La leishmaniasis de las mucosas (ML) se asocia con la destrucción progresiva de tejido y la formación de granulomas, a menudo después de un período de latencia considerable desde una infección cutánea inicial. Presentamos un caso de epistaxis recurrente de 3 años de duración y obstrucción nasofaríngea en una mujer con leishmaniasis cutánea tratada casi 30 años antes y sin más exposición a Leishmania. La tomografía computarizada reveló perforación del tabique nasal y la histopatología demostró inflamación crónica. La microscopía fue negativa para amastigotes, pero las pruebas moleculares de la biopsia de la mucosa nasal detectaron Leishmania (Viannia) braziliensis. La paciente se sometió a 28 días de tratamiento con estibogluconato de sodio intravenoso y sus síntomas mejoraron significativamente. Dieciséis meses después del tratamiento, continúa teniendo epista...

Nutrition transition is a process including changes in the nutritional profile of populations. Many developing countries, including Peru, are in transition. Objectives: The aim of this study was to describe the variation of the nutritional profile of Peruvian children, mothers in reproductive age and families between 1991 and 2005. Material and methods: using available information from databases from Peruvian Health and Demographic National Surveys, between 1991 and 2005, we described the prevalence of malnutrition in Peruvian children less than 5 years of age, mothers in reproductive age, and families, at the national, regional, and socioeconomic level, and by residence area (urban/rural). Results: Stunting in children has been high and constant since 1996. Overweight in children has increased, mainly in Lima and the Coast. Overweight and obesity are the main nutritional problems of mot...

Hepatitis B virus (HBV) and Hepatitis E virus (HEV) are zoonotic pathogens posing significant health concerns in rural Amazonia, a region marked by high endemicity, poverty, and limited healthcare access. However, the epidemiology of HBV and HEV in this ecosystem remains underexplored. This study examines the circulation of HBV and HEV at the human–wildlife interface and identifies risk factors within an isolated Amazonian indigenous community reliant on hunting for subsistence. Antibodies against HBV core antigens (HBcAbs) were found in three wildlife species: Cuniculus paca (0.8%), Tayassu pecari (1.6%), and Mazama americana (4.1%), marking the first record of HBV antibodies in free-ranging wildlife in the Amazon. However, further research is necessary to identify circulating strains and their relation to human HBV. HBcAbs were also detected in 9.1% of human samples, confirming expos...

Background: Deployment of health workforce in rural areas is critical to reach universal health coverage. Students’ perceptions towards practice in rural areas likely influence their later choice of a rural post. We aimed at exploring perceptions of students from health professions about career choice, job expectations, motivations and potential incentives to work in a rural area. Methods: In-depth interviews and focus groups were conducted among medical, nursing and midwifery students from universities of two Peruvian cities (Ica and Ayacucho). Themes for assessment and analysis included career choice, job expectations, motivations and incentives, according to a background theory a priori built for the study purpose. Results: Preference for urban jobs was already established at this undergraduate level. Solidarity, better income expectations, professional and personal recognition, ear...

This research was supported by a grant fromSENACYT FID 16-201 to J. P. C. and A. V., Secretar ́ıa Nacional deCiencia y Tecnolog ́ıa from Panama; by the grant for neglected dis-eases studies in Panama 1.11.1.3.703.01.55.120 from the Ministry ofEconomy and Finance of Panama to J. P. C. and A. V.; and byERANet17/HLH-0271. Scott Weaver also supported this studythrough the World Reference Center for Emerging Viruses and Arbo-viruses, NIH grant R24AI120942. Dr. Lescano is sponsored by thetraining grant D43 TW007393 awarded by the Fogarty InternationalCenter of the US National Institutes of Health. J. L. M. is a doctoralcandidate studying an Epidemiological Research Doctorate at Uni-versidad Peruana Cayetano Heredia under FONDECYT/CIENCIAC-TIVA scholarship EF033-235-2015 and also supported by traininggrant D43 TW007393. A. V. is a member of the Sistema Nacional deInvestigaci ́on de Panam �...

Estudio para comprobar que la eficacia del tratamiento antiparasitario para cisticercosis con albendazole (ABZ) o praziquantel (PZQ) no es óptimo. Se demuestra que la combinación de estas dos drogas mejora la eficacia antiparasitaria.

Estudio de cohorte prospectivo con un sub estudio de control de caso anidado, destinado a evaluar la incidencia de recaídas de convulsiones y su asociación con edema perilesional en pacientes con cisticercosis calcificada. Se incluyeron 17 pacientes de 65 años, atendidos en el Instituto Nacional de Ciencias Neurológicas, en Lima, Perú, con Neurocisticercosis y una historia de convulsiones y dolores de cabeza severos recurrentes dentro de los 10 años previos.

Background: The high incidence of Plasmodium vivax infections associated with clinical severity and the emergence of chloroquine (CQ) resistance has posed a challenge to control efforts aimed at eliminating this disease. Despite conflicting evidence regarding the role of mutations of P. vivax multidrug resistance 1 gene (pvmdr1) in drug resistance, this gene can be a tool for molecular surveillance due to its variability and spatial patterns. Methods: Blood samples were collected from studies conducted between 2006 and 2015 in the Northern and Southern Amazon Basin and the North Coast of Peru. Thick and thin blood smears were prepared for malaria diagnosis by microscopy and PCR was performed for detection of P. vivax monoinfections. The pvmdr1 gene was subsequently sequenced and the genetic data was used for haplotype and diversity analysis. Results: A total of 550 positive P. vivax samp...

Objective: To study the presence of Bartonella bacilliformis in ticks collected from two wild mammals in Madre de Dios, Peru. Results: A total of 110 ticks were collected. Among the 43 Amblyomma spp. extracted from the 3 Tapirus terrestris only 3 were positive for B. bacilliformis. In addition, 12 out of the 67 Rhipicephalus (Boophilus) microplus obtained from the 3 Pecari tajacu were positive for B. bacilliformis. For the first time B. bacilliformis have been detected in arthropods other than Lutzomyia spp. Further studies are required to elucidate the possible role of ticks in the spread of South American Bartonellosis.

Climate-related phenomena in Peru have been slowly but continuously changing in recent years beyond historical variability. These include sea surface temperature increases, irregular precipitation patterns and reduction of glacier-covered areas. In addition, climate scenarios show amplification in rainfall variability related to the warmer conditions associated with El Niño events. Extreme weather can affect human health, increase shocks and stresses to the health systems, and cause large economic losses. In this article, we study the characteristics of El Niño events in Peru, its health and economic impacts and we discuss government preparedness for this kind of event, identify gaps in response, and provide evidence to inform adequate planning for future events and mitigating impacts on highly vulnerable regions and populations. This is the first case study to review the impact of a C...

This work was supported by the US DoD Armed Forces Health Surveillance Division and its Global Emerging Infections Surveillance branch (AFHSD/GEIS), PROMIS ID P0143_19_N6_03, 2019-2020. AGL is supported by training grant D43 TW007393 awarded by the Fogarty International Center of the US National Institutes of Health. JGP was supported by FONDECYT-CONCYTEC (grant contract number 100-2016FONDECYT). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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 describe 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 and high tolerance to plagiarism, poor academic performance, an...

Rickettsiae are a family of ectoparasite-borne bacteria that can produce high morbidity and mortality among humans. There are scarce data on rickettsial ecology in rural areas of the Peruvian Amazon basin, where seroprevalence has not been determined, and the identities of animals acting as reservoirs of these bacteria are not known. We conducted a cross-sectional study in Zungarococha (between 2019 and 2021), a rural community located approximately 20 km away from Iquitos city. Blood samples were collected from humans (175), dogs (123), and cats (12). Blood samples and tissues were collected from black rats (84). Finally, we collected fleas from dogs and cats (222), ticks from dogs (91), and mites from black rats (32). Blood samples from humans, dogs, cats, and black rats were analyzed by indirect immunofluorescence assays (IFA) to detect IgG antibodies against rickettsias. We screened ...

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ARUap:idPdleiaasgencoosntfiicrmtethsatsta(lRlhDeaTdsi)nfgolervceolsroarnearveiprruessednisteedacsoerr(eCcOtlyV: ID) are used in low- and middle- income countries (LMICs) to inform treatment decisions. However, to date, it is unclear when this use is cost-effective. Existing analyses are limited to a narrow set of countries and uses. The aim of this study is to assess the cost-effectiveness of COVID RDTs to inform the treatment of patients with severe illness in LMICs, considering real world practice. We assessed the cost-effectiveness of COVID testing across LMICs using a decision tree model, differentiating results by country income level, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) prevalence, and testing scenario (none, RDTs, polymerase chain reaction tests—PCRs and combinations). LMIC experts defined realistic care pathways and treatment options. Using a healthcare...