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Peru Status Report
- 1. INDIGENOUS HEALTHAND ADAPTATIONTO CLIMATE CHANGEPeruvian AmazonStatus ReportBy:César CárcamoIreneHofmeijerAlejandro LlanosCarol Zavaleta
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- 5. Ethnic GroupsLoreto: ShawiUcayali:Shipibo-Konibo
- 6. ShawiRegion: LoretoProvince: AltoAmazonasDistrict: BalsapuertoCommunities: 1. Nuevo Progreso2. Puerto Porvenir
- 7. Shipibo-KoniboRegion: Ucayali Province: Coronel Portillo Districts: Calleria; IpariaCommunities: 1. Panaillo 2. Puerto ConsueloSource: EsderasSilvanoSource: Google Maps
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- 10. Project ManagementAdministrative lead:Cayetano Heredia Foundation (CHF)Dr. Alejandro LlanosDr. Cesar CarcamoManagement:Indigenous Health unit (CHF)Dra. Carol ZavaletaDr. Isaac AlvaConnie Fernandez (Biologist)Associates: Global Health Unit (CHF)Dra. Patricia GarciaFaculty of Public Health – Epidemiology department (UPCH)Dra. Magaly BlasAngela Bayer (Sociologist)Tropical Medicine Institute (UPCH)Dr. Eduardo Gotuzzo
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- 12. Partner OrganizationsMinistries ofHealth:LoretoDIRESA LoretoRed de Salud Alto AmazonasConnie FernandezUcayaliDIRESA UcayaliEpidemiology departmentDr. CayoEnvironmental health unitIng. Saenz
- 13. Partner OrganizationsOthers:Peruvian AmazonResearch Institute (IIAP)Virginia Montoya (Anthropologist)Elsa Rengifo (Biologist)Manuel Saudre (Agronomist)Jose Choy (Agronomist)National Meteorology and Hydrology Services (SENAMHI) – Loreto BranchMarco Paredes (Engineer)
- 14. CollaboratorsInternational Labour OfficePRO169 LiliamLandeo (regional coordinator)www.pro169.org Instituto del Bien ComunUcayaliCarlos Arana (regional coordinator)Mario Osorio (in charge of SICNA)www.ibcperu.org
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- 16. ObjectivesPrimary Objective: Estimateincidence in indigenous communities of: Water / airborne disease:common diarrheal infection; intestinal parasitic diseases; cyclosporidium; leptospirosisrespiratory infections ( flu, bronchitis, etc.); neumoniaVector-borne disease: malaria; dengue; leishmaniasis; yellow fever; arbovirusSkin diseases: Scabies; miasis; bacterial and fungal diseasesSexually transmitted infectionsFood-qualitySecondary Objective: Identify individual / behavioural / environmental risk factors associated to problems above.
- 17. Cohort StudyImplement communitybased prospective cohort study: Size: 1,000 approxLength: 3 yearsFrequency: Baseline study start of year 1Additional study end of year1, 2, and 3Every three months for water/airborne diseasesWill allow to determine seasonal variations
- 18. MethodsStandardized questionnaire: Socio-demographiccharacteristicsHealth-related knowledge and behavioursPerceived health statusRecent IllnessUse of health care
- 19. MethodsClinical evaluation: Assessnutritional statusGeneral health statusIncluding hypertensionSkin lesionsTraces of leishmaniasisFebriles
- 20. MethodsAnthropometrics:Height and weightLaboratory tests: Malaria thick smearsLeishmaniasis skin test Yellow fever and Dengue IgG,Glucose testSyphilis treponemic test and hematocrit.Ova and parasites stool analysis
- 21. MethodsEntomological surveillance: Tobe carried out by MoH at study sites Water quality:With support from MoHExperience and tools to locally test for: Fecal coliformsTurbidity / conductivitypHparasitologyHeavy metal testing must be done in Lima
- 22. Ethical ConsiderationsCommunity approval:Already obtained from community leadersApproval must be reconfirmedCould result in modification to methodologiesLocal indigenous coordinator: To help communicate the process before, during, and after the development of each research protocol
- 23. Ethical ConsiderationsTreatments: Providedby MoH national programs: MalariaLeishmaniasisProvided by IHACC:AntibioticsAnemiaParasitesSyphilis
- 24. Ethical ConsiderationsTeam memberswith experience working with indigenous groups: Dr. Alejandro LlanosDr. Patty GarciaDr. César CárcamoDr. Isaac AlvaDr. Carol Zavaleta
- 25. Results DisseminationAnnual coordinationmeetings with: Community representatives: Chief and project coordinatorIndigenous leaders: National, regional, and local indigenous organizationsNational authorities: Regional government and local municipalityMinistry of health representativeOther local collaborators
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Editor's Notes
- #7 Rio Armanayacu – Rio huallaga – Rio Marañon – Rio Ucayali
- #11 Cayetano Heredia Fundation will be the administrative leading in this projectIndigenous Health unit will be create to give a better support Global Health unit / Epidemiology department of Public Health will be associatedDra. Patricia GarciaDr. Cesar CarcamoDr. Magaly BlassSoc. Angela BayerTropical Medicine Institute of UPCHDr. Eduardo Gotuzzo
- #13 Connie – trained at UPCH in a master program in control infectious diseases
- #15 SICNA: The Information System on Native Communities in the Peruvian Amazon (Sistema de Información sobre Comunidades Nativas de la Amazonía Peruana, SICNA) is a georeferenced database that contains geographic and tabular information on native communities. The use and dissemination of the SICNA promotes territorial ordering and the defense of the rights of indigenous peoples, allowing for community territories to be titled and protecting indigenous peoples living in voluntary
- #17 Primary objective: To estimate the incidence of water/airborne diseases, vector-borne diseases, sexual transmitted infections (STI) and food security-related diseases in indigenous communities of the peruvian amazon region.Secondary objective:To identify individual, behavioural, and environmental risk factors associated to these problems
- #18 To implement a community based prospective cohort: Aproximately 1000.Three years: a baseline and three additional measures at the end of year 1 , 2 and 3. In the case of water-airborne diseases, participants will be followe very 3 months, in order to determine seasonal variations
- #19 Standardized questionnaire:Sociodemographic characteristics, health-related knowledge and behaviors, perceived health status, recent illnesses, and health care.Clinical evaluation: To assess nutritional status, general health status (including hypertension) and skin lesions (scare of leshmania)
- #21 There is not a program of control of Syphilis in those communities, and there some reports f STDs in native communitiesand because globalization this can be an indicator important to study
- #22 Local Minister of health has experience doing evaluation of the water quality of the river: microbiological, heavy metals and parasitological messuares
- #23 Iterative: We have already gotten permission from leaders of communities, however this could be asked again, It could means some modifications finall in methodologies An indigenous local coordinator will be nominated by each community to “canalizar” el proceso antes , durante y despues del desarrollo de cada protocolo
- #24 Treatment for malaria and leshmania will be provided for MoH as part of National ProgramsTreatment for anemia, parasites and syphilis will be provided by IHACC
- #25 Dr. Llanos, Dra. Patty Garcia, Dr. Isaac Alva y Dra. Carol Zavaleta, tiene experiencia trabajando con estos y con otros grupos indigenas