Dengue Virus Infections among Peace Corps Volunteers in Timor-Leste, 2018-2019.

Dengue is an ongoing health risk for Peace Corps Volunteers (PCVs) working in the tropics. On May 2019, the Peace Corps Office of Health Services notified the Centers for Disease Control and Prevention (CDC) of a dengue outbreak among PCVs in Timor-Leste. The purpose of this investigation was to identify the clinical, demographic, and epidemiological characteristics of PCVs with dengue and recommend dengue preventive measures. To identify PCVs with dengue and describe disease severity, the medical records of PCVs reporting fever during September 2018-June 2019 were reviewed. To identify factors associated with dengue virus (DENV) infection, we administered a questionnaire on demographics, travel history, and mosquito avoidance behaviors and collected blood specimens to detect the anti-DENV IgM antibody to diagnose recent infection. Of 35 PCVs in-country, 11 (31%) tested positive for dengue (NS1, IgM, PCR), eight requiring hospitalization and medical evacuation. Among 27 (77%) PCVs who participated in the investigation, all reported having been recently bitten by mosquitoes and 56% reported being bitten most often at home; only 16 (59%) reported having screens on bedroom windows. Nearly all (93%) PCVs reported using a bed net every night; fewer (70%) reported using mosquito repellent at least once a day. No behaviors were significantly associated with DENV infection. Raising awareness of dengue risk among PCVs and continuing to encourage mosquito avoidance behavior to prevent dengue is critical. Access to and use of measures to avoid mosquito bites should be improved or implemented. Peace Corps medical officers should continue to receive an annual refresher training on dengue clinical management.

Dengue in Peace Corps Volunteers, 2000-14.

BACKGROUND: Dengue is an arboviral disease estimated to cause 50-100 million infections each year in >100 tropical and subtropical countries. Urbanization, human population growth and expanded global travel have resulted in an increase in the incidence of dengue worldwide. International travellers to areas with endemic dengue are at risk of contracting dengue and US Peace Corps Volunteers are one specific group of long-term travellers who are exposed to environments where dengue can be contracted. METHODS: Cases of dengue among Peace Corps Volunteers, defined as clinically apparent infections with laboratory-confirmation by a positive NS1 antigen test, demonstration of IgM antibodies or by a 4-fold increase in IgG antibodies, between 1 January 2000 and 31 December 2014, reported to the Peace Corps' Epidemiologic Surveillance System were analyzed. RESULTS: Overall there were 1448 cases of dengue reported among Volunteers, with an incidence rate of 1.12 cases per 1000 Volunteer-months (95% CI 1.06-1.17). The highest rate of dengue among Volunteers was reported in the Caribbean region, with a rate of 5.51 cases per 1000 Volunteer-months (95% CI 4.97-6.10), followed by the East Asia/South Asia region (3.34, 95% CI 2.96-3.75) and Central America (2.55, 95% CI 2.32-2.79). The rate of dengue peaked in 2007, 2010 and 2013. Each peak year was followed by a trough year. CONCLUSIONS: Globally, there appears to be a 3-year cyclical pattern of dengue incidence among Volunteers, with differences by region. Dengue continues to be a priority health issue for travellers to endemic areas, and enhanced surveillance of dengue among international travellers may result in improved patient education and prevention efforts.

Taenia solium infection in Peru: a collaboration between Peace Corps Volunteers and researchers in a community based study.

BACKGROUND: Neurocysticercosis is a leading cause of seizures and epilepsy in most of the world, and it occurs when Taenia solium larval cysts infect the central nervous system. T. solium tapeworm infection is endemic in much of Peru, but there are scarce data on the prevalence in many rural highland communities where it is likely to be hyper-endemic. Peace Corps Volunteers live and work in these communities; however, to our knowledge, they have not been used to facilitate public health research. MATERIALS AND METHODS: We utilized Peace Corps Volunteers to estimate the prevalence of T. solium tapeworm infection in seven rural communities in northern Peru. A convenience non-random sampling frame was used. Peace Corps Volunteers facilitated the collection of stool samples (N = 2,328), which were analyzed by sedimentation and microscopy. Niclosamide treatment and purgation preceded species identification, which was done by PCR-REA. RESULTS: Taenia sp. egg-positive stool samples were found in three of the seven communities we surveyed. The overall prevalence of Taenia sp. egg positivity was 2.1% (49/2,328) (95% CI = 1.6-2.8%) with prevalence up to 4.3% (42/977) (95% CI = 3.1-5.8%) by community. All 34 of the specimens tested by PCR-REA were T. solium. The overall prevalence of T. solium tapeworm infection was 1.5% (34/2,328) (95% CI = 1.0-2.0%). Prevalence up to 2.9% (28/977) (95% CI = 1.9-4.1%) by community was observed. CONCLUSION/SIGNIFICANCE: This study recorded high T. solium tapeworm prevalence, and identified hyper-endemic rural communities. It demonstrates that synergy between researchers and Peace Corps Volunteers can be an effective means to conducting large-scale, community-based studies in remote areas of Peru.

"Sowing death in our women's wombs": modernization and indigenous nationalism in the 1960s Peace Corps and Jorge Sanjinés' "Yawar Mallku".

This paper explores the centrality of gender and sexual politics to both 1960s modernization discourses and anti-imperialist cultural nationalist ideologies through an analysis of Jorge Sanjinés' 1969 radical neorealist film Yawar Mallku, the text that led to the Peace Corps' expulsion from Bolivia. After outlining the development discourse that explicitly guided both the Peace Corps and the Revolutionary Nationalist (MNR) government of Bolivia and exploring the relationship of this discourse to the Bolivian radical and indigenous movements of the late 1960s, this paper reads Yawar Mallku in the context of these movements to arrive at an understanding how cultural nationalism in Bolivia became directed towards the developmentalist ideal of a masculine utopia whose construction would entail controlling women's bodies. Finally, the paper attempts to understand how indigenous women in Bolivia have articulated radical political visions within and in response to U.S. modernizing forces and indigenous cultural nationalism.

Calidad de vida en sujetos que pertenecen al Programa Nacional de Desmovilización y Reincorporación a la Vida Civil en el departamento del Quindío / Life quality in subjects who belong to the National Program of Demobilization and Reintegration to the Civil Life in the State of Quindio

This current research is a descriptive transversal type of study whose objective is to identify the life quality in subjects who belong to the National Program of Demobilization and Reintegration to the Civil Life (PNDRVC) in the State of Quindio. The target population in this study comprises 200 subjects who attend the Program for the Social and Economic Reintegration (PRSE) in the city of Armenia, from which a sample of 23 participants was chosen (2 women and 21 men), who were given a self-report with a Likert type of answer, designed to assess the life quality. The results show the presence of a medium-high level of life quality in the physical, psychological and social areas. High scores in projection and usefulness, perception of tiredness, preoccupation with physical problems, fear of thinking about death and conflict with close people, were identified. Low scores relating to the physical exercise and perception of economic income were reported, these are issues which require further research.

El presente es un estudio de tipo descriptivo transversal, cuyo objetivo es identificar la calidad de vida en sujetos pertenecientes al Programa Nacional de Desmovilización yReincorporación a la Vida Civil (PNDRVC), en el Departamento del Quindío. La población objeto de este estudio es de 200 sujetos asistentes al Programa para la Reintegración Social y Económica (PRSE) en la ciudad deArmenia, de la cual se seleccionó una muestra de 23 participantes (2 mujeres y 21 hombres), a quienes se les aplicó un autoinforme con formato de respuesta tipo likert, diseñado paraevaluar la calidad de vida. Los resultados muestran la presencia de un nivel medio-alto de calidad de vida en las áreas física, psicológica y social. Se identificaron puntajes altos en proyección y utilidad, la percepciónde cansancio, preocupación por problemas físicos, temor al pensar en la muerte y conflictos con personas cercanas; se reportaron puntajes bajos relacionados con el ejercicio físico y percepción de los ingresos económicos, aspectos que requiere investigación posterior.