug resistance at the Instituto Nacional de Salud (INS) of Peru between March 2008 and December 2010. Viral RNA was extracted from plasma and the segments of the protease (PR) and reverse transcriptase (RT) genes were amplified by reverse transcriptase polymerase chain reaction (RT-PCR), purified, and fully sequenced. Consensus sequences were submitted to the HIVdb Genotypic Resistance Interpretation Algorithm Database from Stanford University, and then aligned using Clustal X v.2.0 to generate a phylogenetic tree using the maximum likelihood method. Intrasubtype and intersubtype recombination analyses were performed using the SCUEAL program (Subtype Classification by Evolutionary ALgo-rithms). A total of 245 samples (91%) were successfully genotyped. The analysis obtained from the HIVdb program showed 81.5% resistance cases (n=198). The phylogenetic analysis revealed that subtype B was predominant in the population (98.8%), except for new cases of A, C, and H subtypes (n=4). Of these cases, only subtype C was imported. Likewise, recombination analysis revealed nine intersubtype and 20 intrasubtype recombinant cases. This is the first report of the presence of HIV-1 subtypes C and H in Peru. The introduction of new subtypes and circulating recombinants forms can make it difficult to distinguish resistance profiles in patients and consequently affect future treatment strategies against HIV in this country.

[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.

78 FR 58378 - Culturally Significant Objects Imported for Exhibition Determinations: “Peru: Kingdoms of the Sun...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-23

... DEPARTMENT OF STATE [Public Notice 8478] Culturally Significant Objects Imported for Exhibition Determinations: ``Peru: Kingdoms of the Sun and the Moon'' SUMMARY: Notice is hereby given of the following... ``Peru: Kingdoms of the Sun and the Moon,'' imported from abroad for temporary exhibition within the...

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

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.

Susac syndrome: the first case report in Peru.

PubMed

Rivadeneira-Sotelo, Carolina; Meza Vega, María; Segura-Chávez, Darwin; Castro-Suarez, Sheila

2017-08-30

Susac Syndrome is a rare entity, characterized by a triad of subacute encephalopathy, retinal artery occlusion and sensorineural hearing loss. It is more common in women and the age of onset fluctuates between 9-58 years of age. The pathogenesis is presented as microangiopathic changes at the cerebral, retinal and cochlear levels associated with an autoimmune mechanism. We present the case of a 31-year-old woman who started with a diffuse headache, puerile behavior, bradylalia and somnolence. As the disease progressed, she had auditory deficit and arterial obstruction of the right temporal retinal branch in retinal fluorescein angiography. Brain magnetic resonance showed rounded hyperintense lesions in the corpus callosum, periventricular region and cerebellum. This is the first reported case of Susac Syndrome in Peru, presented with the classic triad, which is an infrequent presentation. However, cases that show incomplete forms should be evaluated in a timely manner to initiate timely treatment and avoid irreversible consequences.

Measuring medicine prices in Peru: validation of key aspects of WHO/HAI survey methodology.

PubMed

Madden, Jeanne M; Meza, Edson; Ewen, Margaret; Laing, Richard O; Stephens, Peter; Ross-Degnan, Dennis

2010-04-01

To assess the possibility of bias due to the limited target list and geographic sampling of the World Health Organization (WHO)/Health Action International (HAI) Medicine Prices and Availability survey used in more than 70 rapid sample surveys since 2001. A survey was conducted in Peru in 2005 using an expanded sample of medicine outlets, including remote areas. Comprehensive data were gathered on medicines in three therapeutic classes to assess the adequacy of WHO/HAI's target medicines list and the focus on only two product versions. WHO/HAI median retail prices were compared with average wholesale prices from global pharmaceutical sales data supplier IMS Health. No significant differences were found in overall availability or prices of target list medicines by retail location. The comprehensive survey of angiotensin-converting enzyme inhibitor, anti-diabetic, and anti-ulcer products revealed that some treatments not on the target list were costlier for patients and more likely to be unavailable, particularly in remote areas. WHO/HAI retail prices and IMS wholesale prices were strongly correlated for higher priced products, and weakly correlated for lower priced products (which had higher estimated retailer markups). The WHO/HAI survey approach strikes an appropriate balance between modest research costs and optimal information for policy. Focusing on commonly used medicines yields sufficient and valid results. Surveyors elsewhere should consider the limits of the survey data as well as any local circumstances, such as scarcity, that may call for extra field efforts.

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

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

Perspectives of the teaching in astronomy in Peru at the present time

NASA Astrophysics Data System (ADS)

Aguilar, M. L.

1998-11-01

(1)1st. VLP-IAU., Com. 46 : Failed experience in Peru? There are a lot of reasons to explain why the PhD and Mg peruvians do not want to return to Peru. Then, what shall we do? (2)For experience , the faculties of education have more opportunity than faculties of sciences to insert new topics in the national education reforms. Now, we are penetrating in two faculties of education, with astronomical observatories to teaching and scientific research. The sun and variable stars are selected objects. Modern technology and spatial sciences are introduced.

Self-Assessed Disability and Self-Rated Health among Rural Villagers in Peru: A Brief Report

ERIC Educational Resources Information Center

Rohrer, James E.; Merry, Stephen P.; Thacher, Thomas D.; Summers, Matthew R.; Alpern, Jonathan D.; Contino, Robert W.

2010-01-01

Context: Risks for poor self-rated overall health in rural areas of developing nations have not been thoroughly investigated. Purpose: The objective of this study was to assess potential risk factors for poor self-rated health among rural villagers in Peru. Methods: A door-to-door survey of villagers residing in the Pampas Grande region in Peru,…

Research Ethics Training in Peru: A Case Study

PubMed Central

Lescano, A. Roxana; Blazes, David L.; Montano, Silvia M.; Moran, Zoe; Naquira, Cesar; Ramirez, Edwin; Lie, Reidar; Martin, Gregory J.; Lescano, Andres G.; Zunt, Joseph R.

2008-01-01

With the rapidly increasing number of health care professionals seeking international research experience, comes an urgent need for enhanced capacity of host country institutional review boards (IRB) to review research proposals and ensure research activities are both ethical and relevant to the host country customs and needs. A successful combination of distance learning, interactive courses and expert course instructors has been applied in Peru since 2004 through collaborations between the U.S. Naval Medical Research Center Detachment, the University of Washington and the Department of Clinical Bioethics of the National Institutes of Health to provide training in ethical conduct of research to IRB members and researchers from Peru and other Latin American countries. All training activities were conducted under the auspices of the Peruvian National Institute of Health (INS), Ministry of Health. To date, 927 people from 12 different Latin American countries have participated in several of these training activities. In this article we describe our training model. PMID:18818763

Modeling Fluid Flow and Microbial Reactions in the Peru Accretionary Complex

NASA Astrophysics Data System (ADS)

Bekins, B. A.; Matmon, D.

2002-12-01

Accretionary complexes are sites where sediment compaction and deeper reactions drive large-scale flow systems that can affect global solute budgets. Extensive modeling and drilling studies have elucidated the origin of the fluids, pore pressures, duration of flow, and major flow paths in these settings. An important research goal is to quantify the effect of these flow systems on global chemical budgets of reactive solutes such as carbon. The Peru margin represents an end member setting that can serve as a basis to extend the results to other margins. The sediments are relatively high in organic carbon with an average value of 2.6%. The subduction rate at ~9 cm/yr and taper angle at 14-17° are among the largest in the world. Recent microbial studies on Ocean Drilling Program Leg 201 at the Peru accretionary margin provide many key elements needed to quantify the processes affecting organic carbon in an accretionary complex. Pore water chemistry data from Site 1230 located in the Peru accretionary prism indicate that sulfate reduction is important in the top 8 mbsf. Below this depth, methanogenesis is the dominant process and methane concentrations are among the highest measured at any site on Leg 201. The presence of high methane concentrations at shallow depths suggests that methane is transported upward in the prism by fluid flow. Measurements of in-situ pore pressures and temperatures also support the presence of upward fluid flow. A single in-situ pressure measurement at ~100 mbsf indicated an overpressure of 0.14 MPa. For a reasonable formation permeability of ~ 10-16 m2, the measured overpressure is adequate to produce flow at a rate of ~5 mm/yr. This rate is comparable to previous model estimates for flow rates in the Peru accretionary prism. In addition, curvature in the downhole temperature profile can best be explained by upward fluid flow of 1-10 mm/yr. These data are used to constrain a two-dimensional coupled fluid flow and reactive transport model

Do submesoscale frontal processes ventilate the oxygen minimum zone off Peru?

NASA Astrophysics Data System (ADS)

Thomsen, S.; Kanzow, T.; Colas, F.; Echevin, V.; Krahmann, G.; Engel, A.

2016-02-01

The Peruvian upwelling region shows pronounced near-surface submesoscale variability including filaments and sharp density fronts. Submesoscale frontal processes can drive large vertical velocities and enhance vertical tracer fluxes in the upper ocean. The associated high temporal and spatial variability poses a large challenge to observational approaches targeting these processes. In this study the role of submesoscale processes for the ventilation of the near-coastal oxygen minimum zone off Peru is investigated. We use satellite based sea surface temperature measurements and multiple high-resolution glider observations of temperature, salinity, oxygen and chlorophyll fluorescence carried out in January and February 2013 off Peru near 14°S during active upwelling. Additionally, high-resolution regional ocean circulation model outputs (ROMS) outputs are analysed. At the beginning of our observational survey a previously upwelled, productive and highly oxygenated water body is found in the mixed layer. Subsequently, a cold filament forms and the waters are moved offshore. After the decay of the filament and the relaxation of the upwelling front, the oxygen enriched surface water is found in the previously less oxygenated thermocline suggesting the occurrence of frontal subduction. A numerical model simulation is used to analyse the evolution of Lagrangian numerical floats in several upwelling filaments, whose vertical structure and hydrographic properties agree well with the observations. The floats trajectories support our interpretation that the subduction of previously upwelled water occurs in filaments off Peru. We find that 40 - 60 % of the floats seeded in the newly upwelled water is subducted within a time period of 5 days. This hightlights the importance of this process in ventilating the oxycline off Peru.

Seismic gaps and source zones of recent large earthquakes in coastal Peru

USGS Publications Warehouse

Dewey, J.W.; Spence, W.

1979-01-01

The earthquakes of central coastal Peru occur principally in two distinct zones of shallow earthquake activity that are inland of and parallel to the axis of the Peru Trench. The interface-thrust (IT) zone includes the great thrust-fault earthquakes of 17 October 1966 and 3 October 1974. The coastal-plate interior (CPI) zone includes the great earthquake of 31 May 1970, and is located about 50 km inland of and 30 km deeper than the interface thrust zone. The occurrence of a large earthquake in one zone may not relieve elastic strain in the adjoining zone, thus complicating the application of the seismic gap concept to central coastal Peru. However, recognition of two seismic zones may facilitate detection of seismicity precursory to a large earthquake in a given zone; removal of probable CPI-zone earthquakes from plots of seismicity prior to the 1974 main shock dramatically emphasizes the high seismic activity near the rupture zone of that earthquake in the five years preceding the main shock. Other conclusions on the seismicity of coastal Peru that affect the application of the seismic gap concept to this region are: (1) Aftershocks of the great earthquakes of 1966, 1970, and 1974 occurred in spatially separated clusters. Some clusters may represent distinct small source regions triggered by the main shock rather than delimiting the total extent of main-shock rupture. The uncertainty in the interpretation of aftershock clusters results in corresponding uncertainties in estimates of stress drop and estimates of the dimensions of the seismic gap that has been filled by a major earthquake. (2) Aftershocks of the great thrust-fault earthquakes of 1966 and 1974 generally did not extend seaward as far as the Peru Trench. (3) None of the three great earthquakes produced significant teleseismic activity in the following month in the source regions of the other two earthquakes. The earthquake hypocenters that form the basis of this study were relocated using station

Fish debris in sediments of the upwelling zone off central Peru: a late Quaternary record

NASA Astrophysics Data System (ADS)

De Vries, Thomas J.; Pearcy, William G.

1982-01-01

Scales of the anchoveta were abundantly represented among fish remains preserved in partly laminated marine sediments on the upper continental slope of Peru. Hake scales were less common. Sardine scales occurred only sporadically. Recent accumulation rates of scales indicate that prior to exploitation the anchoveta standing stock off Peru was about five times that of northern anchovy off California. During glacial time, however, clupeoids were less abundant off Peru and were more evenly distributed among sardines and anchoveta. Evidence from fish scales and phytoplankton assemblages suggests that the coastal waters off Peru did not respond to continental glacial and neoglacial advances simply by cooling. High accumulation rates of scales from warm-water fishes and tests of cool-water phytoplankton preceded and succeeded an interval containing low numbers of dominantly warm-water taxa. This interval coincided with the second neoglacial advance (2000 to 2700 y B.P.). Similar but less well-defined warm-water and cool-water assemblages coincided with the third neoglacial advance (200 to 400 y B.P.) and the last glacial retreat. Upwelling intensity probably fluctuated more widely during early and late phases of glacial and neoglacial cooling episodes, accounting for the mix of distinctly warm-water and cool-water assemblages and perhaps for an enhanced productivity. A weakened Intertropical Convergence Zone or strengthened coastal countercurrent may explain the warm-water marine faunas and floras and wet climates on the mainland of Peru inferred by others for neoglacial or glacial time.

A Bilingual Experiment in the Amazonian Jungle of Peru

ERIC Educational Resources Information Center

Wise, Mary Ruth

1971-01-01

In the Amazonian jungle of Peru 240 Indian leaders representing 20 different South American Indian language groups are successfully teaching their own people to read and write, first in their mother tongue and then in Spanish. (Author/EB)

New Subtypes and Genetic Recombination in HIV Type 1-Infecting Patients with Highly Active Antiretroviral Therapy in Peru (2008–2010)

PubMed Central

Acuña, Maribel; Gazzo, Cecilia; Salinas, Gabriela; Cárdenas, Fanny; Valverde, Ada; Romero, Soledad

2012-01-01

Abstract HIV-1 subtype B is the most frequent strain in Peru. However, there is no available data about the genetic diversity of HIV-infected patients receiving highly active antiretroviral therapy (HAART) here. A group of 267 patients in the Peruvian National Treatment Program with virologic failure were tested for genotypic evidence of HIV drug resistance at the Instituto Nacional de Salud (INS) of Peru between March 2008 and December 2010. Viral RNA was extracted from plasma and the segments of the protease (PR) and reverse transcriptase (RT) genes were amplified by reverse transcriptase polymerase chain reaction (RT-PCR), purified, and fully sequenced. Consensus sequences were submitted to the HIVdb Genotypic Resistance Interpretation Algorithm Database from Stanford University, and then aligned using Clustal X v.2.0 to generate a phylogenetic tree using the maximum likelihood method. Intrasubtype and intersubtype recombination analyses were performed using the SCUEAL program (Subtype Classification by Evolutionary ALgo-rithms). A total of 245 samples (91%) were successfully genotyped. The analysis obtained from the HIVdb program showed 81.5% resistance cases (n=198). The phylogenetic analysis revealed that subtype B was predominant in the population (98.8%), except for new cases of A, C, and H subtypes (n=4). Of these cases, only subtype C was imported. Likewise, recombination analysis revealed nine intersubtype and 20 intrasubtype recombinant cases. This is the first report of the presence of HIV-1 subtypes C and H in Peru. The introduction of new subtypes and circulating recombinants forms can make it difficult to distinguish resistance profiles in patients and consequently affect future treatment strategies against HIV in this country. PMID:22559065

Quechua Language Attitudes and Maintenance in Cuzco, Peru

ERIC Educational Resources Information Center

Manley, Marilyn S.

2008-01-01

This article qualitatively and quantitatively investigates the Quechua language attitudes and maintenance practices of the members of two non-profit, non-governmental agencies in Cuzco, Peru. Within their respective agency/community contexts, the members of both groups claim to have significantly more positive attitudes toward Quechua and exhibit…

INSTITUTIONAL STAKEHOLDER PERCEPTIONS OF BARRIERS TO ADDICTION TREATMENT UNDER MEXICO’S DRUG POLICY REFORM

PubMed Central

Werb, Dan; Strathdee, Steffanie A.; Meza, Emilo; Gomez, Maria Gudelia Rangel; Palinkas, Lawrence; Medina-Mora, Maria Elena; Beletsky, Leo

2017-01-01

Background Mexico has experienced disproportionate drug-related harms given its role as a production and transit zone for illegal drugs destined primarily for the United States. In response, in 2009, the Mexican federal government passed legislation mandating pre-arrest diversion of drug-dependent individuals towards addiction treatment. However, this federal law was not specific about how the scale-up of the addiction treatment sector was to be operationalized. We therefore conducted in-depth qualitative interviews with key ‘interactors’ in fields affected by the federal legislation, including participants from the law enforcement, public health, addiction treatment, and governmental administration sectors. Among 19 participants from the municipal, state, and federal level, multiple barriers to policy reform were identified. First, there is a lack of institutional expertise to implement the reform. Second, the operationalization of the reform was not accompanied by a coordinated action plan. Third, the law is an unfunded mandate. Institutional barriers are likely hampering the implementation of Mexico’s policy reform. Addressing the concerns expressed by interactors through the scale up of services, the provision of increased training and education programs for stakeholders, and a coordinated action plan to operationalize the policy reform, are likely needed to improve the policy reform process. PMID:28278755

Plagiarism, Cheating and Research Integrity: Case Studies from a Masters Program in Peru

PubMed Central

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.

2017-01-01

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. PMID:27848191

Toward greater inclusion: lessons from Peru in confronting challenges of multi-sector collaboration.

PubMed

Buffardi, Anne L; Cabello, Robinson; Garcia, Patricia J

2012-09-01

Despite widespread enthusiasm for broader participation in health policy and programming, little is known about the ways in which multi-sector groups address the challenges that arise in pursuing this goal. Based on the experience of Peru's National Multi-sector Health Coordinating Body (CONAMUSA), this article characterizes these challenges and identifies organizational strategies the group has adopted to overcome them. Comprising nine government ministries, nongovernmental organizations, academia, religious institutions, and international cooperation agencies, CONAMUSA has faced three principal challenges: 1) selecting representatives, 2) balancing membership and leadership across sectors, and 3) negotiating role transition and conflict. In response, the group has instituted a rotation system for formal leadership responsibiliti es, and professionalized management functions; created electoral systems for civil society; and developed conflict of interest guidelines. This case study offers lessons for other countries trying to configure multi-sector groups, and for donors who mandate their creation, tempering unbridled idealism toward inclusive participation with a dose of healthy realism and practical adaptation.

Residual infestation and recolonization during urban Triatoma infestans Bug Control Campaign, Peru.

PubMed

Barbu, Corentin M; Buttenheim, Alison M; Pumahuanca, Maria-Luz Hancco; Calderón, Javier E Quintanilla; Salazar, Renzo; Carrión, Malwina; Rospigliossi, Andy Catacora; Chavez, Fernando S Malaga; Alvarez, Karina Oppe; Cornejo del Carpio, Juan; Náquira, César; Levy, Michael Z

2014-12-01

Chagas disease vector control campaigns are being conducted in Latin America, but little is known about medium-term or long-term effectiveness of these efforts, especially in urban areas. After analyzing entomologic data for 56,491 households during the treatment phase of a Triatoma infestans bug control campaign in Arequipa, Peru, during 2003-2011, we estimated that 97.1% of residual infestations are attributable to untreated households. Multivariate models for the surveillance phase of the campaign obtained during 2009-2012 confirm that nonparticipation in the initial treatment phase is a major risk factor (odds ratio [OR] 21.5, 95% CI 3.35-138). Infestation during surveillance also increased over time (OR 1.55, 95% CI 1.15-2.09 per year). In addition, we observed a negative interaction between nonparticipation and time (OR 0.73, 95% CI 0.53-0.99), suggesting that recolonization by vectors progressively dilutes risk associated with nonparticipation. Although the treatment phase was effective, recolonization in untreated households threatens the long-term success of vector control.

Chronology of guitarrero cave, peru.

PubMed

Lynch, T F; Gillespie, R; Gowlett, J A; Hedges, R E

1985-08-30

Dating by accelerator mass spectrometry of wooden artifacts, cord, and charcoal samples from Guitarrero Cave, Peru, supports the antiquity of South America's earliest textiles and other perishable remains. The new dates are consistent with those obtained from disintegration counters and leave little doubt about the integrity of the lower Preceramic layers and their early cultivars. Re-evaluation of the mode of deposition suggests that most of the remains resulted from short-term use of the cave in the eighth millennium B.C., with a possible brief human visit as early as 12,560 years ago.

Medical Student Views of Substance Abuse Treatment, Policy and Training

ERIC Educational Resources Information Center

Agrawal, Shantanu; Everett, Worth W.; Sharma, Sonali

2010-01-01

Purpose: This study examined the impact of medical education on students' views of substance abuse treatment, public policy options and training. Method: A longitudinal survey was conducted on a single-class cohort of 101 students in a major American, urban medical school. The survey was administered in the Spring semesters of the first to third…

Curriculum and Assessment Policies and Practices in a Day Treatment Center in North Carolina

ERIC Educational Resources Information Center

Ferrell, Kimberly Ann

2013-01-01

The purpose of this qualitative single case study was to describe current instructional policies and practices in a one-day treatment center in North Carolina for students with emotional and behavioral disorders (EBD). The following research questions guided the study: (1) What are the curriculum policies, practices, and philosophies of day…

Epidemiology of Road Traffic Incidents in Peru 1973–2008: Incidence, Mortality, and Fatality

PubMed Central

Miranda, J. Jaime; López-Rivera, Luis A.; Quistberg, D. Alex; Rosales-Mayor, Edmundo; Gianella, Camila; Paca-Palao, Ada; Luna, Diego; Huicho, Luis; Paca, Ada; Luis, López; Luna, Diego; Rosales, Edmundo; Best, Pablo; Best, Pablo; Egúsquiza, Miriam; Gianella, Camila; Lema, Claudia; Ludeña, Esperanza; Miranda, J. Jaime; Huicho, Luis

2014-01-01

Background The epidemiological profile and trends of road traffic injuries (RTIs) in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973–2008, as well as their relationship to population trends such as economic growth. Methods and Findings Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs) of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43–5.31) on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15–0.43), while among adults the fatality rate increased by 1.25 (95% CI 1.09–1.43). Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP) per capita Conclusions The significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs. PMID:24927195

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.

Landslides Are Common In The Amazon Rainforests Of SE Peru

NASA Astrophysics Data System (ADS)

Khanal, S. P.; Muttiah, R. S.; Janovec, J. P.

2005-12-01

The recent landslides in La Conchita, California, Mumbai, India, Ratnapura, Sri Lanka and Sugozu village, Turkey have dramatically illustrated prolonged rainfall on water induced change in soil shear stress. In these examples, the human footprint may have also erased or altered the natural river drainage from small to large scales. By studying patterns of landslides in natural ecosystems, government officials, policy makers, engineers, geologists and others may be better informed about likely success of prevention or amelioration programs in risk prone areas. Our study area in the Los Amigos basin in Amazon rainforests of Southeastern Peru, has recorded several hundred landslides. The area has no large human settlements. The basin is characterized by heavy rainfall, dense vegetation, river meander and uniform soils. Our objectives were: 1). Determine the spatial pattern of landslides using GIS and Remotely sensed data, 2). Model the statistical relationship between environmental variables and, 3). Evaluate influence of drainage on landscape and soil loss. GIS layers consisted of: 50cm aerial imagery, DEMs, digitized streams, soils, geology, rainfall from the TRMM satellite, and vegetation cover from the LANDSAT and MODIS sensors.

Policy Pathways to Address Provider Workforce Barriers to Buprenorphine Treatment.

PubMed

Haffajee, Rebecca L; Bohnert, Amy S B; Lagisetty, Pooja A

2018-06-01

At least 2.3 million people in the U.S. have an opioid use disorder, less than 40% of whom receive evidence-based treatment. Buprenorphine used as part of medication-assisted treatment has high potential to address this gap because of its approval for use in non-specialty outpatient settings, effectiveness at promoting abstinence, and cost effectiveness. However, less than 4% of licensed physicians are approved to prescribe buprenorphine for opioid use disorder, and approximately 47% of counties lack a buprenorphine-waivered physician. Existing policies contribute to workforce barriers to buprenorphine provision and access. Providers are reticent to prescribe buprenorphine because of workforce barriers, such as (1) insufficient training and education on opioid use disorder treatment, (2) lack of institutional and clinician peer support, (3) poor care coordination, (4) provider stigma, (5) inadequate reimbursement from private and public insurers, and (6) regulatory hurdles to obtain the waiver needed to prescribe buprenorphine in non-addiction specialty treatment settings. Policy pathways to addressing these provider workforce barriers going forward include providing free and easy-to-access education for providers about opioid use disorders and medication-assisted treatment, eliminating buprenorphine waiver requirements for those licensed to prescribe controlled substances, enforcing insurance parity requirements, requiring coverage of evidence-based medication-assisted treatment as essential health benefits, and providing financial incentives for care coordination across healthcare professional types-including behavioral health counselors and other non-physicians in specialty and non-specialty settings. This article is part of a supplement entitled The Behavioral Health Workforce: Planning, Practice, and Preparation, which is sponsored by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration of the U

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.

3 CFR - Establishment of the Interagency Committee on Trade in Timber Products from Peru and Assignment...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 3 The President 1 2010-01-01 2010-01-01 false Establishment of the Interagency Committee on Trade in Timber Products from Peru and Assignment of Function under Section 501 of the United States-Peru Trade Promotion Agreement Implementation Act Presidential Documents Other Presidential Documents Memorandum of May 1, 2009 Establishment of the...

[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.

Genetic divergence in populations of Lutzomyia ayacuchensis, a vector of Andean-type cutaneous leishmaniasis, in Ecuador and Peru.

PubMed

Kato, Hirotomo; Cáceres, Abraham G; Gomez, Eduardo A; Mimori, Tatsuyuki; Uezato, Hiroshi; Hashiguchi, Yoshihisa

2015-01-01

Haplotype and gene network analyses were performed on mitochondrial cytochrome oxidase I and cytochrome b gene sequences of Lutzomyia (Lu.) ayacuchensis populations from Andean areas of Ecuador and southern Peru where the sand fly species transmit Leishmania (Leishmania) mexicana and Leishmania (Viannia) peruviana, respectively, and populations from the northern Peruvian Andes, for which transmission of Leishmania by Lu. ayacuchensis has not been reported. The haplotype analyses showed higher intrapopulation genetic divergence in northern Peruvian Andes populations and less divergence in the southern Peru and Ecuador populations, suggesting that a population bottleneck occurred in the latter populations, but not in former ones. Importantly, both haplotype and phylogenetic analyses showed that populations from Ecuador consisted of clearly distinct clusters from southern Peru, and the two populations were separated from those of northern Peru. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

Subcutaneous mycoses in Peru: a systematic review and meta-analysis for the burden of disease.

PubMed

Ramírez Soto, Max Carlos; Malaga, German

2017-10-01

There is a worrying lack of epidemiological data on the geographical distribution and burden of subcutaneous mycoses in Peru, hindering the implementation of surveillance and control programs. This study aimed to estimate the disease burden of subcutaneous mycoses in Peru and identify which fungal species were commonly associated with these mycoses. We performed a meta-analysis after a systematic review of the published literature in PubMed, LILACS, and SciELO to estimate the burden of subcutaneous mycoses in 25 regions in Peru. The disease burden was determined in terms of prevalence (number of cases per 100,000 inhabitants) and the number of reported cases per year per region. A total of 26 studies were eligible for inclusion. Results showed that sporotrichosis was the most common subcutaneous mycosis (99.7%), whereas lobomycosis, chromoblastomycosis, and subcutaneous phaeohyphomycosis were rare. Cases of eumycetoma and subcutaneous zygomycosis were not found. Of the 25 regions, the burden of sporotrichosis was estimated for four regions classified as endemic; in nine regions, only isolated cases were reported. The highest burden of sporotrichosis was in Apurimac (15 cases/100,000 inhabitants; 57 cases/year), followed by Cajamarca (3/100,000 inhabitants; 30/year), Cusco (0.5/100,000 inhabitants; 4/year), and La Libertad (0.2/100,000 inhabitants; 2/year). In two regions, the mycoses predominantly affected children. Sporotrichosis is the most common subcutaneous mycosis in Peru, with a high disease burden in Apurimac. Chromoblastomycosis, lobomycosis, and subcutaneous phaeohyphomycosis are rare mycoses in Peru. © 2017 The International Society of Dermatology.

Potential Predictability and Prediction Skill for Southern Peru Summertime Rainfall

NASA Astrophysics Data System (ADS)

WU, S.; Notaro, M.; Vavrus, S. J.; Mortensen, E.; Block, P. J.; Montgomery, R. J.; De Pierola, J. N.; Sanchez, C.

2016-12-01

The central Andes receive over 50% of annual climatological rainfall during the short period of January-March. This summertime rainfall exhibits strong interannual and decadal variability, including severe drought events that incur devastating societal impacts and cause agricultural communities and mining facilities to compete for limited water resources. An improved seasonal prediction skill of summertime rainfall would aid in water resource planning and allocation across the water-limited southern Peru. While various underlying mechanisms have been proposed by past studies for the drivers of interannual variability in summertime rainfall across southern Peru, such as the El Niño-Southern Oscillation (ENSO), Madden Julian Oscillation (MJO), and extratropical forcings, operational forecasts continue to be largely based on rudimentary ENSO-based indices, such as NINO3.4, justifying further exploration of predictive skill. In order to bridge this gap between the understanding of driving mechanisms and the operational forecast, we performed systematic studies on the predictability and prediction skill of southern Peru summertime rainfall by constructing statistical forecast models using best available weather station and reanalysis datasets. At first, by assuming the first two empirical orthogonal functions (EOFs) of summertime rainfall are predictable, the potential predictability skill was evaluated for southern Peru. Then, we constructed a simple regression model, based on the time series of tropical Pacific sea-surface temperatures (SSTs), and a more advanced Linear Inverse Model (LIM), based on the EOFs of tropical ocean SSTs and large-scale atmosphere variables from reanalysis. Our results show that the LIM model consistently outperforms the more rudimentary regression models on the forecast skill of domain averaged precipitation index and individual station indices. The improvement of forecast correlation skill ranges from 10% to over 200% for different

Magnetometry and Ground-Penetrating Radar Studies in the Sihuas Valley, Peru

NASA Astrophysics Data System (ADS)

Wisnicki, E.; Papadimitrios, K.; Bank, C.

2013-12-01

The Quillcapampa la Antigua site in Peru's Sihuas Valley is a settlement from Peru's Middle Horizon (600-100 A.D.). Archaeological interest in the area stems from the question of whether ancient civilizations were able to have extensive state control of distant groups, or whether state influence occurred through less direct ties (e.g., marriage, religion, or trade). Our geophysical surveys are preliminary to archaeological digging in the area. Ground-penetrating radar and magnetometry attempt to locate areas of interest for focused archaeological excavation, characterize the design of architectural remains and burial mounds in the area, and allow archaeologists to interpret the amount of influence the Wari civilization had on the local residents.

A population-based estimate of the economic burden of influenza in Peru, 2009-2010.

PubMed

Tinoco, Yeny O; Azziz-Baumgartner, Eduardo; Rázuri, Hugo; Kasper, Matthew R; Romero, Candice; Ortiz, Ernesto; Gomez, Jorge; Widdowson, Marc-Alain; Uyeki, Timothy M; Gilman, Robert H; Bausch, Daniel G; Montgomery, Joel M

2016-07-01

Influenza disease burden and economic impact data are needed to assess the potential value of interventions. Such information is limited from resource-limited settings. We therefore studied the cost of influenza in Peru. We used data collected during June 2009-December 2010 from laboratory-confirmed influenza cases identified through a household cohort in Peru. We determined the self-reported direct and indirect costs of self-treatment, outpatient care, emergency ward care, and hospitalizations through standardized questionnaires. We recorded costs accrued 15-day from illness onset. Direct costs represented medication, consultation, diagnostic fees, and health-related expenses such as transportation and phone calls. Indirect costs represented lost productivity during days of illness by both cases and caregivers. We estimated the annual economic cost and the impact of a case of influenza on a household. There were 1321 confirmed influenza cases, of which 47% sought health care. Participants with confirmed influenza illness paid a median of $13 [interquartile range (IQR) 5-26] for self-treatment, $19 (IQR 9-34) for ambulatory non-medical attended illness, $29 (IQR 14-51) for ambulatory medical attended illness, and $171 (IQR 113-258) for hospitalizations. Overall, the projected national cost of an influenza illness was $83-$85 millions. Costs per influenza illness represented 14% of the monthly household income of the lowest income quartile (compared to 3% of the highest quartile). Influenza virus infection causes an important economic burden, particularly among the poorest families and those hospitalized. Prevention strategies such as annual influenza vaccination program targeting SAGE population at risk could reduce the overall economic impact of seasonal influenza. © 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

75 FR 13421 - Federal Acquisition Regulation; FAR Case 2008-036, Trade Agreements-Costa Rica, Oman, and Peru

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

... 9000-AL23 Federal Acquisition Regulation; FAR Case 2008-036, Trade Agreements--Costa Rica, Oman, and... United States-Oman Free Trade Agreement, and the United States-Peru Trade Promotion Agreement. DATES... interim rule. The interim rule added Costa Rica, Oman, and Peru to the definition of ``Free Trade...

Organic quinoa (Chenopodium quinoa L.) production in Peru: Environmental hotspots and food security considerations using Life Cycle Assessment.

PubMed

Cancino-Espinoza, Eduardo; Vázquez-Rowe, Ian; Quispe, Isabel

2018-05-08

Quinoa is a plant that is cultivated in the Andean highlands across Peru and Bolivia. It is increasingly popular due to its high nutritive value and protein content. In particular, the cultivation of organic quinoa has grown substantially in recent years since it is the most demanded type of quinoa in the foreign market. Nevertheless, despite the interest that quinoa has generated in terms of its nutritional properties, little is known regarding the environmental profile of its production and processing. Therefore, the main objective of this study was to analyze the environmental impacts that are linked to the production and distribution of organic quinoa to the main export destinations through the application of the Life Cycle Assessment (LCA) methodology. An attributional LCA perspective was conducted including data from approximately 55 ha of land used for quinoa production in the regions of Huancavelica and Ayacucho, in southern-central Peru. IPCC, 2013 and ReCiPe 2008 were the two assessment methods selected to estimate the environmental impact results using the SimaPro 8.3 software. Results, which were calculated for one 500 g package of organic quinoa, showed that GHG emissions are in the upper range of other organic agricultural products. However, when compared to other high protein content food products, especially those from animal origin, considerably low environmental impacts are obtained. For instance, if 20% of the average annual beef consumption in Peru is substituted by organic quinoa, each Peruvian would mitigate 31 kg CO 2 eq/year in their diet. Moreover, when the edible protein energy return on investment (i.e., ep-EROI) is computed, a ratio of 0.38 is obtained, in the higher range of protein rich food products. However, future research should delve into the environmental and food policy implications of agricultural land expansion to produce an increasing amount of quinoa for a growing global demand. Copyright © 2018 Elsevier B.V. All

Smoking and tobacco-free policies in women's residential substance use disorder treatment facilities: A community engaged approach.

PubMed

Fallin-Bennett, Amanda; Parker, Kimberly A; Miller, Alana; Ashford, Kristin; Hahn, Ellen J

2017-09-19

The purpose of this study was to: (1) describe the role of smoking in the lives of women in residential SUD treatment; (2) explore perceptions of the facilitators and barriers to tobacco-free policy among women in residential SUD treatment. This was a community engaged study using qualitative descriptive methods. We first recruited women in a residential SUD treatment facility to participate on a community research team. Interviews with staff (N=10) and focus groups with clients (N=42) were conducted using guides informed by the community research team. Interviews and focus groups were analyzed using content analysis. There were two themes related to the role of smoking in the women's lives: (1) smoking facilitates socialization; and (2) smoking as a coping mechanism. There were three themes related to the benefits of tobacco-free policy: (1) improved health; (2) support for continued abstinence from a previous tobacco-free placement (e.g, prison); and (3) less grounds up-keep. Barriers to tobacco-free policy included: (1) lack of an alternative coping mechanism to smoking; (2) fear that a tobacco-free policy would drive clients away; and (3) anticipation of implementation challenges. Many women in residential SUD treatment smoke, which they attribute to the fact that smoking is used to facilitate socialization and cope with stress. Future research is needed to develop and test messages to counter the misperception that smoking is an effective method to cope with stress. Ultimately, evidence based tobacco-free policies are needed to reduce tobacco-related disease among women with SUDs. To promote smoking cessation among women with substance use disorders through evidence based tobacco policy, it is necessary to first understand the role of smoking in their lives as well as facilitators and barriers to tobacco-free policy in residential treatment facilities. Participants reported that smoking facilitated socialization and served as a coping mechanism. Tobacco

[Remunerations, benefits and labor incentives perceived by health care workers in Peru: an analysis comparing the Ministry of Health and the Social Insurance, 2009].

PubMed

Pardo, Karim; Andia, Marcelino; Rodriguez, Amado; Pérez, Walter; Moscoso, Betsy

2011-06-01

To describe the main characteristics of the general salaries situation and the incentive policies of health care workers of Peru, comparing them by their origin institution and type of contract. A mixed design study was done including both quantitative and qualitative components during 2008 and 2009 with both professional and technical personnel of the Ministry of Health (MINSA) and the Social Insurance (EsSalud) in Peru. The salary structure was primarily evaluated considering incentives, bonuses and other remunerations according to position, type of contract and work place. Remuneration and bonus policies at the national level are determined by the responsibilities and amount of time served. The type of contract is determined by the programs of the public system (DL 276) and the private system (DL 728), also by the Special Program of Contract Services Administration (CAS) and exclusively in MINSA contracting is determined by local health administration Committees (CLAS). The salary structure differs between both types of institutions, especially with respect to incentives and benefits. An special economic incentive for assistance (AETA) is unique to MINSA, but the proportion of assistance varies by region. The professionals of MINSA have lower salaries than those of EsSalud, in all types of contracts. A professional contracted through CAS generally has a lower salary than staff peers in MINSA, though this situation is reversed in EsSalud. The lowest salaries are found in contracts made through CLAS. The structure and salary amounts differ between MINSA and EsSalud, just as they differ by existing contracting types.

Nine genera of Eucnemidae (Coleoptera) new to Peru, with a key to Peruvian genera

PubMed Central

Muona, Jyrki; Linna, Ari; Sääksjärvi, Ilari E.

2015-01-01

Abstract Thirteen genera of Eucnemidae containing forty species were collected from the Iquitos region in Peru. Nine of the genera are new to the country: Rhagomicrus Fleutiaux, 1902, Adelorhagus Horn, 1890, Adelothyreus Chevrolat, 1867, Microrhagus Dejean, 1833, Dyscharachthis Blackburn, 1900, Heterotaxis Bonvouloir, 1871, Spinifornax Fleutiaux, 1926, Serrifornax Fleutiaux, 1926 and Maelodrus Fleutiaux, 1928. The previous eucnemid record from Peru contained eleven species in ten genera. Only one of the forty species caught, Entomophthalmus americanus Bonvouloir, was previously known and described from the country. Dyscharachthis, Maelodrus and Adelorhagus are recorded from South America for the first time. Many of the collected species seem to favor white-sand forest as their habitat. Possible reasons for this are discussed. A list of eucnemids from Peru is included, containing taxa already recorded from the country and also taxa that are likely to occur there. A key to the Peruvian genera is included. PMID:25834475

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.

[Cluster of multidrug-resistant tuberculosis cases in a school of the district of Ica, Peru].

PubMed

Torres, Julio; Sardón, Victoria; Soto, Mirtha G; Anicama, Rolado; Arroyo-Hernández, Hugo; Munayco, César V

2011-01-01

We describe the evolution and features of a cluster of Multidrug-resistant tuberculosis (MDR TB) cases that occurred in 2001, in a school located in a sub-urban area of the district of Ica, Peru. We identified 15 students related before becoming infected with tuberculosis. The mean age of the cluster was 15 years. A total of 12 students were MDR-TB cases and 7 were drug-resistant to 5 first-line drugs (RHEZS). Five out of the 15 cases received at least 3 different anti-tuberculosis treatment schemes. The average treatment duration was 37 months (minimum 21 and maximum 59 months). A total of 13 cases recovered and 2 died. This study describes a cluster of MDR -TB cases in an educational facility, which due to the epidemiological link and time presentation, is probably an outbreak of MDR TB with a satisfactory outcome after prolonged treatment.

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.

Nazca Lines, Peru

NASA Image and Video Library

2017-12-08

Acquisition Date: November 10, 2002 In the desert of southwest Peru, between the Andes Mountains and the Peruvian coast, lies a plateau with huge geometric patterns and spirals, animal figures including a monkey, a spider, and an 'owl man,' and thousands of perfectly straight lines. The last of these was drawn about a thousand years ago. Known as the Nazca lines, the drawings have mystified scientists since they were first discovered in the 1920s. Pictured here is all that can be seen of these lines by Landsat 7's 15 meter pan band, which has been used to sharpen the 30 meter Bands 3, 2, and 1. Credit: NASA/GSFC/Landsat/USGS To learn more about Landsat and to see the orginal high res file go to: landsat.usgs.gov/gallery_view.php?category=greenflag&...

Shark fisheries in the Southeast Pacific: A 61-year analysis from Peru

PubMed Central

Gonzalez-Pestana, Adriana; Kouri J., Carlos; Velez-Zuazo, Ximena

2016-01-01

Peruvian waters exhibit high conservation value for sharks. This contrasts with a lag in initiatives for their management and a lack of studies about their biology, ecology and fishery. We investigated the dynamics of Peruvian shark fishery and its legal framework identifying information gaps for recommending actions to improve management. Further, we investigated the importance of the Peruvian shark fishery from a regional perspective. From 1950 to 2010, 372,015 tons of sharks were landed in Peru. From 1950 to 1969, we detected a significant increase in landings; but from 2000 to 2011 there was a significant decrease in landings, estimated at 3.5% per year. Six species represented 94% of landings: blue shark ( Prionace glauca), shortfin mako ( Isurus oxyrinchus), smooth hammerhead ( Sphyrna zygaena), common thresher ( Alopias vulpinus), smooth-hound ( Mustelus whitneyi) and angel shark ( Squatina californica). Of these, the angel shark exhibits a strong and significant decrease in landings: 18.9% per year from 2000 to 2010. Peru reports the highest accumulated historical landings in the Pacific Ocean; but its contribution to annual landings has decreased since 1968. Still, Peru is among the top 12 countries exporting shark fins to the Hong Kong market. Although the government collects total weight by species, the number of specimens landed as well as population parameters (e.g. sex, size and weight) are not reported. Further, for some genera, species-level identification is deficient and so overestimates the biomass landed by species and underestimates the species diversity. Recently, regional efforts to regulate shark fishery have been implemented to support the conservation of sharks but in Peru work remains to be done. PMID:27635216

Shark fisheries in the Southeast Pacific: A 61-year analysis from Peru.

PubMed

Gonzalez-Pestana, Adriana; Kouri J, Carlos; Velez-Zuazo, Ximena

2014-01-01

Peruvian waters exhibit high conservation value for sharks. This contrasts with a lag in initiatives for their management and a lack of studies about their biology, ecology and fishery. We investigated the dynamics of Peruvian shark fishery and its legal framework identifying information gaps for recommending actions to improve management. Further, we investigated the importance of the Peruvian shark fishery from a regional perspective. From 1950 to 2010, 372,015 tons of sharks were landed in Peru. From 1950 to 1969, we detected a significant increase in landings; but from 2000 to 2011 there was a significant decrease in landings, estimated at 3.5% per year. Six species represented 94% of landings: blue shark ( Prionace glauca), shortfin mako ( Isurus oxyrinchus), smooth hammerhead ( Sphyrna zygaena), common thresher ( Alopias vulpinus), smooth-hound ( Mustelus whitneyi) and angel shark ( Squatina californica). Of these, the angel shark exhibits a strong and significant decrease in landings: 18.9% per year from 2000 to 2010. Peru reports the highest accumulated historical landings in the Pacific Ocean; but its contribution to annual landings has decreased since 1968. Still, Peru is among the top 12 countries exporting shark fins to the Hong Kong market. Although the government collects total weight by species, the number of specimens landed as well as population parameters (e.g. sex, size and weight) are not reported. Further, for some genera, species-level identification is deficient and so overestimates the biomass landed by species and underestimates the species diversity. Recently, regional efforts to regulate shark fishery have been implemented to support the conservation of sharks but in Peru work remains to be done.

Iquitos Virus: A Novel Reassortant Orthobunyavirus Associated with Human Illness in Peru

PubMed Central

Aguilar, Patricia V.; Barrett, Alan D.; Saeed, Mohammad F.; Watts, Douglas M.; Russell, Kevin; Guevara, Carolina; Ampuero, Julia S.; Suarez, Luis; Cespedes, Manuel; Montgomery, Joel M.; Halsey, Eric S.; Kochel, Tadeusz J.

2011-01-01

Oropouche (ORO) virus, a member of the Simbu serogroup, is one of the few human pathogens in the Orthobunyavirus genus in the family Bunyaviridae. Genetic analyses of ORO-like strains from Iquitos, Peru, identified a novel reassortant containing the S and L segments of ORO virus and the M segment of a novel Simbu serogroup virus. This new pathogen, which we named Iquitos (IQT) virus, was first isolated during 1999 from a febrile patient in Iquitos, an Amazonian city in Peru. Subsequently, the virus was identified as the cause of outbreaks of “Oropouche fever” during 2005 and 2006 in Iquitos. In addition to the identification of 17 isolates of IQT virus between 1999 and 2006, surveys for neutralizing antibody among Iquitos residents revealed prevalence rates of 14.9% for ORO virus and 15.4% for IQT virus. Limited studies indicate that prior infection with ORO virus does not seem to protect against disease caused with the IQT virus infection. Identification of a new Orthobunyavirus human pathogen in the Amazon region of Peru highlights the need for strengthening surveillance activities and laboratory capabilities, and investigating the emergence of new pathogens in tropical regions of South America. PMID:21949892

Linguistic Purism in Cuzco, Peru: A Historical Perspective.

ERIC Educational Resources Information Center

Nino-Murcia, Mercedes

1997-01-01

Notes that a group of mestizo intellectuals in Peru claims that "Qhpaj'simi" is the Quechua used by the ancient Inca nobility and is the purest form of Quechua. Explains that a social hierarchy has arisen with the use of this "imperial language" demarcating its users from the common people and that these purist attitudes play a…

Availability of tobacco cessation services in substance use disorder treatment programs: Impact of state tobacco control policy.

PubMed

Abraham, Amanda J; Bagwell-Adams, Grace; Jayawardhana, Jayani

2017-08-01

Given the high prevalence of smoking among substance use disorder (SUD) patients, the specialty SUD treatment system is an important target for adoption and implementation of tobacco cessation (TC) services. While research has addressed the impact of tobacco control on individual tobacco consumption, largely overlooked in the literature is the potential impact of state tobacco control policies on availability of services for tobacco cessation. This paper examines the association between state tobacco control policy and availability of TC services in SUD treatment programs in the United States. State tobacco control and state demographic data (n=51) were merged with treatment program data from the 2012 National Survey of Substance Abuse Treatment Services (n=10.413) to examine availability of TC screening, counseling and pharmacotherapy services in SUD treatment programs using multivariate logistic regression models clustered at the state-level. Approximately 60% of SUD treatment programs offered TC screening services, 41% offered TC counseling services and 26% offered TC pharmacotherapy services. Results of multivariate logistic regression showed the odds of offering TC services were greater for SUD treatment programs located in states with higher cigarette excise taxes and greater spending on tobacco prevention and control. Findings indicate cigarette excise taxes and recommended funding levels may be effective policy tools for increasing access to TC services in SUD treatment programs. Coupled with changes to insurance coverage for TC under the Affordable Care Act, state tobacco control policy tools may further reduce tobacco use in the United States. Published by Elsevier Ltd.

Stigma, discrimination, treatment effectiveness, and policy: public views about drug addiction and mental illness.

PubMed

Barry, Colleen L; McGinty, Emma E; Pescosolido, Bernice A; Goldman, Howard H

2014-10-01

Public attitudes about drug addiction and mental illness were compared. A Web-based national survey (N=709) was conducted to compare attitudes about stigma, discrimination, treatment effectiveness, and policy support in regard to drug addiction and mental illness. Respondents held significantly more negative views toward persons with drug addiction. More respondents were unwilling to have a person with drug addiction marry into their family or work closely with them. Respondents were more willing to accept discriminatory practices against persons with drug addiction, more skeptical about the effectiveness of treatments, and more likely to oppose policies aimed at helping them. Drug addiction is often treated as a subcategory of mental illness, and insurance plans group them together under the rubric of "behavioral health." Given starkly different public views about drug addiction and mental illness, advocates may need to adopt differing approaches to reducing stigma and advancing public policy.

Promising Practices in Drug Treatment: Findings from Latin America

ERIC Educational Resources Information Center

Nemes, Susanna; Libretto, Salvatore; Garrett, Gerald; Johansson, Anna Carin; Hess, Lauren

2005-01-01

In a study to evaluate the drug treatment and aftercare efforts sponsored by the State Department's International Narcotics and Law Enforcement Affairs Bureau, residential Therapeutic Community (TC) treatment programs in three Latin American countries--Brazil, Peru and Argentina--were examined to identify promising practices and to assess lessons…

The role of evidence and the expert in contemporary processes of governance: the case of opioid substitution treatment policy in England.

PubMed

Duke, Karen; Thom, Betsy

2014-09-01

This paper is based on research examining stakeholder involvement in substitution treatment policy which was undertaken as part of the EU funded FP7 ALICE-RAP (Addictions and Lifestyles in Contemporary Europe - Reframing Addictions Project). In England, the research coincided with a policy shift towards a recovery orientated drug treatment framework and a heated debate surrounding the role of substitute prescribing. The study aimed to explore the various influences on the development of the new 'recovery' policy from the perspectives of the key stakeholders involved. The paper is based on documentary analyses and key informant interviews with a range of stakeholders, including representatives of user organisations, treatment providers, civil servants, and members of expert committees. Drawing on the theoretical insights offered by Backstrand's 'civic science' framework, the changing role of evidence and the position of experts in the processes of drugs policy governance are explored. 'Evidence' was used to problematise the issue of substitution treatment and employed to legitimise, justify and construct arguments around the possible directions of policy and practice. Conflicting beliefs about drug treatment and about motivation for policy change emerge in the argumentation, illustrating tensions in the governance of drug treatment and the power differentials separating different groups of stakeholders. Their role in the production of evidence also illustrates issues of power regarding the definition and development of 'usable knowledge'. There were various attempts at greater representation of different forms of evidence and participation by a wider group of stakeholders in the debates surrounding substitution treatment. However, key national and international experts and the appointment of specialist committees continued to play dominant roles in building consensus and translating scientific evidence into policy discourse. Substitution treatment policy has

Guaroa Virus Infection among Humans in Bolivia and Peru

PubMed Central

Aguilar, Patricia V.; Morrison, Amy C.; Rocha, Claudio; Watts, Douglas M.; Beingolea, Luis; Suarez, Victor; Vargas, Jorge; Cruz, Cristhopher; Guevara, Carolina; Montgomery, Joel M.; Tesh, Robert B.; Kochel, Tadeusz J.

2010-01-01

Guaroa virus (GROV) was first isolated from humans in Colombia in 1959. Subsequent isolates of the virus have been recovered from febrile patients and mosquitoes in Brazil, Colombia, and Panama; however, association of the virus with human disease has been unclear. As part of a study on the etiology of febrile illnesses in Peru and Bolivia, 14 GROV strains were isolated from patients with febrile illnesses, and 3 additional cases were confirmed by IgM seroconversion. The prevalence rate of GROV antibodies among Iquitos residents was 13%; the highest rates were among persons with occupations such as woodcutters, fisherman, and oil-field workers. Genetic characterization of representative GROV isolates indicated that strains from Peru and Bolivia form a monophyletic group that can be distinguished from strains isolated earlier in Brazil and Colombia. This study confirms GROV as a cause of febrile illness in tropical regions of Central and South America. PMID:20810845

New insight on the water management in Ica Valley-Peru

NASA Astrophysics Data System (ADS)

Guttman, Joseph; Berger, Diego

2014-05-01

The Andes divide Peru into three natural drainage basins: Pacific basin, Atlantic basin and Lake Titicaca basin. According to the National Water Authority (ANA), the Pacific basin is the driest basin. The bulk of water that feed the local aquifers in the coastal Pacific region is coming from rivers that flow west from the Andes. One of them is the Ica River- source of the Ica Aquifer and the Pampas de Villacuri Aquifer. The Ica River flows in a graben that was created by a series of faults. The graben is filled with sand and gravel with interbeded and lenses of clay. The aquifer thickness varies between 25 meters to more than 200 meters. The Ica Valley has an extension of 7700 km2 and belongs to the Province of Ica, the second larger economic center in Peru. The Valley is located in the hyperarid region of the Southern Coastal area of Peru with a few millimeters of precipitation per year. The direct recharge is almost zero. The recharge into the Ica Valley aquifer is comes indirectly by infiltration of storm water through the riverbed generates in the Andes, through irrigation canals and by irrigation return flow. In this hyperarid region, local aquifers like the Ica Valley are extremely valuable resources to local populations and are the key sources of groundwater for agriculture and population needs. Therefore, these aquifers play a crucial role in providing people with water and intense attention should be given to manage the water sector properly and to keep the aquifer sustainable for future generations. The total pumping (from rough estimations) is much greater than the direct and indirect recharge. The deficit in the water balance is reflected in large water level decline, out of operation of shallow wells and the ascending of saline water from deeper layers. The change from flood irrigation that contributes about 35-40% of the water to the aquifer, to drip irrigation dramatically reduces the amount of water that infiltrates into the sub-surface from the

Equity in health and health care in Peru, 2004-2008.

PubMed

Petrera, Margarita; Valdivia, Martín; Jimenez, Eduardo; Almeida, Gisele

2013-02-01

This study evaluates whether recent positive economic trends and pro-poor health policies have resulted in more health equity and explores key factors that explain such change. This study focuses on the evolution of measures of health status (self-reported morbidity) and use of health care services obtained from the 2004 and 2008 rounds of the Peruvian National Household Survey (Encuesta Nacional de Hogares). It concentrates on health inequalities associated with socioeconomic status and uses interquintile differences (gradient), concentration indices with and without needs-based adjustments, and decomposition analysis. Findings show a low level of inequality in measures of health status, with a slightly pro-poor inequality in self-reported health problems and a slightly pro-rich inequality in self-reported chronic illness. Inequity in the use of curative services declined significantly between 2004 and 2008, while inequity in the use of preventive services increased slightly. Use of hospital and dental services remained unchanged during the same period. Limitations of self-reported morbidity measures probably underestimate the results of health inequalities across socioeconomic groups. Improved equity in the use of curative health services can be explained by a number of positive factors that occurred concurrently during the analysis-namely, increased mean household income, reduced economic inequality, the Juntos conditional cash transfer program, and gradual expansion of public health insurance, Seguro Integral de Salud (SIS). Given that SIS expansion is the main public policy for promoting health equity in Peru, it is crucial that future steps in expansion come with a strategy to isolate its contribution to health equity improvements from that of other positive socioeconomic trends.

Residual Infestation and Recolonization during Urban Triatoma infestans Bug Control Campaign, Peru1

PubMed Central

Buttenheim, Alison M.; Pumahuanca, Maria-Luz Hancco; Calderón, Javier E. Quintanilla; Salazar, Renzo; Carrión, Malwina; Rospigliossi, Andy Catacora; Chavez, Fernando S. Malaga; Alvarez, Karina Oppe; Cornejo del Carpio, Juan; Náquira, César; Levy, Michael Z.

2014-01-01

Chagas disease vector control campaigns are being conducted in Latin America, but little is known about medium-term or long-term effectiveness of these efforts, especially in urban areas. After analyzing entomologic data for 56,491 households during the treatment phase of a Triatoma infestans bug control campaign in Arequipa, Peru, during 2003–2011, we estimated that 97.1% of residual infestations are attributable to untreated households. Multivariate models for the surveillance phase of the campaign obtained during 2009–2012 confirm that nonparticipation in the initial treatment phase is a major risk factor (odds ratio [OR] 21.5, 95% CI 3.35–138). Infestation during surveillance also increased over time (OR 1.55, 95% CI 1.15–2.09 per year). In addition, we observed a negative interaction between nonparticipation and time (OR 0.73, 95% CI 0.53–0.99), suggesting that recolonization by vectors progressively dilutes risk associated with nonparticipation. Although the treatment phase was effective, recolonization in untreated households threatens the long-term success of vector control. PMID:25423045

[Anisakidosis a marine parasitic zoonosis: unknown or emerging in Peru?].

PubMed

Cabrera, Rufino; Del Pilar, María; Altamirano, Trillo

2004-01-01

The purpose of this review is to show the experimental studies carried out on the biological cycle, culture, pathogenicity of the anisakidae nematode larvae and to disseminate the information regarding current epidemy and the probable emergence of anisakidosis in Peru, and in addition, to propose measures of prevention and control, as well as the perspective and need for investigation. The studies of experimental pathogenicity in cats, dos, and hamsters are incomplete. Eight cases of acute human anisakidosis have been reported (5 confirmed and 3 unconfirmed). It is probable that it emerges during the "El Niño" Weather Phenomenon; however, during normal conditions it is probably due to the increase of raw fish consumption and other factors. In the coast of Peru, five and four fishes of direct human consumption are parasited by the Anisakis simplex and Anisakis physeteris larva, respectively, and two fishes are parasited by the Pseudoterranova decipiens. The main host for the Anisakis simplex is the dolphin (Delphinus delphia), but the Contracaecum osculatum is hosted by the sea lion: Otaria byronia and Arctocephalus australis, P. decipiens parasita a O. byronia. Eviscerating the fish would be most adequate prevention method to lessen the risk of human infection. There is evidence that anisakidosis is an underestimated zoonosis in Peru, and that it is probably and emerging disease. Therefore, its presence is to be suspected in patients with the prototype clinical syndrome.

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

Engagement of adolescents in a health communications program to prevent noncommunicable diseases: Multiplicadores Jóvenes, Lima, Peru, 2011.

PubMed

Diez-Canseco, Francisco; Boeren, Yulissa; Quispe, Renato; Chiang, Mey Lin; Miranda, J Jaime

2015-03-05

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. 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. 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. 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. 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.

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

[Human and animal fascioliasis in Peru: impact in the economy of endemic zones].

PubMed

Espinoza, José R; Terashima, Angélica; Herrera-Velit, Patricia; Marcos, Luis A

2010-01-01

Fasciola hepatica is the causative agent of fasciolosis in Peru; the disease is an important public health problem by the high prevalence of the human infection affecting mainly children and a major veterinary problem by the high rates of infected livestock. The human disease is endemic in the Sierra and the Coast but sporadic in the Amazonia, and reported in 18 Departments, while the animal infection in 21 of 24 Departments of Peru. Transmission occurs in Andean rural populations engaged in agriculture, but recently an increasing number of people became infected in the cities. The epidemiological situation in Peru includes i) Departments with non-autochtonous cases, where infection occurs by consumption of contaminated vegetables brought from endemic areas or infection is acquired by visit to endemic areas; ii) Departments with hypoendemic and mesoendemic villages, where transmission occurs by ingest of contaminated vegetables and prevalence ≤10%; and iii) Departments with hyper-endemic villages with human prevalence >10 %, with an intense transmission by consumption of contaminated vegetables. The disease affects bovine, sheep, goat, swine, equine, South American camelids, rabbits and guinea pigs. The negative impact of fasciolosis in the livestock economy is not lesser than US$ 50 million per year, estimation based on the prevalence and the number of condemned livers in the abattoirs. It is difficult to estimate the economic impact of this infection in the human health due to its status of neglected disease, but fasciolosis is hyper-endemic in the poorest Andean areas of Peru where the situation has to be recognized as a public health emergency.

Identifying the social and environmental determinants of plague endemicity in Peru: insights from a case study in Ascope, La Libertad.

PubMed

Rivière-Cinnamond, Ana; Santandreu, Alain; Luján, Anita; Mertens, Frederic; Espinoza, John Omar; Carpio, Yesenia; Bravo, Johnny; Gabastou, Jean-Marc

2018-02-06

Plague remains a public health problem in specific areas located in Bolivia, Brazil, Ecuador and Peru. Its prevention and control encompasses adequate clinical management and timely laboratory diagnosis. However, understanding communities' interaction with its surrounding ecosystem as well as the differences between community members and institutional stakeholders regarding the root causes of plague might contribute to understand its endemicity. We aim at bridging the traditionally separate biological and social sciences by elucidating communities' risk perception and identifying knowledge gaps between communities and stakeholders. This approach has been used in other areas but never in understanding plague endemicity, nor applied in the Latin American plague context. The objectives were to identify (i) plague risk perception at community level, (ii) perceived social and environmental determinants of plague endemicity, and (iii) institutions that need to be involved and actions needed to be taken as proposed by stakeholders and community members. The study was performed in 2015 and took place in Ascope rural province, La Libertad Region, in Peru, where the study areas are surrounded by intensive private sugarcane production. We propose using a multi-level discourse analysis. Community households were randomly selected (n = 68). Structured and semi-structured questionnaires were applied. A stakeholder analysis was used to identify policy makers (n = 34). In-depth interviews were performed, recorded and transcribed. Descriptive variables were analyzed with SPSS®. Answers were coded following variables adapted from the Commission on Social Determinants of Health and analyzed with the assistance of ATLAS.ti®. Results showed that risk perception was low within the community. Policy-makers identified agriculture and sugarcane production as the root cause while community answers ranked the hygiene situation as the main cause. Stakeholders first ranked

Perceptions of the state policy environment and adoption of medications in the treatment of substance use disorders.

PubMed

Knudsen, Hannah K; Abraham, Amanda J

2012-01-01

Despite growing interest in the use of evidence-based treatment practices for treating substance use disorders, adoption of medications by treatment programs remains modest. Drawing on resource dependence and institutional theory, this study examined the relationships between adoption of medications by treatment programs and their perceptions about the state policy environment. Data were collected through mailed surveys and telephone interviews with 250 administrators of publicly funded substance abuse treatment programs in the United States between 2009 and 2010. Multiple imputation and multivariate logistic regression were used to estimate the associations between perceptions of the state policy environment and the odds of adopting at least one medication for the treatment of substance use disorders. A total of 91 (37%) programs reported having prescribed any medication for treatment of a substance use disorder. Programs were significantly more likely to have adopted at least one medication if they perceived greater support for medications by the Single State Agency. The odds of adoption were significantly greater if the program was aware that at least one medication was included on their state's Medicaid formulary and that state-contract funding permitted the purchase of medications. States may play significant roles in promoting the adoption of medications, but adequate dissemination of information about state policies and priorities may be vital to further adoption. Future research should continue to study the relationships between the adoption of medications for treating substance use disorders and the evolving policy environment.

Perceptions of the State Policy Environment and Adoption of Medications in the Treatment of Substance Use Disorders

PubMed Central

Knudsen, Hannah K.; Abraham, Amanda J.

2012-01-01

Objective Despite growing interest in the use of evidence-based treatment practices for treating substance use disorders, adoption of medications by treatment programs remains modest. Drawing on resource dependence and institutional theory, this study examined the relationships between adoption of medications by treatment programs and their perceptions about the state policy environment. Methods Data were collected through mailed surveys and telephone interviews with 250 administrators of publicly funded substance abuse treatment programs in the United States between 2009 and 2010. Multiple imputation and multivariate logistic regression were used to estimate the associations between perceptions of the state policy environment and the odds of adopting at least one medication for the treatment of substance use disorders. Results A total of 91 (37%) programs reported having prescribed any medication for treatment of a substance use disorder. Programs were significantly more likely to have adopted at least one medication if they perceived greater support for medications by the Single State Agency. The odds of adoption were significantly greater if the program was aware that at least one medication was included on their state’s Medicaid formulary and that state-contract funding permitted the purchase of medications. Conclusions States may play significant roles in promoting the adoption of medications, but adequate dissemination of information about state policies and priorities may be vital to further adoption. Future research should continue to study the relationships between the adoption of medications for treating substance use disorders and the evolving policy environment. PMID:22227755

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.

Seasonal Distribution, Biology, and Human Attraction Patterns of Mosquitoes (Diptera: Culicidae) in a Rural Village and Adjacent Forested Site Near Iquitos, Peru

DTIC Science & Technology

2008-11-01

and malarial activity in the Amazon Basin, Loreto Department, Peru , to determine the relative abundance, species diversity, and seasonal and vertical...populations. KEY WORDS Anopheles, bionomics, mosquito ecology, Amazon Basin, Peru Malaria and other arthropod-vectored diseases are on the increase...in the Amazon Basin region of Peru to date. The Puerto Almendra area was selected because human cases of dengue, malaria, Mayaro, Oropouche

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.

Maternal Violence, Victimization, and Child Physical Punishment in Peru

ERIC Educational Resources Information Center

Gage, Anastasia J.; Silvestre, Eva A.

2010-01-01

Objectives: This study examined whether mothers' experience of violence was a risk factor for physical punishment. Methods: Data were derived from the nationally representative 2000 Peru Demographic and Family Health Survey. Participants were 12,601 currently married women who were living with biological children aged 0-17 years and were…

The Challenges of Educational Reform in Modern-Day Peru

ERIC Educational Resources Information Center

McDonald, Jane; Lammert, Jill

2006-01-01

The purpose of this article is to examine a nationwide effort of educational reform in Peru. Specifically, the authors take a close look at the nation's efforts to change secondary education through the implementation of a 2-year postsecondary learning opportunity called the "bachillerato." First, the authors briefly present the…

Zooplankton research off Peru: A review

NASA Astrophysics Data System (ADS)

Ayón, Patricia; Criales-Hernandez, Maria I.; Schwamborn, Ralf; Hirche, Hans-Jürgen

2008-10-01

A review of zooplankton studies conducted in Peruvian marine waters is given. After a short history of the development of zooplankton research off Peru, we review zooplankton methodology, taxonomy, biodiversity, spatial distribution, seasonal and interannual variability, trophodynamics, secondary production, and modelling. We review studies on several micro-, meso-, macro-, and meroplankton groups, and give a species list from both published and unpublished reports. Three regional zooplankton groups have been identified: (1) a continental shelf group dominated by Acartia tonsa and Centropages brachiatus; (2) a continental slope group characterized by siphonophores, bivalves, foraminifera and radiolaria; (3) and a species-rich oceanic group. The highest zooplankton abundances and biomasses were often found between 4-6°S and 14-16°S, where continental shelves are narrow. Species composition changes with distance from the shore. Species composition and biomass also vary strongly on short time scales due to advection, peaks of larval production, trophic interactions, and community succession. The relation of zooplankton to climatic variability (ENSO and multi-decadal) and fish stocks is discussed in the context of ecological regime shifts. An intermediate upwelling hypothesis is proposed, based on the negative effects of low upwelling intensity in summer or extremely strong and enduring winter upwelling on zooplankton abundance off Peru. According to this hypothesis, intermediate upwelling creates an optimal environmental window for zooplankton communities. Finally, we highlight important knowledge gaps that warrant attention in future.

Herbal Medicine Practices of Patients With Liver Cancer in Peru: A Comprehensive Study Toward Integrative Cancer Management

PubMed Central

Rojas Rojas, Teresa; Bourdy, Geneviève; Ruiz, Eloy; Cerapio, Juan-Pablo; Pineau, Pascal; Gardon, Jacques; Doimi, Franco; Deparis, Xavier; Deharo, Eric; Bertani, Stéphane

2016-01-01

Rationale: The highest burden of liver cancer occurs in developing countries, where the use of herbal medicine (HM) is still widespread. Despite this trend, few studies have been conducted to report HM practices of patients with a hepatic tumor in the developing world. Hence, this study aimed to document the use of HM among patients with liver cancer in Peru. Study Design and Methods: A comparative behavioral epidemiological survey was conducted among liver cancer patients attending the National Cancer Institute of Peru. Information was obtained by direct interviews based on a semistructured questionnaire. The use of HM in Peruvian liver cancer patients was reported, first, regarding general consumption prior to the onset of disease, and second, after the appearance of symptoms that patients would relate to their tumor. In parallel, general consumption of HM in noncancerous people was assessed as a comparative figure. A correspondence analysis was performed to reveal potential associations between the symptoms of cancer and the specific use of HM. Results: Eighty-eight patients and 117 noncancerous individuals participated in the survey. Overall, 68.3% of the people interviewed claimed to use HM on a regular basis for general health preservation. Furthermore, 56.8% of the patients turned to plants first to treat the disorders for which they later came to the cancer care center. When compared with the number of plant species used routinely (n = 78), a selection of plants was made by patients in response to the symptoms of cancer (n = 46). At least 2 plant species, Aloe vera and Morinda citrifolia, were significantly associated with the treatment of liver cancer–related symptoms in the patient group. Conclusions: The present study is the first survey on the HM practices of patients with liver cancer in Latin America and, more broadly, in the developing world. Our findings confirm that HM remains one of the principal primary health care resources in Peru, even for a

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.

The Peru cervical cancer prevention study (PERCAPS): community-based participatory research in Manchay, Peru.

PubMed

Levinson, Kimberly L; Abuelo, Carolina; Chyung, Eunice; Salmeron, Jorge; Belinson, Suzanne E; Sologuren, Carlos Vallejos; Ortiz, Carlos Santos; Vallejos, Maria Jose; Belinson, Jerome L

2013-01-01

Cervical cancer is a preventable disease which causes significant morbidity and mortality, particularly in developing countries. Although technology for early detection continues to improve, prevention programs suffer from significant barriers. Community-based participatory research is an approach to research which focuses on collaboration with the community to surmount these barriers. The objective of this study was to evaluate the utility of community-based participatory research techniques in a mother-child screen/treat and vaccinate program for cervical cancer prevention in Manchay, Peru. Human papillomavirus (HPV) self-sampling and cryotherapy were used for the screen/treat intervention, and the Gardasil vaccine was used for the vaccine intervention. Community health workers from Manchay participated in a 3-day educational course, designed by the research team. The community health workers then decided how to implement the interventions in their community. The success of the program was measured by (1) the ability of the community health workers to determine an implementation plan, (2) the successful use of research forms provided, (3) participation and retention rates, and (4) satisfaction of the participants. (1) The community health workers used a door-to-door approach through which participants were successfully registered and both interventions were successfully carried out; (2) registration forms, consent forms, and result forms were used correctly with minimal error; (3) screen/treat intervention: 97% of registered participants gave an HPV sample, 94% of HPV-positive women were treated, and 90% returned for 6-month follow-up; vaccine intervention: 95% of registered girls received the first vaccine, 97% of those received the second vaccine, and 93% the third; (4) 96% of participants in the screen/treat intervention reported high satisfaction. Community-based participatory research techniques successfully helped to implement a screen/treat and vaccinate

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.

Frequency of human bocavirus (HBoV) infection among children with febrile respiratory symptoms in Argentina, Nicaragua and Peru

PubMed Central

Salmón‐Mulanovich, Gabriela; Sovero, Merly; Laguna‐Torres, V. Alberto; Kochel, Tadeusz J.; Lescano, Andres G.; Chauca, Gloria; Sanchez, J. Felix; Rodriguez, Francisco; Parrales, Eduardo; Ocaña, Victor; Barrantes, Melvin; Blazes, David L.; Montgomery, Joel M.

2010-01-01

Please cite this paper as: Salmón‐Mulanovich et al. (2010) Frequency of human bocavirus (HBoV) infection among children with febrile respiratory symptoms in Argentina, Nicaragua and Peru. Influenza and Other Respiratory Viruses 5(1), 1–5. Background  Globally, respiratory infections are the primary cause of illness in developing countries, specifically among children; however, an etiological agent for many of these illnesses is rarely identified. Objectives  Our study aimed to estimate the frequency of human bocavirus (HBoV) infection among pediatric populations in Argentina, Nicaragua and Peru. Methods  We conducted a cross‐sectional study using stored samples of an influenza‐like illness surveillance program. Irrespective of previous diagnosis, nasopharyngeal or nasal swab specimens were randomly selected and tested using real‐time PCR from three sites during 2007 from patients younger than 6 years old. Results  A total of 568 specimens from Argentina (185), Nicaragua (192) and Peru (191) were tested. The prevalence of HBoV was 10·8% (95% CI: 6·3; 15·3) in Argentina, 33·3% in Nicaragua (95% CI: 26·6; 40·1) and 25·1% in Peru (95% CI: 18·9; 31·3). Conclusions  These findings demonstrate circulation of HBoV in Argentina, Nicaragua and Peru among children with influenza‐like symptoms enrolled in a sentinel surveillance program. PMID:21138534

Cranial surgery in ancient Peru.

PubMed

Rifkinson-Mann, S

1988-10-01

Trephination is the oldest known surgical technique. Peru has been recognized as a major source of ancient trephined skulls, many of which date back 2300 years. This presentation reviews from a neurosurgical perspective many of the archaeological studies performed on these skulls. Comparative osteology has shown that almost 70% of patients survived the procedure. The various instruments, hemostatic agents, anesthetics, surgical techniques, and cranioplasties used are reconstructed from the anthropological literature. The possible reasons for the use of trephination are discussed. Analysis of the data leads to the conclusion that, despite their rudimentary knowledge of disease, the ancient Incas must have had some knowledge of anatomy and proper surgical procedure.

NCI and the Republic of Peru Sign Statement of Intent

Cancer.gov

The U.S. National Cancer Institute and the Republic of Peru signed a statement of intent to share an interest in fostering collaborative biomedical research in oncology and a common goal in educating and training the next generation of cancer research sci

[Process of construction of the national research agenda on Human Resources in Health in Peru 2011 - 2014].

PubMed

Curisinche, Maricela; Yagui, Martín; Castilla, Teresa; Cabezas, César; Escalante, Giovanni; Casas, María; Lucero, Jorge

2011-06-01

The National Health Authority of Peru, as part of the implementation of national priorities for health research in 2010 developed the process of building the national research agenda on health manpower (HM). In a scenario of technical challenges, national and international policy and under a nation-wide participatory approach with key stakeholders in the health system, training and aid HM linked to the subject, establishing a socially agreed agenda. Process consists of 3 phases: 1. National review of evidence and relevant information on RHUS, 2. Consultation with opinion leaders and subject experts, and 3. A collaborative space (national workshop) of deliberation, consensus and legitimacy of the agenda. Finally, we present the agenda consists of 30 research topics on health manpower, to be developed in the period 2011- 2014, and raises the challenges and prospects for implementation.

Effect of the Spanish Conquest on coastal change in Northwestern Peru

PubMed Central

Belknap, Daniel F.; Sandweiss, Daniel H.

2014-01-01

When Francisco Pizarro and his small band of Spanish conquistadores landed in northern Peru in A.D. 1532 to begin their conquest of the vast Inca Empire, they initiated profound changes in the culture, language, technology, economics, and demography of western South America. They also altered anthropogenically modulated processes of shoreline change that had functioned for millennia. Beginning with the extirpation of local cultures as a result of the Spanish Conquest, and continuing through today, the intersection of demography, economy, and El Niño-driven beach-ridge formation on the Chira beach-ridge plain of Northwestern Peru has changed the nature of coastal evolution in this region. A similar event may have occurred at about 2800 calibrated y B.P. in association with increased El Niño frequency. PMID:24843118

Effect of the Spanish Conquest on coastal change in Northwestern Peru.

PubMed

Belknap, Daniel F; Sandweiss, Daniel H

2014-06-03

When Francisco Pizarro and his small band of Spanish conquistadores landed in northern Peru in A.D. 1532 to begin their conquest of the vast Inca Empire, they initiated profound changes in the culture, language, technology, economics, and demography of western South America. They also altered anthropogenically modulated processes of shoreline change that had functioned for millennia. Beginning with the extirpation of local cultures as a result of the Spanish Conquest, and continuing through today, the intersection of demography, economy, and El Niño-driven beach-ridge formation on the Chira beach-ridge plain of Northwestern Peru has changed the nature of coastal evolution in this region. A similar event may have occurred at about 2800 calibrated y B.P. in association with increased El Niño frequency.

Effect of the Spanish Conquest on coastal change in Northwestern Peru

NASA Astrophysics Data System (ADS)

Belknap, Daniel F.; Sandweiss, Daniel H.

2014-06-01

When Francisco Pizarro and his small band of Spanish conquistadores landed in northern Peru in A.D. 1532 to begin their conquest of the vast Inca Empire, they initiated profound changes in the culture, language, technology, economics, and demography of western South America. They also altered anthropogenically modulated processes of shoreline change that had functioned for millennia. Beginning with the extirpation of local cultures as a result of the Spanish Conquest, and continuing through today, the intersection of demography, economy, and El Niño-driven beach-ridge formation on the Chira beach-ridge plain of Northwestern Peru has changed the nature of coastal evolution in this region. A similar event may have occurred at about 2800 calibrated y B.P. in association with increased El Niño frequency.

Serologic evidence for human hantavirus infection in Peru.

PubMed

Castillo Oré, Roger M; Forshey, Brett M; Huaman, Alfredo; Villaran, Manuel V; Long, Kanya C; Kochel, Tadeusz J; Guevara, Carolina; Montgomery, Joel M; Alvarez, Carlos A; Vilcarromero, Stalin; Morrison, Amy C; Halsey, Eric S

2012-08-01

While human illness associated with hantavirus infection has been documented in many countries of South America, evidence for hantavirus transmission in Peru has been limited to the isolation of Rio Mamore virus from a pigmy mouse rat (Oligoryzomys microtis) in the Amazon city of Iquitos. To address the possibility of human hantavirus exposure in the region, we screened febrile patients reporting to health clinics in Iquitos from 2007 to 2010 for serological evidence of recent hantavirus infection. In addition, we conducted a serological survey for hantavirus-reactive IgG among healthy participants residing in Iquitos and rural areas surrounding the city. Through the febrile surveillance study, we identified 15 participants (0.3%; 15/5174) with IgM reactive to hantavirus (Andes virus) antigen, all with relatively mild, self-limited illness. From the cross-sectional serosurvey we found that 1.7% (36/2063) of residents of the Iquitos area had serum IgG reactive to one or more hantaviruses, with a higher prevalence in the urban population (2.2%, compared to 1.1% in rural areas). These results suggest that human infection with hantavirus has occurred in Peru.

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

7 CFR 319.56-50 - Hass avocados from Peru.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Walsingham, the avocado seed moth. (a) General requirements. (1) The national plant protection organization... eggs and larvae of S. catenifer in the pulp or seed and for the presence of eggs in the pedicel. (2) If... inspection. Following any post-harvest processing, inspectors from the NPPO of Peru must inspect a biometric...

7 CFR 319.56-50 - Hass avocados from Peru.

Code of Federal Regulations, 2011 CFR

2011-01-01

... production to remain eligible to export avocados to the United States. The NPPO of Peru must keep records of fruit fly detections for each trap, update the records each time the traps are checked, and make the records available to APHIS inspectors upon request. (e) Mitigation measures for C. capitata. Places of...

7 CFR 319.56-50 - Hass avocados from Peru.

Code of Federal Regulations, 2013 CFR

2013-01-01

... a biometric sample of fruit at a rate determined by APHIS. Fruit sampled must be either from the... been taken. The NPPO of Peru must keep records of S. catenifer detections for each orchard, update the records each time the orchards are surveyed, and make the records available to APHIS inspectors upon...

7 CFR 319.56-50 - Hass avocados from Peru.

Code of Federal Regulations, 2014 CFR

2014-01-01

... a biometric sample of fruit at a rate determined by APHIS. Fruit sampled must be either from the... been taken. The NPPO of Peru must keep records of S. catenifer detections for each orchard, update the records each time the orchards are surveyed, and make the records available to APHIS inspectors upon...

Cost-Effectiveness of Norovirus Vaccination in Children in Peru

PubMed Central

Mirelman, Andrew; Ballard, Sarah-Blythe; Saito, Mayuko; Kosek, Margaret; Gilman, Robert H.

2015-01-01

Background With candidate norovirus (NV) vaccines in a rapid phase of development, assessment of the potential economic value of vaccine implementation will be necessary to aid health officials in vaccine implementation decisions. To date, no evaluations have been performed to evaluate the benefit of adopting NV vaccines for use in the childhood immunization programs of low- and middle-income countries. Methods We used a Markov decision model to evaluate the cost-effectiveness of adding a two-dose NV vaccine to Peru’s routine childhood immunization schedule using two recent estimates of NV incidence, one for a peri-urban region and one for a jungle region of the country. Results Using the peri-urban NV incidence estimate, the annual cost of vaccination would be $13.0 million, offset by $2.6 million in treatment savings. Overall, this would result in 473 total DALYs averted; 526,245 diarrhea cases averted;153,735 outpatient visits averted; and 414 hospitalizations averted between birth and the fifth year of life. The incremental cost-effectiveness ratio would be $21,415 per DALY averted; $19.86 per diarrhea case; $68.23 per outpatient visit; and $26,298 per hospitalization. Using the higher jungle NV incidence rates provided a lower cost per DALY of $10,135. The incremental cost per DALY with per-urban NV incidence is greater than three times the 2012 GDP per capita of Peru but the estimate drops below this threshold using the incidence from the jungle setting. In addition to the impact of incidence, sensitivity analysis showed that vaccine price and efficacy play a strong role in determining the level of cost-effectiveness. Conclusions The introduction of a NV vaccine would prevent many healthcare outcomes in the Peru and potentially be cost-effective in scenarios with high NV incidence. The vaccine cost-effectiveness model could also be applied to the evaluation of NV vaccine cost-effectiveness in other countries. In resource-poor settings, where NV incidence

Child health in Peru: importance of regional variation and community effects on children's height and weight.

PubMed

Shin, Heeju

2007-12-01

In developing countries, height and weight are good indicators of children's health and nutritional status. Maternal education has been accepted as one of the most important influences on child health. Using the 2000 Demographic and Health Survey of Peru, however, I find that the effect of maternal education varies as a function of region. In the most prosperous urban region, maternal education is less important for child health than in poor rural areas, and a higher level of education has a greater effect in rural areas. Multilevel analysis shows that a significant part of the observed correlation between maternal education and child health is moderated by regional differences and community characteristics. The finding suggests that Peruvian public policy should emphasize resource redistribution as well as women's education, and that investment in maternal education should be considered within regional contexts to enhance child health in rural areas.

[Incentives to attract and retain the health workforce in rural areas of Peru: a qualitative study].

PubMed

Huicho, Luis; Canseco, Francisco Díez; Lema, Claudia; Miranda, J Jaime; Lescano, Andrés G

2012-04-01

The study aimed to identify the main incentives for attracting and retaining health workers in rural and remote health facilities in Ayacucho, Peru. In-depth interviews were performed with 80 physicians, obstetricians, nurses, and nurse technicians in the poorest areas (20 per group), plus 11 health managers. Ayacucho lacks systematic policies for attracting and retaining human resources. The main incentives, in order of relevance, were higher wages, opportunities for further training, longer/permanent contracts, better infrastructure and medical equipment, and more staff. Interviewees also mentioned improved housing conditions and food, the opportunity to be closer to family, and recognition by the health system. Health workers and policymakers share perceptions on key incentives to encourage work in rural areas. However, there are also singularities to be considered when designing specific strategies. Public initiatives thus need to be monitored and evaluated closely in order to ensure the intended impact.

Influenza-Like Illness Sentinel Surveillance in Peru

PubMed Central

Laguna-Torres, V. Alberto; Gómez, Jorge; Ocaña, Víctor; Aguilar, Patricia; Saldarriaga, Tatiana; Chavez, Edward; Perez, Juan; Zamalloa, Hernán; Forshey, Brett; Paz, Irmia; Gomez, Elizabeth; Ore, Roel; Chauca, Gloria; Ortiz, Ernesto; Villaran, Manuel; Vilcarromero, Stalin; Rocha, Claudio; Chincha, Omayra; Jiménez, Gerardo; Villanueva, Miguel; Pozo, Edwar; Aspajo, Jackeline; Kochel, Tadeusz

2009-01-01

Background Acute respiratory illnesses and influenza-like illnesses (ILI) are a significant source of morbidity and mortality worldwide. Despite the public health importance, little is known about the etiology of these acute respiratory illnesses in many regions of South America. In 2006, the Peruvian Ministry of Health (MoH) and the US Naval Medical Research Center Detachment (NMRCD) initiated a collaboration to characterize the viral agents associated with ILI and to describe the clinical and epidemiological presentation of the affected population. Methodology/Principal Findings Patients with ILI (fever ≥38°C and cough or sore throat) were evaluated in clinics and hospitals in 13 Peruvian cities representative of the four main regions of the country. Nasal and oropharyngeal swabs, as well as epidemiological and demographic data, were collected from each patient. During the two years of this study (June 2006 through May 2008), a total of 6,835 patients, with a median age of 13 years, were recruited from 31 clinics and hospitals; 6,308 were enrolled by regular passive surveillance and 527 were enrolled as part of outbreak investigations. At least one respiratory virus was isolated from the specimens of 2,688 (42.6%) patients, with etiologies varying by age and geographical region. Overall the most common viral agents isolated were influenza A virus (25.1%), influenza B virus (9.7%), parainfluenza viruses 1, 2, and 3, (HPIV-1,-2,-3; 3.2%), herpes simplex virus (HSV; 2.6%), and adenoviruses (1.8%). Genetic analyses of influenza virus isolates demonstrated that three lineages of influenza A H1N1, one lineage of influenza A H3N2, and two lineages of influenza B were circulating in Peru during the course of this study. Conclusions To our knowledge this is the most comprehensive study to date of the etiologic agents associated with ILI in Peru. These results demonstrate that a wide range of respiratory pathogens are circulating in Peru and this fact needs to be

Press Coverage of Reagan's China Policy: A Study of Agenda and Treatment.

ERIC Educational Resources Information Center

Chang, Tsan-Kuo

Coverage of Ronald Reagan's China policy in three major newspapers--the "Los Angeles Times," the "New York Times," and the "Washington Post"--immediately before and after he assumed the presidency was submitted to content analysis. Results showed that the newspapers differed significantly both in their treatment of…

Men Who Have Sex With Men in Peru: Acceptability of Medication-Assisted Therapy for Treating Alcohol Use Disorders.

PubMed

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

2017-07-01

In Peru, the HIV epidemic is concentrated in men who have sex with men (MSM) and transgender women (TGW). Multiple studies correlate alcohol use disorders (AUDs) with risky sexual behaviors among Peruvian MSM. Qualitative research was used to inform a clinical trial on the acceptability of medication-assisted therapies to assist management of AUDs and improve antiretroviral therapy (ART) adherence among MSM/TGW in Peru. Three focus groups involving HIV-infected or HIV-uninfected MSM/TGW ( n = 26) with AUDs (AUDIT ≥ 8) were transcribed, translated from Spanish into English, and analyzed using thematic content analysis. Despite having an AUD, participants considered themselves "social" drinkers, minimized their drinking behaviors, and differed about whether or not alcohol problems could be treated. Participants expressed skepticism about medication for treating AUDs. Three concepts emerged as necessary components of a treatment program for alcohol problems: cost, family support, and the potential to drink less alcohol without attaining total abstinence. This study reveals important areas of education to increase potential acceptability of a medication for treating AUDs among MSM/TGW. Given the social conditions and knowledge base of the participants, medication-assisted therapies using naltrexone may be a beneficial strategy for MSM with AUDs.

A new species and new records of Cryptodacus (Diptera: Tephritidae) from Colombia, Bolivia and Peru.

PubMed

Rodriguez, Pedro Alexander; Rodriguez, Erick J; Norrbom, Allen L; Arévalo, Emilio

2016-05-16

Cryptodacus bernardoi Rodriguez & Rodriguez, new species, is described from Colombia. It was reared from fruits of Phoradendron sp. near piperoides (Kunth) Trel. New distribution records are reported for Cryptodacus ornatus Norrbom from Colombia and Peru, for Cryptodacus trinotatus Norrbom & Korytkowski from Colombia, and for Cryptodacus obliquus Hendel from Bolivia and Peru. The female abdomen and terminalia of C. obliquus is described for the first time. The Norrbom & Korytkowski (2008)`s key to species was modified to include C. bernardoi n. sp.

[Plansalud: Decentralized and agreed sector plan for the capacity development in health, Peru 2010-2014].

PubMed

Huamán-Angulo, Lizardo; Liendo-Lucano, Lindaura; Nuñez-Vergara, Manuel

2011-06-01

Human resources are the backbone of health sector actions; however, they are not necessarily the area with the greatest attention, therefore, the Ministry of Health of Peru (MINSA) together with regional governments, led the Decentralized and Agreed Sector Plan for the Capacity Development in Health 2010-2014 (PLANSALUD) with the aim of strengthening the capacities of Human Resources for Health (HRH) and contribute to health care efficient development, quality, relevance, equity and multiculturalism, in the context of descentralization, the Universal Health Insurance (AUS) and health policies. To achieve this goal, they have proposed three components (technical assistance, joint training and education - health articulation) that bring together an important set of interventions, which are planned and defined according to the national, regional and local levels, thus contributing to improve the government capacity, capability management and delivery of health services. This paper presents a first approach of PLANSALUD, including aspects related to planning, management, financing, structure and functioning, as well as monitoring and evaluation measures.

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.

[Bioethics in Peru].

PubMed

Zuloaga, R L

1990-01-01

Bioethics has still not acquired an identity of its own in Peru. The Ethics Committee of the Peruvian Medical School and the National AIDS Commission are review committees that deal with ethical problems arising in practice. Doubts regarding quality control of the drugs being tested have been raised in research on human subjects. Questions related to reproduction are very important. There is a high incidence of adolescent pregnancies, and illegal abortions result in many deaths and hospitalizations of women in serious condition. Birth control methods, such as vasectomy, conflict with attitudes about manhood in Peruvian society. Euthanasia is prohibited by the Ethical Code of the Peruvian Medical School, and legislation penalizes assisted suicide. Organ transplantation is hindered by concerns over early declaration of death. Handicapped children are often rejected by society owing to an absurd belief in the possibility that disorders such as Down's syndrome are contagious. The Ministry of Health requires state hospitals to accept AIDS patients, but instances of rejection are still reported.

Heterogeneous motivations for coca growing: the case of an indigenous Aymara community in Peru.

PubMed

Garcia-Yi, Jaqueline

2014-11-01

Coca is a native bush from the Amazon rainforest from which cocaine is extracted. Growing coca is a profitable activity; however, not all farmers located in the coca-supply areas do so. Little is known about farmers' motivations for the decision to grow coca and if so, how much to grow. This article evaluates the influence of monetary and non-monetary factors on these decisions. The study is based on a survey of 496 households in an indigenous Aymara community in Peru. The results suggest, for example, that farmers are more likely to cultivate coca when their plots are characterized by flatter agricultural slopes and when in debt. In relation to the scale of coca cultivation, farmers can be classified into two groups. The larger group (73 percent) grows a high number of coca bushes when facing economic hardship; farmers in the second group (27 percent) seem to be more motivated by the potential profits from coca production relative to coffee, the alternative crop in the area. Therefore, the results support the common notion that farmers cultivate coca in accordance with economic need. Nonetheless, non-economic factors also influence the number of coca bushes cultivated and offer an additional opportunity to reduce coca cultivation if explicitly considered in drug-control policies. This research also discusses potential farmers' responses to different coca-growing reduction strategies. Common drug-control policies such as organic coffee certification, road construction, and education have mixed effects on coca cultivation, depending on the type of coca grower. As such, farmers' motivations are heterogeneous and the design of effective drug-control policies needs to reflect this. Copyright © 2014 Elsevier B.V. All rights reserved.

Multivariate analysis in provenance studies: Cerrillos obsidians case, Peru

NASA Astrophysics Data System (ADS)

Bustamante, A.; Delgado, M.; Latini, R. M.; Bellido, A. V. B.

2007-02-01

We present the preliminary results of a provenance study of obsidians samples from Cerrillos (ca. 800 100 b.c.) using Mössbauer Spectroscopy. The Cerrillos archaeological site, located in the Upper Ica Valley, Peru, is the only Paracas ceremonial center excavated so far. The archaeological data collected suggest the existence of a complex social and economic organization on the south coast of Peru. Provenance research of obsidian provides valuable information about the selection of lithic resources by our ancestors and eventually about the existence of communication routes and exchange networks. We characterized 18 obsidian artifacts samples by Mössbauer spectroscopy from Cerrillos. The spectra, recorded at room temperature using different velocities, are mainly composed of broad asymmetric doublets due to the superposition of at least two quadrupole doublets corresponding to Fe2+ in two different sites (species A and B), one weak Fe3+ doublet (specie C) and magnetic components associated to the presence of small particles of magnetite. Multivariate statistical analysis of the Mössbauer data (hyperfine parameters) allows to defined two main groups of obsidians, reflecting different geographical origins.

Short sleep duration and childhood obesity: cross-sectional analysis in Peru and patterns in four developing countries.

PubMed

Carrillo-Larco, Rodrigo M; Bernabé-Ortiz, Antonio; Miranda, J Jaime

2014-01-01

We aimed to describe the patterns of nutritional status and sleep duration in children from Ethiopia, India, Peru and Vietnam; to assess the association between short sleep duration and overweight and obesity, and if this was similar among boys and girls in Peru. Analysis of the Young Lives Study, younger cohort, third round. In Ethiopia there were 1,999 observations, 2,011, 2,052 and 2,000 in India, Peru and Vietnam, respectively. Analyses included participants with complete data for sleep duration, BMI, sex and age; missing data: 5.9% (Ethiopia), 4.1% (India), 6.0% (Peru) and 4.5% (Vietnam). Exposure was sleep duration per day: short (<10 hours) versus regular (10-11 hours). Outcome was overweight and obesity. Multivariable analyses were conducted using a hierarchical approach to assess the effect of variables at different levels. Overweight/obesity prevalence was 0.5%/0.2% (Ethiopia), 1.3%/0.3% (India), 6.1%/2.8% (Vietnam), and 15.8%/5.4% (Peru). Only Peruvian data was considered to explore the association between short sleep duration and overweight and obesity, with 1,929 children, aged 7.9±0.3 years, 50.3% boys. Short and regular sleep duration was 41.6% and 55.6%, respectively. Multivariable models showed that obesity was 64% more prevalent among children with short sleep duration, an estimate that lost significance after controlling for individual- and family-related variables (PR: 1.15; 95%CI: 0.81-1.64). Gender was an effect modifier of the association between short sleep duration and overweight (p = 0.030) but not obesity (p = 0.533): the prevalence ratio was greater than one across all the models for boys, yet it was less than one for girls. Childhood overweight and obesity have different profiles across developing settings. In a sample of children living in resource-limited settings in Peru there is no association between short sleep duration and obesity; the crude association was slightly attenuated by children-related variables but strongly

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.

Multisource drug policies in Latin America: survey of 10 countries.

PubMed Central

Homedes, Núria; Ugalde, Antonio

2005-01-01

Essential drug lists and generic drug policies have been promoted as strategies to improve access to pharmaceuticals and control their rapidly escalating costs. This article reports the results of a preliminary survey conducted in 10 Latin American countries. The study aimed to document the experiences of different countries in defining and implementing generic drug policies, determine the cost of registering different types of pharmaceutical products and the time needed to register them, and uncover the incentives governments have developed to promote the use of multisource drugs. The survey instrument was administered in person in Chile, Ecuador and Peru and by email in Argentina, Brazil, Bolivia, Colombia, Costa Rica, Nicaragua and Uruguay. There was a total of 22 respondents. Survey responses indicated that countries use the terms generic and bioequivalence differently. We suggest there is a need to harmonize definitions and technical concepts. PMID:15682251

The 15 August 2007 Peru tsunami runup observations and modeling

NASA Astrophysics Data System (ADS)

Fritz, Hermann M.; Kalligeris, Nikos; Borrero, Jose C.; Broncano, Pablo; Ortega, Erick

2008-05-01

On 15 August 2007 an earthquake with moment magnitude (Mw) of 8.0 centered off the coast of central Peru, generated a tsunami with locally focused runup heights of up to10 m. A reconnaissance team was deployed two weeks after the event and investigated the tsunami effects at 51 sites. Three tsunami fatalities were reported south of the Paracas Peninsula in a sparsely populated desert area where the largest tsunami runup heights were measured. Numerical modeling of the earthquake source and tsunami suggest that a region of high slip near the coastline was primarily responsible for the extreme runup heights. The town of Pisco was spared by the Paracas Peninsula, which blocked tsunami waves from propagating northward from the high slip region. The coast of Peru has experienced numerous deadly and destructive tsunamis throughout history, which highlights the importance of ongoing tsunami awareness and education efforts to ensure successful self-evacuation.

Peru v. Yale: A Battle Rages over Machu Picchu

ERIC Educational Resources Information Center

Glenn, David

2009-01-01

In early 1916, the legendary Yale University archaeologist Hiram Bingham III completed his third and final expedition in southern Peru. He shipped home 74 boxes of artifacts from Machu Picchu, a spectacular site in the Andes that is believed to have been the last major settlement of the Inca empire. Those boxes were supposed to be on temporary…

Health effects of 'Juntos', a conditional cash transfer programme in Peru.

PubMed

Pérez-Lu, José E; Cárcamo, Cesar; Nandi, Arijit; Kaufman, Jay S

2017-07-01

In some countries, conditional cash transfer (CCT) programmes show an impact on maternal and child health. Juntos, the CCT programme in Peru, has been evaluated several times operationally, but seldom for maternal and child health outcomes. The objective of this study is to evaluate the impact of Juntos on children under 6 years, pregnant women and mothers of children under 17 years. Outcomes evaluated included (1) anaemia in women and children; (2) acute malnutrition in children; (3) post-partum complications in mothers; and (4) underweight and overweight in mothers. We identified Juntos eligible respondents from the Demographic and Health Surveys of Peru for years 2007 to 2013. Propensity score matching was used to identify comparable treatment and control groups, including eligible respondents enrolled in Juntos vs. those not enrolled in Juntos (individual-level analysis), as well as eligible respondents living in Juntos districts vs. those not residing in Juntos districts (district-level analysis). We then used generalized linear models to estimate prevalence ratios. Individual level analysis showed that Juntos reduced underweight in women (PR:0.39, 95%CI:0.18 - 0.85) and anaemia in children (PR:0.93, 95%CI:0.86 - 1.00). In the district level analysis, the programme was associated with a reduction of overweight in women (PR:0.94, 95%CI:0.90 - 0.98) and acute malnutrition in children (PR:0.49, 95%CI:0.32 - 0.73), but an increase in the prevalence of anaemia in children (PR:1.09, 95%CI:1.01 - 1.17). We found that Juntos had an effect on maternal and child health indicators, but further studies are required to overcome some limitations encountered here. © 2016 John Wiley & Sons Ltd.

A late Pleistocene human presence at Huaca Prieta, Peru, and early Pacific Coastal adaptations

NASA Astrophysics Data System (ADS)

Dillehay, Tom D.; Bonavia, Duccio; Goodbred, Steve L.; Pino, Mario; Vásquez, Victor; Tham, Teresa Rosales

2012-05-01

Archaeological excavations in deep pre-mound levels at Huaca Prieta in northern Peru have yielded new evidence of late Pleistocene cultural deposits that shed insights into the early human occupation of the Pacific coast of South America. Radiocarbon dates place this occupation between ~ 14,200 and 13,300 cal yr BP. The cultural evidence shares certain basic technological and subsistence traits, including maritime resources and simple flake tools, with previously discovered late Pleistocene sites along the Pacific coast of Peru and Chile. The results help to expand our knowledge of early maritime societies and human adaption to changing coastal environments.

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.

Elevated incidence rates of diabetes in Peru: report from PERUDIAB, a national urban population-based longitudinal study

PubMed Central

Seclen, Segundo Nicolas; Rosas, Moises Ernesto; Arias, Arturo Jaime; Medina, Cecilia Alexandra

2017-01-01

Objective A recent report from a non-nationally representative, geographically diverse sample in four separate communities in Peru suggests an unusually high diabetes incidence. We aimed to estimate the national diabetes incidence rate using PERUDIAB, a probabilistic, national urban population-based longitudinal study. Research design and methods 662 subjects without diabetes, selected by multistage, cluster, random sampling of households, representing the 24 administrative and the 3 (coast, highlands and jungle) natural regions across the country, from both sexes, aged 25+ years at baseline, enrolled in 2010–2012, were followed for 3.8 years. New diabetes cases were defined as fasting blood glucose ≥126 mg/dL or on medical diabetes treatment. Results There were 49 cases of diabetes in 2408 person-years follow-up. The weighted cumulative incidence of diabetes was 7.2% while the weighted incidence rate was estimated at 19.5 (95% CI 13.9 to 28.3) new cases per 1000 person-years. Older age, obesity and technical or higher education were statistically associated with the incidence of diabetes. Conclusion Our results confirm that the incidence of diabetes in Peru is among the highest reported globally. The fast economic growth in the last 20 years, high overweight and obesity rates may have triggered this phenomenon. PMID:28878935

Elevated incidence rates of diabetes in Peru: report from PERUDIAB, a national urban population-based longitudinal study.

PubMed

Seclen, Segundo Nicolas; Rosas, Moises Ernesto; Arias, Arturo Jaime; Medina, Cecilia Alexandra

2017-01-01

A recent report from a non-nationally representative, geographically diverse sample in four separate communities in Peru suggests an unusually high diabetes incidence. We aimed to estimate the national diabetes incidence rate using PERUDIAB, a probabilistic, national urban population-based longitudinal study. 662 subjects without diabetes, selected by multistage, cluster, random sampling of households, representing the 24 administrative and the 3 (coast, highlands and jungle) natural regions across the country, from both sexes, aged 25+ years at baseline, enrolled in 2010-2012, were followed for 3.8 years. New diabetes cases were defined as fasting blood glucose ≥126 mg/dL or on medical diabetes treatment. There were 49 cases of diabetes in 2408 person-years follow-up. The weighted cumulative incidence of diabetes was 7.2% while the weighted incidence rate was estimated at 19.5 (95% CI 13.9 to 28.3) new cases per 1000 person-years. Older age, obesity and technical or higher education were statistically associated with the incidence of diabetes. Our results confirm that the incidence of diabetes in Peru is among the highest reported globally. The fast economic growth in the last 20 years, high overweight and obesity rates may have triggered this phenomenon.

Apollo 9 Mission image - Peru and South America

NASA Image and Video Library

1969-03-03

Vertical Earth Observation taken by the Apollo 9 crew. View is of Peru and South America including Aguja Point and Piura. Film magazine was E,film type was SO-368 Ektachrome with 0.460 - 0.710 micrometers film / filter transmittance response and haze filter,80mm lens. Latitude was 5.35 S by Longitude 81.05 W, Overlap was 0%, Altitude miles were 125 and cloud cover was 20%.

Pre-travel advice concerning vector-borne diseases received by travelers prior to visiting Cuzco, Peru.

PubMed

Mejia, Christian R; Centeno, Emperatriz; Cruz, Briggitte; Cvetkovic-Vega, Aleksandar; Delgado, Edison; Rodriguez-Morales, Alfonso J

2016-01-01

Peru is an increasingly popular tourist destination that poses a risk to travelers due to endemic vector-borne diseases (VBDs). The objective of our study was to determine which factors are associated with receiving pre-travel advice (PTA) for VBDs among travelers visiting Cuzco, Peru. A cross-sectional secondary analysis based on data from a survey among travelers departing Cuzco at Alejandro Velazco Astete International Airport during the period January-March 2012 was conducted. From the 1819 travelers included in the original study, 1717 were included in secondary data analysis. Of these participants, 42.2% received PTA and 2.9% were informed about vector-borne diseases, including yellow fever (1.8%), malaria (1.6%) and dengue fever (0.1%). Receiving information on VBDs was associated with visiting areas endemic to yellow fever and dengue fever in Peru. The only disease travelers received specific recommendations for before visiting an endemic area for was yellow fever. Only 1 in 30 tourists received information on VBD prevention; few of those who traveled to an endemic area were warned about specific risks for infectious diseases prior to their trip. These important findings show that most tourists who travel to Peru do not receive PTA for the prevention of infectious and VBD, which can affect not only the travelers but their countries of origin as well. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Malaria in Brazil, Colombia, Peru and Venezuela: current challenges in malaria control and elimination.

PubMed

Recht, Judith; Siqueira, André M; Monteiro, Wuelton M; Herrera, Sonia M; Herrera, Sócrates; Lacerda, Marcus V G

2017-07-04

In spite of significant progress towards malaria control and elimination achieved in South America in the 2000s, this mosquito-transmitted tropical disease remains an important public health concern in the region. Most malaria cases in South America come from Amazon rain forest areas in northern countries, where more than half of malaria is caused by Plasmodium vivax, while Plasmodium falciparum malaria incidence has decreased in recent years. This review discusses current malaria data, policies and challenges in four South American Amazon countries: Brazil, Colombia, Peru and the Bolivarian Republic of Venezuela. Challenges to continuing efforts to further decrease malaria incidence in this region include: a significant increase in malaria cases in recent years in Venezuela, evidence of submicroscopic and asymptomatic infections, peri-urban malaria, gold mining-related malaria, malaria in pregnancy, glucose-6-phosphate dehydrogenase (G6PD) deficiency and primaquine use, and possible under-detection of Plasmodium malariae. Some of these challenges underscore the need to implement appropriate tools and procedures in specific regions, such as a field-compatible molecular malaria test, a P. malariae-specific test, malaria diagnosis and appropriate treatment as part of regular antenatal care visits, G6PD test before primaquine administration for P. vivax cases (with weekly primaquine regimen for G6PD deficient individuals), single low dose of primaquine for P. falciparum malaria in Colombia, and national and regional efforts to contain malaria spread in Venezuela urgently needed especially in mining areas. Joint efforts and commitment towards malaria control and elimination should be strategized based on examples of successful regional malaria fighting initiatives, such as PAMAFRO and RAVREDA/AMI.

Weaknesses in the reporting of cross-sectional studies according to the STROBE statement: the case of metabolic syndrome in adults from Peru.

PubMed

Tapia, Jose Carlos; Ruiz, Eloy F; Ponce, Oscar J; Malaga, German; Miranda, Jaime

2015-12-30

The inadequate reporting of cross-sectional studies, as in the case of the prevalence of metabolic syndrome, could cause problems in the synthesis of new evidence and lead to errors in the formulation of public policies. To evaluate the reporting quality of the articles regarding metabolic syndrome prevalence in Peruvian adults using the STROBE recommendations. We conducted a thorough literature search with the terms "Metabolic Syndrome", "Sindrome Metabolico" and "Peru" in MEDLINE/PubMed, LILACS, SciELO, LIPECS and BVS-Peru until December 2014. We selected those who were population-based observational studies with randomized sampling that reported prevalence of metabolic syndrome in adults aged 18 or more of both sexes. Information was analysed through the STROBE score per item and recommendation. Seventeen articles were included in this study. All articles met the recommendations related to the report of the study's rationale, design, and provision of summary measures. The recommendations with the lowest scores were those related to the sensitivity analysis (8%, n= 1/17), participant flowchart (18%, n= 3/17), missing data analysis (24%, n= 4/17), and number of participants in each study phase (24%, n= 4/17). Cross-sectional studies regarding the prevalence of metabolic syndrome in peruvian adults have an inadequate reporting on the methods and results sections. We identified a clear need to improve the quality of such studies.

Taenia solium infection in Peru: a collaboration between Peace Corps Volunteers and researchers in a community based study.

PubMed

Watts, Nathaniel S; Pajuelo, Monica; Clark, Taryn; Loader, Maria-Cristina I; Verastegui, Manuela R; Sterling, Charles; Friedland, Jon S; Garcia, Hector H; Gilman, Robert H

2014-01-01

Neurocysticercosis is a leading cause of seizures and epilepsy in most of the world, and it occurs when Taenia solium larval cysts infect the central nervous system. T. solium tapeworm infection is endemic in much of Peru, but there are scarce data on the prevalence in many rural highland communities where it is likely to be hyper-endemic. Peace Corps Volunteers live and work in these communities; however, to our knowledge, they have not been used to facilitate public health research. We utilized Peace Corps Volunteers to estimate the prevalence of T. solium tapeworm infection in seven rural communities in northern Peru. A convenience non-random sampling frame was used. Peace Corps Volunteers facilitated the collection of stool samples (N = 2,328), which were analyzed by sedimentation and microscopy. Niclosamide treatment and purgation preceded species identification, which was done by PCR-REA. Taenia sp. egg-positive stool samples were found in three of the seven communities we surveyed. The overall prevalence of Taenia sp. egg positivity was 2.1% (49/2,328) (95% CI = 1.6-2.8%) with prevalence up to 4.3% (42/977) (95% CI = 3.1-5.8%) by community. All 34 of the specimens tested by PCR-REA were T. solium. The overall prevalence of T. solium tapeworm infection was 1.5% (34/2,328) (95% CI = 1.0-2.0%). Prevalence up to 2.9% (28/977) (95% CI = 1.9-4.1%) by community was observed. This study recorded high T. solium tapeworm prevalence, and identified hyper-endemic rural communities. It demonstrates that synergy between researchers and Peace Corps Volunteers can be an effective means to conducting large-scale, community-based studies in remote areas of Peru.

Taenia solium Infection in Peru: A Collaboration between Peace Corps Volunteers and Researchers in a Community Based Study

PubMed Central

Watts, Nathaniel S.; Pajuelo, Monica; Clark, Taryn; Loader, Maria-Cristina I.; Verastegui, Manuela R.; Sterling, Charles; Friedland, Jon S.; Garcia, Hector H.; Gilman, Robert H.

2014-01-01

Background Neurocysticercosis is a leading cause of seizures and epilepsy in most of the world, and it occurs when Taenia solium larval cysts infect the central nervous system. T. solium tapeworm infection is endemic in much of Peru, but there are scarce data on the prevalence in many rural highland communities where it is likely to be hyper-endemic. Peace Corps Volunteers live and work in these communities; however, to our knowledge, they have not been used to facilitate public health research. Materials and Methods We utilized Peace Corps Volunteers to estimate the prevalence of T. solium tapeworm infection in seven rural communities in northern Peru. A convenience non-random sampling frame was used. Peace Corps Volunteers facilitated the collection of stool samples (N = 2,328), which were analyzed by sedimentation and microscopy. Niclosamide treatment and purgation preceded species identification, which was done by PCR-REA. Results Taenia sp. egg-positive stool samples were found in three of the seven communities we surveyed. The overall prevalence of Taenia sp. egg positivity was 2.1% (49/2,328) (95% CI = 1.6–2.8%) with prevalence up to 4.3% (42/977) (95% CI = 3.1–5.8%) by community. All 34 of the specimens tested by PCR-REA were T. solium. The overall prevalence of T. solium tapeworm infection was 1.5% (34/2,328) (95% CI = 1.0–2.0%). Prevalence up to 2.9% (28/977) (95% CI = 1.9–4.1%) by community was observed. Conclusion/Significance This study recorded high T. solium tapeworm prevalence, and identified hyper-endemic rural communities. It demonstrates that synergy between researchers and Peace Corps Volunteers can be an effective means to conducting large-scale, community-based studies in remote areas of Peru. PMID:25469506

[Information system of the national network of public health laboratories in Peru (Netlab)].

PubMed

Vargas-Herrera, Javier; Segovia-Juarez, José; Garro Nuñez, Gladys María

2015-01-01

Clinical laboratory information systems produce improvements in the quality of information, reduce service costs, and diminish wait times for results, among other things. In the construction process of this information system, the National Institute of Health (NIH) of Peru has developed and implemented a web-based application to communicate to health personnel (laboratory workers, epidemiologists, health strategy managers, physicians, etc.) the results of laboratory tests performed at the Peruvian NIH or in the laboratories of the National Network of Public Health Laboratories which is called NETLAB. This article presents the experience of implementing NETLAB, its current situation, perspectives of its use, and its contribution to the prevention and control of diseases in Peru.

Does the benefits schedule of cash assistance programs affect the purchase of temptation goods? Evidence from Peru.

PubMed

White, Justin S; Basu, Sanjay

2016-03-01

A critique of cash assistance programs is that beneficiaries may spend the money on "temptation goods" such as alcohol and tobacco. We exploit a change in the payment schedule of Peru's conditional cash transfer program to identify the impact of benefit receipt frequency on the purchase of temptation goods. We use annual household data among cross-sectional and panel samples to analyze the effect of the policy change on the share of the household budget devoted to four categories of temptation goods. Using a difference-in-differences estimation approach, we find that larger, less frequent payments increased the expenditure share of alcohol by 55-80% and sweets by 10-40%, although the absolute magnitudes of these effects are small. Our study suggests that less frequent benefits scheduling may lead cash recipients to make certain types of temptation purchases. Copyright © 2016 Elsevier B.V. All rights reserved.

"…still waiting for chloroquine": the challenge of communicating changes in first-line treatment policy for uncomplicated malaria in a remote Kenyan district.

PubMed

Okungu, Vincent; Gilson, Lucy

2014-07-08

Widespread parasite resistance to first-line treatment for uncomplicated malaria leads to introduction of new drug interventions. Introducing such interventions is complex and sensitive because of stakeholder interests and public resistance. To enhance take up of such interventions, health policy communication strategies need to deliver accurate and accessible information to empower communities with necessary information and address problems of cultural acceptance of new interventions. To explore community understanding of policy changes in first-line treatment for uncomplicated malaria in Kenya; to evaluate the potential role of policy communication in influencing responses to changes in first-line treatment policy. Data collection involved qualitative strategies in a remote district in the Kenyan Coast: in-depth interviews (n = 29), focus group discussions (n = 14), informal conversations (n = 11) and patient narratives (n = 8). Constant comparative method was used in the analysis. Being malaria-prone and remotely located, the district offered an ideal area to investigate whether or not and how policy communication about a matter as critical as change of treatment policy reaches vulnerable populations. Three years after initial implementation (2009), there was limited knowledge or understanding regarding change of first-line treatment from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (AL) for treatment of uncomplicated malaria in the study district. The print and electronic media used to create awareness about the drug change appeared to have had little impact. Although respondents were aware of the existence of AL, the drug was known neither by name nor as the official first-line treatment. Depending on individuals or groups, AL was largely viewed negatively. The weaknesses in communication strategy surrounding the change to AL included poor choice of communication tools, confusing advertisements of other drugs and conflicts between

Remaining missed opportunities of child survival in Peru: modelling mortality impact of universal and equitable coverage of proven interventions.

PubMed

Tam, Yvonne; Huicho, Luis; Huayanay-Espinoza, Carlos A; Restrepo-Méndez, María Clara

2016-10-04

Peru has made great improvements in reducing stunting and child mortality in the past decade, and has reached the Millennium Development Goals 1 and 4. The remaining challenges or missed opportunities for child survival needs to be identified and quantified, in order to guide the next steps to further improve child survival in Peru. We used the Lives Saved Tool (LiST) to project the mortality impact of proven interventions reaching every women and child in need, and the mortality impact of eliminating inequalities in coverage distribution between wealth quintiles and urban-rural residence. Our analyses quantified the remaining missed opportunities in Peru, where prioritizing scale-up of facility-based case management for all small and sick babies will be most effective in mortality reduction, compared to other evidenced-based interventions that prevent maternal and child deaths. Eliminating coverage disparities between the poorest quintiles and the richest will reduce under-five and neonatal mortality by 22.0 and 40.6 %, while eliminating coverage disparities between those living in rural and urban areas will reduce under-five and neonatal mortality by 29.3 and 45.2 %. This projected neonatal mortality reduction achieved by eliminating coverage disparities is almost comparable to that already achieved by Peru over the past decade. Although Peru has made great strides in improving child survival, further improvement in child health, especially in newborn health can be achieved if there is universal and equitable coverage of proven, quality health facility-based interventions. The magnitude of reduction in mortality will be similar to what has been achieved in the past decade. Strengthening health system to identify, understand, and direct resources to the poor and rural areas will ensure that Peru achieve the Sustainable Development Goals by 2030.

Rural Community Disaster Preparedness and Risk Perception in Trujillo, Peru.

PubMed

Stewart, Matthew; Grahmann, Bridget; Fillmore, Ariel; Benson, L Scott

2017-08-01

Introduction Disasters will continue to occur throughout the world and it is the responsibility of the government, health care systems, and communities to adequately prepare for potential catastrophic scenarios. Unfortunately, low-and-middle-income countries (LMICs) are especially vulnerable following a disaster. By understanding disaster preparedness and risk perception, interventions can be developed to improve community preparedness and avoid unnecessary mortality and morbidity following a natural disaster. Problem The purpose of this study was to assess disaster preparedness and risk perception in communities surrounding Trujillo, Peru. After designing a novel disaster preparedness and risk perception survey based on guidelines from the International Federation of Red Cross and Red Crescent Societies (IFRC; Geneva, Switzerland), investigators performed a cross-sectional survey of potentially vulnerable communities surrounding Trujillo, Peru. Data were entered and analyzed utilizing the Research Electronic Data Capture (REDCap; Harvard Catalyst; Boston, Massachusetts USA) database. A total of 230 study participants were surveyed, composed of 37% males, 63% females, with ages ranging from 18-85 years old. Those surveyed who had previously experienced a disaster (41%) had a higher perception of future disaster occurrence and potential disaster impact on their community. Overall, the study participants consistently perceived that earthquakes and infection had the highest potential impact of all disasters. Twenty-six percent of participants had an emergency supply of food, 24% had an emergency water plan, 24% had a first aid kit at home, and only 20% of the study participants had an established family evacuation plan. Natural and man-made disasters will remain a threat to the safety and health of communities in all parts of the world, especially within vulnerable communities in LMICs; however, little research has been done to identify disaster perception

Methadone treatment providers' views of drug court policy and practice: a case study of New York State.

PubMed

Csete, Joanne; Catania, Holly

2013-12-05

Specialized drug treatment courts are a central part of drug-related policy and programs in the United States and increasingly outside the U.S. While in theory they offer treatment as a humane and pragmatic alternative to arrest and incarceration for certain categories of drug offenses, they may exclude some forms of treatment-notably methadone maintenance treatment (MMT). We sought to understand from the perspective of treatment providers whether this exclusion existed and was of public health importance in New York State as a case example of a state heavily committed to drug courts and with varying court-level policies on MMT. Drug courts have been extensively evaluated but not with respect to exclusion of MMT and not from the perspective of treatment providers. Qualitative structured interviews of 15 providers of MMT and 4 NGO advocates in counties with diverse court policies on MMT, with content analysis. Courts in some counties require MMT patients to "taper off" methadone in an arbitrary period or require that methadone be a "bridge to abstinence". Treatment providers repeatedly noted that methadone treatment is stigmatized and poorly understood by some drug court personnel. Some MMT providers feared court practices were fueling non-medical use of prescription opiates. Drug court practices in some jurisdictions are a barrier to access to MMT and may constitute discrimination against persons in need of MMT. These practices should be changed, and drug courts should give high priority to ensuring that treatment decisions are made by or in close consultation with qualified health professionals.

Preventing malaria in the Peruvian Amazon: a qualitative study in Iquitos, Peru.

PubMed

Newell, Ian; Wiskin, Connie; Anthoney, James; Meza, Graciela; de Wildt, Gilles

2018-01-16

In Peru, despite decades of concerted control efforts, malaria remains a significant public health burden. Peru has recently exhibited a dramatic rise in malaria incidence, impeding South America's progress towards malaria elimination. The Amazon basin, in particular the Loreto region of Peru, has been identified as a target for the implementation of intensified control strategies, aiming for elimination. No research has addressed why vector control strategies in Loreto have had limited impact in the past, despite vector control elsewhere being highly effective in reducing malaria transmission. This study employed qualitative methods to explore factors limiting the success of vector control strategies in the region. Twenty semi-structured interviews were conducted among adults attending a primary care centre in Iquitos, Peru, together with 3 interviews with key informants (health care professionals). The interviews focussed on how local knowledge, together with social and cultural attitudes, determined the use of vector control methods. Five themes emerged. (a) Participants believed malaria to be embedded within their culture, and commonly blamed this for a lack of regard for prevention. (b) They perceived a shift in mosquito biting times to early evening, rendering night-time use of bed nets less effective. (c) Poor preventive practices were compounded by a consensus that malaria prevention was the government's responsibility, and that this reduced motivation for personal prevention. (d) Participants confused the purpose of space-spraying. (e) Participants' responses also exposed persisting misconceptions, mainly concerning the cause of malaria and best practices for its prevention. To eliminate malaria from the Americas, region-specific strategies need to be developed that take into account the local social and cultural contexts. In Loreto, further research is needed to explore the potential shift in biting behaviour of Anopheles darlingi, and how this interacts

The Forest Indians in the Present Political Situation of Peru.

ERIC Educational Resources Information Center

Varese, Stefano

The article focuses on tribal minorities (American Indians) of the Peruvian tropical forest from the point of view of the political circumstances and the general administrative conditions of the country. In 1968 the revolutionary military government initiated a series of structural reforms which aimed at transforming Peru. This article poses and…

Implementing Climate Services in Peru: CLIMANDES Project

NASA Astrophysics Data System (ADS)

Lavado-Casimiro, Waldo; Mauchle, Fabian; Diaz, Amelia; Seiz, Gabriela; Rubli, Alex; Rossa, Andrea; Rosas, Gabriela; Ita, Niceforo; Calle, Victoria; Villegas, Esequiel; Ambrosetti, Paolo; Brönnimann, Stefan; Hunziker, Stefan; Jacques, Martin; Croci-Maspoli, Mischa; Konzelmann, Thomas; Gubler, Stefanie; Rohrer, Mario

2014-05-01

The climate variability and change will have increasing influence on the economic and social development of all countries and regions, such as the Andes in Latin America. The CLIMANDES project (Climate services to support decision-making in the Andean Region) will address these issues in Peru. CLIMANDES supports the WMO Regional Training Centre (RTC) in Lima, which is responsible for the training of specialized human resources in meteorology and climatology in the South American Andes (Module 1). Furthermore, CLIMANDES will provide high-quality climate services to inform policy makers in the Andean region (Module 2). It is coordinated by the World Meteorological Organization (WMO) and constitutes a pilot project under the umbrella of the WMO-led Global Framework for Climate Services (GFCS). The project is funded by the Swiss Agency for Development and Cooperation (SDC) and runs from August 2012 - July 2015. Module 1 focuses on restructuring the curricula of Meteorology at the La Molina Agraria University (UNALM) and applied training of meteorologists of the Peruvian National Service of Meteorology and Hydrology (SENAMHI). In Module 2, the skills will be shared and developed in the production and delivery of high-quality climate products and services tailored to the needs of the decision makers in the pilot regions Cusco and Junín. Such services will benefit numerous sectors including agriculture, education, health, tourism, energy, transport and others. The goals of the modules 1 and 2 will be achieved through the collaboration of the UNALM, SENAMHI and the Federal Office of Meteorology and Climatology MeteoSwiss, with the support of the University of Bern (UNIBE), Meteodat and WMO.

Programa de Fortalecimiento de Capacidades: Reflections on a Case Study of Community-Based Teacher Education Set in Rural Northern Peru

ERIC Educational Resources Information Center

Alsop, Steve; Ames, Patricia; Arroyo, Graciela Cordero; Dippo, Don

2010-01-01

This article explores distinctive features of a 5-year international education development project set in rural northern Peru (PROMEB, the "Proyecto de Mejoramiento de la Educacion Basica"). Grounded within a partnership between teacher educators from Peru, Mexico and Canada, and rural Peruvian teachers, students and their communities,…

A Policy Analysis: Military Medical Treatment Facility Contingency Inpatient Expansion

DTIC Science & Technology

2005-06-06

Immunology 3 71B Biochemistry 2 Nurse Corps 66H Medical Surgical Nurse 688 66E Operating Room Nurse 72 66C Psychiatry 30 66N Nurse Administration 18...To) 06-06-2005 Final Report I July 2005 to July 2005 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER A Policy Analysis: Military Medical Treatment Facility...Contingency Inpatient Expansion 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER Kalamaras, Peter Jr., Major, Medical

Lake Titicaca, Peru and Bolivia, South America

NASA Technical Reports Server (NTRS)

1991-01-01

Lake Titicaca, high in the Andean Altiplano of South America, is on the border between Peru and Bolivia (15.5S, 70.0W). At an altitude of 12,500 ft, an area of 3,206 sq. mi. and a depth of about 900 ft., it is the world's highest navigable fresh water lake. La Paz, the capital city of Bolivia, may be seen near the center left of the image on the eastern downslope side of the mountains. 3,206 sq mi (8,303 sqkm), 12,

Modeling cost-effectiveness and health gains of a "universal" versus "prioritized" hepatitis C virus treatment policy in a real-life cohort.

PubMed

Kondili, Loreta A; Romano, Federica; Rolli, Francesca Romana; Ruggeri, Matteo; Rosato, Stefano; Brunetto, Maurizia Rossana; Zignego, Anna Linda; Ciancio, Alessia; Di Leo, Alfredo; Raimondo, Giovanni; Ferrari, Carlo; Taliani, Gloria; Borgia, Guglielmo; Santantonio, Teresa Antonia; Blanc, Pierluigi; Gaeta, Giovanni Battista; Gasbarrini, Antonio; Chessa, Luchino; Erne, Elke Maria; Villa, Erica; Ieluzzi, Donatella; Russo, Francesco Paolo; Andreone, Pietro; Vinci, Maria; Coppola, Carmine; Chemello, Liliana; Madonia, Salvatore; Verucchi, Gabriella; Persico, Marcello; Zuin, Massimo; Puoti, Massimo; Alberti, Alfredo; Nardone, Gerardo; Massari, Marco; Montalto, Giuseppe; Foti, Giuseppe; Rumi, Maria Grazia; Quaranta, Maria Giovanna; Cicchetti, Americo; Craxì, Antonio; Vella, Stefano

2017-12-01

We evaluated the cost-effectiveness of two alternative direct-acting antiviral (DAA) treatment policies in a real-life cohort of hepatitis C virus-infected patients: policy 1, "universal," treat all patients, regardless of fibrosis stage; policy 2, treat only "prioritized" patients, delay treatment of the remaining patients until reaching stage F3. A liver disease progression Markov model, which used a lifetime horizon and health care system perspective, was applied to the PITER cohort (representative of Italian hepatitis C virus-infected patients in care). Specifically, 8,125 patients naive to DAA treatment, without clinical, sociodemographic, or insurance restrictions, were used to evaluate the policies' cost-effectiveness. The patients' age and fibrosis stage, assumed DAA treatment cost of €15,000/patient, and the Italian liver disease costs were used to evaluate quality-adjusted life-years (QALY) and incremental cost-effectiveness ratios (ICER) of policy 1 versus policy 2. To generalize the results, a European scenario analysis was performed, resampling the study population, using the mean European country-specific health states costs and mean treatment cost of €30,000. For the Italian base-case analysis, the cost-effective ICER obtained using policy 1 was €8,775/QALY. ICERs remained cost-effective in 94%-97% of the 10,000 probabilistic simulations. For the European treatment scenario the ICER obtained using policy 1 was €19,541.75/QALY. ICER was sensitive to variations in DAA costs, in the utility value of patients in fibrosis stages F0-F3 post-sustained virological response, and in the transition probabilities from F0 to F3. The ICERs decrease with decreasing DAA prices, becoming cost-saving for the base price (€15,000) discounts of at least 75% applied in patients with F0-F2 fibrosis. Extending hepatitis C virus treatment to patients in any fibrosis stage improves health outcomes and is cost-effective; cost-effectiveness significantly increases

Statistical panorama of female physics graduate students for 2000-2010 in Peru

NASA Astrophysics Data System (ADS)

Cerón Loayza, María Luisa; Bravo Cabrejos, Jorge Aurelio

2013-03-01

We report the results of a statistical study on the number of women entering the undergraduate and master's programs of physics at Universidad Nacional Mayor de San Marcos in Peru. From 2006 through 2010, 13 female students entered the master's degree program but no females graduated with the degree. Considering that Peru is a developing country, a career in physics is not considered an attractive professional choice even for male students because it is thought that there are no work centers to practice this profession. We recommend that the causes preventing female physics students from completing their studies and research work be analyzed, and that strategies be planned to help women complete their academic work. We are considering getting help from the Peruvian Physics Society (SOPERFI) in order to draw more attention for our plan.

Could the United States Army Have a Positive Impact on the Insurgency and Counterdrug Problems in Peru

DTIC Science & Technology

1994-06-03

CGSC, Fort Leavenworth, KS, Dec. 1990 LAS FUERZAS ARMADAS DEL PERU Y LOS DERECHOS HUMANOS EN LA LUCHA CONTRA EL TERRORISMO (Not Dated), A Booklet...op- erations were countered by the DINCOTE (Direccion Nacional Contra el Terrorismo ), a special antiterrorist branch of the national police. They...branches of our Army could contribute to a joint and combined operation in Peru to defeat Shining Path ele - ments. In addition to this, the reader may

'You should build yourself up as a whole product': Transgender female identity in Lima, Peru.

PubMed

Pollock, Lealah; Silva-Santisteban, Alfonso; Sevelius, Jae; Salazar, Ximena

2016-01-01

Transgender women in Lima, Peru have, until recently, been grouped together with gay and bisexual men in the category MSM, or men who have sex with men, with little consideration of their unique situation and needs. Transgender women, self-identified in Peru as travesti, are a socially vulnerable population with many unmet health needs, including an HIV prevalence of 30%. Understanding specific transgender identities and their contexts will contribute to the improvement and development of HIV prevention programs. Through qualitative open-ended interviews with trans-identified women in Lima, Peru, this study found that the non-normative travesti identity is constructed within a conservative homophobic and heteronormative social context. Participants strive towards appearances and relationships perceived as feminine, seeking out silicone injections and abusive men as social markers of this femininity. Sex work is the primary economic activity available and travestis are often alienated from their families and communities. Work is needed to increase self-esteem and decrease violence, stigma, and discrimination. There is a need for multilevel HIV prevention campaigns prioritising travesti in Lima, utilising a human rights framework.

Vector Competence of Peruvian Mosquitoes (Diptera:Culicidae) for a Subtype IIIC Strain in the Venezuelan Equine Encephalomyelitis Complex Isolated from Mosquitoes Captured in Peru

DTIC Science & Technology

2006-03-01

Amazon Basin, near Iquitos, Peru , for their suscep- tibility to a subtype IIIC strain of the Venezuelan equine encephalomyelitis complex. This virus...As part of a field ecology study of mosquitoes in the Amazon Basin region of Peru (Jones et al. 2004), over 160 virus isolations were made from...distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT We evaluated mosquitoes collected in the Amazon Basin, near Iquitos, Peru , for their

Dynamics of Malaria Drug Resistance Patterns in the Amazon Basin Region following Changes in Peruvian National Treatment Policy for Uncomplicated Malaria▿ †

PubMed Central

Bacon, David J.; McCollum, Andrea M.; Griffing, Sean M.; Salas, Carola; Soberon, Valeria; Santolalla, Meddly; Haley, Ryan; Tsukayama, Pablo; Lucas, Carmen; Escalante, Ananias A.; Udhayakumar, Venkatachalam

2009-01-01

Monitoring changes in the frequencies of drug-resistant and -sensitive genotypes can facilitate in vivo clinical trials to assess the efficacy of drugs before complete failure occurs. Peru changed its national treatment policy for uncomplicated malaria to artesunate (ART)-plus-mefloquine (MQ) combination therapy in the Amazon basin in 2001. We genotyped isolates collected in 1999 and isolates collected in 2006 to 2007 for mutations in the Plasmodium falciparum dihydrofolate reductase (Pfdhfr) and dihydropteroate synthase (Pfdhps) genes, multidrug resistance gene 1 (Pfmdr-1), the chloroquine (CQ) resistance transporter gene (Pfcrt), and the Ca2+ ATPase gene (PfATP6); these have been shown to be involved in resistance to sulfadoxine-pyrimethamine (SP), MQ, CQ, and possibly ART, respectively. Microsatellite haplotypes around the Pfdhfr, Pfdhps, Pfcrt, and Pfmdr-1 loci were also determined. There was a significant decline in the highly SP resistant Pfdhfr and Pfdhps genotypes from 1999 to 2006. In contrast, a CQ-resistant Pfcrt genotype increased in frequency during the same period. Among five different Pfmdr-1 allelic forms noted in 1999, two genotypes increased in frequency while one genotype decreased by 2006. We also noted previously undescribed polymorphisms in the PfATP6 gene as well as an increase in the frequency of a deletion mutant during this period. In addition, microsatellite analysis revealed that the resistant Pfdhfr, Pfdhps, and Pfcrt genotypes have each evolved from a single founder haplotype, while Pfmdr-1 genotypes have evolved from at least two independent haplotypes. Importantly, this study demonstrates that the Peruvian triple mutant Pfdhps genotypes are very similar to those found in other parts of South America. PMID:19258269

The Peru Cervical Cancer Prevention Study (PERCAPS): Community Based Participatory Research in Manchay, Peru

PubMed Central

Levinson, Kimberly L.; Abuelo, Carolina; Chyung, Eunice; Salmeron, Jorge; Belinson, Suzanne E; Sologuren, Carlos Vallejos; Ortiz, Carlos Santos; Vallejos, Maria Jose; Belinson, Jerome L.

2012-01-01

Objective Cervical cancer is a preventable disease which causes significant morbidity and mortality, particularly in developing countries. While technology for early detection continues to improve, prevention programs suffer from significant barriers. Community Based Participatory Research is an approach to research which focuses on collaboration with the community to surmount these barriers. The objective of this study was to evaluate the utility of Community Based Participatory Research techniques in a mother-child screen/treat and vaccinate program for cervical cancer prevention in Manchay, Peru. Methods/materials HPV self-sampling and cryotherapy were utilized for the screen/treat intervention, and the Gardasil vaccine was utilized for the vaccine intervention. Community health workers from Manchay participated in a 3-day educational course, designed by the research team. The community health workers then decided how to implement the interventions in their community. The success of the program was measured by: 1) the ability of the community health workers to determine an implementation plan, 2) the successful use of research forms provided, 3) participation and retention rates, and 4) satisfaction of the participants. Results 1) The community health workers used a door-to-door approach through which participants were successfully registered and both interventions were successfully carried out; 2) registration forms, consent forms, and result forms were utilized correctly with minimal error; 3) screen/treat intervention: 97% of registered participants gave an HPV sample, 94% of HPV positive women were treated, and 90% returned for 6-month follow-up; vaccine intervention: 95% of registered girls received the 1st vaccine, 97% of those received the 2nd vaccine, and 93% the 3rd; 4) 96% of participants in the screen/treat intervention reported high satisfaction. Conclusion Community Based Participatory Research techniques successfully helped to implement a screen

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

CIRPLAST: Cleft Lip and Palate Missions in Peru.

PubMed

Navarro, Carlos E

2015-06-01

The author presents a 20-year experience leading cleft lip and palate surgical volunteer missions in Peru for CIRPLAST, a nonprofit volunteer plastic surgery goodwill program that has provided free surgery for patients with cleft lip and palate deformities in remote areas of Peru. Surgical procedures were performed by the author, together with a group of experienced plastic surgeons, under the auspices of the Peruvian Plastic Surgery Society, and local health authorities. CIRPLAST missions are scheduled annually in different locations around Peru. Selected patients for surgery after adequate screening are photographed, and their cleft deformity is recorded. Scheduled patients or their parents, when they are minors, sign an informed consent form. Patients operated on in any given day are examined and photographed 1 day after surgery, before discharge. Between 30 and 35 patients are operated on at each mission site. About 2 weeks after the mission, patients are checked and photographed, and the outcome of surgery is recorded. Complications that may occur are recorded and treated by the CIRPLAST team as soon as possible. Almost all operations are performed under general endotracheal anesthesia coupled by local anesthesia containing a vasoconstrictor, to reduce bleeding and facilitate tissue dissection. All wounds of the lip and palate are closed with absorbable sutures, to avoid the need for suture removal. After cleft lip surgery, patients go to the recovery room for monitoring by nurses until they recover completely. A total of 6108 cleft lip and palate repairs, primary and secondary, were performed by CIRPLAST in 141 missions, between May 12, 1994, and October 15, 2014. The medical records of the 5162 patients (84.5%) who returned for follow-up (ranging from 12 days to 9 years) were reviewed retrospectively. Between 45% and 70% of the patients operated on a mission have returned for early follow-up and some the following year. There were 3176 males (51.9%) and 2932

[The concept of man and alcoholism in ancient Peru].

PubMed

Mariátegui, J

1985-12-01

In the ancient Peru, particularly in the Inca Empire, the review of alcohol use and abuse must be made according to the ethnohistorical and cultural context with special emphasis on ideological and customary aspects. The outstanding research sources of alcohol consume types and characteristics are: a) The examination of chronicles of the Spanish Conquest and related papers on a textual criticism; b) The study of language from its semantic scope; and c) The archaeological and ethnological testimony. The only alcoholic beverage existing in the Inca's times was "chicha", mainly that of corn fermentation which was used under the ceremonial, ritual and convivial modalities. The pathological drinking types are clearly defined in the lexicon of the Pre-Columbian Peru prevailing languages, mainly Quechua. The social control of drinking overindulgence was evident and the repressive and punitive measures were similar to those of the great ancient civilizations. The image conveyed by most of the chroniclers as to alcohol excessive drinking among Inca people belongs to the trauma of Conquest which suppressed the psychopolitical and sociocultural control that supported their universe of values generating all sort of misbehaviors and selfdestructive types of toxic consume.

[The health system of Peru].

PubMed

Alcalde-Rabanal, Jacqueline Elizabeth; Lazo-González, Oswaldo; Nigenda, Gustavo

2011-01-01

This paper describes the health conditions in Peru and, with greater detail, the Peruvian health system, including its structure and coverage, its financial sources, its physical, material and human resources, and its stewardship functions. It also discusses the activities developed in the information and research areas, as well as the participation of citizens in the operation and evaluation of the health system. The article concludes with a discussion of the most recent innovations, including the Comprehensive Health Insurance, the Health Care Enterprises system, the decentralization process and the Local Committees for Health Administration. The main challenge confronted by the Peruvian health system is the extension of coverage to more than I0% of the population presently lacking access to basic health care.

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

Short Sleep Duration and Childhood Obesity: Cross-Sectional Analysis in Peru and Patterns in Four Developing Countries

PubMed Central

Carrillo-Larco, Rodrigo M.; Bernabé-Ortiz, Antonio; Miranda, J. Jaime

2014-01-01

Background We aimed to describe the patterns of nutritional status and sleep duration in children from Ethiopia, India, Peru and Vietnam; to assess the association between short sleep duration and overweight and obesity, and if this was similar among boys and girls in Peru. Methods and Findings Analysis of the Young Lives Study, younger cohort, third round. In Ethiopia there were 1,999 observations, 2,011, 2,052 and 2,000 in India, Peru and Vietnam, respectively. Analyses included participants with complete data for sleep duration, BMI, sex and age; missing data: 5.9% (Ethiopia), 4.1% (India), 6.0% (Peru) and 4.5% (Vietnam). Exposure was sleep duration per day: short (<10 hours) versus regular (10–11 hours). Outcome was overweight and obesity. Multivariable analyses were conducted using a hierarchical approach to assess the effect of variables at different levels. Overweight/obesity prevalence was 0.5%/0.2% (Ethiopia), 1.3%/0.3% (India), 6.1%/2.8% (Vietnam), and 15.8%/5.4% (Peru). Only Peruvian data was considered to explore the association between short sleep duration and overweight and obesity, with 1,929 children, aged 7.9±0.3 years, 50.3% boys. Short and regular sleep duration was 41.6% and 55.6%, respectively. Multivariable models showed that obesity was 64% more prevalent among children with short sleep duration, an estimate that lost significance after controlling for individual- and family-related variables (PR: 1.15; 95%CI: 0.81–1.64). Gender was an effect modifier of the association between short sleep duration and overweight (p = 0.030) but not obesity (p = 0.533): the prevalence ratio was greater than one across all the models for boys, yet it was less than one for girls. Conclusions Childhood overweight and obesity have different profiles across developing settings. In a sample of children living in resource-limited settings in Peru there is no association between short sleep duration and obesity; the crude association was slightly

Tobacco Control and Treatment for the Pediatric Clinician: Practice, Policy, and Research Updates.

PubMed

Jenssen, Brian P; Wilson, Karen M

2017-04-01

Tobacco use is the leading cause of preventable death in the United States, and exposure to tobacco smoke harms children from conception forward. There is no safe level of tobacco exposure. Although overall smoking rates have declined, the advent of new products, such as electronic cigarettes, threatens to perpetuate nicotine addiction without clear health benefits. In addition to reviewing traditional and new tobacco products, we discuss the unique role that pediatricians should play in tobacco treatment and control efforts. New policies and technologies can empower pediatric clinicians and pediatric health care systems to help parent smokers quit, and new policies outside of the health care setting might help prevent smoking initiation as well as improve cessation treatments. Future research is needed to continue to study the consequences of tobacco use exposure as well as the best ways to help patients and parents stop tobacco use. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Biological contributions to addictions in adolescents and adults: prevention, treatment, and policy implications.

PubMed

Potenza, Marc N

2013-02-01

Despite significant advances in our understanding of the biological bases of addictions, these disorders continue to represent a huge public health burden that is associated with substantial personal suffering. Efforts to target addictions require consideration of how the improved biological understanding of addictions may lead to improved prevention, treatment, and policy initiatives. In this article, we provide a narrative review of current biological models for addictions with a goal of placing existing data and theories within a translational and developmental framework targeting the advancement of prevention, treatment, and policy strategies. Data regarding individual differences, intermediary phenotypes, and main and interactive influences of genetic and environmental contributions in the setting of developmental trajectories that may be influenced by addictive drugs or behavior indicate complex underpinnings of addictions. Consideration and further elucidation of the biological etiologies of addictions hold significant potential for making important gains and reducing the public health impact of addictions. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Biological Contributions to Addictions in Adolescents and Adults: Prevention, Treatment and Policy Implications

PubMed Central

Potenza, Marc N.

2012-01-01

Purpose Despite significant advances in our understanding of the biological bases of addictions, these disorders continue to represent a huge public health burden that is associated with substantial personal suffering. Efforts to target addictions require consideration of how the improved biological understanding of addictions may lead to improved prevention, treatment and policy initiatives. Method In this article, we provide a narrative review of current biological models for addictions with a goal of placing existing data and theories within a translational and developmental framework targeting the advancement of prevention, treatment and policy strategies. Results Data regarding individual differences, intermediary phenotypes, and main and interactive influences of genetic and environmental contributions in the setting of developmental trajectories that may be influenced by addictive drugs or behavior indicate complex underpinnings of addictions. Conclusions Consideration and further elucidation of the biological etiologies of addictions hold significant potential for making important gains and reducing the public health impact of addictions. PMID:23332567

Substance abuse treatment organizations as mediators of social policy: slowing the adoption of a congressionally approved medication.

PubMed

Wallack, Stanley S; Thomas, Cindy Parks; Martin, Timothy C; Chilingerian, Jon; Reif, Sharon

2010-01-01

Most substance abuse treatment occurs in outpatient treatment centers, necessitating an understanding of what motivates organizations to adopt new treatment modalities. Tichy's framework of organizations as being comprised of three intertwined internal systems (technical, cultural, and political) was used to explain treatment organizations' slow adoption of buprenorphine, a new medication for opiate dependence. Primary data were collected from substance abuse treatment organizations in four of the ten metropolitan areas with the largest number of heroin users. Only about one fifth offered buprenorphine. All three internal systems were important determinants of buprenorphine adoption in our multivariate model. However, the cultural system, measured by attitude toward medications, was a necessary condition for adoption. Health policies designed to encourage adoption of evidence-based performance measures typically focus on the technical system of organizations. These findings suggest that such policies would be more effective if they incorporate an understanding of all three internal systems.

Men Who Have Sex With Men in Peru: Acceptability of Medication-Assisted Therapy for Treating Alcohol Use Disorders

PubMed Central

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

2015-01-01

In Peru, the HIV epidemic is concentrated in men who have sex with men (MSM) and transgender women (TGW). Multiple studies correlate alcohol use disorders (AUDs) with risky sexual behaviors among Peruvian MSM. Qualitative research was used to inform a clinical trial on the acceptability of medication-assisted therapies to assist management of AUDs and improve antiretroviral therapy (ART) adherence among MSM/TGW in Peru. Three focus groups involving HIV-infected or HIV-uninfected MSM/TGW (n = 26) with AUDs (AUDIT ≥ 8) were transcribed, translated from Spanish into English, and analyzed using thematic content analysis. Despite having an AUD, participants considered themselves “social” drinkers, minimized their drinking behaviors, and differed about whether or not alcohol problems could be treated. Participants expressed skepticism about medication for treating AUDs. Three concepts emerged as necessary components of a treatment program for alcohol problems: cost, family support, and the potential to drink less alcohol without attaining total abstinence. This study reveals important areas of education to increase potential acceptability of a medication for treating AUDs among MSM/TGW. Given the social conditions and knowledge base of the participants, medication-assisted therapies using naltrexone may be a beneficial strategy for MSM with AUDs. PMID:25787988

EARTH-SKY - GEMINI-TITAN (GT)-9A - AREAS OF PERU, CHILE AND BOLIVIA

NASA Image and Video Library

1966-06-05

S66-38313 (5 June 1966) --- Areas of Peru (upper right), Chile (top center) and Bolivia as seen from the Gemini-9 spacecraft during its 35th revolution of Earth. The large body of water at lower right is Lake Titicaca. The smaller lake at left edge is Lake Poopo. Salar de Uyuni is the large light-colored area at upper left. At the bottom of the picture is the snow-capped Cordillera Real range of the Andes Mountains. The Pacific coastline of Peru and Chile is at upper right. The range running parallel with the coastline is the Cordillera Occidental. The image was taken with a modified 70mm Hasselblad camera, using Eastman Kodak, Ektachrome MS (S.O. 217) color film. Photo credit: NASA

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…

Educational Impact of a School Breakfast Programme in Rural Peru

ERIC Educational Resources Information Center

Cueto, Santiago; Chinen, Marjorie

2008-01-01

In this paper, we present data from an evaluation of the educational impact of a school breakfast program implemented in rural schools in Peru. The results showed positive effects on school attendance and dropout rates, and a differential effect of the breakfast program on multiple-grade and full-grade schools. Particularly in multiple-grade…

Public views on food addiction and obesity: implications for policy and treatment.

PubMed

Lee, Natalia M; Lucke, Jayne; Hall, Wayne D; Meurk, Carla; Boyle, Frances M; Carter, Adrian

2013-01-01

According to their advocates, neurobiological explanations of overeating, or "food addiction", have the potential to impact public understanding and treatment of obesity. In this study, we examine the public's acceptance of the concept of food addiction as an explanation of overeating and assess its effects upon their attitudes toward obese persons and the treatment of obesity. We conducted an online survey of 479 adults from the US (n = 215) and Australia (n = 264). There was substantial support for the idea of food addiction, particularly among obese participants. Over half favoured treating obesity as a type of addiction. Psychotherapy was believed to be the most effective treatment and educational and support programs were the preferred policies to address food addiction. There was very little support for increasing taxes on obesogenic foods. Despite the strong support for seeing obesity as a form of addiction, respondents still saw obesity as primarily the result of personal choices and emphasized the need for individuals to take responsibility for their eating. Our sample of the general public strongly supported the idea of obesity as a form of food addiction; but this did not translate into support of clinical and public health policies that experts believe are most likely to reduce the prevalence of obesity. The reasons for the apparent disjunction between support for food addiction and a strong emphasis on personal choice for weight warrant further examination.

Avian Influenza in Wild Birds, Central Coast of Peru

PubMed Central

Blazes, David L.; Icochea, Eliana; Gonzalez, Rosa I.; Kochel, Tadeusz; Tinoco, Yeny; Sovero, Merly M.; Lindstrom, Stephen; Shu, Bo; Klimov, Alexander; Gonzalez, Armando E.; Montgomery, Joel M.

2009-01-01

To determine genotypes of avian influenza virus circulating among wild birds in South America, we collected and tested environmental fecal samples from birds along the coast of Peru, June 2006–December 2007. The 9 isolates recovered represented 4 low-pathogenicity avian influenza strains: subtypes H3N8, H4N5, H10N9, and H13N2. PMID:19523296

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.

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.

“…still waiting for chloroquine”: the challenge of communicating changes in first-line treatment policy for uncomplicated malaria in a remote Kenyan district

PubMed Central

2014-01-01

Background Widespread parasite resistance to first-line treatment for uncomplicated malaria leads to introduction of new drug interventions. Introducing such interventions is complex and sensitive because of stakeholder interests and public resistance. To enhance take up of such interventions, health policy communication strategies need to deliver accurate and accessible information to empower communities with necessary information and address problems of cultural acceptance of new interventions. Objectives To explore community understanding of policy changes in first-line treatment for uncomplicated malaria in Kenya; to evaluate the potential role of policy communication in influencing responses to changes in first-line treatment policy. Methods Data collection involved qualitative strategies in a remote district in the Kenyan Coast: in-depth interviews (n = 29), focus group discussions (n = 14), informal conversations (n = 11) and patient narratives (n = 8). Constant comparative method was used in the analysis. Being malaria-prone and remotely located, the district offered an ideal area to investigate whether or not and how policy communication about a matter as critical as change of treatment policy reaches vulnerable populations. Results Three years after initial implementation (2009), there was limited knowledge or understanding regarding change of first-line treatment from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (AL) for treatment of uncomplicated malaria in the study district. The print and electronic media used to create awareness about the drug change appeared to have had little impact. Although respondents were aware of the existence of AL, the drug was known neither by name nor as the official first-line treatment. Depending on individuals or groups, AL was largely viewed negatively. The weaknesses in communication strategy surrounding the change to AL included poor choice of communication tools, confusing

Substitution treatment in the era of "recovery": An analysis of stakeholder roles and policy windows in Britain.

PubMed

Duke, Karen; Herring, Rachel; Thickett, Anthony; Thom, Betsy

2013-08-01

Based on documentary analyses and interviews with twenty key informants in 2012, this paper analyses the shift in British drugs policy towards "recovery" from the perspectives of major stakeholders. The processes involved in reopening the debate surrounding the role of substitution treatment and its re-emergence on to the policy agenda are examined. Drawing on Kingdon's work on agenda-setting, the ways in which methadone maintenance was challenged and defended by key stakeholders in the initial phase of policy development and the negotiation of a "recovery" focus as the organizing concept for British drugs policy are explored. Study limitations are noted.

Framing and sources: a study of mass media coverage of climate change in Peru during the V ALCUE.

PubMed

Takahashi, Bruno

2011-07-01

Studies about mass media framing have found divergent levels of influence on public opinion; moreover, the evidence suggests that issue attributes can contribute to this difference. In the case of climate change, studies have focused exclusively on developed countries, suggesting that media influence perceptions about the issue. This study presents one of the first studies of media coverage in a developing country. It examines newspapers' reporting in Peru during the Fifth Latin America, Caribbean and European Union Summit in May 2008. The study focuses on the frames and the sources to provide an initial exploratory assessment of the coverage. The results show that the media relied mostly on government sources, giving limited access to dissenting voices such as environmentalists. Additionally, a prominence of "solutions" and "effects" frames was found, while "policy" and "science" frames were limited. The results could serve as a reference point for more comprehensive studies.

Protected area coverage of threatened vertebrates and ecoregions in Peru: Comparison of communal, private and state reserves.

PubMed

Shanee, Sam; Shanee, Noga; Monteferri, Bruno; Allgas, Nestor; Alarcon Pardo, Alejandro; Horwich, Robert H

2017-11-01

Protected areas (PAs) are a conservation mainstay and arguably the most effective conservation strategy for species protection. As a 'megadiverse' country, Peru is a priority for conservation actions. Peruvian legislation allows for the creation of state PAs and private/communal PAs. Using publicly available species distribution and protected area data sets we evaluated the coverage of Threatened terrestrial vertebrate species distributions and ecoregions provided by both kinds of PA in Peru. Peru's state PA system covers 217,879 km 2 and private/communal PAs cover 16,588 km 2 . Of the 462 species of Threatened and Data Deficient species we evaluated, 75% had distributions that overlapped with at least one PA but only 53% had ≥10% of their distributions within PAs, with inclusion much reduced at higher coverage targets. Of the species we evaluated, 118 species are only found in national PAs and 29 species only found in private/communal PAs. Of the 17 terrestrial ecoregions found in Peru all are represented in PAs; the national PA system included coverage of 16 and private/communal PAs protect 13. One ecoregion is only protected in private/communal PAs, whereas four are only covered in national PAs. Our results show the important role private/communal PAs can play in the protection of ecological diversity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Bird Diversity, Birdwatching Tourism and Conservation in Peru: A Geographic Analysis

PubMed Central

Puhakka, Liisa; Salo, Matti; Sääksjärvi, Ilari E.

2011-01-01

In the face of the continuing global biodiversity loss, it is important not only to assess the need for conservation, through e.g. gap analyses, but also to seek practical solutions for protecting biodiversity. Environmentally and socially sustainable tourism can be one such solution. We present a method to spatially link data on conservation needs and tourism-based economic opportunities, using bird-related tourism in Peru as an example. Our analysis highlighted areas in Peru where potential for such projects could be particularly high. Several areas within the central and northern Andean regions, as well as within the lowland Amazonian regions of Madre de Dios and Loreto emerge as promising for this type of activity. Mechanisms to implement conservation in these areas include e.g. conservation and ecotourism concessions, private conservation areas, and conservation easements. Some of these mechanisms also offer opportunities for local communities seeking to secure their traditional land ownership and use rights. (Spanish language abstract, Abstract S1). PMID:22132078

Bird diversity, birdwatching tourism and conservation in Peru: a geographic analysis.

PubMed

Puhakka, Liisa; Salo, Matti; Sääksjärvi, Ilari E

2011-01-01

In the face of the continuing global biodiversity loss, it is important not only to assess the need for conservation, through e.g. gap analyses, but also to seek practical solutions for protecting biodiversity. Environmentally and socially sustainable tourism can be one such solution. We present a method to spatially link data on conservation needs and tourism-based economic opportunities, using bird-related tourism in Peru as an example. Our analysis highlighted areas in Peru where potential for such projects could be particularly high. Several areas within the central and northern Andean regions, as well as within the lowland Amazonian regions of Madre de Dios and Loreto emerge as promising for this type of activity. Mechanisms to implement conservation in these areas include e.g. conservation and ecotourism concessions, private conservation areas, and conservation easements. Some of these mechanisms also offer opportunities for local communities seeking to secure their traditional land ownership and use rights. (Spanish language abstract, Abstract S1).

Capabilities and Present Status of The Sicaya Radio Telescope in Peru

NASA Astrophysics Data System (ADS)

Ishitsuka, J. K.; Kobayashi, H.; Miyoshi, M.

2017-07-01

The private telephone company, Telefónica del Perú, stopped operations of the Sicaya Intelsat Station in 2000, we knew that they were looking for some institution to own the Station in 2002 and begun conversations. Finally in 2008, the whole communications station with a 32-meters parabolic antenna was donated to the Geophysical Institute of Peru. Many things have happened since that, but finally we are almost ready to have a radio telescope. National Astronomical Observatory of Japan contributed enormously to set up the radio telescope. Initially as a single dish radio telescope, it will observe methanol maser at 6.7 GHz of young stellar objects. In the near future, equipping for VLBI observations is in the scope. Sicaya is situated on the central part of Peru at 3,370 meters of altitude and the weather is benign for radio astronomical observations, also humidity is low and allows have radio telescopes free of rust.

Psychometric and cognitive validation of a social capital measurement tool in Peru and Vietnam.

PubMed

De Silva, Mary J; Harpham, Trudy; Tuan, Tran; Bartolini, Rosario; Penny, Mary E; Huttly, Sharon R

2006-02-01

Social capital is a relatively new concept which has attracted significant attention in recent years. No consensus has yet been reached on how to measure social capital, resulting in a large number of different tools available. While psychometric validation methods such as factor analysis have been used by a few studies to assess the internal validity of some tools, these techniques rely on data already collected by the tool and are therefore not capable of eliciting what the questions are actually measuring. The Young Lives (YL) study includes quantitative measures of caregiver's social capital in four countries (Vietnam, Peru, Ethiopia, and India) using a short version of the Adapted Social Capital Assessment Tool (SASCAT). A range of different psychometric methods including factor analysis were used to evaluate the construct validity of SASCAT in Peru and Vietnam. In addition, qualitative cognitive interviews with 20 respondents from Peru and 24 respondents from Vietnam were conducted to explore what each question is actually measuring. We argue that psychometric validation techniques alone are not sufficient to adequately validate multi-faceted social capital tools for use in different cultural settings. Psychometric techniques show SASCAT to be a valid tool reflecting known constructs and displaying postulated links with other variables. However, results from the cognitive interviews present a more mixed picture with some questions being appropriately interpreted by respondents, and others displaying significant differences between what the researchers intended them to measure and what they actually do. Using evidence from a range of methods of assessing validity has enabled the modification of an existing instrument into a valid and low cost tool designed to measure social capital within larger surveys in Peru and Vietnam, with the potential for use in other developing countries following local piloting and cultural adaptation of the tool.

Mapping of nutrition and sectoral policies addressing malnutrition in Latin America.

PubMed

Tirado, María Cristina; Galicia, Luis; Husby, Hannah M; Lopez, Jaime; Olamendi, Stephania; Pia Chaparro, Maria; González, María A; Grajeda, Rubén

2016-08-01

To map existing policies addressing malnutrition in all its forms in Latin America and identify gaps in enabling environments supporting the five priority lines of action outlined in the World Health Organization Comprehensive Implementation Plan on Maternal, Infant and Young Child Nutrition (CIP) approved in 2014. This descriptive study consisted of a systematic Internet search for and mapping of publicly available nutrition-related and sectoral policies already in place to address malnutrition in all its forms in 18 Latin American countries (Argentina, Belize, Bolivia, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, and Uruguay). The policies were described in documents retrieved from the websites of ministries of health, education, agriculture, labor, and development; the national congress; and other government agencies. All 18 countries had relevant policies to address malnutrition, especially undernutrition and micronutrient deficiencies, but only a few had policies to address overweight and obesity. Nutrition actions were incorporated in food and nutrition security and social protection policies in all 18 countries, and were part of education, environment, agricultural, development, and/or employment policies in some countries. Information on human and financial resources assigned to nutrition was not available through the search strategies used in the study. All 18 countries included in this review had established enabling environments to support CIP implementation. However, each of the 18 countries needs to develop integrated policies for the promotion of nutrition and prevention of noncommunicable diseases through cross-sector involvement and multi-stakeholder collaboration.

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

The policy and practices of New South Wales drug treatment providers in responding to the possession of illicit substances on premises.

PubMed

Stirling, Robert; Day, Carolyn

2016-09-01

Responding to possession of illicit substances on the premises of drug treatment services is a complex issue. Providers are challenged by balancing duty-of-care and staff safety while attempting to provide a therapeutic environment. This study assessed the current policy and practice of non-government drug treatment services in New South Wales, Australia in responding to possession of illicit substances on their premises. Non-government drug treatment services were invited to participate in a survey that aimed to elicit information about existing policy and practices and how often it occurred. Analysis explored the differences between services that had a written policy and those that did not against service setting, accreditation status, reporting of an illicit drug possession in the last 12 months and having a sharps disposal unit. Fifty-one responses were included in the analysis, 29 (57%) of which reported having a policy and/or procedure. There was no statistically discernible difference between inpatient and outpatient settings, accreditation status of services or availability of a sharps disposal unit on the premises. However, services that reported a possession incident in the previous 12 months were more likely to report having a written policy than those that did not (37% vs. 12%; odds ratio: 4.75, 95% confidence interval 1.32-17.11, P = 0.014). The policy and practice in these settings vary greatly, with many services reporting no documented policy to guide staff. The findings suggest the need to develop organisational policy to support service providers in responding to possession of illicit substances on premises. [Stirling R, Day C. The policy and practices of New South Wales drug treatment providers in responding to the possession of illicit substances on premises. Drug Alcohol Rev 2016;35:644-649]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

Stigma, Discrimination, Treatment Effectiveness and Policy Support: Comparing Public Views about Drug Addiction with Mental Illness

PubMed Central

Barry, Colleen L; McGinty, Emma Elizabeth; Pescosolido, Bernice; Goldman, Howard H.

2014-01-01

Objective This study compares current public attitudes about drug addiction with attitudes about mental illness. Methods A web-based national public opinion survey (N=709) was conducted to compare attitudes about stigma, discrimination, treatment effectiveness, and policy support. Results Respondents hold significantly more negative views toward persons with drug addiction compared to those with mental illness. More respondents were unwilling to have a person with drug addiction marry into their family or work closely with them on a job. Respondents were more willing to accept discriminatory practices, more skeptical about the effectiveness of available treatments, and more likely to oppose public policies aimed at helping persons with drug addiction. Conclusions Drug addiction is often treated as a sub-category of mental illness, and health insurance benefits group these conditions together under the rubric of behavioral health. Given starkly different public views about drug addiction and mental illness, advocates may need to adopt differing approaches for advancing stigma reduction and public policy. PMID:25270497

Structure of the Flat Slab in Southern Peru

NASA Astrophysics Data System (ADS)

Ma, Y.; Clayton, R. W.

2014-12-01

We investigate the detailed structure of the flat-subduction portion of the subduction zone in Southern Peru using converted phases recorded by the PeruSE seismic array. The migrated image along a profile above the flat subduction is shown in the figure, overlain by the receiver functions of one well-recorded event. We see that the slab descends to 100 km depth at a distance of about 100 km inland from the coast, and then it rises to 90 km depth and remains flat for the next 300 km distance before diving into the mantle. The Moho itself has about 10 km relief above the flat slab, which is anti-correlated with the surface topography indicating Airy compensation. Interestingly, the flat slab image is missing under this part of Moho. The mid-crust structure is also evident. In the west, it coincides with the Andean Low Velocity Zone (ALVZ) mapped in this region (Ma and Clayton, 2014). In the east, it is related with the underthrusting Brazilian Shield (Phillips and Clayton, 2014). In this paper, we further investigate the causes of the missing or weak flat slab signal, possibly due to anomalous attenuation of S waves in the mantle wedge (but not P wave, since Moho is well imaged). We will also extend our study to the flat-normal transition area beneath the array.

Cultural Artefact, Ideology Export or Soft Power? Confucius Institute in Peru

ERIC Educational Resources Information Center

Park, Jae

2013-01-01

This paper presents a critical analysis of the transnational interplay of cultural, educational and economic forces that culminated with the establishment of a Chinese language and cultural centre in Peru, the Confucius Institute. Confucius Institutes are government-sponsored cultural centres devoted mainly to Chinese language education around the…

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…

Pre-Incan Archeology of Peru: Paleo-Indians in the Paleo-Climate

ERIC Educational Resources Information Center

Alibrandi, Marsha

2011-01-01

Peru's prehistory, climate, and terrain are the landscape upon which one of humankind's longest migrations occurred. When the glacial period ended, a geographic and cultural transition began when the meltwaters carved river valleys across the South American continent. Culture-rich communities of fishers, miners, artisans, and morticians populated…

Comparison of CMA joint statement on resuscitative interventions and New Brunswick hospital corporations' policies on end-of-life treatments.

PubMed

Poirier, N

2000-01-01

Why do most physicians have so much difficulty respecting the wishes of their terminally ill patients who refuse treatment? The normative pluralism model is introduced to answer this question. Comparative content analysis serves as the theoretical framework for evaluating the Canadian Medical Association Joint Statement on Resuscitative Interventions against the corresponding administrative policies of New Brunswick hospital corporations and relevant New Brunswick law. Despite protection afforded patients by law, fully 75% of New Brunswick hospital corporations' administrative policies permit physicians to ignore patients' expressed objection to treatments. The futility-of-treatment criteria in the CMA joint statement and in all provincial hospital corporations' policies authorize physicians to substitute their judgment for patients' expressed refusal of CPR. The author concludes that when medical professional norms conflict with the law, physicians tend to follow their professional normative order.

Camana, Peru, and Tsunami Vulnerability

NASA Technical Reports Server (NTRS)

2002-01-01

A tsunami washed over the low-lying coastal resort region near Camana, southern Peru, following a strong earthquake on June 23, 2001. The earthquake was one of the most powerful of the last 35 years and had a magnitude of 8.4. After the initial quake, coastal residents witnessed a sudden drawdown of the ocean and knew a tsunami was imminent. They had less than 20 minutes to reach higher ground before the tsunami hit. Waves as high as 8 m came in four destructive surges reaching as far as 1.2 km inland. The dashed line marks the approximate area of tsunami inundation. Thousands of buildings were destroyed, and the combined earthquake and tsunami killed as many as 139 people. This image (ISS004-ESC-6128) was taken by astronauts onboard the International Space Station on 10 January 2002. It shows some of the reasons that the Camana area was so vulnerable to tsunami damage. The area has a 1 km band of coastal plain that is less than 5 m in elevation. Much of the plain can be seen by the bright green fields of irrigated agriculture that contrast with the light-colored desert high ground. Many of the tsunami-related deaths were workers in the onion fields in the coastal plain that were unwilling to leave their jobs before the end of the shift. A number of lives were spared because the tsunami occurred during the resort off-season, during the daylight when people could see the ocean drawdown, and during one of the lowest tides of the year. Information on the Tsunami that hit Camana can be found in a reports on the visit by the International Tsunami Survey Team and the USC Tsunami Research Lab. Earthquake Epicenter, Peru shows another image of the area. Image provided by the Earth Sciences and Image Analysis Laboratory at Johnson Space Center. Additional images taken by astronauts and cosmonauts can be viewed at the NASA-JSC Gateway to Astronaut Photography of Earth.

Do Schools Reinforce or Reduce Learning Gaps between Advantaged and Disadvantaged Students? Evidence from Vietnam and Peru

PubMed Central

Glewwe, Paul; Krutikova, Sofya; Rolleston, Caine

2018-01-01

This paper examines – for two developing countries, Vietnam and Peru – whether disadvantaged children learn less than advantaged children when both types of children are enrolled in the same school. This is done by estimating education production functions that contain two school fixed effects for each school, one for advantaged children and one for disadvantaged children. The paper examines six different definitions of advantage, based on household wealth, cognitive skills at age 5, gender, ethnicity (Peru only), maternal education, and nutritional status. The results show no sign that schools are less effective for disadvantaged groups in Vietnam; indeed if anything one traditionally advantaged group, males, seems to do worse in school than the corresponding disadvantaged group, females. In contrast, in Peru ethnic minority students and students who enter primary school with low cognitive skills appear to learn less in school than ethnic majority students and students with relatively high cognitive skills, respectively, who are enrolled in the same school.

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.

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

Crustal structure of north Peru from analysis of teleseismic receiver functions

NASA Astrophysics Data System (ADS)

Condori, Cristobal; França, George S.; Tavera, Hernando J.; Albuquerque, Diogo F.; Bishop, Brandon T.; Beck, Susan L.

2017-07-01

In this study, we present results from teleseismic receiver functions, in order to investigate the crustal thickness and Vp/Vs ratio beneath northern Peru. A total number of 981 receiver functions were analyzed, from data recorded by 28 broadband seismic stations from the Peruvian permanent seismic network, the regional temporary SisNort network and one CTBTO station. The Moho depth and average crustal Vp/Vs ratio were determined at each station using the H-k stacking technique to identify the arrival times of primary P to S conversion and crustal reverberations (PpPms, PpSs + PsPms). The results show that the Moho depth correlates well with the surface topography and varies significantly from west to east, showing a shallow depth of around 25 km near the coast, a maximum depth of 55-60 km beneath the Andean Cordillera, and a depth of 35-40 km further to the east in the Amazonian Basin. The bulk crustal Vp/Vs ratio ranges between 1.60 and 1.88 with the mean of 1.75. Higher values between 1.75 and 1.88 are found beneath the Eastern and Western Cordilleras, consistent with a mafic composition in the lower crust. In contrast values vary from 1.60 to 1.75 in the extreme flanks of the Eastern and Western Cordillera indicating a felsic composition. We find a positive relationship between crustal thickness, Vp/Vs ratio, the Bouguer anomaly, and topography. These results are consistent with previous studies in other parts of Peru (central and southern regions) and provide the first crustal thickness estimates for the high cordillera in northern Peru.

[Burden of smoking-related disease and potential impact of cigarette price increase in Peru].

PubMed

Bardach, Ariel E; Caporale, Joaquín E; Alcaraz, Andrea; Augustovski, Federico; Huayanay-Falconí, Leandro; Loza-Munarriz, Cesar; Hernández-Vásquez, Akram; Pichon-Riviere, Andrés

2016-01-01

. To calculate the burden of smoking-related disease and evaluate the potential economic and health impact of tax-induced cigarette price increase in Peru. A microsimulation model was used to estimate smoking-attributable impact on mortality, quality of life, and costs associated with heart and cerebrovascular disease, chronic obstructive pulmonary disease, pneumonia, lung cancer, and another nine cancers. Three scenarios, involving increased taxes, were evaluated. . A yearly total of 16,719 deaths, 6,926 cancer diagnoses, 7,936 strokes, and 7,548 hospital admissions due to cardiovascular disease can be attributed to smoking in Peru. Similarly, 396,069 years of life are lost each year from premature death and disability, and the cost of treating smoking-attributable health issues rises to 2,500 million soles (PEN 2015). Currently, taxes on tobacco cover only 9.1% of this expense. If cigarette prices were to increase by 50% over the next 10 years, 13,391 deaths, 6,210 cardiovascular events, and 5,361 new cancers could be prevented, representing an economic benefit of 3,145 million (PEN) in savings in health costs and increases in tax revenues. . Smoking-attributable burden of disease and costs to the health system are very high in Peru. Higher cigarette taxes could have substantial health and economic benefits for the country.

Economic and Public Health Impacts of Policies Restricting Access to Hepatitis C Treatment for Medicaid Patients.

PubMed

Chidi, Alexis P; Bryce, Cindy L; Donohue, Julie M; Fine, Michael J; Landsittel, Douglas P; Myaskovsky, Larissa; Rogal, Shari S; Switzer, Galen E; Tsung, Allan; Smith, Kenneth J

2016-06-01

Interferon-free hepatitis C treatment regimens are effective but very costly. The cost-effectiveness, budget, and public health impacts of current Medicaid treatment policies restricting treatment to patients with advanced disease remain unknown. To evaluate the cost-effectiveness of current Medicaid policies restricting hepatitis C treatment to patients with advanced disease compared with a strategy providing unrestricted access to hepatitis C treatment, assess the budget and public health impact of each strategy, and estimate the feasibility and long-term effects of increased access to treatment for patients with hepatitis C. Using a Markov model, we compared two strategies for 45- to 55-year-old Medicaid beneficiaries: 1) Current Practice-only advanced disease is treated before Medicare eligibility and 2) Full Access-both early-stage and advanced disease are treated before Medicare eligibility. Patients could develop progressive fibrosis, cirrhosis, or hepatocellular carcinoma, undergo transplantation, or die each year. Morbidity was reduced after successful treatment. We calculated the incremental cost-effectiveness ratio and compared the costs and public health effects of each strategy from the perspective of Medicare alone as well as the Centers for Medicare & Medicaid Services perspective. We varied model inputs in one-way and probabilistic sensitivity analyses. Full Access was less costly and more effective than Current Practice for all cohorts and perspectives, with differences in cost ranging from $5,369 to $11,960 and in effectiveness from 0.82 to 3.01 quality-adjusted life-years. In a probabilistic sensitivity analysis, Full Access was cost saving in 93% of model iterations. Compared with Current Practice, Full Access averted 5,994 hepatocellular carcinoma cases and 121 liver transplants per 100,000 patients. Current Medicaid policies restricting hepatitis C treatment to patients with advanced disease are more costly and less effective than unrestricted

Multiple genetic origins of histidine-rich protein 2 gene deletion in Plasmodium falciparum parasites from Peru

PubMed Central

Akinyi, Sheila; Hayden, Tonya; Gamboa, Dionicia; Torres, Katherine; Bendezu, Jorge; Abdallah, Joseph F.; Griffing, Sean M.; Quezada, Wilmer Marquiño; Arrospide, Nancy; De Oliveira, Alexandre Macedo; Lucas, Carmen; Magill, Alan J.; Bacon, David J.; Barnwell, John W.; Udhayakumar, Venkatachalam

2013-01-01

The majority of malaria rapid diagnostic tests (RDTs) detect Plasmodium falciparum histidine-rich protein 2 (PfHRP2), encoded by the pfhrp2 gene. Recently, P. falciparum isolates from Peru were found to lack pfhrp2 leading to false-negative RDT results. We hypothesized that pfhrp2-deleted parasites in Peru derived from a single genetic event. We evaluated the parasite population structure and pfhrp2 haplotype of samples collected between 1998 and 2005 using seven neutral and seven chromosome 8 microsatellite markers, respectively. Five distinct pfhrp2 haplotypes, corresponding to five neutral microsatellite-based clonal lineages, were detected in 1998-2001; pfhrp2 deletions occurred within four haplotypes. In 2003-2005, outcrossing among the parasite lineages resulted in eight population clusters that inherited the five pfhrp2 haplotypes seen previously and a new haplotype; pfhrp2 deletions occurred within four of these haplotypes. These findings indicate that the genetic origin of pfhrp2 deletion in Peru was not a single event, but likely occurred multiple times. PMID:24077522

A Solar Station for Education and Research on Solar Activity at a National University in Peru

NASA Astrophysics Data System (ADS)

Ishitsuka, J. K.

2006-11-01

pepe@geo.igp.gob.pe Beginning in 1937, the Carnegie Institution of Washington made active regional observations with a spectro-helioscope at the Huancayo Observatory. In 1957, during the celebration of the International Geophysical Year Mutsumi Ishitsuka arrived at the Geophysical Institute of Peru and restarted solar observations from the Huancayo Observatory. Almost 69 years have passed and many contributions for the geophysical and solar sciences have been made. Now the Instituto Geofisico del Peru (IGP), in cooperation with the Faculty of Sciences of the Universidad Nacional San Luis Gonzaga de Ica (UNICA), and with the support of the National Astronomical Observatory of Japan, are planning to construct a solar station refurbishing a coelostat that worked for many years at the Huancayo Observatory. A 15 cm refractor telescope is already installed at the university, for the observation of sunspots. A solar Flare Monitor Telescope (FMT) from Hida Observatory of Kyoto University could be sent to Peru and installed at the solar station at UNICA. As the refurbished coelostat, FMT will become a good tool to improve education and research in sciences.

Avifauna of the Pongos Basin, Amazonas Department, Peru

USGS Publications Warehouse

Brooks, Daniel M.; O'Neill, John P.; Foster, Mercedes S.; Mark, Todd; Dauphine, Nico; Franke, Irma J.

2009-01-01

We provide an inventory of the avifauna of the Pongos Basin, northern Amazonas Department, Peru based on museum specimens collected during expeditions spanning >60 years within the 20th century. Four hundred and thirty-eight species representing 52 families are reported. Differences between lowland and higher elevation avifaunas were apparent. Species accounts with overviews of specimen data are provided for four species representing distributional records, two threatened species, and 26 species of Nearctic and Austral migrants, of which six are considered probable migrants.

[Use of evidence in heath policies and programs contributions of the instituto nacional de salud].

PubMed

Gutierrez, Ericson L; Piazza, Marina; Gutierrez-Aguado, Alfonso; Hijar, Gisely; Carmona, Gloria; Caballero, Patricia; Reyes, Nora; Canelo, Carlos; Aparco, Juan Pablo; Tejada, Romina A; Bolaños-Díaz, Rafael; Saravia, Silvia; Gozzer, Ernesto

2016-01-01

This article analyzes some examples about how the Ministry of Health of Peru has used evidence for policy and program formulation, implementation and evaluation. It describes the process by which health budget programs are based and strengthened with scientific evidence. Provides an overview about how the development of clinical guidelines methodology is facilitating the generation of high quality evidence based clinical guidelines.It presents some examples of specific information needs of the Ministry of Health to which the Instituto Nacional de Salud has responded, and the impact of that collaboration. Finally, the article proposes future directions for the use of research methodology especially relevant for the development and evaluation of policy and programs, as well as the development of networks of health technology assessment at the national and international level.

Indigenous Worldviews in Intercultural Education: Teachers' Construction of Interculturalism in a Bilingual Quechua-Spanish Program

ERIC Educational Resources Information Center

Valdiviezo, Laura Alicia

2010-01-01

This paper examines teachers' implementation of a bilingual intercultural education (BIE) program in Peru. This program is inspired by global policies that promote cultural pluralism and educational access to marginalized indigenous populations. Broadly addressed in policy in Andean countries, interculturalism in Peru has remained a core…

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

An endemic new species of Ameiva (Squamata: Teiidae) from an isolated dry   forest in southern Peru.

PubMed

Landauro, Caroll Z; García-Bravo, Antonio; Venegas, Pablo J

2015-04-10

We describe a new species of Ameiva from an interandean dry forest in central-southern Peru. Ameiva reticulata sp. nov. represents the fifth species in the genus known to occur in Peru. The new species is similar to the species of the A. ameiva complex such as A. ameiva, A. atrigularis, A. pantherina, and A. praesignis, and is distinguished from these by a smaller size, a lower count of dorsal scales along the middorsal line and scales across the midbody, and by the gular coloration.

Hepatitis B Infection and Association with Other Sexually Transmitted Infections Among Men Who Have Sex with Men in Peru

PubMed Central

Lama, Javier R.; Agurto, Hellen S.; Guanira, Juan V.; Ganoza, Carmela; Casapia, Martin; Ojeda, Nora; Ortiz, Abner; Zamalloa, Victoria; Suarez-Ognio, Luis; Cabezas, Cesar; Sanchez, Jose L.; Sanchez, Jorge

2010-01-01

To assess the epidemiology of hepatitis B virus (HBV) infection among men who have sex with men (MSM) in Peru, we evaluated the prevalence and associated risk factors for HBV serologic markers among participants of a HIV sentinel surveillance conducted in 2002–2003. The standardized prevalences for total antibodies to hepatitis B core antigen (anti-HBc) and hepatitis B surface antigen (HBsAg) were 20.2% and 2.8%, respectively. Individuals with human immunodeficiency virus (HIV-1) infection had significantly higher anti-HBc (44.3% versus 19.3%) and HBsAg (9.5% versus 2.3%) prevalences than uninfected men. Increasing age (adjusted odds ratio [AOR] = 1.06), versatile sexual role (AOR = 1.59), sex in exchange for money/gifts (AOR = 1.58), syphilis (AOR = 1.74), HIV-1 infection (AOR = 1.64), and herpes simplex virus type 2 (HSV-2, AOR = 2.77) infection were independently associated with anti-HBc positivity, whereas only HIV-1 infection (AOR = 3.51) and generalized lymph node enlargement (AOR = 3.72) were associated with HBsAg positivity. Pre-existing HBV infection is very common among Peruvian MSM and was correlated with sexual risk factors. MSM in Peru constitute a target population for further HBV preventive and treatment interventions. PMID:20595501

Hepatitis B infection and association with other sexually transmitted infections among men who have sex with men in Peru.

PubMed

Lama, Javier R; Agurto, Hellen S; Guanira, Juan V; Ganoza, Carmela; Casapia, Martin; Ojeda, Nora; Ortiz, Abner; Zamalloa, Victoria; Suarez-Ognio, Luis; Cabezas, Cesar; Sanchez, Jose L; Sanchez, Jorge

2010-07-01

To assess the epidemiology of hepatitis B virus (HBV) infection among men who have sex with men (MSM) in Peru, we evaluated the prevalence and associated risk factors for HBV serologic markers among participants of a HIV sentinel surveillance conducted in 2002-2003. The standardized prevalences for total antibodies to hepatitis B core antigen (anti-HBc) and hepatitis B surface antigen (HBsAg) were 20.2% and 2.8%, respectively. Individuals with human immunodeficiency virus (HIV-1) infection had significantly higher anti-HBc (44.3% versus 19.3%) and HBsAg (9.5% versus 2.3%) prevalences than uninfected men. Increasing age (adjusted odds ratio [AOR] = 1.06), versatile sexual role (AOR = 1.59), sex in exchange for money/gifts (AOR = 1.58), syphilis (AOR = 1.74), HIV-1 infection (AOR = 1.64), and herpes simplex virus type 2 (HSV-2, AOR = 2.77) infection were independently associated with anti-HBc positivity, whereas only HIV-1 infection (AOR = 3.51) and generalized lymph node enlargement (AOR = 3.72) were associated with HBsAg positivity. Pre-existing HBV infection is very common among Peruvian MSM and was correlated with sexual risk factors. MSM in Peru constitute a target population for further HBV preventive and treatment interventions.

Teachers' Pedagogical Content Knowledge and Mathematics Achievement of Students in Peru

ERIC Educational Resources Information Center

Cueto, Santiago; León, Juan; Sorto, M. Alejandra; Miranda, Alejandra

2017-01-01

After improving enrolment rates significantly, many developing countries such as Peru are facing the challenge to increase learning levels among students. Over the past few years, many researchers have turned to teacher-related variables as a way to better understand classroom processes that may help increase learning levels among students. In…

Educational Reform in Peru. Experiments and Innovations in Education No. 16.

ERIC Educational Resources Information Center

Bizot, Judithe

In 1970 the Commission for Educational Reform, established by Peru's revolutionary government, published its General Report giving a detailed analysis of the old system's shortcomings, a statement of the philosophical principles which should guide any alternative system, and a description of the form which such an alternative pattern might take.…

Soil microbial communities under cacao agroforestry and cover crop systems in Peru

USDA-ARS?s Scientific Manuscript database

Cacao (Theobroma cacao) trees are grown in tropical regions worldwide for chocolate production. We studied the effects of agroforestry management systems and cover cropping on soil microbial communities under cacao in two different replicated field experiments in Peru. Two agroforestry systems, Imp...

Delivery cost of human papillomavirus vaccination of young adolescent girls in Peru, Uganda and Viet Nam.

PubMed

Levin, Carol E; Van Minh, Hoang; Odaga, John; Rout, Swampa Sarit; Ngoc, Diep Nguyen Thi; Menezes, Lysander; Araujo, Maria Ana Mendoza; LaMontagne, D Scott

2013-08-01

To estimate the incremental delivery cost of human papillomavirus (HPV) vaccination of young adolescent girls in Peru, Uganda and Viet Nam. Data were collected from a sample of facilities that participated in five demonstration projects for hpv vaccine delivery: school-based delivery was used in Peru, Uganda and Viet Nam; health-centre-based delivery was also used in Viet Nam; and integrated delivery, which involved existing health services, was also used in Uganda. Microcosting methods were used to guide data collection on the use of resources (i.e. staff, supplies and equipment) and data were obtained from government, demonstration project and health centre administrative records. Delivery costs were expressed in 2009 United States dollars (US$). Exclusively project-related expenses and the cost of the vaccine were excluded. The economic delivery cost per vaccine dose ranged from US$ 1.44 for integrated outreach in Uganda to US$ 3.88 for school-based delivery in Peru. In Viet Nam, the lowest cost per dose was US$ 1.92 for health-centre-based delivery. Cost profiles revealed that, in general, the largest contributing factors were project start-up costs and recurrent personnel costs. The delivery cost of HPV vaccine was higher than published costs for traditional vaccines recommended by the Expanded Programme on Immunization (EPI). The cost of delivering HPV vaccine to young adolescent girls in Peru, Uganda and Viet Nam was higher than that for vaccines currently in the EPI schedule. The cost per vaccine dose was lower when delivery was integrated into existing health services.

El Niño, Climate, and Cholera Associations in Piura, Peru, 1991-2001: A Wavelet Analysis.

PubMed

Ramírez, Iván J; Grady, Sue C

2016-03-01

In Peru, it was hypothesized that epidemic cholera in 1991 was linked to El Niño, the warm phase of El Niño-Southern Oscillation. While previous studies demonstrated an association in 1997-1998, using cross-sectional data, they did not assess the consistency of this relationship across the decade. Thus, how strong or variable an El Niño-cholera relationship was in Peru or whether El Niño triggered epidemic cholera early in the decade remains unknown. In this study, wavelet and mediation analyses were used to characterize temporal patterns among El Niño, local climate variables (rainfall, river discharge, and air temperature), and cholera incidence in Piura, Peru from 1991 to 2001 and to estimate the mediating effects of local climate on El Niño-cholera relationships. The study hypothesis is that El Niño-related connections with cholera in Piura were transient and interconnected via local climate pathways. Overall, our findings provide evidence that a strong El Niño-cholera link, mediated by local hydrology, existed in the latter part of the 1990s but found no evidence of an El Niño association in the earlier part of the decade, suggesting that El Niño may not have precipitated cholera emergence in Piura. Further examinations of cholera epicenters in Peru are recommended to support these results in Piura. For public health planning, the results may improve existing efforts that utilize El Niño monitoring for preparedness during future climate-related extremes in the region.

Public Views on Food Addiction and Obesity: Implications for Policy and Treatment

PubMed Central

Lee, Natalia M.; Lucke, Jayne; Hall, Wayne D.; Meurk, Carla; Boyle, Frances M.; Carter, Adrian

2013-01-01

Background According to their advocates, neurobiological explanations of overeating, or “food addiction”, have the potential to impact public understanding and treatment of obesity. In this study, we examine the public’s acceptance of the concept of food addiction as an explanation of overeating and assess its effects upon their attitudes toward obese persons and the treatment of obesity. Methods and Findings We conducted an online survey of 479 adults from the US (n = 215) and Australia (n = 264). There was substantial support for the idea of food addiction, particularly among obese participants. Over half favoured treating obesity as a type of addiction. Psychotherapy was believed to be the most effective treatment and educational and support programs were the preferred policies to address food addiction. There was very little support for increasing taxes on obesogenic foods. Despite the strong support for seeing obesity as a form of addiction, respondents still saw obesity as primarily the result of personal choices and emphasized the need for individuals to take responsibility for their eating. Conclusions Our sample of the general public strongly supported the idea of obesity as a form of food addiction; but this did not translate into support of clinical and public health policies that experts believe are most likely to reduce the prevalence of obesity. The reasons for the apparent disjunction between support for food addiction and a strong emphasis on personal choice for weight warrant further examination. PMID:24086382

Socioeconomic disparities in access to ART treatment and the differential impact of a policy that increased consumer costs.

PubMed

Chambers, G M; Hoang, V P; Illingworth, P J

2013-11-01

What was the impact on access to assisted reproductive technology (ART) treatment by different socioeconomic status (SES) groups after the introduction of a policy that increased patient out-of-pocket costs? After the introduction of a policy that increased out-of-pocket costs in Australia, all SES groups experienced a similar percentage reduction in fresh ART cycles per 1000 women of reproductive age. Higher SES groups experienced a progressively greater reduction in absolute numbers of fresh ART cycles due to existing higher levels of utilization. Australia has supportive public funding arrangements for ARTs. Policies that substantially increase out-of-pocket costs for ART treatment create financial barriers to access and an overall reduction in utilization. Data from the USA suggests that disparities exist in access to ART treatment based on ethnicity, education level and income. Time series analysis of utilization of ART, intrauterine insemination (IUI) and clomiphene citrate by women from varying SES groups before and after the introduction of a change in the level of public funding for ART. Women undertaking fertility treatment in Australia between 2007 and 2010. Women from higher SES quintiles use more ART treatment than those in lower SES quintiles, which likely reflects a greater ability to pay for treatment and a greater need for ART treatment as indicated by the trend to later childbearing. In 2009, 10.13 and 5.17 fresh ART cycles per 1000 women of reproductive age were performed in women in the highest and lowest SES quintiles respectively. In the 12 months after the introduction of a policy that increased out-of-pocket costs from ∼$1500 Australian dollars (€1000) to ∼$2500 (€1670) for a fresh IVF cycle, there was a 21-25% reduction in fresh ART cycles across all SES quintiles. The absolute reduction in fresh ART cycles in the highest SES quintile was double that in the lowest SES quintile. In this study, SES was based on the average relative

GEMINI-TITAN (GT)-9 - EARTH-SKY VIEW - PERU - OUTER SPACE

NASA Image and Video Library

1966-06-05

S66-38290 (5 June 1966) --- The north coastal area of Peru looking southeast across the Andes Mountains as seen from the National Aeronautics and Space Administration's Gemini-9A spacecraft. The body of water is the Pacific Ocean. The image was taken with a modified 70mm Hasselblad camera, using Eastman Kodak, Ektachrome MS (S.O. 217) color film. Photo credit: NASA

[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.

A Spatial Probit Econometric Model of Land Change: The Case of Infrastructure Development in Western Amazonia, Peru

PubMed Central

Arima, E. Y.

2016-01-01

Tropical forests are now at the center stage of climate mitigation policies worldwide given their roles as sources of carbon emissions resulting from deforestation and forest degradation. Although the international community has created mechanisms such as REDD+ to reduce those emissions, developing tropical countries continue to invest in infrastructure development in an effort to spur economic growth. Construction of roads in particular is known to be an important driver of deforestation. This article simulates the impact of road construction on deforestation in Western Amazonia, Peru, and quantifies the amount of carbon emissions associated with projected deforestation. To accomplish this objective, the article adopts a Bayesian probit land change model in which spatial dependencies are defined between regions or groups of pixels instead of between individual pixels, thereby reducing computational requirements. It also compares and contrasts the patterns of deforestation predicted by both spatial and non-spatial probit models. The spatial model replicates complex patterns of deforestation whereas the non-spatial model fails to do so. In terms of policy, both models suggest that road construction will increase deforestation by a modest amount, between 200–300 km2. This translates into aboveground carbon emissions of 1.36 and 1.85 x 106 tons. However, recent introduction of palm oil in the region serves as a cautionary example that the models may be underestimating the impact of roads. PMID:27010739

A Spatial Probit Econometric Model of Land Change: The Case of Infrastructure Development in Western Amazonia, Peru.

PubMed

Arima, E Y

2016-01-01

Tropical forests are now at the center stage of climate mitigation policies worldwide given their roles as sources of carbon emissions resulting from deforestation and forest degradation. Although the international community has created mechanisms such as REDD+ to reduce those emissions, developing tropical countries continue to invest in infrastructure development in an effort to spur economic growth. Construction of roads in particular is known to be an important driver of deforestation. This article simulates the impact of road construction on deforestation in Western Amazonia, Peru, and quantifies the amount of carbon emissions associated with projected deforestation. To accomplish this objective, the article adopts a Bayesian probit land change model in which spatial dependencies are defined between regions or groups of pixels instead of between individual pixels, thereby reducing computational requirements. It also compares and contrasts the patterns of deforestation predicted by both spatial and non-spatial probit models. The spatial model replicates complex patterns of deforestation whereas the non-spatial model fails to do so. In terms of policy, both models suggest that road construction will increase deforestation by a modest amount, between 200-300 km2. This translates into aboveground carbon emissions of 1.36 and 1.85 x 106 tons. However, recent introduction of palm oil in the region serves as a cautionary example that the models may be underestimating the impact of roads.

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.

The anthropometric history of Argentina, Brazil and Peru during the 19th and early 20th century.

PubMed

Baten, Joerg; Pelger, Ines; Twrdek, Linda

2009-12-01

This anthropometric study focuses on the histories of three important Latin American countries - Brazil, Peru, and Argentina - during the 19th century, and tests hypotheses concerning their welfare trends. While non-farm Brazil and Lima, Peru, started at relatively low height levels, Brazil made substantial progress in nutritional levels from the 1860s to the 1880s. In contrast, Lima remained at low levels. Argentinean men were tall to begin with, but heights stagnated until 1910. The only exception were farmers and landowners, who benefited from the export boom.

Translating research into maternal health care policy: a qualitative case study of the use of evidence in policies for the treatment of eclampsia and pre-eclampsia in South Africa

PubMed Central

Daniels, Karen; Lewin, Simon

2008-01-01

Background Few empirical studies of research utilisation have been conducted in low and middle income countries. This paper explores how research information, in particular findings from randomised controlled trials and systematic reviews, informed policy making and clinical guideline development for the use of magnesium sulphate in the treatment of eclampsia and pre-eclampsia in South Africa. Methods A qualitative case-study approach was used to examine the policy process. This included a literature review, a policy document review, a timeline of key events and the collection and analysis of 15 interviews with policy makers and academic clinicians involved in these policy processes and sampled using a purposive approach. The data was analysed thematically and explored theoretically through the literature on agenda setting and the policy making process. Results Prior to 1994 there was no national maternal care policy in South Africa. Consequently each tertiary level institution developed its own care guidelines and these recommended a range of approaches to the management of pre-eclampsia and eclampsia. The subsequent emergence of new national policies for maternal care, including for the treatment of pre-eclampsia and eclampsia, was informed by evidence from randomised controlled trials and systematic reviews. This outcome was influenced by a number of factors. The change to a democratic government in the mid 1990s, and the health reforms that followed, created opportunities for maternal health care policy development. The new government was open to academic involvement in policy making and recruited academics from local networks into key policy making positions in the National Department of Health. The local academic obstetric network, which placed high value on evidence-based practice, brought these values into the policy process and was also linked strongly to international evidence based medicine networks. Within this context of openness to policy development

Molecular characterization and phylogenetic analysis of Fasciola hepatica from Peru.

PubMed

Ichikawa-Seki, Madoka; Ortiz, Pedro; Cabrera, Maria; Hobán, Cristian; Itagaki, Tadashi

2016-06-01

The causative agent of fasciolosis in South America is thought to be Fasciola hepatica. In this study, Fasciola flukes from Peru were analyzed to investigate their genetic structure and phylogenetic relationships with those from other countries. Fasciola flukes were collected from the three definitive host species: cattle, sheep, and pigs. They were identified as F. hepatica because mature sperms were observed in their seminal vesicles, and also they displayed Fh type, which has an identical fragment pattern to F. hepatica in the nuclear internal transcribed spacer 1. Eight haplotypes were obtained from the mitochondrial NADH dehydrogenase subunit 1 (nad1) sequences of Peruvian F. hepatica; however, no special difference in genetic structure was observed between the three host species. Its extremely low genetic diversity suggests that the Peruvian population was introduced from other regions. Nad1 haplotypes identical to those of Peruvian F. hepatica were detected in China, Uruguay, Italy, Iran, and Australia. Our results indicate that F. hepatica rapidly expanded its range due to human migration. Future studies are required to elucidate dispersal route of F. hepatica from Europe, its probable origin, to other areas, including Peru. Copyright © 2015. Published by Elsevier Ireland Ltd.

Two new species of Andean gymnophthalmid lizards of the genus Euspondylus (Reptilia, Squamata) from central and southern Peru

PubMed Central

Chávez, Germán; Siu-Ting, Karen; Duran, Vilma; Venegas, Pablo J

2011-01-01

Abstract Two new species of lizards assigned to the genus Euspondylus from the montane forests of the Peruvian Andes in the Pasco Department (central Peru) and Ayacucho Department (southern Peru) both at elevations of 2550 and 3450 m, respectively, are described. The new species are distinguishable from all other Peruvian and Ecuadorian species of Euspondylus by a unique combination of morphometric, scalation and color pattern characteristics. Natural history data for the new species and for Euspondylus spinalis are also provided. PMID:21852931

Migration, urbanisation and mortality: 5-year longitudinal analysis of the PERU MIGRANT study

PubMed Central

Pena, Melissa S Burroughs; Bernabé-Ortiz, Antonio; Carrillo-Larco, Rodrigo M; Sánchez, Juan F; Quispe, Renato; Pillay, Timesh D; Málaga, Germán; Gilman, Robert H; Smeeth, Liam; Miranda, J Jaime

2015-01-01

Objective To compare all-cause and cause-specific mortality among 3 distinct groups: within-country, rural-to-urban migrants, and rural and urban dwellers in a longitudinal cohort in Peru. Methods The PERU MIGRANT Study, a longitudinal cohort study, used an age-stratified and sex-stratified random sample of urban dwellers in a shanty town community in the capital city of Peru, rural dwellers in the Andes, and migrants from the Andes to the shanty town community. Participants underwent a questionnaire and anthropomorphic measurements at a baseline evaluation in 2007–2008 and at a follow-up visit in 2012–2013. Mortality was determined by death certificate or family interview. Results Of the 989 participants evaluated at baseline, 928 (94%) were evaluated at follow-up (mean age 48 years; 53% female). The mean follow-up time was 5.1 years, totalling 4732.8 person-years. In a multivariable survival model, and relative to urban dwellers, rural participants had lower all-cause mortality (HR=0.27; 95% CI 0.07 to 0.98), and both the rural (HR=0.07; 95% CI 0.01 to 0.87) and migrant (HR=0.13; 95% CI 0.02 to 0.81) groups had lower cardiovascular mortality. Conclusions Cardiovascular mortality of migrants remains similar to that of the rural group, suggesting that rural-to-urban migrants do not appear to catch up with urban mortality in spite of having a more urban cardiovascular risk factor profile. PMID:25987723

[Diphyllobothrium pacificum (Nybelin,1931) margolis, 1956 in Canis familiaris from Chincha city, Peru].

PubMed

Cabrera, R; Tantaleán, M; Rojas, R

2001-01-01

In this communication is presented the finding of the tapeworm Diphyllobothrium pacificum, parasite of sea lions, in Canis familiaris (dog) in Chincha city, Peru. This is the first canine infection with D. pacificum in the South Peruvian coast.

Validation of the 'drinking expectancy questionnaire for men who have sex with men' in Peru.

PubMed

Vagenas, Panagiotis; Wickersham, Jeffrey A; Calabrese, Sarah K; Lama, Javier R; Benites, Carlos M; Pun, Monica; Sanchez, Jorge; Altice, Frederick L

2015-06-29

Alcohol use disorders are highly prevalent among men who have sex with men (MSM) in Peru, where the HIV epidemic is concentrated 100-fold greater among MSM than in the general population. Drinking expectancies have been associated with the intent to drink and engage in high-risk behaviours. Assessing them in this population may uncover attractive intervention targets that in turn can be used to reduce problematic drinking and risky sexual behaviours. The drinking expectancy questionnaire for MSM (DEQ-MSM) was developed to accurately measure drinking expectancies, specifically among MSM. This study aimed to validate this instrument for the first time in Spanish, in South America and among MSM in Peru. To validate the DEQ-MSM among Spanish-speaking MSM in Peru, we used exploratory and confirmatory factor analysis in a sample of 5148 MSM, including 700 transgender women (TGW). Exploratory factor analysis showed a two-factor structure to the Spanish version of the DEQ-MSM (DEQ-MSM-S), which was similar for MSM and TGW. The reliability of the translated DEQ-MSM was excellent (α = 0.91). The DEQ-MSM-S was shown to be highly reliable in a large population of Peruvian MSM and TGW. This short instrument can be effectively integrated into research or clinical practice, in order to identify alcohol-consuming, high-risk MSM, who can then be directed for further screening and/or intervention. Future research should aim to associate the Spanish version of the DEQ-MSM with risky sexual behaviours among this population, in order to identify potential intervention targets. [Vagenas P, Wickersham JA, Calabrese SK, Lama JR, Benites CM, Pun M, Sanchez J, Altice FL. Validation of the 'drinking expectancy questionnaire for men who have sex with men' in Peru. Drug Alcohol Rev 2015]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Malaria diagnostic testing and treatment practices in three different Plasmodium falciparum transmission settings in Tanzania: before and after a government policy change.

PubMed

Bastiaens, Guido J H; Schaftenaar, Erik; Ndaro, Arnold; Keuter, Monique; Bousema, Teun; Shekalaghe, Seif A

2011-04-02

Patterns of decreasing malaria transmission intensity make presumptive treatment of malaria an unjustifiable approach in many African settings. The controlled use of anti-malarials after laboratory confirmed diagnosis is preferable in low endemic areas. Diagnosis may be facilitated by malaria rapid diagnostic tests (RDTs). In this study, the impact of a government policy change, comprising the provision of RDTs and advice to restrict anti-malarial treatment to RDT-positive individuals, was assessed by describing diagnostic behaviour and treatment decision-making in febrile outpatients <10 years of age in three hospitals in the Kagera and Mwanza Region in northern Tanzania. Prospective data from Biharamulo and Rubya Designated District Hospital (DDH) were collected before and after policy change, in Sumve DDH no new policy was implemented. Diagnosis of malaria was confirmed by RDT; transmission intensity was evaluated by a serological marker of malaria exposure in hospital attendees. Prior to policy change, there was no evident association between the actual level of transmission intensity and drug-prescribing behaviour. After policy change, there was a substantial decrease in anti-malarial prescription and an increase in prescription of antibiotics. The proportion of parasite-negative individuals who received anti-malarials decreased from 89.1% (244/274) to 38.7% (46/119) in Biharamulo and from 76.9% (190/247) to 10.0% (48/479) in Rubya after policy change. This study shows that an official policy change, where RDTs were provided and healthcare providers were advised to adhere to RDT results in prescribing drugs can be followed by more rational drug-prescribing behaviour. The current findings are promising for improving treatment policy in Tanzanian hospitals.

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

Schooltime, Classtime, and Academic Learning Time in Rural Highland Puno, Peru.

ERIC Educational Resources Information Center

Hornberger, Nancy H.

1987-01-01

Uses data from ethnographic study in two Quechua-speaking communities of Puno, Peru, to explore schooltime spent in other-than-academic endeavors. Documents uses to which schooltime is put in these communities, and then seeks to account for observed uses of time in terms of ethnographically derived insights as to social, cultural, economic, and…