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PubMed1999

Histological and immunophenotypic profile of nasal NK/T cell lymphomas from Peru: high prevalence of p53 overexpression.

Nasal NK/T-cell lymphoma is a unique form of lymphoma highly associated with Epstein-Barr virus (EBV). These lymphomas are rare in Western populations and much more prevalent in some Asian and Latin American countries. Although there are several sizable studies from Asian countries, the same is not true from South America. The aim of this study was to analyze a series of 32 cases of nasal T-cell lymphoma from Peru and to further extend the characterization of this disease. Immunohistochemistry was performed on paraffin sections using the following antibodies: CD20 (L26), CD45RO, CD3, Ki67, CD57, CD56, TIA-1, bcl-2, and p53. The presence of EBV was investigated with immunohistochemical analysis for latent membrane protein (LMP)-1 and in situ hybridization using an antisense riboprobe to EBER 1. The 32 patients included 18 men and 14 women (M:F ratio, 1.2:1), with a median age of 43 years (11 to 72). Three categories were identified: (1) Nasal NK/T cell lymphomas (28 cases): The morphology ranged from small or medium-sized cells to large transformed cells. Necrosis was present in 86% of the cases, and angioinvasion was seen in 36% of the cases. All cases were positive for CD45RO, CD3, and for TIA-1. CD56 was positive in 21 of 27 cases (78%), and CD57 was negative in all cases. EBER 1 positivity was identified in most of the tumor cells in 27 of 28 cases (96%), including the six cases in which CD56 was negative. Overexpression of p53 was detected in 24 cases (86%). (2) Blastic NK cell lymphoma (1 case): The neoplastic cells resembled those of lymphoblastic lymphoma. CD56 and CD45RO were positive; TIA-1, TdT, and EBER-1 were negative. (3) Peripheral T-cell lymphoma (PTCL) unspecified (3 cases): CD56, TIA-1, and EBER-1 were negative. Nasal lymphomas from Peru with a T cell phenotype are predominantly EBV-associated NK/T cell lymphomas, similar to those described in Asian countries. The expression of CD56, TIA-1, and EBER-1, in combination, are very useful markers for the diagnosis of nasal NK/T cell lymphoma in paraffin-embedded tissue. The differential diagnosis of T-cell lymphomas in the nasal region should include rare cases of PTCL unspecified and the blastic variant of NK cell lymphoma. P53 is overexpressed in 86% of the cases. The significance of this finding with regard to clinical behavior and prognosis remains to be determined.

Adolescent↗

PubMed1984

Comparative studies on nutritional and physiological characteristics of Vibrio parahaemolyticus originating from Germany, Togo and Peru.

During monitoring of bathing areas on the German North Sea coast, 24 strains of V. parahaemolyticus were obtained from 32 water samples. The similarity of these strains to 80 V. parahaemolyticus strains isolated in Togo (patients and environment) and Peru (environment), respectively, was studied using 53 tests (fermentation of carbohydrates, decarboxylation of amino acids and utilisation of different C-sources). The results show a high degree of similarity among all strains with regard to fermentation properties (except fermentation of arabinose and decarboxylation of ornithine). Pronounced differences were found by tests for utilisation of different C-sources. A statistical computerized evaluation of the results revealed a closer relatedness of the German strains to isolates from Togo than to those from environmental sources of Peru. Additional tests for determination of the minimal inhibitory concentration of 11 antibiotics resulted in a high degree of similarity, too. Examination of 3014 faeces specimens from patients with acute enteric disease for V. parahaemolyticus were negative.

Bacteriological Techniques↗

PubMed1997

Health care allocation and selective neglect in rural Peru.

This study of health care allocation to children in northern Puno, Peru, utilizes quantitative and qualitative data to explore differential resource allocation to children in rural Andean households. As part of a broader ethnographic study of health in two communities, quantitative data on reported health status, symptoms, and treatments (both lay and specialist) were collected for 23 children under the age of 7 over a one year period. Additional data were collected from local health post records. Data were analyzed by gender, and by three age groups (birth to 1 year, 1-3 years, 4-6 years) to determine if differences existed in the allocation of health care. The data suggest a pattern of discrimination against females and younger children, especially infants under age one, despite the fact that these groups were reported to be sicker. Differences were especially significant in the allocation of biomedical treatments, the most costly in terms of parental time, effort, and money. Ethnographic data on child illness, gender, and developmental concepts help to explain why children of different genders and ages may be treated differently in the rural andes. They provide a context in which to interpret health care allocation data, and, in the absence of a population-based study, reinforce findings based on the limited study sample. Female children are valued less because of their future social and economic potential. Females are also regarded to be less vulnerable to illness than male children, meaning that less elaborate measures are necessary to protect their health. Young children are thought to have a loose body-soul connection, making them more vulnerable to illness, and are though to be less human than older individuals. The folk illnesses uraña (fright) and larpa explain child deaths in culturally acceptable ways, and the types of funerals given to children of different ages indicate that the death of young children is not considered unusual. Health care allocation and ethnographic data suggest that selective neglect (passive infanticide) may be occurring in rural Peru, possibly as a means of regulating family size and sex ratio. It is important to go beyond placing blame on individual parents or on culture, however, to address the underlying causes of differential health care allocation, such as poor socioeconomic conditions, lack of access to contraceptives, and female subordination.

Age Factors↗

PubMed2002

An assessment and monitoring program for birds in the Lower Urubamba region, Peru.

We developed an assessment and monitoring plan for birds in connection with the exploration and potential development of a large natural gas field in the Lower Urubamba drainage of Peru, a project of Shell Prospecting and Development Peru (SPDP). Our objectives were to: (1) inventory the birds in the area, including information on habitat use and abundance, and (2) devise long-term monitoring protocols for birds. We sampled birds through a combination of visual and auditory surveys and mist-netting at 4 well sites and 3 sites along the Urubamba and Camisea rivers. We recorded 420 species during 135 days of field work. We consider the highest priorities for a future monitoring program to be: (1) establish whether edge effects are occurring at well sites, along roads and along the planned pipeline route and determine the significance and extent of these effects and (2) assess the impact of increased human access to the area on game and other exploited species. The remoteness of the area, its rugged terrain and dense vegetation and the lack of trained personnel limit the choice of survey and monitoring methods. We recommend use of mist-netting and transects for monitoring edge effects and use of transects for monitoring game and other exploited species.

Animals↗

PubMed2002

The corporate impact of addressing social issues: a financial case study of a project in Peru.

Large, multinational resource development projects can affect many aspects, including social, economic and ecological realities, in the regions where they operate. Social and environmental issues that are usually ignored in such projects are increasingly affecting the financial future of multinational corporations in negative ways. In this article, we advance the argument that corporations can successfully manage these issues and that if they choose to view these management efforts as an investment rather than an expense, they may well acquire a competitive advantage over companies that do not. We describe as a case study the Camisea natural gas and condensates development project in Peru, operated by Shell Prospecting and Development Peru (SPDP). Camisea is one of the first projects anywhere in the world to conduct a detailed analysis of key industry-related social issues and the processes, required investment and financial impact of managing them. The Camisea example supports the argument that addressing social and environmental concerns makes financial sense. In present value terms, the benefit of managing these concerns was expected to surpass the cost investment by approximately US$50 million.

Conservation of Energy Resources↗

PubMed2002

Framework for assessment and monitoring of amphibians and reptiles in the Lower Urubamba region, Peru.

Populations of amphibians and reptiles are experiencing new or increasing threats to their survival. Many of these threats are directly attributable to human activity and resource development. This presents the increasing need for worldwide amphibian and reptile assessments and effective, standardized monitoring protocols. Adaptive management techniques can assist managers in identifying and mitigating threats to amphibian and reptile populations. In 1996, Shell Prospecting and Development, Peru initiated a natural gas exploration project in the rainforest of southeastern Peru. The Smithsonian Institution's Monitoring and Assessment of Biodiversity Program worked closely with Shell engineers and managers to establish an adaptive management program to protect the region's biodiversity. In this manuscript, we discuss the steps we took to establish an adaptive management program for amphibian and reptile communities in the region. We define and outline the conceptual issues involved in establishing an assessment and monitoring program, including setting objectives, evaluating the results and making appropriate decisions. We also provide results from the assessment and discuss the appropriateness and effectiveness of protocols and criteria used for selecting species to monitor.

Amphibians↗

PubMed2004

Dental Project Peru. Interview by Arveen Bajaj.

For dentist Jacqui Nimmo, an action packed trip to Peru sowed the seed for much bigger things to come. From her experiences in the country, she founded the charity Dental Project Peru, as she tells Arveen Bajaj.

Charities↗

PubMedDate not supplied

Potential adoption and management of insect-resistant potato in Peru, and implications for genetically engineered potato.

This paper analyzes some important issues surrounding possible deployment of genetically engineered (GE) insect-resistant potato in Peru, based on a large farmer survey held in Peru in 2003. We found that the formal seed system plays a limited role compared with the informal seed system, especially for smallholder farmers. Although 97% of smallholder farmers would buy seed of an insect-resistant variety, a majority would buy it only once every 2 to 4 years. Survey data show that farmers would be willing to pay a premium of 50% on seed cost for insect resistant varieties. Paying price premiums of 25% to 50%, farmers would still increase their net income, assuming insect resistance is high and pesticide use will be strongly reduced. Of all farmers, 55% indicated preference for insect-resistant potato in varieties other than their current varieties. The survey indicates that smallholder farmers are interested to experiment with new varieties and have a positive perception of improved varieties. Based on these findings, and considering the difficulties implementing existing biosafety regulatory systems such as those in place in the U.S. and E.U., we propose to develop a variety-based segregation system to separate GE from conventionally bred potatoes. In such a system, which would embrace the spread of GE potatoes through informal seed systems, only a limited number of sterile varieties would be introduced that are easily distinguishable from conventional varieties.

Agriculture↗

PubMed2000

Schulzia chiribita n. sp. (Nematoda, Trichostrongylina, Molineoidea) parasite of Leptodactylus rhodonotus (Amphibian) from Peru.

A third species of the genus Schulzia Travassos, 1937 a parasite of Leptodactylus rhodonotus (Amphibian, Leptodactylidae) originating from Peru is described. By the pattern of the caudal bursa, the specimens are closely related to the two other species. They are distinguished from Schulzia uzu Lent & Santos, 1989, parasite from Atelopus oxyrhynchus in Venezuela, by the shape of the ovejector and from Schulzia travassosi Durette-Desset, Baker & Vaucher, 1985, parasite from Bufo crucifer in Brasil, Bufo granulosus and Leptodactylus bufonius in Paraguay, by the shape of the spicules. The presence of a new species in Peru points out the wide geographic distribution of the genus in the Neotropical region.

Animals↗

PubMed2005

Burning down the brewery: establishing and evacuating an ancient imperial colony at Cerro Baul, Peru.

Before the Inca reigned, two empires held sway over the central Andes from anno Domini 600 to 1000: the Wari empire to the north ruled much of Peru, and Tiwanaku to the south reigned in Bolivia. Face-to-face contact came when both colonized the Moquegua Valley sierra in southern Peru. The state-sponsored Wari incursion, described here, entailed large-scale agrarian reclamation to sustain the occupation of two hills and the adjacent high mesa of Cerro Baúl. Monumental buildings were erected atop the mesa to serve an embassy-like delegation of nobles and attendant personnel that endured for centuries. Final evacuation of the Baúl enclave was accompanied by elaborate ceremonies with brewing, drinking, feasting, vessel smashing, and building burning.

Agriculture↗

PubMedDate not supplied

When "the program is good, but the disease is better": lessons from Peru on drug-resistant tuberculosis.

This is a qualitative study of the politics of public health surrounding a resurgent tuberculosis epidemic in Lima, Peru during the 1990s. The paper traces the role of debt and neoliberal economics in creating conditions for the epidemic, and the reforms that turned Peru's TB program into a model for treating drug-susceptible disease by 1996. Despite this success, public health officials were blind-sided by the appearance of drug-resistant TB in the late 1990s when their "good" program turned out to be not good enough. The study follows the conflict, and eventual collaboration, that ensued between the Ministry of Health and a local NGO affiliated with Boston-based Partners in Health, which undertook a radical program of community-based directly-observed therapy (DOTS-Plus) to treat drug-resistant patients who otherwise would have died. Lessons from this case are relevant to many international settings where "hot-spots" of drug-resistant TB currently exist and go untreated, posing a threat to the success of national TB control programs.

Disease Outbreaks↗

PubMedDate not supplied

The ethnographic context of illness among single-women-headed households in rural Peru.

Peru is undergoing many deleterious economic and social changes, and the health consequences for families headed by single women is of special concern. However, not all single mothers' families may be at similar risk of morbidity. My purpose in the present study was to determine whether variation in illness prevalence was associated with ostensibly small differences in socioeconomic resources and physical living conditions in areas like Peru. I used both qualitative and quantitative methods in this study. The sample included single-women-headed households from the rural Nuñoa District, located in the southern Peruvian Andes (N = 22 families with 90 individuals). Quantitative cross-sectional survey results suggested that the mother's formal education, the availability of a latrine, drinking water contamination, the gender ratio of the household, and the quality of the social support network were key risk factors. They statistically predicted 35-91% of the morbidity variance between families (p < or = .03-.0001). I illustrate these findings in three ethnographic case studies. The case studies show how the degree of illness among single-women-headed families was affected by small differences in their social and physical living conditions.

Adult↗

PubMed2000

Sporotrichosis in Peru: description of an area of hyperendemicity.

Sporotrichosis is a sporadic and rare mycotic infection in most of the developed world. In many parts of the developing world, sporotrichosis is much more commonly recognized, but epidemiological data are generally lacking from these regions. We report epidemiological, clinical, and treatment data from 238 cases of culture-proven sporotrichosis occurring in a relatively remote area of the south central highlands of Peru that were retrospectively collected during 1995-1997. Most cases (60%) occurred in children aged </=14 years, and the most commonly affected anatomic site was the face. Disease was clinically confined to the skin and subcutaneous tissue in all patients. The incidence of sporotrichosis in this region ranged from 48 to 60 cases per 100,000 persons and was highest among children aged 7-14 years, approaching 1 case per 1000 persons. Sporotrichosis is a significant mycosis in the rural highlands of Peru, with an incidence exceeding those of other invasive mycoses in individuals without human immunodeficiency virus infection.

Adolescent↗

PubMed2004

Clinical characteristics of patients in Peru with human T cell lymphotropic virus type 1-associated tropical spastic paraparesis.

BACKGROUND: Human T cell lymphotropic virus type 1 (HTLV-1) is associated with tropical spastic paraparesis (TSP). Peru is an area of endemicity for HTLV-1. METHODS: All patients with suspected cases of TSP referred to our institute (Institute of Tropical Medicine Alexander von Humboldt, Lima, Peru) from 1989 through 2002 were interviewed and tested for HTLV-1. All patients with positive results were evaluated by an expert physician. Disease progression was defined as "rapid" if the time between TSP onset and inability to walk unaided was <2 years. RESULTS: Among 165 patients enrolled, the symptoms and signs most frequently found were spasticity (in 97.5% of patients), hyperreflexia (95.4%), lower limb paresthesia (90.2%), pyramidal signs (82.6%), urinary complaints (82.0%), and lumbar pain (79.0%). Rapid progression was present in 21.5% of patients; mean age at TSP onset was higher among these patients than among slow progressors (P<.001). Severe spasticity, diminished vibratory sensation, and tremor were found more frequently among rapid progressors, compared with slow progressors. CONCLUSIONS: HTLV-1--associated TSP is frequently diagnosed in areas of HTLV-1-endemicity. A subgroup of patients experiences rapid disease progression.

Adolescent↗

PubMed2004

Etiologies and manifestations of persistent diarrhea in adults with HIV-1 infection: a case-control study in Lima, Peru.

UNLABELLED: OBJECTIVE We sought to determine the etiologies, manifestations, and risk factors for persistent (> or =7 days) diarrhea in human immunodeficiency virus type 1 (HIV-1)-infected persons in Peru. DESIGN: The present study is a case-control study of 147 HIV-1-infected case subjects with persistent diarrhea and 147 HIV-1-infected control subjects without diarrhea. METHODS: We obtained clinical, demographic, and exposure data, CD4 lymphocyte counts, and stool samples for detection of enteric parasitic and bacterial pathogens and rotavirus. RESULTS: One or more enteric pathogen was identified in 55% of case subjects and 21% of control subjects (odds ratio adjusted for CD4 lymphocyte count, 3.8; 95% confidence interval, 2.2-6.5). The median CD4 lymphocyte count was highest with pathogen-free diarrhea and lowest with Cryptosporidium infection. Cryptosporidium species (the most frequent pathogen), Giardia lamblia, Aeromonas species, Campylobacter species, and rotavirus were all significantly associated with diarrhea. Bacterial pathogens were significantly associated with G. lamblia and rotavirus infection. Of the bacterial pathogens (Aeromonas, Campylobacter, Salmonella, and Vibrio species and enterotoxigenic Escherichia coli), only 24% were susceptible to cotrimoxazole, whereas 90% were susceptible to ciprofloxacin. In no case did the sensitivity or positive predictive value of specific clinical and laboratory findings for curable enteric infections exceed 50%. CONCLUSIONS: Several enteric pathogens were associated with diarrhea in HIV-1-infected case subjects in Peru, especially among those who were heterosexual. Clinical findings were poor predictors of detectable microbial etiology. The guidelines for initial management of chronic diarrhea with sulfamethoxazole-trimethoprim in HIV-1-infected persons require revision, at least in settings where prophylaxis with this agent is common.

Adult↗

PubMed2006

Association of herpes simplex virus type 2 infection and syphilis with human immunodeficiency virus infection among men who have sex with men in Peru.

BACKGROUND: We evaluated associations between human immunodeficiency virus (HIV) infection, herpes simplex virus type 2 (HSV-2) infection, and syphilis among men who have sex with men (MSM) in Peru. METHODS: A surveillance survey of 3280 MSM was conducted; sexual behavior was assessed with a structured computer-assisted self-interview, and serum antibody testing was performed for HIV, HSV-2, and Treponema pallidum. RESULTS: HIV, HSV-2, and syphilis seroprevalences of 13.9%, 46.3%, and 13.4% were detected, respectively. HSV-2 seroprevalence was twice as high in HIV-infected subjects (80.5%) than it was in HIV-uninfected subjects (40.8%) (P < .01), and HSV-2 seropositivity (adjusted odds ratio [AOR], 5.66) was found to be strongly associated with HIV infection. In addition, homosexual self-definition (AOR, 3.12), exchange of sex for money (AOR, 1.61), unprotected sex (no condom) (AOR, 2.81), history of sex work (AOR, 1.89), oral receptive sex (AOR, 1.43), and cocaine use before/during sex (AOR, 2.53) within the preceding 6 months, as well as such sexually transmitted infections (STIs) and STI syndromes as proctitis (AOR, 2.80), genital ulcer disease (GUD) (AOR, 2.06), prior syphilis (AOR, 2.64), genital warts (AOR, 1.70), and self-reported STIs within the preceding 6 months (AOR, 1.61), were also found to be significant predictors of HIV infection. CONCLUSIONS: We found a strong association between HSV-2 seropositivity and HIV infection. Intervention measures against GUD due to HSV-2 infection and syphilis, such as routine testing, early detection, HSV-2 suppressive treatment, and condom distribution, need to be enhanced as part of STI prevention strategies at a national level to effectively reduce HIV infection among MSM in Peru.

Adolescent↗

PubMed2006

Genetic diversity and structure of managed and semi-natural populations of cocoa (Theobroma cacao) in the Huallaga and Ucayali Valleys of Peru.

BACKGROUND AND AIMS: Cocoa (Theobroma cacao) is indigenous to the Amazon region of South America, and it is well known that the Peruvian Amazon harbours a large number of diverse cocoa populations. A small fraction of the diversity has been collected and maintained as an ex-situ germplasm repository in Peru. However, incorrect labelling of accessions and lack of information on genetic diversity have hindered efficient conservation and use of this germplasm. This study targeted assessment of genetic diversity and population structure in a managed and a semi-natural population. METHODS: Using a capillary electrophoresis genotyping system, 105 cocoa accessions collected from the Huallaga and Ucayali valleys of Peru were fingerprinted. Based on 15 loci SSR profiles, genetic identity was examined for each accession and duplicates identified, population structure assessed and genetic diversity analysed in these two populations. KEY RESULTS: Ten synonymous mislabelled groups were identified among the 105 accessions. The germplasm group in the Huallaga valley was clearly separated from the group in Ucayali valley by the Bayesian assignment test. The Huallaga group has lower genetic diversity, both in terms of allelic richness and of gene diversity, than the Ucayali group. Analysis of molecular variance suggested genetic substructure in the Ucayali group. Significant spatial correlation between genetic distance and geographical distances was detected in the Ucayali group by Mantel tests. CONCLUSIONS: These results substantiate the hypothesis that the Peruvian Amazon hosts a high level of cocoa genetic diversity, and the diversity has a spatial structure. The introduction of exotic seed populations into the Peruvian Amazon is changing the cocoa germplasm spectrum in this region. The spatial structure of cocoa diversity recorded here highlights the need for additional collecting and conservation measures for natural and semi-natural cocoa populations.

Cacao↗

PubMed1991

Annotated list of ticks (Acari: Ixodidae, Argasidae) reported in Peru: distribution, hosts, and bibliography.

A literature review and compilation of the tick specimens found in Peru and now held in the National Tick Collection was carried out to develop a working list of the tick species likely to be found in Peru. Evidence of 44 species (29 Ixodidae, 15 Argasidae), was found; representatives of 40 species are held as reference specimens. This report adds 14 species to the previously published list.

Animals↗