Addressing tuberculosis patients' medical and socio-economic needs: a comprehensive programmatic approach.

OBJECTIVE: For a cohort of patients with tuberculosis in Carabayllo, Peru, we describe the prevalence of medical comorbidities and socio-economic needs, the efforts required by a comprehensive support programme ('TB Cero') to address them and the success of this programme in linking patients to care. METHODS: Patients diagnosed with tuberculosis in Carabayllo underwent evaluations for HIV, diabetes, mental health and unmet basic needs. For patients initiating treatment during 14 September, 2015-15 May, 2016, we abstracted data from evaluation forms and a support request system. We calculated the prevalence of medical comorbidities and the need for socio-economic support at the time of tuberculosis diagnosis, as well as the proportion of patients successfully linked to care or support. RESULTS: Of 192 patients, 83 (43%) had at least one medical comorbidity other than tuberculosis. These included eight (4%) patients with HIV, 12 (6%) with diabetes and 62 (32%) deemed at risk for a mental health condition. Of patients who required follow-up for a comorbidity, 100% initiated antiretroviral therapy, 71% attended endocrinology consultations and 66% attended psychology consultations. Of 126 (65%) patients who completed the socio-economic evaluation, 58 (46%) reported already receiving food baskets from the municipality, and 79 (63%) were given additional support, most commonly food vouchers and assistance in accessing health care. CONCLUSION: Carabayllo tuberculosis patients face many challenges in addition to tuberculosis. A collaborative, comprehensive treatment support programme can achieve high rates of linkage to care for these needs.

Accelerating to Zero: Strategies to Eliminate Malaria in the Peruvian Amazon.

AbstractIn February 2014, the Malaria Elimination Working Group, in partnership with the Peruvian Ministry of Health (MoH), hosted its first international conference on malaria elimination in Iquitos, Peru. The 2-day meeting gathered 85 malaria experts, including 18 international panelists, 23 stakeholders from different malaria-endemic regions of Peru, and 11 MoH authorities. The main outcome was consensus that implementing a malaria elimination project in the Amazon region is achievable, but would require: 1) a comprehensive strategic plan, 2) the altering of current programmatic guidelines from control toward elimination by including symptomatic as well as asymptomatic individuals for antimalarial therapy and transmission-blocking interventions, and 3) the prioritization of community-based active case detection with proper rapid diagnostic tests to interrupt transmission. Elimination efforts must involve key stakeholders and experts at every level of government and include integrated research activities to evaluate, implement, and tailor sustainable interventions appropriate to the region.

Estudio seroepidemiológico de fiebre tifoidea en población escolar en el área norte de Lima metropolitana / Sero-epidemiological study of thyphoid fever in schoolchildren of the northern area of Lima

Entre los meses de setiembre y noviembre de 1989, se realizó un estudio transversal en 1322 escolares supuestos sanos, del distrito de San Juan de Lurigancho, sin antecedentes de inmunización contra fiebre tifoidea, seleccionados mediante muestreo por conglomerados, con el objetivo de estimar las prevalencias de serología positiva para antígeno O y H de Salmonella typhi y su distribución según sexo, grupo etáreo y tipo de colegio. La determinación de los títulos se hizo con la técnica de microaglutinación en placa, que tiene una sensibilidad de 84 por ciento y una especificidad del 87 por ciento para un punto de corte mayor e igual 1:160 para el diagnóstico de fiebre tifoidea. Las prevalencias de serología O positiva para los diferentes tipos de corte (mayor e igual 1:20, mayor o igual 1:40, mayor o igual 1:80), fue significativamente mayor en mujeres (41.6 por ciento, 12.4 por ciento, 3.9 por ciento) que en hombres (41.1 por ciento, 9.1 por ciento, 1.1 por ciento) (p<0.05). Las prevalencias de serología H para los puntos de corte mencionados fueron similares en mujeres (69.0 por ciento, 18.8 por ciento, y 5.6 por ciento) y en hombres (73.1 por ciento, 16.5 por ciento, y 6.4 por ciento) (p>0.05). Ambas prevalencias positivas O y H fueron estadísticamente diferentes según grupo etáreo; pero, similares según tipo de colegio. Las altas proporciones de prevalencia encontradas, sugieren frecuente infección subclínica lo cual perpetúa la endemicidad de esta enfermedad

Doctrina, normas y procedimientos para el control de la fiebre amarilla en el Perú / Doctrine, standards and procedures to the control of yellow fever in Peru

Contiene: la fiebre amarilla en el Perú; definiciones y organización funcional; prevención en fiebre amarilla; diagnóstico y tratamiento de casos; el laboratorio en el control de la fiebre amarilla; vigilancia y control vectorial integrado en fiebre amarilla; vigilancia epidemiológica de fiebre amarilla; sistema de registro e información operacional