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PubMedDate not supplied

[Prevalence of viral hepatitis type C in blood donors in Peru].

UNLABELLED: In Peru there is limited information on the prevalence of HVC in the general population, for which reason we seek this information through blood donors in the different departments throughout the country. MATERIALS AND METHODS: Information was gathered from the Blood Bank Programs of the Ministry of Health establishments between 2000 and 2001, on which basis prevalences and their distribution by departments were obtained. RESULTS: The average prevalence, nationwide, was in the year 2000, 0.25% for HVC (0.08-0.48), 0.95% for HbsAg, 4.25% for Anti-HBc. In 2001, it was 0.60% for HVC (0.18-1.33), 0.9% for HbsAg and 4.51% for anti HBc. During 2000, for HVC, the result was 0.28% in the Coast and Jungle area 0.20% in the Sierra (Andean area) and during 2001 it was 0.89% in the jungle, 0.6% in the Coast and 0.46% in the Sierra. CONCLUSION: HVC prevalence in blood donors in Peru is low, however, it is necessary to extend the studies in the general population.

Blood Banks↗
PubMedDate not supplied

[New case of human infection by a Pseudoterranova decipiens larva (Nematode, Anisakidae) in Peru].

The purpose of this report is to divulge a new case of human anisakidosis in Peru, caused by a larva of the Pseudoterranova decipiens nematode found in a 17 year old female patient from Lima, who had ingested "cebiche" in a restaurant in the city of Ica, in the central coast of Peru. Approximately 4 hours after having ingested the food, the patient reported a feeling of uneasiness, with a nauseous sensation in the epigastric region, which intensified 5 hours later when she vomited. In the vomit content a live nematode was found, which was identified as larva L3 of P. decipiens. This is one of the etiologic agents of anisakidosis.

Adolescent↗
PubMed2004

Evaluation of surveillance devices for monitoring Aedes aegypti in an urban area of northeastern Peru.

In this study, we assessed the efficacy of the American Biophysics Corporation Standard Professional (ABC-PRO) light trap, the Omni-Directional Fay-Prince trap (with and without CO2), and the Centers for Disease Control and Prevention Wilton trap as a means of evaluating populations of adult Aedes aegypti in an urban area of northeastern Peru. Efficacies of collections from each of the trap types were compared to backpack-aspirator collections and human-landing collections. Collections were conducted twice daily, 3 days per week, for 27 wk from July 2001 to July 2002. Backpack-aspirator collections yielded significantly more mosquitoes (1,764) than any of the other collecting methods with a mean of 21.80 mosquitoes collected per sampling period. This method was less specific for Ae. aegypti than were human-landing collections because only 28.3% of mosquitoes collected with backpack aspirators were Ae. aegypti. Human-landing collections yielded only 23% (554/2,411) of the total mosquitoes collected. However, more than 80% (445/554) of the mosquitoes collected by this method were Ae. aegypti. None of the trapping devices evaluated collected mosquitoes, specifically Ae. aegypti, as effectively as backpack-aspirator or human-landing collections. The ABC-PRO trap, which was the most effective device in collecting mosquitoes, particularly Ae. aegypti, collected less than 2% of the total mosquitoes (mean of 0.12 mosquitoes/sampling period), and less than 3% of total Ae. aegypti (mean of 0.11 Ae. aegypti/sampling period). We conclude that none of the trap devices evaluated in this study is an acceptable alternative to backpack-aspirator or human-landing collections for monitoring populations of adult Ae. aegypti in Peru.

Aedes↗
PubMed2004

Evidence of rickettsial and leptospira infections in Andean northern Peru.

Between May and October 2002, a cluster of acute febrile illnesses occurred in the subtropical Andean foothills of Peru. Serologic evidence in villages where disease had been documented showed that the prevalence of IgM antibody to Leptospira ranged from 6% to 52%, that of IgM antibody to spotted fever group (SFG) rickettsia ranged from 10% to 19%, and that of IgM antibody to Coxiella burnetii from 1% to 15%. Measurement of IgG antibodies for SFG rickettsiae suggested that this disease was endemic. In contrast, IgG antibodies against C. burnetii were largely absent. In humans, microagglutination tests identified pathogenic variants of Leptospira. The presence of an SFG rickettsial infection was confirmed in four febrile patients following polymerase chain reaction and sequencing of the conserved 17-kD common antigen gene (htrA). Collectively, these analyses indicated that Rickettsia sp., C. burnetii, and Leptospira sp. were circulating in the region during the time of disease outbreak and implicate the involvement of an as yet undetermined SFG rickettsia in northwestern Peru.

Adolescent↗
PubMed2003

Use of isotope ratios to identify sources contributing to pediatric lead poisoning in Peru.

In 1998, a school-based blood lead level (BLL) survey of 2,510 children, conducted in Lima and Callao, Peru, revealed elevated BLLs in children from 2 Callao schools (mean BLL = 25.6 microg/dl; n = 314) and in children from Callao overall (mean BLL = 15.2 microg/dl; n = 898), compared with children from Lima (mean BLL = 7.1 microg/dl; n = 1,612). Public health officials at Peru's Direccion General de Salud Ambiental (DIGESA) hypothesized that a possible source of the elevated pediatric BLLs observed in Callao was a large depository near the port where mineral concentrates are stored prior to shipment. The U.S. Centers for Disease Control and Prevention worked with DIGESA to identify source(s) that contributed to the pediatric lead poisonings by comparing isotopic profiles of lead in blood, mineral, gasoline, and air filter samples. The lead isotope ratio (IR) observed in mineral samples from the depository in Callao differed from those in gasoline samples from Lima and Callao. The blood lead IRs of children living near the depository were similar to the IRs of the mineral samples and different from the IRs of the gasoline samples, suggesting that lead from the depository-and not gasoline-was the primary source of lead in these children. Lead IR analysis of regional air filter samples supported these findings.

Air Pollutants↗
PubMed2004

Short report: endemic focus of cystic echinococcosis in a coastal city of Peru.

No evidence of Echinococcus granulosus infection has been described in the coastal region of Peru, with the exception of the capital city of Lima. Anecdotal evidence suggests the existence of a focus of echinococcosis in the coastal city of Chincha, located south of Lima. We conducted a preliminary epidemiologic study in Chincha, which included an ultrasound, chest radiography, and serologic survey of abattoir workers, a review of medical records from local hospitals, and examination of the intestines of stray dogs to determine the presence of canine echinococcosis. Among 25 abattoir workers examined for the presence of cystic echinococcosis, we found three (12%) subjects with echinococcal cysts. A review of medical records showed a surgical incidence of 32/100,000 for the period 1996-1998. Three of 48 dogs (6.25%) were found to be infected with E. granulosus tapeworms. This study demonstrates the existence of an undocumented endemic focus of E. granulosus previously unknown in the coastal region of Peru.

Abattoirs↗
PubMedDate not supplied

[Cysticercosis as the main cause of partial seizures in children in Peru].

INTRODUCTION: Seizures are a common neurological problem in the pediatric population, and their etiologies in certain developing countries are still not clear. From previous studies it is well known that neurocysticercosis is the main cause of partial seizures in the adult population in Peru and in many developing countries, but the situation has not been clarified for the paediatric population yet. PATIENTS AND METHODS: Fifty-four consecutive patients in pre- and school ages, with partial seizures, were evaluated in the outpatient clinics and emergency room of a public hospital in Lima. Evaluation consisted in clinical exam, computed tomography of the head, and in some cases serological evaluation. RESULTS: Thirty-seven percent were diagnosed with neurocysticercosis, which was found to be the main cause. CONCLUSIONS: The possible explanations may be the high incidence of neurocysticercosis in Peru, and the fact that epilepsy and seizures are the most common clinical manifestation of neurocysticercosis in children. These findings are also representative of the current situation in gravel developing countries.

Adolescent↗
PubMedDate not supplied

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

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

Contraceptive Devices, Male↗
PubMed2005

Efficacy and tolerability of artesunate plus sulfadoxine-pyrimethamine and sulfadoxine-pyrimethamine alone for the treatment of uncomplicated Plasmodium falciparum malaria in Peru.

To assist the Peruvian Ministry of Health in modifying the malaria treatment policy for their north Pacific coastal region, we conducted an in vivo efficacy trial of sulfadoxine-pyrimethamine (SP) and SP plus artesunate (SP-AS) for the treatment for uncomplicated Plasmodium falciparum infections. A total of 197 patients were randomized to therapy with either SP (25 mg/kg of the sulfadoxine component in a single dose on day 0) or a combination of SP plus AS (4 mg/kg on days 0, 1, and 2) and were followed for 28 days for symptoms and recurrence of parasitemia. No statistically significant differences between the two groups were observed on enrollment with respect to age, sex, history of malaria, or geometric mean parasite density. A total of 185 subjects completed the 28-day follow-up. Of the 91 subjects treated with SP alone, two had recurrences of parasitemia on day 7 and one on day 21. Of the 94 subjects treated with SP-AS, one had a recurrence of parasitemia on day 21. Fever and asexual parasite density decreased significantly more rapidly and the proportion of patients with gametocytemia on days 3-28 was significantly lower in subjects treated with combination therapy than in those who received SP alone. No severe adverse drug reactions were observed; however, self-limited rash and pruritus were significantly more common and an exacerbation of nausea, vomiting, and abdominal pain were observed significantly more frequently among patients who had received SP-AS. These results have contributed to a National Malaria Control Program decision to change to SP-AS combination therapy as the first-line treatment for uncomplicated P. falciparum malaria in northern coastal Peru in November 2001, making Peru the first country in the Americas to recommend this combination therapy.

Adolescent↗
PubMed2005

Norwegian scabies in Peru: the impact of human T cell lymphotropic virus type I infection.

Isolates cases and groups of patients co-infected with human T cell lymphotropic virus type I (HTLV-I) and Norwegian scabies have been previously reported. Peru is considered to be endemic for HTLV-I. Between June 1999 and December 2000, 23 patients with Norwegian scabies were enrolled in this study after written informed consent was obtained. Antibodies against HTLV-I were detected by an enzyme-linked immunosorbent assay and confirmatory Western blot. Patients ranged in age from 3 months to 84 years; 15 (65.2%) were female. Infection with HTLV-I was found in 16 (69.6%) patients. Comorbid features included corticosteroid therapy (8.6%), malnutrition (8.6%), and Down's syndrome (4.3%). Among those who consented to be tested for human immunodeficiency virus (n = 13, 56.5%), no one had a positive result. The three patients that reported one or more prior episodes of Norwegian scabies were infected with HTLV-I and two of these HTLV-I-positive patients died. Infection with HTLV-I is an important co-factor related to Norwegian scabies in Peru. In our setting, the evaluation for HTLV-I in all Norwegian scabies cases is highly recommended, especially when no other risk factors are apparent.

Adolescent↗
PubMed2005

The sensitivity of clinical isolates of Leishmania from Peru and Nepal to miltefosine.

Clinical isolates of Leishmania, from visceral leishmaniasis (VL) cases in Nepal and from cutaneous leishmaniasis (CL) cases in Peru, were cultured using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to type species and strain. Promastigotes from 38 isolates, within eight passages from isolation, were used to infect mouse peritoneal macrophage cultures in vitro, and the amastigote sensitivity to miltefosine was determined. The concentration required to kill 50% of intracellular amastigotes from Nepalese VL isolates, all typed as Leishmania (L.) donovani (N = 24) from both Sbv responders and nonresponders, ranged from 8.7 to 0.04 microg/mL. In contrast, the concentration required to kill 50% intracellular amastigotes from isolates from Peru, typed as L.(V.) braziliensis (N = 8), was > 30 to 8.4 microg/mL, L.(V.) guyanensis (N = 2) > 30 to 1.9 microg/mL, L.(L.) mexicana (N = 1) > 30 microg/mL, and L. (V.) lainsoni (N = 4) was 3.4 to 1.9 microg/mL. This demonstrates a notable difference in the intrinsic sensitivity of Leishmania species to miltefosine in vitro. If this model can be correlated to therapeutic outcome, it may have implications for the interpretation of clinical trials.

Animals↗
PubMed2005

Design and implementation of Cell-PREVEN: a real-time surveillance system for adverse events using cell phones in Peru.

With more clinical trials involving evaluations of new drugs or vaccines, monitoring for early detection of adverse events is essential. The overall goal of this study was to develop an interactive-computer system using cell phones for real-time collection and transmission of adverse events related to metronidazole administration among female sex workers (FSW) in Peru. We developed an application for cell phones in Spanish, called Cell-PREVEN, based on a system from Voxiva Inc. We used cell phones to enter data collected by interviewers from FSW in three communities. Information was stored in an online database, where it could be immediately accessed worldwide and exported over a secure Internet connection. E-mail and text messages sent to mobile devices alerted key personnel to selected symptoms. This pilot project has demonstrated that it is feasible to develop a public-health-surveillance system based on cell phones to collect data in real-time in Peru (http://www.prevenperu.org).

Anti-Infective Agents↗
PubMed2006

A model of dental public health teaching at the undergraduate level in Peru.

There has been a growing interest among dental educators regarding the opportunities offered by community-based dental education as a means to allow dental students to assume their role as health professionals in the real world. Although several dental schools have integrated community-based education into their curricula, most have not engaged their students in the development of competencies to address dental health needs at the community level. The purpose of this article is to discuss the teaching-learning experiences in dental public health at the undergraduate level in the Faculty of Stomatology at the Universidad Peruana Cayetano Heredia (FS-UPCH) in Lima, Peru. The teaching-learning activities in dental public health at the FS-UPCH consist of two well-defined stages: experiences in low-income urban communities and experiences in low-income rural communities. Both stages have been designed to make it possible for students to acquire competency in addressing oral health needs at the community level as well as to enlarge and deepen their knowledge about the social and health situation in Peru. In community-based dental education, students are not only placed in community settings to treat individual patients, but also challenged to consider dental public health issues, including the administrative aspects of dental services.

Curriculum↗
PubMed2006

Is classic Kaposi's sarcoma endemic in Peru?: report of a case in an indigenous patient.

Kaposi's sarcoma (KS) has been classified in four clinical variants (classic or Mediterranean; endemic or African; epidemic or AIDS-related; iatrogenic or immunosuppression-related). Human herpesvirus 8 (HHV-8), has been found in all these variants. We herein discuss the unusual presentation of a 53-year-old indigenous patient with purplish-brown nodular lesions on lower extremities, and miliary tuberculosis. ELISA-HIV tests were negative and immunohistochemistry (IHC) of the tumor tissue was positive for HHV-8. This is the first reported case in which the presence of HHV-8 was evidenced by means of IHC techniques in Peru. We also review all available Peruvian literature of classic KS, a disease that has been frequently reported in indigenous population of Peru since 1968, making this country a possible endemic zone of classic KS.

Antibodies, Viral↗
PubMed2006

Latent tuberculosis infection: risks to health care students at a hospital in Lima, Peru.

SETTING: University hospital and university campus in Lima, Peru. OBJECTIVE: To demonstrate the risk of latent tuberculosis infection (LTBI) in the hospital relative to the community. DESIGN: Prospective cohort study of university students measuring prevalence, boosting, and conversion of tuberculin skin tests (TSTs) among health care students (HCS) and non-health care students (NHCS). RESULTS: Among the HCS relative to NHCS, prevalence of initial positive TST was 20.9% vs. 12.2% (P < 0.001), and conversion rate was 1.1% vs. 0% (P = 0.423) at the 10 mm cut-off and 11.8% vs. 0% at the 6 mm cut-off (P = 0.00005). Multivariate analysis showed that the HCS group had a higher risk of baseline positive TST compared with the NHCS group after controlling for confounding factors (OR 1.7, 95% CI 1.1-2.6). CONCLUSION: HCS are at greater risk than NHCS for having positive baseline TSTs and for TST conversion at the 6 mm cut-off. We conclude that the hospital we studied in Lima, Peru, poses a greater risk than the surrounding community for tuberculosis infection, and greater attention to hospital infection control measures is warranted. A higher rate of skin test boosting among the HCS cohort suggests the possibility of transient, non-progressive LTBI, which merits further study.

Adolescent↗
PubMed2006

Tuberculosis control in Bolivia, Chile, Colombia and Peru: why does incidence vary so much between neighbors?

SETTING: In 2003, Peru and Bolivia reported the highest annual tuberculosis (TB) incidence rates in the Americas. Neighboring Colombia and Chile had lower annual incidence rates despite their proximity. OBJECTIVE: To determine what factors contribute to differences in TB incidence rates among Chile, Colombia, Bolivia and Peru. DESIGN: Multiple sources of literature dating between 1990 and 2005 were used and World Health Organization TB control guidelines were consulted for policy level comparisons. RESULTS: Comprehensive implementation of the DOTS strategy is the main factor explaining the differences in TB incidence rates, even after considering socio-economic factors. CONCLUSION: Cross-national comparisons suggest ways to improve regional DOTS implementation.

Bolivia↗
PubMed1991

The etiology of childhood diarrhea in northern coastal Peru: the 1989 Fuerzas Unidas Humanitarian Civic Action--a model for international and interservice cooperation, community service, and scientific opportunity.

As a humanitarian civic action project, American and Peruvian military medical personnel established a temporary clinic in Dos Palos, Peru. Fecal specimens from 20 diarrheic children and 10 non-diarrheic controls were tested for common agents of diarrhea. Enteropathogens detected in diarrheic stools were enterotoxigenic Escherichia coli (ETEC; 30%), Aeromonas (20%), enteropathogenic E. coli (15%), and Campylobacter (15%). Isolates from control specimens were Aeromonas (10%) and Campylobacter (10%). ETEC-associated diarrhea was more common in this study (30%) than in three similar populations studied in Lima (2-16%). The results suggest that the northern coastal area of Peru is a relatively high-risk area for diarrhea caused by ETEC.

Child, Preschool↗
PubMed1989

[Prevalence of serologic markers of viral hepatitis in various population groups in Peru].

A review was undertaken of 7,521 serum samples that had been tested to detect or confirm the presence of different hepatitis A, B, and delta serologic markers. The sources of the samples included a national reference laboratory, several outbreaks of viral hepatitis in civilian and military populations, and a serologic survey. They were examined using the enzyme-linked immunosorbent assay (ELISA). The prevalence of antibody to hepatitis A virus was very high (means = 92.2%), and it was uniform. Prevalence of hepatitis B markers was more variable and inconsistent; it was high in samples from the jungle region of Peru, where the average prevalence of hepatitis B surface antigen (HBsAg) was 4.9%. Antibodies to delta hepatitis were present in 28.6% of the carriers of HBsAg identified in the outbreaks. All the outbreaks had similarities, including a high, cyclic case-fatality rate associated with the delta virus. Hepatitis A is highly endemic in Peru, while hepatitis B has average endemicity. It will be necessary to do more etiologic diagnosis of cases and conduct more research in order to better understand the epidemiology of viral hepatitis in this country.

Enzyme-Linked Immunosorbent Assay↗