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PubMedDate not supplied

Mercury exposures in informal gold miners and relatives in southern Peru.

Subjects working in or living near informal gold mining and processing in southern Peru were studied to determine mercury exposures from two tasks: amalgamation and amalgam smelting. The authors collected 17 airborne and 41 urinary mercury levels. The mean urinary levels were 728 (range: 321-1662) and 113 (45-197) microg/L for working in smelters and living near smelters, respectively. A third group working in amalgamation had a mean 18 microg/L (range 8-37). People living in the mining town but with no mining activities had 8 microg/L (5-10), while a control group outside the town had 4 microg/L (2-6). Mean airborne mercury exposure was 2423 microg/m3 (range 530-4430) during smelting, 30.5 microg/m3 (12-55) during amalgamation, and 12 microg/m3 (3-23) in the mining town. Smelters are highly contaminated with mercury, as are the people living around smelters.

Air Pollutants↗
PubMed2006

National and sub-national under-five mortality profiles in Peru: a basis for informed policy decisions.

BACKGROUND: Information on profiles for under-five causes of death is important to guide choice of child-survival interventions. Global level data have been published, but information at country level is scarce. We aimed at defining national and departmental trends and profiles of under-five mortality in Peru from 1996 through 2000. METHODS: We used the Ministry of Health registered under-five mortality data. For correction of under-registration, a model life-table that fitted the age distribution of the population and of registered deaths was identified for each year. The mortality rates corresponding to these model life-tables were then assigned to each department in each particular year. Cumulative reduction in under-five mortality rate in the 1996-2000 period was estimated calculating the annual reduction slope for each department. Departmental level mortality profiles were constructed. Differences in mortality profiles and in mortality reduction between coastal, andean and jungle regions were also assessed. RESULTS: At country level, only 4 causes (pneumonia, diarrhoea, neonatal diseases and injuries) accounted for 68% of all deaths in 1996, and for 62% in 2000. There was 32.7% of under-five death reduction from 1996 to 2000. Diarrhoea and pneumonia deaths decreased by 84.5% and 41.8%, respectively, mainly in the andean region, whereas deaths due to neonatal causes and injuries decreased by 37.2% and 21.7%. For 1996-2000 period, the andean, coast and jungle regions accounted for 52.4%, 33.1% and 14.4% of deaths, respectively. These regions represent 41.0%, 46.4% and 12.6% of under-five population. Both diarrhoea and pneumonia constitute 30.6% of under-five deaths in the andean region. As a proportion, neonatal deaths remained stable in the country from 1996 to 2000, accounting for about 30% of under-five deaths, whereas injuries and "other" causes, including congenital anomalies, increased by about 5%. CONCLUSION: Under-five mortality declined substantially in all departments from 1996 to 2000, which is explained mostly by reduction in diarrhoea and pneumonia deaths, particularly in the andean region. There is the need to emphasize interventions to reduce neonatal deaths and emerging causes of death such as injuries and congenital anomalies.

Cause of Death↗
PubMed2025

Identification of intragenic variants in pediatric patients with intellectual disability in Peru.

BACKGROUND: Intellectual disability in Latin America can reach a frequency of 12% of the population, these may include nutritional deficiencies, exposure to toxic or infectious agents, and the lack of universal neonatal screening programs. In 90% of patients with intellectual disability, the etiology can be attributed to variants in the genome. OBJECTIVE: to determine intragenic variants in patients with intellectual disability between 5 and 18 years old at Instituto Nacional de Salud del Niño. METHODS: It is a descriptive cross-sectional study with convenience sampling. A total of 124 children diagnosed with intellectual disability were selected based on psychological test results and availability for whole exome sequencing. In addition, a chromosomal analysis of 6.55 M was performed on ten patients with a negative result in sequencing. Relative and absolute frequencies and measures of central tendency and dispersion were determined according to their nature. In addition, multiple linear regression and Poisson regression were used to determine the association between some clinical characteristics and the probability of occurrence in patients with positive results. RESULTS: The median age of the patients was 6.3 (IQR = 5.95), males accounted for 57.3%, and 91.9% of the cases had mild intellectual disability. Exome sequencing determined the etiology in 30.6% of patients with intellectual disability, of which 52.6% were autosomal dominant inheritance. The most frequent genes found were MECP2, STXBP1 and LAMA2. A broad genotype-phenotype correlation was identified, highlighting the genetic heterogeneity of intellectual disability in this population. The presence of dermatologic lesions, dystonia, peripheral neurological disorders, and fourth finger flexion limitation were observed more frequently in patients with intellectual disability with "positive results". CONCLUSIONS: This study shows that one-third of patients with intellectual disability exhibit intragenic variants, highlighting the importance of genetic analysis for accurate diagnosis. The identification of genes such as MECP2, STXBP1, and LAMA2 underscores the genetic heterogeneity of intellectual disability in the studied population. These findings emphasize the need for genetic testing in clinical management and the implementation of early detection programs in Peru.

Humans↗
PubMed2026

Prevalence and persistence of high-risk HPV genotypes in unvaccinated asymptomatic women: a six-year study in Peru.

OBJECTIVE: This study was to determine the frequency of HPV-hr and describe the distribution by categories (HPV16, HPV18, HPV-hr non16/18) among unvaccinated asymptomatic women in Peru over a 6-year period (2013-2018). In addition, the disease clearance rate is assessed in a percentage of cases. RESULTS: Of the 6,665 samples, 2,240 (33.6%) tested positive for HPV. Among the positive cases, single-genotype infections were caused by HPV-16 (14.8%), followed by HPV-18 (2.2%) and clustered high-risk HPV (HR-HPV) genotypes (66.7%). Multiple HPV-16 infections were more common than HPV-18 infections. In addition, 22 cases (1%) presented with infection with HPV-16, HPV-18, and HR-HPV genotypes. A subset of 116 samples from patients with 1 to 2 years of follow-up was analyzed further. Clearance rates were high, at 68.8% for HPV-16 infections and 67.5% for HR-HPV infections. However, the elimination rate of multiple infections with HPV-16 and HR-HPV genotypes was slightly lower, at 55.6%.

Prevalence↗
PubMed2005

Phylogenetic analysis of a novel molecular isolate of spotted fever group Rickettsiae from northern Peru: Candidatus Rickettsia andeanae.

Phylogenetic analysis of five rickettsial genes (17-kDa gene, gltA, ompB, ompA, and sca4) from two molecular isolates of Candidatus Rickettsia andeanae from two ticks (Amblyomma maculatum and Ixodes boliviensis) collected from two domestic horses living in two separate locations in northern Peru (Coletas and Naranjo) was conducted to more clearly characterize this recently reported novel spotted fever group (SFG) rickettsia. Following nested polymerase chain reaction (PCR) amplification of the 17-kDa gene, gltA, ompB, ompA, and sca4, amplicons were purified, sequenced, and compared to those downloaded from GenBank. Phylogenetic analyses of the Candidatus Rickettsia andeanae sequences generated from 17-kDa gene (483 bp), gltA (1185 bp), ompA (1598 bp), ompB (4839 bp), and sca4 (2634 bp) demonstrated that they aligned strongly with those of SFG rickettsiae. Moreover, the sequences of these five genes most closely aligned with the following rickettsiae: ompA: Rickettsia sp RpA4 (98.03%), R. sp DnS28 (97.90%), and R. rhipicephali and R. massiliae (97.11%); ompB: R. aeschlimannii (97.22%), R. rhipicephali (97.20%), and R. sp Bar 29 (97.10%); and sca4: R. massiliae (97.8%), R. rhipicephali, and R. slovaca (97.7%). These results from the additional phylogenetic analyses of Candidatus Rickettsia andeanae confirm its inclusion within, and distance and uniqueness from, other known SFG rickettsiae.

Animals↗
PubMed1988

Cranial surgery in ancient Peru.

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.

History, Ancient↗
PubMed2004

A study of a rural telemedicine system in the Amazon region of Peru.

Voice and data communication facilities (email via VHF radio) were installed in 39 previously isolated health facilities in the province of Alto Amazonas in Peru. A baseline study was carried out in January 2001 and a follow-up evaluation in May 2002, after nine months of operation. We measured the reliability of the technology and the effect the system had on staff access to medical training and information. We also measured the indirect effects on the general population of access to better health-care. The experimental data were collected from 35 of the 39 sites in face-to-face questionnaire interviews. Before installation of the system, the mean consultation rate was 3 per month per facility (95% CI 1.5 to 4.5). At the end of the study, the mean consultation rate was 23 per month per facility (95% CI 14.7 to 31.5). There were 205 emergency transfers from the 39 health facilities. The system was employed in all these cases to alert the referral centre. The mean time required for evacuation was reduced from 8.6 h to 5.2 h. Health-care personnel reported that in 58 of the emergency cases (28%) the use of the system saved the life of the patient. The study shows that the use of communication technologies appropriate to local needs solves many problems in rural primary care, and that voice and email communication via VHF radio are feasible and useful for rural telemedicine.

Attitude of Health Personnel↗
PubMed1978

High altitude pulmonary edema. Epidemiologic observations in Peru.

The incidence of high altitude pulmonary edema was examined by a survey (via questionnaire) of residents living at 3,750 meters (12,303 feet) in the mining community of La Oroya, Peru. Ninety-seven subjects made a total of 1,157 ascents to high altitude after a stay at sea level of longer than 14 days. Sixty-four subjects experienced at least one episode of high-altitude pulmonary edema. The incidence was higher in subjects aged 13 to 20 years, where 17 percent (15) of 90 ascents resulted in episodes of high-altitude pulmonary edema, than in subjects 21 years or older (3 percent; 18/686 ascents). Young subjects (2 to 12 years old) had more severe episodes of high-altitude pulmonary edema (81 percent; 30/37 episodes) than adults (22 percent; 4/18 episodes). No episodes were observed in children under two years old. Five subjects under 21 years of age experienced recurrent episodes. Our estimated incidence of severe episodes of high altitude pulmonary edema per ascent in adults (0.6 percent; 4/686) is similar to that reported by other workers (incidence of 0.15 to 0.57 percent) in various parts of the world.

Adolescent↗
PubMed2003

A prospective study of bacillus Calmette-Guérin scar formation and tuberculin skin test reactivity in infants in Lima, Peru.

OBJECTIVES: To determine the sensitivity of the bacillus Calmette-Guérin (BCG) scar as an indicator of previous vaccination and to ascertain the tuberculin skin test (TST) response in infancy after vaccination in a community from an area hyperendemic for tuberculosis (TB). METHODS: In a birth cohort of healthy term infants from Lima, Peru, a single dose of BCG vaccine was administered within the first month of life. Scar formation was assessed biweekly during the first 6 months and again at 3 years after vaccination. TST response was evaluated 6 months after vaccination. RESULTS: Six months after vaccination, 99% (68) of the newborns exhibited a BCG scar (>2 mm). Scar size did not differ by sex, birth weight, age at vaccination, or nutritional status in the first 2 months. Eighty percent of the participants were found 3 years after vaccination, and all of them had a BCG scar. Mean TST reaction size 6 months after vaccination was 2.9 +/- 0.3 mm. No association was found between sex or age at BCG vaccination and TST size. Only 3 children had a TST >10 mm, and the 3 had a TB contact at home. CONCLUSIONS: The BCG scar was a sensitive indicator of vaccination status up to 3 years after the administration of the vaccine in the first month of life. Although nearly a quarter of the children had a TST response >5 mm 6 months after vaccination, TST reactions >10 mm did not occur in the absence of exposure to a person with tuberculosis. A cutoff of 10 mm should be used for disease control purposes in people who are born in countries where TB is endemic.

Antibodies, Bacterial↗
PubMed1996

A Bushmaster bite during a birding expedition in lowland southeastern Peru.

Birders and other ecotourists are traveling to increasingly remote areas of the world where sophisticated medical care may be difficult to obtain. This report presents a case of a Bushmaster (Lachesis muta muta) bite in Peru and details the difficulties encountered from initial care to evacuation and definitive medical care.

Adult↗
PubMedDate not supplied

[Geographic distribution of Lutzomyia verrucarum (Townsend, 1913) (Diptera, Psychodidae, Phlebotominae), vector of human bartonellosis in Peru].

Lutzomyia verrucarum (Townsend, 1913) (Diptera: Psychodidae); the natural vector of Bartonella bacilliformis, agent of human bartonellosis (peruvian verruga or Carrion's disease), is a native species of Peru; its geographic distribution occurrs between latitudes 5 degrees and 13 degrees 25' South: in the Occidental and Interandean valleys of the Andean. The altitudinal distribution of Lu. verrucarum in the different valleys is as follows: Occidental between 1100 and 2980 m sea level and Interandean from 1200 to 3200 m sea level. Some discrepancies between the distribution of Carrion's disease and Lu. verrucarum suggest the existence of secondary vectors in certain areas where Lu. verrucarum is not present.

Animals↗
PubMedDate not supplied

Chicken as potential contamination source of Campylobacter lari in Iquitos, Peru.

In order to know the importance of chicken as natural reservoir of Campylobacter lari in Iquitos, Peru; samples were obtained by cloacal swabs from 200 chickens and immediately placed into a semisolid enrichment medium; these were streaked on modified Skirrow Agar. The organism was isolated from 21 (10.5%) samples, corresponding 58.8% to biovar I and 41.2% to biovar II (Lior scheme). The results provide evidence that chicken appear to be prominent reservoirs of Campylobacter lari in Iquitos.

Animals↗
PubMedDate not supplied

Human infection with Trypanosoma cruzi in Nasca, Peru: a seroepidemiological survey.

We estimated the proportion of seropositivity for infection with Trypanosoma cruzi (Chagas' disease) in a sample of the rural population of the Province of Nasca, Department of Ica, southwestern Peru. Although Triatoma infestans, the only vector species identified in the Department of Ica, is often found in domestic environments, data of the extent of human infection with T. cruzi are scant. This study comprised 446 houses, known to be infested with triatomines, distributed in 19 rural localities. While visiting those houses we collected filter paper bloodspots from 864 occupants (of both sexes, aged one year or over). By means of the indirect fluorescent antibody test (IFAT), we detected anti-T. cruzi IgG antibodies in samples from 178 individuals (20.6%). Seropositivity was significantly more frequent in females (23.8%) than in males (17.5%). Among the 410 individuals in the 1- to 10-year-old age group (47.5% of the population sample), 85 (20.7%) were found seropositive, which is indicative of an early acquisition of the infection. Within this group no significant differences in seropositivity were associated with sex.

Adolescent↗
PubMedDate not supplied

A prospective study of Cat-Scratch Disease in Lima-Peru.

Cat-Scratch Disease (CSD) is a benign lymphadenitis that may progress to severe or recurrent forms, and it is occasionally associated with morbidity. Between January of 1998 and March of 1999, forty-three suspected CSD patients were assessed in the Hospital Cayetano Heredia and the Instituto de Salud del Niño, in Lima, Peru. Twelve patients had a confirmed diagnosis, 8 of whom were women, and the mean age was 10 years old. The majority (53%) of the cases were encountered in the summer. All patients reported having had contact with cats. Fever, malaise, lymphadenopathy and skin lesions were the most frequent clinical features. Twelve patients had indirect immunofluorescence antibody test titers of between 1/50 and 1/800 for Bartonella henselae and Bartonella clarridgeiae. Two lymph node biopsies were histologically compatible with CSD. No positive blood cultures could be obtained. This is the first Peruvian prospective study able to identify B. henselae and B. clarridgeiae in pediatric patients.

Adolescent↗
PubMed2004

First report of a human case of polycystic echinococcosis due to Echinococcus vogeli from neotropical area of Peru, South America.

We report a human case of polycystic hidatidosis due to Echinococcus vogeli from Contamana (Department of Loreto) village located in the central jungle of Peru. The patient is a 44 year-old lady, teacher, who carried a painless liver mass since a year ago. She was submitted to abdominal surgery and the liver mass was removed and showed multiple cysts containing colorless liquid as is showed in the polycystic hidatidosis. The morphology and measure of the hooks obtained from the liquid contained in the cysts are from Echinococcus vogeli. It is the first report of this parasitism in Perú.

Adult↗
PubMedDate not supplied

[Phlebotomus fauna (Diptera: Psychodidae) of 3 provinces of the northeastern region of Marañon, Peru].

Two thousand seven hundred and seventy four sand flies were captured since 1987 to 1992 in endemic areas of human bartonellosis and Peruvian Verruga (district of San José de Lourdes, province of San Ignacio - 05 degrees 03' LS, and district of Lonya Grande, province of Utcubamba - 06 degrees 05'30" LS) belonging to the Northeast region of Marañon, Peru. Thirteen species were identified, 11 belonging to the genus Lutzomyia, 1 to Brumptomyia and the other to Warileya. Lutzomyia sp, close to L. serrana and L. maranonensis n. sp., Galatti, Cáceres & Le Pont are more prevalent (89.74% of the individuals captured). Suggests working of the kind. Lutzomyia verrucarum (Townsend, 1913) is reported in Utcubamba province for the first time.

Animals↗
PubMedDate not supplied

Genetic variability and microdistribution of Triatoma infestans genotypes and Trypanosoma cruzi clones in Arequipa region (Peru).

The genetic variability of Triatoma infestans and Trypanosoma cruzi populations was studied by isoenzyme analysis in two distinct areas of Arequipa province (Peru); one, Santa Rita de Siguas, being an endemic area for Chagas' disease, the second, Arequipa, recently infected. Analysis of T. infestans genetic variability indicates, (i) temporal stability of genotypes found in Santa Rita de Siguas, (ii) high genetic differences between Arequipa and Santa Rita de Siguas populations suggesting minor contact between them, (iii) multiple origin of the T. infestans population in Arequipa, and (iv) poor dispersal capacity of T. infestans: the panmictic unit could be reduce to a house. Parasite isoenzyme analysis was performed in 29 Peruvian stocks of T. cruzi, mainly isolated from bugs taken in a single locality, Santa Rita de Siguas. The results show, (i) a high genetic polymorphism, (ii) nine different multilocus genotypes were detected and clustered in two different clades, (iii) most of the parasite isolates pertained to one of the clade and were genetically similar to those analyzed 12 years before. This sample allowed the study of the mating system of T. cruzi in strict sympathic conditions and gave more strength to the hypothesis of the clonal structure of T. cruzi populations.

Animals↗