RESUMEN
Highland native Andeans have resided at altitude for millennia. They display high aerobic capacity (VO2max) at altitude, which may be a reflection of genetic adaptation to hypoxia. Previous genomewide (GW) scans for natural selection have nominated Egl-9 homolog 1 gene (EGLN1) as a candidate gene. The encoded protein, EGLN1/PHD2, is an O2 sensor that controls levels of the Hypoxia Inducible Factor-α (HIF-α), which regulates the cellular response to hypoxia. From GW association and analysis of covariance performed on a total sample of 429 Peruvian Quechua and 94 US lowland referents, we identified 5 EGLN1 SNPs associated with higher VO2max (Lâ min-1 and mLâ min-1â kg-1) in hypoxia (rs1769793, rs2064766, rs2437150, rs2491403, rs479200). For 4 of these SNPs, Quechua had the highest frequency of the advantageous (high VO2max) allele compared with 25 diverse lowland comparison populations from the 1000 Genomes Project. Genotype effects were substantial, with high versus low VO2max genotype categories differing by â¼11% (e.g., for rs1769793 SNP genotype TT = 34.2 mLâ min-1â kg-1 vs. CC = 30.5 mLâ min-1â kg-1). To guard against spurious association, we controlled for population stratification. Findings were replicated for EGLN1 SNP rs1769793 in an independent Andean sample collected in 2002. These findings contextualize previous reports of natural selection at EGLN1 in Andeans, and support the hypothesis that natural selection has increased the frequency of an EGLN1 causal variant that enhances O2 delivery or use during exercise at altitude in Peruvian Quechua.
Asunto(s)
Altitud , Prolina Dioxigenasas del Factor Inducible por Hipoxia/fisiología , Hipoxia/genética , Oxígeno/metabolismo , Polimorfismo de Nucleótido Simple , Aclimatación , Adaptación Fisiológica , Femenino , Frecuencia de los Genes , Genotipo , Humanos , Prolina Dioxigenasas del Factor Inducible por Hipoxia/genética , Prolina Dioxigenasas del Factor Inducible por Hipoxia/metabolismo , Pueblos Indígenas , Masculino , Perú , Selección Genética , Estrés FisiológicoRESUMEN
OBJECTIVES: To determine knowledge and attitudes of adult Peruvian women regarding the human papillomavirus (HPV), cervical cancer, and acceptability of the HPV vaccine. METHODS: A 4-section survey was administered to 511 25- to 65-year-old Peruvian women living in 3 low-income districts in Lima. RESULTS: Knowledge of HPV, the HPV vaccine, cervical cancer, and the association between HPV and cervical cancer was low. Approximately two-thirds of the participants knew nothing about HPV, the vaccine, and cervical cancer. However, vaccine acceptability was very high: 90% indicated they would get vaccinated if the HPV vaccine was available. In addition, 58% of the population was willing to pay "something," versus nothing, to be vaccinated. CONCLUSIONS: Although their knowledge was limited, mid adult Peruvian women have a very high level of acceptance for the HPV vaccine. Efforts to educate the population about HPV and cervical cancer are warranted along with further studies exploring the reasons for high vaccination acceptability to help reduce the rate of cervical cancer.
Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/inmunología , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/prevención & control , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Infecciones por Papillomavirus/inmunología , Aceptación de la Atención de Salud/estadística & datos numéricos , Perú/epidemiología , Encuestas y Cuestionarios , Neoplasias del Cuello Uterino/inmunologíaRESUMEN
BACKGROUND: Cervical cancer, although usually preventable by Pap smear screening, remains the leading cause of cancer-related deaths among women in Peru. The percentages and characteristics of women in Peru who have or have not had a Pap smear have not been defined. METHODS: In an urban community randomized trial of sexually transmitted infection (STI)/HIV prevention in Peru, 6712 randomly selected women between the ages of 18 and 29 from 20 cities were interviewed regarding having had cervical Pap smears. RESULTS: Among women sampled, only 30.9% had had a Pap smear. By multivariate analysis, the main predictors of having a Pap smear were having had sex, having had children, completion of secondary education and increasing age. Regional variations were also found: women from the highlands and rainforest were less likely to have had Pap smears than women from the coast. CONCLUSION: A norm of seeking and receiving Pap smears has not been established among sexually active young Peruvian women. To improve Pap smear coverage in Peru, promotion efforts should target underserved women and regions with less coverage.