Launching of the Anaemia Research Peruvian Cohort (ARPEC): a multicentre birth cohort project to explore the iron adaptive homeostasis, infant growth and development in three Peruvian regions.

BACKGROUND: Preventing infantile anaemia and ensuring optimal growth and development during early childhood, particularly in resource-constrained settings, represent an ongoing public health challenge. Current responses are aligned to treatment-based solutions, instead of determining the roles of its inter-related causes. This project aims to assess and understand the complex interplay of eco-bio-social-political factors that determine infantile anaemia to inform policy, research design and prevention practices. METHODS: This is a longitudinal birth cohort study including four components: (1) biological, will assess known blood markers of iron homeostasis and anaemia and stool microbiota to identify and genetically analyse the participants' flora; (2) ecological, will assess and map pollutants in air, water and soil and evaluate features of nutrition and perceived food security; (3) social, which will use different qualitative research methodologies to explore key stakeholders and informants' perceptions related to nutritional, environmental and anaemia topics, participant observations and a participatory approach and (4) a political analysis, to identify and assess the impact of policies, guidelines and programmes at all levels for infantile anaemia in the three regions. Finally, we will also explore the role of social determinants and demographic variables longitudinally for all study participants. This project aims to contribute to the evidence of the inter-related causal factors of infantile anaemia, addressing the complexity of influencing factors from diverse methodological angles. We will assess infantile anaemia in three regions of Peru, including newborns and their mothers as participants, from childbirth until their first year of age. ETHICS AND DISSEMINATION: Ethical approval was obtained from the Institutional Research Ethics Committee of the Instituto Nacional de Salud del Niño (Lima, Peru), CIEI-043-2019. An additional opinion has been granted by the Ethical Committee of Queen Mary University of London (London, UK). Dissemination across stakeholders is taking part as a continues part of the research process.

Health, biodiversity, and natural resource use on the Amazon frontier: an ecosystem approach

Visa melhorar a saúde das comunidades rurais amazônicas mediante o desenvolvimento e a aplicaçäo de abordagem ecossistêmica participante na avaliaçäo da saúde humana. Na área estudada, oscilaçöes sazonais definem a disponibilidade de alimentos, a qualidade da água e a incidência de doenças. A determinaçäo dos elos causais entre variáveis ecossistêmicas, uso de recursos e saúde exigiu uma gama de formas de investigaçäo, em múltiplas escalas, com participaçäo local. O mapeamento espacial da paisagem quanto ao uso de recursos mostrou a diversidade dos recursos ecológicos de que as comunidades dependem. Inquéritos domiciliares detalharam padröes de consumo e produçäo familiares e individuais. Medidas antropométricas, carga parasitária, qualidade da água e níveis de anemia foram empregados como indicadores do estado de saúde individual e coletivo. Tais marcadores foram complementados com avaliaçäo etnográfica e participante sobre saúde, o que criou a base para desenvolver planos de açäo comunitária para lidar com questöes de saúde. A discussäo enfoca três atributos de abordagem ecossistêmica: (a) pluralismo metodológico, (b) interaçöes transversais, em termos de escala e (c) pesquisa-açäo participante.