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PubMed1991

Sequential migration theory and evidence from Peru.

"The standard human capital model of labor migration has been successful in explaining several empirical regularities of the migration process. However, there are a number of empirical facts that have not yet been explained or empirically tested; among them, that migrants usually perform more than one move in their lifetime; return migration accounts for a very important share of total migration rates; and there is a high positive correlation between in- and out-migration rates in the more advantageous regions. This paper presents both a simple model explaining these facts and an empirical analysis using data from Peru."

Americas↗
PubMed1988

Nontoxigenic 01 Vibrio cholerae in Peru: a report of two cases associated with diarrhea.

Two 01 Vibrio cholerae, E1 Tor strains, serogroup Ogawa were isolated from diarrheal stool material of two North American males residing or visiting in Peru. No other enteric pathogens were found. These strains did not produce cholera toxin as detected by enzyme-linked immunosorbent and Y1 adrenal cell assays, nor did they hybridize with an oligonucleotide probe for heat-labile (LT) toxin of Escherichia coli. These two cases are the first reports of 01 V. cholerae isolated from clinical specimens in South America.

Adult↗
PubMed1994

Evaluating a school-based intervention for STD/AIDS prevention in Peru.

PURPOSE: In a context of increasing HIV/STD risks among adolescents in Latin America, new conceptions of sequential "sex education" are needed. However, older adolescents must be reached through shorter programs. A quasi-experimental study was conducted to evaluate the impact of a short school-based STD/AIDS prevention program on knowledge, attitudes, and intended behavior among secondary students in Lima. METHODS: Aimed at empowering adolescents regarding their sexuality, improving knowledge and attitudes, and developing skills and prevention-oriented behavioral intentions, the program consisted of seven weekly two-hour sessions. Cost exclusive of research expenses was $3 per student reached. RESULTS: 1213 students from 14 schools participated in either the intervention or control groups. Significant changes in knowledge on sexuality and AIDS, erotophilia, acceptance of contraception, machismo, and discrimination against persons with HIV/AIDS were found in the intervention group, as compared to the control group. Self-efficacy and prevention-oriented behavioral intentions were significantly better in the intervention group. CONCLUSIONS: Owing to its effectiveness, acceptability, and low cost, this program may become useful in reaching adolescents unable to participate in longer-term sex education programs in Peru and elsewhere.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Penicillin resistance and serotypes/serogroups of Streptococcus pneumoniae in nasopharyngeal carrier children younger than 2 years in Lima, Peru.

The purpose of this study was to determine the carriage rate, susceptibility pattern, and serotype distribution of Streptococcus pneumoniae in the nasopharynx of children younger than 2 years old in Lima, Peru. A total of 666 children were evaluated during 3 periods, 1997, 2001, and 2003. The overall pneumococcal carrier rate was 41%. Reduced susceptibility to penicillin was found in 5% (4/75) of isolates in 1997, 20% (15/75) in 2001, and 37% (40/109) in 2003. Reduced susceptibility to ceftriaxone was found in 12% of isolates in 2003. Serogroups 6, 19, 23, 15, and 14 accounted for 68% of all the isolates and for 81% of the penicillin-nonsusceptible strains. Only 65% of the isolated strains had serogroups found in the 7-valent conjugate pneumococcal vaccine. This highlights the importance of regional surveillance studies for effective vaccine strategies and treatment protocols.

Anti-Bacterial Agents↗
PubMed2006

A pilot study to assess residential endotoxin and blood IgE in a group of pregnant women from Trujillo, Peru.

OBJECTIVE: This November 2003 pilot study investigates the correlation between serum IgE and residential endotoxin levels from a group of 18 pregnant women living in Trujillo, Peru, and investigates the impact of the demographic and lifestyle factors of this group on the IgE and endotoxin levels measured. METHODS: Serum samples were collected from 19 subjects and analyzed for IgE. Dust samples were collected from the mattresses of 18 subjects and measured for endotoxin levels. A questionnaire was used to obtain demographic, socioeconomic, and lifestyle information for each subject. RESULTS: Geometric means for IgE and endotoxin were 246.8 (GSD=4.3, n=19) IU/mL and 66.5 EU/mg (GSD=1.7, n=18), respectively. Log-transformed IgE and endotoxin were not correlated (R2=0.02; p=0.60). CONCLUSIONS: Residential endotoxin and serum IgE were not correlated in this group. Potential selection bias and sample size are major limitations of the study. However, 74% (14/19) of the subjects in this study had an IgE over 100 IU/mL, a level generally considered elevated.

Adolescent↗
PubMed2005

Identification and biochemical characterization of Leishmania strains isolated in Peru, Mexico, and Spain.

Eight Leishmania promastigotes were isolated from different geographical areas: three (LP1, LP2, and LP3) from the provincial department La Libertad and the fourth (LP4) from the department of Cajamarca (northern Peru); another three (LM1, LM2, and LM3) in the province of Campeche (Mexico); and the last (LS1) from a clinical case of a dog in Madrid (Spain). The isolates were characterized by carbohydrate cell-surface residues using agglutinations with four purified lectins, by isoenzyme analysis using different isoenzymes, by analysis of kinetoplast DNA (kDNA) restriction fragment length polymorphism using four different restriction endonucleases and by the final metabolite patterns after in vitro culture. These isolates were compared with four reference strains and typified as: Leishmania (Leishmania) donovani, two strains of L. (L.) infantum, and one species of L. (Viania) peruviana. According to our results and the statistical study, the Peruvian isolates represent three different strains: one would be L. (V.) peruviana, another the strain isolated in Cajamarca (LP4) and the third would include the three strains from the department of La Libertad (LP1, LP2, and LP3), these latter three isolates being phylogenetically closer to the reference strain L. (L.) donovani. Meanwhile, the three isolates from Mexico form a group with close phylogenetic relationships to each other. The isolate from Spain belongs to the species L. (L.) infantum. Thus, a close correlation was drawn between the identity of each strain and its geographical origin.

Acetates↗
PubMed2005

Evaluating program effects on institutional delivery in Peru.

We evaluate the joint effects of two targeted Peruvian health programs on a mother's choice of whether to deliver in a public emergency obstetric care (EmOC) facility. The national maternal and child health insurance, or SMI Program, provided delivery care coverage to Peru's poorest households beginning in 1998. During 1996-2002, Proyecto 2000 sought to improve the quality of EmOC and increase utilization of public EmOC facilities in the districts reporting the highest maternal and neonatal mortality levels. Our data come from the Proyecto 2000 endline evaluation, which sampled 5335 mothers living in the catchment areas of 29 treatment and 29 matched control EmOC facilities. Using propensity scoring and two quality of care indices, we find significantly higher quality of care in Proyecto 2000 treatment facilities. Using variance components logistic models, we find a mother enrolled in the SMI Program was more likely to have delivered her last child in a public EmOC, controlling for household constraints. Residence in a Proyecto 2000 treatment area did not significantly affect the choice. A cross-level interaction term was insignificant, indicating the two program effects were independent.

Catchment Area, Health↗
PubMed2005

Acquired sulphonamide resistance genes in faecal Escherichia coli from healthy children in Bolivia and Peru.

Antimicrobial resistance and sulphonamide resistance determinants were studied in 20 co-trimoxazole resistant Escherichia coli in faecal samples from healthy children in Bolivia and Peru. Methods used were disc diffusion susceptibility tests, PCR, sequence analysis and plasmid conjugation assays. All isolates but one were resistant to at least two different classes of antimicrobials; 19 isolates also carried at least one sul-gene. The most frequent gene was sul2 followed by sul1 and sul3, which was detected in one isolate. This is the first observation of sul3 on the American continent. In conclusion, the high prevalence of sul-genes in this material of faecal commensal E. coli isolates points to a potential role of the faecal flora in the emergence and spread of antimicrobial resistance.

Anti-Infective Agents↗
PubMed2005

Design of PREVENCION: a population-based study of cardiovascular disease in Peru.

Latin America is undergoing the epidemiologic transition that occurred earlier in developed countries, and is likely to face a gigantic epidemic of heart disease in the next few years unless urgent action is taken. The first essential component of any effective cardiovascular disease (CVD) control program is to establish reliable estimates of cardiovascular disease-related morbidity and mortality. However, such data from population-based studies in Latin America are still lacking. In this paper, we present the design and operation of PREVENCION (Estudio Peruano de Prevalencia de Enfermedades Cardiovasculares, for Peruvian Study of the Prevalence of Cardiovascular diseases). PREVENCION is an ongoing population-based study on a representative sample of the civilian non-institutionalized population of the second largest city in Peru. Its population is comparable to the rest of the Peruvian urban population and closely resembles other Latin American populations in countries such as Bolivia and Ecuador. Our study will contribute to the enormous task of understanding and preventing CVD in Latin America.

Cardiovascular Diseases↗
PubMed2006

Clinical correlates of tuberculosis co-infection in HIV-infected children hospitalized in Peru.

INTRODUCTION: In developing countries, tuberculosis (TB) is responsible for almost 250,000 deaths among children yearly. Active TB in children with human immunodeficiency virus (HIV) infection is difficult to diagnose and progresses rapidly to death. The aim of this preliminary study was to investigate the prevalence and clinical correlates of TB-related illness among HIV-infected children admitted to an infectious diseases ward in Peru, a country where TB is highly endemic. METHOD: Forty-seven HIV-infected children admitted for a suspected infectious process in a Peruvian hospital were investigated for evidence of clinical tuberculosis by auramine stain, culture, and polymerase chain reaction (PCR) of clinical specimens. RESULTS: Eight children (17%) had evidence of tuberculosis, including five with positive cultures and three with positive PCR tests only. Weight loss was the only feature associated with a positive test for tuberculosis. Radiological changes were very common in both TB-positive and TB-negative groups and these changes were not useful to identify TB-positive cases. CONCLUSIONS: Weight loss may be used to identify high-risk HIV positive children who require more aggressive evaluation for tuberculosis. Radiological changes were common in both TB-positive and TB-negative groups.

AIDS-Related Opportunistic Infections↗
PubMed2006

Parasite risk factors for stunting in grade 5 students in a community of extreme poverty in Peru.

Malnutrition in school-age children is common in developing countries and includes both stunting and underweight. Stunting, which represents a chronic state of nutritional stress, leads to adverse health, educational and cognitive effects. Although much research is focused on preschool-age children, recent studies show both the high prevalence of stunting and the effectiveness of interventions in school-age children. The objectives of the current study were to determine the risk factors for stunting only, and stunting and underweight. A survey was conducted in 1074 grade 5 children (mean age 10 years) from 17 schools in Belen, Peru, a community of extreme poverty. Prevalence of underweight and stunting were 10.5 and 34.5%, respectively, co-prevalence was 9.3%. Based on multivariable logistic regression analyses, significant independent risk factors (odds ratio: OR) for stunting and underweight were: age (per 1 year increment) (OR=1.55; 95% confidence interval (CI): 1.33, 1.81); diarrhoea in the last week (OR=1.96; 95% CI: 1.17, 3.29) and hookworm infection (OR=1.74; 95% CI: 1.05, 2.86). Significant independent risk factors for stunting only were: age (per 1 year increment) (OR=1.51; 95% CI: 1.35, 1.70); anaemia (OR=1.98; 95% CI: 1.26, 3.11); and moderate and heavy Trichuris and Ascaris co-infection (OR=1.95; 95% CI: 1.35, 2.82). Our results indicate a high prevalence of stunting, in addition to other adverse health indicators, in the study population. Due to the interrelation between many of these health and nutrition problems, interventions at both the school and community levels, including de-worming, feeding programs and health and hygiene education, are needed to reduce malnutrition in this and other similar populations living in conditions of extreme poverty.

Adolescent↗
PubMed2006

Ethnobotanical study of medicinal plants used by the Andean people of Canta, Lima, Peru.

A survey aiming to document medicinal plant uses was performed in Canta Province Lima Department, in the Peruvians Andes of Peru. Hundred and fifty people were interviewed. Enquiries and informal personal conversations were used to obtain information. Informants were men and women over 30 years old, who work in subsistence agriculture and cattle farming, as well as herbalist. Eighty-seven species were collected and identified that had indigenous uses. Common names, habit, part of the plant used, preparation, administration and illnesses treated were recorded for each species. Results are compared with other ethnopharmacological studies performed in the Peruvian Andes.

Adult↗
PubMed2005

Molecular characterisation of Trypanosoma rangeli strains isolated from Rhodnius ecuadoriensis in Peru, R. colombiensis in Colombia and R. pallescens in Panama, supports a co-evolutionary association between parasites and vectors.

We present data on the molecular characterisation of strains of Trypanosoma rangeli isolated from naturally infected Rhodnius ecuadoriensis in Peru, from Rhodnius colombiensis, Rhodnius pallescens and Rhodnius prolixus in Colombia, and from Rhodnius pallescens in Panama. Strain characterisation involved a duplex PCR with S35/S36/KP1L primers. Mini-exon gene analysis was also carried out using TrINT-1/TrINT-2 oligonucleotides. kDNA and mini-exon amplification indicated dimorphism within both DNA sequences: (i) KP1, KP2 and KP3 or (ii) KP2 and KP3 products for kDNA, and 380 bp or 340 bp products for the mini-exon. All T. rangeli strains isolated from R. prolixus presented KP1, KP2 and KP3 products with the 340 bp mini-exon product. By contrast, all T. rangeli strains isolated from R. ecuadoriensis, R. pallescens and R. colombiensis, presented profiles with KP2 and KP3 kDNA products and the 380 bp mini-exon product. Combined with other studies, these results provide evidence of co-evolution of T. rangeli strains associated with different Rhodnius species groups east and west of the Andean mountains.

Animals↗
PubMed2006

A prospective study of the effect of Neospora caninum and BVDV infections on bovine abortions in a dairy herd in Arequipa, Peru.

We used a prospective seroepidemiological approach to investigate endemic abortion in a dairy herd in Arequipa, Peru, and its association with Neospora caninum and bovine viral-diarrhoea virus (BVDV) infections. Between January 2002 and March 2004, 1094 pregnancies were confirmed in 538 cows. Of these, 137 pregnancies (13%) in 121 cows ended in abortion. The serological status to N. caninum was assessed using a single serological screening, whereas BVDV status was assessed at the herd level through consecutive samplings of young stock. Cox proportional-hazards models were used to estimate the effect of N. caninum and BVDV on the hazard of early (between day 42 and day 100 in gestation), and late (after day 100) abortions, respectively. Serological status to N. caninum was included as a dichotomous variable, and the effect of BVDV estimated at the herd level, as a time-dependent seasonal effect. Because data from repeated pregnancies were included, we considered possible lack of independence between observations and included frailty effects into the models. Our models also considered the possible confounding by parity and animal origin. Only multiparity was associated with the hazard of early abortion (HR=2.8 compared to nulliparous heifers). N. caninum seropositivity significantly affected the hazard of late abortion, but interacted with parity. The HRs for Neospora-positive animals were 6.4, 3.7 and 1.9, respectively, for nulliparous heifers, first-lactation cows and multiparous cows. Evidence of BVDV circulating (or not) among the young stock was not associated with abortions, but few cows in this herd were susceptible to incident infection.

Abortion, Veterinary↗
PubMed2005

Molecular diversity of native bradyrhizobia isolated from lima bean (Phaseolus lunatus L.) in Peru.

The diversity of a collection of 21 bradyrhizobial isolates from Lima bean (Phaseolus lunatus L.) was assayed by molecular methods. Moderately high to high genetic diversity was revealed by multilocus enzyme electrophoresis (MLEE) analysis of seven enzyme loci and genomic fingerprints with ERIC and BOX primers. Two groups with differences in growth rate were found among the isolates and their differentiation as two divergent bradyrhizobial lineages was supported by PCR-RFLP of the rpoB gene and sequence analysis of the 16S rDNA and dnaK genes. Isolates with slow growth (SG) were identified as Bradyrhizobium yuanmingense, while extra-slow growing isolates (ESG) constitute a new lineage different from all described Bradyrhizobium species. Three distinct symbiotic genotypes were detected among Lima bean bradyrhizobia by PCR-RFLP and sequence analysis of the nifH and nodB genes. One genotype was found in the ESG lineage and two in B. yuanmingense. Another symbiotic genotype was detected in B. yuamingense isolated from Lespedeza plants. The identified bradyrhizobial lineages constitute sympatric species effectively nodulating Lima bean on the coast of Peru.

Bradyrhizobium↗
PubMed2005

Risk factors for canine echinococcosis in an endemic area of Peru.

An epidemiological study was conducted in a highland rural community in Peru to determine risk factors for canine echinococcosis caused by Echinococcus granulosus. Dogs were diagnosed using a coproantigen enzyme-linked immunosorbent assay (ELISA). Dog owners were interviewed prior to stool collection and asked for attitudes, practices and beliefs likely to be associated with local patterns of E. granulosus transmission. Univariate and multivariate analysis were used to determine odds ratios (OR) and their 95% confidence intervals (CI). The main risk factors found to be significantly associated with canine echinococcosis by univariate analysis were dog age (3-25 months) (OR, 5.14; CI, 1.7-15.7), female sex (OR, 4.3; CI, 1.4-13.3) and having been fed hydatid infected offal (OR, 2.9; 95% CI, 1.0-8.6). There was complete lack of knowledge about echinococcosis transmission. In addition to periodic dog treatment, control programs need to emphasize education of the human population to increase knowledge of parasite transmission and to change human practices associated with high rates of infection.

Animals↗
PubMed2006

Intraspecific variation of Echinococcus granulosus in livestock from Peru.

Echinococcus granulosus infection is a problem of public health in livestock-rearing regions of Latin America, like in Peru. This species is characterized by the morphometry of the large and small rostellar hooks in both metacestodes and adult worms. The aim of this work was to study biometrical characteristics of rostellar hooks in hydatid cysts (lung and liver) from some Peruvian provinces (Arequipa, Cuzco, Huancavelica, Junin and Puno). The biometrical analysis was obtained in a digital system for image analysis. The following parameters were studied: area, perimeter, length and width total of the handle, the blade and the distance between the blade and the guard of large and small hooks. For statistical analysis Student's t-test and Analysis of Variance (ANOVA) with Pos-test of Tukey were used, considering the values of p< or =0.05 as of statistic significance. All morphometric characters of large and small hooks were highly significant (p<0.000), when data were compared among the samples from the different provinces. Rostellar hooks in specimens from Huancavelica presented smallest measurements, whereas hooks in specimens from Junin were bigger in relation to the total and blade measurements. Generally, samples from Arequipa presented the biggest large hooks in relation to the handle parameters. The rostellar hooks of cattle and sheep hosts varied depending on the geographic localization, host and organ. Hooks recovered from the lungs were larger than those collected in the liver. It was concluded that morphometry using computer image analysis allows the characterization of E. granulosus. The rostellar hooks presented morphometric polymorphism.

Analysis of Variance↗
PubMed1999

Randomized, community-based trial of the effect of zinc supplementation, with and without other micronutrients, on the duration of persistent childhood diarrhea in Lima, Peru.

OBJECTIVE: To determine whether supplemental zinc, with or without additional micronutrients, affects the severity and duration of persistent childhood diarrhea and the rate of nutritional recovery. DESIGN: The study was a community-based, double-blind, randomized trial implemented in a shanty town in Lima, Peru. Children aged 6 to 36 months with persistent (>/=14 days) diarrhea received daily, for 2 weeks, a placebo (group P, n = 136) or a supplement of 20 mg of zinc, either with (group Z+VM, n = 137) or without (group Z, n = 139) additional vitamins and minerals. Symptoms of illness were recorded daily, and biochemical and anthropometric assessments were completed at baseline and on day 15. RESULTS: The treatment groups were similar at baseline with regard to the characteristics of the presenting episode, anthropometric data, and plasma zinc concentration. The children consumed, on average, 95% (group P), 94% (group Z), or 88% (group Z+VM) of the supplement (P <.001). The plasma zinc concentration did not change significantly from baseline to day 15 in group P (4 microg/dL) but increased by 38 microg/dL in group Z and 14 microg/dL in group Z+VM. The median duration of diarrhea after starting treatment was 1 day; among children who continued to have diarrhea, there was a significant effect of treatment on diarrheal duration (P =.04, analysis of covariance). Specifically, the duration of illness was significantly reduced by 28% in children in group Z (P =.01) and by 33% in girls in group Z+VM (P =.04). There were no differences in the severity of the episode by treatment group. CONCLUSION: There was a significant reduction in the duration of persistent diarrhea in selected subgroups of zinc-supplemented ambulatory patients in this population.

Analysis of Variance↗